The Life! App is a new application that provides an innovative way to determine a patient's eligibility for the Diabetes Victoria Life! program and have them enrolled within the program. 

  • The app's functionality includes a Cardiovascular Disease (CVD) risk calculation, an AUSDRISK calculation, and dynamic intervention options. 
  • The app checks the patient's details, including age, ethnicity, measurements, and clinical history, against three risk criteria to determine the patient's eligibility. The three criteria are related to age, Aboriginal or Torres Strait Islander background, cardiovascular disease absolute risk score, pre-existing conditions, and BMI. 
  • The app is equipped with a reset button that removes patient details from the app screen and a calculate button that computes the CVD and AUSDRISK risk scores, which are displayed in the middle panel. 
  • The final section of the app allows health providers to select one or multiple intervention options to promote health-related discussions and to provide medication and lifestyle recommendations based on the selected interventions. 
  • Finally, the app displays the risk criteria that are pertinent to the patient and allows health providers to open the Diabetes Victoria Life! Enrollment form to enroll the patient in the program.


Using the Life! App
When you open a patient in your clinical system, the Life! App will check the patient details (age, ethnicity, measurements, and clinical history) against the risk criteria provided by Diabetes Victoria and, depending on the patient, display the relevant eligibility criteria within the app. There are three possible criteria which determine a patients eligibility for participation in the program:
Risk Criteria 1:

  • ≥ 18 years and;
  • AUSDRISK ≥ 12 and;
  • BMI ≥ 25 kg/m2 (if patient is of Asian background a BMI ≥ 23 kg/m2)

Risk Criteria 2:

  • ≥ 45 years or;
  • Aboriginal or Torres Strait Islander ≥ 30 years and;
  • Cardiovascular disease absolute risk score ≥ 10%

Risk Criteria 3:

  • ≥ 18 years and;
  • One or more of the following pre-existing conditions –
    • CVD
    • CKD
    • GDM
    • PCOS
    • Pre-diabetes
    • Familial Hypercholesterolemia
    • Serum total cholesterol > 7.5mmol/L
    • Syst BP of ≥ 180 mmHg or Diastolic BP ≥110mmHg.


First Time Access
Open Topbar App home page and Select the Life! Program.




Once application is open, the Terms and Conditions will pop-up, once accepted the app will notify you of eligible patients when they are open in the CIS.


 

Overview of the Life! App



Details of the Life! App Functionality


CVD Risk Calculation
The top left section of the home page houses the patient details required for the Cardiovascular Disease (CVD) risk calculation.



Once consent has been provided by both health care provider and patient, these details will pre-fill from the opened Clinical Information Software (CIS) and patient clinical file.


List of Relevant Pre-Existing Conditions
This section is a static list of pre-existing conditions that form the majority of the third risk criteria, this is in the app for quick reference by the user.




Active Patient Diagnoses
This section is a dynamic list of diagnoses as per the selected patient's clinical file. This section should always show the active conditions a patient has in their file.



AUSDRISK Calculation
The final section on the left panel of the app home page is reserved for the AUSDRISK calculation. This is of course the Australian Type 2 Diabetes Risk Assessment Tool, and is comprised of a shot list of questions to assess the risk of developing type 2 diabetes over the next 5 years.



Where the information is available within the CIS it will be pulled into and pre-filled in the app.


The Buttons
The Reset button will wipe the patient details recorded from the app home page.



The Calculate button will take the information provided in both the CVD and AUSDRISK sections and calculate the risk scores respectively for both measures for display in the next panel over.


CVD Risk Score
The middle panel shows both CVD and AUSDRISK calculated risk scores. The CVD risk score is calculated as per the Australian Absolute Cardiovascular Disease Risk Calculator. It determines the patients risk as an individual of getting CVD.



The risk score visualized here in this section shows less than 10% as low risk, 10-15% as moderate risk, and 15% and above as high risk of developing CVD within the next 5 years.


AUSDRISK Score
The next section in this middle panel is reserved for risk score in relation to Type 2 diabetes as measured by AUSDRISK. This measure uses a combination of age, ethnicity, waist circumference and physical activity to develop a 5 year risk score for developing diabetes.



The scoring system for AUSDRISK is as follows; score of 5 or less is considered low risk (1/100 develop diabetes); 6-11 intermediate risk (1/50 develop diabetes) and; 12 and over as high risk (1/14 develop diabetes).


Dynamic Intervention Options
The final section of the app begins with some intervention options that dynamically interact with the medication and lifestyle recommendations section below it.



The app will allow the selection of one or multiple of the above intervention options to promote health related discussions between health provider and patient and exemplify the outcomes of this interventions on the patients health should they be followed.


Medication & Lifestyle Recommendations
The Medication and Lifestyle recommendations are based on the health interventions chosen by the provider/user. If no interventions are chosen, this section will remain blank. With each new intervention selected a new action item will populate.



For example, should a patient who smokes agree to try and quit, the provider would toggle on the "Stop Smoking" button, which will both adjust the risk score for the patient, and provide recommendations for the patient.
Under lifestyle it may suggest providing advice and pharmacotherapy for smoking cessation support.
While, under medication it would advise it's not necessarily widely recommended and may populate a reminder about withdrawal therapy for people who make profound lifestyle changes.


Risk Criteria Triggered
As mentioned at the start of this document there are three primary risk criteria that determine a patient's eligibility for enrolment in the Life! Program. Depending on which of the three are pertinent to the patient being seen, they will display towards the bottom of this right panel.



Should the patient be eligible for enrolment due to more than one criterion being fulfilled then the app will display each criteria triggered.


Patient Enrolment Form
Finally, should the patient be eligible and willing to take part, the health care provider can select the enroll button to open the Diabetes Victoria Life! Enrollment form.




The majority of information on this form can, and will, be pre-filled from the app to ensure no double handling in the process.
Once the provider and patient are both happy with the contents of the form the user can select the print option on the form. This will prompt a final challenge screen for the provider to pop-up and confirm patient consent has been provided. Once the check box is ticked the user can complete the workflow and save locally to send to Diabetes Victoria how they see fit (whether singly or in bulk).