Conference : Clinical Audit General : General Forum http://www.clinicalaudit.com.au/forums/ Pen CAT not detecting INR results. Recent audit of those taking warfarin yielded a result on no client having a record of an INR. File audit shows otherwise. http://www.clinicalaudit.com.au/forums/messages.cfm?threadid=3E4432CD-B36B-99D3-302F8378BE5071F3&r=1 2010-06-16T10:59:03--10:00 Pathology detection I have suggested something similiar to Pen as well. It was in the context of searching for Diabetes patients: "[There is] No way to specify ?or? in a search. For example: I want all patients with diabetes as a condition, who do not have anything recorded for HDL, or LDL, or Triglycerides, or HbA1c. In that example, the search would alert the clinician to incomplete records that could not be properly reviewed. (It might require a pop-up window to modify the search with some flexible interface.)" I would like to see the pop-up window where I could toggle the search conjunctions of each criterion for "OR" or "AND" (or perhaps more mathematical "XOR", meaning "one or the other, but not both", "either/or"). [i]* Last updated by: csheppard on 28/1/2010 @ 12:50 PM *[/i] http://www.clinicalaudit.com.au/forums/messages.cfm?threadid=723B69BB-0E14-2B14-54BC629D13162424&r=2 2010-01-28T12:42:05--10:00 45-49 yr health check As you are aware, people in 45-49 yr age with predisposing factors for chronic disease can receive a MBS service 717. Practices using pracsoft 3 can search their databases using CAT for these people with the click of the mouse in CAT. Other practices can create searches for each risk factor. Is it possible to create an "or" function in the CAT so users can set their own requirements for this search and capture all patients rather than patients with all risk factors. Alternately modifying the search available to pracsoft practices by deleting the financial aspect would also be useful. http://www.clinicalaudit.com.au/forums/messages.cfm?threadid=723B69BB-0E14-2B14-54BC629D13162424&r=3 2010-01-28T11:01:21--10:00 45-49 yr health check In the HMR tab of PenCAT, there should be some compensation made for the data of the last script looking for the most recent data, e.g. last 6, 3 or 1 month/s. The core problem is that the GP has not ?deleted? (modified) the current script to be an old script. This is actually finding ?dirty data? that is currently being applied in HMR in such a way that is counter productive. This compensation might take the form of a report (not the global search) filter that could allow the user to specify the monthly period, including all. To clarify this problem as an issue, as defined by a Practice I work with, is that the HMR search, as we are aware, is the ?dirty data? coming out of the current search method. More precisely in addition to the search based on time periods, if such a data search has options to look for drugs prescribed in chronic illnesses generally requiring on-going drug treatment then it would give a better picture of patients suitable for HMR. This would be helpful for GPs to search data specifying more recent time periods for medications that the patient has been prescribed. http://www.clinicalaudit.com.au/forums/messages.cfm?threadid=4453F788-0F0C-E852-A87F3E200E5FD960&r=4 2010-01-19T13:05:38--10:00 HMR Issue Possible Dirty or Bad Data This is now available for MD/Pracsoft users in CAT 2.6 http://www.clinicalaudit.com.au/forums/messages.cfm?threadid=53EA04AF-9EAC-F20D-A6F603EC97ACB6F0&r=5 2009-10-14T10:59:32--10:00 75+ Checks (MBS Item No. 700) Alcohol has now been added but without the risk assessment. We are gathering information on what is best to display here given that the clinical applications all differ on what they record. Any feedback on this issue would be helpful. Christine http://www.clinicalaudit.com.au/forums/messages.cfm?threadid=7FAC1AFC-1174-411D-A747E23CB1DEAF2D&r=6 2009-10-14T10:55:23--10:00 Alcohol tab The Diabetes SIP billing items have been added in CAT 2.6 http://www.clinicalaudit.com.au/forums/messages.cfm?threadid=2F404A29-D1C1-111C-18FBB2C94B3FBCA2&r=7 2009-10-14T09:36:25--10:00 Item number searches Also, have an ability to search for dates that have only 2 digits for it year. http://www.clinicalaudit.com.au/forums/messages.cfm?threadid=C53D67E7-C890-E776-E3947338A24D011E&r=8 2009-09-10T15:36:40--10:00 Addition of a Data Cleaning Tab (or Window) in Pen CAT Hi CAT users, During an install yesterday, a PN asked if she could find out which patients in the dB has completed a 75+ check. Any ideas/suggestions on how I can get this info? Thanks http://www.clinicalaudit.com.au/forums/messages.cfm?threadid=53EA04AF-9EAC-F20D-A6F603EC97ACB6F0&r=9 2009-08-26T09:35:28--10:00 75+ Checks (MBS Item No. 700) The ability to find patients without a billing item recorded was added in the last CAT release (2.5.3). More billing item numbers will be added in the CAT Septeember release. http://www.clinicalaudit.com.au/forums/messages.cfm?threadid=2F404A29-D1C1-111C-18FBB2C94B3FBCA2&r=10 2009-08-24T10:12:58--10:00 Item number searches I am a problem when downloading the software there is a small message box displaying the downloading status. In it there is a 'cancel' button that is default (having focus in programming terms). I have found that sometimes it is accidentally pressed from the keyboard while its downloading and the user is performing other tasks, or some accidental key stroke is selecting it. Can this be made safer? For example, not making it a default, and if selected it only cancels with a confirmation. That confirmation should not have the stopping of the download as the default either. http://www.clinicalaudit.com.au/forums/messages.cfm?threadid=302B6BF3-D052-5F42-A6F11F717A871B00&r=11 2009-08-19T11:00:35--10:00 Downloading Cancellation Hume - thank you for this really useful information. We will be prioritising the Diabetes SIP work first - I have had other requests about this and it seems to be what most people are after. I will log all your suggestion in our development work database so they stay on our agenda. Christine http://www.clinicalaudit.com.au/forums/messages.cfm?threadid=2F404A29-D1C1-111C-18FBB2C94B3FBCA2&r=12 2009-07-30T16:03:54--10:00 Item number searches This will be in our September release http://www.clinicalaudit.com.au/forums/messages.cfm?threadid=7FAC1AFC-1174-411D-A747E23CB1DEAF2D&r=13 2009-07-29T17:00:48--10:00 Alcohol tab I would like to suggest the addition of a search tab in the Pen Clinical Audit Tool. I feel that it would assist Practices to have a central Search Tab (or Window) and standard method of cleaning and maintaining data. Some might or could be covered by Saved Filters, but I think some should just be standardised and incorporated regardless. The primary reason for the need for this is that I have encountered some practices who have a legacy of very old patient records (e.g. they started using clinical software 10 years ago), or they migrated from one version or a different software product to another. Another possibility might be that they changed computers and operating systems that forced a migration activity to occur. I have found that it?s likely that at least a few practices in our area are affected, and either are suffering from it, or may not be aware of such data quality problems. Some specific ideas include: - Lift of patients with No Age 'Start Age: 998' - List of patients with No Gender - List of patients without a Medicare Number. - List of all adult patients over 25 years of age who have not visited in the past 7 years. (These are patients whose records could be destroyed, or inactivated.) - List of all adult patients over 90 years of age. (These are patients who might be deceased, whose records could be marked deceased, or inactivated.) - List of potentially duplicated Patients. (List to search for matching Patient Name for First and Last name. Their Middle name may or may not be recorded properly, so best to exclude it or make it optional.) - List of patients with non-alpha numeric characters in these fields: - First Name - Middle Name - Last Name - Address - Postcode - State - Country (This could indicate which records are corrupted. This might be due poor data or system migration.) - List of patients with numeric characters in these fields: - First Name - Middle Name - Last Name - State - Country (This could indicate which records are corrupted. This might be due poor data or system migration.) - Search for alphabetical characters in these fields: - Postcode (This could indicate which records are corrupted. This might be due poor data or system migration.) This tab could also generate a simple report showing a summary count of each of these searches for the purposes of indicating to a regular user that there might be a problem with the basic data quality of their Patient database. http://www.clinicalaudit.com.au/forums/messages.cfm?threadid=C53D67E7-C890-E776-E3947338A24D011E&r=14 2009-07-29T16:40:51--10:00 Addition of a Data Cleaning Tab (or Window) in Pen CAT How is this progressing? http://www.clinicalaudit.com.au/forums/messages.cfm?threadid=7FAC1AFC-1174-411D-A747E23CB1DEAF2D&r=15 2009-07-29T16:38:29--10:00 Alcohol tab One of the huge plusses of CAT is its ability to interigate the billing package (in my case Pracsoft) as well as the clinical database. Love this feature. However, I would like to see other item numbers added to the list. My priorities would be: Items 2517 to 2526, and Items 2620 to 2635. These are the Diabetic Cycle of Care items. So far the CAT can identify those patients for whom the clinical work has been done, but not whether the item number has been billed. This final piece of information is what practices need to maximise the billing. A similar search for the asthma items (2546-2559; 2664-2677), combined with a search of our asthma patients who are on inhaled or oral steroids could maximise our use of these numbers. Regarding 2710s (Mental Health Plan), and 2712s (Review of Mental health Plan): The HIC have indicated that they will be auditing these items, and our reliable sourses tell us that their initial screen of doctors to audit will be those who have had a 2710 done, but not a follow up 2712. Therfore we need to know those patients who have had a 2710 done, but not a subsequent 2712. Similarily, the HICs audits of care Plans (721)will be targeting doctors who havne't done a subsequent Care Plan Review (725) There are no doubt other item number searches that would be usefull from a clinical, financial and auditing purpose; This is a start. Hume http://www.clinicalaudit.com.au/forums/messages.cfm?threadid=2F404A29-D1C1-111C-18FBB2C94B3FBCA2&r=16 2009-06-30T13:40:58--10:00 Item number searches Yes - alcohol will be included - its a bit tricky because the guidelines have changed and the applications that do collect good data are not completely in line any more. The graph will be like the smoking one - it will show Non Drinker, Low Risk, At Risk and Not Recorded At Risk is anyone who drinks > 2 drinks on a regular occasion or > 4 drinks on any occasion. The current applications collect >=6 drinks for the latter. Applications that collect minimal data: Genie only provides a tick box at the moment for alcohol with free text comments. Probably we will treat this as Non Drinker and At Risk http://www.clinicalaudit.com.au/forums/messages.cfm?threadid=7FAC1AFC-1174-411D-A747E23CB1DEAF2D&r=17 2009-06-29T17:10:50--10:00 Alcohol tab We are currently testing the ZedMed extraction. It should be available to ZedMed users early August. http://www.clinicalaudit.com.au/forums/messages.cfm?threadid=8F9E316E-411F-489C-892594D63CB8F389&r=18 2009-06-29T17:01:13--10:00 Pen CAT for ZedMed When you recieve a pathology report as a pit file, you recieve a picture of the page, like a fax. If you recieve the report as a hl7 file, it comes in as individual pieces of data, and your own programs can break it downm, and use the data to populate other tables. EG in a FBC, the Hb, WCC, Neuts, Plats etc are all recorded individually. You must recieve your pathology as hl7's for programs like CAT to use the data. Unfortunately, although pathology companies can send in either format, most default to the pit option. This happened with us in Toowoomba. When we started getting practices to analyse their data, the first thing they had to do was specifically ask our local profider to change to sending reports using hl7 format http://www.clinicalaudit.com.au/forums/messages.cfm?threadid=A83EDFDF-F531-31B3-A0EC3FCD0A84A018&r=19 2009-06-23T14:08:50--10:00 Comparison with MSD PARIS We have MSD suggesting practices use their CAT and stating: "Pen tool does not pick up PIT file pathology which equates to anywhere from 20-40% of a clinics pathology and thus missing a lot of patient results. This said the PEN tool is great at looking at what a clinic has done as well as information for things like Accreditation but isn't designed as well as PARIS to pick up patients to do more preventative medicine with." Please comment. http://www.clinicalaudit.com.au/forums/messages.cfm?threadid=A83EDFDF-F531-31B3-A0EC3FCD0A84A018&r=20 2009-06-04T08:30:41--10:00 Comparison with MSD PARIS