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MODULE 1: Creating and maintaining a population-based DRS or Diabetes Register (and informing healthcare professionals of the status of their patients)
1.1 The Requirement
The National Screening Committee (NSC) recommends that there should be a single central register from which patients are invited to participate within a
DRS programme. This is set in the context of a broader number of new population-based screening programmes being established.
1.2 The Issues
Practice Based Register - a number of existing DRS programmes are using Practice based Registers. However, this does not meet the NSC
requirement or enable all patients who would benefit from the DRS programme to be identified. Data Quality issues within clinical systems
leads to lower prevalence of diabetes than expected and Practice based Registers therefore lead to issues with coverage.
Central DRS Register - where Central DRS Registers are being formed, they do not always include mechanisms for enabling the efficient
transfer of data from Practice systems. For example, some rely on paper-based referrals; others are attempting an extract of patient data,
however very often the security and patient consent imperatives are being overlooked. General Practice need to be able to efficiently refer
patients into the DRS programme; keep control of their patients' involvement in the programme; and be able to access DRS Results.
The importance of a cross sector solution is also often overlooked. For example, many patients with diabetes are under the care
of an Ophthalmologist for Diabetic Retinopathy. These patients need to be identified and excluded from the screening programme.
1.3 Our Solution
1st Retinal Screen has identified and resolved these issues and offers a service that responds accordingly:
- Acquisition of data - from Primary Care, Secondary Care, Blind and Partially Sighted Registers and
Optometrists: to establish and maintain an NHSnet/N3 ready, secure web-based Central DRS Register
(CDRIntell) or more broadly a Central Diabetes Register.
- Delivering a Security and Patient Consent Framework - to enable the programme to operate in
compliance with all relevant legislation, for example, Data Protection Act (1998), Health and
Social Care Act (2001).
- Identification of patients "At Risk of Diabetes" - (their clinical data indicates they are likely
to be diabetic; however there is no current diagnosis on their GP Practice Clinical System).
Through this data quality initiative, we can find up to an additional 10% of patients who would
otherwise not be provided with access to the DRS programme. Importantly only once the Practice
confirms a diagnosis of Diabetes can the patient be included within the programme.
- Reporting Results - to Patient, their GP Practice and Optometrist. We offer a GP results
Notification Service, electronically notifying those that need to know of the DRS results.
- Comprehensive Reports - to manage all aspects of your DRS programme, from waiting times
to reporting against the NSC standards.
- Supporting the broader needs of patients with Diabetes - with this infrastructure in place,
and informed written consent from patients, the service may be extended to form a population
based register for Diabetes more generally.
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