Membership Model

The CWC PCN’s membership model is designed to align with and provide sustainable support to you as you build Patient Medical Homes.

The College of Family Physicians of Canada advocates the Patient Medical Home (PMH) model as a “vision for family practice across Canada.” Their goals for it include team-based care, timely access, the use of EMR, and continuous evaluation and improvement work. PMH is also a provincial objective.

The membership model reflects this commitment to the PMH. Membership is inclusive with core programs and services available to all. Your readiness to engage in PMH activities determines your membership type.

Programs & Services by membership 

Click the dial below to cycle through the memberships.

Member Benefit Types
Standard Membership
Enhanced Membership
Comprehensive Membership

 

For a detailed description of the supports and services provided by each membership type, please click on the sections below:

standard membership

Supporting physicians in their everyday practice and their patients’ medical neighbourhood.

All member physicians enjoy access to the following programs and services: 

PCN Orientation

  • Introduction to our vision, mission and objectives
  • Information on programs, services and benefits
  • Information on the PMH, membership and corresponding benefits

Patient Care

  • Primary Care Centre
    • Seven-day-a-week, same-day appointment service on weekdays, evenings and weekends
    • 24-hour blood pressure monitoring
    • After-hours patient care and urgent lab coverage
    • RhoGAM referral service
  • Senior Services: Specialized primary care for seniors with complex medical issues to support them to remain at home for as long as possible.
  • Social Workers: Temporary resource brokers who connect patients with programs, services and resources in the community.
  • Collaborative partnerships in the community
    • Emergency Department Redirect at Rockyview General Hospital
    • Nurse Practitioner postpartum support at Rockyview General Hospital
    • LTC on-call program
  • Seniors Home Based Primary Care: Pilot project with AHS that provides homebound seniors with a comprehensive care program and team for care at home.

Physician Education and Digital Resources

Engagement Opportunities

  • Focus groups on various topics
  • Engagement surveys
  • One-on-one, topic-specific interviews

Other Benefits

  • Paid shifts at the Primary Care Centre
  • Paid after-hours, on-call shifts
  • CWC PCN materials (plaques, business and appointment cards, promo material)
  • HUTV: Health education TV for clinics
  • Vendor discounts

Membership Support

  • Physician Liaison: Your primary contact for the CWC PCN. Answers your questions and ensures you are up to date on our programming, services and other opportunities.
  • Ongoing two-way communication about PCN benefits, services, resources and directives.

enhanced membership

Supporting physicians with their individual PMH improvement goals.

All benefits of Standard membership, plus:

PMH Team

The PMH team includes the following CWC PCN team members:

  • Patient Care Coordinator: Supports the coordination of planned care aimed at improving screening and management of patient care.
  • Improvement Associate: Facilitates physician-led improvement projects that underpin the Patient Medical Home model of practice.
  • Measurement & Evaluation Consultant: Provides analytic support to the physician-led PMH team.
  • Primary Care Nurse: Performs a detailed assessment and utilizes modalities, such as health education, lifestyle modification and chronic disease management, to deliver preventive health services and encourage patients to become active participants in their own health.
  • Behavioural Health Consultant: Provides short-term behavioural and psychological interventions to address a wide range of psychosocial health concerns with the goals of early identification, quick resolution, prevention and health promotion.

PMH services

Team members collaborate with physicians and use an evidence-informed improvement approach to identify and implement clinic processes that promote patient care and management.  

In addition to in-person patient care, the CWC PCN is introducing a digital health option to increase access to the Patient Care Team through secure email, text and video conferencing. This technology will also improve team collaboration by connecting staff at different locations.

Examples of how we support our members:

  • Helping members to identify and maintain their patient panel
  • Optimizing the EMR to support patient care. This may include:
    • Assisting with the development of standard data entry processes for recording patient information
    • Creating documentation of standard EMR processes
  • Identifying care pathways for delivering patient care and self-management support
  • Providing care coordination support relating to improvement goals. This may include:
    • Managing requisitions
    • Conducting outreach or opportunistic screening activities
    • Assisting with external referrals
    • Ensuring test results (e.g., lab, DI) and external communications are in the EMR 
  • Measurement and analytic support including:
    • Developing evidence-informed search criteria to identify patients for screening or chronic disease management
    • Tracking changes over time (e.g., tracking time for patients to get an appointment; tracking patient outcomes resulting from process changes for chronic disease management)
    • Data collection, data analytics and reporting (e.g. a report that describes a patient panel; reports that identify patients eligible for Complex Care Plans)
  • Providing patient outcome information to enhance care delivery
  • Supporting Occupational Health and Safety
    • Providing OHS resources (first aid kit, Material Safety Data Sheets)

comprehensive membership

Supporting members who practice in a mature Patient Medical Home model, where two or more physicians work together with a collaborative team to manage their patients.

All benefits of Standard membership, plus:

PMH Team

The PMH team includes the following CWC PCN team members:

  • Patient Care Coordinator: Supports the coordination of planned care aimed at improving screening and management of patient care.
  • Improvement Associate: Facilitates physician-led improvement projects that underpin the Patient Medical Home model of practice.
  • Measurement & Evaluation Consultant: Provides analytic support to the physician-led PMH team.
  • Primary Care Nurse: Performs a detailed assessment and utilizes modalities, such as health education, lifestyle modification and chronic disease management, to deliver preventive health services and encourage patients to become active participants in their own health.
  • Behavioural Health Consultant: Provides short-term behavioural and psychological interventions to address a wide range of psychosocial health concerns with the goals of early identification, quick resolution, prevention and health promotion.

PMH Services

Team members work with Comprehensive physicians in the same clinic to manage patient care for shared patient populations. For example, if both physicians have a large patient population with diabetes, then shared clinic processes and care pathways are developed to manage this patient group. 

In addition to in-person patient care, the CWC PCN is introducing a digital health option to increase access to the Patient Care Team through secure email, text and video conferencing. This technology will also improve team collaboration by connecting staff at different locations.

Examples of how we support our members:

  • Helping members to identify and maintain their patient panel
  • Optimizing the EMR to support patient care. This may include:
    • Assisting with the development of standard data entry processes for recording patient information
    • Creating documentation of standard EMR processes
  • Identifying care pathways for delivering patient care and self-management support
  • Providing care coordination support relating to improvement goals.  This may include:
    • Managing requisitions
    • Conducting outreach or opportunistic screening activities
    • Assisting with external referrals
    • Ensuring test results (e.g., lab, DI) and external communications are in the EMR
  • Measurement and analytic support including: 
    • Developing evidence-informed search criteria to identify patients for screening or chronic disease management
    • Tracking changes over time (e.g., tracking time for patients to get an appointment; tracking patient outcomes resulting from process changes for chronic disease management)
    • Data collection, data analytics and reporting (e.g. a report that describes a patient panel; reports that identify patients eligible for Complex Care Plans)
  • Providing patient outcome information to enhance care delivery
  • Supporting Occupational Health and Safety
    • Providing OHS resources (first aid kit, Material Safety Data Sheets)

Frequently Asked Questions

If you have additional questions or require more information, please speak with your Physician Liaison or contact the Member Services & Engagement Team at memberservices@cwcpcn.com.