QIM 5 – Influenza immunisation for patients with diabetes

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Recipe Name:	QIM 5 – Influenza immunisation for patients with diabetes
Rationale:	Diabetes was the underlying cause of around 10% of all deaths in Australia in 2016. People with diabetes are considered to be at high risk of complications from influenza. During recent influenza epidemics, diabetes was considered a significant risk factor for hospitalization The administration of influenza vaccine to persons at risk of complications is the single most important measure in preventing or attenuating influenza infection and preventing mortality. While best practice guidelines recommend annual immunisation, a 15 month interval allows for cases when a client decides to receive a vaccine earlier than recommended (e.g. from a pharmacy), or delay and wait for the release of an ‘enhanced’ vaccine.
Target:	Proportion of regular clients with type I or type II diabetes who are immunised against influenza. A person is immunised against influenza if they have received an influenza vaccine within the previous 15 months.
CAT Starting Point:	CAT Open - CAT4 view (all reports) loaded Population Extract Loaded and Extract Pane “Hidden” Filter Pane open and under the ‘General’ tab ‘Active Patients’ (3x <2 years) selected

Please note that the improvement measure is defined for patients with diabetes type I or type II. In this recipe patients with 'undefined' diabetes will be included, so it is a good idea to clean up your diabetes register regularly. However any patients with a free text diagnosis of diabetes will not be included in the report. Here is a recipe that shows the steps: Clean up the diabetes register

CAT4 starting point

RECIPE Steps Filters:

• In the “General” Tab, click the 'active' box
  
  

• On the 'Conditions' tab under 'Chronic', select 'Yes' for Type I or Type II diabetes:

• Then select the 15 month date range result filter, to only show results that were entered in the last 15 months:

• Click "Recalculate"

• Click ‘Hide Filters’

Report Steps

• Select the "Immunisations/Influenza" tab

This report will show you the Immunisation status of your selected patient group and will allow you to measure improvement over time by comparing your reports. The percentage of patients with 'Nothing Recorded' are those patients without an immunisation in the last 15 months

The immunisation report is designed to show patients who have received the current vaccine for the calendar year, so the 15 month criteria for this measure will show patients who have received last year’s vaccine if it was within 15 months of the extract date. Patients appearing in the ‘previous year’ category might still benefit from a vaccine this year!

To Export Patient List to Microsoft Excel:

1.  Click on the “Export Icon”  at the top of the Patient Reidentification window.

2.  Click on “Excel”

3.   Choose a file name and a location to save to (eg. Create a folder C:/ClinicalAudit/CAT Patient FollowUp)

4.  Click “Save”

The steps above will produce a list of patients with contact details in MS Excel which can then be used to:

1.   Go back through the individual patient records in the GP Clinical Desktop System (CDS) and update known records

2.  Phone patients to update their record

3.  Produce a mail merge to recall patients for follow up

Optional: Use Recall CAT SMS and voice messages for patient recall

Full details are here: Recall CAT

After you have applied one or more filters and/or cross tabulations and have selected the group of patients of interest, you will see the choices for SMS Recall and other options at the bottom of the patient re-identification report. This can be applied to all of our CAT Recipes or any custom search you want to perform.

CAT Starting Point:
The Patient Reidentification window displays your list of filtered patients

Customising Steps

You can refine the selection manually by clicking the 'Refine Selection' button.

If you click on "SMS Recall", the "SMS Recall" window will be displayed with the name of your clinic. Enter a message that relates to the purpose of the notification. There are a number of options under the inclusion criteria:

• Patients who have opted out of receiving SMS from your clinic are removed by default
• Linking your online booking system to the SMS recall
• Include the opt-out message in the SMS for patient to "STOP" receiving SMS notifications sent through CAT4

Clicking on "Send" will send the message to all patients with a valid mobile phone number in their record. A confirmation message will prompt you with the number of messages to be sent and the required credits. Click yes to send the SMS recall.

After sending a SMS or Voice Message you will see a message like this one (for SMS)

For full details on the prompt history, click on 'Prompts' and select 'SMS and Voicemail'

Recall CAT - Message History: http://help.pencs.com.au/display/CG/Recall+CAT+-+Message+History

Optional: Create a prompt to display in Topbar

Remember you need to be in the CAT4 Daily View to be able to create prompts. Other pre-requisites are:

• Topbar is installed
• CAT4 is linked to Topbar via Edit/Preferences/Topbar - check here for details: Linking CAT4 to Topbar
  
  

 To start CAT4 in the Daily View, click on the 'Daily View' icon in the dashboard:

Once you have applied the filter(s) and displayed the patients of interest as described above, you can create a prompt that will be shown to all clinicians using Topbar if a patient meeting the prompt criteria is opened in their clinical system. The full guide is available at CAT PLUS PROMPTS and a short guide on how to create prompts in CAT4 can be found at  Creating a Prompt in CAT4

To start you have to use the drop-down menu at the bottom of the patient details report and select "Prompt at Consult - Topbar" then click on "Go" to give the new prompt a name.

The name you enter is the prompt text displayed in Topbar, so choose a simple but clear name that tells the clinician seeing the prompt what should be done.