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Introducing the EMIS Risk Stratification Tool

Introducing the EMIS Risk Stratification Tool. Dr Kevin Yee, GP & EMIS Project Clinical Lead with EMIS Representatives Paul Davis and Debbie Pope. An explanation of the plan. New Risk Stratification Tool in EMIS Web for Bromley

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Introducing the EMIS Risk Stratification Tool

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  1. Introducing the EMIS Risk Stratification Tool Dr Kevin Yee, GP & EMIS Project Clinical Lead with EMIS Representatives Paul Davis and Debbie Pope

  2. An explanation of the plan • New Risk Stratification Toolin EMIS Web for Bromley • QAdmissions Algorithm – designed by GPs in conjunction with academics • Clinical risk prediction tool • To help ID patients at high risk of unplanned care or admissions – Vision compatible version being developed in parallel • Previous Risk Strat Tool ran into problems due to IG issues and sharing of patient identifiable data – new tool utilising practice data only and stays within the practice • Anticipated roll out from July 2014

  3. Variables used in the QAdmissions Algorithm FYI • _ Sex • _ Age • _ Alcohol use • _ Atrial fibrillation • _ Congestive cardiac failure • _ Use of anticoagulants (more than two prescriptions in the last six months) • _ Use of antidepressants (more than two prescriptions in the last six months) • _ Use of antipsychotics (more than two prescriptions in the last six months) • _ Cancer • _ Asthma or chronic obstructive pulmonary disease • _ Use of corticosteroids (more than two prescriptions in the last six months) • _ Cardiovascular disease (heart attack, angina, stroke or transient ischaemic attack) • _ Epilepsy • _ Falls • _ Chronic liver disease or chronic pancreatitis • _ Malabsorption (including Crohn’s disease, ulcerative colitis, coeliac disease, steatorrhoea, blind loop • syndrome) • _ Manic depression or schizophrenia • _ Non-steroidal anti-inflammatory drugs (NSAIDs) • _ Chronic renal disease • _ Diabetes • _ Venous thromboembolism • _ Body mass index • _ Haemoglobin < 11g/dl • _ Ethnicity • _ Emergency admissions in the last year • _ Abnormal liver function tests • _ High platelets • _ Smoking status • _ Location and deprivation

  4. Interim arrangements • Developing an Interim Risk Strat Tool based upon the QAdmissions algorithm to be implemented by April 2014 – whilst EMIS is completing QAdmissions, CCG interim step as precursor, to engage GPs in the process • Clinical Coding Sub-group agreed codes based upon the algorithm but with local variables and weighting based on ProMISE learning  • Key variables weighted, linked to age, gender, polypharmacy, etc. • Build and testing the search with our EMIS support resource ongoing

  5. Interim Risk Tool Variables

  6. Expected Benefits • Improved patient care • Reduce GP time spent on unplanned appointments • Reduced costs to NHS • New Unplanned Admissions DES requires regular risk profiling and proactive care management. This enhanced service will be funded using funding from the QP scheme in QOF (100 points) and the funding from the Risk Profiling DES.

  7. Operational arrangements • EMIS and CCG advice & support • Practice training • Fair Processing Notice/Patient engagement • Early adopters to test

  8. Will you be an early adopter? Contact Ellen Baldry, Project Support Officer Bromley Clinical Commissioning Group 1st Floor Beckenham Beacon 379 - 397 Croydon Road Beckenham BR3 3QL Ellen.Baldry@bromleyccg.nhs.uk 01689 866172 • Any Questions?

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