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Report Results

Once you have run the APCC report it is important that you look through the results carefully. Some of the most commonly asked questions in relation to the APCC report results are listed below.

* The questions below have been framed in relation to Diabetes data however you can take a broadly similar approach with the CHD data

The APCC report figures are not accurate. I know I have more patients with diabetes / CHD than it says.
Problems with the accuracy of the reported figures are usually due to the required information being entered in the wrong place in the patient record. For example, a blood pressure recorded in progress notes will not be found. It must be entered in one of the Blood Pressure fields in the program. An HbA1c result that came to you in PIT format must be manually entered into the HbA1c field of the diabetic record.

Where should I enter information in my clinical software so that it is properly collated by APCC reports?
If you are entering a diagnosis, use the coded list. (See "What is coding?"). If you are entering any numerical information, it should go into the correct field. ie Blood pressure goes in the BP field, INR goes in the INR field etc. Some data extraction tools need to be set to look in the correct location for the data. Contact your software vendor for assistance in checking this and other specific support if you suspect your data is not being counted correctly by your APCC report.

The number of diabetics reported is much lower than you expected...
(Note that the APCC reports do not count Gestational Diabetes Mellitus, see APCC measures at the bottom of the Introduction page)

Check that all GPs know how to correctly enter a diagnosis in your clinical software.
Check that all known diabetics are diagnosed as such.
Search for patients who might be diabetic but not coded as such, ie patients with an HBA1C test in the past 12 months, patients prescribed insulin or lipid lowering medication. Also consider patients with polyuria, polydipsia, retinopathy, foot ulcers, unexplained weight loss etc.
Check your paper records to see if patients are able to be transfered to your electronic notes.

NB* - approximately 7.5% of the Australian population has diabetes. If your practice population is typical, you can expect around this number. It is important that you are confident that your register is up to date.

The number of diabetics reported is close to your expected figure, but BP, Cholesterol and HbA1c percentages are low

Check that GPs know how to enter blood pressure and test results in the recommended fields; not just jot them in progress notes where they can not be counted.
Check your paper records to see if these values are available for transfer to your electronic notes.
Ensure pathology results are transmitted in HL7 format.
Ensure all GPs at the practice have a uniform understanding about when blood testing is warranted.
Recall patients and begin testing and recording these values.

If the number of diabetics reported is close to your expected figure and your BP, Cholesterol and HbA1c percentages are good

Check that all eligible patients are on care plans, team care arrangements and that you are claiming the annual cycle of care payment for these patients.
Consider establishing an in-practice "care pathway" for your diabetic patients. The pathway should map out future visits in advance. It should detail what activity will occur at each visit and prompt front desk staff to bill the appropriate item number as care is delivered. For an example from one Australian practice see Dr Ayman Shenouda & Dr Sami Azab, Glenrock Country Practice, NSW (W2) RRMA 3.

You can now take a broadly similar approach to your CHD patients. For an example from some Australian practices on how they have done this please see Shane Conway - Creating a CHD Register and Lindsey Hyde - Implementing a CHD clinic (you will need to scroll down to the bottom of the page to access these presentations.