Question
I would be most grateful if someone could explain the difference between these tabs!
Answer
The QMAS profile is automatically updated to reflect the same parameters as the latest report submitted to QMAS.
For the Contract year 2009 - 2010
In V2.4 and later, there is a default profile called "1 Apr Submission" which has parameters set to be 1st April 2010, strict QMAS analysis (see below) turned ON. Basically, this will give practices a measure of the number of points they will score on 1st April throughout the year.
By default the "Today" profile has a reference date AND a medication date of "today", to give a current view.
By default the "1 April 2008" profile had a reference date of 1/4/2008 and a medication date of "today" - but strict QMAS analysis was turned 'OFF'. This meant that you have populated disease registers all year round, but you could still see where your diagnostic and measurement indicators would be falling short by April 1st 2008. NB: because of feedback from users, please note that the the "1 April 2010" profile is created with a reference date of 1/4/2010 and a medication date of "today" - but strict QMAS analysis is turned 'ON'; this will affect the counts displayed for registers such as Asthma and Epilepsy; you can add your own profile(s) with the 'strict QMAS
analysis option' disabled or untick this option for the '1 Apr 2010' profile, but you must be aware that this means that you will not be implementing the rulesets as specified and will see patients in registers either 'ahead' of when they should really appear or who may not appear in the final registers at all.
The QMAS profile will have Reference AND Medication dates of 1/4/2010, intially, after May 1st 2010 (until then it shows the settings which were prevalent for the end of the previous GMS year - ie 1/4/2009). This will then update throughout the contract year.
The key things are the parameters that are used to drive the reports. There are essentially 3 dates: the Reference date, the Baseline date and the Medication date.
The Reference date is something with which most people are familiar; reports sent to QMAS are always fixed with a reference date of "next" 1st April. You can see the Contract+ Help | Reference section for more information about reference dates, if needs be.
The Baseline date is part of the QMAS report and essentially allows the system to produce retrospective reports, if needs be. The report produces results based on data in the system on the baseline date, so the active list used for the report reflects patients registered on the baseline date, not the "current" active list. For QMAS reports, the baseline date is the same as the report production date e.g. the first of the month. In practice, unless a historic baseline date is entered (such as for the catch-up reports generated when you first install Contract+), the baseline date is effectively the same as the reference date and reflects your current active list.
The Medication date is something that Contract+ provides. There is no corresponding concept in the rulesets themselves. Essentially, the Medication date is a reference date that applies only to medication issues. For QMAS reports, the medication date is set to be the same as the reference date, ie 1st April next. For the Contract+ profiles, which are actually unrelated to the QMAS reports, the medication date can be changed. The reason for this is that some of the disease registers (asthma, thyroid)
are based on medications issued within 6 months of the reference date. If the reference date is 1st April then, by definition, the disease registers are empty between the months of April - September, as no patient qualifies on grounds of having medication issued up to 6 months in the future. In order that the practice can have some idea of "who" is on the various disease registers, we let you define a Medication date of "today" that applies this date to all ruleset logic that applies to medication issues
rather than the real reference date.
As a result the parameters are different for each of the reports and so the points and prizes will be too. The "1st April 2010" profile will give you the most accurate idea of how you are doing towards your targets, assuming your prescribing patterns remain largely unchanged over the rest of the year (so that your disease registers don't change too much), but the '1 Apr Submission' profile will show you how you are doing 'strictly' speaking. NOTE (1): it is the QMAS profile which is the one used when submitting report to QMAS and by the end of the year though the '1 Apr 2010' and QMAS profile may be similar - there may be some differences - because of differences in the profile settings. NOTE (2): The value of the points in the profiles is there as a guide as a number of variables are unknown until the year end (eg national prevalence and average practice size).
STRICT QMAS analysis
Usually the Contract+ profiles relax a few rules from the rulesets in order to be more useful.
For example, the default profiles use medication issued relative to "today" rather than the reference date, as otherwise some disease registers and indicators are completely empty for 6 months of the year (eg Epilepsy and Hypothyroidism), because a criterion for inclusion is to have medication issued within 6 months of the reference date.
Another example is some of the logic in the Cancer ruleset, which excludes patients from the denominators if the cancer has been added in the last 6 months but not yet reviewed. This is good for your final points analysis, but bad throughout the year as it excluding the patient from the denominator prevents Contract+ from displaying a useful prompt, or from showing you the patients that actually need a review adding.
There are some other examples where the Contract+ profiles "add value" throughout the year. However, sometimes practices want to have a "strict" analysis that shows exactly how they'll get paid. The QMAS submissions and the QMAS profile (for iSOFT sites) obviously always obey the rulesets 100%, but some practices want to be able to define their own profiles which also show strict QMAS/payment results, so enabling these flags allows you to do this.
In V2.4, a new default profile called "1 Apr Submission" which has parameters set to be 1st April 2008, strict QMAS analysis turned ON was included. Basically, this will give practices a measure of the number of points they will score on 1st April throughout the year.
The reason for including this profile was that it is the only one that is guaranteed to give practices a correct idea of how many points they will get on their final submission on 1st April. The other profiles (except the QMAS profile itself) can have "strict QMAS analysis" turned OFF (by default); this makes them more useful throughout the year as these profiles include patients in the registers all year round, and ignores certain GMS rules that could cause them to "miss" patients.
However, some practices didn't understand that the "1 Apr 2007" submission would not necessarily be identical to their final submission for reasons of the strict analysis, so it was deemed prudent to have a profile that showed the exact amount that would be claimed. As the GMS year draws to a close in March, all of the profiles with the same reference date do asymptote towards convergence, but aren't always identical down to the last point. From recent experience we know that our Support lines can get VERY busy with practices disputing every last half point!
