Recipe Name:

QIM 9 – Cervical Screening

Rationale:

Australia has the lowest mortality rate and the second lowest incidence of cervical cancer in the world. The success of the cervical screening program is dependent upon the recruitment of women. Higher participation in cervical screening means that more women with precancerous abnormalities can have these detected and treated, which is necessary for achieving the overall aim of reducing incidence and mortality from cervical cancer.

Target:

Proportion of female regular clients who are aged 25 to 74, who have not had a total hysterectomy and who have had a cervical screening (HPV test) within the previous 5 years. Only HPV screening since 1/12/2017 will be considered for the PIP QI report.

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

CAT4 starting point


RECIPE Steps Filters:

  • In the “General” Tab, enter Start Age = 25 and End Age = 74


You can select the Gender/Female but the report will automatically show female patients as well as patients with no gender entered. This is the preferred approach, as it will include all potential patients.


  • In the 'Date Range Result' tab, select the custom date range starting on the 1/12/2017 and ending at the date of your extract



  • Click "Recalculate"
  • Click ‘Hide Filters’


Report Steps

  • Select the "Screening/Cervical Screening" tab

This report will show the selected patients and the proportion of patients without a test recorded and will allow you to measure improvement over time by comparing your reports:




Please note that you can't directly compare the percentages displayed in this report with the percentages in your PIP QI report. The PIP QI report doesn't include women who are not eligible or have opted out in the denominator, so you can only compare numbers, not percentages. Alternatively you can add the numbers for 'Not recorded' and 'HPV <= 5 years' & 'Pap <= 2 years' to get your denominator and then calculate the percentages based on that.



This report excludes patients with a number of conditions, including hysterectomy. Full details can be found here:

https://help.pencs.com.au/display/CG/Diagnosis+Codes+Screening+Tests

The report can also be exported to be sent to the national cancer register for bulk enquiries on patients cervical screening status.


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 CAT to Topbar

 To start click on the 'Daily View' icon on the top of your CAT4 screen:



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.