User guide CAT4. Part 2 Functionality. Version 4.0 June 2015

Transcription

1 User guide CAT4 Part 2 Functionality Version 4.0 June 2015

2 Company Contacts Sydney (Head Office) Pen Computer Systems Level 1, 35 Moore St LEICHHARDT NSW 2040 Phone: Fax: enquiries@pencs.com.au Web: Document Contact Contact: Matthias Merzenich Document Manager Phone: matthias.merzenich@pencs.com.au Melbourne Office Pen Computer Systems Level 6, 3 Bowen Cres MELBOURNE VIC 3004 Phone: Fax: July 2015 PAGE 2 of 106

3 Document Control Version Date Modified By Description /02/2007 Christine Chidgey Initial /03/2007 John Johnson Review and Comment /03/2007 Christine Chidgey Add Appendices for Conditions and Medications Mappings /07/2007 Christine Chidgey Updates for revised functionality and screens /08/2007 Christine Chidgey Add Cardiovascular Risk Calculator /09/2007 Christine Chidgey Updates for revised functionality and screens /09/2007 Christine Chidgey Update version number to match chm file /03/2008 Christine Chidgey Additional information included in various sections Add Home Medicine Review Updates to Appendices /06/2008 Christine Chidgey Updates to HMR for 0 meds Updates for Version 2 release /06/2008 John Johnston Reviewed /06/2008 Tarkan Shahho Reviewed /09/2008 Christine Chidgey Updates for new functionality Immunisations Data Summary Report Cross Tabulation Report /09/2008 Christine Chidgey Add revised screen shots for new functions /10/2008 Christine Chidgey Updates for NPI Reports Clarification of BP results /12/2008 Christine Chidgey Updates for version 2.3 release and in particular to 1) add a Results Date filter 2) provide ability to save filter criteria 3) improve Diabetes SIP graphs /02/2009 Christine Chidgey The CAT4 User Guide has been split into 2 parts this is Part 2 which covers the functionality of the application. Updates for the APCC Report /03/2009 Christine Chidgey Check MBS 717 added for MD/Pracsoft3 users /04/2009 Christine Chidgey Pap Smear Summary Report Card /05/2009 Christine Chidgey The CAT4 User Guide Appendices B, C and D have been split out into separate documents. These Appendices cover the clinical Desktop System data mappings for Medical Director, Best Practice and Genie respectively. Waist, BSLF (renamed FBG) graphs added MBS Items graph added for MD/Pracsoft3 users Additional Mental Health conditions and medications added to Disease and Medications graphs. Refer to appendices for mappings /06/2009 Christine Chidgey Updates for new CV Risk Calculator 7 July 2015 PAGE 3 of 106

4 Updates for new logos on screens /07/2009 Christine Chidgey Rename BSLF graph to FBG (Fasting Blood Glucose) Appendix E has been added as a separate document covering the clinical Desktop System Zedmed data mappings /08/2009 Christine Chidgey Update MBS Linkages Reports to 2008/09 FY MBS Items not recorded graph added for MD/Pracsoft3 users Update support information /09/2009 Christine Chidgey Group some existing tabs to reduce scrolling Measures tab contains BMI, Weight, BP Pathology tab contains Lipids, egfr, MALB, HbA1c, FGB Updates to General Filter selections Add Alcohol ACR graph has been replaced by MALB egfr calculation has been changed Additional MBS Items have been added for MD/Pracsoft3 users Condition Drug Abuse has been added NPI CDM3 report has been amended in line with DoHA (BP cut-off of <=130/80) QAIHC Indicators report added for MD users /11/2009 Christine Chidgey New conditions added to filter and APCC Reporting: Peripheral Vascular Disease Carotid Stenosis Renal Artery Stenosis Chronic Renal Failure Immunisation chart for Swine flu /12/2009 Christine Chidgey Fix typo in CV Event Risk age range /02/2010 Christine Chidgey Update document template. Updates for new functionality: Tools menu option, Select All report option, Age bracket changes, Diabetes SIP worksheet improvements. 7 July 2015 PAGE 4 of 106

5 2.9 17/05/2010 Christine Chidgey Charts ACR, INR added Condition Atrial Fibrillation added MBS Item changes (45-49 tab has been removed) Timeline functionality Send Data To functionality /07/2010 Christine Chidgey Update the Ethnicity filter to include Not Recorded /09/2010 Christine Chidgey QAIHC Report is available for MD and BP users Filters General: add Medicare Number, Conditions: add extra Mental Health, Medications: add extra Mental Health and Respiratory Graphs add Spirometry Send Data To an additional option is available Saved Filters can set a default to be preloaded /01/2011 Christine Chidgey Rename Gardasil Immunisation to HPV Update the ACR graph information Add practix compatibility /07/2011 Christine Chidgey Add Communicare compatibility Add Medinet compatibility Updates for APCC revised screens New filters for last visit, activity, postcode and suburb Condition: Gestational Diabetes added Medication: Dabigatran added /11/2011 Christine Chidgey New Screening tab this includes subtabs for the screening of Cervical and Colorectal (Cancer: Pap Smear and FOBT respectively. The Pap Smear tab is unchanged but has been moved under the Screening tab. MBS Items added at 1 st Nov 2011 for GP Mental Health Careplan (2700, 2701, 2715, 2717) MBS Item for Respiratory added NT AHKPI report is available for all users and can be submitted to the Improvement Foundation portal /11/2011 Christine Chidgey National KPI report is available for all users and can be submitted to the Improvement Foundation portal. The IF data submission has moved to the main menu (from the APCC Report) Immunisations > Childhood Schedule has been added /02/2012 Christine Chidgey HMR tab has been removed. The Medications per Patient graph is now under the Medications tab. 7 July 2015 PAGE 5 of 106

6 Filters for musculoskeletal conditions and medications have been added. Additional Pain Relief medications have been added. New graphs/reports: Medications > Medications Not Printed in Last 6mths Musculoskeletal Risk Factors The Communicare Patient Status flag has been added to the General filter tab (Communicare Users only) /02/2012 Christine Chidgey Data Quality tab providing a clinical Data Self-Assessment (CDSA) tool funded by NEHTA comprises of a suite of graphs and reports relating to data completeness /03/2012 Christine Chidgey Patient name filter Patient Report for individual measures /06/2012 Christine Chidgey Extracting additional patients to meet reporting requirements refer under Reports section Patient status filter /7/2012 Christine Chidgey Updates to functionality for Last Visit filter, egfr and CKD graphs /9/2012 Christine Chidgey CVD Risk graph Updated to include 74+ age group Acknowledgement that the guidelines have been updated in 2012 Add Medtech Mappings Appendix Update the definition of a patient visit to clarify difference between clinical systems 3.5 7/11/2012 Christine Chidgey Add Maternal Health tab Add Visits tab MBS Add HKC item Updates to BMI, ACR /01/2013 Christine Chidgey Update egfr calculation from MDRD to epi as per Update HbA1c results to take account of the change in units to mmol/mol. CAT4 will continue to report % and will do a conversion where results are sent with the new units. Add Physical Activity graph under Measurements Remove NT AH KPI Report /3/2013 Christine Chidgey After Hours functionality Add Visits > Visit Type MBS items add AH Item numbers /5/2013 Christine Chidgey NKPI Report has been updated with the 2013 indicators 7 July 2015 PAGE 6 of 106

7 /6/2013 Christine Chidgey OSR Online Services report is available for all users and can be submitted to the Improvement Foundation portal. OSR Supporting graphs for Visits (Contacts and Episodes) and Antenatal Visits /8/2013 Christine Chidgey Ethnicity filter has been moved onto a its own filter tab Formatting changes to the FOBT summary report card BP data can be collected by location, where location is a prefix to the Patient Record No CAT Data Cleansing module has been added /01/2014 Chris Hardie Screenshots updated to reflect V3.8, all sections reviewed. The Diabetes SIP graphs have been updated to include egfr as the kidney function test measure The DVA filter has been enhanced to include the DVA Card Color /02/2014 Christine Chidgey Cleansing CAT - 3 new reports My CAT - a new view that allows users to customise their own Classic CAT views Spirometry graph has been updated to display measurement ranges using the FEV1/FVC ratio The After Hours Reports for Medicare Locals is available under the Visits tab Childhood Immunisations has been updated for the NIPS changes on 1st July 2013 see QRG Patient withdrawn consent (or opt-out) for sharing data can be flagged /02/2014 Christine Chidgey APCC Report includes new measures for CKD and CVD Immunisations Swine flu has been removed as this immunisation is no longer available as a single vaccine and is now included in the seasonal flu vaccine Immunisations HPV graph has been updated to include males as well as females /05/2014 Christine Chidgey ehealth tab provides information about PCEHR, IHI and Shared Health Summaries Indicator Sets ehealth report is available and can be submitted to the IF portal Registrar CAT module has been added 7 July 2015 PAGE 7 of 106

8 /06/2014 Christine Chidgey Mediflex Integration for billing (see Part 1) Cleansing CAT Medication review report Health Providers Report After Hours Reporting View Ethnicity tab Filter for Antidiabetic medications Filter for Risk Factors Immunisations updates /10/2014 Matthias Merzenich Updated Send-to functionality for PATCAT data Updated formatting /12/2014 Matthias Merzenich New online store functionality added New units for HBA1c added New filter for gestational diabetes added Childhood immunisations updated Password retrieval updated /03/2015 Matthias Merzenich NKPI essential immunisations worksheet description updated Extracting additional patients description updated to clarify Communicare extractor /03/2015 Matthias Merzenich New data security feature description added /06/2015 Matthias Merzenich Major update to new version CAT4 o revised document for company name and logo changes o new reports added o replaced screenshots to reflect UI changes 7 July 2015 PAGE 8 of 106

9 Contents 1 INTRODUCTION CLINICAL AUDIT TOOL (CAT4) USER GUIDE DEFINITIONS, ACRONYMS AND ABBREVIATIONS RELATED DOCUMENTS SYSTEM REQUIREMENTS, INSTALLATION AND CONFIGURATION CAT4 USER INTERFACE STARTING CAT PASSWORD RETRIEVAL THE CAT4 DASHBOARD NAVIGATING THE CAT4 USER INTERFACE SWITCHING VIEWS COLLECTING DATA WHAT DATA IS COLLECTED HOW IS THE DATA STORED DATA SECURITY AND ACCESS EXISTING DATA SET COMPATIBILITY WITH CHANGES TO CAT DATA FILTERING DATA FILTERING OVERVIEW CHANGING FILTERS CLEARING FILTERS DEMOGRAPHIC FILTERING Demographic Filter Mappings with clinical systems ETHNICITY FILTERING MEDICAL CONDITIONS FILTERING Medical Conditions Filter Mappings with clinical systems Pregnancy MEDICATIONS FILTERING Medications Filter Mappings with clinical systems DATE RANGE (RESULTS) FILTERING DATE RANGE (VISITS) FILTERING PATIENT NAME FILTERING PATIENT STATUS FILTERING PROVIDER FILTERING Method of assigning a patient to a provider RISK FACTORS FILTERING SAVING FILTER CRITERIA Creating a New Filter Name Loading existing filters Setting a default filter ANALYSING A DATA SET DATA SET RESULTS OVERVIEW July 2015 PAGE 9 of 106

10 6.2 DATA SET RESULTS GRAPHS AND REPORTS Demographics (and Bar Chart functions) Patient Reidentification Report Patient Consent Withdrawn Data Quality Patient Report Allergies (and Pie Chart functions) Allergies Mappings with clinical systems Ethnicity Smoking Smoking Mappings with clinical systems Alcohol Alcohol Mappings with clinical systems Measures BMI (Body Mass Index) Waist BP (Blood Pressure) Spirometry Physical Activity Pathology Lipids egfr (Estimated Glomerular Filtration Rate) ACR (Microalbumin Creatinine Ratio) MALB (Microalbumin) HBA1c FBG (Fasting Blood Glucose) RBG (Random Blood Glucose) INR (International Normalised Ratio) Creatinine Serum Disease Disease Mappings with clinical systems Screening Pap Smear Mammogram FOBT Co-morbidities Medications Diabetes SIP (Service Incentive Payment) Items Cycle of Care by Item Recorded/Remaining Cycle of Care by Items Completed Per Patient The Diabetes SIP Worksheet Diabetes SIP Mappings with clinical systems CKD (Chronic Kidney Disease) Musculoskeletal CV (Cardiovascular) Event Risk Immunisations Immunisations Mappings with clinical systems MBS Items MBS Eligibility Sexual Health Maternal Health Care July 2015 PAGE 10 of 106

11 Baby Birth Weight Antenatal Visits Visits Last Visit Assigned Provider Visit Types Episode Count Contacts by OSR Worker Type Age Gender Visit Count Disease Visit Count ehealth PCEHR Status PCEHR and SHS SHS Uploads SHS Age REPORTS STANDARD REPORTS APCC (Australia Primary Care Collaboratives) Report NPI (National Performance Indicators) Report Summary Report Card Mental Health (MH) Summary Report Card QAIHC Indicators Report Healthy For Life Report National KPI Indicators Report Collecting Additional Patients in CAT4 for Reporting OSR Online Services Report ehealth Report Health Providers Report CROSS TABULATION REPORT Clearing Report Selections HOW TO IMPROVE DATA QUALITY USING CAT PATIENTS WITH NO DATE OF BIRTH PATIENTS WITH NO GENDER PATIENTS WITH NO ALLERGY STATUS RECORDED PATIENTS WITH NO SMOKING STATUS RECORDED PATIENTS WITH INCORRECT DIABETES CODING TIMELINE SEND DATA TO FUNCTION CONFIGURING LOCATIONS ConImage Send by Configure Send by FTP Configure Send to PATCAT SENDING DATA CAT4 TOOLS MENU DE-IDENTIFY DATASET CHECK FOR UPDATES July 2015 PAGE 11 of 106

12 11.3 ADD GTAGS SEND DATA HISTORY EXPORT DATA FILE CAT4 VIEW OPTIONS CLEANSING VIEW REGISTRAR VIEW AFTER HOURS REPORTING MY CAT WIZARD APPENDIX A1 - GENIE DATA COLLECTION APPENDIX A2 PRACTIX DATA COLLECTION APPENDIX A3 MEDINET DATA COLLECTION APPENDIX A4 MMEX DATA COLLECTION July 2015 PAGE 12 of 106

13 1 INTRODUCTION 1.1 Clinical Audit Tool (CAT4) The Clinical Audit Tool (CAT4) analyses and reports on clinical information from GP clinical Desktop Systems. It translates data into real statistical and graphical information that is easy to understand and action. This allows practitioners to assess and improve both the quality and completeness of patient information. This benefits the practice by assisting with ongoing accreditation and providing opportunities to grow practice income. The emphasis of the tool is to enable practice staff to take specific action to improve patient coverage in chronic disease management and prevention. Other benefits of using CAT4 are many, and include: targeting patients with particular needs, targeting patients with specific health risk profiles, improving compliance with statistical data collection requirements, extracting data to meet a specific need, and meeting statutory reporting requirements. 1.2 User Guide The purpose of this document is to provide instructions on how to install and use the functionality provided by CAT4. The manual is split into 2 parts: Part 1: Installation and Configuration, including information on collect data sets Part 2: Functionality (This document) Notes about this User Guide This User Guide describes the use of the Pen CS Clinical Audit Tool with reference to the following clinical systems: Medical Director 3 clinical desktop system Best Practice clinical desktop system by Best Practice Software Genie clinical desktop system by Genie Solutions Zedmed clinical desktop system by Zedmed Medical Software Solutions practix clinical desktop system by isoft Communicare by Communicare Systems Medinet clinical desktop system by Abaki Medtech clinical desktop system by Medtech Global MMeX the web-based ehealth platform by ISA Healthcare Solutions The range of clinical Desktop Systems able to interoperate with the Pen CS Clinical Audit Tool is expanding all the time, additions will be made to this User Guide as this functionality becomes available. Not all reports/functions will be available for all clinical Desktop Systems as the level of data that can be extracted is not the same for all systems. 7 July 2015 PAGE 13 of 106

14 1.3 Definitions, acronyms and abbreviations Term Description ACR Microalbumin Creatinine Ratio APCC Australian Primary Care Collaboratives ATSI Aboriginal Torres Strait Islander BMI Body Mass Index BP Blood Pressure BP Best Practice BSLF Blood Sugar Level (Fasting) more commonly called FBG CAT4 Clinical Audit Tool CHD Coronary Heart Disease COPD Chronic Obstructive Pulmonary Disease CV Cardiovascular CVD Cardiovascular Disease DoHA Department of Health and Ageing DVA Department Veteran Affairs FBG Fasting Blood Glucose egfr Estimated Glomerular Filtration Rate HbA1c Haemoglobin A1c HDL High-density Lipoproteins HMR Home Medicine Review IF Improvement Foundation LDL Low-density Lipoprotein MD Medical Director NEHTA National E-Health Transition Authority NPCC National Primary Care Collaboratives NPI National Performance Indicators NVDPA National Vascular Disease Prevention Alliance Pen CS Pen Computer Systems PCEHR Personally Controlled ehealth Record QAIHC Queensland Aboriginal and Islander Health Council QRG Quick Reference Guide RACGP Royal Australian College of General Practitioners SHS Shared Health Summary as part of PCEHR SIP Service Incentive Payment 1.4 Related Documents Pen CS CAT4 User Guide Part 1 Installation and Configuration This User Guide provides instructions on how to use install and configure CAT4. All user guides are available from help.pencs.com.au/cat.htm 7 July 2015 PAGE 14 of 106

15 2 SYSTEM REQUIREMENTS, INSTALLATION AND CONFIGURATION These sections are included in the Pen CS CAT4 - User Guide Part 1 Installation and Configuration. 3 CAT4 USER INTERFACE Please refer to the Installation and Configuration guide available at help.pencs.com.au/cat.htm for details on how to install and configure CAT. 3.1 Starting CAT4 Once the CAT4 software has been installed it is available from your Programs List and as a short cut on the desktop. Click the Desktop Shortcut to start the program. Image 1: CAT4 icon OR Click Start > All Programs > Pen Computer Systems > Pen CS clinical Audit Tool 4 This will load the login screen Enter your Username and Password and click Login This will load the dashboard, allowing you to choose different views and other functionality. Please refer to the quick reference guide CAT4 Dashboard for full details Image 2: CAT4 Logon Screen 7 July 2015 PAGE 15 of 106

16 3.2 Password retrieval To access CAT4 you will need a valid licence. This may have been supplied by an organisation such as a Medicare Local/PHN or your practice might have purchased their own licence covering all users. Log on by entering the username and password in the respective fields and click on OK. Please note that both username and password are case sensitive. If you enter an incorrect password or username this message will be displayed: Image 3: Invalid Username/Password The Forgotten Password link on the logon screen allows you to reset your password via our web portal. Please note that we store password encrypted and are not able to provide you with your password the only option is to reset the password to a new one even if you call our support desk. The screen below will open in your web browser if you click the Forgotten Password link. Please follow the instructions to receive a new password by . This function requires your to be up to date please also check your junk folder for our reset . Image 4: Password Reset Request 7 July 2015 PAGE 16 of 106

17 Once reset you can log into our portal at any time to change the password to one of your preference. To log onto the portal you need to use this link: and log on with your CAT4 username and password. You will see your own account and other accounts in your organisation. Image 5: CAT4 User Portal As a basic user you can only change your own password by clicking on your username and then on the password tab on the following screen. As administrator you can change the passwords of other users at your organisation. Image 6: CAT4 Password Change 3.3 The CAT4 Dashboard With the release of CAT4 we have introduced a new feature called the dashboard. For a full overview of the dashboard please refer to the QRG CAT4 Dashboard at help.pencs.com.au/cat.htm The CAT4 dashboard provides a central screen to launch different new CAT4 modules, access aggregated data via PAT CAT (if participating), remote support and other functions. The dashboard also provides access to the MyCAT Wizard, which allows the creation of custom views. This new user interface element will improve performance and help users to focus on reports relevant to their role and clinical interests. 7 July 2015 PAGE 17 of 106

18 Image 7: CAT4 Dashboard Once you have clicked on the view you want to load, the CAT4 view will load. The screenshot below shows the Daily View as an example: Image 8: CAT4 Daily View 7 July 2015 PAGE 18 of 106

19 3.4 Navigating the CAT4 User Interface Click the View Extracts and the View Filter buttons to display all areas of the CAT4 user interface. The user interface is divided into 3 sections: Data Extracts (snapshots) collected for analysis (Left Hand Panel) Data Filters (Top Right Panel) Data Reports (Bottom Right Panel) Image 9: CAT4 User Interface It is recommended to hide the data extracts (Snapshots) and data filter (Filters) areas of the screen in order to make best use of your screen space to view the data results (Reports). You can toggle between the View/Hide modes at any time by clicking on the respective icon in the menu bar. Note: On first start-up, the report tabs will be empty as you have not yet collected data from your clinical desktop system or loaded an existing extract file. Image 10: Demographic Breakdown Before Collection 7 July 2015 PAGE 19 of 106

20 3.5 Switching Views From any view in CAT4 you can either 1) go back to the dashboard by using the dashboard icon and select a different view there, or 2) use one of the icons displayed in the menu bar to switch directly between the different views. The view you are currently using is shown with a black frame around the icon, in the example below this is Daily CAT Image 11: CAT4 Menu Icons 4 COLLECTING DATA NOTE: Before you start collecting data ensure you have set up your preferences to point to the correct clinical desktop system for your practice See User Guide Part 1: Setting Your Preferences for details about how to do this. A data set is collected by clicking the Collect button at the top left of the screen. Once you click the Collect button you will see the status bar in the top right hand corner of the screen flashing while the data is retrieved from the clinical desktop system. Genie, practix, Medinet and MMex users please note: data collection is performed from within the clinical application. Clicking the CAT4 Collect button at the top left of the screen will provide you with the summary steps on how this is done within your clinical application. Step by step details are provided in the appendix section of the mappings document for your clinical system. The data set collected is saved in your preferred data folder (see Setting Your Preferences for more information). When the data extraction has completed you will see an entry in the left hand column (Click the View Extracts button if the Snapshots panel is not visible). The data is now stored as an extract on your PC. You can use this snapshot for analysis at any time in the future and you can load older extract to investigate change over time. Note: Depending on the number of patients in your clinical desktop systems, data retrieval can take some time. A data set will be loaded automatically on completion of the data retrieval if the collection has occurred within CAT. Genie, practix, Medinet and MMex users will need to click on the required data set to load it. Tip: To refresh the list of snapshots toggle the Hide/View Extracts button. 7 July 2015 PAGE 20 of 106

21 Image 12: Collecting Data Sets Image 13: Data Set Entries Each data set entry displays the date/time of collection, the number of records retrieved, and the machine name on which the collection was performed. There is no limit to the number of data sets you can collect. Each data set will be listed as an entry in the left hand panel. To analyse a specific data set, click on the entry for that data set. It will become highlighted and you will see the status bar in the top right hand corner of the screen flashing while the data is reloaded from the snapshot into CAT What data is collected Data is only collected for patients who are active in your clinical system. Data for patients who are deceased or have been made inactive/archived is not collected unless it is required for reporting and the practice has specifically enabled this option (available for MD/BP only and done by default for Communicare and MMEx users). Therefore, when you are analysing your data using CAT4 you are only working with patients who are currently marked as active in your clinical system. If you find patients in CAT4 that you know are no longer active at your practice, you simply need to update them to be inactive in your clinical system; such patients will then be excluded from future data collections. 4.2 How is the data stored The collection process creates 2 xml data files which are encrypted and saved as a.dat file to the data folder as dictated by your system preferences. One file is pure clinical data and has no identifiable patient information. This is called the DATA file. This file can be made available in its xml file form by using the De-identify Dataset tool. The second file is the LINK file and contains all patient identifiable data. The LINK file is only used when you want to re-identify a list of patients that make up a segment of a graph. This file is never made available. 7 July 2015 PAGE 21 of 106

22 4.3 Data security and access To ensure data security and prohibit non authorised access to your private clinic data the extract data will be locked to authorised CAT4 users belonging to the originating clinic only. CAT4 will not allow users from other organisations to open a data file that was collected in your clinic only de-identified extracts can be opened by users from outside your organisation. This functionality was introduced to improve security and prevent access to patient data for anyone not working at the clinic where the data originated. 4.4 Existing data set compatibility with changes to CAT Updates to the CAT4 data set allow new filters and reports to be added. Older CAT4 extracts will not contain the required data needed to utilise these functions. You may still load older CAT4 extracts and analyse them as before, however functionality which requires data not included in these extracts will not be available and be greyed out in the interface. 7 July 2015 PAGE 22 of 106

23 5 DATA FILTERING 5.1 Data Filtering Overview Data filtering enables viewing graphs and reports based on specific criteria. The data filters are organised into a series of tabs: General (Demographics including Health Cover and DVA status) Ethnicity Conditions Medications Date Range (Results) Date Range (Visits) Patient Name Patient Status Providers Risk Factors Another tab is provided for you to save a specific set of filter criteria: Saved Filters To filter the data, simply select the criteria you wish to view. This is generally done by ticking selection boxes, however some filters are based on entering information such as a Postcode or Suburb. The criteria on which you are filtering is displayed at the top of the Results panel, this display remains even if the Filter panel is hidden. Click Recalculate. You will see the status bar in the top right hand corner of the screen flashing while the filtered data is reloaded from the snapshot into CAT4. This will update to Results panel to look at only patients that match all the conditions ticked. Example: Image 14: Filtering Example Examples for each of the filter types are provided in the following sections. 7 July 2015 PAGE 23 of 106

24 5.2 Changing Filters The Results panel is not updated to a change in filter criteria until you click the Recalculate button. The Recalculate label will turn red when the filter criteria have changed but the button has not been clicked Image 15: Recalculate Button Only after the recalculate button has been clicked will the Filtering By text be updated. The Filtering By text always matches the criteria for the data been displayed in the Reports pane, and will also display on any printed graphs and reports 5.3 Clearing Filters To clear filters that have been selected, either: Click the Clear Filters button in the top right hand corner of the screen, this will clear all currently selected filters. The Clear Filters dialogue box will appear. The Clear all Filter Selections will be pre-ticked. Click OK to continue. Image 16: Clear Filters Note: This dialogue box may also be used to clear any Report Selections that have been made. Refer to the Cross Tabulation Report section for details on this functionality. Or you can click the Clear button at the bottom right hand corner of each tab to clear only the filters for that tab. 7 July 2015 PAGE 24 of 106

25 Image 17: Clear General Button Make sure you click Recalculate when you have changed the filters. 5.4 Demographic Filtering Image 18: Demographic Filters Patient data can be filtered as follows: Gender Male Female Other No selection = All Note: Ticking multiple boxes will create an OR criteria (i.e. Male OR Female). 7 July 2015 PAGE 25 of 106

26 DVA DVA (Department Veteran Affairs) non DVA No selection = All Note: Ticking multiple boxes will create an OR criteria (i.e. DVA OR non DVA). Age DVA Card color can be selected from the drop down selection list 1. Enter a numeric start age or end age to limit your selection Choose Years (default) or Months as your search filter for start/end age. [Note: choosing Months will display the Demographics graph in months.] 2. No Age ticked will search for patients with a missing date of birth Health Cover Medicare No. Recorded Medicare No. Not Recorded No selection = All Last Visit The last visit date is the most recent date a patient contact has been recorded. Note that in some clinical systems it is not possible to distinguish a clinical contact from other notes made in the patient record. This will affect the quality of the data reported. Check the General Data Mappings Appendices for your clinical system. Values for selection are: Any = the last visit was at any time (all patients will be selected) None = no last visit is recorded <6 mths = has visited in the last 6 months <15 mths = has visited in the last 15 months <24 mths = has visited in the last 24 months <30 mths = has visited in the last 30 months Date Range with from/to date selection = only patients whose most recent visit occurred within a period of time. Patients with a visit after the to date will be excluded. The Date Range filter to note: The Date Range filter cannot be used to retrospectively look at the data in a snapshot. The snapshot is only valid for the point in time at which it was taken. For example: If you filter on last visit between 1 and 2 years ago you will be excluding patients you have had a visit more recently. These patients may or may not have had a visit in the period of time you are selecting. You will not be selecting all patients who visited within that period. 7 July 2015 PAGE 26 of 106

27 Activity Activity is how many patient visits (or contacts) have been recorded with the practice. Values for selection are: Active = has had 3 visits in the last 2 years (RACGP definition) Not Active = a patient not meeting the RACGP definition of active And/Or (Number of ) Visits in the last 6 mths Has not visited in the last X mths; where X can be selected via the drop down. Postcode Enter a 4 digit postcode (you can use * as a wildcard) or Multiple postcodes can be entered separated by a comma This filter allows you to select whether the list of postcodes is for Include in the filter Patients matching a postcode in the list will be selected Exclude from the filter Patients matching a postcode will not be selected The Exclude option allows practices to find patients that do not reside in their local area and may be transient. Suburb Enter a suburb The same options as for postcode apply to suburb Demographic Filter Mappings with clinical systems The demographic filter mappings are provided in the General Data Mappings Appendices for each clinical system. 5.5 Ethnicity Filtering Image 19: Ethnicity Filtering Patient data can be filtered as follows: Ethnicity Indigenous Aboriginal and Torres Strait Islander 7 July 2015 PAGE 27 of 106

28 Aboriginal Torres Strait Islander Non-indigenous Not Recorded No selection = All Note: Ticking multiple boxes will create an OR criteria (i.e. Indigenous OR Non- Indigenous; Aboriginal and Torres Strait Islander OR Aboriginal etc.) 5.6 Medical Conditions Filtering Conditions are divided into 3 tabs to allow for a greater number of conditions to be selected. These are Conditions Chronic Conditions Mental Health Conditions - Other Image 20: Medical Conditions Filtering Selecting Conditions by ticking the boxes will limit your data to look at only patients that match all the conditions ticked: Condition Yes, No, no selection = All Please note that the Gestational Diabetes filter will also identify patients where the conditions is marked as inactive as well as active in the clinical system. This enables you to produce a list of patients who have ever been diagnosed with gestational diabetes. Other condition filters will only filter for active conditions as diagnosed in the clinical system. You can select to filter by patients that Have a condition (tick the Yes box) Do not have a condition (tick the No box) If you tick one of the main condition headings (bolded) the sub-heading selections will not be available and all patients matching that broad condition category will be selected. 7 July 2015 PAGE 28 of 106

29 5.6.1 Medical Conditions Filter Mappings with clinical systems The conditions filter mappings are provided in the Conditions Data Mappings Appendices for each clinical system. Note that some conditions are flagged as true for a patient if the patient has ever had the condition i.e. the condition forms part of the patient history but is not currently listed as active (e.g. heart disease). Check the appendix for your clinical system for details about how different conditions are collected Pregnancy Pregnancy is included under the Conditions > Other filter. Ticking this as Yes will give you a list of the patients who are currently flagged as pregnant in the clinical system. Check the appendix for your clinical system for details about how this is checked. 5.7 Medications Filtering Medications are divided into 4 tabs to allow for a greater number of medications to be selected. These are Medications Heart Medications Respiratory Medications - Antidiabetics Medications Other Image 21: Medications Heart Filtering Selecting Medications by ticking the boxes Yes or No will limit your data to look at only patients that match the medication status selected: Medication Yes, No, no selection = All You can select to filter by patients that Have a current medication (tick the Yes box) Do not have a current medication (tick the No box) If you tick one of the main medication headings (bolded) the sub-heading selections will not be available and all patients matching that broad medication category will be selected. 7 July 2015 PAGE 29 of 106

30 5.7.1 Medications Filter Mappings with clinical systems The medications filter mappings are provided in the Medications Data Mappings Appendices for each clinical system. Medications are flagged as true if they are on the patient s current medication list. The collection process does not make any decisions about whether a medication should actually have been removed from the current medication list. The GP is responsible for making sure the list of medications is accurate. 5.8 Date Range (Results) Filtering Image 22: Results Filtering This filter allows the user to view the last recorded result that falls within a specified time period or date range. It is also applied to the MBS Items (item date) and Maternal Health Care (baby birth date). By selecting a date range from the choices below <= 6mths <=12 mths <=24 mths User defined range results that have not been measured within the selected period will be filtered out. Results outside the selected period are treated as Not recorded. This will give a more meaningful picture for charts like HbA1c where old results are generally not relevant. The filter is only applicable to some charts. Where the filter has been applied the chart title will include the selected period. For example, Image 23: Date Range Filter Display 7 July 2015 PAGE 30 of 106

31 5.9 Date Range (Visits) Filtering This filter allows to filter for patients that have visited in a specific time period. This filter will remove all patients that have not visited in the specified period for most reports. This filter will affect all reports with the exception of the standard reports such as APCC, NPKI, OSR and others. Image 24: CAT4 Date Range Visits Filter Unlike the Last Visit filter criteria on the General tab, this filter can be used to analyse data from patients that have visited at any period of time and will show data for those patients who have visited in the specified time only Patient Name Filtering The patient name filter allows you to search by first name and/or surname text 5.11 Patient Status Filtering This filter will only have available options if your extract contains patients that are archived or deceased. Refer to the CAT4 Extracting Additional Patients Quick Reference Guide available at help.pencs.com.au/cat.htm for information about this functionality Provider Filtering The provider filter allows you to filter patients by provider. This allows providers within your practice to drill down to their own patients. The provider filter tab displays a list of the practice clinicians with a provider number. You can filter by Practice all providers are ticked One or more providers tick those you wish to filter on and un-tick the No Assigned Provider box No Assigned Provider to find patients that are not assigned to any provider Providers with No Patients 7 July 2015 PAGE 31 of 106

32 There may be providers in your database that are not attached to any patients. For example, this can occur in MD when a patient is imported from another practice and the providers attached to the patient are imported as well to keep the patient history complete. Providers with no patients attached to them are hidden by default. The checkbox Hide Providers with No Patients is ticked by default. To see all Providers un-tick this box. Image 25: Provider Filtering The default for this filter is to filter by assigned provider, but this can be changed to filter by visits to any provider. If filtering for any visit to provider is selected the filter will display any patient with at least one visit to the selected provider. Image 26: Visit To Any Provider Setting Method of assigning a patient to a provider The method of Assigned Provider determination is provided in the Assigned Providers Appendix for each clinical application Risk Factors Filtering The Risks Factors Filter allows practices to filter for patients with risk factors: Smoking, Alcohol (Drinker and High Risk), Drug Abuse, Pregnancy and Obesity. In addition it allows filtering for patients with conditions that are associated with an increased risk of pneumococcal for immunisation purposes. The risk factors are defined as: Smoking daily or irregular smokers Alcohol drinker: drinks alcohol Alcohol drinker high risk: 2 or more drinks on a regular occasion or more than 4 drinks on any occasion Medication/Drug abuse coded diagnosis in patient record 7 July 2015 PAGE 32 of 106

33 Pneumococcal has a condition that requires immunisation is up to date please refer to the QRG on adult immunisation for full details. The guide is available at help.pencs.com.au/cat.htm Pregnancy has active pregnancy in clinical record Obesity BMI of 30 or more 5.14 Saving Filter Criteria The Saved Filters tab allows a set of filter criteria to be saved as a named search. Saved searches can be reloaded at a later time and rerun. This gives the ability for practices to run the same filters over intervals of time and against different data snapshots and compare results. A saved filter can also be set as the default and be automatically loaded each time CAT4 opens. Image 27: Saved Filters tab Creating a New Filter Name Initially the Saved Filters tab will be empty. To create a filter: Select some filter options eg. Active Patient with Diabetes The Save New Filter button will become available 7 July 2015 PAGE 33 of 106

34 Image 28: Save New Filter button Click the Save New Filter button The Filter Details dialogue box will open The filter options you have selected will be shown in the filter Description. Image 29: Filter Details - Description Fill in the Filter Name Image 30: Filter Details Filter Name entry Click OK The new filter name will now be listed on the Saved Filters tab 7 July 2015 PAGE 34 of 106

35 Image 31: Saved Filters tab with new saved filter The filter name can be changed using the Edit button. The filter can be deleted using the Delete button Loading existing filters To load a saved filter Click the Saved Filters tab Click on the filter name required The Filtering By details will be loaded into the other filter tabs and will display at the top of the Results panel The Recalculate button will turn red Click the Recalculate button to update the results pane. Image 32: Loading a saved filter Setting a default filter A saved filter can also be set as a default so it will be automatically loaded when CAT4 opens. From the Default Filter drop-down list choose the filter you would like to have preloaded. 7 July 2015 PAGE 35 of 106

36 Image 33: Selecting a default filter On reopening CAT4 the Default Filter is preloaded. If you wish to clear the preloaded filter click the Clear Filters button Image 34: The default filter is preloaded on opening CAT 6 ANALYSING A DATA SET 6.1 Data Set Results Overview Once you have selected your data set snapshot and your data filters click Recalculate. You will see the status bar in the top right hand corner of the screen flashing while the filtered data is reloaded from the snapshot into CAT4. Once this has finished you are ready to work with the data set of patients that match the selected conditions. The data set for this exercise has patients and has been filtered on Gender = Female and Condition = Asthma. 173 patients have been returned matching the filter. Example: Total Patients (7402), Filter (Female patients with Asthma), Selected Patients (379) 7 July 2015 PAGE 36 of 106

37 Image 35: Filtering a data set for analysis Click the View Population button at the top of the screen to get a list of the patients that have been selected in the currently filtered dataset. Image 36: View Population button This will display the Patient Reidentification Report with a list of patient details for the filtered population. Use the Export menu option to export the data to Excel format for follow up, if required. Note: The far right column on the Population list shows the patient s last visit date and assigned provider. 7 July 2015 PAGE 37 of 106

38 Image 37: Patient Reidentification Report for filtered population 6.2 Data Set Results Graphs and Reports Remember: Click the Hide Extracts and Hide Filter buttons to maximise the use of your screen for viewing results. The tabs along the top of the reports panel allow you to view various graphical representations of your data set. Image 38: Report Tabs With the introduction of CAT4 and the dashboard there are now different ways of customising the way CAT4 displays the reports. In the list below all available reports are detailed, but depending on the view you are using there will be less reports visible. To view all reports in the same order as below you will have to load the CAT4 view which shows every report tab. These are Demographics Ethnicity Data Quality (review patient data completeness and duplicate patients report) Data Cleansing o Missing Demographics o Missing Clinical/Accreditation Items o Indicated CKD with no diagnosis o Indicated Diabetes with no diagnosis o Indicated Mental Health with no diagnosis 7 July 2015 PAGE 38 of 106

39 o Indicated COPD with no diagnosis o Medication Review Allergies Smoking Alcohol Measures o BMI (Body Mass Index) o Waist o BP (Blood Pressure) o Spirometry o Physical Activity Pathology o Lipids (includes Cholesterol, HDL, LDL, Triglycerides, Total Chol/HDL Ratio) o egfr (Estimated Glomerular Filtration Rate) o ACR (Albumin Creatinine Ratio) o MALB (Microalbumin) o HBA1c o FBG (Fasting Blood Glucose) o RBG (Random Blood Glucose) o INR (International Normalised Ratio) o Creatinine Serum Disease (Count/Prevalence) Screening o Pap Smear (includes Recorded, Done Date and Summary Report Card) o Mammogram o FOBT Co-morbidities Medications o Count/Prevalence o Medications per Patient o Scripts Not Printed in Last 6mths Diabetes SIP (Service Incentive Payment) Items (includes Items Recorded, Remaining and Completed Per Patient) CKD Musculoskeletal CV (Cardiovascular) Event Risk Immunisations (includes Influenza, Adult, Adolescent and Child Schedule and a summary report) Standard Reports o Indicator Sets APCC (Australian Primary Care Collaboratives) Report QAIHC Report Healthy For Life National KPI OSR ehealth Health Care Providers o NPI (National Performance Indicators) o Summary Report Card o Mental Health Summary Report Card MBS items (includes Count, Not Recorded and After Hours Claims) Sexual Health (includes Chlamydia, Gonorrhoea, Trichomoniasis, Positive STI Follow up, Testing Patterns, Syphilis, HepB, HepC, HIV and STI Screening Report) 7 July 2015 PAGE 39 of 106

40 Maternal Health Care o Baby Birth Weight > Patient Record/Mothers Antenatal Record o Antenatal Visit > Date of First Visit/Number of Visits Visits o Last Visit o Assigned Provider o Visit Types o Episode Count o Contacts by OSR worker type o Age Gender Visit Count o Disease Visit Count ehealth (includes PCEHR Status, PCEHR and SHS, SHS Uploads and SHS Age) All views are of the filtered data set not the full data set, except for the Indicator Sets Reports. The Indicator Sets Reports specify which population they are reporting on. Note: Some views are automatically filtered further to suit the data being represented. The graph header or footer titles will specify the population that is displayed. For example, Pap Smear and Mammogram filters out gender=male CV Event Risk filters out age <45 (Non ATSI), <35 (ATSI), Condition=Cardiovascular disease (CVD) Immunisations > HPV filters out age< Demographics (and Bar Chart functions) Demographics displays your data set as a breakdown of males/females and age group. The data is displayed as a bar chart of the number of patients per age group. Age group defaults to years but can be changed to months by selecting Mths in the Age filter. Choosing to view demographics in months allows children to be targeted. 7 July 2015 PAGE 40 of 106

41 Image 39: Demographics Report The bar chart report provides the following features: Select All checkbox Show Total Counts checkbox (only available where counts are not shown by default) Age bracket selection box (only available for bar charts grouped by age) Print button Export button These are explained below. Select All checkbox click this checkbox to select all segments of the graph (legend is also selected) Image 40: Select All 7 July 2015 PAGE 41 of 106

42 Show Total Counts checkbox click this checkbox to display the count in each group. Image 41: Show Total Counts Age Bracket selection box this allows you to select an age bracket value between 1 and 10 years. The default value is 5 which displays ages grouped from 0-4, 5-9 etc. Changing this value, for example to 10, would display as below. The change is effected immediately on the chart. Image 42: Age bracket selection Print button click the Print button to print a copy of the graph. Export button this allows you to obtain a list of patients making up any segment of the bar chart. If you click on any segment of the bar chart it will become highlighted and the Export button in the right hand corner of the results panel will become active. You can select more than one segment of the graph. 7 July 2015 PAGE 42 of 106

43 Once a segment of the chart is highlighted, the Export button becomes active Image 43: Export Button Click the Export button to get a list of the patients that make up this group. This works the same way as the View Population button except that you not looking at the filtered population but are drilling down to a subset of only those patients selected on the graph. The Patient Reidentification Report window will pop up with a list of patient details. The specific values related to the report you choose will be provided in the last column. In the example below the HbA1c report was chosen and you can see the result and date it was taken in the last columns. This will be the same for all reports and can be very useful for reports in the clinic or to create your own graphs in Excel. Use the Export menu option to export the data to Excel format for follow up, if required. Image 44: Patient Re-identify Report for selected report segments 7 July 2015 PAGE 43 of 106

44 Patient Reidentification Report The Patient Reidentification Report allows you to identify a list of patient that make up the filtered population a segment of a pie or bar chart The last column of the report will give you information specific to the graph you are looking at, for example: population list will show you the patient last visit date demographics graph will show you age BMI graph will show you the BMI value The Refine Selection button lets you remove patients from the reidentified list for printing purposes. This is helpful if you wish to target a small number of patients for follow up and only wish to print those you are targeting: Click the Refine Selection button From the pop-up list of patients untick those you do not wish to target Click OK (the reidentified list has removed the unticked patients) Image 45: Refine Selection button 7 July 2015 PAGE 44 of 106

45 Patient Consent Withdrawn Patient consent withdrawn or patient opt-out for sharing data can be flagged within CAT4. This is set from the patient list and should be used where a patient has requested their data not be used for research purposes. It removes a patient s data completely from any de-identified data files that CAT4 creates. Refer to the CAT4 Patient Consent Withdrawn Quick Reference Guide for the steps to set this for a patient. This guide is available at help.pencs.com.au/cat.htm Data Quality The clinical Data Self-Assessment (CDSA) Tool has been developed to report on the completeness of patient demographic and health summary data within the general practice clinical system. It provides the following reports: Data Quality Dashboard Report to indicate the overall status of data quality based on the data indicators. Data Completeness Report to report the % of completeness for each data indicator. Data Completeness Patient Graph to provide a graphical view of the data indicators and allow reidentification of patients where data is missing. Duplicate Patients Report to list patient records within the clinical system where a duplication is suspected. A Quick Reference Guide for this new tab is available with the CAT4 User Documentation at help.pencs.com.au/cat.htm Patient Report This report details key health outcome measures for an individual patient. Click the Data Quality tab Click the Patient Data Report tab A patient list matching the filter criteria you have selected will be displayed 20 patients per page will be displayed Use the Prev Page and Next Page buttons to browse the list if it has more than 20 patients Select the patient from list and click the Patient Report button to display a report with the key health outcome measures for this patient The report is divided into 3 sections Clinical Data Items Medicare Items Diabetes Care Plan Items (this section will only be displayed if the patient has a coded diagnosis of Diabetes) The patient report is designed to be able to be de-identified by hiding the patient name and data values. The default settings are: o o Patient name this appears above the report and is not printed on the report Data values these are displayed as recorded/completed = yes/no ie. the data value details are not displayed Changing the report default display: The Show Name in Report button will toggle the name on in the report if you wish to have this information printed. 7 July 2015 PAGE 45 of 106

46 The Show Details in Report button will toggle the data values on in the report where they are available if you wish to have this information printed Data Cleansing The Data Cleansing Tab is a new tab in the CAT4 view but will be familiar to users of Cleansing CAT. It contains six report tabs: Missing Demographics Missing Clinical/Accreditation Items Indicated CKD with no diagnosis Indicated diabetes with no diagnosis Indicated Mental Health with no diagnosis Indicated COPD with no diagnosis Medication Review (for patients with diabetes) Please refer to the Cleansing CAT QRG for full details on each of the reports available at help.pencs.com.au/cat.htm Allergies (and Pie Chart functions) Allergies displays your data as a breakdown of allergy status: Allergy Recorded, No Known Allergies, Nothing Recorded. The data is displayed as a pie chart. The patient count in each allergy status group is displayed for each segment of the pie chart. 7 July 2015 PAGE 46 of 106

47 Image 46: Allergies Report The report provides the following features: Select All checkbox Show Percentage checkbox Print button Export button These are explained below Select All checkbox click this checkbox to select all segments of the graph (legend is also selected) Image 47: Select All Show Percentage checkbox click this checkbox to display the percentage in each group rather than the count. 7 July 2015 PAGE 47 of 106

48 Image 48: Show Percentage Uncheck this checkbox to display count. Print button click the Print button to print a copy of the graph. Export button if you click on any segment of the pie chart it will become highlighted and the Export button in the right hand corner of the results panel will become active. You can select more than one segment of the pie. 7 July 2015 PAGE 48 of 106

49 Highlighted segment of pie chart Export button active Image 6.2.2D Export Button Click the Export button to get a list of the patients that make up this group. (This works the same way as the View Pop. button except that you not looking at the filtered population but are drilling down to a subset of it.) This will pop up the Patient Reidentification Report with a list of patient details. The specific allergy value for each patient in the group selected will be provided in the last column. Use the Export menu option to export the data to Excel format for follow up, if required Allergies Mappings with clinical systems The allergies mappings are provided in the General Data Mappings Appendices for each clinical system Ethnicity Ethnicity displays your data as a breakdown of status: Aboriginal Torres Strait Islander Aboriginal and Torres Strait Islander Non-Indigenous Nothing Recorded 7 July 2015 PAGE 49 of 106

50 The data is displayed as a pie chart. Functions available are as described for Allergies Smoking Smoking displays your data as a breakdown of smoking status: Daily Smoker, Irregular Smoker, Ex Smoker, Never Smoked, Nothing Recorded. The data is displayed as a pie chart. Functions available are as described for Allergies at the beginning of this chapter Smoking Mappings with clinical systems The smoking mappings are provided in the General Data Mappings Appendices for each clinical system Alcohol Alcohol displays your data as a breakdown of alcohol status: Drinker, Non Drinker, Nothing Recorded. The data is displayed as a pie chart. Functions available are as described for Allergies at the beginning of this chapter. Alcohol level of risk is currently under discussion and will be added soon Alcohol Mappings with clinical systems The alcohol mappings are provided in the General Data Mappings Appendices for each clinical system Measures The Measures tab contains a number of reports on clinical measures normally recorded at the clinic. The recorded results can be picked up from the respective fields in the clinical system but not from free text progress notes. Please refer to the mapping guides for more information BMI (Body Mass Index) Measures > BMI displays your data as a breakdown of BMI status: Morbid Obesity (40+), Obese(30 to 40), Overweight(25 to 29.9), Healthy(18.5 to 24.9), Underweight(<18.5). The data is displayed as Count per age range in a bar chart Average BMI per age range in a bar chart with the healthy range indicated Incomplete where either of height, weight or height/weight are missing so BMI cannot be calculated Functions available are as described for Demographics (Bar Chart). 7 July 2015 PAGE 50 of 106

51 The Count on the Count graph will show you the total of the patients graphed this is the total number of patients where BMI has been able to be calculated. The Percentage equivalent of Count is displayed in brackets. Image 49: BMI Count of patients where data is complete BMI Mappings with clinical systems The BMI mappings are provided in the General Data Mappings Appendices under Measurements for each clinical system. BMI, where calculated from height and weight, will use the weight date as the measurement dates and requires that height has been recorded in the following timeframes: Age >= 18: Height/weight dates are within 5 years of each other At least one height recorded since age 17 OR At least one height recorded since age 25 Age < 18: Height/weight dates are within 1 year of each other Waist Measures > Waist displays your data as a breakdown of risk status. The risk ranges differ depending on whether you are measuring waist for risk of CVD or Diabetes. CAT4 provides 2 separate tabs: Waist > CVD Risk 7 July 2015 PAGE 51 of 106

52 Waist > Diabetes Risk Ranges: CVD Risk Male <93, , >102 Female <80, 80-88, >88 Diabetes Risk Non ATSI Male < 102, , >110 Non ATSI Female <88, , >100 ATSI Male <90, , >100 ATSI Female <80, 80-90, >90 and No Waist Recorded. Functions available are as described for Allergies at the beginning of this chapter Waist Mappings with clinical systems The Waist mappings are provided in the General Data Mappings Appendices under Measurements for each clinical application BP (Blood Pressure) Measures > BP displays your data as a breakdown of BP status: <=130/80, 130/80-140/90, >140/90, No BP Recorded. The data is displayed as a pie chart. Functions available are as described for Allergies at the beginning of this chapter. A patient s BP must have both systolic and diastolic values recorded on the same day to be valid. The most recent recording is used. If only one value is recorded this will be invalid and display in the No BP Recorded category. A patient s BP will be shown in the higher segment if either of the systolic or diastolic values is above the cut-off. Eg. a BP of 141/85 will end up in the >140/90 category BP Mappings with clinical systems The BP mappings are provided in the General Data Mappings Appendices under Measurements for each clinical application Spirometry Measurements > Spirometry displays your data as a breakdown of the ration FEV1/FVC. FEV1 is the forced expired volume in one second FVC is the forced vital capacity FEV1/FVC provides an index of airflow limitation; a value < 0.7 indicates limitation The breakdown is shown as FEV1/FVC < 0.07 FEV1/FVC >= July 2015 PAGE 52 of 106

53 Not recorded Spirometry Mappings with clinical systems The Spriometry mappings are provided in the General Data Mappings Appendices under Measurements for each clinical application Physical Activity Measurements > Physical Activity displays your data as a breakdown of patients with a physical activity status recorded and what level of activity they perform. The breakdown is shown as Sufficient Sedentary Insufficient Not recorded Physical Activity Mappings with clinical systems The physical activity mappings are provided in the General Data Mappings Appendices under Measurements for each clinical application Pathology Under this report a number of pathology results are listed. The data for these reports is commonly uploaded from the laboratory electronically to the clinical system and is extracted from there by CAT. Some results can be entered manually through specific fields in some clinical systems, for details please refer to the mapping guides for your clinical system Lipids Pathology > Lipids displays your data as a breakdown of: Cholesterol: <4.0, >4.0 and <=5.5, >5.5 and <=6.5, >6.5 and <=7.5, >7.5, No Cholesterol Recorded. HDL: <1.0, >1.0 and <=2.0, >2.0, No HDL Recorded LDL: <2.5, >2.5 and <=4.0, >4.0, No LDL Recorded Triglycerides: <2.0, >2.0 and <=4.0, >4.0, No Triglycerides Recorded Total Chol/HDL Ratio: <3.5, >3.5 and <5.0, >5.0, No Total Chol/HDL Ratio Recorded The data is displayed as a pie chart. Functions available are as described for Allergies at the beginning of this chapter. 7 July 2015 PAGE 53 of 106

54 Lipids Mappings with clinical systems The lipids mappings are provided in the General Data Mappings Appendices under Measurements for each clinical application. If there are results for Cholesterol, HDL, LDL and/or Triglycerides then the most recent values will be displayed. If there are results for HDL and cholesterol is recorded the most recent values will be used by CAT4 to display the Chol/HDL ratio. Where the LD results is missing CAT4 will calculate it if possible using the Friedewald equation: LDL cholesterol (mmol/l) = total cholesterol - HDL cholesterol - triglyceride/ egfr (Estimated Glomerular Filtration Rate) Pathology > egfr displays your data in mg/ml as a breakdown of: Stage 1: >= 90 Stage 2: >=60 to <90 Stage 3a: >=45 to <60 Stage 3b: >=30 to <45 Stage 4: >=15 to <30 Stage 5: <15 No Data The egfr value is obtained through pathology results or via calculation (see below). Where both are available the latest value is displayed in the graph. The data is displayed as a pie chart. Functions available are as described for Allergies at the beginning of this chapter. Calculation method: egfr (ml/min) is calculated using the CKD-EPI formula from serum creatinine measurement (in µmol/l), age and gender. This formula is where SCr is serum creatinine in mg/dl (convert from µmol/l to mg/dl by dividing by 88.4) k is 0.7 for females and 0.9 for males a is for females and for males min indicates the minimum of SCr/k or 1, and max indicates the maximum of SCr/k or 1 The CKD-EPI formula is for age >= 18. For children the Schwartz equation is used: GFR (ml/min/1.73 m2) = (0.41 x Height) / (Serum creatinine / 88)) 7 July 2015 PAGE 54 of 106

55 egfr Mappings with clinical systems The egfr and creatinine mappings are provided in the General Data Mappings Appendices under Measurements for each clinical application ACR (Microalbumin Creatinine Ratio) Pathology > ACR displays your data as a breakdown of: <2.5 Male (Normal) <3.5 Female (Normal) Male (Microalbinuria) Female (Microalbinuria) >25 Male (Macroalbinuria) >35 Female (Macroalbinuria) No Gender No Data ACR is either collected directly or is calculated as ACR (mg/mmol) = microalbumin (mg/l) / urinary creatinine (mmol/l) where microalbumin and urininary creatinine have the same date The data is displayed as a pie chart. Functions available are as described for Allergies at the beginning of this chapter ACR Mappings with clinical systems The ACR. microalbumin and urinary creatinine mappings are provided in the General Data Mappings Appendices under Measurements for each clinical application MALB (Microalbumin) Pathology > MALB displays your data as a breakdown of: <= 15 mg/l > 15 mg/l No Data The data is displayed as a pie chart. Functions available are as described for Allergies at the beginning of this chapter MALB Mappings with clinical systems The microalbumin mappings are provided in the General Data Mappings Appendices under Measurements for each clinical application 7 July 2015 PAGE 55 of 106

56 HBA1c Pathology > HBA1c displays your data as a breakdown of HBA1c status: Due to the current transition to new units both ranges will be displayed on the graph, the mmol/mol will be displayed in brackets: % ranges Mmol/mol ranges <=7 <=53 >7 and <=8 >53, <=64 >8 and < 10 >64, <86 >= 10 >=86 The data is displayed as a pie chart. Functions available are as described for Allergies at the beginning of this chapter. Details on the change of HbA1c units from percentage to mmol/mol can be found on page 6 of the guidelines for Diabetes Management available at The CAT4 HbA1c graph will now report both % and mmol/mol. The MD and BP extractors will extract both units and the most recent result will be used. A conversion to the alternative units will be implemented using the conversion algorithm below: Conversion from the old to the new units is as follows: HbA1c (mmol/mol) = 10.93(A1c% ) Other graphs/reports that currently report in % will continue to display the % value. The % sign will be included for clarity about which units are being reported The most recent result will be used and a conversion back to % will be applied if the most recent result is in mmol/mol HbA1c Mappings with clinical systems The HbA1c mappings are provided in the General Data Mappings Appendices under Measurements for each clinical application FBG (Fasting Blood Glucose) Pathology > FBG displays your data as a breakdown of FBG status: <5.5, , > 7.0, No FBG Recorded. The data is displayed as a pie chart. Functions available are as described for Allergies at the beginning of this chapter FBG Mappings with clinical systems The FBG mappings are provided in the General Data Mappings Appendices under Measurements for each clinical application. 7 July 2015 PAGE 56 of 106

57 Note: Medical Director sometimes refers to FBG as BSLF (Blood Sugar Level Fasting) RBG (Random Blood Glucose) Pathology > RBG displays your data as a breakdown of RBG status: <7.8, , > 11.2, No RBG Recorded. The data is displayed as a pie chart. Functions available are as described for Allergies at the beginning of this chapter RBG Mappings with clinical systems The FBG mappings are provided in the General Data Mappings Appendices under Measurements for each clinical application INR (International Normalised Ratio) Pathology > INR displays your data as a breakdown of INR status: <1.5, , , , >4.0, No INR Recorded. The data is displayed as a pie chart. Functions available are as described for Allergies at the beginning of this chapter INR Mappings with clinical systems The INR mappings are provided in the General Data Mappings Appendices under Measurements for each clinical application Creatinine Serum Pathology > Creatinine Serum displays your data as a breakdown of Creatinine Serum levels: <45, >=45 and <60, >= 60 and <= 90, >90 and <= 110, >110 and No Creatinine Serum Recorded. The data is displayed as a pie chart. Functions available are as described for Allergies at the beginning of this chapter Creatinine Serum Mappings with clinical systems The Creatinine Serum mappings are provided in the General Data Mappings Appendices under Measurements for each clinical application. 7 July 2015 PAGE 57 of 106

58 Disease Disease is displayed as a count (the number of patients that have the disease) and the prevalence in the population. The Disease Prevalence is calculated by identifying the number of patients with a specific disease diagnosis and expressing it as a percentage of the total population. The disease categories are the same as the conditions provided in the conditions filter (except for some Mental Health Conditions). The data is displayed as: Count per condition in a bar chart Prevalence per condition as a percentage of this population in a bar chart A bar is also provided on the chart for patients that have None of these disease categories. This is provided to assist practices in targeting patients for preventative care and miscoding. Functions available are as described for Demographics (Bar Chart). Image 50: Disease Report Disease Mappings with clinical systems The conditions (disease) mappings are provided in the Conditions Data Mappings Appendices for each clinical system. 7 July 2015 PAGE 58 of 106

59 Note that some conditions are flagged as true for a patient if the patient has ever had the condition ie. the condition forms part of the patient history but is not currently listed as active (eg. heart disease). Check the appendix for your clinical system for details about how different conditions are collected Screening General Practice Victoria has developed an electronic decision support (EDS) tool for the identification of patients who meet the criteria for the screening of Cervical Cancer, Breast Cancer and Colorectal Cancer. This tool will be available in early December 2011 via the PrimaryCare Sidebar and will provide point of care screening prompts for the three identified cancer screening groups and the recording of screening details where those details are not held in the GP CIS (i.e. Mammogram date and result). CAT4 provides population based reporting for the tool under a new Screening tab which contains three sub tabs for the various screening sections. These are: Pap Smear Mammogram (only available with compatible PrimaryCare Sidebar functionality) FOBT A Quick Reference Guide for this new tab is available with the CAT4 User Documentation at help.pencs.com.au/cat.htm Pap Smear The pap smear tab automatically filters out the male population. The population Image displayed on this tab is the number patients in your filtered dataset with gender female or other. Pap Smear displays your data as a breakdown of: Pap Smear Recorded: Pap Smear Recorded, No Pap Smear Recorded, Ineligible*. Pap Smear Done Date (where Pap Smear Recorded): <1yr, 1-2yrs, 2-3yrs, 3-4yrs, >4yrs and in a report format: Pap Smear Summary Report Card this is explained below. This report is always derived from your full dataset not you filtered dataset. The data is displayed as a pie chart. Functions available are as described for Allergies at the beginning of this chapter. * The pap smear category of Ineligible includes patients who are flagged in the clinical system as not requiring a pap smear or who have a coded condition recorded that excludes them (eg. hysterectomy). Check the pap smear mappings for your clinical system Pap Smear Summary Report Card The Pap Smear Summary Report Card is an initiative of the SA Cervix Screening Program (SACSP) to improve the management of clinical information related to cervical screening and support increased participation of women in screening. 7 July 2015 PAGE 59 of 106

60 It provides a report of eligible females aged 18-70, categorised by: Females with a last visit < 36 mths Active Females Not pregnant, Pregnant and Total Each category is broken down into subcategories by how long ago the last pap smear was recorded. The subcategories match the pie chart breakdowns provided allowing patients for follow up to be targeted. Not Recorded 4 years ago 3-4 years ago 2-3 years ago 1-2 years ago < 1 year ago Within each subcategory there is a further breakdown by age range: 18-29, 30-39, 40-49, 50-59, Total Count and Percentage is provided for each report line item. Percentage at the subcategory level is against the category total. Percentage at the age range level is against the subcategory total Pap Smear Mappings with clinical systems The pap smear mappings are provided in the General Data Mappings Appendices for each clinical application Mammogram The Mammogram tab provides: Mammogram Last Recorded A pie chart displays the % of patients with a Mammogram Last Recorded in the following categories: 0-2 years, >2-3 years, >3-4 years,> 4 years, Not Recorded, Ineligible*. Mammograms for this graph are retrieved from electronic results and from completed prompts in the PrimaryCare Sidebar. Electronic results have been sent to GPs who have patients screening at BreastScreen Victoria Clinics since October 2011 and it is hoped other States will follow with this functionality. * The Mammogram category of Ineligible includes patients that are no longer required to have a Mammogram because they have a coded condition that implies exclusion. Check the mappings for your clinical system FOBT The FOBT (Faecal occult blood test) tab provides 2 subtabs: FOBT Last Recorded A pie chart displays the % of patients with a FOBT Last Recorded in the following categories: 0-2 years, >2-3 years, >3-4 years,> 4 years, No FOBT Recorded, Ineligible*. FOBT Orders and results 7 July 2015 PAGE 60 of 106

61 A pie chart displays the % of patients who are required to have an FOBT test (i.e. are not ineligible) and have had an FOBT test order or result in the last 12 months in the following categories: FOBT Order and result - an FOBT test result has been received in the last 12 months with an order recorded within 6 months prior FOBT Order only - an FOBT order has been recorded but no result has been received FOBT Result only - an FOBT order has been received but no order is recorded This graph allows the clinician to follow up patients who have had an order placed but where a result has not been received. * The FOBT category of Ineligible includes patients that are no longer required to have an FOBT test because they have a coded condition that implies exclusion. Check the mappings for your clinical system FOBT Mappings with clinical systems The FOBT smear mappings are provided in the General Data Mappings Appendices for each clinical application Co-morbidities This report shows patients with at least one of the following conditions: Diabetes Respiratory Cardiovascular Musculoskeletal Renal Impairment Mental Health The data is displayed in a pie chart and lists patients with 1, 2, 3, 4 and more than 4 conditions. When part of the graph is selected, the Worksheet button in the top right corner provides patient details and which conditions they have been diagnosed with. 7 July 2015 PAGE 61 of 106

62 Image 51: Co-morbidities Pie Chart Image 52: CAT4 Co-morbidities Worksheet This report uses the same rules for disease mapping as the Disease report Medications All reports under the medications tab are based on current (active) prescriptions in the clinical system. Not all medications are listed and CAT4 groups some medications by name and/or class. Some medications are listed 7 July 2015 PAGE 62 of 106

63 individually (Aspirin, Warfarin) but include generic and brand names. Please refer to the mapping guides for your clinical system for more details Medications count per category Medications is displayed as a count by medication category (of patients that are currently taking a medication in the category) and the prevalence in the population. The Medication Prevalence is calculated by identifying the number of patients taking a specific medication category and expressing it as a percentage of the total population. The medication categories are the same as the medication groups provided in the medications filter (except for some Mental Health Medications). The data is displayed as: Count per medication category in a bar chart Prevalence per medication category as a percentage of this population in a bar chart A bar is also provided on the chart for patients that have None of these medications categories. This is provided to assist practices in targeting patients for preventative care and miscoding. Functions available are as described for Demographics (Bar Chart) Medications count per patient The Medications Per Patient tab displays the current medication status as a breakdown of the number of medications per patient: 0, 1, 2, 3, 4, 5, 6, 7, 8+. The number of medications is simply a count of the medications listed as current for the patient Medications Not Printed in Last 6mths The displays the number of scripts per patient that have not been printed in the last 6 months i.e. that may be out of date. Functions available are as described for Allergies at the beginning of this chapter. Exporting the data to a patient list from this tab will show you exactly how many medications a patient is on. Exporting this list to Excel will allow you to sort the data by medication count, allowing you to target patients on the greatest number of medications Medications Mappings with clinical systems The medications mappings are provided in the Medications Data Mappings Appendices for each clinical application. Medications are flagged as true if they are on the patient s current medication list. The collection process does not make any decisions about whether a medication should actually have been removed from the current medication list. The GP is responsible for making sure the list of medications is accurate. 7 July 2015 PAGE 63 of 106

64 Diabetes SIP (Service Incentive Payment) Items The Diabetes SIP graph is not automatically filtered by the patients with Diabetes. To review your Diabetes SIP items you need to first filter on Condition = Diabetes. The filtering is not done automatically as some of the items may be of interest for the wider patient population eg. CHD patients who have not had a BP in the past 6 mths. Diabetes SIP displays your data as a breakdown of diabetes care items: HbA1c Eye Exam BMI < 6mths, BMI 6-12 mths Blood pressure (BP) < 6mths, BP 6-12 mths Foot Exam < 6mths, Foot Exam 6-12 mths Cholesterol Triglycerides HDL Microalbuminuria Smoking egfr The data is displayed as: Count of Patients with Care Item Recorded in the Last x Months Count of Patients with No Care Item Recorded in the Last x Months (ie. Items Remaining) Count of Items Completed per Patient where x is the number of months within which an item is required to be recorded (6, 12 or 24 months) Image 53: Diabetes SIP Items Report NOTE: Old Extract files did not contain data for BMI, BP and Foot Exam recorded in the last 6-12 months. Where these are loaded CAT4 will display a message to alert the user that the extract file they are viewing does not contain the data elements in the last 6-12mths. The bar segments of the chart for these data elements will always be empty and show 0. 7 July 2015 PAGE 64 of 106

65 Cycle of Care by Item Recorded/Remaining The Items Recorded and Items Remaining graphs will help you to identify by item the areas of care that still need to be recorded for a patient. Functions available are as described for Demographics (Bar Chart) Cycle of Care by Items Completed Per Patient The Items Completed per Patient graph provides a view by patient of items that have been completed or not. Functions available are as described for Demographics (Bar Chart) but the Export button is renamed Worksheet for this graph as it gives a different style of re-identify report. Please note that you have to have at least one part of the graph selected to use the worksheet The Diabetes SIP Worksheet Image 54: Diabetes SIP Worksheet button From the Items Completed per Patient graph, click the Worksheet button to get a list of the patients in any segment(s) of the graph and view the list as a Diabetes SIP Worksheet. The worksheet reports which items have been completed for a patient. For completed items it reports in the item column either the value of an item where it can, or 7 July 2015 PAGE 65 of 106

66 a tick ( ) where no value is available (eg. smoking). In this example we have picked patients that have 11 and 13 items completed. Image 55: Diabetes SIP Worksheet NOTE: Old Extract Files will only have a possible maximum of 10 items counted. BMI, BP and Foot items in the last 6-12mths have not been collected. When claiming a SIP payment you should always check all requirements have been met in your clinical software system Diabetes SIP Mappings with clinical systems The Diabetes SIP mappings are provided in the Diabetes SIP Data Mappings Appendices for each clinical application. 7 July 2015 PAGE 66 of 106

67 CKD (Chronic Kidney Disease) The Victorian Department of Health, the Victorian Renal clinical Network, Kidney Health Australia and Western Health together with General Practice Victoria (GPV) have funded enhancements to CAT4 to support 1) the management of kidney disease patients and 2) early identification of at risk kidney disease patients. This has resulted in a CKD tab being added to CAT. The CAT4 CKD tab provides 2 graphs: CKD Management This graph is designed to enable practices to manage their patients who have been diagnosed with CKD. It displays the status of the clinical items that need to be reviewed for these patients, allowing clinicians to follow up on items that are outstanding or not at target. A worksheet provides a report of all the management items for the target population CKD AT Risk This graph is designed to enable practices to identify their patients who are at risk of CKD. It excludes patients who are already diagnosed with CKD. It displays the status of the CKD risk factors for patients who have one or more risk factors, allowing clinicians to recall patients with high risk levels or multiple risk factors. A worksheet provides a report of all the at risk factors for the target population. More information about this graph is provided in the CKD Management and Risk Quick Reference Guide available from help.pencs.com.au/cat.htm Musculoskeletal The Musculoskeletal > Musculoskeletal Risk Factors graph provides a graph of Musculoskeletal Risk Factors. These are: Low BMI, Vitamin D deficiency, Smoking, High alcohol intake, Calcium deficiency, Fracture (minimal trauma), Chronic kidney disease, Multiple myeloma Selecting all segments of the graph and exporting to the reidentified patient list will provide a worksheet with details of which risk factors each patient has. This graph along with the new musculoskeletal condition and medication categories will allow patients at risk to be identified for follow up: Patients who have musculoskeletal risk factors and are not on a musculoskeletal medication Patients who have musculoskeletal diagnosis and are not on a musculoskeletal medication 7 July 2015 PAGE 67 of 106

68 CV (Cardiovascular) Event Risk The CV Event Risk graph displays your data as the % risk of a Cardiovascular Event in 5 years time. It is a guide only based on population health statistics and is useful for clinicians to gain a high level view of patients who are at risk for surveillance. It is derived from the publication "National Vascular Disease Prevention Alliance. Guidelines for the management of absolute cardiovascular disease risk. 2012" which is available from the websites of the members of the National Vascular Disease Prevention Alliance (Heart Foundation, National Stroke Foundation, Diabetes Australia and Kidney Health Australia). About the Guidelines The National Vascular Disease Prevention Alliance (NVDPA) 1 Guidelines for the management of absolute cardiovascular disease risk has been developed through an evidence and consensus-based approach, and has received endorsement from the National Health and Medical Research Council. The National Health and Medical Research Council approved guidelines build on the cardiovascular disease (CVD) risk assessment guidelines, which introduced a new way of calculating CVD risk for people in Australia, released in Absolute cardiovascular risk assessment, using the Framingham Risk Equation to predict risk of a cardiovascular event over the next 5 years, should be performed for all adults aged over 45years without existing CVD or not already known to be at increased risk of CVD. Commence assessment in Aboriginal and Torres Strait Islander adults at 35 years. In the guidelines, absolute risk is defined as the numerical probability of a cardiovascular event occurring within a 5- year period. This is a more accurate prediction of a person s individualised risk of CVD, compared with traditional methods based on single risk factor assessments (e.g. high cholesterol, high blood pressure etc). This release represents an important step towards improving health outcomes by establishing a more integrated approach to cardiovascular disease prevention and management in Australia. clinical decisions based on absolute CVD risk will help direct lifestyle advice and medicines to those who have the most to benefit. Health professionals can access a range of related resources at : including the CVD online risk calculator. 1 The National Vascular Disease Prevention Alliance (NVDPA) includes the Heart Foundation, National Stroke Foundation, Kidney Health Australia and Diabetes Australia. 7 July 2015 PAGE 68 of 106

69 The Framingham Risk Equation (FRE) The FRE predicts the risk of a cardiovascular event over the next 5 years. The calculation can be found in the Absolute CVD Risk Resources provided at the website. The calculation excludes patients who have: Age: Non ATSI <45 or >74*, ATSI <35 or >74* Condition: CVD * Risk for patients who have age>74 is calculated using age=74. The data items used in the calculation are: Age Gender Systolic BP (mm Hg) Total Cholesterol (Mg/dL) HDL (Mg/dL) Smoking Status (Smoker/Non-smoker) Diabetes ECG-LVH (always set to 0) 2 CV Event Risk displays your data as a breakdown of the % 5 Year Risk of a Cardiovascular Event: >=30%, 25-29%, 20-24%, 16-19%, 10-15%, 5-9% and <5%. The data is displayed as Count per age range in a bar chart Chart functions available are as described for Demographics (Bar Chart). The graph provides a total population number (the filtered population) and an eligible population number. The eligible population is the number of patients in your filtered dataset that can be assessed for risk i.e. patients that do not fall into one of the excluded groups. The Count on the Count graph will show you the total of the patients graphed this is the total number of patients where CV Event Risk has been able to be calculated. The eligible population graph count = patients with incomplete data where no risk can be calculated. These patients are displayed on the second tab. In the example below there are 2802 patients eligible with 1300 displayed out of a total of ECG-LVH: ECG (Echocardiogram) is a test and LVH (Left Ventricular Hypertrophy) is a condition that is detected by this test. If LVH is detected as definite this value in the FRE is set to 1, otherwise it is set to 0. Currently the outcome of this test is not recorded as a coded value in the clinical software packages and therefore cannot be extracted. Hence, this value is always set to 0. 7 July 2015 PAGE 69 of 106

70 Image 56: CV Event Risk Report By selecting the high risk sections of the bar chart and clicking the Export button a list of the patients that make up this group can be obtained. This provides valuable information for practice staff working to improve chronic disease management and prevention. The information can also, for example, be used to substantiate the year old health check. Within the eligible population a patient may have incomplete results for the data items used in the calculation. The % risk therefore cannot be calculated for these patients. This data is displayed under the tab patients were excluded, out of those 219 because they already were diagnosed with a CVD patients had incomplete date for the risk calculation which together with the 1300 displayed on the previous graph adds up to the total of 2802 eligible patients. 7 July 2015 PAGE 70 of 106

71 Image 57: CV Risk Excluded and Incomplete Incomplete data This horizontal bar chart helps practice staff improve their data quality by identifying patients with missing data. The Export button can be used for this purpose as described above. Excluded data The number of patients that have been excluded is provided in order of exclusion category: <35 (<45 non ATSI), CVD. Once a patient is excluded for meeting an exclusion category they are not counted in subsequent categories. The content from the publication "National Vascular Disease Prevention Alliance. Guidelines for the assessment of absolute cardiovascular disease risk. 2009" was used with permission from the Heart Foundation (copyright material). Updates to these guidelines can be found at Immunisations The Immunisations tab contains sub-tabs for: Influenza Adult - Pneumococcal, Pertussis Adolescent HPV, DTP, VZV Child Child Schedule and Child NKPI Essential Immunisations Reports Influenza by Age and Risk, Pneumococcal by Age and Risk The charts are all pie charts and the Reports tab provides aggregated information by age, gender and ethnicity. Each graphs displays either 7 July 2015 PAGE 71 of 106

72 Date last Immunised Influenza, Pertussis Immunisation Status Pneumococcal, HPV, DTP, VZV Child Schedule provides a pie chart for children aged 0-7 years with their immunization status: Fully immunised (a child has received all the immunisations required for their age) Up to date (a child is not fully immunised but no dose is due) Due (immunisations are due now) Overdue (immunisations are overdue) A reidentification worksheet provides details for each immunisation in the schedule. In the worksheets the overdue immunisation will be displayed with a * next to the current count to assist in identifying the reason for the child being listed as overdue. Image 58: Childhood Immunisation Worksheet More information is available in the Quick Reference Guides available at help.pencs.com.au/cat.htm: CAT4 Adult Immunisations Quick Reference Guide v 3-12 CAT4 Adolescent Immunisations Quick Reference Guide v3-12 CAT4 Childhood Immunisations Quick Reference Guide v3.14 Image 59: Immunisations tab Functions available are as described for Allergies at the beginning of this chapter Immunisations Mappings with clinical systems The immunisation mappings are provided in the Medications Data Mappings Appendices for each clinical application MBS Items The MBS Items tab is available when the clinical and billing systems are provided by the same vendor and the data extract for the clinical system is version 1_5 or above. The Pen CS CAT4 - User Guide Part 1 Installation and Configuration explains how to configure your preferences to collect billing data as well as clinical data. 7 July 2015 PAGE 72 of 106

73 The data is displayed as a bar graph of: Count of MBS items recorded Count of MBS items not recorded Notes 1. You can use the Results filter to find the most recent MBS items that have been billed in a specific time period. 2. Old item numbers are still collected and displayed in the appropriate bar segment of the graph. Refer to the table below. The item number will be viewable via the Reidentify report. MBS Items currently collected are: HC 75+ where HC includes item numbers: 701, 703, 705 and 707 HC where HC includes item numbers: 701, 703, 705 and 707 HC 3-5 (HKC) where HC includes item numbers: 701, 703, 705 and 707, also includes item number HC Other where HC includes item numbers: 701, 703, 705 and 707 Old item numbers still collected Health Check Health Check (home) Health Check 715 (ATSI 55+ HC) 704/706 ATSI 55+ AHC 715 (ATSI HC) 710 ATSI AHC 715 (ATSI <15 HC) 708 ATSI CHC 721 CDM - GP Management Plan 723 CDM - Team Care Arrangement 732 CDM Review 725 GP Management Plan Review 727 Team Care Arrangement Review 900 DMMR 903 RMMR GP MH Care Plan includes item numbers: 2700, 2701, 2715, 2717 (from 1 st Nov 2011) 2712 GP MH Care Plan Review 2713 GP MH Care Consultation Diabetes SIP includes item numbers: 2517, 2518, 2521, 2522, 2525, , 2622, 2624, 2631, 2633, 2635 Asthma COC includes item numbers: 2546, 2547, 2552, 2553, 2558, 2559, 2664, 2666, 2668, 2673, 2675 and Respiratory AH Urgent Soc includes items 597, 598 AH Urgent Unsoc includes items 599, GP MH Care Plan 2710 GP MH Care Plan 7 July 2015 PAGE 73 of 106

74 AH Non-Urgent includes items 5000, 5020, 5040, 5060, 5200, 5203, 5207, , 5010, 5023, 5028, 5043, 5049, 5063, 5067, 5220, 5223, 5227, 5228, 5260, 5263, 5265, 5267 Some item numbers have a follow up item number attached. For example, patients who have had a 2710 (Mental Health Plan) should have a follow up 2712 (Review of Mental Health Plan). You are able to identify patients that have not had the follow up item number by using selecting item 2710 from the recorded tab and item 2712 from the not recorded tab and using the Report button to do a cross-tabulation MBS Eligibility The MBS Eligibility tab is available when the clinical and billing systems are provided by the same vendor and the data extract for the clinical system is version 1_5 or above. The Pen CS CAT4 - User Guide Part 1 Installation and Configuration explains how to configure your preferences to collect billing data as well as clinical data. This report is visible in the Daily, CDM and I-qi view as well as in the CAT4 full view. For the details of the MBS item numbers used in this report please see the table above in the MBS item report paragraph. There are three tabs showing different MBS item eligibilities: Health Assessment Eligibility This report shows the number of patients eligible for the 75+ year old (not claimed in the previous 12 months), the year old (never claimed) and the Indigenous (item 715) health checks (not claimed in the previous 12 months). Diabetes SIP Eligibility This report shows the Diabetes SIP item for patients with diabetes and displays those patients with a claim in the last 12 months and those without a claim in that period GPMP/TCA Eligibility This report applies to patients with Diabetes, CVD or CKD (please refer to the mapping document for your clinical systems for details of which diagnosis is included in these groups) and displays a bar chart with GPMP and Review < 3mths TCA and Review < 3 months GPMP < 12mths, no review TCA < 12 months, no review GPMP/TCA, not claimed last 12 months All reports display the information in the reidentification report with the patient details, information on the MBS item not claimed and the date of the last claim. 7 July 2015 PAGE 74 of 106

75 Image 60: MBS Eligibility Reidentify Report Sexual Health The Sexual Health module was developed with the National Aboriginal Community Controlled Health Organisation (NACCHO). Its aim is to measure the amount of STI screening and re-screening that is done by health services. The module reviews screening for the last 12 months for the target population of people aged or screening during pregnancy. A detailed QRG is available at help.pencs.com.au/cat.htm Screening The module provides graphs to display the amount of screening for the following STI/BBV s: Chlamydia Gonorrhoea Trichomoniasis Syphilis Hepatitis B Hepatitis C HIV Re-screening The module provides a graph to review the amount of retesting done: Following a positive STI test result for Chlamydia, Gonorrhoea or Trichomoniasis The amount of testing done for Syphilis and HIV within 3 months of the positive result The amount of retesting done for the same STI within 4 months of treatment Testing Patterns The module provides graphs to review the activity for patients screened/not screened: Screened number of visits, tests and coverage of tests Not Screened number of visits Maternal Health Care 7 July 2015 PAGE 75 of 106

76 The Maternal Health Care tab provides data on Baby Birth Weight and Antenatal Visits. These graphs can be filtered by Ethnicity and Baby Birth Date (using Results > Date Range) to check data in the NKPI, HFL and QAIHC Reports Baby Birth Weight Patient Record This report shows a pie chart for children aged 0-7 by the birth weight recorded in their patient record. The birth weight is the weight taken on the patient s birth date Mothers Antenatal Record This report shows a pie chart for patients who gave birth in the last 12 months by the birth weight recorded in the completed pregnancy record Antenatal Visits In the Antenatal Visits tab four different reports are shown in their respective tabs Antenatal First Visit Date This report shows a pie chart for patients who gave birth in the last 12 months by the time in weeks at which the date of first antenatal visit is recorded Size in weeks at First Visit This report shows a pie chart for patients who gave birth in the last 12 months by the gestational age recorded in the antenatal visit record. If a clinical value is entered this will be used in preference to a calculated value Antenatal Number of Visits This report shows a pie chart for patients who gave birth in the last 12 months by the number of antenatal visits recorded for the pregnancy Antenatal Count This report shows a pie chart which displays the antenatal visit count per patient for the last 12 months (this includes mothers whether or not they have given birth). A reidentification worksheet provides details such as gestation, last menstrual period (LMP), first visit date and first visit calculated in weeks Visits The Visits tab provides a number of sub tabs. 7 July 2015 PAGE 76 of 106

77 Last Visit This report shows a pie chart for patients by the date of last visit. The graph segments are in line with the last visit filter Assigned Provider This report shows a pie chart for patients by their assigned provider. This is the provider who they most frequently see Visit Types This report shows a bar chart displaying the number of patients seen in visit periods: Business Hours After Hours Sociable After Hours Unsociable Total visit data is displayed in the footer and a worksheet with data breakdown is available. Refer to the After Hours Quick Reference Guide available at help.pencs.com.au/cat.htm Episode Count This report shows a pie chart for the number of episodes of care provided to clients in the last 12 months. An episode of care is one or more contacts (with the same clinical reason) by a client with one or more health workers on the same calendar day 3. This graph supports the OSR Report Indicator CS Contacts by OSR Worker Type This report shows a bar chart for the number of contacts provided to clients in the last 12 months for each worker type 4. This graph supports the OSR Report Indicator CS-2. Graphs for Other OSR Visit Types (SEWB, Linkup and Substance Use) are provided for Communicare users. After Hours Reporting this tab has moved under Views > After Hours Reporting Image 61: After Hours Reporting 3 It is not possible to accurately determine the clinical reason in MD and BP, hence all contacts on the same calendar day are deemed an episode. 4 Worker type mappings for Medical Director (MD), Best Practice (BP) and Communicare are provided in the Appendix at the end of the OSR Quick Reference Guide available at help.pencs.com.au/cat.htm 7 July 2015 PAGE 77 of 106

78 These graphs can be used in conjunction with other CAT4 graphs to help target patients. Select segments and use the Report button (under the top menu) to create a cross tabulation report of clinical data, provider and last visit Age Gender Visit Count This report will break down all patients seen by age group and gender and will display visits to the practice and, if the filter is applied, compare visits to the practice to visits to the selected provider. This report is part of the Registrar CAT view and a QRG with more details is available at help.pencs.com.au/cat.htm Disease Visit Count This report will break down all patients seen by disease using the same disease categories as the Disease report. It will display visits to the practice and, if the filter is applied, compare visits to the practice to visits to the selected provider. This report is part of the Registrar CAT view and a QRG with more details is available at help.pencs.com.au/cat.htm ehealth The ehealth tab provides a number of graphs showing information about PCEHR and Shared Health Summaries PCEHR Status This graph will show patients that have an IHI recorded and, of that group, patients that the clinical system has detected have a PCEHR PCEHR and SHS This graph will show patients that have a PCEHR (the number will match that on the PCEHR Status graph) and, of that group, patients that have a Shared Health Summary (SHS). The Date Range (Results) filter can be used to find SHS's that have been last uploaded in a timeframe SHS Uploads This graph will show patients that have a SHS (the number will match that on the PCEHR and SHS graph) and, of that group, the number of times the SHS has been uploaded. The Date Range (Results) filter can be used to find SHS's that have been last uploaded in a timeframe and will display the number of times in that timeframe. Patients will only appear in the 'no SHS upload' category if their last upload date is outside the date range selected. If there is no date range filter applied this category will be empty. 7 July 2015 PAGE 78 of 106

79 SHS Age This graph will show patients that have a SHS (the number will match that on the PCEHR and SHS graph) and, of that group, the age of the SHS. The age is calculated using the last upload date. 7 July 2015 PAGE 79 of 106

80 7 Reports 7.1 Standard Reports A number of reports are available under the Standard Reports tab. Image 62: Standard Reports Tab These are: Indicator Sets Some reports have been grouped under a tab Indicator Sets. o o o o o o o o APCC (Australian Primary Care Collaboratives) Report Queensland Aboriginal and Islander Health Council (QAIHC) Indicators Report Healthy For Life NT AHKPI (Northern Territory Aboriginal Health Key Performance Indicators) National KPI OSR Online Services Report ehealth Report Health Providers Report More information about the submission process for these reports is available in the Pen CS CAT4 User Guide APCC Report and IF Submission available from help.pencs.com.au/cat.htm NPI (National Performance Indicators) Summary Report Card Mental Health (MH) Summary Report Card Please note that the Pap Smear Summary Report Card is found under the Pap Smear tab. 7 July 2015 PAGE 80 of 106

81 7.1.1 APCC (Australia Primary Care Collaboratives) Report The APCC Report is available under the Standard Reports > Indicator Sets tab. NOTE: For this report to collect Assessment Data from the PrimaryCare Sidebar you must have your Prompts Preferences > Patient Data Storage Shared Directory set. Refer to the APCC Guide advised at the end of this section for instructions. The APCC Report is always derived from your full data set not your filtered data set. It will always show the practice total number for your registers Diabetes, CHD, COPD, CKD and CVD patients. This report provides you with summary statistics for these patients. This report cannot be filtered by date. It is applicable only to the date at which the data collection was extracted. The date of extract will appear on the report. The reason is because CAT4 collects a snapshot of a patient s current results at the date of extract. It does not collect a full patient history and hence it is not possible to create an APCC report retrospectively. The report shows a breakdown of patients by ATSI, Non ATSI and Not Recorded. Image 63: APCC Report 7 July 2015 PAGE 81 of 106

82 APCC participating practices The APCC Report functionality is available from a set of menu options contained at the top of the APCC Report tab. APCC Report tab with menu options Standard Reports tab A report toolbar is available which provides functions to view, print and export the document. Image 64: APCC Report functionality The APCC Report menu options are: Prepare Report this option has been replaced by the Data Submission main menu option which will guide the user through the data transmission process View History allows the user to view a list of previous reports that have been submitted Manual Measures a data entry screen for the manual measures Prevention Measure a data entry screen for the prevention measures that are not collected Practices that are not participating in the APCC program will be able to use the report but will not be able to submit any data. APCC participating practices should refer to the Pen CS clinical Audit User Guide APCC Report and IF Submission which provides detailed information about the report and submission process. This guide is available from help.pencs.com.au/cat.htm 7 July 2015 PAGE 82 of 106

83 7.1.2 NPI (National Performance Indicators) Report The NPI Reports are available under the Standard Reports tab. The NPI Reports are always derived from your full data set not your filtered data set. The following NPI Reports for are available: CDM 2 for reporting on Diabetes patients HbA1c results in last 12 months CDM 3 for reporting on CHD patients with BP <= 130/80 in last 12 months PREV 4 for reporting on female patients aged with a pap smear in last 2 years These reports cannot be filtered by date. They are applicable only to the date at which the data collection was extracted. The date of extract will appear on the report. The reason is because CAT4 collects a snapshot of a patient s current results at the date of extract. It does not collect a full patient history and hence it is not possible to create NPI reports retrospectively. A report toolbar is available which provides functions to view, print and export the document. Image 65: NPI Report 7 July 2015 PAGE 83 of 106

84 7.1.3 Summary Report Card The Summary Report Card is available under the Standard Reports tab. This report provides an instant snapshot of GP data quality across most of the graphs provided. This means the user doesn't have to go to each tab and write the figures down. The report can be exported to Excel so the user can create a month by month set of figures if they choose. [Note the user needs to collect new extract files for each monthly report.] The user can also use the filters to target specific populations. This report is found under the Standard Reports tab > Summary Report Card sub-tab Image 66: Summary Report Card tab Mental Health (MH) Summary Report Card The MH Summary Report Card is available under the Standard Reports tab. This report provides a snapshot of GP data relating to Mental Health. It is designed to encourage GPs to review and update their management strategies for patients diagnosed with mental health disorders, specifically schizophrenia, in their practices. These new management strategies are in line with the Royal Australian and New Zealand College of Psychiatrists (RANZCP) guidelines and take into account the International Diabetes Federation criteria for metabolic syndrome. How to use this report This report is designed to be used in conjunction with the CAT4 filters. Some medications can increase a patient s metabolic risks and this report highlights areas of patient care that may need further management. Some suggested filters are: 1. Filter on Condition = Schizophrenia 2: Filter on Medications = Antipsychotics Where the filtered population shows increased risk or a lack of data for physical measures like BP, BMI and Waist the practice may need to consider their overall management strategies for these patients. The report can be exported to Excel. 7 July 2015 PAGE 84 of 106

85 7.1.5 QAIHC Indicators Report The Queensland Aboriginal and Islander Health Council (QAIHC) have a set of core indicators designed to support quality improvement initiatives. A subset of these indicators is provided in the CAT4 QAIHC Indicators report. The CAT4 QAIHC Report is available for clinical systems where the CAT4 data extract meets the CAT4 data specifications version 1_6 or higher. MBS Item Indicators in the report are available where the clinical and billing systems are provided by the same vendor. More information is available in the CAT4 QAIHC Indicators Quick Reference Guide available at help.pencs.com.au/cat.htm Healthy For Life Report Healthy for Life (HFL) is a program funded by the Office of Aboriginal and Torres Strait Islander Health (OATSIH) which aims to improve the health outcomes of Aboriginal and Torres Strait Islander peoples. 10 essential indicators have been developed for reporting purposes. These indicators cover the areas of: Maternal and Antenatal (indicators 1-4) Child Health (indicators 5-6) Adult Health (indicators 6-10) The CAT4 HFL Report is available for clinical systems where the CAT4 data extract meets the CAT4 data specifications version 1_6 or higher. MBS Item Indicators in the report are available where the clinical and billing systems are provided by the same vendor. More information is available in the CAT4 HFL Quick Reference Guide available at help.pencs.com.au/cat.htm National KPI Indicators Report As part of the National Indigenous Reform Agreement (NIRA), the Council of Australian Governments (COAG) agreed that the Department of Health and Ageing, in partnership with the state and territory health departments and in collaboration with the Australian Institute of Health and Welfare (AIHW), would develop a set of national key performance indicators (KPIs) for Indigenous specific primary health care services. AIHW have provided specifications for these indicators. The CAT4 National KPI Report is available for clinical systems where the CAT4 data extract meets the CAT4 data specifications version 1_6 or higher. MBS Item Indicators in the report are available where the clinical and billing systems are provided by the same vendor. More information is available in the CAT4 National KPI Indicators Quick Reference Guide available at help.pencs.com.au/cat.htm. 7 July 2015 PAGE 85 of 106

86 Collecting Additional Patients in CAT4 for Reporting Practices submitting data for the National KPI report will need to extract additional patients to meet the population base required for the report. The report requires that all patients who have visited the practice in the last 2 years should be included. This definition includes archived and deceased patients. The Medical Director and Best Practice preference tabs now include a new option Extract Archived and Deceased Patients which can be set to Yes to enable this functionality. The default selection will be set to 'No'. Communicare data includes deceased and archived patients as well as transient and banned patients the settings on the Patient Status filter allow for these patients to be identified but they are excluded from standard CAT4 reports by default. For practices where this set to 'No' there will be no change to the way CAT4 functions. For practices where this set to 'Yes' the default population loaded will exclude patients that are archived and deceased through the default settings of the Patient Status filter, enabling practices to continue working with CAT4 in the same way they always have. The NKPI Report will include the additional patients and this will be noted at the top of the report. (Note for the 30 th June 2012 collection deceased patients will not be included in the report to align the figures reported with Communicare. Not all Communicare users will have been upgraded to extract deceased patients.) More information about this functionality is provided in the CAT4 Extracting Additional Patients Quick Reference Guide available at help.pencs.com.au/cat.htm. 7 July 2015 PAGE 86 of 106

87 7.1.8 OSR Online Services Report The OSR Data Collection Instrument defines the indicators that are to be submitted. A subset of these indicators can be automatically extracted by CAT4 from the practice clinical systems. These are: Clinical Services (CS) CS-1, CS-2, CS-3a, CS-4 Maternal and Child Health (MCH) MCH-1, MCH-2, MCH-3 Health Promotion (HP) HP-1 Social and Emotional Wellbeing SEWB (SE) SE-6, SE-7 Link Up (L) L-6, L-7 Standalone Substance Use Services (S) S-6, S-7a, S-7b, S-7c, S-10, S-11, S-13, S-14 Not all clinical systems will have all the data items required for all indicators. The CAT4 OSR module is available in CAT4 Version 3, for clinical systems where the CAT4 data extract meets the CAT4 data specifications version 1_15 or higher (or Communicare version 13.2 or higher). The module provides: The indicator report Supporting graphs which allow the indicators to be verified The OSR Report displays data for all clients, including archived and deceased, who have had a contact in the last 12 months. MBS Item Indicators in the report (indicators CS-4 and MCH-1) are available where the clinical and billing systems are provided by the same vendor or are supported by CAT. More information about this functionality is provided in the CAT4 OSR Report Quick Reference Guide available at help.pencs.com.au/cat.htm. 7 July 2015 PAGE 87 of 106

88 7.1.9 ehealth Report The ehealth clinical Indicators Report contains the following sections: Allergies and adverse reactions Medications Medical History Health Risk Factors Immunisations Relevant Family History Relevant Social History Medication Currency Shared Health Summary More information about this functionality is provided in the CAT4 ehealth Quick Reference Guide available at help.pencs.com.au/cat.htm Health Providers Report The Health Care Provider Report contains a list of providers that have been active at the practice for the financial year. The following data is provided: Provider Last Name Provider First Name Provider No. Speciality 7.2 Cross Tabulation Report The cross tabulation report provides the ability to find patients who appear on more than one graph - this assists with the identification of target population risk groups. For example: Highlight the graphs segment for BMI >30, Smoker, BP >140/90, Cholesterol level >7.5 and view which patients meet all these criteria. As you highlight report chart segments you will see 2 pieces of information on the screen 1. A will appear on the tab where you have made a chart segment selection 2. A new line will appear underneath where the filter details display. This line will provide details of which chart segments are selected. The example below shows BMI (Obese, Morbid), Smoking (Daily), BP (>140/90). Lipids Cholesterol (>7.5). You will see that the Report button has become active. 7 July 2015 PAGE 88 of 106

89 Image 67: Multiple report selections for cross-tabulation Click the Report button The standard Reidentification Report will display in an adjusted format to allow the data values for the chart selections you have made to be provided. Image 68: Cross Tabulation Report Clearing Report Selections To clear the Report Chart Segments you have selected click the Clear Filters button at the top right hand corner of the CAT4 screen. The Clear Filters dialogue box will appear. The Clear all Report Selections tick box will be pre-selected if report segment selections have been made. Click OK. Image 69: Clear Filters dialogue box The which appears on the tabs with selected report segments will be cleared. The text line with selected report segments information will be cleared. 7 July 2015 PAGE 89 of 106

90 8 How to improve data quality using CAT There are a number of ways that CAT4 can be used to improve the data quality of your clinical desktop system. Some of these are listed below. Please also see for step-by-step guides and other resources. 8.1 Patients with no Date of Birth To find patients with no date of birth (DOB) use the age filter. Tick Age = No Age Click the Recalculate button Click the View Pop. Button The Patient report for this filtered group will be displayed and you will see that the DOB column is empty 8.2 Patients with no Gender Patients with no gender will have their gender as something other than M or F in the data set probably it will be blank. To find them use the gender filter. Tick Gender = Other Click the Recalculate button Click the View Pop. Button The Patient report for this filtered group will be displayed and you will see that the sex column is empty or has something other than M or F 8.3 Patients with no Allergy status recorded The Allergies tab displays your data as a breakdown of allergy status: Allergy Recorded, No Known Allergies, Nothing Recorded. Use this tab to identify patients with the status of Nothing Recorded. Refer to the section on Allergies. 8.4 Patients with no Smoking status recorded Smoking displays your data as a breakdown of smoking status: Daily Smoker, Irregular Smoker, Ex Smoker, Never Smoked, Nothing Recorded. Use this tab to identify patients with the status of Nothing Recorded. You may need to use the age filter to exclude patients under 10 years old. Refer to the section on Smoking. 7 July 2015 PAGE 90 of 106

91 8.5 Patients with incorrect Diabetes coding Patients with Diabetes should be coded with a Diagnosis of Type I or Type II. To find incorrect coding search for Patients with both Type I and Type II recorded Tick the Diabetes Type I checkbox Tick the Diabetes Type II checkbox Click the Recalculate button Click the View Pop. Button The Patient report for this filtered group will have both diagnosis recorded Patients with an Undefined only diagnosis recorded patients should have a primary diagnosis of Type I or Type II recorded Tick the Diabetes Type I NO checkbox Tick the Diabetes Type II NO checkbox Tick the Diabetes Undefined checkbox Click the Recalculate button Click the View Pop. Button The Patient report for this filtered group will no primary Diabetes diagnosis recorded 7 July 2015 PAGE 91 of 106

92 9 Timeline The Timeline functionality allows you to view changes in your data extracts over time. Most graphs have a Timeline button at the top right near the Export and Print buttons. Note that the timeline only shows data from the total patient population it does not work with filters. Click segments from any graph(s) you like The Timeline button of a graph becomes active when a segment is selected on that graph Click any active Timeline button The Timeline graph is loaded into the new Timeline tab at the far right of the tabs Image 70: Timeline TIPS: 1. If you add or remove graph segments you can return to the Timeline tab and click the Timeline Recalculate button to refresh the graph 2. The From and To Dates default to cover a year before the extract date. Adjust these to include older extracts if you have them. If an extract does not appear you may simply need to reload it this will create summary data for the timeline which may not have previously been created. 7 July 2015 PAGE 92 of 106

93 10 Send Data To function The Send Data To function allows practices to send a de-identified CAT4 data file from within CAT4 to an external location of their choice. Extracts that have not been de-identified using the steps described in the next chapter (11) can t be sent and CAT4 will show an error message if a user attempts to send a not de-identified file. CAT4 will first compress the data file and then send it using the selected method. The function allows data to be sent securely via 1) (MAPI or Other); 2) Secure FTP or 3) Send to PATCAT for clinics that submit data to an organisations such as a Medicare Local for data aggregation. Clinic consent is required in all cases for the data submission and CAT4 will not send data automatically unless configured under the Scheduler options. Please see the user guide (Pen CS CAT4 PATCAT Scheduler User Guide v1-0) for details on how to set up automatic data submission. Submitting data by is often limited by settings on your system prohibiting large attachments. For larger clinics (more than patients) we strongly recommend to set up data submission via FTP or Send to PATCAT as described below. FTP does not have the size restrictions and is a safer way to send data as it is using a secure transmission. The receiving organisation needs to set up the FTP server before this method can be used and also needs to supply the FTP details Configuring locations A new menu option Edit > Send Data Extracts Locations allows practices to configure locations they are have consented to send data to. More than one location can be set up if a practice is submitting data to more than one organisation. Image 71: Send Data configuration menu option Clicking on the Send Data Extracts Location menu item will open the configuration window as shown below. 7 July 2015 PAGE 93 of 106

94 Image 72: Send Data configuration screen ConImage Send by Select Edit > Send Data Extracts Locations from the menu bar The Send Data Extracts Locations configuration screen will be displayed If you use Outlook, select -MAPI from the drop-down Send Data Method list Otherwise, select -SMTP Enter a location name that describes where the data will be sent Click Add A new location tab will added to the Send Data Extracts Locations window with the location name you have provided MAPI - Fill in the mandatory fields To Address Practice ID and Practice Name Other fields are optional If you wish to encrypt the zipped data file tick Enable Encrypt and provide a password. You will need to let the receiver know what this password is so they can un-encrypt the file when they receive it. Click the Test button to check a test is successfully sent and received Click OK 7 July 2015 PAGE 94 of 106

95 Image 73: Send data configuration Outlook SMTP Fill in the mandatory fields o Mail Server o Username for your mail server o Password for your mail server o From Address o To Address o Practice ID and Practice Name You may need to check with your service provider or system administrator to configure the settings correctly. Other fields are optional If you wish to encrypt the zipped data file tick Enable Encrypt and provide a password. You will need to let the receiver know what this password is so they can un-encrypt the file when they receive it. Click the Test button to check a test is successfully sent and received Click OK 7 July 2015 PAGE 95 of 106

96 Image 74: Send data configuration SMTP Configure Send by FTP Select Edit > Send Data Extracts Locations from the menu bar The Send Data Extracts Locations configuration screen will be displayed Select Secure FTP from the drop-down Send Data Method list Enter a location name that describes where the data will be sent Click Add A new location tab will added to the Send Data Extracts Locations window with the location name you have provided Fill in the mandatory fields o FTP Address o Username o Password o Practice ID and Practice Name o Other fields are optional you should check with the receiving location If you wish to encrypt the zipped data file tick Enable Encrypt and provide a password. You will need to let the receiver know what this password is so they can decrypt the file when they receive it. Click the Test button to check a test file is successfully sent and received Click OK 7 July 2015 PAGE 96 of 106

97 Configure Send to PATCAT Image 75: Send data secure ftp configuration Select Edit > Send Data Extracts Locations from the menu bar The Send Data Extracts Locations configuration screen will be displayed Select Send to PATCAT from the drop-down Send Data Method list Enter a location name that describes where the data will be sent Click Add A new location tab will added to the Send Data Extracts Locations window with the location name you have provided Fill in the mandatory fields o Webservice Address o Username o Password If you wish to encrypt the zipped data file tick Enable Encrypt and provide a password. You will need to let the receiver know what this password is so they can decrypt the file when they receive it. Click the Test button to check a test file is successfully sent and received Click OK 7 July 2015 PAGE 97 of 106

98 Image 76: Send data to PATCAT configuration 10.2 Sending data Once a dataset from the Extracts panel is loaded and a send to location has been configured as described in the previous chapter the right-click function is available. This will display the list of send to locations that have been configured for the practice to choose from. NOTE: Only de-identified data is sent. If a non de-identified dataset is selected, the following error message is displayed. Image 77: Error Message non De-identified Data 7 July 2015 PAGE 98 of 106

99 Load the de-identified data set you wish to send Right-click on the extract listed in the extracts panel Select Send To The list of configured locations will be available Select the location A confirmation dialogue box will appear Click OK A progress bar will display while the send is in progress Once completed a status message will be provided A history record will be written under menu option: Tools > Send Data History Image 78: Send To location selections Image 79: Send To location confirmation Image 80: Send To location sending progress 7 July 2015 PAGE 99 of 106

100 Image 81: Send To location Success 11 CAT4 Tools Menu The CAT4 Tools menu provides the following options: Image 82: CAT4 Tools menu 11.1 De-identify Dataset A data extract can be de-identified using the De-identify tool menu option within CAT. You must load the data set you wish to de-identify before running the tool. Click Tools > De-identify Dataset You will receive a confirmation message once the process had completed Click OK The new de-identified dataset will appear in your list of extracts Image 83: Completed de-identify message 7 July 2015 PAGE 100 of 106

101 Image 84: Original and de-identified datasets in extracts list 11.2 Check for Updates If a practice has skipped the option to take updates available for CAT4 they will not be prompted again when new updates are released.this menu option has been added to allow practices to check for updates in case some have been missed. Click on Tools > Check for Updates Image 85: CAT4 Check for Update 11.3 Add GTAGs This function is optional and only used for clinics that will submit data to an organisation for data aggregation in PATCAT. PATCAT has a build in mapping function that can project aggregated data on a map for easy data analysis and prioritisation of projects. This function attracts an extra cost and needs to be licensed before it can be used. Image 86: CAT4 Gtag 11.4 Send Data History Any activity using the send to function will be logged and the log is accessible under Tools/Send Data History. The history is presented in a new window and will show successful as well as unsuccessful attempts. This can be used for trouble shooting and provides a record for the clinic. The history shows which data file was sent, when, where and by who. 7 July 2015 PAGE 101 of 106

102 Image 87: Send Data History 11.5 Export Data File This will allow clinics to export their data file for use in specific projects. This function is only available for participants of particular projects and needs to be licenced by PENCS. 12 CAT4 View Options The current set of all tabs available to all users is called CAT4. The user is able to switch between the full view to different views introduced with CAT4. The details of the available views is described in the CAT4 Dashboard QRG available at help.pencs.com.au/cat.htm The new views will allow users to focus on specific tasks by reducing the number of displayed reports to show only those relevant to the current task and also improve performance as CAT4 doesn t have to load unnecessary report tabs. Switching between views can be done from the menu bar as below or by switching into the dashboard and selecting the view of interest from there. Image 88: CAT4 Toggle between different views 12.1 Cleansing View The CAT4 Data Cleansing module provides a set of predefined reports that target potential data issues. The reports available are: Missing Demographics Missing clinical/accreditation Items Indicated CKD with no diagnosis Indicated Diabetes with no diagnosis Indicated Mental Health with no diagnosis Indicated COPD with no diagnosis 7 July 2015 PAGE 102 of 106

103 Medication review for Diabetes with elevated HbA1c Clicking on a patient in the report will open that patient in the clinical system. This is available for MD, BP and Zedmed with other clinical systems to follow. Data issues are highlighted according to the type of report: Reports of missing information will highlight the missing data in red Disease Register Reports will flag potential inaccuracies and highlight the indication Refer to the CAT4 Data Cleansing Quick Reference Guide available at help.pencs.com.au/cat.htm for further information Registrar View Registrar CAT4 provides supporting information for practice accreditation and reporting as a training post for Registrars. It allows the practice to report and manage Registrar activities. 1. It provides graphical reports on the range of clinical presentations a Registrar has seen in the practice compared to the full set of presentations that are being seen at the practice. This enables the practice to ensure the Registrar is seeing a good coverage of practice presentations. 2. It provides graphs of clinical information that should be recorded in a patient s record. This can help determine if a Registrar has not carried out activities that should have been reviewed as part of the consultation. Refer to the Registrar CAT4 Quick Reference Guide available at help.pencs.com.au/cat.htm for further information After Hours Reporting A View has been created for After Hours Reporting. Click View > After Hours Reporting from the menu bar. It contains a number of reports on times of visit, reason for visit and MBS items. Image 89: After Hours Reporting Menu The After Hours Reporting by MBS Item and Reason for Visit provides a set of reports including age, gender, indigenous status, MBS item and reason for visit. MBS > After Hours Claims graph Visits > Visit Types graph 7 July 2015 PAGE 103 of 106

104 These reports can sent to the Medicare Local using the CAT4 send data functionality. Refer to the 'After Hours Reporting Quick Reference Guide' available at help.pencs.com.au/cat.htm 12.4 My CAT Wizard The My CAT Wizard allows users to configure their own customised views from the Classic CAT4 tab selections. Please refer to the My CAT Wizard Quick Reference Guide available at help.pencs.com.au/cat.htm Image 90: CAT4 View menu 7 July 2015 PAGE 104 of 106