Useful SmartTag Examples

If(gen(C10).f(6m)) searches Medical History for the earliest diabetic diagnostic read code and if this was within the past 6 months only the {} element is used the {} part will be discarded completely. If the earliest diagnosis is over 6 month old the {} will be used instead

If(gen(C10).f(6m)){You have recently been found to be diabetic. This means that you will need to consider a number of lifestyle choices that can improve your health. The main considerations for you are: to maintain a healthy weight with a good Body Mass Index: yours is weight#f. If(weight#f>28){It would be to reduce this by losing weight and eating healthily.} Try to exercise regularly. If(smok#b){It would be wise to stop smoking.} We will help keep you blood pressure under control and maintain a good cholesterol level.}{ It was good to see you for your diabetic review. You were found to be diabetic on gen(C10).f#a and currently takeIf(active(f1,f2,f3,f4,f5,ft,fw).(t)){:active(f1,f2,f3,f4,f5,ft,fw).(t)#bfo[Regular Diabetic Medication]}{no regular diabetic medication.}}Diabetics need to be careful in several areas:

If {} is used then weight#f simply gives the latest BMI.

If(weight#f>28){It would be to reduce this by losing weight and eating healthily.} adds the losing weight sentence only if the BMI is over 28.

If {} is used then:

gen(C10).f#a gives the date of the earliest diagnostic entry

If(active(f1,f2,f3,f4,f5,ft,fw).(t)){:active(f1,f2,f3,f4,f5,ft,fw).(t)#bfo[Regular Diabetic Medication]}{no regular diabetic medication.}

Checks for any active diabetic repeat medications and if found presents them in the pre-formatted table provided

It filters searching by Read Code for:

• f127. Actrapid 100units/ml solution for injection 10ml

• f25a. Humulin I 100units/ml suspension for injection 10ml vials

• f3a1. Tolbutamide 500mg tablets

• f41u. Metformin 1g modified-release tablets

• ft5z. Pioglitazone 15mg tablets

• fw11. Humalog Mix25 100units/ml suspension for injection 3ml

Paragraphs have been highlighted using the <Mark Ifs> button to demonstrate the If(){}{}(If(condition)then{} else{}) clause elements. Colouring is for illustration only.

If(hba1(42W4).(2y)>=hba1(42W5).(2y)){hba(42W4)#d. We aim to keep this below 7.5 as far as possible}{hba(42W5)#d. We aim to keep this below 58 as far as possible}

If(hba1(42W4).(2y)>=hba1(42W5).(2y))

Checks whether there are more IFCC standardised HbA1c readings than older style DCCT aligned ones. Then the relevant Hba value is given with the relevant comment.

Using:

If(hba1(42W4).(10)>1){Your readings overall: If(hba1(42W4).(2y)>hba1(42W5).(2y)){ Graph(Hba1,GoodControl7.5,PoorControl8.5,Message=LowerReadingsAreBetter,read=42W4)}{ Graph(Hba1,GoodControl58,PoorControl70,Message=LowerReadingsAreBetter,read=42W5)} If(hba1(42W4)#d<=7.5|hba1(42W5)#d<=58){Your control is steady}{Your control is not ideal. If(active(f1,f2,f3,f4,ft,fw)<3){It may be possible to improve you control with extra medication}{however you are already on several diabetic medications}}}

A graph is shown if there are 2 or more readings and;

If(hba1(42W4).(2y)>hba1(42W5).(2y)){Graph(Hba1,GoodControl7.5,PoorControl8.5,Message=LowerReadingsAreBetter,read=42W4)}{Graph(Hba1,GoodControl58,PoorControl70,Message=LowerReadingsAreBetter,read=42W5)}

Is used to select the relevant IFCC or DCCT values to display as a graph with Good Control, Poor Control tramlines and a message encouraging lower readings.

Using:

If(hba1(42W4)#d<=7.5|hba1(42W5)#d<=58){Your control is steady}{Your control is not ideal.If(active(f1,f2,f3,f4,ft,fw)<3){It may be possible to improve you control with extra medication}{ however you are already on several diabetic medications}}

If(hba1(42W4)#d<=7.5|hba1(42W5)#d<=58) checks for good control for IFCC or DCCT values.

If control is poor:

If(active(f1,f2,f3,f4,ft,fw)<3){It may be possible to improve you control with extra medication}{however you are already on several diabetic medications}

If(active(f1,f2,f3,f4,ft,fw)<3) checks whether 3 or more active diabetic repeat medications and suggests additional treatment if not otherwise stating patient is already on several medications.

Graph(weight,ideal,obese,bmi=,Message=YourWeightShouldBeBeneathTheObeseLinePreferablyBelowTheIdealOne)

BMI graphed with ideal BMI & Obese BMI tramlines plus a message recommending weight reduction.

As the graph shows your weight If(weight#f<=27){is satisfactory}{needs improvement as it is on the high side. We considered dietetic/nutritional assessment and spoke about diets you might try - the best diet for you is the one you can continue most easily, Weight Watchers, Slimming World, Atkins all work and have helped many diabetics. It is important to try and increase your activity levels and exercise as much as possible as well as being careful with the types and quantities of food you eat.}

If BMI is over 27 the weight reduction advice displays.

If(weight#f>40){As you are unhealthily overweight it is most important for you future health that you really try very hard to loose weight, your weight is making you less well than you should be.}

Adds a sentence especially for those with a BMI greater than 40.

Paragraphs have been highlighted using the <Mark Ifs> button to demonstrate the If(){}{}(If(condition)then{}else{}) clause elements. Colouring is for illustration only.

If(active(b2,b3,b4,bb,bd,be,bf,bh,bi,bk,bl)){You are on treatment for blood pressure and currently take:

active(b2,bd,be,bf,bg,bh,bi,bk,bl).(t)#bfo[Regular Blood Pressure Medication]}{You are not currently taking any blood pressure medication. }We aim to keep your top reading below 145/130 and your lower reading below 85/80.

If(active(b2,b3,b4,bb,bd,be,bf,bh,bi,bk,bl)) searches Active Repeats by Drug Read Code.

If any hypotensive repeats are found they are then show in a preformatted table.

Graph(BP,Target140,TightControl130,Target85,Message=LowerBloodPressureReadingsAreBetterForYou)

Shows a graph with tramlines for tight control and target control giving a message: Lower Readings Are Better For You.

As you see your current control If(bp#x>150|bp#y>90){needs improvement. If(weight#f>25){People with an ideal weight tend to have better control and need less medication .}After discussion we agreed to try and loose more weight, increase you medication, add a new tablet.}{is good.}

States either 'As you see your current control needs improvement' with a comment on weight if BMI over 25 and some italic text likely to require manual editing, or, 'As you see your current control is good'.

Paragraphs have been highlighted using the <Mark Ifs> button to demonstrate the If(){}{}(If(condition)then{}(condition)then{}(condition)then{} else{}) clause elements. Colouring is for illustration only.

ACE inhibitor and ARB medications help improve kidney health

If(active(bi,bk)){ – you take active(bi,bk)#b}{, you have not needed one yet} Inserts a comment if an ACE or ARB is taken naming the drug used or states ', you have not needed one yet'.

Graph(gfr,GoodGFR60,LowGFR30,Message=HigherRatesAreBetterForYourKidneys)[Kidney Function – blood tests]

Inserts a graph of eGFR with Good/Low tramlines and suitable message.

if(general(G2)&gfr#d>=60){Your kidneys are working well but we like to keep your blood pressure below 145/90 as you have gen(G2,C10).f#b, your blood pressure on bp#a was bp#e.}(general(G2)&gfr#d<60&gfr.(5)#d>45){We like to keep your blood pressure below 130/85 - your blood pressure on bp#a was bp#e.}

(gfr.(5)#d>=60){Your kidney function is fine, the graph may show a dip at the end but only because the labno longer report values over 60.}(gfr.(5)#d<60&(gfr.(5)#d>=45)&(gfr#d>=gfr.(5)#d)){Your kidney function is borderline (CKD3a) but your latest test shows a steady result}(gfr.(5)#d<60&(gfr.(5)#d>=45)&(gfr#d<gfr.(5)#d)){Your kidney function is borderline (CKD3a) and your latest test shows we need to be careful.}(gfr.(5)#d<45&gfr.(5)#d>=30&gfr#d>=gfr.(5)#d){Your kidney function is mildly impaired (CKD3b) but your latest test is showing a steady result.}(gfr.(5)#d<45&gfr.(5)#d>=30&gfr#d<gfr.(5)#d){Your kidney function is mildly impaired (CKD3b) and your latest test shows we need to be careful.}(gfr.(5)#d<30&gfr#d>=gfr.(5)#d){We need to be especially careful of your kidney function (CKD 4/5) and you may need help from a kidney specialist but your latest result is giving a steady result.}(gfr.(5)#d<30&gfr#d<gfr.(5)#d){We need to be especially careful of your kidney function (CKD 4/5) and you may need help from a kidney specialist.}

Shows how you can create a complex SmartTag using '&' (and) '|' (or) and comparisons: '>', '<', '>=', '<=', '='. Within a condition SmartTags averages numeric values from several records for comparisons. It can perform simple arithmetic calculations with +, -, * & /. you can also use brackets to ensure logic is processes in the intended order.

When using cascading If(conditions) they are checked in the order given so place the tighter/narrower conditions earlier. This is why the G2(hypertension) filters are earliest in the sequence above.

Paragraphs have been highlighted using the <Mark Ifs> button to demonstrate the If(){}{}(If(condition)then{}(condition)then{}(condition)then{} else{}) clause elements. Colouring is for illustration only.

Uses recent foot risk codes to insert relevant paragraphs.

The {Else} clause is inserted if there is no recent record and gives a table of foot examinations within the past 2 years with a reminder to check the feet

If(foot(2G5E).(6m)&foot(2G5I).(6m)){were in good condition. Please remember that if any cuts, abrasions, scratches or ulcers happen please see the nurse if they are in any way slow to heal.}(foot(2G5J,2G5K,2G5F,2G5G).(6m)){need special care and attention due to reduced blood flow or reduced sensation (numbness). This means that any problems should be assessed by our nurse to ensure proper treatment.}(foot(2G5L,2G5H).(6m)){are ulcerated. This needs special care that the nurse will ensure that you receive.}{Absent/old Diabetic Risk Score – please check foot care and risks foot(2G5E,2G5I,2G5J,2G5K,2G5F,2G5G,2G5L,2G5H).(24mt)}

If(smok#b){risks increase if smoking (smok#ai) especially if your cholesterol is high, if you would like help to stop smoking please let us knows.}

Adds a comment about smoking for current smokers.

Graph(Chol,Target5,TightControl4,Message=LowCholesterolReadingsAreBetterForYou)

Displays a graph of cholesterol levels with control tramlines and a message about lower cholesterols

If(active(bx)&chol#d>5){You take:active(bx).(t)#bfo[Regular Cholesterol Medication]

Your cholesterol is high despite the medication, it needs to be taken regularly. We can also consider increasing your dose.}(active(bx)&chol#d<=5){You take:active(bx).(t)#bfo[Regular Cholesterol Medication]Your latest cholesterol level shows that your medication is working well}(chol#d>5&pat.age>40){You are not currently taking any cholesterol lowering medication but as your latest cholesterol is high at chol#d You may wish to consider starting a cholesterol lowering medication to reduce your risk of heartattacks and strokes.}(chol#d>5){You are not currently taking any cholesterol lowering medication but your latest cholesterol is high at chol#d You may wish to consider starting a cholesterol lowering medication to reduce your risk of heart attacks and strokes but this is not always justified in younger people.}{Even without medication your cholesterol level is fine.}