HbA1c

Step-by-Step Guide: Using the HbA1c Pathology System for Diabetic Control

1. Access Clinical Reporting

   • Navigate to Reports and select Welby Innovate Pathology HbA1c from the menu.

2. Add Reports to Favourites

   • To easily access the necessary reports, select them and use the recycling icon to add them to your favourites for quick access in the future.

3. Understanding Report Structure

   • Top Section: Focus on reports relevant to reviewing individual patients.
   • Bottom Section: Contains bulk processes for admin staff, such as coding patients with NDH or informing them of HbA1c results. Nurses typically won’t need to handle these tasks.

4. Diagnosis and Review Reports

   • Patients Needing a Diabetes Diagnosis: These patients have had HbA1c results of 48 or higher but are not yet coded as diabetic. Use the pathology template (accessible via the graph icon) to either code a diagnosis or exclude them if appropriate.
   • Patients with Raised HbA1c Over 55: These patients have had one raised HbA1c result and require a repeat test or exclusion.
   • Patients in Remission: This report helps you identify patients whose HbA1c has improved but now exceeds 48, signalling a need for review.
   • NDH Patients: Some patients may show signs of NDH (Non-Diabetic Hyperglycaemia) but cannot be bulk coded, for example, if they’re on steroids. You’ll need to review these manually.
   • Patients Without Diabetes Education Referral: These patients have been diagnosed but haven’t been referred for diabetes education. Ensure they are referred or that their first appointment is booked.

5. Reviewing Diabetic Patients

   • Poorly Controlled Diabetes: Patients whose HbA1c is above target. The system checks if a personalised target has been set (if not, it defaults to QOF targets). You can view and adjust their target in the pathology template.
   • Patients at Risk of Hypoglycaemia: These are patients with low HbA1c levels who may be overlooked. The system flags them for review to prevent missed hypos.
   • Consider SGLT2 Medication: Review patients whose HbA1c results may indicate a need for SGLT2 inhibitors.
   • Frail Patients: The system flags patients coded as moderately or severely frail. Although their HbA1c target is 75, you may choose to review them for additional care.

6. HbA1c Pathology Template Overview

   • For individual patients, the HbA1c page displays key information:
     • HbA1c Target and the last five test results.
     • Medication: See what medications the patient is on and when they were first diagnosed.
     • Review Section: Options include recording a medication review, no further action, or arranging follow-up. You can also indicate if the patient is under the care of a Diabetes Specialist Nurse (DSN) or if you’ve referred them.

7. Actions Based on Review

   • You can:
     • Arrange a follow-up, which generates a task.
     • Record that a review has been done, removing the patient from future reports.
     • Use personalised notes for each patient's review process.

8. Configuring Follow-Ups

   • If preferred, the system can be configured to arrange telephone reviews instead of in-person follow-ups.

9. Alternative Options

   • If this method of reviewing patients doesn’t suit your workflow, consider configuring the system to flag patients who need a review and arrange appointments directly.

10. Additional Support

• If there’s anything you’d like added or changed in the system, reach out for adjustments.

System Summary:

This is a summary of how results are Auto-Reviewed and the outcome: