Disease Register

The Disease Register can display those active patients who have been marked as having diabetes, or who have CHD. To display CHD patients automatically, the relevant Current Problems and Past History must have been coded with ICPC2 Plus.

You can also display the disease register for any patient records displayed in the Patients List. So even if you aren’t using ICPC, you can still do a text search to find those patients with “angina” for example.

Patients can be individually marked as diabetic by clicking the Diabetic checkbox in either the Demographic window, or the clinical window.

Patients are automatically marked as diabetic when a new Current Problem is added from the Current Problems menu, which meets the criteria below:

Note: The patient is NOT automatically marked when you right-click on a Presenting Problem and choose Add to Current Problems. Also note that if you subsequently delete the Current Problem, the patient is not automatically “unmarked”. This needs to be done manually.

It is possible that non-diabetic patients might be marked e.g. If they have a Current Problem of “Gestational diabetes”, or even “No history of diabetes”. It is therefore the practice’s responsibility to ensure that all diabetic patients have been marked correctly.

When updating to Genie v7.2.8, Genie will have tried to automatically mark your diabetic patients by searching for Current Problems matching the criteria above. This is a rather limited search, particularly if you are not using ICPC or ICD10 codes. Therefore, there is no guarantee that all your diabetic patients will have been correctly identified during the update.

Disclaimer: Genie Solutions will accept no responsibility for any loss of income, or any law suits, actions, proceedings, liabilities, claims, damages and the like arising directly or indirectly from this attempt to automatically identify your diabetic patients.

The Register is opened by selecting Patients > Disease Register in the Patients List. The window below will appear:

Genie will display all patients who have been marked as Diabetic, but who have not been marked as Inactive. There is no time limit on when they were last seen. Therefore the number of patients found may be higher than those found in the NPCC Report.

If you are not using ICPC coding, the CHD option will be disabled. Otherwise, Genie searches the Past History and Current Problem tables for relevant ICPC codes. These are the same codes as used in the NPCC Report, but again there is no time limit on when they were last seen. Therefore the number of patients found may be higher than those found in the NPCC Report.

This option will display a register for all patients currently on display in the Patients List, whether they are Inactive or not.

Check Hypoglycaemics: If this checkbox is ticked, Genie will check each patient to see if they are taking insulin, a sulfonylurea, metformin and a Thiazolidinedione. This is ticked by default when Option 1 is selected. Unticking it for Option 2 and 3 may allow the register to gather information faster.

As the register window opens, Genie searches for other information about each patient as detailed below:

Last Visit:	This is the last invoice date, and therefore not necessarily the last consultation note.
Next Appointment:	Displays the date of the next appointment after the current date.
Last 721/723/725/727:	Displays the date that these items were last billed. For tracking any other items please refer to the Item Register
Provider:	If the Usual Provider field in the Demographics window has an entry, then Genie will insert this. Otherwise it displays the last provider who billed the patient with an asterisk in front of their name eg *Dr Joe Smith. Right clicking on this allows you to set or modify the Usual Provider field (see below).
SIP Trigger:	Displays the last date a SIP item was billed. The items searched for are 2517, 2518, 2521, 2522, 2525, 2526, 2620, 2622, 2624, 2631, 2633 and 2635.
Eye Exam:	This searches consultation records where at least one of the Presenting Problems starts with “Referral to Op”, or contains “eye exam”. This is to cover the terms “Referral to Ophthalmologist” (This is ICPC code F67) and “Referral to Optometrist". It is suggested that you add one or all of these terms to the Presenting Problems drop down menu to avoid having to get the spelling right each time.
Foot Exam:	This searches consultation records where at least one of the Presenting Problems begins with “Referral to Podiatrist”, if you are using ICPC, the full term is actually “Referral to Podiatrist/Chiropodist", or contains the text “foot exam” or “feet exam”. Again, it is suggested that you add one or all of these terms to the Presenting Problems drop down menu.
Statin:	Displays “Yes” if the patient has a statin in their current medication list. The date it was last printed is irrelevant i.e. even if it hasn’t been printed in the past 12 months, Genie will still report a “Yes”, because the patient may have got the script elsewhere.
ACE-I:	Displays “Yes” if the patient has an ACE_Inhibitor in their current medication list. Again, the print date is irrelevant.
Insulin/Sulfonyl/ Metform/Thiaz	Displays "Yes" if the patient has one of these drugs or classes in their current medication list. These columns are only displayed if the Check hypoglycaemics checkbox was ticked in the initial choice window.
Last BP:	Displays the patient’s last recorded blood pressure from the Measurements table in the Consult window.
BP Date:	The date of the last recorded BP reading.
BMI:	Last recorded BMI in the Measurements table in the Consult window.
Date:	Date of the last recorded BMI.
W-Hip%:	Last recorded waist-hip ratio in the Measurements table in the Consult window.
HbA1C:	Last recorded HbA1C as recorded in the Measurements table. If this is not being automatically extracted from downloaded pathology results, and you are not entering it manually, then this may be incorrect.
Date:	Date of last record HbA1C.
Creat:	Last recorded Creatinine result.
GFR:	The GFR recorded on the same date as the latest Creatinine. If the patient’s height has not been entered, then the GFR will not have been calculated.
Date:	Date of last recorded Creatinine.
Microalb:	Last recorded microalbuminuria.
Date:	Date of last recorded microalbuminuria. This is not automatically extracted from downloaded results, so you would have to be entering this manually.
Chol/Trigs/LDL/HDL:	Last recorded lipid measurements. If these are not being automatically extracted from downloaded pathology results, and you are not entering them manually, then these may be incorrect.
Date:	Date of last lipids.

Right-clicking on the Provider’s name allows you to set or modify the Usual Provider field.

Right-clicking on a measurement allows you to graph or edit the measurement record.

The display can be sorted by clicking on any of the headers. In a multi-doctor practice, if you only want to view your own patients, click on the Provider header to sort by Provider. You may then highlight your patients by clicking on the first of your patients and Shift-clicking on the last. Click on the Use Selected button to remove all the non-highlighted patients.

To create a Task e.g. to recall the patient, click on the patient and then click the Create a Task button.

To mark a patient as Inactive so that they stop showing up on the register, click the Make Inactive button.

To remove a patient from the diabetic register, click the Remove from Diabetic Register button. This unticks the Diabetic checkbox in the patients demographics and clinical window.

Note: It is not possible to print the register directly. However, the data can be exported to an Excel spreadsheet and printed from there.