2ndary Care Screening

Secondary Care CVD Risk Screening (SCS)

CVD Screening from Secondary Care

This is an extension of our Secondary Care CVD Diabetes platform, previously known as Acute Predict. This extension is aimed at helping primary care to increase their CVD Risk Assessment health target measurement through activity conducted within secondary care, helping to screen those hard-to-reach patients. Secondary-care often gets to see patients who might not regularly turn up in primary care, so by linking the secondary admission records to primary care CVD screening histories, we’re helping the secondary care workforce to know who to offer this intervention to while the patients are within the hospital setting.

CVD Risk screening activities will only be counted within the health target measurement if the records get found and counted within the PPP counts, so ensuring that the information flows back into the appropriate primary care clinic, and in a manner which can automatically be placed into the correct and meaningful place has been critical.

Waitemata DHB has pioneered this approach with Enigma to create mapping tools which enable the automatic flow of data from an inbox record (same as a normal Lab result) into the relevant place within the PMS. When the primary care users ‘File’ the message, it will be written back into the appropriate place. This ensures that the PPP tools (CPI extract) will find and count the screenings for that practice (and against the PHO).

The efforts provided here by the DHB are two-fold – they are helping the practices and PHOs to achieve better health target counts, and they’re also providing a valuable clinical service to the patients by helping to risk assess those who haven’t already been assessed. The DHB is passing back the CVD Risk profiles along with a request for the primary care groups to undertake appropriate CVD Risk Management where warranted.

It doesn’t matter whether the practice is a Predict user or not; we’ve adopted messaging standards which will enable the primary care users to view and use the information being provided.

Other DHBs are very interested in this approach and have shown interest in this project, so it could very well come to a DHB near you soon. The Auckland and Northern Region DHBs are at various stages of planning/implementation and use of this approach.



How to map the inbound lab-style messages into useful places:

MyPractice users: You don’t need to do anything; a general update has taken care of this. You should see the CVD Results showing up in their normal place.

Medtech users: These messages arrive in your inbox, and you need an Inbox/Screening mapping setup in order for the information to flow into the area where you normally record a CVD Risk. If you use the ‘CVR’ Screening term, then this has been made particularly easy; Medtech has made a mapping tool for the WDHB practices which will add the mapping setting for you.

If you use a term other than CVR, this may be best done manually. Here’s how… (This assumes you have already received a copy of an inbound lab-style message from PREDICT – if you haven’t yet, then it won’t show up in your list to map from.

  1. Use the menus as follows: Setup | In/Out Box | InBox Screening
  2. A long list of inbound labs should appear; you’ll need to scroll down this list and look for ‘PREDICT’ as the Facility in the first column. This list is alphabetically sorted, but the upper and lower case facilities are separate… Find the record which is for ‘Calculated 5 Yr Cvd Risk’. Double click this record with your mouse.
  3. A popup window should appear; in the lower half of the window, there are details of which Screening Term and Screening Value to map the risk into. You should choose the Screening Term which your practice routinely use, and make sure that you choose the correct value to put this into. If you are a PREDICT user already, this will commonly be Term: ‘CVR’ and Value: ‘CVD Risk’. It needs to be the same area where your normal CVD Risk values are stored in order for your PPP extract tools to find and count these risks.

NB// Adding new mappings does not address the results which arrived into your Inbox prior to you adding the mapping. If you have CVD Risk values which have already been filed, you will need to manually re-file those results after you have added the mapping.

To re-file inbox records:

  1. Open the Inbox message by locating it within the Inbox and double-clicking on the message.
  2. On the top right of the message window, you will see a section showing who it has been marked for attention to; if it has been previously filed, then this drop-down box will be blank. Change the blank value in the ‘Attention:’ field to your username. Then hit OK at the bottom of the window; the message window should close.
  3. Re-open the message window by double-clicking on the message from within the Inbox again. This time you should see the Attention field has your name marked in it. This time click on the ‘File’ button on the bottom of the message window. The message window should close.
  4. Taking note of the date of the message, now go to the Screening area for that patient and check that there is a CVD Risk recorded on the same date as the message. If there is, then the filing has worked, and the mapping is in place. Double-check that the Screening Term being used is the one which your practice commonly uses for all other CVD Risk screenings; if not, you will need to manually re-map the Inbox/Screening mapping using the instructions in the above section.

If you need help, please don’t struggle, give us a call: 0800 PREDICT – Option 1.

Confused about a result which has come in with a value of ‘101’? – See this page for an explanation…