nKPI 7 GP Management Plan (MBS Item 721) C C U See nKPI 03. nKPI 8 Team Care Arrangement (MBS Item 723) C C U See nKPI 03. nKPI 9 Smoking status recorded R C C MedicalDirector – Did not count any patients who did not have smoking status recorded. Figures for "Without Smoking Status Recorded" are incorrect and repeat the "With Smoking Status Recorded". This was fixed after being identified in testing. nKPI 10 Smoking status result C C C No issues identified with this nKPI. nKPI 11 Smoking status results of women who gave birth C C C No issues identified with this nKPI. nKPI 12 BMI (overweight or obese) C C C No issues identified with this nKPI. nKPI 13 First antenatal care visit C C R In MMEx, where there is no antenatal visit (and therefore no gestational age at a visit), the record is counted as a visit with no gestational age – ie. records are included in the “no gestational age” numerator even where there is no visit. The issue has been identified and will be fixed in the next release. nKPI 14 Influenza immunisation (aged 50 and over) C C C No issues identified with this nKPI. nKPI 15 Influenza immunisation (type 2 diabetes or COPD clients C C I See nKPI 05. Although there was a consistent interpretation of this nKPI between vendors, there are inconsistencies between vendors in the list of conditions that are counted as COPD for the purposes of this nKPI.
days, they will be excluded as not fully immunised). Although this issue was identified in testing, it is expected to have a minimal impact. Communicare defines a as “fully immunised” if the child has no outstanding immunisation reviews. However, in itself this is not cause for being not fully immunised if there is evidence of a completed review that is acceptable. For example, a completed four year review overrides an uncompleted 18 month review as all age based reviews include a review of all immunisations for that child ( for more detail on the business rules applied). 5 HbA1c test recorded (clients with type 2 diabetes) MMEx offers two pathways for adding a Type 2 Diabetes diagnosis to a patient, it appears that data entered through only one of those pathways is captured within Type 2 Diabetes related items within the nKPI report. Specifically, a special diabetes care plan is included within MMEx that allows a user to assign a Care Plan and a diagnosis within the same workflow. MMEx has advised that this care plan applies specifically to Type 2 Diabetes patients and has been developed in response to user demands. MMEx also offers the opportunity to enter the diagnosis directly into the medical history section of the patient’s record. However, it would appear that a specific Type 2 diabetes diagnoses entered through this pathway will not be appropriately captured within the nKPI reports. General There are inconsistencies between vendors in the specification of the diabetes codes that should be included for type 2 diabetes. 6 result (clients with type 2 diabetes) See nKPI 05. 7 GP Management Plan (MBS Item 721) See nKPI 03. 8 Team Care Arrangement (MBS Item 723) See nKPI 03. 9 Smoking status recorded MedicalDirector – Did not any patients who did not have smoking status recorded. Figures for "Without Smoking Status Recorded" are incorrect and repeat the "With Smoking Status Recorded". This was fixed after being identified in testing. 10 Smoking status result No issues identified with this nKPI. 11 Smoking status results of women who gave birth No issues identified with this nKPI. 12 BMI (overweight or obese) No issues identified with this nKPI.
23 Proportion of regular clients with Type 2 diabetes who have had a blood pressure measurement result recorded, 2015-2017 C 24 Proportion of regular clients with Type 2 diabetes whose blood pressure measurement result was less than or equal to 130/80 mmHg, 2015-2017 C Legend C Calculations are correct E Errors with potentially significant impact on nKPIs M Minor issues – not expected to significantly impact on nKPIs I Calculation correct according to vendor specification, but issues with interpretation on nKPI between vendors R identified and vendor will resolve in next release Analysis of Issues The specific issues that were identified during the analysis were as follows: Table 5: MedicalDirector issues summary nKPI Description Report issues MedicalDirector response 2 Proportion of Indigenous babies born within the previous 12 months whose birth weight results were low, normal or high, 2015-2017 Relies entirely on the baby’s record and so there is no means of recording, and hence excluding, multiple births or births with a gestational age less than 20 weeks. The issue with nKPI 02 (failing to exclude multiple births) is a limitation of the software and would require product enhancement to resolve. Given the small percentage of multiple births (approximately 1.5% of all births), the impact of this on nKPI results would be minimal. 9 Proportion of regular clients whose smoking status has been recorded, Did not count any patients who did not have smoking status recorded. Figures for "Without Smoking Status Recorded" are incorrect and repeat the "With Smoking Status Recorded". This issue has now been fixed. There are 4 alternative ways of recording smoking status. All were counted correctly for nKPI numerator. This has been resolved in Medical Insights version 1.4.