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Using the Diabetes Data Dashboard to prioritise patients most in need of care

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A Clinical Pharmacist at Forest View Medical Centre in Treorchy, Wales has used the Diabetes Data Dashboard to prioritise patients most in need of care.

Forest View Medical Centre has one Clinical Pharmacist for a list size of 17,000 patients - prioritisation of patients is therefore essential.

Challenge: Efficiently prioritise patient populations in greatest need of care

Before using the Diabetes Data Dashboard, risk stratification and prioritisation was limited; diabetes reviews were carried out every 6 months for all patients, regardless of their needs.

The Clinical Pharmacist observed that this way of working benefited patients who were managing their diabetes well, but patients who were in most need of additional care were more difficult to engage, which led to an increased workload for the practice team. Due to searches being difficult and time-consuming to build, the practice was not working as efficiently as it could have been.

“[Running searches takes time], which puts you off doing a search if you are pushed for time”

Clinical Pharmacist, Forest View Medical Centre

Results: 6 months after introducing the Diabetes Data Dashboard

After implementing the Diabetes Data Dashboard, which can be used by any individual within a practice, the practice team was able to identify patients whose diabetes is less well-managed, and who therefore have greater needs. For example, patients who have elevated blood pressure, BMI and/or HbA1c levels or who are missing data for the nine key care processes.

These patients were invited for a review after 3 months, rather than 6 months. The Clinical Pharmacist reported that this prioritisation of reviews enabled better workforce planning and appointment allocation, helping the team feel they were better equipped to handle their post-COVID-19 backlog, focusing their efforts where they are needed most.

 

“Identifying patients who need our attention first has allowed us to prioritise patients who have elevated blood pressure, BMI, and/or HbA1c levels, as well as those with missing data for the nine care processes”

Clinical Pharmacist, Forest View Medical Centre

Patients who needed to switch to a formulary device were also able to be identified using the Diabetes Data Dashboard, eliminating the need to run complex searches on the Patient Medication Record system, helping to save the practice time.

“I can go into the Diabetes Data Dashboard and with two clicks I have the information straight away”

Clinical Pharmacist, Forest View Medical Centre

Ultimately, by using the Diabetes Data Dashboard the Clinical Pharmacist felt that the practice increased its efficiency and saved time, through improved prioritisiation of patients and elimination of the need to build and run complex searches.

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The lifestyle images included in this article is a stock photo used for illustrative purposes only.

Quotations sourced from a recorded interview with a Clinical Pharmacist as part of a consultancy agreement with Roche Diabetes Care in 2022.