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How POLAR assists to manage patients with Type 2 Diabetes and those at risk

06 June 2022

Diabetes is one of the leading chronic diseases in Australia that challenges our health system. There are approximately 1 million Australians over the age 18 who have type 2 diabetes, and over 2 million people are pre-diabetic and at high risk of developing this chronic disease. 

CSIRO infographic showing 422 million people world-wide have diabetes and this is expected to double in teh next 20 years. 85-90 percent of cases have type 2 diabetes.
CSIRO infographic showing 422 million people world-wide have diabetes and this is expected to double in teh next 20 years. 85-90 percent of cases have type 2 diabetes. Around 1 milion Australian adults have type 2 diabetes. Around t=2 million are pre-diabetic and at high risk of developing the disease.

Reference: CSIROscope     

A large proportion of the population is unaware they have type 2 diabetes and are at   high risk of developing the disease. Early detection is one of the key elements to prevent or delay its development. The Australian Type 2 Diabetes Risk Assessment (AUSDRISK) Tool is a validated tool to identify modifiable risk factors in type 2 diabetes.

 

Outcome Health has recently released a chronic disease module in POLAR focusing on diabetes. This module aims to assist clinicians in managing patients with a current diagnosis of diabetes and those who are at risk of developing the condition.  

What does the module look like?

This module is located within the QIPC Clinic report under “Clinical” at the top of menu. It has three tabs: Information and Trends, At-Risk Cohort, and Management. 

Information and Trends

This tab includes:

  1. An overview of the diabetes clinical module.
  2. Insights of diabetes patients’ HbA1c profile.
  3. A snapshot of at-risk type 2 diabetes patient population indicated by AUSDRISK assessment, suspected patients with diabetes and patients who have active diabetes.

Most of the items on this page are filterable, and it provides flexibility for clinicians to identify patient cohorts that they want to investigate further, track changes in diabetes patients’ HbA1c management and determine whether they are being coded properly.

 

POLAR dashboard od diabetes patients

At-Risk Cohort

This tab provides an overview of AUSDRISK items for patients with high/intermediate/low risk.

It is presented in two forms: a table and a bar chart with filterable items.

The table on top shows the value or status of each AUSDRISK assessment item. Clinicians can filter patient cohorts in a specific risk group and investigate those patients to see if there is any data missing or need to be closely monitored. Completing the missing data helps to reflect patients’ true at-risk level which may also impacts on the risk management plan.

polar-diabetes-patient-interface

 

The bottom bar chart represents the number of patients at risk of the individual AUSDRISK elements, assists practices in identifying which risk element has more patient counts, and provides further investigation if needed.

For example, out of 3,777 patients in the intermediate-risk group, 142 patients have a score under “High glucose.” As one of the modifiable risk elements, this patient cohort should be closely monitored or reviewed to prevent or delay those patients in developing type 2 diabetes in the future years.

polar-diabetes-distinct-patient-interface

Management

This management tab only focuses on active patients with diabetes.

The table includes all items associated with the Diabetes Cycle of Care. There are two ways to view the care items: completion status or measurements of the item, by clicking on the filters above the table, shown on the below screenshot.

 

Some items that are required to be completed more than once per 12 months would have three completion statuses: complete (C), partial complete (PC), or not complete (NC).

diabetes-status-interface

It is important to document each item in the file correctly. Data mapping of each tab is available in this module to guide clinicians in documenting care items to their designated spot.

Example of utilising the module:


POLAR demonstration video

View the demonstration video on using the module on the POLAR webinar page.

 


Tips & Tricks

It is not always easy to remember what filters have been applied to obtain the required patient cohort each time, especially when you have used multiple filters and need to track the progress over a long period of time. POLAR allows you to create a private bookmark to memorise this information.

This function is available in all POLAR reports. By creating your bookmark, one single click from the bookmark list will be able to bring up all the filters you have applied for the previously required patient cohort. 

See POLAR Walkthrough – Private Bookmark training guide

If you would like further support in using the Diabetes module or the private bookmark, please get in touch with your assigned Practice Support Officer or Health Systems Improvement Officer.