When one patient is on two panels.

People move and change clinics without telling the old one. Clinics keep patients on their panel long after the last visit. Two clinics may each have been told the person is theirs. Panels loaded from different EMRs, on different days, will disagree.

None of this is the patient's fault, and none of it should cost them their provider.

A child can have a family doctor and a pediatrician. Someone can have interim care while waiting for a longer-term provider. Treating these as conflicts creates work and worries families. Astam only opens a conflict when one person has two active primary attachments at different clinics. A pediatric attachment beside a primary one opens nothing.

A second confirmed primary attachment at another clinic opens one conflict case. It is not refused and nothing is overwritten. The case shows both attachments side by side: the practitioner, how and when each side confirmed, the last known visit and where the record came from.

A registry navigator asks the patient which provider they see. The patient's answer is recorded and resolves the case. The attachment they did not choose is ended with the reason “ended by conflict resolution” and stays in the history, so the decision can be traced and reversed if needed.

Cases open longer than 30 days are escalated on the conflict screen. The program dashboard shows how many are open, waiting for the patient and resolved.

The first time panels are loaded, the number of duplicates can be large. Before go-live, a province should agree which relationships are legitimate, who contacts patients, how quickly cases should close, and how the outreach is staffed. Astam's conflict screen and counts make that workload visible from the first day.