Ardens has created a variety of resources to assist with identifying patients who may have heart failure, and to support their ongoing management once diagnosed. 


Recording Information on the Management of Heart Failure Patients

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

 

To locate the Ardens Heart Failure Template, access the relevant patient record. Open a new consultation and select the Run Template option (if not in consultations, 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 by typing “heart failure” in the search box.

 

 

This will return the Heart Failure (Ardens) template (alternatively select the Ardens > Chronic disease templates folder to the right of the screen).


All the Ardens Chronic Disease Templates follow 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. 

 

 

The Initial Diagnosis – History page can be used for recording acute deterioration as well as diagnosis and includes sections for recording typical symptoms and risk factors. 


The Initial Diagnosis – Invstgtns page suggests investigations that should be considered including a section to record specialist referral/result or Echo. Please note - the appropriate diagnosis codes for heart failure can be found within the QOF page.

 

 

All patients with heart failure on the register, should have a review in the preceding 12 months, including an assessment of functional capacity and a review of medication to ensure medicines optimisation at maximum tolerated doses.  The Review pages enable details of this to be captured as well as recording lifestyle, alcohol screening and examination findings.

 

 

The Complications/End-Stage page lists various complications to be considered and common symptoms indicating end-stage heart failure.

 

 

The Review & Recall page enables users to record that the annual or interim review has been completed and to record a future diary date to arrange an interim review – this will link to our Diary Recall System.  For more information on the Diary Recall System, please see our dedicated 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 Resources page.

 

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

 

Ardens Clinical Safety alerts

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

 

The following alert will be displayed if you are issuing Spironolactone for your heart failure patients and they have not had their U+E bloods measured in the last 6 months:


 

When issuing amiodarone to your heart failure patients, the following alert will notify you if the recommended investigations have not been completed:

 

  

Ardens Data Quality Alerts

 The Ardens resources includes Data Quality Alerts to alert practice staff in real time of incorrect coding or missing QOF requirements. These will ensure that you are entering accurate data to include your heart failure patients on the QOF Heart Failure register, whilst also alerting you of missing requirements.


When entering a diagnosis code for heart failure that is not a recognised QOF code, the following data quality alert will be displayed:

 

When entering a heart failure code, you will be alerted if the patient has no echo recorded or referral for echo having been made (within 12 months of diagnosis):

 

 

Ardens Heart Failure Searches 

There are various searches that might be useful to support practices with the care of Heart Failure 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 HF 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 HF patients are called back for any interim HF review that is set for them, or any blood tests required:

 

 

For more information, please see our dedicated support article.

 

1.4 Ardens Clinical Safety Searches

Ardens has created medication related searches to support practices with identifying patients on medication that may need extra care or monitoring.  For your HF patients who are issued with Anticoagulants, within the Medication Related Searches > Anticoagulants search folder will suggest patients who may require medication to be reviewed or bloods/weight recorded. 


The Spironolactone and ACE or ARB folder identifies patients currently on Spironolactone who may require a review as they have not had recent bloods recorded, their latest GFR is below 30 or their latest potassium is raised.


 

5.0 Ardens Case Finders

To support practices to improve data quality and ensure QOF payments are correctly calculated for your HF patients, the following searches can be accessed via > 5.0 Ardens Case Finders > Heart Failure folder:

 

The searches are reporting on patients that fulfil certain criteria which indicates the patient potentially could be included in the Heart Failure QOF register but are not recorded with the correct diagnostic code. For more information, please see our dedicated Support Article.

 

5.1 Ardens Condition Reports

To help practices monitor activity, alerts, case finders, performance indicators and register information for various conditions, within the Conditions – Cardiovascular folder you will find searches relating to your heart failure patients:

 

 

The Activity Last Month folder provides information around diagnosis, reviews and screening completed in the last month:



The Alerts folder displays potential safety issues for your heart failure patients:

 

 

The Case Finders folder includes additional searches to increase prevalence and will display patients who do not have a heart failure diagnosis code on their records, however they fulfil certain criteria which indicates potentially they could have heart failure:


 

The Performance Indicators folder includes searches identifying where certain elements of review for your heart failure patients is missing:


 

The Registers folder includes additional HF registers which practices may find useful over and beyond the standard QOF register:


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