The eAMS was developed by researchers at the University of Toronto and other centres around Canada, over a period of over a decade. Each part of the system was systematically designed, built, and tested with user input for workflow integration and user interface optimization. Over 20 peer-reviewed publications support various aspects of the eAMS, including a clinical trial in busy, real-world family practices demonstrating significant improvements in quality of care.
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The eAMS toolbar(s) will appear in PSS charts of all patients aged ≥16 years with the following evidence-based EMR definition of asthma: 1) patients who have been prescribed an asthma medication within the last 1 year, AND 2) either: a) have asthma listed in the cumulative patient profile (CPP); or b) have had the diagnostic code for asthma (493) billed within the last 3 years (excluding those who have had the diagnostic code for COPD – 491/492/496 billed within the last 3 years).
We ask that you invite your patients with asthma to download the free eAMS app from the Google Play or Apple Store (it can be found by searching for “eAMS asthma”). When you open the chart of an eligible patient, the eAMS toolbar will also alert you that the patient has not registered, and remind you to ask them to register.
Upon request, we can also provide posters for clinics and download reminder cards that you can give to your patients. We are also running an awareness campaign with our partner Asthma Canada to improve patient awareness about the eAMS tool.
If your clinic uses an email reminder service such as OCEAN Patient Reminders, one week before and the day before their booked appointment, your patient will automatically receive an email reminder to complete their asthma questionnaire. Alternatively, we provide a search function that a clinic staff member can use to periodically send email reminders. Patients can also be reminded to complete the questionnaire on their device when they arrive for their virtual/in-person appointment.
Once completed, patient responses are valid for 1 month. For patients returning after 1 month but within 3 months of completing the questionnaire, they will only be asked to run through the questionnaire if they have had a change in their asthma medications or symptoms since last completing it. After 3 months, patients will be asked to run through the questionnaire again, however prior answers are pre-filled for ease.
Once the patient has completed the questionnaire, if actions are required, decision support is generated automatically and remains valid for 1 month. The eAMS Toolbar will appear in the chart and present the patient’s current status, with a link to open the decision support window:
If no action is taken in the decision support system, a PSS message outlining the patient's asthma control and remaining available decision support actions is automatically sent to the MRP (this message is sent when the chart is next opened, as long as the decision support is still valid, but no earlier than the next day). Because decision support steps do not require the patient to be present, many clinicians prefer to complete the decision support in advance of the clinical visit and inform the patient of any medication changes and their action plan at the time of the visit or by telephone.
If the patient did not complete sufficient parts of the questionnaire before their clinical visit, the eAMS Toolbar will indicate that the questionnaire requires completion, and will provide a link to the questionnaire. If you wish to access eAMS decision support, you can either open the link and run through the questionnaire with your patient, or ask the patient to immediately complete it on their device. Decision support will then be available upon clicking “Refresh” in the toolbar:
Once you have approved the asthma action plan in the eAMS decision support window, it will be available to the patients in their eAMS portal/app.
We suggest that patients who do not have their own devices be offered use of an internet-enabled waiting room tablet/laptop device to register and complete the questionnaire. However, patients still require a personal email address in order to validate their registration.
All personal health information is kept private and secure, and is handled in accordance with provincial personal health information protection laws. For a more detailed description of our privacy practices, please see our Privacy Notice.
There are a few reasons why you may not see the eAMS toolbar in an asthma patient’s chart, even if they have completed the questionnaire. Please consider the following:
There are also some scenarios in which the toolbar is intentionally hidden:
If you are still having difficulty, please feel free to Contact Us for further assistance.
The eAMS Toolbar appears in the charts of all eligible patients, as long as the currently logged in user has eAMS privileges (all users have these privileges by default, unless they were excluded at the clinic’s request). If a chart is opened by a user other than the MRP (i.e. the provider identified as “Patient MD/NP” in PSS), this user will have the option to act on the decision support. If the user does act on the decision support, if there are remaining decision support steps required, PSS sends the MRP a PSS message informing them of decision support actions taken and remaining available actions for their patient. This message is sent when the chart is next opened, as long as the decision support is still valid (but no earlier than the next day).
When a patient completes their eAMS questionnaire, unless actions are taken the same day in the eAMS toolbar, an automatic summary note is generated for posting to the chart. Similarly, an automatic informational PSS message is generated for the MRP. Similar messages go out when there are interactions with the toolbar decision support by someone other than the MRP. Due to a peculiarity in PSS, the chart note is only posted and the PSS message to the MRP is only sent when the chart is opened or refreshed, and whomever the user was that opened/refreshed the chart will be automatically designated as the person who “sent” the PSS message to the MRP and/or “signed” the chart note. However, to ensure that there is no confusion, if there were actual actions taken in the toolbar, the PSS message to the MRP and chart note will always specify exactly which provider took those actions.
If the eAMS toolbar is appearing in the chart of a patient for whom you don't want it to appear, you can remove it from the chart. To do this, follow these instructions.
If you do not want to receive automated PSS messages about your asthma patients, you can opt out of the “MRP Messages” feature. To do this, please ask the appropriate team member at your site to contact the eAMS team member who assisted with onboarding.