Recalls for ongoing RHD management

Add on qualifier and on completion rules to continue the recall protocols for the patient after the initial recall.

Tip:

To record secondary prophylaxis, a local clinical item with the export code BICILLIN must be configured. Commonly, this is Injection;Bicillin LA.

The RHD and acute rheumatic fever dataset creates the following rules:

On recording an outcome for the qualifier Next RHD/ARF check up due a recall is offered for the next Check up;RHD and acute rheumatic fever due according to the interval specified.
On completing a positive outcome for the qualifier GP review required? a recall is offered for a Review;GP;RHD and ARF due immediately.

Set up recalls for secondary prophylaxis injections:
1. A trigger for the first recall, either:
  - Triggering from the diagnosis - commonly, a health service will already have a recall rule to trigger the Bicillin injections. It may be triggered by a group of conditions (see below) or by a selection of specific conditions in different rules. Use this rule to check all previous diagnoses of RHD and add a recall if there has never been a Bicillin recorded.
  - Triggering from the completion of the first check up
2. Once the first injection has been given, an ongoing on completion recall to manage the four-weekly or three-weekly injections until cancelled.
  
  Note:
  The default is for 4 weeks, but when the prompt is given, the clinician can adjust this to 3 weeks if required. This value will be remembered for that patient until it is altered again in the future.
Set up recalls for echocardiography.
Recalls for the clinical item Echocardiography can be triggered on qualifier based on the Echocardiography due qualifier.
Set the following recalls:
- Offset of 12 months to trigger a recall for Echocardiography due in 12 months
- Offset of 2 years to trigger a recall for Echocardiography due in 2 years
- Offset of 3 months to trigger a recall for Echocardiography due in 3 months
- Offset of 3 years to trigger a recall for Echocardiography due in 3 years
- Offset of 6 months to trigger a recall for Echocardiography due in 6 months
- Offset of Now to trigger a recall for Echocardiography due in 0 days
Set up recalls for specialist follow-ups.
The check-up has required qualifiers to declare when the next review is due by:
- Cardiologist – Cardiologist review due
- Physician – Physician review due
- Paediatrician - Paediatric review due
- Dentist – Dental review due
Tip:
Recalls for the GP review and next check-up are centrally distributed.
Depending on the health service, different approaches will be taken to recording recalls for these reviews. A large health service may require recalls for appropriate reviews or consults and the specialists may be ‘in-house’. Health services may have visiting specialists and prefer to trigger recalls for the same or for referrals. More remote health services may trigger referrals to external specialist away from the community.
If you already have clinical items for specialist reviews, these can be used in the recall rules. Otherwise, consider the following ICPC terms:
- Recalls for in-house management for the next consultation or review by each specialist:
  - Consult;cardiologist
  - Consult;physician (create this item locally)
  - Consult;paediatrician
  - Consult;dentist
- Recalls for external management or for formal referral details to be recorded:
  - Referral;cardiologist
  - Referral;physician
  - Referral;paediatrician
  - Referral;dentist

For patients who already have a response to the qualifier, the recall rule will do nothing, it is effective only from the date of enabling.

When new responses are added, the clinician is prompted to accept the recall for the appropriate item due after the specified interval.