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Single Hub Access Referral Program for Gastroenterology (SHARPGI)   at
Anderson Hall
Connect Care Specialty: Gastroenterology
Connect Care Department: EDM RAH AH SHARPGI
Estimated time to routine appointment: Within 3 months
Alberta Health Services - Edmonton Zone
SERVICE DESCRIPTION
The Single Hub Access Referral Program for Gastroenterology(SHARPGI) in an initiative to streamline access for patients who need Gastrointestinal Specialist care.SHARPGI is an AHS funded multiphase improvement initiative between Primary Care and the Edmonton Zone Gastroenterology.

SHARPGI's Goals:
  • To reduce care delays related to referral management and triage
  • To improve patient care through referral quality and pathway integration
  • To improve understanding between Primary Care and Gastroenterology
The Single Hub Access Referral Program for Gastroenterology(SHARPGI) in an initiative to streamline access for patients who need Gastrointestinal Specialist care.SHARPGI is an AHS funded multiphase improvement initiative between Primary Care and the Edmonton Zone Gastroenterology.

SHARPGI's Goals:
  • To reduce care delays related to referral management and triage
  • To improve patient care through referral quality and pathway integration
  • To improve understanding between Primary Care and Gastroenterology
ROUTINE REFERRAL PROCESS
The Single Hub Access Referral program for gastroenterology (SHARPGI) is a centralized referral service for access to Gastroenterology. 
Referrals can be submitted by filling out the AHS Referral Form and submitting the appropriate supporting assessment reports, documents, investigations and information identified under the reasons for referral below.
The Single Hub Access Referral program for gastroenterology (SHARPGI) is a centralized referral service for access to Gastroenterology. 
Referrals can be submitted by filling out the AHS Referral Form and submitting the appropriate supporting assessment reports, documents, investigations and information identified under the reasons for referral below.
URGENT REFERRAL PROCESS
Please indicate on the referral form if this is to be considered Urgent.
Please indicate on the referral form if this is to be considered Urgent.
EMERGENCY REFERRAL PROCESS
Direct patients to the nearest Emergency Department if they are experiencing a serious illness or injury. Patients with potentially life threatening conditions should immediately phone 9-1-1.  If an emergency consult is required, providers can call RAAPID NORTH (patients north of Red Deer) at 1-800-282-9911 or 780-735-0811 or RAAPID SOUTH (patients in and south of Red Deer) at 1-800-661-1700 or 403-944-4486.
Direct patients to the nearest Emergency Department if they are experiencing a serious illness or injury. Patients with potentially life threatening conditions should immediately phone 9-1-1.  If an emergency consult is required, providers can call RAAPID NORTH (patients north of Red Deer) at 1-800-282-9911 or 780-735-0811 or RAAPID SOUTH (patients in and south of Red Deer) at 1-800-661-1700 or 403-944-4486.
ELIGIBILITY REQUIREMENTS
We accept specific zone identified (by PCN and GI) referral reasons which include:
-Abnormal Imaging of Gastrointestinal Tract
-Barrett Esophagus (Surveillance or Known Disease)
-Chronic Abdominal Pain
-Chronic Constipation
-Chronic Diarrhea
-Dyspepsia
-Endoscopic Evaluation of Unexplained Iron Deficiency Anemia
-FIT+ patients requiring Colorectal Cancer Screening that do NOT meet the established SCOPE criteria
-GERD
-H. pylori
-Hepatitis C
-High Risk Rectal Bleeding
-Irritable Bowel Syndrome (IBS)
-Non-Alcoholic Fatty-Liver Disease (NAFLD)
-Suspected Celiac Disease
We accept specific zone identified (by PCN and GI) referral reasons which include:
-Abnormal Imaging of Gastrointestinal Tract
-Barrett Esophagus (Surveillance or Known Disease)
-Chronic Abdominal Pain
-Chronic Constipation
-Chronic Diarrhea
-Dyspepsia
-Endoscopic Evaluation of Unexplained Iron Deficiency Anemia
-FIT+ patients requiring Colorectal Cancer Screening that do NOT meet the established SCOPE criteria
-GERD
-H. pylori
-Hepatitis C
-High Risk Rectal Bleeding
-Irritable Bowel Syndrome (IBS)
-Non-Alcoholic Fatty-Liver Disease (NAFLD)
-Suspected Celiac Disease
COMMUNICATION PROCESS
  • Communication of referral receipt to referral source will occur within 7 calendar days.
  • Communication of appointment details or wait list status to patient and referral source will occur within 14 calendar days.
  • Communication of initial appointment outcomes to referral source will occur within 30 calendar days.
 
PHONE
780-613-5524
FAX
780-670-3607
REFERRAL FORM
AHS Referral Form
Referrals specific to Colorectal Cancer screening that are not eligible under SCOPE please contact us. 

Referrals for High Risk Iron Deficiency Anemia, please complete the form below
High Risk IDA checklist

Referrals for Rectal Bleed, refer to the Facilitated Access to Surgical Treatment program.
AHS Referral Form
Referrals specific to Colorectal Cancer screening that are not eligible under SCOPE please contact us. 

Referrals for High Risk Iron Deficiency Anemia, please complete the form below
High Risk IDA checklist

Referrals for Rectal Bleed, refer to the Facilitated Access to Surgical Treatment program.
REFERRAL RESOURCES
Connect MD
eReferral Advice Request
eReferral Consult Request
LINKED SPECIALISTS
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
Timing
Additional Details
+-
Barrett esophagus
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
Body mass index
 
Within 6 months
Previous gastroscopy report and pathology report
 
Relevant
+-
Celiac disease
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
Body mass index
 
Within 6 months
Is patient following a gluten-free diet?
 
Relevant
Copy of small bowel biopsy imaging report
 
Relevant
In general, it is preferred that small bowel biopsies to prove that the patient has Celiac Disease before a gluten-free diet is started
 
Relevant
CBC, Ferritin
 
Within 3 months
Celiac Serology
 
Within 3 years
- Previous gastroscopy report
- Previous pathology report
- Optional INR, Ca/albumn, B12

Patient and Provider Resourse:

Nutrition Guideline Household Food Insecurity
+-
Chronic abdominal pain
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
Body mass index
 
Within 6 months
ALP, ALT, Albumin, total bilirubin, lipase
 
Within 3 months
C-reactive protein (if suspecting inflammatory or infectious conditions)
 
Within 3 months
CBC, electrolytes, Calcium, Magnesium, Phosphorus, creatinine
 
Within 3 months
Ferritin and transferrin saturation
 
Within 3 months
In the presence of alarm features, provide evidence and documentation for all portions of Clinical Pathway with your referral to SHARPGI.
 
Relevant
Any diagnostic testing as appropriate.
Chronic Abdominal Pain Primary Care Pathway (albertahealthservices.ca)
If applicable <6months:
C.Difficle, O&P, Celiac serology, TSH, HpSAT, urinanalysis, pregnancy test, abdominopelvic ultrasound
+-
Chronic constipation
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
Body mass index
 
Within 6 months
CBC, ferritin, TSH, glucose, calcium/albumin
 
Within 6 months
Celiac Serology
 
Within 3 years
Define the problem including the frequency of bowel movements and duration of symptoms-Attempted interventions and response to therapy
 
Relevant
In the presence of alarm features, provide evidence and documentation for all portions of Clinical Pathway with your referral to SHARPGI.
 
Relevant
Chronic Constipation - Pathway
+-
Chronic diarrhea
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
Body mass index
 
Within 6 months
C.Difficile, ova and parasites
 
Within 3 months
CBC, electrolytes, ferritin, CRP,
 
Within 3 months
Celiac serology
 
Within 3 years
In the presence of alarm features, provide evidence and documentation for all portions of Clinical Pathway with your referral to SHARPGI.
 
Relevant
Any related diagnostic testing as appropriate.
If high clinical suspicion of inflammatory bowel disease (IBD), do fecal calprotectin test
TSH

Chronic Diarrhea Primary Care Pathway (albertahealthservices.ca)
+-
Deficiency anemias
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
Body mass index
 
Within 6 months
Males > 40, females - post menopausal or post hysterectomy
 
Relevant
CBC, Ferritin, Reticular count (no saturation required) -Celiac serology (anti-TTG)
 
Within 3 months
Identification/results of any gastsroscopy/colonoscopy
 
Past 2 years
Previous GI surgery information (If applicable) 
+-
Dyspepsia
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
Body mass index
 
Within 6 months
CBC, ferritin
 
Within 6 months
Celiac Serology
 
Within 3 years
In the absence of alarm features, provide evidence and documentation for all portions of Clinical Pathway with your referral to SHARPGI.
 
Relevant
Negative H. pylori test (HpSAT or Urea breath test)
 
Within 6 months
Any related diagnostic testing as appropriate.

Dyspepsia - Pathway
+-
Family history of colorectal cancer
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
Body mass index
 
Within 6 months
CBC, Electrolytes, Creatinine/GFR
 
Within 2 years
Family history of CRC/ advanced adenoma in a first degree relative over the age of 60 FIT Test
 
Relevant
Patients who do not qualify under the SCOPE program criteria should be referred to SHARPGI.
Based on the age of affected first degree family members:
1.Family history of CRC or advanced adenoma in one first degree relative less than or equal to 60 years or 2 or more affected first degree relatives at any age
a) Screening begins at age 40 or 10 years earlier than the youngest diagnosis in the family, whichever comes first
b) NO FIT testing required
2. Family history of CRC or advanced adenoma in a first degree relative OVER the age of 60
a) Screening begins at age 40
b) Order FIT
+-
GERD - Gastro-esophageal reflux disease
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
Body mass index
 
Within 6 months
In the absence of alarm features, provide evidence and documentation for all portions of Clinical Pathway with your referral to SHARPGI.
 
Relevant
Any related motility and diagnostic testing as appropriate.

GERD - Pathway
+-
Helicobacter pylori
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
Body mass index
 
Within 6 months
HpSAT or Urea Breath Test
 
Within 3 months
In the absence of alarm features, provide evidence and documentation for all portions of Clinical Pathway with your referral to SHARPGI.
 
Relevant
Indicate three failed attempts of treatment
 
Relevant
Any related diagnostic testing as appropriate.

H. pylori - Pathway
+-
Hepatitis C
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
Body mass index
 
Within 6 months
Medication history including herbs/remedies/all OTC drug use/illicit drugs
 
Relevant
Alcohol intake, symptoms (e.g. jaundice, abdominal pain, etc.)
 
Relevant
Systemic symptoms (i.e. sore throat, rash)
 
Relevant
Liver enzymes: ALT, AST, Alk phos
 
Within 6 months
Liver function: INR, total/direct bilirubin, albumin
 
Within 6 months
CBC, electrolytes, creatinine, CK
 
Within 6 months
Etiological: Hep A IgM, Hep B surface Ag, Hep B core IgM, Hep C Ab
 
Within 6 months
Toxin screen (acetaminophen, cocaine, if applicable)
 
Within 1 month
Exclusion: Sudden severe increase in INR should be treated as URGENT
 
Relevant
- Ultrasound if available; indicate if it has been ordered
<3 Months
- Previous liver enzymes

Hepatitis C - Pathway
+-
History of adenomatous polyp of colon
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
Body mass index
 
Within 6 months
CBC, electrolytes, creatinine/ GFR
 
Within 2 years
Copy of previous colonoscopy and pathology report
 
Relevant
Patients who do not qualify under the SCOPE program eligibility criteria should be referred to SHARPGI
+-
History of colorectal cancer
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
Body mass index
 
Within 6 months
CBC, electrolytes, creatinine/ GFR
 
Within 2 years
Copy of previous colonoscopy, surgery and pathology report
 
Relevant
+-
IBS - Irritable bowel syndrome
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
Body mass index
 
Within 6 months
CBC, TSH, CRP If diarrhea: Fecal calprotectin, stools for C&S, C.diff, stool for O&P
 
Within 6 months
Celiac Serology
 
Within 3 years
Frequency and duration of symptoms-Severity of symptoms and impact of daily activities-Previous GI consultations, attempted interventions and response to therapy
 
Relevant
In the presence of alarm features and/or an elevated fecal calprotectin (>200mcg/g), please provide evidence and documentation for all relevant portions of the Irritable Bowel Syndrome (IBS) Primary Care Pathway with your referral
 
Relevant
Irritable Bowel Syndrome (IBS) - Pathway
+-
Imaging of gastrointestinal tract abnormal
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
Body mass index
 
Within 6 months
Description of symptoms and reason for requesting imaging
 
Relevant
CBC, electrolytes, creatinine
 
Within 3 months
Unintended weight loss. Include amount of weight lost and over what duration of time
 
Relevant
Include a copy of the abnormal imaging report with the referral
+-
Non-alcoholic fatty liver
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
Body mass index
 
Within 6 months
Possible NAFLD diagnosis (at least one of): Incidental ultrasound finding of fatty liver Incidental finding of abnormal alanine transaminase (ALT). Is ALT > 2x ULN for 6 months?
 
Relevant
Have you ruled out other causes of liver disease in addition to NAFLD through the following stepwise testing: Medication review (including herbals and supplements) Liver ultrasound if not completed within one year)HBsAg and HCV antibody, ANA, anti-actin/ anti-smooth muscle antibody (depending on local availability), immunoglobulins (IgG, IgA, IgM)Ferritin and iron/ TIBC, celiac screen, serum ceruloplasmin (if age < 30)
 
Required
Baseline investigations:ALT, AST, ALP, GGT Liver function tests if cirrhosis is suspected: INR, bilirubin, albumin, CBC with platelets, HbA1C, lipid profile
 
Within 3 months
NAFLD diagnosed: further follow-up is dependent on risk stratification by FIB-4 score calculation
 
Within 1 month
Non-Alcoholic Fatty-Liver Disease (NAFLD) - Pathway 
+-
Screening for colon cancer
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
Body mass index
 
Within 6 months
Significant medical diagnosis/ process that excludes them from the SCOPE program.
 
Relevant
CBC, electrolytes, creatinine/ GFR
 
Within 2 years
Positive FIT test
 
Relevant
Patients 50-74 years of age with positive FIT should be referred to the SCOPE program with the exception of patients that meet the criteria list (link below) that then should be referred to SHARPGI
SCOPE program exclusion criteria
Do NOT refer if: 
Age <40 or >85 years
Dementia-in care (e.g. Supportive Living, Continuing Care)
Nursing Home or Long Term Care Resident (with ADL provided by others)
+-
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
Timing
Additional Details
+-
Iron deficiency anemia
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
CBC
 
Within 8 weeks of referral
Ferritin
 
Within 8 weeks of referral
Celiac serology
 
Within 3 years
Height and Weight
 
At time of referral (Trend if weight loss noted)
TIBC, transferrin saturation, creatinine, ALP, total bilirubin, ALT
 
Within 8 weeks of referral
IDA defined as Hgb <130 g/L (men) or <120 g/L (women) AND serum ferritin below lower limit of normal
URGENT referral consists of:
IDA with Hgb <110 g/L (men) or <100 g/L (women) OR
IDA with at least one of the following alarm symptoms:
-Significant diarrhea as can occur in IBD
-Unintentional weight loss(≥5-10% of body weight over 6 mth)
-Significant and progressive change in bowel habit
-Significant abdominal pain
SEMI URGENT referral consists of:
IDA with Hgb 110-130 g/L (men) or 100-120 g/L (women)
+-
Rectal bleeding
Medication List (dose, frequency, route)
 
Within 1 month
Past medical history
 
Within 1 month
CBC
 
Within 8 weeks
CRP (optional if ulcerative colitis is suspected)
 
Within 1 month
Describe; *recent change in bowel habit (duration and frequency) *family history
 
Within 1 month
Indicate within the referral any of the following co-morbidities;*history of stroke *cardiovascular disease (e.g. prior MI) *respiratory disease *peripheral vascular disease *GI disease (e.g. Crohn's) *renal disease *liver disease (hepatitis B or C) *diabetes
 
Within 12 months
Semi-Urgent Referral: Rectal Bleeding as defined under the additional details to the right, AND Associated with at least one of the following; *new or worsening anemia (Hb <130g/L in men, Hb <120g/L in women) *iron deficiency (serum ferritin belowlower limit of normal) *new onset, persistent or worsening abdominal pain *new onset or progressive unintentional weight loss (≥5-10% of body weight over 6 months) *concerning change in bowel habit
 
Current
Specify antithrombotics (type and reason), antiplatelets and insulin/oral hypoglycemic agent
 
Current
Submit previous colonoscopy/flexible sigmoidoscopy or imaging reports.
 
If available
Urgent Referral: Rectal Bleeding as defined under the additional details to the right, AND *Palpable abdominal or rectal mass, OR suspected colorectal lesion or evidence of metastases seen on imaging *New or worsening anemia (Hgb <100 g/L men and Hgb <100 g/L women) AND iron deficiency (serum ferritin below lower limit of normal)
 
Current
High Risk Rectal Bleeding defined as (all must be present):
  • Blood visibly present in/on the stool OR in the toilet AND not just on the tissue paper
  • New onset or worsening AND persistent rectal bleeding (ie. not just a single episode: present most days of the week for > 2 weeks)
  • Unexplained (ie. absence of complete colonoscopy within last 2 years)


*Concerning change in bowel habit (increase or decrease in frequency and/or consistency).
PATIENT APPOINTMENT INFORMATION
Email
Print
 
MISSED APPOINTMENT GUIDELINES
Please provide 48 hours notice if needing to cancel or reschedule. Multiple cancellations may result in a re-referral to the program.
Please provide 48 hours notice if needing to cancel or reschedule. Multiple cancellations may result in a re-referral to the program.
 
HOURS OF OPERATION
Monday: 8:00 am - 3:30 pm
Tuesday: 8:00 am - 3:30 pm
Wednesday: 8:00 am - 3:30 pm
Thursday: 8:00 am - 3:30 pm
Friday: 8:00 am - 3:30 pm
   
 
ADDRESS
10959 102 Street NW
Edmonton Alberta
T5H 2V1
PATIENT APPOINTMENT INSTRUCTIONS
 
DIRECTIONS
Directions will be provided upon referral acceptance and booking appointment.
Directions will be provided upon referral acceptance and booking appointment.
 
PHONE
780-613-5524
 
PARKING INSTRUCTIONS
Parking is available at all sites offering this service.
Parking is available at all sites offering this service.
 
EMAIL
sharp@ahs.ca
VIRTUAL APPOINTMENT INFORMATION
 
PARKING MAP
There is currently no parking map available for this site.
There is currently no parking map available for this site.
 
WHEELCHAIR ACCESSIBILITY
Yes

Elevator available to 2nd floor


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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