Q: We seem to be having a problem with the template with regards calculation of 10 year risk %. The problem is that it doesn't always work out the percentage figure and there doesn't appear to be any discernable pattern as to why it does work for some patients whilst it does for others. I wonder if you have come across this before or have any suggestions.
Q: Loading the CHD template yesterday, I noticed that in place of the smoking status prompt there appeared a family history prompt instead (Code 13WF). The rest of the subtemplate appeared the same as usual.
I have checked the rest of the practices templates for one coded by 137, but none exist. What do you think the problem is here?
Answer : The smoking template is set up to prompt for smoking FH (family history) in children, instead of smoking itself. Its one of the handy features of EMIS that you can make the appearance of a template depend on the age/sex of the patient it is being used for. My guess is you happened to look at the template in a child. Should be ok in an adult! So its not a problem - just a cunning template design.
Q. I have just been running through the Diabetes protocol with the practice and a few questions have been raised
Would like to just go through the whole template without having to negotiate the block of menus.
See the instructions that came with the download - which address this issue. I have not created 1 diabetes template because it is a certainty that it would not suit everyone as each practice's diabetes clinic runs in a different order with different priorities. Also if I had I would have used C10 Diabetes Mellitus as the identifying code thus overwriting peoples own diabetes templates at the time of download upsetting everyone! 2 options:-
1) Create a new template by mixing and matching the imported subtemplates according to practices preferred order
2) Adapt existing template by inserting imported subtemplates according to preference.
This will ensure correct codes used but in an order that suits practice
Could we incorporate Fundal Photography?
You can make entries into eye care template off picking list under 'Fundoscopy 4 DM'
Not all U's & E's results are recorded in this new protocol
...but where do you draw the line? ?FBG, ?LFTs ?TFTs etc etc. If included people will say the results subtemplate is too big - one can argue about this endlessly. No reason why practices can't add them to the relevant renal or test results subtemplate if needed. In CM its actually v easy to see results in Values so I opted to leave them out of the template to try to keep it vaguely manageable.
Feel that the template we are currently using is more dynamic than Dr Shepherds one, so it may be better if the read codes in our template were changed to correspond with that in the new one.
see 2) above - the problem is trying to produce a template for everyone which needs to include everything - inevitably it gets rather large & non dynamic. If you make it small and dynamic people complain about the bits left out - if you make it inclusive they complain its not dynamic! I worked on the principle that its easier to remove bits than put them in so opted for the second approach. In template/protocol design it is not possible to keep all of the people happy all of the time!
Q: The diabetes template is useless why is there no entry for shared diabetes care?
Answer: There has been some discontent over the terminology used in the diabetes template to indicate the locus of responsibility for diabetes care in the PCAG templates.
Until April 2002 there was no Read Code for Diabetes care by hospital only (66AU) for diabetes, just 66AP Diabetes: practice programme and 66AQ Diabetes: shared care program. As the rubric for these codes is too long for the EMIS template display, they had been abbreviated to GP care (66AP) and Hospital care (66AQ) because shared care & hospital care were synonymous. The addition of the hospital only care option has meant that some have felt that the Shared Care option was somehow missing (despite the underlying code being present). It may be that you would be happier having the words shared care displayed. If this is the case the abbreviations for these codes can be changed as follows:-
From Main Menu type DT then C then F. Enter 66AP and enter the new abbreviation Practice Care. Repeat the process for 66AQ and enter Shared care. NB Ensure you get these the right way round!!!
When you next use the template the new abbreviations will appear
The website will be updated with the new abbreviations in the template.
NB: this only changes the abbreviation for the code and does NOT affect the codes themselves.