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1. Why are GP practices using the PHN's Data Quality Improvement Plan and installing the CAT ToolPlus?
2. What is the Quality Improvement Process the PHN is using?
3. How is the Quality Improvement program applied at the practice level?
4. What is the typical installation process for the CAT Plus products?
5. Who will contact our practice to install the tools?
6. Does the practice have to pay for installation?
7. What does PEN CS install for the practice?
8. What is "administrative access to the server mean"?

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Installation

1. Why does the CAT Tool need to be installed on the server?
2. Can CAT4 be installed on a desktop computer instead of the Server?
3. Is there a special password for Best Practice that I need?
4. Do I need to have my IT support person present during the installation?
5. Why is my IT required to be involved during installation?
6. Why does a practice need to provide IT contact details to PEN CS for PEN CS installation?
7. What if a practice gets charged by the IT company? Is there a way to avoid the charge?
8. How can other users in the practice see the extracts?
9. If I need to cancel or reschedule the appointment what should I do?
10. I had an appointment booked but no one from PEN CS called, what happened?

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Products

1. What exactly is the Clinical Audit Tool / CAT4?
2. What is Topbar?
3. Do CAT4 and Topbar rely on each other to work at a practice? Is one or the other optional?
4. What is PAT CAT?
5. How does a practice benefit from submitting data to the PHN/PATCAT?

Scheduler

1. Our practice already has Scheduler installed, why does it need to be updated?
2. What is Scheduler?
3. What is the benefit of Scheduler?
4. When will Scheduler Run?
5. Why is it preferable to run scheduler out of hours?
6. What are the impacts if it has to be done and set up during business hours?
7. Why are the products free to our practice?
8. Can our practice submit data manually?

Data Security 

1. Where is the PAT CAT data stored?
2. Does any identified information leave the general practice?
3. Can I exclude patients that do not wish to have their data shared with the PHN?
4. Will other practices see my data?
5. What is de-identified data?
6. Do the CAT Products write back to the Clinical System? 
7. Does CAT Plus always connect to the Clinical System every time it runs? 

Ethics 

1. Does the RACGP Require ethics approval before using the CAT plus products?

Checklist for Practices

Important Phone Numbers  

General

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Why are GP practices using the PHN's Data Quality Improvement Plan and installing

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CAT

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Plus?

RACGP Guidelines
General Practices are centre of healthcare in Australia and the RACGP Standards for General Practices (4^th edition) state;
The guideline Criterion 3.1.1 Quality Improvement Activities

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http://www.racgp.org.au/your-practice/standards/standards4thedition/safety,-quality-improvement-and-education/3-1/quality-improvement-activities/
The CAT4 tool can be an integral part of achieving these goals.

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• It allows the practice to use the graphs that are produced to show how the practice has improved in the past three years. To do this the tool can collect a data extract each month.
• The practice can review their own data, and the PHN can assist with providing benchmarking with other practices in the PHN catchment to see how the practices data compares.
• Decisions about what quality improvement programs can be decided on the basis of what areas the practice is not complying with the RACGP guidelines.

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The PHN may choose to apply a public health methodology to building sustainable systems and process that improve patient health outcomes. The Plan, Do, Study Act (PDSA) cycle is one example of how CAT Plus can be the backbone for practice assistance. It can be deployed through a Quality Improvement Management Framework (QIMF), and as such a PHN can target specific projects and implement them.

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Installation

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You may have had your phone switched to go to voicemail, or the contact was not available. Please contact PENCS on 1800 762 993 to reschedule the appointment.

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Products

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Do CAT4 and Topbar rely on each other to work at a practice? Is one or the other optional?

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CAT Plus is a population health planning and reporting platform for PHNs who manage a data quality initiative. The tool has the unique capacity to compile statistics, reports, indicators, timelines. This information is used to assist each PHN in understanding and interpreting their catchment epidemiology. The next step is for the information gathered to be analysed, and interpreted so that the PHN can accurately plan the type of services and interventions that are required within their catchment to meet their KPI's. For this to be possible the CAT4 needs to be installed at the practice, the scheduler to deidentify and send the information, and PAT CAT to receive the information. http://www.pencs.com.au/products/pat-cat/

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Practices benefit from working with the PHN by submitting the data on a monthly basis and allowing the PHN to understand the health needs of the practice and the PHN's catchment. If there are unmet needs in your practices area the PHN can use the information in an aggregated form to develop strategies to help meet this need, and develop a business case for the unmet needs in the area. The PHN is also able to notice trends that are occurring in your area. With this information practices and PHN's can work collaboratively and discuss how they can best assist the patients in their catchment.

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PENCS released a version of scheduler V2 and it relied on a windows username and password to be created. If the password was changed this meant that the scheduler did not run and the impact was that their monthly extract not being collected on the day they had set up. PENCS have developed a new version of the software V3 that will run in a different way. This software can also receive updates without the need for PENCS to remotely log in.
In consultation with the PHN we have developed the new version of the software and are working to update this software with all the practices.

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Scheduler is a piece of software when installed on the server that runs on a regular basis usually monthly and saves the practice staff from having to remember to run the software to have the de-identified data extracted in a regular interval. The monthly extracts can from an important part of the clinical and business information for the practice. Scheduler can also send a deidentified extract to the PHN upon the involved patients' agreement and nomination request.

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This software allows the practice to compare the changes in the data on a monthly basis, or over the entire three year period. The practice can use the data and quality improvements that can be easily described using the graphs.
The RACGP requires in the Quality Improvement activities that "Our Practice can describe aspects of our practice that we have improved in the past three years" http://www.racgp.org.au/your-practice/standards/standards4thedition/safety,-quality-improvement-and-education/3-1/quality-improvement-activities/

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By far and large, Scheduler runs on a monthly basis, or on any other nominated regular periodical schedule like quarterly, most practices and PHNs choose to run the scheduler on the 1^st of every month and out of business hours.

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It is preferable to run the scheduler out of hours particularly in practices with large patient numbers as it may take a while to run. Running the scheduler out of hours also means that the practice sets and forgets and that a monthly extract is completed.

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The installation process typically takes between 30 minutes and one hour. Once installed the scheduler runs automatically if it is run during business hours it may impact users with older computers and slow down the system for that reason it is recommended that practices install scheduler and have the work completed out of hours.

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Your local PHN has paid the license fee for the products, and provides them to your practice on a contractual basis. The normal retail cost of a licence for a practice is $1650.

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Yes, practices can run the software each month and manually prepare an extract. The extract can be sent to the PHN, or provided to the PHN on a USB drive for upload. Practices should discuss this arrangement with their PHN and if it meets the contractually agreed terms.

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Pen CS do not store the data, the data is stored on the PHN's servers. The data is sent directly from the practice to the PHN server.

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CAT4 de-identifies the information within the practice before submitting the de-identified extract to PAT CAT. Practices are encouraged to follow the RACGP guidelines on
"In general, a practice's quality improvement or clinical audit activities for the purpose of seeking to improve the delivery of a particular treatment or service would not be considered a directly related secondary purpose for information use or disclosure. In other words, it is likely the practice would need to seek specific consent for this use of patients' health information for clinical audit activities.
To ensure patients understand and have reasonable expectations of quality improvement activities, practices are encouraged to include information about quality improvement activities and clinical audits in the practice policy on managing health information. Ideally, express consent for these activities will be obtained upon patient registration." http://www.racgp.org.au/your-practice/standards/standards4thedition/practice-management/4-2/confidentiality-and-privacy-of-health-information/

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Yes. Individual patients can have their data withheld from being submitted. Instructions can be found on the PENCS website. http://help.pencs.com.au/display/CG/Patient+Consent+Withdrawn

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No identifiable information ever leaves the practice. The PHN may do benchmarking comparisons as part of the quality improvement program you can discuss with the PHN how they use the data.

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De-identified data means that the information that would identify the patient is removed. This includes first name, surname and

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No. No CAT Plus products write back to the practices clinical system.

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No. The CAT Plus runs independently from the clinical system and uses the extracts. 

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For a quality improvement activity to be undertaken within a general practice, where the primary purpose is to monitor, evaluate or improve the quality of healthcare delivered by the practice, ethics approval is not required.
Clinical audits using a tool such as the Clinical Audit Tool (CAT) (see Criterion 3.1.1 Quality improvement activities) or 'plan, do, study, act' cycles undertaken within a general practice as part of a quality improvement activity do not require ethics approval. For example, a practice wishing to determine how many of its pregnant patients are given advice on smoking cessation, or how many patients with heart failure are prescribed ACE inhibitors and beta blockers, may complete an audit on their practice data.
In general, a practice's quality improvement or clinical audit activities for the purpose of seeking to improve the delivery of a particular treatment or service would not be considered a directly related secondary purpose for information use or disclosure. In other words, it is likely the practice would need to seek specific consent for this use of patients' health information for clinical audit activities.
To ensure patients understand and have reasonable expectations of quality improvement activities, practices are encouraged to include information about quality improvement activities and clinical audits in the practice policy on managing health information. Ideally, express consent for these activities will be obtained upon patient registration.
Source:http://www.racgp.org.au/your-practice/standards/standards4thedition/practice-management/4-2/confidentiality-and-privacy-of-health-information/
Checklist for Practices

• Our practice has Best Practice Software, Medical Director, Genie, Communicare.
• I know what billing system we have installed.
• I am able to install software on the main computer, or server.
• If needed I know the password to install software on the server.
• I have the contact details of our IT person and if needed I can contact them to obtain passwords.
• If our IT contact is unavailable I understand that another call may be needed to
• If using Best Practice, I am aware that a browser password may be required.

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CAT4 is an audit and extraction tool, Topbar is a decision support tool. CAT4 works with the patient population in your clinical system, Topbar provides relevant notifications about the patients at your clinic. The two products can work completely independent of each other, but there are some important and very useful links. In particular the CAT Plus Prompts (more information here: CAT PLUS PROMPTS) where patients identified through a CAT4 search can be flagged for a notification to be shown if they visit the clinic. CAT4 and Topbar compliment each other but don't rely on each other. Improvements to data quality made by using Topbar can be easily measured in CAT4.

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What is PAT CAT?

CAT Plus is a population health planning and reporting platform for PHNs who manage a data quality initiative. The tool has the unique capacity to compile statistics, reports, indicators, timelines. This information is used to assist each PHN in understanding and interpreting their catchment epidemiology. The next step is for the information gathered to be analysed, and interpreted so that the PHN can accurately plan the type of services and interventions that are required within their catchment to meet their KPI's. For this to be possible the CAT4 needs to be installed at the practice, the scheduler to deidentify and send the information, and PAT CAT to receive the information. http://www.pencs.com.au/products/pat-cat/

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How does a practice benefit from submitting data to the PHN/PATCAT?

Practices benefit from working with the PHN by submitting the data on a monthly basis and allowing the PHN to understand the health needs of the practice and the PHN's catchment. If there are unmet needs in your practices area the PHN can use the information in an aggregated form to develop strategies to help meet this need, and develop a business case for the unmet needs in the area. The PHN is also able to notice trends that are occurring in your area. With this information practices and PHN's can work collaboratively and discuss how they can best assist the patients in their catchment.

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Scheduler

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Our practice already has Scheduler installed, why does it need to be updated?

PENCS released a version of scheduler V2 and it relied on a windows username and password to be created. If the password was changed this meant that the scheduler did not run and the impact was that their monthly extract not being collected on the day they had set up. PENCS have developed a new version of the software V3 that runs in a different way. This software can also receive updates without the need for PENCS to remotely log in.
In consultation with the PHNs we have developed the new version of the software and strongly encourage all practices to book an appointment to update their V2 Scheduler to the new V3.

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What is Scheduler?

Scheduler is a piece of software when installed on the server that runs on a regular basis usually monthly and saves the practice staff from having to remember to run the software to have the de-identified data extracted in a regular interval. The monthly extracts can from an important part of the clinical and business information for the practice. Scheduler can also send a deidentified extract to the PHN if agreed to by the practice.

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What is the benefit of Scheduler?

This software allows the practice to compare the changes in the data on a monthly basis. The practice can use the data and quality improvements that can be easily described using the graphs.
The RACGP requires in the Quality Improvement activities that "Our Practice can describe aspects of our practice that we have improved in the past three years" http://www.racgp.org.au/your-practice/standards/standards4thedition/safety,-quality-improvement-and-education/3-1/quality-improvement-activities/

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When will Scheduler Run?

By far and large, Scheduler runs on a monthly basis, or on any other nominated regular periodical schedule like quarterly, most practices and PHNs choose to run the scheduler on the 1^st of every month and out of business hours.

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Why is it preferable to run scheduler out of hours?

It is preferable to run the scheduler out of hours particularly in practices with large patient numbers as it may take a while to run. Running the scheduler out of hours also means that the practice sets and forgets and that a monthly extract is completed.

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What are the impacts if it has to be done and set up during business hours?

The installation process typically takes between 30 minutes and one hour. Once installed the scheduler runs automatically if it is run during business hours it may impact users with older computers and slow down the system for that reason it is recommended that practices install scheduler and have the work completed out of hours.

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Why are the products free to our practice?

Your local PHN has paid the license fee for the products, and provides them to your practice on a contractual basis. The normal retail cost of a licence for a practice is $1650.

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Can our practice submit data manually?

Yes, practices can run the software each month and manually prepare an extract. The extract can be sent to the PHN, or provided to the PHN on a USB drive for upload. Practices should discuss this arrangement with their PHN and if it meets the contractually agreed terms.

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Ethics

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Does the RACGP Require ethics approval before using the CAT plus products?

For a quality improvement activity to be undertaken within a general practice, where the primary purpose is to monitor, evaluate or improve the quality of healthcare delivered by the practice, ethics approval is not required.
Clinical audits using a tool such as the Clinical Audit Tool (CAT) (see Criterion 3.1.1 Quality improvement activities) or 'plan, do, study, act' cycles undertaken within a general practice as part of a quality improvement activity do not require ethics approval. For example, a practice wishing to determine how many of its pregnant patients are given advice on smoking cessation, or how many patients with heart failure are prescribed ACE inhibitors and beta blockers, may complete an audit on their practice data.
In general, a practice's quality improvement or clinical audit activities for the purpose of seeking to improve the delivery of a particular treatment or service would not be considered a directly related secondary purpose for information use or disclosure. In other words, it is likely the practice would need to seek specific consent for this use of patients' health information for clinical audit activities.
To ensure patients understand and have reasonable expectations of quality improvement activities, practices are encouraged to include information about quality improvement activities and clinical audits in the practice policy on managing health information. Ideally, express consent for these activities will be obtained upon patient registration.
Source:http://www.racgp.org.au/your-practice/standards/standards4thedition/practice-management/4-2/confidentiality-and-privacy-of-health-information/

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Checklist for Practices

• Our practice has Best Practice Software, Communicare, Genie, Medical Director, Medinet, Medtech32, MMeX, PractiX or Zedmed.
• I know what billing system we have installed.
• I am able to install software on the main computer, or server.
• If needed I know the password to install software on the server.
• I have the contact details of our IT person and if needed I can contact them to obtain passwords.
• If our IT contact is unavailable I understand that another call may be needed to
• If using Best Practice, I am aware that the database browser password may be required.

Important Phone Numbers

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Pen CS Support 1800 762 993 support@pencs.com.au help.pencs.com.au
Best Practice Support 1300 40 1111 www.bpsoftware.net support@bpsoftware.net
Communicare 08 6212 6900 communicare@healthconnex.com.au
Genie Solutions 07 3870 4085 support@geniesolutions.com.au
Zedmed 1300 933 000
Practix www.isofthealt.com
Medical Director 1300 788 802 www.medicaldirector.com
Medinet 1300 723 938
MMEx 08 6250 9170 info@isahealthcare.com
Medtech32 1800 148 165 support@medtechglobal.com

Ideally create this table in Excel and email to your PHN to have Topbar logins created.