09 March 2023

A guide to using the POLAR QIPC report to treat and manage patients with cardiovascular disease (CVD) and identify those at risk.

Cardiovascular disease (CVD) is a group of diseases which affects the heart and blood vessels, and includes coronary heart disease, atrial fibrillation and stroke (WHO). CVD affects more than four million Australians and is a leading cause of death, accounting for one in four deaths in Australia. Aboriginal and Torres Strait Islander peoples are twice as likely to develop CVD than non-Indigenous peoples, with CVD occurring 10 to 20 years earlier in Indigenous populations (AIHW).


Risk Factors

CVD is largely preventable with 90 per cent of CVD risk factors being modifiable (Heart Foundation, HRI), such as:

    • Lifestyle – smoking, excessive alcohol, low physical activity, poor diet
    • Biomedical – high blood pressure, abnormal cholesterol, overweight and obesity

Absolute CVD risk principles are: CVD is largely preventable, modified CVD risk factors are well defines, absolute CVD risk management most effective, targeting therapy to highest risk groups creates greatest benefit, CVD risk calculators are essentialSource: Heart Foundation


Impact of COVID-19 on chronic disease management

Missing regular medical appointments and pathology testing can lead to under-diagnosis, disease progression and deterioration. While the emergency phase of the COVID-19 pandemic has passed, it continues to affect chronic disease management in primary care. The Medical Journal of Australia reports this is for several reasons, such as:

  • Patient illness, self-isolation or other restrictions
  • Administration and clinical staff shortages
  • Use of telehealth services
  • Reduction in referrals and appointments available to specialist services


CVD Risk Assessment and Heart Health Check as part of the QIPC/PIP QI program

The Australian Government has implemented several initiatives to help general practices care for CVD patients and aid in identifying at risk patients. These include:

“Implementing systematic absolute CVD risk assessments for eligible patients via Heart Health Checks helps your practice implement quality improvements and attract additional funding to support these important activities.”
(Heart Foundation)

The Heart Foundation infographic shows one way your practice could use the Heart Health Check assessment to identify and care for patients at risk of CVD:

Flow chart showing a loop between: identify at-risk population, recall at-risk population, heart health check, set regular reminders and recall patients annually.

The SWSPHN QIPC program can assist practices with checking patient eligibility for a Heart Health Check. POLAR QIPC Tracked MBS can generate a list of patients who are potentially eligible for a Heart Health Check, subject to Medicare verification. We have provided a link below for a POLAR QIPC walkthrough guide to help you.



In collaboration with SWSPHN, Outcome Health has developed a new POLAR QIPC module focusing on CVD. The aim of the module is to help clinicians better treat patients with an active diagnosis of CVD, as well as identify patients who are at risk of developing the condition based on certain risk factors.
The CVD module is found within the POLAR QIPC report under the “Clinical” menu and has three tabs:

1. Information and Trends
2. At Risk Cohort
3. Management


POLAR Information and Trends tab

The Information and Trends tab gives a snapshot of your practice’s CVD population, those patients at risk based on Absolute CVD Risk or associated factors, a Top 10 SNOMED Chronic CVD Diagnosis table, and a Cholesterol Management table.

Screen capture of QIPC CVD report on Information and trends tab


POLAR At Risk tab

Filter items on the At Risk table to identify patients with ‘at risk’ criteria. This tab includes a chart to select patients with a Single Risk Element such as diabetes (or indicated diabetes) or elevated HDL.

Screen capture of QIPC CVD report on At Risk Cohort tab



POLAR Management tab

The Management tab focuses on patients with an active CVD diagnosis. The filterable items allow for a targeted approach to CVD management, with the ability to track multiple items over a set time.

Screen capture of QIPC CVD report on management tab (sample data used)

POLAR QIPC walkthroughs

To aid you in using the POLAR QIPC Report for CVD management and prevention, we have prepared the below step-by-step walkthroughs:

Other POLAR walkthrough guides can be found on the POLAR Resources page of the SWSPHN website.

Tips & Tricks

Private Bookmark

It is not always easy to remember what filters have been applied to obtain the required patient cohort, especially when using multiple filters.

The Private Bookmark function is available on all POLAR reports. By creating your bookmark, a single click from the bookmark list will allow you to retrieve all previously applied filters needed for the patient cohort.


Correct documentation

For POLAR to extract the most accurate data, it is important each item is correctly documented in the patient’s file. Data mapping of each tab is available in the Help menu, to guide clinicians in documenting care items in the correct place in their clinic’s medical software.

Screen capture showing to find Data mapping for this page under the Help menu

If you would like further support in using the POLAR QIPC CVD module or the private bookmark, please contact your assigned Practice Support Officer or Health Systems Improvement Officer.