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June 2016 edition
Email: dame.liaison@casa.gov.au

DAME Newsletter - June 2016

From Principal Medical Officer, Dr Michael Drane

Greetings! This will not be news to those of you who attended the interesting ASAM NSW meeting held at the Historical Aircraft Restoration Society, but Av Med has been significantly restructured. The doctors have been reconfigured as a stand-alone technical specialist group, and all assessments are now handled by a separate “client services centre”. This should not change anything for DAMEs or DAOs. For assessment queries and IT support, your phone and email contacts remain the same.

Another topic covered at the meeting related to the update of cardiovascular risk assessment. It is essential that we reflect current approaches such as calcium scoring, CT angios and cardiac MRIs. I look forward to updating you on developments once we have had worked through the processes carefully. Another area of policy development is the assessment of strokes. We intend to address this at the beginning of next year.

Improvements continue to be made to the medical records system, MRS. We value user feedback, so please give us your suggestions. The upgrade on 9 June 2016 took into account feedback received from DAMEs about the system. Applications are now automatically submitted to CASA where payment has been made and the examination and problem mapping has been completed. You will now also receive an automated email reminding you to finalise an application if you haven’t worked on the application for seven days. The email will include a link which will take you to where you last left the application in MRS. Viewing and navigation of medical questionnaires in MRS has also been improved and tabs have been made more prominent.

We are aware that SNOMED/problem mapping is posing difficulties for some DAMEs. This newsletter contains a number of useful pointers and examples. I encourage you to keep this information on hand for easy reference and to also keep an eye out for a short online survey that we will soon be emailing to you. We want to know how many DAMEs would be interested in taking part in an MRS webinar and the processes in MRS you would like to learn more about. Please take a moment to respond to this survey so we have a better understanding of the support you need for using MRS and the best way to provide it.

With best wishes,

Michael

Problem mapping pointers

  • SNOMED problem codes are for diagnoses, not treatments. Therefore you search for the condition that made the treatment or procedure necessary.
  • FINDINGS will come up at the end of the medical examination.
  • Think about whether any of the declared conditions are safety relevant and map the FINDING to a PROBLEM.
  • All FINDINGS must be mapped to a PROBLEM, but PROBLEMS can be added without having a FINDING mapped to it.
  • It is not necessary to re-code every condition that the applicant has declared, particularly if they are past and resolved.
  • A date must be entered for each PROBLEM (even an unresolved problem) before the problem mapping section can be completed and you can finalise the exam. If the date is unknown, then enter the exam date.

Problem mapping examples

Findings that have no associated diagnosis

Findings for many applicants will be related to age-requirement tests, routine blood tests or doctor visits that do not have a diagnosis attached to them as they found nothing wrong with the applicant. To speed up the problem mapping process, you can map any and all of these findings to ‘Screening – NAD’ (No Abnormalities Detected).  Simply search in SNOMED for ‘NAD’.

Findings that you can’t find a problem for

If there is a finding that you cannot find a problem for, such as a family history of heart disease or one stating that they will require an additional eye report, put that finding in the ‘Findings’ field, select the ‘Unresolved Problem’ checkbox and enter a date identified. Marking it as ‘unresolved’ means that you will not have to find a problem to map it to using the SNOMED description field.

Mapping multiple findings to a single problem

If an applicant has had a heart attack for example, they might have findings for a hospital visit, elevated blood pressure, prescribed medication and another for the attack itself. You can map all of those findings to just the heart attack diagnosis. At the top-left of each ‘Problem’ box next to the words 'Safety Relevant' there is a small toggle. If you select the toggle it will bring up a dotted line around the ‘Problem’ box and the ‘Unallocated Findings’ box. Once this dotted line is there, you can click on any of the findings in the ‘Unallocated Findings’ box and they will move over to the findings box in the ‘Problem’ box.

Upcoming events

AMSVIC: Saturday 13 August at Alfred Hospital, Melbourne.

ASAM Annual Conference: 15 – 18th September 2016 in Townsville.

Av Med contacts

If you need technical support for using MRS, please call 02 6217 1405 or email avmed.itsupport@casa.gov.au

For all other enquiries, please contact us via the DAME Liaison line, 02 6217 1170, or at dame.liaison@casa.gov.au.