BeatAsthma+ Guide for SystmOne

The main asthma tab provides an overview of current asthma issues.  It is set out in three columns: a column to record important information or link to other templates; a column to show important information and warnings; a column to show expanded information from the record.  

The following information is shown in the middle column: 

• Asthma status (i.e. never had asthma, suspected asthma, previous asthma, current asthma, on asthma QoF register) 
• Latest asthma control test score and date 
• Relevant medication information eg antibiotic and steroid use 
• Smoking Status 
• Current Triggers recorded 
• Rhinitis status 
• BMI Centile  

1. Current Symptoms 

The Asthma Control Test (ACT) protocol takes you through the relevant questionnaire to calculate the ACT score.   

Once completed, click the Save Final Version button above the questionnaire.  The ACT score and associated symptoms codes will be recorded automatically.  The ACT score will then show on the main template. 

If needed, the ACT score can be manually recorded (e.g. if the patient has completed a paper ACT questionnaire) in the boxes on the template 

The ACT questionnaire can be completed by the patient in SystmOnline ahead of the asthma review. 

2. Exacerbations – A questionnaire to guide you through exacerbation history, prompting the relevant questions to ask the patient/family. 

3. Smoking Status – including passive and e-cigarette use 

4. Triggers – Current asthma triggers can be recorded here.  The middle column shows the latest recorded trigger and the button in the third column shows all previous triggers. 

5. Current Action Plan (if exists) 

6. Child Growth Charts and BMI Centile recording 

The medication tab helps you to:  

• Record concordance/compliance 
• Links to national guidance (built directly within the template): 

• Link to the Right Breathe website which has extensive information about inhalers, spacers, pathways and really useful videos of inhaler techniques for all devices. 
• Record inhaler technique and spacer use: 

• The middle column of the Asthma Medication template shows: 
  • Latest recorded compliance 
  • Current asthma medication 
  • A alert to show if the patient has rhinitis 
  • The following warnings: 
    • Patients receiving excessive SABA issues 
    • Patients with an exacerbation in the past 24m who are not receiving ICS 
    • Patients who appear to be overusing preventers 
    • Patients with an apparently unlicensed inhaler 
    • Patients with inappropriate generic repeats 
    • Patients who appear to have low concordance for non-ICS preventers 
  • Latest record of inhaler technique and demonstration 
  • Latest information about spacer use 
  • An alert to suggest spacer issue if the patient is on a preventer that is compatible with a spacer which has not been issued in the past 18 months.  
• The buttons in the third column show more detailed information about medication issues:

The medication timeline function helps highlight medication concordance and what has been tried before: 

The steroid safety section helps to promote safe use of oral and inhaled corticosteroids. 

The steroid safety button links to a steroid monitoring template which helps to give an overview of use of corticosteroids over time, along with safety and monitoring information (NB: template used across multiple clinical areas, not just Asthma): 

There is a link to the child growth charts for children taking moderate or high dose ICS 

The middle column shows the following information: 

• Oral steroid issues in the past 12 months 
• A warning for patients appearing to be taking high dose ICS 
• A warning to consider discussion about steroid safety cards for relevant patients 
• A warning when appropriate monitoring is overdue for patients taking oral steroids 

This tab shows the key factors that increase the risk of asthma exacerbation and the relevant information from that patient’s record. 

Safeguarding template:  

Severe asthma exacerbation risk pre-set options: 

This tab allows the viewing, creation and updating of a personal asthma plan. 

The peak flow template helps you to record best-ever and recorded peakflows: 

To Create An Asthma Care Plan 

If the relevant PEFR results have not already been recorded (they will be shown in the second column), use the buttons to record them.  The care plans can be based on either predicted or best ever PEFR. 

Click on the ‘Complete BEAT Child Asthma Action Plan’ to  complete the action plan questionnaire.  

NB clicking the buttons marked ‘A’ will display common pre-sets to make data entry quicker.   

Once the information is complete, click Save Final Version.  

***The final care plan will not include the information if you do not choose Save Final Version *** 

If you wish to amend an existing plan, right click on the box in the second column showing the current plan and choose the Copy Questionnaire option, then choose Copy Comments.  An editable version of the previous questionnaire will then be displayed.  Amend any entries as appropriate, then click Save Final Version. 

Once the questionnaire is complete, click the Create Action Plan button to create a Word care plan (select BEAT Asthma Child Plan when prompted), that can be saved and/or printed/emailed to the patient.   

Use the final tick boxes on this tab to record that the patient has a care plan.  

This tab shows the key information required to diagnose asthma.  This includes: possible triggers, personal and FHx of atopy, allergy and anaphylaxis; spirometry; FeNO; PEFR variability; asthma challenge results. 

The top of the template has links to the NICE assessment algorithms. 

The exceptions allows recording and viewing of asthma exceptions 

This tab summarises relevant reports/searches which are available:  

The above reports could be added to an automated/batch reporting process so the relevant person or team in the practice is notified of the results at regular intervals for an ongoing quality improvement process. 

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Please see below for overview of automated (batch) reporting process:  

Automated reports (called batch reports) are a powerful feature of SystmOne.  They allow a report to be run at set time intervals and for the result to be sent via a task to an individual or group. 

To Set Up An Automatic Report (diabetes searches used as an example) 

Navigate to Batch Reporting then click Create New Batch 

Given the batch a name and then add the reports that you wish to run. 

Set the time interval e.g. every week, every month 

Tick the Send Task box  

Choose an individual or group that the result will go to 

The example below identifies patients whose Hba1c suggests they have diabetes but who have not been given a diabetes code and the second report identifies those recently diagnosed with diabetes who have not been referred for structured education e.g. DESMOND. 

The user or group will receive a task once the report has run. 

Actioning the task shows the results.  Right click on any report to display the usual reporting options 

Links to important resources are shown on this tab.  Customised local information can be shown on this tab if required. 

If required, the RCP Asthma questions can be added using this tab: