data relevant changes to CAT Plus for March release publi

Item

Details of changes

CV Event Risk updates for revised NVDPA guidelines

The National Vascular Disease Prevention Alliance (NVDPA) has updated their guidelines for the calculation of the CV Event risk and PEN CS is adjusting the algorithms used in CAT Plus to the new guidelines and aligning the terminology. While we are implementing the change in algorithm, we also align the rounding used in PAT CAT and CAT4. The changes are mainly around patients with diabetes without a full set of measurements and the increased for older indigenous patients. The newly considered criteria are:

• Diabetes + ACR >= 2.5M, 3.5F
  
• eGFR < 45
  
• BP diastolic >= 110
  
• Indigenous Age > 74
  
  
  This change will affect the report in two ways:
  
  
• More patients will be included in the report as there are now additional criteria available
  
• More patients will be reported in the 16%-19% risk group who were previously reported in the <16% risk group.
  
  Full details on the latest guidelines can be found here: https://www.cvdcheck.org.au/australian-absolute-cardiovascular-disease-risk-calculator
  This change will affect the CV Event risk report in PAT CAT and CAT4.
  A recalculate of the CV Event risk report is required to apply the new algorithm to the report in PAT CAT. While we are implementing the change in algorithm we also align the rounding used in PAT CAT and CAT4.
  

Item

Details of changes

Indicated CKD Report update to include patients without a CKD diagnosis and with a eGFR < 60 and no ACR

Based on the guidelines in the 3^rd edition of the CKD management handbook available from the kidney foundation here:
https://kidney.org.au/health-professionals/prevent/chronic-kidney-disease-management-handbook
This change will increase the number of patients with indicated CKD as it will now include those patients with an eGFR <60. Prior to this change we only included patients with eGFR and ACR results, now we will include those with eGFR only provided the eGFR is <60. As we can't calculate the timing for the clinical action plan without the ACR we will display only the indicated stage of CKD without a colour indicating the urgency for the clinical action plan.

This change will affect the 'Indicated CKD with no diagnosis' under the 'Data Cleansing' reports in CAT4 and the 'indicated conditions' report in PAT CAT as well as the data cleaning app in Topbar.

Item

Details of changes

MBS Item Lists – add non VR Item numbersUnclear how to do this in NKPI/APCC reports as they only list standards

Medicare addeded new item numbers for non-vocationally registered GPs and PEN CS has addeded these item numbers to the existing medicare reports. These items are specific to non VR GPs and are not expected to have a large impact on numbers in MBS related reports.
Details of the new items:

• Diabetes_SIP added "259", "260", "261", "262", "263", "264"
  
• Health_Check added "224", "225", "226", "227"
  
• Asthma_COC added "265", "266", "268", "269", "270", "271"
  
• Mental_Health_Careplan added "272", "276", "277"
  
• RACF "183", "188", "202", "212"
  
• Telehealth added "812", "827", "829", "867", "868", "869", "873", "876", "881", "885", "891", "892"
  
• Indigenous HC (715) added "228"
  
• GPMP (721) added "229"
  
• TCA (723) added "230"
  
• GPMP/TCA Review (732) added "233"
  
• DMMR (900) added "245"
  
• RMMR (903) added "249"
  The changes will affect the MBS item report and MBS attendance filter groups in CAT4, the MBS item report in PAT CAT and the MBS app in Topbar.

Item

Details of changes

MBS Item Lists – add respiratory item numbers

Medicare has added new item numbers specific for respiratory care and PEN CS has added these items to the relevant reports. Some of the items are only relevant to specialist care, but some increase is expected in the MBS item report. The details of the new items are:
11503,11505,11507,11508,11512
The changes will affect the MBS item report in CAT4 and PAT CAT.

Deidentified extract will include data for patients that have been reviewed as not having an indicated condition

CAT Plus users can remove patients indicated with a chronic condition from the respective lists in CAT4 Cleansing reports or in the data cleansing app in Topbar. Until now these reviews were not included in the deidentified data uploaded to PAT CAT. With the latest update PEN CS is addressing this issue and the work done at the practice level will be reflected in the 'Indicated Diagnosis' PAT CAT report. Numbers are expected to drop for the five indicated conditions depending on the level practices have cleaned up their data locally.
The changes will affect the 'indicated conditions' report in PAT CAT.

MD Uncoded Diagnosis extraction will be removed.

Some data items for MD3 users were included in the deidentified upload to PAT CAT/PAT BI which stem from an old only partly implemented project. This has caused some confusion for our PAT BI users and it will be removed. No reports will be impacted as this was an incomplete and unsupported function.

Item

Details of changes

Respiratory meds -
Add Category Respiratory COPD Combination (ICS/LAMA/LABA)

The Asthma Council has added a new category for Asthma & COPD medications in 2018 (source https://www.nationalasthma.org.au/living-with-asthma/resources/health-professionals/charts/asthma-copd-medications-chart)
and PEN CS is aligning the respiratory medication filters and reports with this new category of medication. The new category is a combination of ICS/LAMA/LABA for COPD patients and it category includes generic fluticasone furoate/umeclidinium/vilanterol (Trelegy Ellipta).
This change will affect the Medication report and filter in CAT4 and PAT CAT.