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.

Recording Information on the Management of Diabetes Patients

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, Network Contract 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 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 if there are any outstanding elements.

Ardens Diabetes Searches

There are various searches that might be useful to support practices with the care of diabetic patients:

• Ardens LTC Recall System - a month of birth recall system, designed to recall a patient for multiple QOF conditions at once.  These searches will ensure your Diabetic patients are attending their annual review. 
• Diary Recall System - allows practice staff to easily manage diary recalls for blood tests, injections, procedures, and follow-ups.   
• Chronic Disease Risk Stratification Searches – searches to enable practices to prioritise reviews for high-risk Diabetic patients. 
• Ardens Case Finders - contains a suite of searches to support practices to improve data quality and ensure QOF payments are correctly calculated.

• Ardens Condition Reports - 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.

There are documents that may be useful in the care of Diabetic patients, particularly the My Diabetes Care Plan and 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 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).

For different documents you will be presented with different prompts e.g. for the Sick Day Rules document you are 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