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COPD CARE USER GUIDE - BLUEBAYCT
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1. Caucasian Age BF gt Height 165 Actual Expected FEW1 219 3390 Forced expired volume in 1 sec 2 19 339F Expected FEY 100 0 3395 Percent Expected FEYT FYE 263 3396 Forced vital capacity 26d 3390 Expected FYC 100 0 33962 Percentage of Expected FYC 0 83 331 FEY17F C ratio Read codes 74501 Spirometr Applied Date 96 06 2012 Priority D Fe om oo oo 4 3 42 46 0 o4 ata G2 r Cancel 10 COPD Care Lothian Respiratory MCN BlueBayCT To use the Spirometry screen do the following 1 In the COPD Care template click the Spirometry button es This will launch the Spirometry calculator tool 2 Choose a suitable reference Source from the drop down box The three choices are E R S 1993 Hankinson 1999 and Knudson 1976 The reference source selected affects which Read codes are used 3 Choose the Test Type from the five different options The Test Type is essentially which stage the test was performed at 4 The patients Sex Race Age and Height are automatically extracted from the patients notes The Age and Height can be altered on the screen doing so does NOT alter them in the patients record 5 Enter the FEV1 and FVC values into the relevant boxes The expected values can been seen along side along with the expected percentage values and the FEV1 FVC ratio All the relevant Read codes that will be added are displayed and t
2. The report should take between two and ten minutes to complete amp GMS Contract Patient List iy Patient Hame gt Description Register COUNT 103 gt Description Patents with COPD who have been refered for pulmonary rehabilitation COUNT Description Patents who have a record of self management plan for COPD in the past 12 months COUNT 3 When finished you ll see a number of different reports that have been created for you You can view the patients included in any of these reports by clicking on the Expand button The identification report is at the top of the report list and is titled COPD Care Lothian Respiratory MCN COPD Care Lothian Respiratory MCN BlueBayCT PRODUCE INVITATION LETTERS FOR TARGET POPULATION It s easy to produce invitation letters for your identified COPD Care target population using BlueBayCT s mail merge tools BlueBayCT will automatically track the letters that you send to each patient along with any other recall methods that you use and keep a history of engagement methods in the COPD Care screen To generate invitation letters do the following 1 On the Patient List screen right click the Register list 2 From the Toolbar choose Merge Indicator This will launch the Merge screen E 5 Register Home Appearance on 3 Please select a letter template a td Sh Letter Preview Select Templates l Letter I
3. THE COPD CARE SCREEN FROM A POPUP ALERT scesessecesessecessececesveceecevaceesecsceevaceesavsceevanseeevaeen 12 ACCESS THE COPD CARE SCREEN FROM THE 12 ACCESS THE COPD CARE SCREEN FROM THE CALL RECALL LIST ccccecessecssessecesescscesssessesvacessevscesvacseeevaeen 12 COPD CARE TEMPLATE 13 DININ ONEEN LE 13 ACUTE EPISODES amp HOSPITAL ADMISSIONS cccccecescsesescecssescececesvscessecsccevaceusevaceevacsusevacessavsecevaceusavacersas 14 COPD SEYE I tpn ce ce cee ec cen elegans erence sap 14 PULMONARY REHABILITATION cccccccecesccecessscescecscescscsceevscsecsvaceecevscevacsucevaceevavsceavacsusavaceusavsueevacsucavacensanas 14 COPD MANAGEMENT PLAN ccc cccesessecesescecessecscesvsceececsceevacsscevacessavaceavacsusavacesvavsucavaceusavsceevaceutavaceuvarseeevacen 14 SAVING THE INFORMATION cccccescesecessscscescecescscsceececsccevaceesevsceevaceucevaceuvavscsavacsusavacessavsuevaceusavaceevaceeevacen 14 DATA EXTRACT ccein E EE haceivacesavameshouedsncaislueneabaiabanastitenatbaiiadsned desnpbatedsanemvespeshevehieciutecmenets 15 RUNNING DATA EXTRACT MANUALLY c ceccscccesescecessscscessececcevscescscsceevscsscevaceesavsceevacsucav
4. Templates list 5 Click the Preview Letter button on the Toolbar A sample invitation letter will be generated using Microsoft Word allowing you to check the format and spacing of the invitation letter before you continue with the patient mail merge and update 6 Click the Mail button on the Toolbar The mail merge process will begin and invitation letters generated using Microsoft Word If you have a lot of patients on your merge list you ll see a progress bar appear at the bottom of the window This is used to indicate how much time it takes to update each patient with the appropriate Read code When the update is complete you ll notice that the invitation status in the Letter Level column has changed Invitation letters are stored on the practice server for easy retrieval within the practice just in case you need to re print because of a printer jam or if you ve lost the letters Letters are stored on the server in the NetworkShare directory The exact location of merged letters is servername NetworkShare practicecode Letters Where servername is replaced by the name of your practice server and practicecode is replaced by your practice code COPD Care Lothian Respiratory MCN BlueBayCT RECORDING TELEPHONE INVITATIONS To record a telephone invite for a COPD Care patient from the patient list do the following 1 On the Patient List screen right click the COPD Care Lothian Respiratory MCN list From the me
5. COPD CARE USER GUIDE BLUEBAYCT June 2012 COPD Care Lothian Respiratory MCN BlueBayCT Contents DOWNLOADING COPD CARE cececessecesessecescscscescececcevscesvecsceavacsecavscsesacsusevaceesavaceevacsusavaceusavaeeevaceaeavaceevaneeevacen 1 CHANGING YOUR SETTINGS ccccccescscssescscescecscescscsccsvscessevsceevacscavacsusavaceevacsusavaceusavaceavacsuavaceusavaceevacsucavacensaees 2 USE POPUP ALERTS TO IDENTIFY PATIENTS ccccccsscssscescscssescecescscscescscsecevsceecevsceesacsecevacessevauesvaceutevaceevavaeeevaeen 3 CREATE A CALL RECALL LIST TO IDENTIFY PATIENTS ccccscescccsscsscescecscescecscesvscescecsceesscseevaceesavaceuvacsuevacersaees 4 PRODUCE INVITATION LETTERS FOR TARGET POPULATION c cccccessesssessecessevscessecsccevscessevsceevaceeeevaceevavseeesaeen 6 RECORDING TELEPHONE INVITATIONS ccscecscescecesescscescecscessscsscevsceesecscevaceesevsceevacsesevacessavaceuvaceasevaeeevavsaeevaeen 8 USING THE COPD CARE SCREEN c cccescssecescesscessececcevscescecscevacsecevsceesacseevaceusavaceavacsusavacessavaueevacusevaceevasaeevacen 9 VIEWING AND RECORDING INFORMATION cccccscccsssscecessscscescscescevacescecscavacsecevaceesacsesevaceetavaceesacsueevaceasanas 9 SPIROMETRY CALCULATOR ENESES SEANS ESENES ASERRE SERERE EASES EEAS Erana ennas 10 HOW TO ACCESS THE COPD CARE SCREEN cescesecessecesessecescevaceccecscevacsesevacesvavsesavacsusavacessavaceavaeeutavacentacseeess 12 ACCESS
6. List Data Extract Data Extract COPD Care Lothian Respiratory MEN Frequency 0 Daily 0 Weekly CO Monthly Wi eek i 0 Mon Monthly Day To schedule the running of the COPD Care Data Extract use the following method 1 Right click the Light Bulb icon on the Notification area of the Windows Taskbar 2 From the popup menu left click Settings 3 In the Schedule option list left click Data Extract and select the report you wish to extract from the Data Extract drop down menu 4 In the Frequency option list choose one of the following 9 Daily Schedule the task to run every day 9 Weekly Schedule the task to run on a specific day of the week 9 Monthly Schedule the task to run on a specific day of the month 5 In the Weekly option list choose the required day of the week if the Weekly option was selected in step 4 6 In the Monthly option list choose the required day of the month if the Monthly option was selected in step 4 16 COPD Care Lothian Respiratory MCN BlueBayCT 7 In the Schedule Time box enter the time that you want the schedule to start in 24hr format and select the report you wish to extract from the Data Extract drop down menu 8 Left click OK to set the schedule 9 The location of the data extract file is then displayed and by clicking on Folder it will take you to the relevant location The data extract file can be viewed by the practice and collected r
7. aceevavacavacsutacaeenaeas 15 RUNNING DATA EXTRACT AUTOMATICALLY VIA THE SCHEDULER 16 COPD Care Lothian Respiratory MCN BlueBayCT DOWNLOADING COPD CARE You will need to download the COPD Care software into your system to enable all of the functionality BlueBayCT has a dedicated tool that allows you to easily do this without the fuss of having to download and install it manually To download the COPD Care software do the following 1 Make sure that BlueBayCT is in Practice Mode no open encounters 2 In the notification area of the Windows taskbar right click the BlueBayCT light bulb Icon ey E 15 30 3 From the menu choose Download Web Files Eg Download Web Files 5 Admin 34 Download Group Hame Web Version Local Version Status Download Delete v Group Type Enhanced Services programmes Shared Care Drug Monitoring Lithium ABRIL Up to date Group Type National programmes Up to date keep Well WHS Borders Updated please download Pneumococcal vaccination Not downloaded Seasonal flu vaccination programme Up to date Type 2 Diabetes NICE Up to date Group Type Practice Alerts amp Lists Carer Registers Mot downloaded Child Immunizations Child Protection District Nurse Attending Up to date Not downloaded Not downloaded Drug Misuser Mot downloaded Howsebound Patients Not downloaded Mental Health Re
8. ce Reports screen left click on the Other tab on the toolbar and select Data Extract 5 Select Ruleset 53 A Report Date Tue 06 03 2012 Multiple Files Remove Old Files Ruleset Asthma Care Lothian Respiratory MCN Keep Well NHS Borders OK Cancel 5 From the Select Ruleset window choose COPD Care Lothian Respiratory MCN 6 Change the Report Date by selecting a new date from the drop down box or typing it directly into the box if you want to run the Data Extract based on a date in the past 7 Left click the Multiple Files option to toggle it if you wish to get a CSV file for each column that has been defined 8 The location of the data extract file is then displayed and by clicking on Folder it will take you to the relevant location The data extract file can then be viewed by the practice and collected remotely by the Health Board as necessary 15 COPD Care Lothian Respiratory MCN BlueBayCT RUNNING DATA EXTRACT AUTOMATICALLY VIA THE SCHEDULER TAB The Scheduler tab can be used to schedule the running of the Data Extract This is particularly useful if you want to run it at a more convenient time or you are unable to run it during the day Settings H Reset Position DO Options Scheduler Ha Forward Dating Advanced ES Schedies None Time 05 30 a O Contract Manager a Order Schedule Schedule Time FF Protocols O QOF
9. e Er K 15 30 2 From the menu choose Settings Settings H Reset Position g Options 1a Options Forward Dating 8 Advanced scheduler Order Roles GP 0 Nurse i Admin 0 Custom Extra Indicators W Prevalence Searches w g Protocols Notes Summam Indicators Disable Auto Popup Exception Lists Disable User Defined Indicators Combine Triggers Cancel 3 On the Settings screen clear the Disable User Defined Indicators checkbox This will result in additional popup alerts appearing during the patient encounter which are non QOF related such as those for COPD Care health checks Any other solutions downloaded using the Download Web Files tool will also appear in the additional popup alerts box You can switch between the QOF and non QOF alerts by clicking the QOF and OTH buttons on the BlueBayCT Toolbar if this has been made visible If you would prefer to have all QOF and non QOF related alerts appearing in the same alerts box you can select the Combine Triggers checkbox in the Settings screen The QOF and OTH buttons are then replaced with an ALL button on the BlueBayCT Toolbar COPD Care Lothian Respiratory MCN BlueBayCT USE POPUP ALERTS TO IDENTIFY PATIENTS When you open a patient encounter in your system BlueBayCT will check the demographics and clinical history to determine whether the patient is eligible for a COPD Care review If the patient is eligible a popup ale
10. emotely by the Health Board as necessary L After the scheduler has been set to run you will need to leave the PC running at the time specified It is not necessary to be logged into your clinical system but it does require that the PC be left on with BlueBayCT running The data extract is Anonymised and no patient identifiable data is held within the extract The extract is stored in NetworkShare PracticeCode Extract folder 17
11. ent Please note however that any information that you record from the call recall lists are not assigned to a specific staff member but are recorded as Data Entry for the Admin user To open the COPD Care template screen from the patient list do the following 1 In the Patient List right click on the name of the patient that you want to open the COPD Care screen for 2 From the menu choose Show Template 12 COPD Care Lothian Respiratory MCN BlueBayCT COPD CARE TEMPLATE The COPD tab within the COPD Care template screen is used to record and display the patients COPD relevant information COPD Care Lothian Respiratory MCN for MISS HARDMAN MARY 25 07 1944 ES Home Appearance v NHS Lothian DIAGNOSIS amp STATUS Mot troubled by breathlessness except on strenuous exercise Short of breath when hurrying or walking up a slight hill Walks slower than contemporaries on level ground because of breathlessness or has to stop for breath when walking at own pace Stops for breath after walking about 100m or after a few minutes on level ground Too breathless to leave the house or breathless when dressing or undressing ACUTE EPISODES amp HOSPITAL ADMISSIONS Record the total number of hospital admissions and acute exacerbations for COPD in the past 12 months Number of hospital admissions for COPD Mo Data Recorded Humber of acute exacerbations of COPD No Data Recorded COPD SE ERITY se
12. he data is plotted on the graph 6 Select a Read code from the drop down list 7 Change the Applied date and Priority if necessary 8 Click OK to save 11 COPD Care Lothian Respiratory MCN BlueBayCT HOW TO ACCESS THE COPD CARE SCREEN There are a number of different ways to access the COPD Care Screen and how you do this will generally depend on what you want to use it for For example you will most likely use it during an encounter with the patient to carry out a health check or when working on the call recall list ACCESS THE COPD CARE SCREEN FROM A POPUP ALERT The easiest way to access the COPD Care screen is from the popup alert that appears during the patient encounter Simply double click on the alert and the COPD Care template screen will open ACCESS THE COPD CARE SCREEN FROM THE BLUEBAYCT MENU The BlueBayCT menu provides quick access to all features within the software including the COPD Care screens To access the COPD Care screen from the BlueBayCT menu use the following procedure 1 Whilst in the patient clinical record right click the BlueBayCT light bulb icon in the Notification Area of your Windows taskbar 2 On the menu choose Clinical Templates and then click COPD Care Lothian Respiratory MCN ACCESS THE COPD CARE SCREEN FROM THE CALL RECALL LIST When using the call recall list for COPD Care you can open the COPD Care template screen to record or view clinical information for the pati
13. nu choose Merge Indicator This will launch the Merge screen 3 Select the Mail checkbox for the patient you want to phone 4 On the Toolbar click the Phoned button 5 Click OK to confirm that the selected patients have been verbally invited by phone This will update the patient s invite status in the Letter Level column as well as adding an appropriate Read code to the patient s clinical record COPD Care Lothian Respiratory MCN BlueBayCT USING THE COPD CARE SCREEN BlueBayCT s COPD Care solution includes a COPD Care template screen that you can use to record and look up all the different types of information required for the review As well as being able to add new items of information you can also view a detailed clinical history for the patient All information recorded using the COPD Care screen is filtered back into your clinical system and updated into the relevant areas within your clinical system VIEWING AND RECORDING INFORMATION Each item within the COPD Care screen is designed to let you view historical information in chronological order This means you will not have to use the clinical system to search for the information you need It s all been conveniently collated for you into the screen so that you can easily access it To view historical information for any item on the COPD Care screen click the History button This will show you all the entries for the item from the patient s clinical record with date
14. nvi Al Actions Letters Mail Patierit DOE Invite Status Invite Date Usual Surgery Telephone Mo Address ADRIAN GEORGE ROSS 07701 1986 151 invite required ROAD LEEDS 4 HARDMAN MARY 2570771944 1st invite required 20 CHURCH FATH LEEDS 2 4 1 The Merge screen is designed to help you manage your screening invitations and includes important information such as the name of the Patient the patient s DOB the Usual Surgery they attend or branch surgery if any and Telephone No You can also see the patient s invitation status in the Letter Level column Filters can be applied to each column allowing you to reduce the number of patients on the list For example you may want to only show those patients who have an invite status of Send 1st Letter You can apply a filter by clicking on the column heading and selecting a filter button at the top of each column and choosing an entry from the list or choosing custom Each patient in the list has a checkbox which includes or excludes them from invitation On the Toolbar you ll find various options for selecting the appropriate letter generating letters and recording other invitation methods COPD Care Lothian Respiratory MCN BlueBayCT 3 Do one of the following 9 Select the Mail checkbox for each patient you want to include in your invite 9 On the Toolbar click Select All to select all the patients 4 Choose the required letter invitation letter from the Letter
15. rt will appear to notify you providing that the Combine Trigger option is selected a MISS HARDMAN MARY COPD Care Lothian Respirator MON Number of acute exacerbations of COPD not recorded for patients prescribed oral steroids Not refered for pulmonary rehabilitation No record of self management plan for COPD in past 12 months Chronic kidney disease LEDS Blood pressure not recorded LEDS Blood pressure is not 140 85 or less CEOS ACE inhibitor or alternative treatment needed This helps with opportunistic screening as well as making sure that the patient is suitable for health check From the popup alert you can open the COPD Care screen and carry out the screening for the patient To open the COPD Care screen do one of the following 9 Double click any of the three Alert Indicators within the COPD Care Lothian Respiratory MCN category 9 Click the COPD Care Lothian Respiratory MCN category alert and on the Toolbar click the Show Template button 9 Right click any of the three Alert Indicators within the COPD Care Lothian Respiratory MCN category and from the menu choose Show Template COPD Care Lothian Respiratory MCN BlueBayCT CREATE A CALL RECALL LIST TO IDENTIFY PATIENTS The most frequently used method of identifying your patients who are eligible for COPD Care is by creating a call recall list This will show you ALL of the eligible patients and allow you to manage their invitation
16. s values extension entries If you are viewing the history for items with values or measurements the history will also display a chart showing trends for the item For the majority of the items in COPD Care screen you ll also be able to record information in these fields How you enter the data might differ depending on the type of information in the field In most cases the method of recording the information will be by selecting a Read code from a picking list To record information using the Read code list do the following 1 For the item you want to record click the Codeset button This will display the Codeset screen with the list of available Read codes Codeset Codes 4 a Comments Apple Frionty Episode Type Date Recorded Read Code Description Value Extension 05 03 2012 05 03 2012 05 03 2012 0503 2012 05 03 2012 05 03 2012 05 03 2012 05 03 2012 05 03 2012 05 03 2012 05 03 2012 05 03 2012 0503 2012 Chronic bronchitis Simple chronic bronchitis Chronic catarrhal bronchitis Simple chronic bronchitis NOS MMucopurulent chr bronchitis Purulent chronic bronchitis Fetid chronic bronchitis Mucopurulent chr bronchit MOS Obstructive chronic bronchitis Chronic asthmatic bronchitis Emphysematous bronchitis Bronchiolitis obliterans Obstructive chr bronchitis NOS Cancel 2 Select the Apply checkbox for the code that you want to use COPD Care Lothian Respiratory MCN Bl
17. status for screening using the other COPD Care tools From the list you can do one or more of the following 9 Generate a printed report of all eligible patients for a COPD Care health check 9 Produce invitation letters for the target population 9 View information that has already been recorded for each COPD Care screening 9 Record other invitation methods for eligible patients To create a call recall list use the following procedure 1 Make sure that BlueBayCT is in Practice Mode no open encounters 2 In the notification area of the Windows taskbar right click the BlueBayCT light bulb icon 15 30 3 From the menu choose Practice Reports 4 On the Practice Reports screen click the Other button on the Toolbar 8 Practice Reports 28 Home Appearance A 4 p aly a lo T H QOF Enhanced SIGN NICE Warfarin Server Login Synchronise Letter Services Details Templates Show Options i Create 19 Other Asthma Care Lothian Respiratory MCN Data Extract COPD Care Lothian Respiratory MCN Multi dimensional Report Immunisations child imms Keep Well NHS Borders Seasonal flu vaccination programme Synchronised 23 Feb 2012 12 39 5 Click COPD Care Lothian Respiratory MCN COPD Care Lothian Respiratory MCN BlueBayCT If you are a split practice who share the same clinical database you will first need to choose the required practice from the Practice Name list
18. tation COPD MANAGEMENT PLAN 9 COPD self management plan use this field to view and record if the patient has been given a self management plan m The bottom part of the template which includes all fields below the MRC Breathlessness score will be greyed out and will not allow data entry until a MRC Breathlessness score of Grade 3 or above is recorded SAVING THE INFORMATION When you have finished using the COPD Care screen click the Save amp Close button on the Toolbar This will store the information within the clinical record in the clinical system You must make sure you save when exiting the clinical system to save this information in the patient record 14 COPD Care Lothian Respiratory MCN BlueBayCT DATA EXTRACT RUNNING DATA EXTRACT MANUALLY The COPD Care solution includes a facility to extract anonymised patient clinical data into a CSV file which can then be used by your Health Board to compile statistical information and to verify any related payments for Enhanced Services Your Health Board may require this to be sent via email or they will be able to collect the file remotely To access the Data Extract screen and produce a data extract file manually do the following 1 Make sure that BlueBayCT is in Practice Mode no open encounters 2 In the notification area of the Windows taskbar right click the BlueBayCT light bulb icon 3 From the menu choose Practice Reports 4 On the Practi
19. ueBayCT If you require more than one Read code select the Apply checkbox for each one If the Read code you want to record does not appear in the list try clicking the Show More button By default only the most commonly used codes are displayed 3 Do one or more of the following if required e Change the Priority for the Read code by choosing a new one from the list e Change the Date Recorded from the default of today s date This is useful when you need to backdate information e Type a Value for any readings measurements or scores It s important to make sure that these are numeric values only so that the information is stored correctly within the clinical system Type any free text entries in the Extension box or pick a pre defined entry from the list 4 Click OK to enter the Read code s into the COPD Care screen If you have made a mistake and would like to remove the Read codes you have entered click the Undo button SPIROMETRY CALCULATOR The Spirometry Calculator is used to record actual spirometry values and calculate what would be expected for the patient based on their Sex Age Race and Height The FEV1 FVC ratio is also calculated The Spirometry screen will appear as shown below Spirometry MISS HARDMAN MARY 01 Apr 2013 p Source 5 1993 Test Type Normal CO Before Bronchodilator O After Bronchodilator C0 Pre Steriod O Post Steriod Sex Female Race
20. verity of COPD lb PULMONARY REHABILITATION Referral for pulmonary rehabilitation Data Recorded WF COPD MANAGEMENT PLAN COPD self management plan 197 0172012 COPD self management plan given Click here for a printable COPD self management plan WHS Lothian Respiratory Managed Clinical Network Designed and Developed by BlueBay Medical Systems Previous amp Next No Data Recorded gt Previous Tab 7 Next Tab DIAGNOSIS amp STATUS Chronic obstructive pulmonary disease use this field to view or record information about any COPD diagnosis the patient has had 9 MRC Breathlessness Score use this field to view or record the severity using the MRC Breathlessness Scale 13 COPD Care Lothian Respiratory MCN BlueBayCT ACUTE EPISODES amp HOSPITAL ADMISSIONS 9 Number of Hospital Admissions for COPD use this field to view and record the number of COPD related hospital admissions in the last 12 months 9 Number of Acute Exacerbations of COPD use this field to view and record the number of acute exacerbations of COPD in the last 12 months COPD SEVERITY 9 Severity of COPD use this field to view and record the severity of the COPD 9 Spirometry use this tool to calculate spirometry values PULMONARY REHABILITATION 9 Referral for pulmonary rehabilitation use this field to view and record the referrals for pulmonary rehabili
21. view Not downloaded Nen QOF Registers 2012 Mot downloaded MM P BP Oo oy S Oo Up to date Venous thromboembolism MICE Clinical Guideline The Download Web Files screen shows all the available solutions that you can add into your BlueBayCT software These items may include Enhanced Services National Health Programs Clinical Guidelines and other useful additions to the QOF tools Each practice within a Health Board may have a different list of items in the Download Web Files screen depending on whether or not they are granted access from their software licence 4 In the Download Web Files list select the Download check box for COPD Care Lothian Respiratory MCN listed under Group Type National Programmes 5 Click Download on the Toolbar You ll be able to use the downloaded COPD Care software immediately after the download is complete If anyone else at the practice also requires the use of the COPD Care software they will first need to restart their BlueBayCT software COPD Care Lothian Respiratory MCN BlueBayCT CHANGING YOUR SETTINGS In order to use the full functionality of the COPD Care software you will need to check your BlueBayCT settings to ensure the software is configured correctly To configure BlueBayCT to use the COPD Care software use the following steps 1 In the notification area of the Windows taskbar right click the BlueBayCT light bulb Icon e
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