The indications tab will display notifications for four chronic conditions based on the following rules:

Indicated Diabetes with no Diagnosis

The "Indicated Diabetes with no Diagnosis" prompt will display the likelihood of Diabetes based on HbA1c, Anti-diabetic Medication and/or FBG being recorded in the patient record without a diagnosis:
•Red = likely
•Orange = possible
•Yellow = flag for review

Red: ANY of the following
•HbA1c >= 6.5
•OR HbA1c recorded AND on an Anti-diabetic Medication
•OR FBG > 7

Orange: ANY of the following
•HbA1c >6 and <6.5
•OR on an Anti-diabetic Medication excluding Metformin

Yellow : ANY of the following
•on Metformin


Medications need to be long term to be included.

 

Indicated CKD with no Diagnosis

The "Indicated CKD with no Diagnosis" prompt displays patients where the staging of CKD, as determined by the combined results of kidney function (eGFR) and kidney damage (the level of albuminuria using ACR), indicates the possibility of CKD.

Please note that currently only POST values for spirometry are taken into consideration in this report!



The report displays:

  • eGFR, ACR and the resulting Indicated Staging of CKD
  • Color code for the Clinical Action Plan to manage CKD
  • Other CKD Risk Factors

Patients on dialysis are displayed as 'level 5' CKD.


Red
•Clinical Action Plan to be monitored 1-3 monthly

Orange
•Clinical Action Plan to be monitored 3-6 monthly

Yellow
•Clinical Action Plan to be monitored 12 monthly

Indicated Mental Health with no Diagnosis

The "Indicated Mental Health with no diagnosis" prompt will display the likelihood of a Mental Health condition based on a mental health medication or a mental health care plan being recorded in the patient record without a diagnosis. Any mental health diagnoses included in the existing CAT4 reports/filters is considered regardless if the diagnosis is marked as active or inactive in the patient record.
•Red = likely
•Orange = possible

RED:
•Has a Mental Health Care Plan MBS Item number claimed (2700, 2701, 2715, 2717 or previous 2702 or 2710)

ORANGE:
•On a Mental Health Medication

 

Indicated COPD with no Diagnosis

The "Indicated COPD with no diagnosis" prompt will display the likelihood of COPD based on tiotropium medication or an adverse spirometry reading being recorded in the patient record without a diagnosis:
•Red = likely
•Orange = possible

RED:
• Spirometry of FEV1/FVC < 0.7 and FEV < 50% predicted (High risk)

ORANGE:
•Spirometry of FEV1/FVC < 0.7 and FEV >= 50% predicted (Low risk)
•OR On a LAMA/LABA Medication

Indicated Osteoporosis with no Diagnosis

The "Indicated Osteoporosis with no diagnosis" prompt will display when a patient meeting the criteria below is opened in the clinical system. The likelihood of the patient having osteoporosis rises from Yellow over Orange to Red as per the table below.

Red - Likely

•  Aged > 50 with a coded history of a Minimal trauma fracture)

•  On treatment and without a cancer diagnosis

Orange – Possible

•  On treatment (Medication)
and with a coded history of a Minimal trauma
fracture and with a cancer diagnosis

Yellow – Review

•  On treatment (Medication) and with a cancer diagnosis

The following medications are currently considered:

  • Bisphosphonates: alendronate, risedronate, zoledronic acid, pamidronate
  • Selective oestrogen modulating drugs: raloxifene
  • RANK Lipid Inhibitors: Prolia (brand)
  • Anabolic drugs: teriparatide or pamathyroid tumor hormone (1-34)
  • Others: stronitium ranelate



If a patient has new results such as pathology or medications that indicate the condition exists after a patient has been reviewed, the patient will appear again on the 'indicated condition' report. For example:

  1. A patient taking anti-diabetic medication since many years but the patient doesn't have diabetes and has thus been removed from the 'indicated diabetes without diagnosis' report and the respective Topbar prompt
  2. This patient has a FBG and/or HbA1c done and the values indicate that the patient might have diabetes, but no diagnosis is recorded.
  3. Now the patient appears again on the 'indicated diabetes without diagnosis' report and will receive the prompt in Topbar