Anticoagulation Manager - Getting Started

Transcription

1 Vision 3 Anticoagulation Manager - Getting Started Copyright INPS Ltd 2014 The Bread Factory, 1A Broughton Street, Battersea, London, SW8 3QJ T: +44 (0) F:+44 (0) W:

2 Copyright Notice 2014 INPS All Rights Reserved. No part of this document may be photocopied, reproduced, stored in a retrieval system or transmitted in any form or by any means, whether electronic, mechanical, or otherwise, without the prior written permission of INPS. No warranty of accuracy is given concerning the contents of the information contained in this publication. To the extent permitted by law, no liability (including liability to any person by reason of negligence) will be accepted by INPS, its subsidiaries or employees for any direct or indirect loss or damage caused by omissions from or inaccuracies in this document. INPS reserves the right to change without notice the contents of this publication and the software to which it relates. Product and company names herein may be the trademarks of their respective owners. INPS Ltd. The Bread Factory 1a Broughton Street London SW8 3QJ Website: Contents ANTICOAGULATION MANAGER 5 Getting Started 5 What this Guide Covers 5 Prerequisites 5 What you need to do before using Anticoagulation Manager 6 Downloading Anticoagulation Manager 7 Enabling the Warfarin Dosing Tool 8 Identifying Patients on Warfarin using the Warfarin Monitoring Tool 8 Warfarin Monitor Screen 9 Scanning for Warfarin Patients 11 Adding a Diagnosis Indication to Patients Identified Using the Warfarin Monitoring Tool 12 Amalgamating QOF and Non QOF Alerts 14

3 Setting Practice Defaults 15 INDEX 17 iii

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5 Anticoagulation Manager Getting Started The following topics provide useful information regarding setting up Anticoagulation Manager: What this Guide Covers This user guide gives details of the following: Prerequisites - See Prerequisites (page 5). What you need to do before using Anticoagulation Manager - See What you need to do before using Anticoagulation Manager (page 6). Downloading Anticoagulation Manager - See Downloading Anticoagulation Manager (page 7). Enabling the Warfarin Dosing Tool - See Enabling the Warfarin Dosing Tool (page 8). Identifying Patients on Warfarin - See Identifying Patients on Warfarin using the Warfarin Monitoring Tool (page 8). Adding Diagnosis Indication - See Adding a Diagnosis Indication to Patients Identified Using the Warfarin Monitoring Tool (page 12). Setting Practice Defaults - See Setting Practice Defaults (page 15). Prerequisites Amalgamating QOF and Non QOF Alerts - See Enabling the Warfarin Dosing Tool (page 8). To use the Anticoagulation Manager tools provided by INPS you must: DLM457 and SIS You must have DLM457 and SIS10330 installed before you can use Anticoagulation Manager. Download the Anticoagulation Manager - You must download the Anticoagulation Manager Template and Reports from Vision+. See Downloading Anticoagulation Manager (page 7). Enable the Warfarin Tool - Built into the Anticoagulation Template is a powerful Warfarin dosing tool. By default this dosing tool is disabled so before you start using the template you must enable this function. See Enabling the Warfarin Dosing Tool (page 8). 5

6 What you need to do before using Anticoagulation Manager Anticoagulation Manager is a monitoring tool. To use all of its functionality the patient must be stabilised on Warfarin before you can start using the dosing tool within Anticoagulation Manager. It is therefore recommended you carry out the following checks: Identify patients on Warfarin using the Warfarin Monitoring Tool - You can quickly identify patients who are on Warfarin using the specific Warfarin monitoring tool. See Identify Patients on Warfarin using the Warfarin Monitoring Tool (page 8). Add Diagnosis Indication - Before patients can have their INR monitored and Warfarin dose adjustment calculated, they must first have a current Diagnosis Indication. This Diagnosis Indication is in addition to the patient's diagnosis that may already be present in the patient's record. The reason for the Diagnosis Indication is that it is the indication that provides the therapeutic level of the dose, not the diagnosis entry. The Diagnosis Indication can be linked to an existing Read code in the patient's record using the Warfarin Monitoring Tool. See Adding a Diagnosis Indication to Patients Identified Using the Warfarin Monitoring Tool (page 12). Enter Past INR and Warfarin Dose Values - INR and Warfarin dose historical data must be available in Anticoagulation Manager in order for the correct dosing calculations and recalls to be performed. If the patient has more than five INR and five Warfarin readings then only the last five of each are used. This information is populated from Vision and is available on the History tab within the Warfarin Dosing Tool screen. For or advice on reviewing and adding INR and Warfarin details, please Refer to the full Anticoagulation Manager user guide. Alert Popup Window - By default QOF alerts appear when you select a patient in Consultation Manager. If you want to amalgamate non QOF alerts eg the Anticoagulation popup window with QOF Alerts see Amalgamating QOF and Non QOF Alerts (page 14). Patient Settings - To assist in managing the patient's Warfarin dosing regime you can set the patient's INR Target range and choose the tablet strengths that are available to the patient. In addition, you can specify if the patient is under hospital care, which will place a marker alongside the patient's record. For more information on Patients Settings, see the full Anticoagulation Manager user guide. Practice Settings - The Practice Defaults screen enables you to configure a number of settings for patients who are newly monitored by Anticoagulation Manager. To check your settings - See Setting Practice Defaults (page 15). 6

7 Downloading Anticoagulation Manager The Anticoagulation Manager file can be downloaded and managed from Download Web Files. To access the file: 1. Log into Vision, right click on the Vision+ icon in the Windows Notification area and select Download Web Files from the menu. Download Web Files Note - To access Download Web Files, you must not have a patient selected in Consultation Manager. 2. A list of files available to download and files already downloaded is displayed. 3. Select Anticoagulation Manager by ticking the Download box, then select the Download button. Anticoagulation Manager 4. A splash screen will appear at the base of the screen showing the progress of the download. Note - Templates that have been downloaded by your practice are available to all users. 5. The status column quickly shows which templates have already been downloaded to the system, and which templates have a new version that may be downloaded. Template Version numbers can be compared between the Web Version and Local Version to see if a more recent version is available for download from the web. 6. Close the Download Web Files screen to exit. 7

8 Enabling the Warfarin Dosing Tool By default the Warfarin dosing tool is disabled in Vision+. In order to use the Warfarin dosing tool in Anticoagulation Manager you must enable this in Settings for each user: To access Vision+ Settings: 1. Login to Vision. 2. From the Windows Notification Area, right click on the Vision+ icon and select Settings. Accessing the Vision+ Settings Screen Note - To access the Vision+ Setting screen, you must not have a patient selected in Consultation Manager. 3. The Settings Configuration screen displays. Settings - Disable Warfarin 4. Remove the tick from the Disable Warfarin box and click OK to save the changes. Identifying Patients on Warfarin using the Warfarin Monitoring Tool 1. Login to Vision. 8

9 2. From the Windows Notification Area, right click on the Vision+ Icon and select Practice Reports. Accessing Vision+ Practice Reports Note - To access Practice Reports, you must not have a patient selected in Consultation Manager else the patient-specific menu displays. 3. The Practice Reports screen appears. Select Warfarin on the toolbar. Practice Reports - Warfarin 4. Select Warfarin Monitor from the main area of the screen. Select Warfarin Monitor Warfarin Monitor Screen The Warfarin Monitor screen lists the patients who are currently having their Warfarin dose managed by the practice and have a Diagnosis Indication recorded. The Tool has two purposes: It can be used to scan for patients who are currently being prescribed Warfarin but do not appear on the Warfarin Monitor list as they do not 9

10 have a current indication recorded. This Getting Started guide details how to use the Scan Patients option - See Scanning for Warfarin Patients (page 11) and explains how to add the Diagnosis Indication - See Adding a Diagnosis Indication to Patients Identified Using the Warfarin Monitoring Tool (page 12), or; The initial Warfarin Monitor screen lists patients who already have an Indication Diagnosis recorded and at a glance you can see such information as those patients who have an abnormal INR result or you can review their recalls. For more information on all the options available within the Warfarin Monitor screen, please refer to the Anticoagulation Manager user guide. Note - The patient list will be empty if you are running the Warfarin monitor for the first time as only the patients who are currently being monitored and hence have a current Diagnosis Indication are shown. Initial Warfarin Monitor screen 10

11 Scanning for Warfarin Patients To find patients who need a Diagnosis Indication you can use the Scan Patients function. Click Scan Patients on the toolbar. The report can take quite a while to run depending on your practice list size. The window is then populated with patients who are currently taking Warfarin who need a Diagnosis Indication recorded. To record this information, see Adding a Diagnosis Indication to Patients Identified Using the Warfarin Monitoring Tool (page 12). Scan Patient List 11

12 Adding a Diagnosis Indication to Patients Identified Using the Warfarin Monitoring Tool After identifying patients who require a Diagnosis Indication using the Warfarin Monitoring Tool, you can work on the list and add the Indication. The Diagnosis Indication can also be entered on a patient by patient basis in Consultation Manager. This topic explains how to do both: Using Practice Reports to Add a Diagnosis Indication 1. From Practice Reports - Warfarin Monitor - Scan Patient list, double click on the patient's name. Scan Patients List 2. The Confirm dialog window appears and prompts you to enter a diagnosis. 3. Click OK. Confirm Diagnosis 12

13 4. The New INR/Warfarin Diagnosis screen appears as below. Add Diagnosis 5. Relevant Diagnosis Read codes for the patient are displayed in the History column. 6. Click on the History ( ) icon alongside the Diagnosis Read code you wish to use. 7. Historical Read codes are displayed as below. Historical Read codes 8. Double click on the relevant Read code. 13

14 9. The corresponding indicator will then appear in the Indication section at the bottom of the screen with the Start Date set to that of the Diagnosis Read code. If the treatment has a known end date then it can be entered into the End Date box. If no end date is given then this box can be left blank (this will be the case for the majority of patients). 10. Click OK. 11. The patient will then be removed from the current list (Scan patients), and next time appear in the initial list, as a result of them having a current Diagnosis Indication. Training Tip - If you want to view patients who now have a current Diagnosis Indication, close Warfarin Monitor and re-open it. Recording a Diagnosis Indication on individual patients in Consultation Manager 1. In Consultation Manager, select a patient. 2. From the Windows Notification Area, right click on the Vision+ icon select Warfarin Monitor. Alternatively, click the Vision+ icon toolbar and select Warfarin Monitor. 3. Click New Diagnosis. off the floating Warfarin Monitor -New Diagnosis 4. Refer to step 4 above on how to choose a new Diagnosis Indication. Note - Diagnosis Indications can also be recorded via the Anticoagulation Manager Template. For more information refer to the Anticoagulation Manager user guide. Amalgamating QOF and Non QOF Alerts By default QOF alerts appear when you select a patient in Consultation Manager. To amalgamate non QOF alerts eg the Anticoagulation popup window with the QOF window: Note - This is a user specific setting. 1. Log into Vision, right click on the Vision+ icon in the Windows Notification area and select Settings. 2. The Settings screen displays. 14

15 3. Tick the box Combine Triggers and click OK. Combine Triggers 4. The alert window will automatically show both QOF and other indicators when you select a patient. You also see a new Combined popup icon on the Vision+ Floating Toolbar. Setting Practice Defaults The Practice Defaults screen enables you to configure a number of settings for patients who are newly monitored by Anticoagulation Manager. Any changes made to these settings do not affect patients who are currently being monitored. Note - Practice Defaults are a practice wide setting. To check your practice defaults: 1. In Consultation Manager, select a patient. 2. From the Windows Notification Area, right click on the Vision+ icon select Warfarin Monitor. Alternatively, click the Vision+ icon off the floating toolbar and select Warfarin Monitor. Warfarin Monitor 15

16 3. Click Practice Defaults. Practice Defaults 4. Confirm the details on the Dosing Tab are correct. Changes may need to be made to tablets available (ie the practice may not use 500μg tablets), or practice clinic days (eg the days patients can come into the Warfarin clinic). 5. Click OK. Practice Default Screen 16

17 Index What this Guide Covers 5 What you need to do before using Anticoagulation Manager 5, 6 A Adding a Diagnosis Indication to Patients Identified Using the Warfarin Monitoring Tool 5, 6, 10, 11, 12 Amalgamating QOF and Non QOF Alerts 6, 15 Anticoagulation Manager 5 C Copyright Notice ii D Downloading Anticoagulation Manager 5, 7 E Enabling the Warfarin Dosing Tool 5, 8 G Getting Started 5 I Identifying Patients on Warfarin using the Warfarin Monitoring Tool 5, 6, 9 P Prerequisites 5 S Scanning for Warfarin Patients 10, 11 Setting Practice Defaults 5, 6, 15 W Warfarin Monitor Screen 10 17