More Heart and Diabetes Checks

Enigma is excited to see the new MoH campaign promoting more Heart and Diabetes checks kicking into full swing!

The official promotional website and resources are available here:

To help with implementation of PHOs programmes, and also tracking practice’s own activites we have created Predict’s weekly target report resources.

What is Enigma doing in this space?

  • Predict CVD and Diabetes, clinical decision support tool
    • Supports PHO based programmes to systematically screen and provide management programmes under this initiative.
    • Helps to drive Diabetes screening as well as CVD screening.
    • Supports appropriate recalls once patients are initially screened.
    • Integrates with the Your Heart Forecast tool.
    • Provides useful Patient – ‘Take Home’ information, tailored specifically for the individual patient.
  • Your Heart Forecast
    • A risk visualisation and communication tool aimed at helping Health Providers to explain the complex notion of ‘CVD Risk’ to patients, this is endorsed by the NZ guidelines and forms part of the strongly recommended approach when delivering a CVD Risk intervention under these programmes, formally this is known as a ‘CVD Risk Trajectory approach’ to explaining CVD Risk.
    • Easily provides the patient with an emailed or TXT based link to return to the tool at home to re-play what they’ve been shown (using their clinical details) when they’re with their family or wider support group.
  • Billing / programme management tools for clinics and PHOs
    • We’re making the claiming and payment side of this easier for practices. When Predict is used it can directly drive payments and claiming functions, simplifying things for PHOs to run their programmes.
    • We’re creating ‘BCTIs’ for PHOs to help direct payments to clinics for their participation within these programmes.
  • Clinical activity and performance measures
    • We’ve ensured that activity using Predict is measurable under the MoH and PHO’s PPP schemes. This involves placing key, structured data back into the supported PMS systems so that the PPP programme’s tools can see the delivered interventions. They contribute towards the health target measurement.

What about secondary care?

We have not ignored the hospital based users. We have provided a system called ‘SCS’ or Secondary Care Screening. It’s an extension of our secondary care version of Predict CVD Diabetes, which enables secondary care, nursing workers to help to perform Heart Checks on suitable patients while they’re in hospital. Some of the key features are:

  • Views of who have and haven’t already been screened within Primary Care (this is a best efforts indication of those who are known to have already been screened within Primary Care), it intends to cut down on duplicated efforts. It’s not an open view of all screenings, it’s an indication attached to the list of patients who the hospital currently have with them, and who they have requested information on. (They need to be actively cared for within the hospital in order for them to request this information). Very limited information is returned, in most cases it’s just a simple Yes or No, as to whether they have been screened elsewhere.
  • Messaging services from the hospital system back into Primary Care. We’ll send an account of the Heart Check back to the normal GP and we do this in a way which is structured and provides the risk details back so that they can be stored and then found by the PPP programme’s activity counts (goes towards the health target measurements).

And workplaces?

These are harder to link in with Primary Care. Workplace Heart Checks are not yet fully accredited, nor do the nurses who perform these checks have access to some of the systems needed to send the results back into GPs in the same way. What’s missing? – Access to the NHI, and also to centralised PHO enrolment data. Enigma are actively working in this area and trying to encourage that suitable access is provided to enable accredited providers to perform these kinds of activities within workplaces, under DHB based contracts.

With the DHBs involved, we believe that a ‘clearing house’ function for the Heart Checks could be performed within the DHB, to ensure that the checks are suitably addressed (with NHI, and to the correct GP clinic). If this is achieved then these workplace based assessments could be counted a towards the ‘More Heart and Diabetes checks’ counts.

What else… Point of Care testing…?

To perform a Heart and a Diabetes check in one visit the supporting systems need to be simple and convenient (for the providers and for the general public). To make this as quick and simple as possible, we believe that greater use of Point of Care Test equipment is a critical piece of the puzzle.

Enigma have partnered with Roche and have created an interface for the cobas b 101 device which generates LIPID and HbA1c results (the two which are needed for Heart and Diabetes checks). The device generates both results within 11-12 minutes.

The results are then collected from the device and made available directly within Predict almost instantaneously. For completeness the results are also messaged through HealthLink and into the practice (assuming use within a GP’s clinic environment).

This is an exciting and emerging area, so watch this space.

For more information on any of the above, please feel free to contact Enigma: [email protected]