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INTRODUCING THE DIABETIC FOOT ASSESSMENT FORM ON MMEX (E-HEALTH PLATFORM) Audrey Xie, BPodM Podiatrist e: 31 st October 2013.

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Presentation on theme: "INTRODUCING THE DIABETIC FOOT ASSESSMENT FORM ON MMEX (E-HEALTH PLATFORM) Audrey Xie, BPodM Podiatrist e: 31 st October 2013."— Presentation transcript:

1 INTRODUCING THE DIABETIC FOOT ASSESSMENT FORM ON MMEX (E-HEALTH PLATFORM) Audrey Xie, BPodM Podiatrist e: 31 st October 2013

2 BACKGROUND – MMEX 1 E-health platform Provided by the UWA Center for Software Practice

3 BACKGROUND – MMEX 1 Pros: Small annual fee of $250 (FREE for Department of Health) Ease of use – patient notes, alerts, reminders, calendar No physical storage Attachment of photos, documents, letters, forms Secure database Safe and confidential communication with health professionals and hospitals (including tertiary hospitals) Cons: Not all health professionals in the Wheatbelt are aware of it or are using it

4 A KEY CHALLENGE – FOOT ULCERS Foot ulcers can be detrimental Poor blood glucose control Neuropathy and/or microvascular disease Foot ulcers Wound infection Osteomyelitis Amputation Wound infection Systemic infection Death

5 STATISTICS & FIGURES Cost to the patient and the health department 5-year mortality rates for diabetes amputations are 50% (twice that of cancer) 2 Each amputation costs $26,000 to the health department 2 An area for improvement – it can be achieved

6 NATIONAL EVIDENCE-BASED GUIDELINES: PREVENTION “85% of diabetes amputations are entirely preventable” 3 Identify patient’s risk “Assess all people with diabetes and stratify their risk of developing foot complications” 4 Regular foot assessments “Any suitably trained healthcare professional may perform the risk assessment” 4

7 NATIONAL EVIDENCE-BASED GUIDELINES: MANAGEMENT “Pressure reduction optimises healing of foot ulcers” 4 “People with diabetes-related foot ulceration are best managed by a multi-disciplinary foot care team” 4 Deep ulcers (probe to tendon/bone) 4 weeks’ duration Absence of foot pulses Ascending cellulitis Suspected Charcot’s neuroarthropathy

8 USING THE DIABETIC FOOT ASSESSMENT FORM ON MMEX Formulated by Deborah Schoen Universal form for all diabetic foot assessments Evidence-based Available on MMEx for all users Able to attach completed forms to patient record Easy to use & risk is automatically calculated 5 essential components 1. Current foot ulcer 2. History of amputation/foot ulcer 3. Foot deformity 4. Palpation of foot pulses 5. Presence of protective sensation

9 1. CURRENT FOOT ULCER 2. HISTORY OF AMPUTATION/FOOT ULCER If any “Yes” is checked, patient is immediately classified as High Risk

10 3. FOOT DEFORMITY If 3 or more “Yes”, patient is considered to have a foot deformity

11 4. PALPATION OF FOOT PULSES If 3 or more “+”, patient is considered to have palpable foot pulses

12 5. PRESENCE OF PROTECTIVE SENSATION As long as 1 site is “-”, patient is considered to have no protective sensation

13 RISK FACTOR 6 months 12 months 3 months

14 CONCLUSION As a primary health professional, you can help to: Identify ulcer risk Conduct a foot check every 3/6/12 months Encourage pressure relief Refer to Podiatrist or multidisciplinary foot care team

15 TAKE-HOME MESSAGE “A foot ulcer is serious…” 3 – help to prevent it!

16 REFERENCES 1. UWA CSP. MMEx [Internet]. Perth, WA (Australia): MMEx; 2013 [updated 2013 Aug 21; cited 2013 Oct 20]. Available from: 2. Australasian Podiatry Council. Diabetic Amputations in Australia. Brunswick East (VIC): Australasian Podiatry Council; 2013 Oct per cent of diabetes amputations "entirely preventable”. Diabetes WA [Internet] Aug 31 [cited 2013 Oct 20]; Diabetes WA News. Available from: WA_News/News_Details/85_per_cent_of_diabetes_amputatio ns 4. National Evidence-Based Guideline on Prevention, Identification and Management of Foot Complications: Part of the Guidelines on the management of Type 2 Diabetes [Internet]. Melbourne: National Health and Medical Research Council; 2011 [cited 2013 Oct 20]. Available from: ents/diabetes_foot_full_guideline_ pdf


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