Introduction

What is CII/CPAR?

CII/CPAR enables physicians and their teams to share patient information to Alberta Netcare directly from their electronic medical record (EMR).

CII/CPAR enhances communication amongst providers by enabling the sharing of important healthcare information across the province. This two-way connection between clinic EMRs and Alberta Netcare is improving continuity of care between the Patient’s Medical Home and Health Neighbourhood.

CII allows providers to send select patient information to Alberta Netcare including consult letters and information about patient visits to contribute to Community Encounter Digests (CEDs).

CPAR identifies relationships between patients and their primary provider in Alberta Netcare.

Who is eligible to participate in CII/CPAR?

Physicians are eligible to participate in CII/CPAR if they are working in a community-based clinic.

The criteria to participate include:

You must be using one of these electronic medical records in your clinic:
1. Accuro
2. Ava
3. CHR
4. Healthquest
5. Med Access
6. PS Suite
7. Okaki
Your clinic must be willing to or have implemented Alberta Netcare.
Your practice needs a privacy impact assessment that reflects the current clinic environment.

Signing up for CII/CPAR

The first step to signing up for CII/CPAR is completing this Confirmation of Participation form.

It should be completed by someone who has the authority to submit forms on behalf of the clinic such as a clinic manager or a PCN contact such as a practice facilitator.

This form takes approximately 10 minutes to complete. You will receive an important email once you begin that provides a link to access this form if you cannot complete it in one session.

If you have any questions, please contact us at [email protected].

Let's get started

Please tell us about the providers that will be participating in CII/CPAR at this clinic:*

Non-Family Medicine Physicians who want to send consult letters to Alberta Netcare. Family Physicians, General Practitioners, Nurse Practitioners or Pediatricians that have a panel of patients they are the primary care provider for. Clinic has both Family Medicine and Non-Family Medicine physicians that want to participate.

A clinic practice type specification is required.

Contact Information

First Name* Last Name* Email* Confirm Email* Telephone* Telephone Ext.

The information collected on this form is personal information as described in the Freedom of Information and Protection of Privacy Act (FOIP). This personal information is collected and used pursuant to sections 33(c) and 39(1)(a) of the FOIP Act, as the collection is related directly to and is necessary for administering provider participation in CII/CPAR. Alberta Health provides necessary information to the Alberta Medical Association to administer financial support under the IM/IT Physician Practice Support Program. If you have questions or concerns about the collection, use or disclosure of this personal information, please contact eHealth Support Services at 1-855-643-8649.

Once you click Next, you will receive an important email with a link that will allow you to access this form if you are not able to complete it in one session.

Electronic Medical Record

Please select the EMR that your clinic uses. If your EMR is not listed, contact us at [email protected].

EMR

Do you share your EMR with another clinic?

Has your clinic implemented Alberta Netcare?

WDFA

Facility ID

Clinic Name Clinic Address Clinic City Clinic Province Clinic Postal Code

Is this clinic actively participating in a capitation based Clinical Alternative Relationship Plan?*

Clinic Information

The Primary CII/CPAR Site Liaison is designated by the clinic to be the CII/CPAR clinic contact who will coordinate the required paperwork and go-live activities. This is an administrative role, not a clinical one, and the person must be employed by the clinic. See the Roles and Responsibility document for more information.

First Name Last Name Role Email Telephone Telephone Ext.

The Alternate CII/CPAR Liaison cannot be the same person listed above.

First Name Last Name Role Email Telephone Telephone Ext.

First Name Last Name Email Telephone Telephone Ext. PCN

Participating Providers

List the names of all providers who will participate in CII/CPAR.

Click here to locate the Specialty Skill Code within your EMR

Click on an existing row to select/deselect it for Edit or Delete.

Provider First Name	Provider Last Name	Email	Panels	PCN	Consult Reports	Encounter Data	Specialty Skill Code

Governance & Privacy

A custodian representative is a custodian that has been duly authorized to sign the CII/CPAR PIA Endorsement Letter and any necessary updates on behalf of the other custodians at the facility organization. This authorization does not revoke the other custodians’ duties and powers under the Health Information Act.

Is there a custodian representative at the clinic?

Use this AMA resource to help you find the clinic EMR or Netcare PIA number.

EMR

OIPC Submission Date OIPC File Number OIPC Accepted Date (if available)

Expedited Netcare

OIPC Submission Date OIPC File Number OIPC Accepted Date (if available)

* Site liaison or custodian representative, please confirm that all current and future providers:

Will be made aware and agree with the data that will be shared from the EMR and displayed in Alberta Netcare.
Understand and agree that the EMR vendor may access their EMR instance to configure system for CII.
Telus users only confirm EMR Mobile is turned on http://help.telusemrmobile.com/en/70_Mobile/Mobile_managing_access.htm.

* I understand that all current and future participants should be made aware of the privacy tools and information, including patient brochures, are available on the AMA-ACTT webpage. This includes the requirement to have a Health Collection Notice available in your clinic, which can be in the form of a poster, clinic TV screen, website, patient registration form, etc.

Finish

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If you have completed the form to the best of your knowledge and are ready to submit it to Alberta Medical Association and eHealth, please click the Submit button below.