#54 PCIT Gems: DNA’s l EMIS Library l Excel shortcuts

New week, new hints and tips!

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SystmOne tip – DNA’s

Within Organisation Preferences you can select the option to automatically code DNA’s overnight. This will help with the consistency of marking DNA’s for reporting purposes and if this is used to other areas such as patient alerts or reminders. Note this will not affect telephone appointments or if the appointment has been marked as ‘Patient will not be present’.

Top tip: EMIS Library

Before creating your own resources, be sure to check the EMIS Library first to see if there’s something similar already created.  There are EMIS library items for searches, concepts, templates and library items.

QOF Hints

We’ve had a lot of queries via our help desk from our subscribers about AF008 and how to achieve it for patients who are on warfarin.

This is the indicator definition:

Percentage of patients on the QOF Atrial Fibrillation register and with a CHA₂DS₂-VASc score of 2 or more, who were prescribed a direct-acting oral anticoagulant (DOAC), or, where a DOAC was declined or clinically unsuitable, a Vitamin K antagonist.How to achieve it?For patients with no mechanical heart valve:

1. be prescribed a direct-acting oral anticoagulant (DOAC) in the 6 months up to the end of the QOF year.
2. be prescribed a Vitamin K antagonist (warfarin) in the 6 months up to the end of the QOF year and have any of the following criteria:
   • Have chosen not to receive a direct-acting oral anticoagulant (DOAC) in the QOF year
   • Have a direct-acting oral anticoagulant (DOAC) contraindication code anywhere in their record.
   • Have an Antiphospholipid syndrome diagnosis anywhere in their record.
   • Have a direct-acting oral anticoagulant (DOAC) not indicated code in the QOF year AND whose last recording of ‘Time in Therapeutic Range (TTR)’ was greater than or equal to 65% and recorded in the last 6 months of the contract year.

For patients who have a mechanical prosthetic valve replacement:

1. be prescribed a Vitamin K antagonist in the 6 months up to and including the reporting period end date.

How to remove patients from eligibility?

The following will remove patients with a mechanical heart valve:

• a Vitamin K antagonist contraindication code anywhere in their record orhave chosen not to receive a Vitamin K antagonist in the QOF year

The following will remove patients without a mechanical heart valve:

• Have both of the following:

1. Have any of:
   • a direct-acting oral anticoagulant (DOAC) contraindication code anywhere in their record
   • an Antiphospholipid syndrome diagnosis anywhere in their record
   • a direct-acting oral anticoagulant (DOAC) not indicated code in the QOF year
2. AND Have a Vitamin K antagonist contraindication code anywhere in their record OR chosen not to receive a Vitamin K antagonist in the QOF year

• Have both of the following:

1. have chosen not to receive a direct-acting oral anticoagulant (DOAC) in the QOF year
2. have a Vitamin K antagonist (warfarin) contraindication code anywhere in their record or have chosen not to receive a Vitamin K antagonist in the QOF year

The following will remove patients regardless of the presence of a mechanical heart valve:

• Have a persisting generic oral anticoagulant contraindication code recorded 
• Have an expiring generic oral anticoagulant contraindication code recorded within with QOF year
• Have a declined oral anticoagulant medication recorded within the QOF year
• Patients who were diagnosed in the last 3 months of the QOF year
• Patients who were registered with the practice in the last 3 months of the QOF year