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The Diabetes Cycle of Care. Presenter: Dr Greg Wyatt. Minimum requirements for Cycle of care. Clinical: Measure weight: twice a year (height and BMI first time ) Measure blood pressure: twice a year Examine feet: twice a year Provide self-care education and review medicines
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The Diabetes Cycle of Care Presenter: Dr Greg Wyatt
Minimum requirements for Cycle of care • Clinical: • Measure weight: twice a year (height and BMI first time) • Measure blood pressure: twice a year • Examine feet: twice a year • Provide self-care education and review medicines • Check SNAP (smoking, nutrition, alcohol & physical activity) • Pathology: • Measure HbA1c: yearly • Measure Chol, HDL and TG: yearly • Test for microalbuminuria/ACR: yearly • Check kidney health with eGFR: yearly • Referral: • Comprehensive eye exam: every two years Bp Sunshine Summit 2014
Item numbers • Fees: • Same as equivalent visit (23/36/44 or 24/37/45) • SIP of $40 per patient per year for each completed cycle (if PIP) • PIP of $20 per diabetic SWPE if > 50% diabetic patients have completed cycle of care [whole practice] (if PIP) Bp Sunshine Summit 2014
Claiming Cycle of Care • Cycle of care claimed once per year, certifies to Medicare that ALL elements of cycle have been performed • Doesn’t matter who performed each element – GP, endocrinologist, optometrist/ophthalmologist, podiatrist • If audited, you would need to show evidence that all elements are completed, so need good communication • Medicare used to be very strict on 12 months – one day short and would be rejected. Now can be claimed after 11 months • Easiest way to keep track is to use EPC Diabetes tool in Bp • HL7 pathology populates automatically (almost all labs now) Bp Sunshine Summit 2014
Start of cycle • Cycle of care starts as soon as previous cycle is complete (or at diagnosis of new diabetic) • Educate patient on concept of cycle of care • Maintenance of good control • Prevention of diabetic complications • Early detection of complications • Usually 2-4 visits per year, just for diabetes • Consider handout for patient • Send reminders to patient Bp Sunshine Summit 2014
Reminders • Reminders are the key to keeping everything on track • GPs are too busy to remember • Patients never remember • When I complete a cycle of care (or at new diagnosis) • Add reminder “Diabetes – 6 month check” (6 months time) • Add reminder “Diabetes – Annual check” (12 months time) • Add reminder “Diabetes – HbA1c” in 3 months time if necessary • Reminders don’t automatically update • When reminders are printed, I enclose appropriate pathology request • If eye check is due, I write a note on letter Bp Sunshine Summit 2014
Before the visit • Consider practice policy of longer visit for annual review • More to do • Patients rarely come for JUST their diabetes • Better to have some catch-up time than run even later • Current reminders show on appt screen Bp Sunshine Summit 2014
At the visit • Complete consultation • Discuss SNAP (smoking, nutrition, alcohol & physical activity) and document • Appropriate examination for visit • Check and discuss pathology reports, other info (specialist, eye) • Document using Diabetes tool • Consider what needs to be done for next visit • Check and enter Reminders • Consider HbA1c check in 3/12 at 6 month review • Billing • Normal consultation at intermediate visits • Appropriate Cycle of care item at Annual visit Bp Sunshine Summit 2014
Live demonstration Bp Sunshine Summit 2014
Thank-you!Any questions? Bp Sunshine Summit 2014
For assistance, please visit www.bpsoftware.com.au You can contact our Customer Support Team on: (07) 4155 8800 (07) 4153 2093 support@bpsoftware.com.au This session’s over. (But we’re still here for you) Bp Sunshine Summit 2014
