Preventative Health Alerts: User Guide

MediRecords automatically generates Preventative Health Alerts on the Patient Dashboard to help clinicians identify patients who may benefit from preventative care interventions. These alerts are based on clinical guidelines from the Royal Australian College of General Practitioners (RACGP) Guidelines for Preventive Activities in General Practice, 9th Edition (Red Book 9), and are triggered automatically based on patient demographics, medical history, immunisation records, observations, and recorded clinical activity.

Contents:

1. What are Preventative Health Alerts?
2. Alert Types and Triggers
   • Smoking Cessation Due
   • Activity Level Assessment
   • Cervical Screening Test is Due
   • Influenza Vaccination is Due
   • Pneumococcal Vaccination is Due
   • Mammogram is Due
   • Patient is Due a Health Check
   • Patient is Due a Health Check for Cardiovascular Disease
   • Patient is Due a Health Check for Diabetes
   • Patient is Due a Health Check for Renal Disease
   • Patient is Due a Health Check for High Blood Pressure
   • Herpes Zoster Vaccination Due
3. Responding to Alerts

What are Preventative Health Alerts?

Preventative Health Alerts are automated clinical prompts that appear on the Patient Dashboard when a patient meets certain criteria associated with a preventative care need. They are designed to support clinicians in delivering timely, guideline-based preventative care without requiring manual recall searches.

Alerts are evaluated in real time using data already recorded in MediRecords, including the patient's demographics, medical history, immunisation records, observations, and clinical activity history. When a patient meets the criteria for an alert, it will appear automatically on their dashboard.

Each alert is assigned a risk level to indicate the degree of clinical urgency:

• Normal Risk - the patient meets standard population-level criteria for a preventative activity.
• Increased Risk - the patient has additional characteristics that elevate their risk above the general population.
• High Risk - the patient has characteristics associated with significantly elevated clinical risk, requiring prompt attention.

Alert Types and Triggers

The following sections describe each Preventative Health Alert, its risk level, and the conditions that trigger it.

Smoking Cessation Due

This alert prompts clinicians to discuss smoking cessation with patients who have a recorded smoking status or who belong to higher-risk groups.

Normal Risk

• Patient's smoking status is recorded as active (non-ATSI)
• Patient is at least 10 years old

High Risk — either of the following conditions triggers a High Risk alert:

• Patient is at least 10 years old, has an ATSI (Aboriginal and Torres Strait Islander) status recorded, and has an active smoking status
• Patient is at least 10 years old, is pregnant, and has an active smoking status

Dashboard message: "This patient has been identified as being at risk of smoking related diseases. Action: Ask about quantity, frequency / offer smoking cessation advice / goals, pharmacotherapy, referral, follow up"

Activity Level Assessment

This alert identifies patients who may benefit from a physical activity assessment.

Normal Risk

• Patient is at least 10 years old
• Patient has not had 2 Health Assessment activities recorded in the past year

Increased Risk — either of the following conditions triggers an Increased Risk alert:

• Patient is between 13–20 years old and is female
• Patient has an ATSI status recorded (no minimum age)

Cervical Screening Test is Due

This alert reminds clinicians when a patient is due for routine cervical screening.

Normal Risk

• Patient's sex is recorded as female
• Patient is at least 25 years old
• Patient has not had a pap smear result recorded in the past 2 years

Dashboard message: "Guidelines recommend a papsmear test at least once every 2 years"

Influenza Vaccination is Due

This alert identifies patients who are overdue for an influenza vaccination, based on age and risk factors.

Increased Risk

• Patient is at least 15 years old
• Patient has an ATSI status recorded
• Patient has no influenza vaccination on record

Normal Risk

• Patient is at least 65 years old
• Patient has no influenza vaccination on record

Dashboard message: "At Risk. This patient has been identified as being at risk of Influenza. Update Immunisations or create a clinical action activity to contact patient"

Pneumococcal Vaccination is Due

This alert identifies patients who may be at risk of pneumococcal disease and are due for vaccination.

Increased Risk — either of the following conditions triggers an Increased Risk alert:

• Patient is at least 50 years old, has an ATSI status recorded, and has no pneumococcal vaccination on record
• Patient is at least 70 years old and has no pneumococcal vaccination on record

Normal Risk

• Patient is at least 65 years old
• Patient has no pneumococcal vaccination on record

Dashboard message: "At Risk. This patient has been identified as being at risk of pneumoccocal disease. Update Immunisations or create a clinical action activity to contact patient"

Mammogram is Due

This alert prompts clinicians to arrange routine breast cancer screening for eligible patients.

Normal Risk

• Patient's sex is recorded as female
• Patient is between 50–70 years old
• Patient has not had a mammogram recorded in the past 2 years

Dashboard message: "Guidelines recommend a mammogram screening at least once every 2 years"

Patient is Due a Health Check

This alert identifies patients with elevated BMI and associated conditions who are due for a general health check.

Increased Risk

• Patient has a BMI of 25.0 or greater
• Patient has any of the following conditions recorded in their Medical History:
  • Diabetes Mellitus
  • Thrombotic Stroke
  • Gout
  • Hypertensive Emergency
  • Alcoholic Hepatitis

High Risk

• Patient has a BMI of 25.0 or greater (regardless of Medical History conditions)

Dashboard message: "At Risk"

Patient is Due a Health Check for Cardiovascular Disease

This alert identifies patients who are due for a cardiovascular disease (CVD) health check based on age, medical history, and ATSI status.

Normal Risk

• Patient is at least 45 years old
• Patient has Hypertensive Emergency recorded in their Medical History

Increased Risk

• Patient is at least 35 years old
• Patient has an ATSI status recorded
• Patient has not had 2 CVD Activity records in the past year

Dashboard message: "At Risk"

Patient is Due a Health Check for Diabetes

This alert identifies patients with diabetes-related conditions who are due for a diabetes health check or review.

High Risk — any one of the following sets of conditions triggers a High Risk alert:

• Patient is at least 60 years old, has Diabetes Mellitus in their Medical History, and has not had 1 Diabetes Review activity in the past year
• Patient has both Diabetes Mellitus and Microalbuminuria (finding) recorded in their Medical History
• Patient has both Myocardial Infarction and Polycystic Ovaries recorded in their Medical History
• Patient has both Impaired Glucose Tolerance and Impaired Fasting Glycaemia recorded in their Medical History

Patient is Due a Health Check for Renal Disease

This alert identifies ATSI patients who are at elevated risk of renal disease and due for a health check.

High Risk

• Patient is at least 30 years old
• Patient has an ATSI status recorded

Patient is Due a Health Check for High Blood Pressure

This alert triggers when a patient's blood pressure observations indicate hypertensive levels requiring clinical attention.

High Risk

• Patient has a Systolic BP reading of 180 mmHg or greater recorded via the General Examination Clinical Template
• Patient has a Diastolic BP reading of 110 mmHg or greater recorded via the General Examination Clinical Template

Herpes Zoster Vaccination Due

This alert identifies patients who are due for a herpes zoster (shingles) vaccination.

Normal Risk

• Patient is at least 60 years old

• Patient has no herpes zoster vaccination on record

   

Responding to Alerts

Each Preventative Health Alert includes an Add Action button, which allows a clinician to create a Clinical Action directly from the alert. For vaccination-related alerts (Influenza, Pneumococcal, Mammogram), the Clinical Action is created with a type of Immunisation.

Creating and completing a Clinical Action records the clinician's response to the alert. However, for some alerts  such as the Activity Level Assessment, marking a Clinical Action as complete does not automatically dismiss the alert. The alert will continue to display until the underlying trigger criteria are no longer met.

Further Reading

• RACGP Red Book 9th Edition — Guidelines for Preventive Activities in General Practice