Medtech Training Guide

Transcription

1 Medtech Training Guide Clinical Audit Tool Copyright Medtech Limited Page 1 of 80

2 Clinical Audit Tool v4.0 Contents Chapter 1: Getting Started... 3 Logging In... 3 Logging Out... 3 Setting the Preliminary Filter... 7 Screening Mapper Menu Chapter 2: Tool Navigation Navigation Panel Action Menus Filter Demographics Filter Medications Filter Classification Filter Data Grid Graphs Functional Elements Home Page Advanced Filter Action Functionality Data Export Save Query Chapter 3: Functional Screens Demographics Screen Using the Demographic Filter Demographics Grid Demographics Graphs No Values Graph Medications Screen Medications Filter Medications Grid Medications Graph Medications Mapping with MT Screening Terms Screen Screening Grid BMI Lipids Creatinine HbA1C Cervical Smear BP Smoking Screen Allergy Screen Classifications Screen Classification Screen Disease Filter Disease Grid Disease Graphs Immunisation Screen Reports HealthStat Integration Chapter 4: Scenarios Copyright Medtech Limited Page 2 of 80

3 Logging In Chapter 1: Getting Started The Clinical Audit Tool (CAT) is accessed with the password used for Medtech Go to CAT > Launch Clinical Audit Tool, or click the Clinical audit tool web link icon on the Toolbar. 2. The following screen will appear. You are now logged into the Clinical Audit Tool. Logging Out 1. To log out from Clinical Audit Tool click SignOff. 2. Clicking SignOff will log you out and present you with the login screen of Clinical Audit Tool. Use your Medtech Staff Code and Password to log back. Copyright Medtech Limited Page 3 of 80

4 Copyright Medtech Limited Page 4 of 80

5 CAT Menu CAT menu can be located between ManageMyHealth and Window on the Medtech menu bar. Five options are available under the CAT menu: 1. Clicking About Clinical Audit Tool option will launch Medtech website page containing information about Clinical Audit Tool. 2. Clicking Launch Clinical Audit Tool will open the Clinical Audit Tool in a custom browser within Medtech32. Copyright Medtech Limited Page 5 of 80

6 3. Clicking Setup Clinical Audit Tool will open the Clinical Audit Tool Setup window. The Server Name/IP field will be shown. 4. Clicking About HealthStat will open the HealthStat Home Page in a new browser. 5. Clicking Launch HealthStat will log the user into Health Stat and open the user s Health Stat home page in a custom browser within Medtech32. Copyright Medtech Limited Page 6 of 80

7 6. If both the CAT and Health Stat custom browsers are open, selecting one browser will automatically place the other browser in the background. Setting the Preliminary Filter The Preliminary Filter allows you to filter the practice population based on registration, enrolment and funding status. Filtering allows clinical audit of a particular portion of the practice population, i.e. filtering registered patients only. This can be achieved using the registration filter. You can use one filter at a time, or multiple filters, i.e. filtering registered and enrolled patients. Using a single filter 1. Select the Reg Status from the list available. Copyright Medtech Limited Page 7 of 80

8 Hint To select more than one registration status (i.e. viewing data for Registered and Casual patients) hold the CTRL button on your keyboard while selecting Reg Status with Left Mouse Click. See screenshot below 2. You are now ready to proceed with querying the practice data and select one of the following Functional Screen filters: Demographics, Medications, Screening, Smoking, Allergy, Classification and Immunisation. Note: The preliminary filter is not applicable to the Reports and Health Stat screens. Copyright Medtech Limited Page 8 of 80

9 Using multiple filters 1. Select the Reg Status from the list available. 2. Select the Enrolment Status from the drop down list available. 3. Select the Funding Status from the drop down list available. 4. You are now ready to proceed with querying the practice data and select one of the following Functional Screen filters: Demographics, Medications, Screening, Smoking, Allergy, Classification and Immunisation. Copyright Medtech Limited Page 9 of 80

10 The Data Range filter allows filtering patient population based on the clinical data and can be used in conjunction with Reg Status, Enrolment Status and Funding Status. Screening Mapper Menu The Clinical Audit Tool allows the alignment of the Screening Terms available in the tool with the Screening Codes used in Medtech32. This alignment ensures that the correct screening data is used during the querying process, i.e. BP Term in CAT is set to match Blood Pressure (BP) screening in Medtech32. It is essential that the initial setup is done immediately after installation. Once the screening term mapping has been completed for each clinic, the Clinical Audit Tool will retain the setting for future use. This does not add screening terms to the PMS only allows CAT to interpret which terms you use and map these to the key indicators so your reports are accurate. If the user is registered with Health Stat, screening terms specific for Health Stat queries are imported into the CAT screening mapper during the CAT installation. Use the Screening Mapper menu to make your selections. 1. To access the Screening Mapper, click on the Map Screening Terms link on the Clinical Audit Tool landing page. Copyright Medtech Limited Page 10 of 80

11 2. The Screening Mapper window will open. 3. To map a screening term click the screening term name e.g. Breast 4. Select the Breast term and Breast Value Copyright Medtech Limited Page 11 of 80

12 5. Click the Add button. Cardiac Enzimes will appear within the Screening Mapper window. 6. Once all selections are completed, click OK to save. Copyright Medtech Limited Page 12 of 80

13 Deleting mapping 1. Tick the box next to the screening term you wish to delete. 2. Use the Delete button to remove unwanted or incorrect Screening Terms from the Screening Mapper screen. Hint A red star next to a screening term value indicates an invalid value or term for that particular screening. 3. Once all selections are completed, click OK to save. Copyright Medtech Limited Page 13 of 80

14 Chapter 2: Tool Navigation The Clinical Audit Tool enables the practice to extract and analyse important statistics of the practice population and take necessary action to address the essential healthcare measures. The Clinical Audit Tool provides statistical information about key health indicators for the practice population and/or key performance indicators for the practice indicating the effectiveness of the healthcare measure. Navigation Panel The Clinical Audit Tool screen is divided into four sections: Action Menu Filter Data Grid Graphs Action Menus The main screen of Clinical Audit Tool has the Action Menus that can be used to perform and analyse various auditing functionalities. The Action Menus are categorised into the following: Demographics, Medications, Screening, Smoking, Allergy, Classification, Immunisation, CPI Report and HealthStat. Copyright Medtech Limited Page 14 of 80

15 Filter The filter section is located on the left hand side of the CAT screen. There are three filters available Demographics, Medications and Classification. Demographics Filter 1. The Demographics filter can be accessed by selecting the Demographics action menu. 2. The Demographics filter will appear. Copyright Medtech Limited Page 15 of 80

16 Medications Filter 1. The Medications filter can be accessed by selecting the Medications action menu. 2. The Medications filter will appear below the Demographics filter. Copyright Medtech Limited Page 16 of 80

17 Classification Filter 1. The Classification filter can be accessed by selecting Classifications action menu. 2. The Classification filter will appear below the Demographics filter. Copyright Medtech Limited Page 17 of 80

18 Data Grid The Data Grid is always present at the bottom part of the screen. The Data Grid contains the list of all patients data filtered based on the selected criteria. Depending on the number of records returned, multiple pages maybe available, each page showing 15 patients. 1. To hide graph and view Data Grid only, click Hide your graph button Copyright Medtech Limited Page 18 of 80

19 3. To move up and down the page, use the scroll bar. 4. To navigate from one page to another click the page number. 5. Clicking on the patient s name in the Data Grid will bring the relevant patient onto Medtech32 palette and minimise the CAT custom browser and Health Stat custom browser, if open. If a single patient has been taking different medications or suffering from different medical conditions that are present under the filter, then after clicking the specific action menu, these patients will be listed multiple times in the data grid (one entry for each of the medications or diseases). Copyright Medtech Limited Page 19 of 80

20 Click Eliminate Duplicate Record Set button to eliminate the multiple listing of single patient and list the latest entry for each patient, depending on the screen you are in. Example: If you click Eliminate Duplicate Record Set button within medication screen it will show the latest entry of medication for each patient. The Visit column has two functionalities: 1. For each action menu screen the visit column lists the date the data was entered into the patient s record. 2. Clicking any of the Visit Date in the list will display a pop up box which will consist of a chronologically ordered list of all the related data that has been entered in the patient s record. Copyright Medtech Limited Page 20 of 80

21 The display filter drop down box in the top right corner reorganises the labels on the graph. Clinical Audit Tool v Select one of the options available e.g. Gender 2. You will be presented with the following graph. Copyright Medtech Limited Page 21 of 80

22 Graphs The Graph section is located at the top half of the screen and displays two types of graphs: 1. An interactive graph which always shows the data based on the filter applied. 2. A static graph named Sex Distribution Chart based on Gender and/or Age Range of the patients represented in the Data Grid. Analysis Chart icon - clicking this icon will display the interactive graph. Sex Distribution Chart icon - clicking this icon will display the static sex distribution chart. Copyright Medtech Limited Page 22 of 80

23 Pie chart functionalities Right click on any Pie chart to get a list of functionalities such as enabling the rotation of the chart, viewing in 2D and slicing the chart into separate sections. Enable rotation 1. Right click on the Pie chart and select Enable Rotation option. 2. Left click on the Pie chart, hold the mouse button and move it clockwise or anti clockwise. The Pie chart will rotate. Copyright Medtech Limited Page 23 of 80

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25 View 2D 1. Right click on the Pie chart and select View 2D option. 2. The Pie chart will be presented in 2D View. Copyright Medtech Limited Page 25 of 80

26 Enable slicing movements 1. Right click on the Pie chart and select Enable Slicing Movement option. 2. Left click on any segment of the Pie chart. The segment will be separated from the Pie chart. Copyright Medtech Limited Page 26 of 80

27 3. Multiple segments can be moved by left clicking each segment. Note: If an interactive graph has less than 30 items, the graph will be displayed as a pie graph. If an interactive graph has more than 30 items, the graph will be displayed as a bar graph and 10 bars per screen will be shown. Next and Prev links will be provided for navigation. Copyright Medtech Limited Page 27 of 80

28 Copyright Medtech Limited Page 28 of 80

29 Functional Elements The Functional Elements present in the Clinical Audit Tool provide with the ability to apply various functions. They are explained below. Home Page The Home Page Filter icon can be used to return to the Home Page of CAT. Advanced Filter The Advanced Filter can be used for drilling down the data queries. This filter is used for cross tabulated queries. It can be accessed by clicking the Advanced Filter icon. The Advanced Filter has three sections: 1. Select the field select the field data you would like to apply the filter to. 2. Select a condition select the conditions based on the filter you would like to apply. 3. Value select the value based on the condition selected. To select multiple values, use the Shift or Ctrl key. Copyright Medtech Limited Page 29 of 80

30 4. Click OK to apply all selections and view the patients list and graphs. Copyright Medtech Limited Page 30 of 80

31 Action Functionality The Action Functionality provides with ability to perform an action on the results or data list generated by the use of Clinical Audit Tool. Tight integration with Medtech32 provides the ability for sending Recalls, Staff and Patient Tasks and Mail Merge letters to an individual or a group of patients. The Action Functionality can be accessed by clicking Do Recall Tasks for Selected Patients icon. To use Action Functionality do the following: Mail Merge 1. Ticking the box All will place a tick next to all patients currently in the Data Grid to apply the specific action. If a patient has not been selected and the Do Recall Tasks for Selected Patients icon is selected, the following pop-up will be displayed. 2. Click the Do Recall Tasks for Selected Patients icon to bring up the Patients Next Visit screen. Copyright Medtech Limited Page 31 of 80

32 3. Selecting one of the radio buttons and clicking the OK button will invoke the specific Clinical Audit Tool utility screen. Example: Select Mail Merge and click OK. Mail Merge screen Next Patient Visit 1. On the Patients Next Visit screen, select Patients Next Visit and click OK. Copyright Medtech Limited Page 32 of 80

33 2. This will bring up the following screen where you can type in a free-text message for the patient task and click OK. 3. This will add a patient task to each of the applicable patients in Medtech. Patient Recalls 1. On the Patients Next Visit screen, select Patient Recall and click OK. 2. This will bring up the following screen where you can select Recall Type, Code, Provider, Date or Spread Over. Tick Update Existing to avoid duplicate recalls and click OK. Copyright Medtech Limited Page 33 of 80

34 3. This will add a patient recall to each of the applicable patients in Medtech. Alerts 1. On the Patients Next Visit screen select Alerts and click OK. 2. This will bring up the following screen where you can select the Alert Code, add a note, then tick Auto Prompt and Update Existing (if required). 3. This will add a patient alert to each of the applicable patients in Medtech. Note These screens are similar to the Medtech32 screens that are accessible via the Query Builder. Copyright Medtech Limited Page 34 of 80

35 Data Export The Data Export functionality is used for exporting the data or patient list generated by using various filters. At present users can export lists generated by the Clinical Audit Tool to an Excel sheet. The Data Export functionality can be accessed by clicking the icon. 1. Click the Data Export functionality icon for the File Download pop-up to appear. 2. Click the Save button to save the file. Save Query The Save Query functionality is used for saving specific queries generated by CAT. When this option is selected, the queries are saved in a text file. The Save Query functionality can be accessed by clicking the icon. Note: The Save Query icon is unavailable for the CPI Reports and Health Stat screens. 1. Click the Save Query functionality icon for the File Download pop-up to appear. 2. Click the Save button to save the file. Copyright Medtech Limited Page 35 of 80

36 Chapter 3: Functional Screens When the Preliminary Filter settings selection is completed, you can access one of the following Functional Screens: Demographics, Medications, Screening, Smoking, Allergy, Classification, Immunisation, CPI Report, and Health Stat. When the Functional Screen is selected, the name of the screen will appear in the top right corner of the Clinical Audit Tool. Demographics Screen The Demographics Screen consists of a comprehensive demographic filter. It displays data of the practice population based on Ethnicity, Gender, Age, Postcode, Patient s last visit and Provider. Copyright Medtech Limited Page 36 of 80

37 Using the Demographic Filter 1. Select the filter that needs to be applied by ticking the appropriate boxes and entering the values in the appropriate boxes. Example: Male patients 18 years old and older. 2. Click the Get Values button to generate an interactive graph and the list of patients. 3. The Clear Conditions button will clear all filters that have been applied. Demographics Grid The Grid in the Demographics screen displays the details of all patients present in the practice based on the filter applied. The columns in the grid consist of Patient Name, NHI Number, Age, Age Range, Ethnicity, Gender, Provider, Postcode and Visit. Copyright Medtech Limited Page 37 of 80

38 Demographics Graphs The data present in the Grid section is represented in a graphical format in the Graph section of the Clinical Audit Tool. Based on the columns selected or filter applied the graphs will be generated differently. In the Demographics screen users can generate graphs for NHI No., Age, Age Range, Gender, Ethnicity, Postcode, Street, Suburb, City and Provider. Pie Graph Ethnicity Count Bar Graph Sex Distribution Selecting the Sex Distribution Chart icon will display the sex distribution results for the pie graph. Copyright Medtech Limited Page 38 of 80

39 Clicking on a specific graph segment of the pie graph will generate a graph representing data for patients relative to the selected graph segment, and generate a list of patients in the Grid section. Example: 1. Click the graph segment Maori - NZ. 2. The pie chart for Maori - NZ will appear. The Data Grid will be populated with the list of patients fitting this criterion. Copyright Medtech Limited Page 39 of 80

40 3. You can view excluded data (all other Ethnicities excluding Maori excluded records icon. - NZ) by clicking View 4. The following graph will appear. Copyright Medtech Limited Page 40 of 80

41 5. To return to chart showing Maori - NZ patients, click View Included Records icon. 6. To view the Sex Distribution chart, click the Sex Distribution icon. Copyright Medtech Limited Page 41 of 80

42 No Values Graph The No Values Graph for a particular filter shows that patients don t have relevant data recorded, i.e. Null Graph in Ethnicity section indicates that a number of patients don t have an ethnicity recorded in the Patient Register screen (or F3). You have the ability to perform actions via the Action Functionality for the patients identified in the No Value Graph data. Example: Add an alert such as Add patient ethnicity. 1. Click on the No Values segment of the Graph to generate a list of patients without ethnicity information recorded in the Patient Manager. Copyright Medtech Limited Page 42 of 80

43 2. Tick all patient names on the list by placing a tick into the All tick box. 3. Click the Do Recall Tasks for Selected Patient icon to access the Patients Next Visit screen. Copyright Medtech Limited Page 43 of 80

44 4. Select the Alerts radio button and click OK. 5. This will bring up the following screen. Select Code, add a note and if required tick Auto Prompt and Update Existing and click OK. 6. This will add a patient alert to each of the applicable patients in Medtech. Copyright Medtech Limited Page 44 of 80

45 Medications Screen Medications Filter The Medications Filter can be accessed as follows: 1. Select the Medications Functional Screen. 2. The Medications Filter will appear in the left bottom corner of the screen. The Medications Filter is divided into two sections: 1. Medications Heart this filter consists of all commonly used medications given for treating Heart conditions. 2. Medications Other this filter consists of all commonly used medications given for treating other medical conditions like Diabetes, Asthma, and Mental Health, etc. Copyright Medtech Limited Page 45 of 80

46 Use the scroll bar to view the Medications Other section. Ticking the Select All selection box will lead to automatic application of the filter for all the medications. Un-ticking it will not apply any filter. You can select individual or a few medications manually. Copyright Medtech Limited Page 46 of 80

47 1. Un-tick box Select All. 2. Select individual medications or groups of medications. 3. Click the Get Values button. 4. The list of patients taking the specified medications will be displayed in the Data Grid section of the screen. 5. The relevant graph will be displayed in the Graph section of the screen. Copyright Medtech Limited Page 47 of 80

48 Medications Grid The medications Data Grid section has three extra columns Brand, Generic Name and Generic Group that shows the brand and generic name details of the medications selected. The remainder of the fields and columns are the same as the Demographics screen. Medications Graph Selecting the Brand, Generic Name or Generic Group field on the display filter will generate relevant interactive graphs allowing the evaluation of the medications data. Example: List all patients who take Ismo 20 medication. 1. Select the Brand field on the Medications display filter. Copyright Medtech Limited Page 48 of 80

49 2. Interactive graph will appear. 3. The graph above shows that 9.68% of the patients are taking Ismo 20 medication. 4. Clicking on that graph segment would generate a single graph for the Ismo 20 and those 9.68% or 3 patients names would be shown on the Data Grid as well. Copyright Medtech Limited Page 49 of 80

50 Example: How many of the patients are taking Ace Inhibitors? 1. Un-tick box Select All. 2. Tick the Ace selection box which would apply only that filter and look for patients on these drugs present it in an interactive graphical format. 3. Click the Get Values button. 4. The interactive graph will be displayed showing number of records found. Medications Mapping with MT32 At present the Clinical Audit Tool is only extracting MIMS medications and for this purpose we are looking for the MIMS Class ID in the Medtech32 database. It is recommended that practices use only the latest MIMS medications if they want to perform medications auditing for the patients data. Consequently, MIMS must always be kept up to date. Copyright Medtech Limited Page 50 of 80

51 Screening Terms Screen The Screening Terms screen gives users the functionality of extensive data filtering and display of Laboratory values and Screening Items such as BMI, Lipids, Creatinine, HbA1c, Cervical Smear and BP. Screening Grid Each Screening Term has different fields and columns in the Grid section. BMI To view BMI Screening, go to Screening > BMI The default landing page for BMI Screening shows the results if the patient is healthy, underweight, overweight, obese or morbidly obese based on the BMI value, or does not have BMI recorded. Copyright Medtech Limited Page 51 of 80

52 Lipids To view Lipids Screening, go to Screening > Lipids, and select one of four values Cholesterol, LDL, HDL or Triglycerides. Lipids have been divided into four sections Cholesterol, LDL, HDL, Triglycerides. For each of these screening items, their screening results value and its range have been included in the Data Grid. Lipids Graph Selecting the Cholesterol field or the Cholesterol Range field in the display filter will generate the particular graph in the graph section. Copyright Medtech Limited Page 52 of 80

53 Creatinine To view Creatinine Screening, go to Screening > Creatinine. The Creatinine grid displays the outcomes and the Creatinine value. The Pie chart shows the Outcome of the Creatinine result, with the Null section showing that nothing has been entered as outcome under the Creatinine screening term for 10% of the patients although they have Creatinine values recorded. Copyright Medtech Limited Page 53 of 80

54 HbA1C To view HbA1C Screening, go to Screening > HbA1C. Clicking on the Not Recorded section of the graph to get list of patients who don t have HbA1C screening value recorded. Copyright Medtech Limited Page 54 of 80

55 Cervical Smear To view Cervical Smear Screening, go to Screening > Cervical Smear. By default the landing page for Cervical Smear screen consists of the Outcome graph and the Grid. Outcome data is present under the screening terms used to enter Cervical Smear data in the Screening screen of MT32. A list of patients can be generated by clicking on each graph bar. Example: Click the Not Sufficient Sample graph bar to generate a list of patients with this entry as an outcome. Copyright Medtech Limited Page 55 of 80

56 BP To view BP Screening, go to Screening > BP. The BP grid displays the outcomes and the BP value for both Systolic as well as Diastolic values, the graph shows the Outcome of the BP result, with the No Values section showing that nothing has been entered as outcome under the BP screening term for 94.5% of the patients although they have got BP readings recorded. Copyright Medtech Limited Page 56 of 80

57 Smoking Screen To access Smoking Functional Screen, click Smoking. The Smoking screen displays smoking status for the practice population. The No Values section in the above graph would show the list of patients who have a value entered in the Smoking template of Medtech32, but the status has not been entered or entered incorrectly. The practice can select this list of patients to rectify the mistake made while entering smoking data. 1. Click the No Values section of the graph. Copyright Medtech Limited Page 57 of 80

58 2. The Data Grid section of the screen will list patients without smoking status outcome or with incorrect smoking status outcome. 3. You can now add or correct smoking status outcome for these patients. Copyright Medtech Limited Page 58 of 80

59 Allergy Screen To access Allergy Functional Screen, click Allergy. The Allergy screen will allow the practice to do auditing based on the allergy related data in a patient s record. Allergy data can be entered in MT32 using various methods, for example by adding read codes in the Classification section or by adding Medical Warnings screen. Under these circumstances the CAT will look into each of these different sections and extract the latest data entered for the allergy. If a single patient has multiple allergy entries (eg. RX allergy and Food allergy), these patients will be listed multiple times in the Data Grid (one entry for each of the allergies). Copyright Medtech Limited Page 59 of 80

60 Copyright Medtech Limited Page 60 of 80

61 Classifications Screen To access Classifications Functional Screen, click Classifications. Classification Screen The Classification screen allows the practice to audit chronic and other important diseases that need constant monitoring and thus help in the management of these diseases. The landing page for the Classifications screen will consist of the Disease Group graph by default. Selecting the Disease field on the display filter will display another graph showing a further breakdown of the disease that come under that particular group. Copyright Medtech Limited Page 61 of 80

62 Copyright Medtech Limited Page 62 of 80

63 The Disease Group represents the classification category under which various other diseases fall. Example: Disease Group Diabetes mellitus will have Diseases like Diab.mell. with neuropathy, Diab.mell.+periph.circul.dis, etc. 1. Click Classification to view Classification Functional Screen. 2. The following graph will appear, displaying Classifications by Disease Group. 3. Click the Diabetes Mellitus section of the graph. Copyright Medtech Limited Page 63 of 80

64 4. You will be presented with Diabetes Mellitus graph. The Data Grid will contain list of patients names with disease name. Copyright Medtech Limited Page 64 of 80

65 Disease Filter The Disease Filter has been divided into various sections like Diabetes, Respiratory, Cardiovascular, etc, and each of these sections consists of the related diseases in it. Users can unselect the automatically applied filter and select relevant diseases manually to get individual graphs. Ticking the Select All box will lead to automatic application of the filter for all the classifications. By default, this check box will be ticked automatically. Copyright Medtech Limited Page 65 of 80

66 Un-ticking the Select All box will undo all the filters so that practice can select individual or a few classifications manually. The Get Values button is common for the Demographics, Medications and Classifications filter. Clicking the Get Values button will apply the filter selected in the classifications filter and give the list of patients in the Data Grid and display the graph with the classification breakdown. Disease Grid The Disease grid can be used to find out the Age Range, Gender etc of patients suffering from diseases. Example: Users can select the Gender field on the display filter and it will display a graph for the Copyright Medtech Limited Page 66 of 80

67 prevalence of diseases based on gender, which would give users input on how many of females/males are suffering from chronic diseases. Copyright Medtech Limited Page 67 of 80

68 Disease Graphs Clicking any of the graph segments will generate the list of patients suffering from these diseases. This graph was generated by selecting the Disease field on the display filter. Immunisation Screen The Immunisation screen shows all Vaccines given to the patients. By default the Immunisation screen displays only the latest immunisation recorded for each patient. If you click the Next link it will display continuation of the graph with vaccines showing alphabetically from left to right. Copyright Medtech Limited Page 68 of 80

69 Clicking the Prev link will return you to the previously displayed section of the graph. There are instances where some of the practices are using the Immunisation screen in MT32 to enter medications that are given through injections. This has been done since there is no provision to recall patients for injections if it is entered through the Medications screen. For this purpose practices are using various vaccine groups like Pneumococcal or Tetanus groups to enter the medical injection data. The Clinical Audit Tool cannot segregate these medical injections from that of the actual vaccines. Therefore, there would be instances where these medicines will be listed along with the vaccines. Reports To view the various Reports, click Reports. The Reports menu has three submenus: CPI (Clinical Performance Indicators) Report PPP (PHO Performance Programme) Queries Pre-Defined Queries o Screening Management o Register Management Copyright Medtech Limited Page 69 of 80

70 o o Chronic Disease Management Read Coding Management CPI Report shows the 14 Clinical Performance Indicators that are sent by practices to PHO. These graphs can be used by practices to get more input on the patients clinical data that comes under each of the government mandated indicators. If the title of the indicator is not fully displayed, mouse over the bar for the particular indicator to read the full title. The CPI Report queries are: Current smoker status recorded Statins prescribed when CVD risk >= 15% Patients having their CVD risk recorded as >= 15% in the 5 years CVD risk recorded in the last 5 years Diabetes patients wth HbA1C 8 or below at last annual check (if part of Diabetes Get Checked) or in the last year (if not part of the Diabetes Get Checked) Diabetes recorded in the past year (Get Checked) Diabetes ever recorded Heart failure ever recorded Ischaemic CVD event ever recorded Diabetes patients who have had a positive microalbuminuria test and are on ACE inhibitor or A2 receptor agonist at last annual check Diabetes patients recorded as having a microalbuminuria tset in the last 18 months Myocardial infarction ever recorded Smoking status ever recorded Stroke ever recorded The PPP Queries screen displays 14 PHO performance KPIs and each KPI shows the patients that require action by the PHO. The PPP Queries are: All funded patients aged >= 35 that have never had a CVD risk recorded All high need (Maori/Polynesian/Indian sub continent) female patients aged that do not have CVDR recorded All non high need female patients aged that do not have CVDR recorded All high need (Maori/Polynesian/Indian sub continent) male patients aged that do not have CVDR recorded All non high need male patients aged that do not have CVDR recorded All patients with diagnosis of DM that have not had a review in the last 12 months All patients with prescription for hypoglycemic not recorded as having DM All high need patients with prescription for hypoglycemic not recorded as having DM Funded high need women patients aged without mammogram done in the last 2 years Funded patients, women aged 20-69, without cervical smear recorded in the last 3 years Funded high need women patients, aged 20-69, without cervical smear recorded in the last 3 years Copyright Medtech Limited Page 70 of 80

71 All high need patients with diagnosis of DM that have not had a review in the last 12 months All patients 65+ and with known diagnosis of asthma/diabetes/ihd that have not had a flu immunisation since the beginning of the year, based on the flu immunisation code in PMS All high need patients 65+ and with known diagnosis of asthma/diabetes/ihd that have not had a flu immunisation since the beginning of the year, based on the flu immunisation code in PMS The Pre-Defined Queries display the negative or opposite conditions of the Health Stat queries. These queries are designed to highlight to the PHO the patients that require action in that category. The Pre-Defined Queries are divided into four sections: Screening Management o o o o o o o Registered patients >= 35 with no BP recorded in the last 5 years Registered patients >= 35 whose smoking has not been recorded Registered patients >= 16 whose smoking has not been recorded Registered patients >= 35 with no HDL recorded Registered patients >= 35 with no LDL recorded Registered patients >= 35 with no total cholesterol recorded Registered patients aged >= 10 with no height recorded o Registered patients aged >= 10 with no weight recorded Register Management o o o o Registered patients with no age recorded Registered patients with no ethnicity recorded Registered patients with no gender recorded Registered patients with no NHI recorded Read Coding Management o o o o All patients under 45 on inhaled steroid not recorded as having asthma All patients with prescription for hypoglycemic not recorded as having DM All patients with prescription for nitrate not recorded as having IHD All patients with prescription for depression but no diagnosis recorded Chronic Disease Management o o o o o o o o All patients with 5 yr CVD risk > 15 not on aspirin All patients with 5 yr CVD risk > 15 not on Statin Registered patients with IHD that have not had a cholesterol recorded in the last year Registered patients with IHD (diagnosis or nitrate prescription) without aspirin prescription in the last 6 months Registered patients with IHD diagnosis that are not on a beta blocker Registered patients with IHD diagnosis that are not on a Statin Registered patients with DM that have not had an ACEI in the last 6 months Registered patients with DM that have not had a Statin in the last 6 months Note: Copyright Medtech Limited Page 71 of 80

72 If a patient has the same disease entered in History and Classification, CPI Reports will only show the latest dated entry of that disease. CPI Reports displays data for all patients, not only registered and enrolled patients. HealthStat Integration The Clinical Audit Tool has been integrated with the HealthStat Primary Healthcare Intelligence Utility enabling practices to view their dataa in comparison with other practices in the PHO. Clicking specific graphs related to specific queries displayed in the HealthStat website will get the patients list and the graph in CAT for further analysis. This is done by specifying the URL link for CAT under HealthStat and for each query a unique identifier will be appended to the URL so that CAT will know the sort of query it has to run against the database where CAT has been installed. There is a main action menu titled HealthStat in CAT where users can generated through the HealthStat website. analyse the patient list Users will be able to take the patients list generated through the HealthStatt to other sections of the Clinical Audit Tool for further analysis. Example: If a practice wishes to view patients with no smoking recorded, they can drill down on the Health Stat Smoker Recorded query and CAT will display the patients in their practice with no smoking recorded. Copyright Medtech Limited Page 72 of 80

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75 Chapter 4: Scenarios Query 1: How many of the CHD patients are smokers? 1. Go to the Classification screen and apply the CHD filter. 2. Then go to Smoking screen which will show the list of CHD patients who have smoking data entered for them. Copyright Medtech Limited Page 75 of 80

76 3. To generate the list of smokers, click the Advance Filter icon. 4. Set the Select the field to Status, and the Select a condition to Equal To. 5. To select multiple entries in the value drop down box, press CTRL key on your keyboard and then use the mouse to select the desired multiple entries. Press the OK button. 6. The graph and list of patients suffering from CHD who are smokers will be generated. Copyright Medtech Limited Page 76 of 80

77 Copyright Medtech Limited Page 77 of 80

78 Query 2: How many Preventive Inhaler users have Asthma? 1. Go to the Medications screen and click Preventive Inhalers section of the graph. 2. You will be presented with Preventive Inhalers users graph. 3. Then go to Classification screen which will show the list of Preventive Inhalers users with different classifications. The graph shows that there are 197 asthma patients who use Preventive Inhalers. Copyright Medtech Limited Page 78 of 80

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80 Query 3: How can I find out the entire medication list for a single patient. 1. Go to the Medications screen and click the visit day for the selected patient. 2. The following window with patient s medications will open. Copyright Medtech Limited Page 80 of 80