APCC




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Introduction to the APCC Reports

What is the APCC program?
The Australian Primary Care Collaboratives Program is a quality improvement initiative funded by the Australian government to support Australian general practices deliver systematic and sustainable improvements in the quality of primary care they provide to their patients. It focuses on three areas: the secondary prevention of coronary heart disease, diabetes, and patient access to primary care services. APCC staff members are employees of the Improvement Foundation Australia.

What are the APCC reports
The APCC reports are a standard set of measures that look at key clinical and financial indicators in the areas of Diabetes and Coronary Heart Disease. The measures were created by expert reference groups (ERPs) comprised of GPs and specialists.

Diabetes ERP
Coronary Heart Disease ERP
Access ERP

What is the purpose of the APCC reports?

APCC reports rapidly and easily present you with information about the "overall state of play" of your patients with diabetes and CHD as groups. Knowing the "state of play" of a particular cohort of patients provides you with insight into the mechanisms of care delivery at work within your practice and can reveal opportunities to enhance earning potential, streamline practice systems, and improve the quality of care that you may have been unaware of. This type of information has not been readily available to GPs before.

What is the Online Reporting Website?

The online reporting website allows participating practices to lodge their monthly data electronically and review their improvement progress over the course of the Collaboratives. There are a number of functions and useful tools on the site including access to view the 'good PDSA' database. Practices can also compare and benchmark their progress in relation to other practices within the Collaboratives. Each practice participating in the Collaboratives has a unique URL that allows them to lodge their data securely. This URL can be obtained from your Collaboratives Division Coordinator (CDC) or the APCC team.

How do they do this?
APCC reports collate 15 selected measures from your electronic patient records. This collated information is presented to you in the form of a percentage of your patients who meet certain criteria. For example, the percentage of your diabetic patients with a current HbA1c of less than 7.

I'm doing ok. Why should I bother?
Experience from GPs in over 600 Australian practices indicates that you will find the information in APCC reports surprisingly useful. By considering your patients with diabets and CHD as a whole group, a new perspective on your patients is available to you. From this new perspective, you can consider issues that affect both patient care and business profitability.

Isn't this just a big brother approach by the Government to constrain the way I practice medicine?
No. It's about helping you streamline your business. APCC reports produce very powerful information which is immediately useful in your practice. A simple statistic like the % of diabetic patients with an HbA1c <7 might trigger an examination of many aspects of your practice. If the figure is low, questions might include:

how much income are we missing from diabetes SIP payments,
do the GPs in this practice have a consistent understanding of when a new HbA1c test is required
are we recording this information properly
is our recall system working
is our delivery of diabetes care sufficiently methodical or do gaps exist in our systems
are we setting ourselves up for a high future workload with acute diabetic patients by constantly missing opportunities to intervene early?

What are the actual measures that the report(s) cover?

Note: These measures are being updated for Phase 2 and will be uploaded to the site as they become available.

Diabetes

Total number of Diabetic patients in your electronic records.
> For the purposes of the NPCC reports diabetes incdludes, diabetes type 1& diabetes type 2. Also assumes diagnosis properly coded.
> It does not include, Gestational Diabetes Mellitus (GDM), previous GDM, impaired Fasting Glucose, impaired Glucose Tolerance

% of patients with diabetes with a last recorded HbA1c of = 7.0% within the previous 12 months

% of patients with diabetes with a last recorded HbA1c of > 7.0% and < 8.0% within the previous 12 months

% of patients with diabetes with a last recorded HbA1c of >8.0% and < 10.0%within the previous 12 months

% of patients with diabetes with a last recorded HbA1c of > 10.0% within the previous 12 months

% of patients with diabetes with no HbA1c recorded

% of patients with diabetes with a last measured total cholesterol of <4 mmol/l within the previous 12 months

% of patients with diabetes with a last recorded BP reading of <130/80 mm Hg within the previous 12 months

% of patients with diabetes that have had diabetes Service Incentive Payments claimed for them within the last 12 months

CHD

Total number of CHD patients in your electronic records.
> For the purposes of the NPCC reports CHD includes myocardial infarction, unstable angina pectoris, angina,revascularisation as evidenced by:

angioplasty +/- stent, coronary artery bypass surgery. Also assumes diagnosis properly coded)

% of patients with CHD on aspirin

% of patients with CHD who are on a statin

% of patients who have had an MI in past 12 months

% of patients who have had an MI in past 12 months and who are on beta-blockers

% of patients with CHD whose last recorded BP within the last 12 months <140/90 mmHg