Background – how searches work
Running searches in EMIS web helps you to identify specific groups of patients who share identifying factors. This enables a practice to monitor and improve the care they provide, or to report on activity and give evidence of work done for payment purposes.
Once you have run a search, the Population Included tab in the searches and reports details pane will list the patients who have been checked against all the rules in the search and have emerged in the final result.
The Population Excluded tab lists patients that have not met all or any of the rules that make up the search.
Patients included or NOT included
There are often occasions when you will need to know why a patient has either been included or not included in a search result, or you might simply want to understand the specific reason why a patient was included or excluded.
This is where the Check Patient feature can be enormously helpful. What it will do is to check the selected patient against each rule in the search, and tell you specifically where the patient does or does not meet the rules’ features and criteria, so that you can pinpoint the reasons for the inclusion, or the point at which the patient was excluded.
Note: The Check Patient feature is available on any search, but not for reports.
Understanding search rules
Let us first understand a little bit about rules in a search, using a simple example to later illustrate the Check Patient feature for both outcomes - where a patient is included and where a patient is excluded in the search results.
The Ardens 5.00 Contracts – QOF – Case Finders folder contains many searches which help to identify patients who may be missing from the QOF clinical domain registers.
One such search will look for patients who have had 6 or more SABA inhalers issued in the last year, are aged between 6 and 18 years, and are not on the Asthma register. The baseline (or parent) population for this search is ‘Currently registered regular patients’.
Rule 1 is looking to see if a patient is included in another search, which is the search for patients who are on the Asthma register. If they are (i.e. they pass Rule 1), then they are excluded from the search at this point.
Any patient who is not in the register search, i.e., fails Rule 1, will be moved to the next rule to be checked against it.
Rule 2 looks for patients who must have two things on their record in order to stay in the search results.
They must have 6 or more medication issues of a specific drug group (Selective Beta-2-Adrenoceptor Stimulants), issued in the last year, and they must be aged between 6 years and younger than 18 years when the search is run.
If they fail either part of this rule, they fail the entire rule and are then excluded from the final result.
Checking a patient who IS in the search result
Let us first use the Check Patient for a patient that is included in the above search example. You can try this yourself in your own system; make sure the search has been run. (The search example above is located in folder 5.00 Contracts – QOF – Case Finders > Asthma > More detail).
Navigate to the Population Included tab for the search highlighted in the upper pane of the Population Reporting screen.
Here you can see that the search has been run, and it has returned one patient. The Population Included tab gives you the brief details of that patient.
Next, right click on the patient’s name and select Check Patient from the menu.
The following screen will show you the status of the patient against the search that they are included in.
Here, we can see that the patient does not pass Rule 1 (there are ‘no matches’; they are not in the search of patients who are on the asthma register) and so they fail Rule 1 and pass to Rule 2.
In Rule 2, they must have two things. They must have 6 issues of a SABA inhaler in the last year, which the search has found. And they must be aged between 6 and 18 - this patient is 6 years old. They have therefore passed Rule 2 and so are included in the final result.
Checking a patient who is NOT in the search result
You can also perform a Check Patient on a patient who you think should be included, but who is not.
For this, with the search selected, you can do any of the following:
- Select a patient in the Population Excluded tab, right click and select Check Patient
- Right click on the search itself, select Check Patient and then choose the patient from the Patient Find screen
- Select the Check Patient button on the ribbon and choose the patient from the Patient Find screen (note – this is ideal if you have a patient from a different list to check against the search).
The same Check Patient screen will display.
This time, we already know that the patient has been excluded from the search, but we want to know why.
The Check Patient tells us in Rule 1 that this patient has no matches to being in the search ‘Patients on the Asthma register’. They therefore fail Rule 1 and ‘move to the next rule’ - Rule 2.
In Rule 2, the search has found that this patient does have 6 medication issues of a SABA inhaler in the last year. However, there are no matches to the second part of Rule 2, i.e. the patient is not in the required age range and therefore fails Rule 2 and is excluded from the final result. (You will notice the words ‘Must have’ and ‘And’ indicating that both parts of Rule 2 are needed for the patient to be included).
Drilling down further in the Check Patient screen
Wherever you see text such as ‘the Drug is’, or ‘the Clinical Code is’ where the key words are in bold text, you can double click on the bold text to view a full list of codes that are included in the search. This can help you investigate specific coding for the patient and is relevant to medications, clinical codes and also vaccinations.
Using the Check Patient in sub-searches
There is a great deal of interdependency between Ardens EMIS searches, and an individual search can often contain one or more 'sub-searches'.
Using the same search example as earlier, you can see that Rule 1 has another search within it. The rule will exclude any patients who are included in the results of the search titled 'AST005 - Patients on the asthma register'.
When using Check Patient where there is a sub-search, you might need to perform a separate Check Patient in that sub-search.
For example, you are checking a patient in the '6 or more SABAs' search, and find that they are excluded because they have been found in the 'AST005 - Patients on the asthma register' search.
If you wish to know WHY they are in the 'AST005 - Patients on the asthma register' search, you would need to locate that search and perform a second Check Patient there.
In this example, we check the patient against the sub-search, and find that the reason they are 'found' (included) in that search is because there is an asthma code on their record, dated January 2023.
So do bear in mind that to perform a full Check Patient you may need to look at the search in question, and also in other searches that have been included. If you have trouble locating the sub-search, you can use the Find button on the ribbon to search for it.
Help us to help you!
Please do not hesitate to contact either our EMIS Support Team or our Ardens Manager Support Team if you are having difficulty understanding a patient’s inclusion or exclusion in a search result.
If emailing your query, it would be really helpful if you could please include a screenshot of the Check Patient screen with your detailed query, but do remember please, to block out any patient identifiable information before you send to us.
If you require any further assistance on the process above, please contact Ardens support on: