Shared Care and CPAR
The Central Patient Attachment Registry (CPAR) is a system designed to confirm the relationship between a patient and their Primary Care Provider (PCP). When a family physician goes live on CII/CPAR, their name and clinic location is displayed in Netcare and Connect Care, allowing others in the healthcare system to correctly identify them as the PCP.
The ability to create a shared CPAR panel was developed to accommodate practices where two or more physicians provide care for a shared panel of patients. When patients join one of these truly shared-care practices, they understand that they are not being attached to a single family physician, and they agree to be seen by whichever physician is available. Sharing a panel also requires changes to clinic workflows to ensure appropriate care and coverage.
How shared care is defined can vary by practice, but at minimum it usually means:
- All providers that share the panel are able to act as the most responsible provider across all patients in the panel.
- All providers are equally responsible for comprehensive care needs including screenings and preventative care, as well as referrals and other care coordination.
- Information about that patient may appear in either physician’s inbox, or sometimes both. Providers will have to determine how inboxes are managed between them.
If two or more physicians are truly sharing care for a panel of patients, then they may choose to create a shared CPAR Panel.
Practical Implications of Sharing a CPAR Panel
It’s important to be aware of the various technical, financial, clinical, and administrative impacts that may result from sharing a CPAR panel. These include but may not be limited to:
Administrative burden considerations:
- CPAR eNotifications will be copied to the EMR inboxes of all providers attached to a shared CPAR panel
- All providers attached to a shared CPAR panel will be listed as the primary care provider in Netcare. This may confuse other providers, and/or cause information to be duplicated and/or be routed incorrectly.
- Connect Care only displays one of the providers on a shared CPAR panel. This may result in one of the provider’s inboxes receiving the bulk of Connect Care communications. This resource provides more detail about how Connect Care and CPAR work with respect to document routing.
Financial considerations:
- PCPCM: Shared CPAR panels will not be eligible to practice under the PCPCM funding model. If a provider has a shared panel and an unshared panel, only the unshared panel will count towards the provider’s PCPCM panel size.
- PMSP payments will be split equally between all physicians that share the panel, with no accounting for potential differences in work hours between the physicians.
Clinical considerations:
- Shared panels require significant planning and coordination to provide optimal care.
Shared panels can work well for some physicians and practices that practice truly shared care, so long as they implement clinic processes and policies to mitigate some of these concerns. In other situations, such as group practices where physicians cover their colleagues' panels or patients occasionally, it is usually better for each physician to maintain an individual (i.e., not shared) CPAR panel.