Diabetic care is often high on the agenda for all primary care organisations. Ardens has created many different resources to support practices, PCNs and CCGS with monitoring and managing the care of their diabetic patients.


Diabetes Clinical Template

The Ardens Diabetes template has been designed to standardise consultations, ensuring clinicians are following the same national guidelines and recording accurate coding of data.


To locate the Ardens Diabetes template, access the relevant patient record. Open a new consultation and select the Run Template option (if not in a consultation, click on the Add button on the EMIS ribbon, followed by Data Using Template option). 


This will open the Template Picker screen. If you have accessed any templates before, these will display to the left of the screen. Search for the template using the search box provided (alternatively select the Ardens > Chronic disease templates folder to the right of the screen). 



All of the Ardens Chronic Disease Templates following the latest NICE guidance and best practice information. They include a QOF page for capturing QOF requirements and Review pages to complete a structured review.


Any information displayed in red relates to payment purposes such as QOF, PCN DES or local payment. Please note - if the information is relevant for the current financial year you do not need to duplicate this information. 



For clinician requiring to complete a full review, the Review pages includes contract requirements and best practice information. The hyperlinks will direct you to useful external websites.



The Review and Recall page enables users to code that they have completed a Diabetic annual review or Interim review. For patients requiring an interim review (e.g. patient to repeat HbA1C in 6 months time), completing the ‘Follow-up diabetic assessment’ field and entering a future date, will trigger the Ardens Diary Recall System. For more information please see the following support article.



The template contains many helpful links and information including links to NICE guidance within the Management Guidance page and leaflets for your patients within the Patient Resources page.


Please note – for patients presenting with multiple long term conditions, you may wish to use the Ardens Multi-Morbidity template.


Ardens Diabetes Searches

There are various searches that might be useful to support practices with the care of diabetic patients The searches can be accessed via the Population Reporting module > Ardens Searches folder.


1.1 Chronic Disease (QOF) Recall Syst

This is a month of birth recall system, designed to recall a patient for multiple conditions at once.  These searches will ensure your diabetic patients are attending their annual review.



For more information please see our dedicated support article

 

1.2 Ardens Diary Recall Searches

The Ardens Diary Recall System allows practice staff to easily manage diary recalls for ad-hoc tests, including blood tests and interim reviews.  These can be used to ensure your diabetic patients are called back for  6monthly HbA1C and any interim diabetic review that is set for them.



For more information please see our dedicated support article.

 

2.1 Risk Stratification Searches

The Ardens Risk Stratification searches can help practices focus on their higher risk Type 2 Diabetic patients, enabling them to pro-actively priorities those most at risk.  The different risk categories are looking at areas such as HbA1C results, age, frailty, BAME among other things.



For more information please see our dedicated support article.


5.0 Case Finding Searches

The Case Finding searches folder contains a suite of searches to support practices to improve data quality and ensure QOF payments are correctly calculated for your Diabetic patients.  These will display patients who are not on the QOF Diabetic register but potentially should be, for example they may be taking diabetic medication, or may have been coded as having a Diabetes review.  This will be affecting your prevalence for Diabetes and therefore affecting your practice’s QOF income, but more importantly these patients may not be getting the care they should as they will not be appearing in the results of any recall searches.



For more information please see our dedicated support article

 

5.1 Ardens Service Reports

The Ardens Service Reports > Conditions - Diabetes folder contains a suite of searches which enables practices to monitor Diabetic activity for last month, be alerted to potential safety issues and areas of best practice that has not been completed.



The searches have been designed to work with our separate cloud based system Ardens Manager. Ardens Manager enables practice staff to upload Diabetes information to easily readable dashboard, which can be viewed at PCN and CCG level depending on sharing agreements. For more information on Ardens Manager Service Reports , please watch this short video.


Ardens Diabetic Clinical Safety Alerts

The Ardens resources includes Clinical Safety alerts to flag important MHRA drug safety and NICE guidance information that maybe missed. The alerts are triggered on certain activity in the patient record e.g. entering a particular code or prescribing specific drugs.


The Diabetes Clinical Safety alerts include:


Diabetes Resolved alert 

When a Diabetes Resolved code is entered in the patient record, this will alert practice staff of the use of this code. It is recommended even after normalisation of glycaemia that patients continue to receive monitoring for micro and macrovascular complications of diabetes, the clinician may wish to consider using the ‘Diabetes in Remission’ code.


 

Gliflozins alert

The Gliflozins safety alert is triggered on issuing the drug and will remind clinicians to discuss the signs, symptoms and risks of Diabetic Ketoacidosis with the patient:


 

Metformin alert

When issuing Metformin, if the patients latest eGFR is less than 30ml/min/1.73m, you will be alerted   of the risk of lactic acidosis.


 

New Diabetes alert

When entering a new diabetes diagnosis code for a patient over the age of 60, you will be reminded of the NICE cancer guidelines if the patient has noticed any weight loss:


 

Diabetic 9KCP alert

To support the management of the 9 key care processes, the following Ardens alert will display in the pink pop up box.



Diabetes Document Templates 

For your diabetic patients you may wish to supply them with the Sick Day Rules document.  

To access the Document Templates:

  • Within a consultation, select the Documents > Create letter option.
  • Outside of a consultation, select the Add > Document > Create letter option.

 

This will display the New Patient letter screen.


Click on the magnify glass to search for the document template:

 

 

 

This will display the Find Document Templates screen.

 

Search for the Sick Day Rules document template using the search box provided, select the relevant document template and click on OK to launch (alternatively double click on the document to open).

 

 

You will now be prompted to select the medication you would like to include in the document, the document will launch with the pre-populated information:

 

 

When completed, select File from the EMIS button on the left of the screen, Print (if needed) and Save and Close to save the document to the patients care record.



If you require any further assistance on the process above, please contact Ardens support on: support-emis@ardens.org.uk