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Recipe Name:

QIM 1 – HBA1C status for patients with diabetes

Rationale:

Diabetes was the underlying cause of around 10% of all deaths in Australia in 2016 and recent reports show death rates for people with Type 2 diabetes are rising. As part of their care, people with Type 1 and 2 diabetes should have their glycosylated haemoglobin (HbA1c) measured at least every 12 months, or more frequently depending on the level of blood glucose control. Effective management of chronic disease can delay the progression of disease, improve quality of life, increase life expectancy, and decrease the need for high-cost interventions.

Target:

Proportion of regular clients who have Type 1 or Type 2 diabetes and who have had an HbA1c measurement result recorded at the primary health care service within the previous 12 months.

CAT Starting Point:

  1. CAT Open - CAT4 view (all reports) loaded
  2. Population Extract Loaded and Extract Pane “Hidden”
    1. Filter Pane open and under the ‘General’ tab ‘Active Patients’ (3x <2 years) selected

This recipe has two parts as the improvement measure is defined for patients with diabetes type I or type II. To achieve this we need apply to separate filters, one for each diagnosis. Please note that patients with 'undefined' diabetes or a free text diagnosis will not be included, so it is a good idea to clean up your diabetes register regularly. Here is a recipe that shows the steps: Clean up the diabetes register


CAT4 starting point

 

RECIPE Steps Filters:

  • In the “Conditions” Tab, under the Chronic category, select “Type I"  in the Diabetes category

 

Or select "Type 2" diabetes


Then select the 12 month date range result filter, to only show results that were entered in the last 12 months:


  • Click "Recalculate"
  • Click ‘Hide Filters’

 

Report Steps

  • Select the "Pathology/HbA1c" tab


The Pathology/HbA1c report will show the proportion of those without a result in the last 12 months (or longer) under the ‘No HbA1c Recorded’ category:

 


The HbA1c report will show you the numbers/percentage of your patients Hba1c status and will allow you to measure improvement over time by comparing reports. It will also allow you to see more details of those patients with a result by double clicking on a selected slice of the graph to see the patient details and measurements:

 


To Export Patient List to Microsoft Excel:

1.  Click on the “Export Icon”  at the top of the Patient Reidentification window.

2.  Click on “Excel”

3.   Choose a file name and a location to save to (eg. Create a folder C:/ClinicalAudit/CAT Patient FollowUp)

4.  Click “Save”

 

The steps above will produce a list of patients with contact details in MS Excel which can then be used to:

1.   Go back through the individual patient records in the GP Clinical Desktop System (CDS) and update known records

2.  Phone patients to update their record

3.  Produce a mail merge to recall patients for follow up

Optional: Use Recall CAT SMS and voice messages for patient recall


Full details are here: Recall CAT

After you have applied one or more filters and/or cross tabulations and have selected the group of patients of interest, you will see the choices for SMS Recall and other options at the bottom of the patient re-identification report. This can be applied to all of our CAT Recipes or any custom search you want to perform.

CAT Starting Point:
The Patient Reidentification window displays your list of filtered patients


Customising Steps


You can refine the selection manually by clicking the 'Refine Selection' button.



If you click on "SMS Recall", the "SMS Recall" window will be displayed with the name of your clinic. Enter a message that relates to the purpose of the notification. There are a number of options under the inclusion criteria:

  • Patients who have opted out of receiving SMS from your clinic are removed by default
  • Linking your online booking system to the SMS recall
  • Include the opt-out message in the SMS for patient to "STOP" receiving SMS notifications sent through CAT4

Clicking on "Send" will send the message to all patients with a valid mobile phone number in their record. A confirmation message will prompt you with the number of messages to be sent and the required credits. Click yes to send the SMS recall.



After sending a SMS or Voice Message you will see a message like this one (for SMS)




For full details on the prompt history, click on 'Prompts' and select 'SMS and Voicemail'



Recall CAT - Message History: http://help.pencs.com.au/display/CG/Recall+CAT+-+Message+History

Optional: Create a prompt to display in Topbar

 

Remember you need to be in the CAT4 Daily View to be able to create prompts. Other pre-requisites are:

  • Topbar is installed
  • CAT4 is linked to Topbar via Edit/Preferences/Topbar - check here for details: Linking CAT4 to Topbar

 To start CAT4 in the Daily View, click on the 'Daily View' icon in the dashboard:



Once you have applied the filter(s) and displayed the patients of interest as described above, you can create a prompt that will be shown to all clinicians using Topbar if a patient meeting the prompt criteria is opened in their clinical system. The full guide is available at CAT PLUS PROMPTS and a short guide on how to create prompts in CAT4 can be found at  Creating a Prompt in CAT4

To start you have to use the drop-down menu at the bottom of the patient details report and select "Prompt at Consult - Topbar" then click on "Go" to give the new prompt a name.

 


The name you enter is the prompt text displayed in Topbar, so choose a simple but clear name that tells the clinician seeing the prompt what should be done.