Topic: QIPC

Cancer and its prevalence in Australia

In Australia, according to the Australian Institute of Health and Welfare (AIHW), three out of every 10 deaths are caused by cancer, and it is estimated there were 162,163 new cancer cases diagnosed in 2022.

The treatment of cancer can become increasingly challenging as the disease progresses and spreads.

In numerous instances, cancer only presents symptoms after it has metastasised.

Therefore, early detection and screening of the asymptomatic population is crucial in preventing the disease’s advancement and achieving successful outcomes.

What is cancer screening?

Cancer screening detects early signs or risk factors for cancer, increasing treatment success and may prevent cancer.

However, further investigation is necessary for confirmation of positive findings.

There are three different approaches to screening:

• Population-based screening: This involves testing of an entire target population.
• Targeted risk screening: This involves screening high-risk individuals, such as those with a strong family history of certain types of cancer.
• Opportunistic screening: This involves screening conducted during a medical check-up, such as tests which may be ordered by a healthcare professional during an appointment for medication review or a yearly immunisation like the flu vaccine.

Three population-based cancer screening programs in Australia are free for eligible people:

• BreastScreen Australia Program: Women over 40 can have a free mammogram and women aged 50 to 74 are actively invited to screen every two years.
• National Bowel Cancer Screening Program: The Australian National Bowel Cancer Screening Program (NBCSP) provides population screening for bowel cancer free of charge to eligible people every two years for ages 50 to 74.
• National Cervical Screening Program: Women and people with a cervix aged 25 to 74 years are invited to have a Cervical Screening Test every five years through their healthcare provider.

Each program aims to detect pre-cancerous abnormalities or early-stage cancers before symptoms occur, maximising the chance of successful treatment.

Primary healthcare and its role in cancer screening

Primary healthcare providers are essential collaborators and drivers in the promotion and implementation of cancer screening programs.

Patient-centred care and participation in cancer screening programs are critical factors in decreasing cancer-related morbidity and mortality.

Studies from Cancer Institute NSW suggest the recommendation or endorsement of cancer screening programs by a primary healthcare provider elevates the participation rate in cervical, breast and bowel screening programs.

Furthermore, healthcare providers play a pivotal role in encouraging individuals to seek and engage in cancer screening programs by providing educational resources and accessible tools.

How can QIPC cancer screening module in POLAR be useful?

Outcome Health and SWSPHN have collaborated to develop a cancer screening module.

This module can be accessed through the POLAR QIPC report and is located under the “Clinical” tab.

Its purpose is to help general practices identify high-risk patients who are due for screening, in order to improve their management and health outcomes.

The module has five tabs covering information and trends, cervical screening, breast screening, bowel cancer screening and skin cancer screening.

SWSPHN has created a set of POLAR Walkthroughs to assist in utilising the Cancer Screening Module effectively: 

• POLAR Walkthrough – patients due for SCC or BCC review
• POLAR Walkthrough – non-urgent patients now due for bowel screen with a history of polyposis
• POLAR Walkthrough – non-urgent first nations patients due for breast screening
• POLAR Walkthrough – identifying URGENT patient cohorts in cancer screening module

Helpful tips for GPs, managers and nurses

• Private bookmark: The Private Bookmark function in POLAR allows the user to save searches of specific patient cohorts by creating a bookmark. The user can create these bookmarks at the top right-hand corner of the page. This enables the user to recall specific patient cohorts without having to re-apply filters. This can be a very effective function as it only requires the user to open the bookmarks tab and select their desired saved search.

Download Private Bookmark Walkthrough

• Correct documentation: In order for POLAR to obtain precise and reliable data, it is crucial to ensure every item is accurately documented in the patient’s file. To assist clinicians and practice staff in documenting care items in the appropriate location in their clinic’s medical software, data mapping of each tab is accessible in the Help menu.

POLAR Patient Flagging is a grouping structure designed to enable practices and PHNs to identify (in a privacy-protecting way) a specific cohort of patients to provide additional services or perform analysis.

POLAR can filter and extract data from a practice’s patient file if it is recorded in a field POLAR can read.

Currently there are limitations and not all patient information can be searched for or filtered, both within the practice clinical software such as Best Practice or Medical Director, and by the POLAR clinical audit tool.

Outcome Health has developed a patient flagging system in POLAR which may assist in filling this gap in functionality.

How to use Patient Flagging in your practice

There are many potential use cases for POLAR Patient Flagging, two of these are outlined below:

Use 1. Identifying patients living in a Residential Aged Care Home (RACH)

A practice may wish to generate a list of patients who reside in a RACH to identify those who are eligible or overdue for healthcare items.

In the POLAR Clinic Summary report, a practice POLAR user can apply general demographic filters, such as age, to create a list of patients who may reside in a RACH.

The practice can then access the Patient Flagging function to apply a Flag to those patients who they identify as living in a RACH.

Within the Clinic Summary report the RACH flagged patients can then be retrieved and filters applied to identify those who, for example, are eligible for a shingles vaccination.

Use 2. Identifying patients who have refugee status

Similarly, a practice can flag patients who have refugee status.
General demographic filters can be applied in the Clinic Summary report, such as ethnicity/country of birth, to generate a list of patients who may have refugee status.

On the Patient Flagging page, patients identified as having refugee status can be flagged.

This patient list can then be retrieved in the Clinic Summary report and filters applied to identify those who are potentially eligible for a Health Assessment or missing immunisations.

Advanced POLAR use of the Patient Flagging function

Practices can use and apply Flags created by their PHN such as the RACH and Refugee Flags, or create their own Flags based on their requirements.

Flag creation and management

The Flagging function can be accessed via either the POLAR landing page or from within the Clinic Summary Report.

On the Flags Setup and Patient Flagging pages, practices may see two types of Flags listed:

Practice-level Flags

Practice-level Flags are created by the practice and have an ‘Edit’ function. These Flags are only visible and available to the practice which created them.

PHN-level Flags

PHN-level Flags are created by the PHN and do not have an ‘Edit’ function – Practices can use these Flags if the PHN has granted the practice access. PHN Flags will be differentiated by a ‘PHN’ prefix when applying a Flag.

A PHN may create Flags and assign to practices for use, for example, for a project or data analysis. Flags created by a PHN cannot be modified, edited or deleted by the practice.

A PHN is not able to Flag patients as they do not have access to a practice’s identified data.

Flag Status

Every Flag must have at least one Status.

A Flag can have multiple statuses but only one Status can be allocated to a patient with that Flag at any given point in time.

The Status allocated to a patient can be changed, for example if a patient moves through various stages of a program. A patient can be attached to more than one Flag with a Status for each Flag.

What is data quality?

Data quality is the degree to which a given dataset meets requirements on accuracy, completeness, consistency, validity, uniqueness, and timeliness. Quality data is critical in the healthcare industry.

Why is it important?

Data is a source which provides evidence.

In primary healthcare, data quality can impact greatly on the care a patient receives.

If data quality is not being continuously monitored and improved it can cause a series of negative impacts, resulting in:

• Poorer services provided to patients
• Decrease in patient and staff satisfaction
• Decrease in business revenue

On the other hand, good quality data enables care providers and managers to be better decision-makers and optimises the healthcare coverage as well as service quality.

Continuously working on data quality can benefit general practice in different ways:

• Improve patient experience in terms of accessing safer care, which results in better health outcomes
• Improve effectiveness in communication between healthcare professionals internally and externally
• Better management of population health by reducing the burden of disease and health inequalities across the region

In addition to the above benefits, continuous improvement in data quality, which includes maintaining patients’ health records clearly and accurately, also increases the chance of practices obtaining accreditation from AGPAL, as it is one of the main criteria under the RACGP Standards for general practices, 5th edition.

Continuously working on data quality enables general practices to increase business revenue.

Practices who participate in Practice Incentives Program Quality Improvement (PIP QI) qualify to receive incentive payments when they:

1. Participate in continuous quality improvement and
2. Provide the PIP Eligible Data Set to your local Primary Health Network (PHN)

How practices can improve their data quality

General practices can ensure high-quality data by developing relevant policies and procedures, and through education and training to staff. Continuously creating action plans with progress measures is another effective method.

South Western Sydney PHN’s Quality Improvement in Primary Care (QIPC) is a data-driven QI program to assists general practices continuously improve data quality by identifying gaps using a clinical audit tool – POLAR – and completing a Model for Improvement (MFI) plan with one of our officers every quarter.

The data quality page within QIPC Clinic report in POLAR uses a traffic light colour system to indicate the practice’s data quality performance against RACGP Accreditation standards 5th edition:

• Green indicates meeting the RACGP standard
• Orange indicates within 20 per cent of the RACGP standard
• Red indicates more than 20 per cent from the RACGP standard

This gives practices an overview of their data quality and to easily identify which item or patient has requires more information in the clinical software.

POLAR’s company also has a tool called Walrus which everyone in the practice can use to find areas with missing data.

Walrus also provides information on data quality, risk/clinical, PIPQI, MBS item eligibility, as well as patient timelines, patient summaries and clinical graphs.

Speak to a QIPC officer about using Walrus in your practice.

Continuous data quality improvement is simplified for practices who partner with SWSPHN and participate in the QIPC program, and gain access to resources and guidance on using POLAR.

Links

RACGP Standards for general practices, 5th edition

POLAR and WALRUS: edu.polarexplorer.org.au

Help us improve

We welcome your feedback or suggestions on the QIPC program. To help us improve, please complete the evaluation form:

Please contact your assigned Practice Support officer or Health Systems Improvement officer if you would like further information about QIPC program or support in using POLAR and Walrus.

Contact the SWSPHN HSI team via email at HSIsupport@swsphn.com.au to learn more about QI activities.

Additional resources are available on the SWSPHN QIPC webpage.

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

Source: 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:

• Practice Incentive Program Quality Improvement (PIP QI) Measure 8 for CVD Risk Assessment eligibility
• MBS item numbers 699 and 177 for Heart Health Checks

“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:

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.

POLAR QIPC CVD Module

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.

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.

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.

A guide to using the POLAR QIPC report CKD module to identify patients with Chronic Kidney Disease (CKD) in your practice.

Chronic kidney disease is a health condition often under-recognised and under-diagnosed in Australia (RACGP). About 10 per cent of Australian adults have asymptomatic early kidney disease. In some patients, up to 90 per cent of kidney function can be lost before symptoms appear. Aboriginal and Torres Strait Islander people are twice as likely to have CKD than non-indigenous people (healthdirect).

Chronic kidney disease snapshot in Australia

Chronic kidney disease is common and treatable and, in some cases, reversible.

Who is at risk of chronic kidney disease?

Adult Australians are at increased risk of developing CKD if they have any of the following risk factors:

• Diabetes
• Hypertension
• Established cardiovascular disease
• Family history of kidney failure
• Obese (body mass index greater than 30kg/m²)
• Smoker
• 60 years or older
• Aboriginal or Torres Strait Islander
• History of acute kidney injury (AKI)

Impact of COVID-19 on chronic disease management

The Medical Journal of Australia reported the COVID-19 pandemic has adversely affected chronic disease management in primary care for several reasons, such as:

• Patient illness, self-isolation or other restrictions
• Redirection of clinic resources to COVID-19 treatment and immunisation
• Administration and clinical staff shortages
• Increase in telehealth services and cutback in face-to-face appointments
• Reduction in referrals and appointments available to specialist services

“The management of CKD is always a collaborative effort, and a whole of practice approach involving the general practitioner (GP), primary healthcare nurse and practice staff maximises the opportunity for best practice care to occur.”

kidney.org.au

POLAR can help your practice identify patients with chronic kidney disease and those at risk, to improve management and health outcomes

In collaboration with SWSPHN, Outcome Health has developed a new POLAR module focusing on chronic kidney disease.

The CKD module is found within the POLAR QIPC report under the “Clinical” tab. It aims to help clinicians better treat patients with an active diagnosis of CKD and identify patients who are at risk of developing the condition.

The module has three tabs:

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

POLAR Information and Trends tab

The Information and Trends tab in POLAR gives a snapshot of your practice’s CKD population, those with indicated impaired kidney function based on eGFR results, and a colour coded reference table to understand kidney disease stage categories used in the Management tab.

POLAR At Risk Cohort tab

Filter items on the At Risk table in POLAR 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).

POLAR Management tab

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

Essential – maintain routine immunisation

Immunisation is a safe and effective way to protect children from serious vaccine-preventable diseases. The Australian National Immunisation Program (NIP) provides free vaccines for all children in Australia against 14 diseases. A report from the Australian Institute of Health and Welfare indicated the vaccine-preventable disease burden rate reduced by 31 per cent between 2005 and 2015 due to more vaccines being included in the NIP Schedule.

According to the Department of Health and Aged Care, Australia’s national aspirational vaccine coverage target to achieve herd immunity is 95 per cent Herd Immunity is when enough people are vaccinated against a disease to prevent it from spreading. However, the national immunisation coverage rates were still under 95 per cent for all one to five years old as of June 2022. Hence, increasing and maintaining immunisation coverage rates in all age groups to 95 per cent is essential, making spreading disease from person to person more unlikely.

COVID-19 impact on routine childhood vaccinations

RCH National Child Health POLL from Royal Children’s Hospital Melbourne found one in five children had their routine vaccination doses delayed after the onset of the COVID-19 pandemic. About 43 per cent of children aged younger than five years were overdue for their routine childhood vaccinations.

Some reasons behind parents/caregivers delaying children’s routine immunisation might include:

• The fear of catching COVID-19 from healthcare facilities
• Routine childhood vaccination is considered the least priority during the COVID-19 pandemic by the parents
• Lockdown/Isolation due to COVID-19 infection within the household
• Limited immunisation services from medical providers

Delaying or missing vaccination is a pressing problem in Australia and even globally. Children are more likely to contract vaccine-preventable diseases. Consequently, they have lower herd immunity. This might place immunocompromised populations, neonates, and infants at higher risk of an outbreak.

How can general practices support and improve childhood immunisation uptake?

Identify children’s immunisation status regularly

• POLAR is a useful tool for general practice to identify children who are missing scheduled vaccines at a certain age in your practice. General practices can follow the POLAR Immunisation Walkthrough to identify patients aged one to two years old who may be missing their first dose of MMR (measles, mumps, and rubella) and Meningococcal ACWY.

Tips and tricks:

You can create a private bookmark to remember the filters applied, and it will enable you to track progress at any time. This private bookmark function is available in all POLAR reports. By creating your bookmark, one click from the bookmark list will enable you to bring up all the filters you have applied for the previously required patient cohort.

POLAR Walkthrough for private bookmarks

• The 10A report identifies patients due/overdue for immunisation. General practices can follow the walkthrough (Pages 9 to 17) to request this report from the Australian Immunisation Register (AIR).

Provide education to parents/caregivers and reduce their concerns about immunisation risks

• Increase awareness of the immunisation schedule by informing parents of the up-to-date National Immunisation Program Schedule (updated on October 2021), and advise them to download the Save The Date To Vaccine app.
• Provide resources for parents to take home such as Following Vaccination – what to expect and what to do. You can order this pad from the Department of Health.
• Advise of the facts a higher number of under-vaccinated children will decrease protection from communicable diseases and place other children and vulnerable people at risk.

Planning practice and patient outcome improvements

• General practices can participate in SWSPHN’s QIPC program which contributes to clinical quality improvement outcomes like childhood immunisation rates. Your assigned Health Systems Improvement Officer will support you in achieving better health outcomes for children and financial prospects.
• Implement reminder and recall systems to increase routine vaccination uptake and close the immunity gaps.
• Encourage clinicians to maintain up-to-date childhood immunisation knowledge. You can find out a lot of useful information from:
  Australian Immunisation Handbook
  Catch-up Calculator 
  NCIRS fact sheets 
  Public Health Unit 
  Childhood Immunisation HealthPathways – login detail: Username: select the region in which you practise (Bankstown, Fairfield, Highlands, Liverpool, Macarthur) and Password: network.

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. 

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.

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.

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.

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).

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 Walkthrough – Intermediate AUSDRISK score patient with high glucose has visited more than 10 times in the past 12 months
• POLAR Walkthrough – Type 2 diabetes patient without HbA1c record in the last 12 months

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.

What is Walrus?

Walrus is a flexible point of care tool developed by Outcome Health to support clinicians and practice staff to pull up insights of patients quickly with prompt notifications sitting on top of clinical software. It is a tool that can provide guidance to a GP/ nurse/ receptionist to ensure patient records and PIP QI data are always up to date.

Who will benefit from using Walrus?

1. Clinician
   • Walrus can provide clinician prompts to specific items such as missing data, clinical prompts, risk scores, or MBS items
   • Support systematic approach for health promotion and preventative care 
   • Colour-coded urgency notifications support clinicians identifying risk factors, allowing early intervention 
   • Improve patient quality of care by keeping patient’s clinical data up to date
   • Assist clinicians to easily identify patient’s MBS eligibility according to practice billing history and increase practice revenue
   • The tool is able to be repositioned freely but consistently on top of the clinical software during a consultation
   • Walrus can be minimised to the desktop notification bar if you do not want to see it on the screen

2. Practice staff
   • Improve workflow efficiency
   • Increase productivity by filling in missing non-clinical patient information
   • Customise group button that suits staff position or role with hide/unhide function
   • It does not slow down the clinical system as it communicates with the POLAR extraction tool instead of the clinical database

3. Patient
   • Avoid delays in intervention with up-to-date clinical data
   • Improve health outcomes

How does Walrus work?

Once Walrus is logged in and a patient file is opened in the clinical software, the Walrus interface will appear with the patient’s basic information and notification groups underneath. It will only pick up the active window information, hence, if a user has multiple patient files open, Walrus will only show the patient information that is currently in the active window.

It consists of 7 groups with coloured tags on the top left-hand corner and colour codes to the items within each group. Each colour represents a different level of urgency:

• Green: appear against the group with no data missing or not relevant
• Yellow: data missing – low urgency
• Orange: data missing – medium urgency
• Red: data missing – high urgency

Users can choose groups that apply to their role by clicking “+” on the right-hand side.

Simply clicking on each group button will bring up a page of information or missing data above the Walrus interface. By clicking “Open”, it will take you to the page in the clinical software where you can fill in the missing data. Once missing data is filled, coloured notification will be updated/disappear in 24 hours.

What now?

With Walrus roll outs to all practices, you can easily install the tool by following the below steps:

1. Download the Walrus tool installer from the front page of POLAR or via this installation link
   
2. Click the INSTALL button to download the setup file
3. Run the installer application, setup.exe
4. Click the INSTALL button
   
5. When Walrus starts, you will be asked to enter your POLAR username and password

Tips for setting up your Walrus

• Before starting to use the tool, it is important to go to the settings wheel and tick the checkboxes ‘Remember Login’ and ‘Start with Windows’ to have this tool automatically opened whenever the user accesses the clinical software tool
• Selecting “Screen Triggering” is recommended as it enables the user to enter missing data more efficiently by opening the relevant screen of the clinical software
  
• Walrus tool is required to be installed in each workstation, and it is recommended that each user to have their own login account for the tool

Support and Resources

Resources are available on our POLAR resources webpage if you would like to know more about its functionality and how it can assist your daily task:

• Walrus Webinar
• Walrus FAQ
• Walrus User Guide

Please get in touch with your assigned Practice Support Officer or Health System Improvement Officer for any further support in using the Walrus tool.