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Southern Alberta Clinical and Metabolic Genetics Services - Central Access and Triage   at
Alberta Wide
Central Access Healthcare Service
Specialty: Genetics
Connect Care Department: AHS SOUTH GENETIC SERVICES CAT
Estimated time to routine appointment: Greater than 18 months
Alberta Health Services - Provincial Health Services
CENTRAL ACCESS SERVICES
This central access referral service single point of entry for individuals requiring Genetic services in Southern Alberta (Red Deer and South). 
 
Provides care for people and their families who have, or who are at risk for, genetic conditions during pregnancy, infancy, childhood and adulthood. Services include assessment, diagnosis and genetic counselling, and screening and management recommendations.
 
A team-based approach to care may include appointments with medical geneticists, genetic counsellors, registered nurses, dieticians, pharmacists, social workers and genetic assistants. Appointments may occur in-person, by video call, or by telephone, depending on the referral reason. Wait times also vary by referral reason, but may be greater than 18 months for routine referrals. 
 
If your patient is admitted and will remain admitted, please consider calling the inpatient genetics consult service. In-patient consultation services are provided at all tertiary hospitals in Calgary by medical geneticists. Please call the Alberta Children’s Hospital Switchboard at 403-955-2711 and ask to speak to the Medical, Prenatal or Metabolic Geneticist on-call. Please note that Prenatal on-call coverage is provided from Monday- Friday from 8am to 5pm. Outside of these hours, calls will be taken by the Medical Geneticist on-call.

For URGENT referrals:  
  • Please mark clearly on the referral form or referral letter that the referral is URGENT.  
  • Please indicate why the referral is urgent, i.e. how a patient’s immediate or short-term management / treatment will be impacted by a genetics assessment and/or genetic testing.  
  • All referrals to the Prenatal Genetics Clinic are considered urgent.
The following reasons for referral should be considered urgent: 
  1. A patient pregnancy where the genetic or family history concern may have implications on the pregnancy health or outcome.  
  2. A genetic diagnosis or genetic testing will impact immediate or short-term management/treatment decisions. 
  3. Patient is palliative. 
Referrals for a family history of a genetic condition require the following information:  
  • Relationship to the affected family member  
  • Outline the genetic testing that has been completed in the affected family member (if possible, attach a copy of the relative’s genetic test report or Family Letter)  
  • If no genetic testing has occurred in the family, genetic testing may not be available to an unaffected family member. Please provide your patient with this resource: Genetic testing: When your family member has a genetic condition
Your patient may be asked to complete a Family History Questionnaire and/or ask a relative to sign a Release of Information form for review of relevant records. Depending on the reason for referral, a referral may be declined as incomplete if your patient does not return the requested information. This occurs when an accurate assessment cannot be made without the additional information.
This central access referral service single point of entry for individuals requiring Genetic services in Southern Alberta (Red Deer and South). 
 
Provides care for people and their families who have, or who are at risk for, genetic conditions during pregnancy, infancy, childhood and adulthood. Services include assessment, diagnosis and genetic counselling, and screening and management recommendations.
 
A team-based approach to care may include appointments with medical geneticists, genetic counsellors, registered nurses, dieticians, pharmacists, social workers and genetic assistants. Appointments may occur in-person, by video call, or by telephone, depending on the referral reason. Wait times also vary by referral reason, but may be greater than 18 months for routine referrals. 
 
If your patient is admitted and will remain admitted, please consider calling the inpatient genetics consult service. In-patient consultation services are provided at all tertiary hospitals in Calgary by medical geneticists. Please call the Alberta Children’s Hospital Switchboard at 403-955-2711 and ask to speak to the Medical, Prenatal or Metabolic Geneticist on-call. Please note that Prenatal on-call coverage is provided from Monday- Friday from 8am to 5pm. Outside of these hours, calls will be taken by the Medical Geneticist on-call.

For URGENT referrals:  
  • Please mark clearly on the referral form or referral letter that the referral is URGENT.  
  • Please indicate why the referral is urgent, i.e. how a patient’s immediate or short-term management / treatment will be impacted by a genetics assessment and/or genetic testing.  
  • All referrals to the Prenatal Genetics Clinic are considered urgent.
The following reasons for referral should be considered urgent: 
  1. A patient pregnancy where the genetic or family history concern may have implications on the pregnancy health or outcome.  
  2. A genetic diagnosis or genetic testing will impact immediate or short-term management/treatment decisions. 
  3. Patient is palliative. 
Referrals for a family history of a genetic condition require the following information:  
  • Relationship to the affected family member  
  • Outline the genetic testing that has been completed in the affected family member (if possible, attach a copy of the relative’s genetic test report or Family Letter)  
  • If no genetic testing has occurred in the family, genetic testing may not be available to an unaffected family member. Please provide your patient with this resource: Genetic testing: When your family member has a genetic condition
Your patient may be asked to complete a Family History Questionnaire and/or ask a relative to sign a Release of Information form for review of relevant records. Depending on the reason for referral, a referral may be declined as incomplete if your patient does not return the requested information. This occurs when an accurate assessment cannot be made without the additional information.
ELIGIBILITY REQUIREMENTS
This service is available to individuals who are affected by, or at moderate to high risk for, inherited genetic conditions. Risk level is determined by evaluation of the medical and family history reported at the time of referral.

Reasons for which the Program may decline referrals currently includes:
  1. Patient Resides Outside of Catchment Area: 
    • BC or SK patients who reside within the catchment of the Vancouver or Saskatoon Genetics Programs, or else who can receive care via telehealth by these programs (e.g. genetic counselling appointment only not requiring face-to-face appointment / physical exam).
  2. Personal or Family history of Complex Trait / Multifactorial Condition, for example Celiac Disease and MTHFR.
  3. Request for Genetic Testing for the Following Indications:
    • Cystic Fibrosis testing: for male infertility in cases where the vas deferens is present.
    • Chromosomal microarray (CMA) testing: for children with isolated behavioural abnormality, neurodevelopmental delay, or intellectual disability, CMA can be ordered by pediatrician. Please see Genetics: Chromosomal microarray testing for information for patients and families about this test. 
    • Leber hereditary optic neuropathy genetic testing: for index patients, can be ordered by patient's ophthalmologist.
    Please visit Genetic Laboratory Services Webpage for the Test Directory and requisitions: Genetics and Genomics (formerly Genetic Lab Services) | Alberta Health Services. Any patient found to have a positive genetic test result is subsequently eligible for consultation with Genetic Services and should be referred.
  4.  Direct-to-consumer genetic test results:
    • Patients found to have mutations in genes associated with monogenic conditions are eligible.
    • Variants of uncertain clinical significance or variants with minimal clinical impact are not eligible.
  5. Personal or family history of hypermobility, including hypermobile Ehler’s Danlos syndrome (EDS Type III / Benign Hypermobility syndrome). For primary care management, please refer to the Management section here: Hypermobile Ehlers-Danlos Syndrome - GeneReviews® - NCBI Bookshelf and/or the 2017 EDS Classification for Non-experts - The Ehlers Danlos Society for guidance from the International Consortium on Ehlers-Danlos Syndromes and Related Disorders.
  6. Pediatric patients who carry thalasemia and hemoglobinopathies:  Individuals of reproductive age, are eligible.  Patient-centered resources are available through MyHealthAlberta:
  7. Non-medical indications:
    • paternity testing
    • ancestry testing
    • twin zygosity testing for information purposes.
    • limited or unknown family history.
  8.  Other:
    • If Family History Form or Relevant Genetic/Clinical Information on an affected relative is not provided (when requested) and is required to provide an accurate assessment.
This service is available to individuals who are affected by, or at moderate to high risk for, inherited genetic conditions. Risk level is determined by evaluation of the medical and family history reported at the time of referral.

Reasons for which the Program may decline referrals currently includes:
  1. Patient Resides Outside of Catchment Area: 
    • BC or SK patients who reside within the catchment of the Vancouver or Saskatoon Genetics Programs, or else who can receive care via telehealth by these programs (e.g. genetic counselling appointment only not requiring face-to-face appointment / physical exam).
  2. Personal or Family history of Complex Trait / Multifactorial Condition, for example Celiac Disease and MTHFR.
  3. Request for Genetic Testing for the Following Indications:
    • Cystic Fibrosis testing: for male infertility in cases where the vas deferens is present.
    • Chromosomal microarray (CMA) testing: for children with isolated behavioural abnormality, neurodevelopmental delay, or intellectual disability, CMA can be ordered by pediatrician. Please see Genetics: Chromosomal microarray testing for information for patients and families about this test. 
    • Leber hereditary optic neuropathy genetic testing: for index patients, can be ordered by patient's ophthalmologist.
    Please visit Genetic Laboratory Services Webpage for the Test Directory and requisitions: Genetics and Genomics (formerly Genetic Lab Services) | Alberta Health Services. Any patient found to have a positive genetic test result is subsequently eligible for consultation with Genetic Services and should be referred.
  4.  Direct-to-consumer genetic test results:
    • Patients found to have mutations in genes associated with monogenic conditions are eligible.
    • Variants of uncertain clinical significance or variants with minimal clinical impact are not eligible.
  5. Personal or family history of hypermobility, including hypermobile Ehler’s Danlos syndrome (EDS Type III / Benign Hypermobility syndrome). For primary care management, please refer to the Management section here: Hypermobile Ehlers-Danlos Syndrome - GeneReviews® - NCBI Bookshelf and/or the 2017 EDS Classification for Non-experts - The Ehlers Danlos Society for guidance from the International Consortium on Ehlers-Danlos Syndromes and Related Disorders.
  6. Pediatric patients who carry thalasemia and hemoglobinopathies:  Individuals of reproductive age, are eligible.  Patient-centered resources are available through MyHealthAlberta:
  7. Non-medical indications:
    • paternity testing
    • ancestry testing
    • twin zygosity testing for information purposes.
    • limited or unknown family history.
  8.  Other:
    • If Family History Form or Relevant Genetic/Clinical Information on an affected relative is not provided (when requested) and is required to provide an accurate assessment.
Referral instructions for primary care, community care, private
providers etc. who do not send referrals via Connect Care.
REFERRAL PROCESS - FOR NON-CONNECT CARE USERS
Complete the appropriate referral form or a physician letter and fax it to the referral fax: 403-476-8752.
Complete the appropriate referral form or a physician letter and fax it to the referral fax: 403-476-8752.
REFERRAL PROCESS - FOR CONNECT CARE USERS
Send an Internal Referral using the Ambulatory Referral Order to Genetics, type AHS SOUTH GENETIC SERVICES CAT in the “To Department” section and complete order.
Send an Internal Referral using the Ambulatory Referral Order to Genetics, type AHS SOUTH GENETIC SERVICES CAT in the “To Department” section and complete order.
COMMUNICATION PROCESS
  • Referral receipt to referring source within 7 days.
  • Acceptance via appointment details or wait list status letter to referring source and patient within 14 days.
  • Wait list status update every 90 days.
  • Appointment outcome to referral source within 30 days.
ADDITIONAL SERVICE DETAILS

If a patient was seen in the past and no diagnosis was made or a follow-up appointment was planned, we are now requesting a re-referral as we are unable to maintain on-time scheduled follow-ups. 


Outreach clinics are offered in both Lethbridge and Medicine Hat, involving medical geneticists, genetic counsellors and genetic assistants. Patients in these cities may still be offered appointments in Calgary, depending on the referral reason. Prenatal Genetics services are no longer available at the Lethbridge and Medicine Hat Outreach Locations. Prenatal Genetics appointments are either coordinated with scheduled Maternal Fetal Medicine appointments or are offered virtually where possible. 

Patients with hypermobility may also find it helpful to watch: Hypermobile Ehlers Danlos Syndrome Information Session.
 
Please encourage your patient to visit the Frequently Asked Questions at: www.ahs.ca/genetics and to review general information about genetics and their health at:  MyHealth.Alberta.ca - Genetics. 

If a patient was seen in the past and no diagnosis was made or a follow-up appointment was planned, we are now requesting a re-referral as we are unable to maintain on-time scheduled follow-ups. 


Outreach clinics are offered in both Lethbridge and Medicine Hat, involving medical geneticists, genetic counsellors and genetic assistants. Patients in these cities may still be offered appointments in Calgary, depending on the referral reason. Prenatal Genetics services are no longer available at the Lethbridge and Medicine Hat Outreach Locations. Prenatal Genetics appointments are either coordinated with scheduled Maternal Fetal Medicine appointments or are offered virtually where possible. 

Patients with hypermobility may also find it helpful to watch: Hypermobile Ehlers Danlos Syndrome Information Session.
 
Please encourage your patient to visit the Frequently Asked Questions at: www.ahs.ca/genetics and to review general information about genetics and their health at:  MyHealth.Alberta.ca - Genetics. 

 
CENTRAL ACCESS REFERRAL PHONE
403-955-7373
CENTRAL ACCESS REFERRAL FAX
403-476-8752
REFERRAL FORMS
REFERRAL ADVICE
eReferral eConsult
RAAPID
CENTRAL ACCESS LINKED SERVICES
CLICK + TO VIEW REFERRAL GUIDELINES
+-
Routine Reason for Referral
Access Targets convey the clinically appropriate timeframe patients should be seen within, by reason for referral and priority level.
Access Target
Required Information/Investigations
Investigation Timing
Additional Details
+-
Family history of hereditary disease
< 18 Months
Past medical history
 
Within 1 month
Family History Information
 
N/A
Relative's Genetic Test Result or Family Letter
 
N/A
Referrals for a family history of a genetic condition require the following information: 
  • Relationship to the affected family member 
  • Outline the genetic testing that has been completed in the affected family member (if possible, attach a copy of the relative’s genetic test report or Family Letter) 
  • If no genetic testing has occurred in the family, genetic testing may not be available to an unaffected family member. Please provide your patient with this resource: Genetic testing: When your family member has a genetic condition
Your patient may be asked to complete a Family History Questionnaire and/or ask a relative to sign a Release of Information form for review of relevant records. Depending on the reason for referral, a referral may be declined as incomplete if your patient does not return the requested information. This occurs when an accurate assessment cannot be made without the additional information.
+-
Genetic disease
< 18 Months
Past medical history
 
Within 1 month
N/A
 
N/A
Assessment, genetic testing and genetic counselling provided to those with, or suspected to have, a genetic condition.
+-
Metabolic disease
< 6 Months
Past medical history
 
Within 1 month
N/A
 
N/A

+-
Urgent Reason for Referral
Access Targets convey the clinically appropriate timeframe patients should be seen within, by reason for referral and priority level.
Access Target
Required Information/Investigations
Investigation Timing
Additional Details
+-
Prenatal genetic consultation
1 Month
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
  • Complete Blood Count
  • Blood Type
 
Within 3 months
Alberta Prenatal Record
 
N/A


The primary purpose of the All Locations list is to let the user easily access any location of a healthcare service without going back to the main search screen.

The locations listed have 3 background colors:
  • Green means the healthcare service@location has referral information attached to it.
  • Brown means the healthcare service@location never had referral information attached to it, or it has unpublished referral information.
  • Red means
    • IA changed the healthcare service@location's status to something other than Current
    • It was deleted if it is an ARD healthcare service@location.
Green  and Brown are always at the top of the list. These are the Healthcare Service@Locations with the status of Current.
The Red list at the bottom consists of non-current Healthcare Service@locations that once had Published referral information in the ARD.
If the referral information was never published in ARD the Healthcare Service@location will not show in the Red list.

The secondary purpose of the All Locations list is to allow ARD Administrators to recover (copy) referral information from the non-current Healthcare Service@Locations to ones that are current.

Common Scenario:
A Healthcare Service moves from one location to another. In this case the IA Healthcare Service@Location record will be made defunct (non-current) and a new Healthcare Service@Location record will be created with a current status. In this scenario the captured referral guidelines in ARD can become "orphaned" as they are not attached to any current IA healthcare service.

Categories of non-current or orphaned referral guidelines: INDIVIDUAL and COMMON.
The REFERRAL GUIDELINES section of the profile has the prefix INDIVIDUAL or COMMON to help you choose the method below when transferring referral guidelines from a non-current Healthcare Service@Location to a current healthcare service@location.

Individual referral process
  1. Click on a non-current (Red) Healthcare Service@Location at the bottom of the All Locations list.
  2. The non-current referral info is displayed with the link Copy this Referral Process to another Healthcare Service@Location link on the upper right hand corner. Click on the copy link.
  3. Choose a current location (Green or Brown) from the All Locations list. This will be the Healthcare Service@Location you are pasting the referral info into.
  4. The system will display the Edit Referral Info screen populated with the referral info from the non-current Healthcare Service@Location you viewed in the first step.
  5. Click Save and the referral info is transferred from the non-current Healthcare Service@Location to the current one.
  6. Repeat these steps for each Healthcare Service@Location that needs attention.

Common referral process - 2 sub cases.
Case 1: At least 1 current Healthcare Service@Location with common referral info is with current status for this healthcare service; One or more Healthcare Healthcare Service@Locations where replaced by new one.
  1. Click on any current Healthcare Service@Location whether it has referral info (Green) or not (Brown).
  2. The healthcare service location opens in the Edit Referral Info screen populated with the current common referral info.
  3. Save it. 
  4. All locations will be updated with the common referral information, including all the locations that don't have referral info yet (Brown). The non-current referrals (Red) will also be updated.
Case 2:  All Healthcare Healthcare Service@Locations for a healthcare service are set to a non-current status and replaced by new ones. In this case there is no current additional referral info to copy from, so the only alternative is to pick up the non-current common referral process (Red). Follow the steps described in the section Individual Referral Process above to copy/paste the non-current common referral info to the current healthcare service locations.
Generally we want to replicate current common referral info to new or replaced healthcare service locations. We only resort to copying non-current common referral info if there is no other option.

Remember: Some fields can be location specific with the common referral process:
Parking Instructions, Directions, Parking Map, Wait Time, Referral Phone or Referral Fax.
To update these items you have to edit each Healthcare Service@Location separately.

ADDITONAL NOTES:
  • The info icon after the All Locations drop down will be visible to ARD Administrators.
  • The system doesn't allow you to copy referral information from one non-current Healthcare Service@Location to another.

 

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