Quick Reference Guide CAT4. CAT4 Cleansing View

Transcription

1 Quick Reference Guide CAT4 CAT4 Cleansing View <4.0> - September 2015

2 Organisation Contacts Sydney Office Pen CS Level 1, 35 Moore St LEICHHARDT NSW 2040 Phone: + 61 (0) Fax: +61 (0) Document Owner Matthias Merzenich Training Programs Manager Phone: matthias.merzenich@pencs.com.au Melbourne Office Pen CS Level 6, 3 Bowen Crescent Melbourne VIC 3004 Phone: Fax: SUPPORT FREECALL support@pencs.com.au Document Control Version Release Date Modified By Description /09/2015 Matthias Merzenich Initial release with updated names/logos and new functionality to exclude patients from reports 15 September 2015 PAGE 2 of 15

3 1 INTRODUCTION Clinical Audit Tool 4 (CAT4) The Clinical Audit Tool (CAT) analyses 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 the quality and completeness of patient information. The benefit to the practice is to assist with its ongoing accreditation and provide opportunities to grow practice income. The emphasis of the tool is to help practice staff to take specific action to improve patient coverage in chronic disease management and prevention. CAT4 is the latest release of our clinical audit tool with many changes to functionality, user interface and performance. CAT4 uses preconfigured Views to provide our users with easy access to the relevant information for their current investigations and field of work. CAT4 is part of the CAT Plus suite and has integration links with the other products in the suite. These links are still at an early stage but will gradually be introduced and will make CAT4 a central tool for data quality improvement and patient population management at the practice level. Quick Reference Guides Quick Reference Guides (QRG) are provided as a reference for modules and specific reports in our tools. All user guides are available online at help.pencs.com.au/cat.htm Cleansing CAT and Cleansing View Previous versions of CAT4 had a separate module called Cleansing CAT which had to be purchased separately. With the release of CAT4 this module has now been integrated into CAT4 and is available to all users. The Cleansing CAT View will show the same information as the old Cleansing CAT and is also accessible from a new report tab called Data Cleansing. The details are described in this document. 15 September 2015 PAGE 3 of 15

4 2 CAT4 Cleansing View The Cleansing CAT module allows the easy identification of critical missing patient data by providing a set of predefined reports. These reports provide data that would otherwise require multiple filter selections and recalculation. The reports available allow for identification of: missing demographic data missing clinical / accreditation data indicated CKD patients where no diagnosis is recorded indicated Diabetes patients where no diagnosis is recorded medication review for Diabetes with elevated HbA1c indicated Mental Health where no diagnosis is recorded indicated COPD patients where no diagnosis is recorded Pen CS wishes to acknowledge the ideas and commitment to continually improving primary health care provided by Judy Evans, Manager e-health, RACGP in this project. Prerequisites and accessing the Cleansing View CAT4 has to be installed and configured to extract data from your clinical system. On start-up the new dashboard will be displayed. Here you can select a number of different pre-configured views or create your own views by using the My CAT Wizard. To load the Cleansing view click on the icon in the dashboard: Figure 1: Cleansing View dashboard icon If you have loaded the CAT4 view which shows all available reports there are two ways to look at the cleansing reports. From the top of your screen you can either click on the Cleansing CAT icon or you can click on the Data Cleansing report tab both will show you the same reports. Figure 2: Cleansing CAT Access 15 September 2015 PAGE 4 of 15

5 Overview There are 7 reports available in the Cleansing CAT Module: 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 Diabetes with elevated HbA1c Sorting All reports can be sorted by clicking any column Export/Printing Click the Export button on any report to obtain a patient worksheet which can be exported to Excel/PDF and/or printed. Assigned Provider This column is included on all reports to facilitate provider input where required Figure 3: Cleansing View Reports 15 September 2015 PAGE 5 of 15

6 3 Report Details Missing Demographics Report The Missing Demographics Report displays patients where any of the following fields are missing: Surname Address First name Suburb Date of Birth (DOB) Postcode Sex Home Phone, Work Phone and Mobile Phone Figure 4: Missing Demographic Tab This report allows customisation of the displayed demographic items by using the Show/Hide Colums button highlighted above. When clicked, the additional options are displayed: Figure 5: Additional Columns Missing Demographics 15 September 2015 PAGE 6 of 15

7 The additional columns will appear on the report after they are selected on the Show/Hide Column form shown above. Missing Clinical / Accreditation Items Report The Missing Clinical / Accreditation Items Report displays patients where any of the following fields are missing: Surname First name Date of Birth (DOB) Sex Allergies Height Weight Smoking Alcohol Figure 6: Missing Clinical/Accreditation Items Tab This report allows customisation of the displayed demographic items by using the Show/Hide Colums button highlighted above. When clicked, the additional options are displayed: Figure 7: Additional Columns Missing Clinical/Accreditation 15 September 2015 PAGE 7 of 15

8 Indicated CKD with no Diagnosis Report The Indicated CKD with no Diagnosis Report displays patients where the Staging of CKD, as determined by the combined results of kidney function (egfr) and kidney damage (the level of albuminuria using ACR), indicates the possibility of CKD. The report displays egfr, ACR and the resulting Indicated Staging of CKD Color code for the Clinical Action Plan to manage CKD Other CKD Risk Factors Red Clinical Action Plan to be monitored 1-3 monthly Orange Clinical Action Plan to be monitored 3-6 monthly Yellow Clinical Action Plan to be monitored 12 monthly For more information refer to Kidney Health Australia web site and the CKD Guideline Booklet available at Detection of CKD requires follow up testing once an abnormal result is recorded. The outcome of 3 tests over a 3 month period will inform a diagnosis. CAT4 is only using the most recent egfr and ACR, not the last 3 results. This will inform a diagnosis if 3 tests have been done or flag that a patient should be recalled for follow up testing if there are not 3 results in the Patient Record. Pen CS wishes to acknowledge the input of Dr Craig Nelson in the creation of this report. Figure 8: Indicated CKD Tab 15 September 2015 PAGE 8 of 15

9 Indicated Diabetes with no Diagnosis Report The Indicated Diabetes with no Diagnosis Report will display the likelihood of Diabetes based on HbA1c, Antidiabetic Medication and/or FBG being recorded in the patient record without a diagnosis: Red = likely Orange = possible Yellow = flag for review Red: ANY of the following HbA1c >= 6.5 OR HbA1c recorded AND on an Anti-diabetic Medication OR FBG > 7 Orange: ANY of the following HbA1c >6 and <6.5 OR on an Anti-diabetic Medication excluding Metformin Yellow : ANY of the following HbA1c <=6 OR on Metformin The report displays HbA1c, Anti-diabetic Medication, FBG and the resulting likelihood Diabetes Care items that have been recorded Pen CS wishes to acknowledge the input of Dr Ralph Audehm in the creation of this report. Figure 9: Indicated Diabetes Tab The HbA1c test is used to monitor Diabetic patients so the fact that there is an HbA1c in the patient s record indicates they could be diabetic. The HbA1c test can also be used by clinicians for pre-diabetics or patients with impaired glucose test. So it is just alerting the practice to review. The report shows other data items such as eye check and foot check. These are presented to show other activities that are being carried out that are part of the SIP cycle for reference. 15 September 2015 PAGE 9 of 15

10 Indicated Mental Health with no Diagnosis Report The Indicated Mental Health with no diagnosis Report will display the likelihood of a Mental Health condition based on a mental health medication or a mental health care plan being recorded in the patient record without a diagnosis: Red = likely Orange = possible RED: Has a Mental Health Care Plan MBS Item number claimed (2700, 2701, 2715, 2717 or previous 2702 or 2710) ORANGE: On a Mental Health Medication The report displays MH medication, MH MBS item numbers and the resulting likelihood Chronic disease co-morbidities Other MH risk factors Pen CS wishes to acknowledge the input of Noel Stewart from NEVDGP and his work in the use of CAT to manage patients with chronic disease and mental health conditions in the creation of this report. Figure 10: Indicated Mental Health Tab 15 September 2015 PAGE 10 of 15

11 Indicated COPD with no Diagnosis Report The Indicated COPD with no diagnosis Report will display the likelihood of COPD based on tiotropium medication or an adverse spirometry reading being recorded in the patient record without a diagnosis: Red = likely Orange = possible RED: Spirometry of FEV1/FVC < 0.7 and FEV < 50% predicted (High risk) ORANGE: Spirometry of FEV1/FVC < 0.7 and FEV >= 50% predicted (Low risk) OR On a Tiotropium Medication The report displays Tiotropium medication, spirometry readings and the resulting likelihood Chronic disease co-morbidities Management items For more information refer to The Spirometry Handbook available from The Pocket Guide to COPD Diagnosis, Management, and Prevention available from Figure 11: Indicated COPD Tab A FEV1/FVC ratio of less than 0.7 indicates airflow limitation. The predicted normal values are dependent on age, gender and height. The tables are provided in Appendix B of The Spirometry Handbook. 15 September 2015 PAGE 11 of 15

12 Medication review for Diabetes with elevated HbA1c The Medication review > Diabetes with elevated HbA1c Report will display patients with Type 2 Diabetes whose HbA1c is not being controlled on their current Antidiabetic medications. Patients will appear on the report where they meet the following criteria: Diabetes Type 2 HbA1c > 8% The report will display the Antidiabetic medications the patient is currently taking: Oral Hyperglycaemics Number of OHA Classes List of OHA Classes Injectables GLP-1 Insulin This report provides the opportunity to review and modify the medications being taken to try and bring the HbA1c level into normal range. It also relates to the Diabetes SIP item medication review that should be performed yearly for patients with diabetes. Figure 12: Medication Review Tab 15 September 2015 PAGE 12 of 15

13 Accessing a Patient Record (All Reports) To access a patient record, double-click anywhere on the row containing the patient s details within the displayed report. This will open the patient record within the appropriate clinical system. Note: The clinical system must be open and logged in for the above step to complete. If the clinical system is not open, an alert message will pop up requesting the clinical system be started. Clinical systems where this functionality is currently provided are Medical Director Best Practice Zedmed Other clinical systems are planned to be added. Figure 13: Open Patient in Clinical System If your clinical system is not open you will be alerted that you need to start it and login Figure 14: Clinical System Error Message 15 September 2015 PAGE 13 of 15

14 Condition Does Not Exist Option CAT4 has an option to permanently remove a patient from the Cleansing View reports by confirming that a particular condition does not exist. This will stop the patient from appearing on the Cleansing View and Cleansing App in Topbar again. Only users of Topbar and CAT4 can use this option as it uses the Topbar server to store the information. CAT4 needs to be linked to Topbar in the Edit/Preferences/Topbar settings to activate this function, the details are provided in the CAT4 Installation and Setup guide available at help.pencs.com.au/cat.htm Excluding patients can be done in CAT4 by using the Cleansing View or in Topbar in the Cleansing App. This guide describes the process for CAT4, please refer to the Cleansing App user guide available at help.pencs.com.au/topbar.htm for Topbar users. The following reports allow users to exclude patients from future reports and notifications: Indicated CKD with no diagnosis Indicated Diabetes with no diagnosis Indicated Mental Health with no diagnosis Indicated COPD with no diagnosis Each report has a column called Confirm Condition Does Not Exist and a Save & Remove button as shown below: Figure 15: Confirm Condition Does Not Exist Column To remove a patient permanently from the list in CAT4 (and the Topbar notifications) for the displayed chronic condition tick the box in the Confirm Condition Does Not Exist and then click the Save & Remove button. This will immediately remove the patient from the Indicated report tab shown above and add the patient to the second tab called Reviewed : Figure 16: CAT4 Reviewed Tab 15 September 2015 PAGE 14 of 15

15 The Reviewed tab shows any patients who have been removed from the Indicated tab for the current indicated chronic condition and also the user name of the person who removed them, the date and software used to remove them. The report will show patients removed by CAT4 as well as those removed by Topbar, as shown above. Please note that the process described above is permanent and can t be undone, so make sure that there is a reason to remove the patient from the report. 4 Troubleshooting For further assistance with CAT4, please contact the PEN CS Help Desk on or support@pencs.com.au 15 September 2015 PAGE 15 of 15