Mixed Provider Contexts

Prescribers who work where the Connect Care clinical information system (CIS) is the record of care and also work in at least one setting where the CIS is not the record of care (inside or outside of AHS facilities supported by paper or electronic medical records) are said to be working in a "mixed context". These mixed-context prescribers need to manage some unique information flows that may relate to clinical documentation, communication and results delivery.


As soon as a prescriber gains access to the Connect Care CIS, that prescriber has an active "In Basket" and secure messaging presence. Any other Connect Care user can look up a prescriber for purposes of communication. The Connect Care provider directory reflects all Alberta providers. Attempts to send an In Basket or secure chat communication are blocked for providers who do not have Connect Care accounts. Consequently, any Connect Care prescriber, even those who do a minority of their work where Connect Care is the record of care, must make provisions for monitoring Connect Care clinical communications. 

The safest approach for mixed-context prescribers is to regularly log in to Connect Care for the purpose of checking communications (In Basket and secure chat). It is also possible to enable Connect Care communication options for short or longer periods when it may not be possible or practical to regularly check Connect Care.

Note that, while a physician working in a mixed context may be added to a patient’s care team in Connect Care as a Primary Care Provider (PCP) for a patient receiving services with AHS, their role as PCP is related to the community clinic. Patient messages sent via MyAHS Connect in this case would not be related to their care with AHS nor to the work the physician does in AHS. As there are no pools or structure to support these messages, the messages are routed to an IT team error pool instead of to the intended physician. After confirming that the intended recipient does not have a department that schedules appointments in Connect Care and therefore does not have a clinical support advice request pool to support message management. IT will then respond to the patient, letting them know their physician cannot be reached via MyAHS Connect, and to instead contact the community clinic directly.


In general, health care must be documented in the record of care for the entity providing that care. However, there are situations where the association between service provision and care documentation is more complex.

Connect Care is the record of care for all AHS facilities. It is also the record of care for all health care organizations that have entered into an agreement where AHS provides health record information services.  This includes contracted and affiliated health care organizations as well as health businesses subject to health information management agreements with AHS. "Mixed context" providers work in clinical settings that use Connect Care as well as other settings that use a different health record.

When mixed context prescribers have access to both Connect Care and one or more community electronic medical records (or even paper records), the same group of patients may be seen in more than one facility or context under the oversight of the same health care service. Questions may arise about which health record(s) to use. Examples include:

If Connect Care is the record of care for part, but not all, of an integrated health service program, episode or plan, it may be appropriate to use Connect Care integrative charting tools (e.g., therapy plans, care paths, disease management documentation, SmartSets, etc.) to manage and document related care. This can be done with non-scheduled (ad hoc) encounter types. A "Documentation" visit can be created if the outreach support need is limited to generating and sharing a consultation letter. More commonly, the "Telemedicine" visit type is preferred where virtual or outreach service benefits from specialty-specific visit, order and documentation tools in Connect Care.

Whichever outpatient encounter type is used, it is essential to create and attach copies of pertinent documentation to all relevant or implicated health records. The Connect Care ad hoc encounter could, for example, be used to ensure that episodes of care data is kept intact while the resulting consultation letter is attached to Netcare and to the community EMR in play where part of a service is provided. 

Care should be taken to ensure that integrated care records are available to all contributing to that care. For example, it is not appropriate to create a note saying “see Connect Care note” since that note may not be available to implicated community providers. Instead, ensure that all notes essential to understanding an episode of care are shared and co-documented in mixed context health records. 

Results and Reports Routing

Regardless of where a patient is seen (Connect Care or non-Connect Care context), some test results or reports must route to the In Basket. This applies to all Connect Care users, including those who work in mixed contexts. This lowers the risk of a privacy breach and allows reports to be correctly routed to the correct provider, particularly when the report does not contain specific information about where the result or report should route to. 

Most often, the In Basket result is a copy of information routed to a prescriber's preferred external electronic medical record (EMR). In some cases, the In Basket result will not additionally route via mail, fax or eDelivery (independent EMRs appropriately configured). In almost all cases, the information is copied to the Alberta Netcare Portal. 

Specific result routing pathways can change over time, as Connect Care continues its deployment throughout Alberta - another reason for Connect Care prescribers to make provisions for In Basket monitoring.

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