Nurse Practitioner Primary Care Program

Through the Nurse Practitioner Primary Care Program, nurse practitioners will be paid to practice comprehensive primary care and operate their own independent clinics, or practice independently in team-based care settings. They will offer services based on their scope of practice, training, and expertise. Participation in Community Information Integration (CII) and the Central Patient Attachment Registry (CPAR) is mandatory for participants in the program.                  

For detailed information about the program, visit the Nurse Practitioner Primary Care Program on Alberta.ca.

To apply for the Nurse Practitioner Primary Care Program please contact the Alternative Compensation Delivery Unit at health.npprogram@gov.ab.ca

What is CII/CPAR?

CII/CPAR will enable the nurse practitioner to share patient information directly from community Electronic Medical Records (EMRs) to Alberta Netcare (a provincial health information system), allowing for a seamless exchange of patient information among care teams.  

CII allows nurse practitioners to share essential patient information with Alberta Netcare, including consult letters and details of patient visits, which contribute to Community Encounter Digests (CEDs) between community EMRs and other care providers via Alberta Netcare. This enhances communication among health care providers across the province, promoting continuity of care between the Patient’s Medical Home and Health Neighborhood.

CPAR is an enabler for continuity between patients and their providers in Alberta. It collects the confirmed panels of nurse practitioners and other providers to identify primary provider-patient relationships. Patient-provider relationships are shared to Alberta Netcare, so other providers are aware of the relationship. CII can also send electronic notifications to CPAR providers when their patients undergo emergency department visits, hospital admissions, or day surgeries, ensuring that nurse practitioners stay informed about their patient’s health care journey. 
 


Prerequisites for Participation


Clinical Prerequisites

There are four key prerequisites for participation in CII/CPAR:
  1. Clinic must be using the latest version of a conformed Electronic Medical Record (EMR)
  2. Clinic EMR Privacy Impact Assessment (PIA) must be up to date
  3. Clinic must be live on Alberta Netcare
  4. Clinic must be panel ready 

Panel Readiness  

The clinic must have a process in place to actively ask patients about their attachment:

  • Patients are asked consistently to confirm that their nurse practitioner is their one and only provider for comprehensive, longitudinal primary care.
  • Attachment information is recorded in the clinic EMR including the date of confirmation. Note: for inclusion in CII/CPAR panels patients MUST have a date of last visit and a confirmation date
  • Confirmation rates are calculated regularly as a process check.
  • The clinic EMR is used to produce lists of each provider’s paneled patients.

For more information about paneling, refer to the Panel Processes Change Package summary.



Prerequisites for Participation

To participate in CII/CPAR, the clinic's Privacy Impact Assessment (PIA) must reflect the current clinic environment. The PIA is a due diligence tool for identifying and addressing privacy risks that may occur within a practice or information system.

If you previously completed a PIA, use the self-assessment tool to determine if a PIA update is required for your clinic. If you cannot locate your PIA number, consult the quick reference How to Find Your PIA Number.  

  For guidance on completing a PIA, consult the Materials below.

           

For detailed information visit the Privacy and Security Prerequisites page.



CII/CPAR Registration Process

Successful applicants for the Nurse Practitioner Primary Care Program will be guided through the registration and onboarding process by the Alternative Compensation Delivery Unit (ACDU) and the eHealth Services team. The process begins with the submission of a Confirmation of Participation (CoP) form which will be provided by the ACDU as part of the nurse practitioner application approval email . Once the CoP form has been submitted, the eHealth team will support nurse practitioners through onboarding and implementation.


Clinic Roles and Responsibilities

There are some key roles for successful implementation of CII/CPAR:
  • Site Liaison – is the primary point of contact at the clinic for the eHealth team as the clinic goes through onboarding
  • CPAR Access Administrator – grants and removes access to the CPAR portal for CPAR Panel Administrators
  • CPAR Panel Administrator – responsible for maintaining panel lists for participating providers and downloading reports from the CPAR portal

For a more detailed description of these roles and responsibilities please refer to the CII/CPAR quick reference Roles and Responsibilities.  


Panels

A patient panel is a set of patients that have established relationships with a primary provider. There is an implicit agreement that the identified provider and team will provide comprehensive, longitudinal primary care.

With that in mind, a CPAR panel of patients can be thought of as that group of patients for whom you:

  • Provide comprehensive longitudinal care and consider that you “quarterback” their care, and wish to
  • declare yourself to the rest of the health care system as their primary provider, or as a partner in their primary care team in Alberta Netcare Portal (ANP) 
  • receive eNotifications of events at AHS facilities such as Emergency Room (ER) discharges, inpatient admissions and discharges, and day surgery discharges
  • receive panel conflict reports for those patients who are on your panel and also on the panel of another or other primary provider(s)  
  • For more information about panel readiness and for links to more information about paneling in your practice please see the CPAR Panel Readiness Checklist.

Encounters and the Community Encounter Digest (CED)

CII allows participants to share basic data about encounters with patients that they record in their EMRs. Encounter information is shared to Alberta Netcare in the form of the CED. The CED report is created in Alberta Netcare Portal (ANP) by summarizing care the patient has received over the past 12 months from all community-based clinics participating in CII in Alberta. Information feeds the CED from the following areas:     
  • Service providers and delivery location 
  • Encounter: Patient reason and provider assessment
  • Health concerns (problems/profile items)
  • Possible allergies
  • Observations (e.g., blood pressure, height and weight)
  • Immunizations
  • Referral requests (these remain on the CED for 36 months)

*Important: Information is not pulled from subjective or note fields

The CED is a rolling snapshot of care that an Alberta patient has received to provide an at-a-glance view for other providers.

Information is added to the CED if it is recorded during a patient visit. 

For a more detailed description of the CED and how information flows from your EMR please refer to the CII/CPAR CED quick reference.


Post Implementation

Once your clinic is live it is important to incorporate new processes and workflows into your practice to take advantage of the new information and connectivity that CII/CPAR offer:
  • Keep panels up to date in your EMR so CPAR information is accurate
  • Ensure panel uploads are successful each month 
  • Develop a panel conflict management process
  • Periodically check that information in CED entries looks appropriate

For a more detailed description of post implementation activities please refer to the CII/CPAR quick reference Post Implementation Checklist.


This content is in development. New materials will be added shortly.