Our Quality Improvement metrics empower you to review key areas within your practice that may require improvement, offering clear, actionable insights to help you meet your goals.
NOTE: Some of the QI metrics in this cabinet may not be available for our MedicalDirector integration customers. Zedmed integration customers currently do not have a QI cabinet available.
To navigate these metrics, go to Clinic Optimisation tab > Quality Improvement > Operational Impact.
The sections included in this article are:
- 1. Goal and Threshold Cubiko allows your practice to set a Goal for specific Quality Improvement (QI) metrics to work towards as a target. Some QI metrics use a Threshold rather than a Goal. A Threshold represents a maximum acceptable limit
- 2. Measure: Are you on track to reach your goal or stay below the threshold?
- 3. Action: View key patient lists and begin actioning
- 4. Quality Improvement Measures
- Bp and MD customers
- Bp only
1. Goal and Threshold
Cubiko allows your practice to set a Goal for specific Quality Improvement (QI) metrics to work towards as a target.
Some QI metrics use a Threshold rather than a Goal. A Threshold represents a maximum acceptable limit — a level your practice should not exceed.
This step helps you assess whether your practice goal or threshold is achievable by offering insights into patient eligibility across various categories. By reviewing the number of patients eligible and actionable for each measure, you can identify where improvements are needed.
TOP TIP! You can adjust Goals and Thresholds in Settings > Metrics > QI Goals to reflect your practice's focus areas.
2. Measure
Use the key metrics, percentages and trend graphs provided for each measure to track your progress and ensure you are on track to meet your goal or stay below your threshold. This can be measured against the practice goal or threshold, which can be amended in the Settings area of Cubiko. This data can be used to help study the progress of your Quality Improvement activity and recorded in your Plan Do Study Act (PDSA) cycle.
This will vary for each QI activity. Refer to the individual activity details below for an overview of key metrics and guidance on how to use them.
3. Action
For each activity, you can view key lists and begin actioning steps to improve your activity to reach your goal or identify gaps in your workflow to stay below your threshold.
This will vary for each QI activity. Refer to the individual activity details below for an overview of lists and guidance on how to use them.
4. Quality Improvement Measures
QIM: DNA Rate
Type: Threshold (Maximum acceptable limit)
What this measures: The proportion of appointments in the selected period where the patient did not attend the booked appointment.
Description: Click through this measure to view detailed metrics reporting on DNA (Did Not Attend) rates and actionable insights to reduce DNAs. Use key breakdowns to analyse your DNA rates by appointment type, practitioners, and monitor trends over time. An appointment must be marked as DNA/No Show in your Practice Management Software to show in these metrics.
Measure:
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- Overall DNA rate percentage and Estimated potential lost billings due to DNAs: View the total percentage for the date period applied, the number of DNA appointments and the potential lost billings for both regular and online appointments.
- DNA rate by appointment type: Are there certain appointment types, where patients have a higher tendency to not turn up for, more so than for other appointment types?
- DNA rates by practitioner: Which Practitioners have the highest number of DNA patients? You can focus your reception team time on confirming these Practitioners' patients to help reduce their overall DNA rate.
- Unconfirmed appointments today: How many patients are coming in today with unconfirmed appointments? Use the unconfirmed appointments today list below to review and action. This is the number of patients that are booked for an appointment today, that are yet to confirm their appointment.
- Frequent DNAers: Do you have a high volume of frequent DNA patients? Use the list to show details of patients with an appointment booked who have frequently missed their appointments over the past 12 months.
- Trendline: Use this graph to help identify trends, is there a particular week or month that has more DNA appointments? What could be behind these trends? If you are working on reducing your DNA, here you can track the decrease in DNA appointments.
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Action:
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- Patients with unconfirmed appointments today: Check daily your unconfirmed appointments, particularly those with a DNA history and try to confirm. This can help you keep track of how many DNA appointments the patient has already had over a 12-month period and assist you in implementing a cancellation fee if you have one in the practice.
- Patients who are frequent DNAers: Create new policies or procedures to handle patients who have a high DNA history. Patients who tend to repeatedly DNA to their appointments are your frequent DNAers. Add this to your favourites and check daily to quickly identify patients with upcoming appointments that are "Frequent DNAers".
- List of patients with past DNAs: This table lists the details of all the patients that have had DNAs in the selected time period. This table also shows the next booking for each patient so that your reception staff can confirm appointments with patients who regularly DNA. Use the drop-down filters on the metric to specify the minimum DNA rate and the minimum number of DNAs to filter this patient list further.
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Below is a list of other ideas to assist in your Quality Improvement activities to reduce your practice DNA rate:
- Allow for easy appointment amendments or cancellations
- Send out appointment reminders
- Set policies for your frequent patients who DNA
- Record patient attendance
- Confirm appointments with patients who have a DNA history
QIM: Item 10997
Type:
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- Potential - Goal
- Historical - Threshold
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What this measures: These metrics help practices track and optimise the billing of item 10997.
Description: Eligibility for a 10997 (and Telehealth equivalents 93201 or 93203) is based on previous billings at the practice. 10997 eligibility is calculated by considering the number of patients who have had an item 721, 723, or 732 billed in the past 12 months and have not had 5 x item 10997s in the calendar year of the date range used. Patients who received 5 x item 10997s in a calendar year are not considered eligible for further billing opportunities of item 10997s in that calendar year.
The calculated revenue shows the value of billings that could be made from the remaining 10997s in the calendar year. This will not take into account any gap fee payments charged. See MBS Online for more details regarding eligibility for 10997 and equivalent items. Always provide these lists to Practitioners to make billing decisions.
This data is divided into two key sections:
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Potential 10997s: Identifies upcoming billing opportunities and tracks progress.
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Historical 10997s: Highlights missed opportunities where eligible patients may not have been billed for an item 10997 service.
Measure:
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- Potential 10997's
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Potential 10997 opportunities today by Practitioner. The number of appointments today with patients who are potentially eligible for an item 10997.
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Number of potential item 10997s remaining: The count of patients who have had an item 721, 723, or 732 billed in the past 12 months and have not yet received 5 x item 10997s this calendar year. Note: This figure includes only currently eligible patients, not all patients who were eligible earlier in the year.
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All 10997 items completed this year: The total number of item 10997 services completed this calendar year, is used to calculate the completion rate.
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Number of all eligible 10997 items for this year: The total count of eligible 10997 services for the current calendar year, used to track overall completion.
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- Historical 10997's
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Eligible 10997 appointments vs. Historical 10997 opportunities: A graph showing trends of nurse appointments where patients were eligible for an item 10997 versus those where a 10997 was not billed.
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Trend of 10997 completion rate: A graph displaying the completion rate trend for item 10997 over a selected time period.
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10997 completion rate: A comparison of the current year's completion rate against past years.
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- Potential 10997's
Action:
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- Potential 10997s
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List of patients eligible for item 10997: A table listing upcoming patient appointments where item 10997 eligibility criteria are met (i.e., patients with a previously billed item 721, 723, or 732 and fewer than 5 x item 10997 billings in the current calendar year).
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Excludes patients who have already reached their annual limit.
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For a complete list of all potentially eligible patients, refer to the Item Optimisation section.
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Identify opportunities for increased billing: Use this data to track service provision and identify additional patient opportunities.
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Monitor progress with the PDSA template: Track improvements in billing completion rates using structured planning.
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Use filtering options effectively: Practices can filter the action lists in two ways:
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All eligible patients: Review the full list of patients who have not yet reached their item 10997 limit.
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Patients with upcoming appointments: Focus on patients already scheduled for an appointment to integrate item 10997 opportunistically.
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Ensure daily review: Encourage the team to check these lists daily. The Possible Service Opportunities Today metric can also be used for Opportunistic Patient Engagement, ensuring eligible services are offered when patients attend appointments.
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- Historical 10997s
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List of historical potential 10997 opportunities: A table displaying past nurse appointments where an eligible patient may have received a service but was not billed for item 10997.
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Review past appointments: Ensure services were performed, documented, and meet MBS/DVA guidelines for billing. Note: Not all listed appointments will qualify for retrospective billing.
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- Potential 10997s
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Optimise billing practices: Use this data to refine processes and maximise eligible billing opportunities.
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Regularly audit historical opportunities: Practices should frequently review this list to identify trends in missed billing opportunities and address any documentation gaps.
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Cross-check appointment records: When reviewing the historical list, verify whether a service was performed but not billed by checking nurse notes and clinical records.
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Follow up with Practitioners: If a missed billing opportunity is identified, communicate with the relevant Practitioner or nurse to confirm whether an item 10997 should have been applied.
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Below is a list of other ideas to assist in your Quality Improvement activities to track and optimise the billing of item 10997:
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Use the metric 'Possible service opportunities today > 10997' to formulate a daily list of patients coming in for an appointment today for item 10997. Provide this list to your nursing team to proactively see patients and bill this item number. Use our care prompts feature to send these opportunities to Best Practice appointments (for Best Practice customers).
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Create an appointment book column in Best Practice for each member of your Nurse team. This allows easy tracking of how many patients your nursing team is seeing each day.
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Create a dedicated appointment type for item 10997 so nurses can book patients using this appointment type. This will make it easy to search for and identify any potential missed billings. Use the 'Select Appt Type' filter at the top of the page to refine the list to appointments booked specifically as '10997' only.
QIM: Item 10987
Type:
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- Potential - Goal
- Historical - Threshold
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What this measures: These metrics help Practices track and optimise the billing of item 10987.
Description: Eligibility for a 10987 (and Telehealth equivalents 93200 or 93202) is based on previous billings at the Practice. 10987 eligibility is calculated by considering the number of patients who have had an item 715 billed in the past 12 months and have not had 10 x item 10987s in the calendar year of the date range used. Patients who received 10 x item 10987s in a calendar year are not considered eligible for further billing opportunities of item 10987s in that calendar year.
The calculated revenue shows the value of billings that could be made from the remaining 10987s in the calendar year. This will not take into account any gap fee payments charged. See MBS Online for more details regarding eligibility for 10987 and equivalent items. Always provide these lists to Practitioners to make billing decisions.
This data is divided into two key sections:
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Potential 10987s: Identifies upcoming billing opportunities and tracks progress.
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Historical 10987s: Highlights missed opportunities where eligible patients may not have been billed for an item 10987 service.
Measure:
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- Potential 10987's
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Potential 10987 opportunities today by Practitioner. The number of appointments today with patients who are potentially eligible for an item 10987.
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Number of potential item 10987s remaining: The count of patients who have had an item 715 billed in the past 12 months and have not had 10 x item 10987s billed this calendar year.
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All 10987 items completed this year: The total number of item 10987 services completed this calendar year, is used to calculate the completion rate.
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Number of all eligible 10987 items for this year: The total count of eligible 10987 services for the current calendar year, used to track overall completion.
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- Historical 10997's
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Eligible 10997 appointments vs. Historical 10997 opportunities: A graph showing trends of nurse appointments where patients were eligible for an item 10997 versus those where a 10997 was not billed.
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Trend of 10997 completion rate: A graph displaying the completion rate trend for item 10997 over a selected time period.
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10997 completion rate: A comparison of the current year's completion rate against past years.
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- Potential 10987's
Action:
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- Potential 10987s
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- List of patients eligible for 10987: This table lists appointments for patients who are coming in for appointments in the chosen date range, who have had an item 715 billed in the past 12 months and are eligible to book for an item 10987. This excludes patients who have had 10 or more 10987s this calendar year.
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Excludes patients who have already reached their annual limit.
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For a complete list of all potentially eligible patients, refer to the Item Optimisation section.
-
-
Identify opportunities for increased billing: Use this data to track service provision and identify additional patient opportunities.
-
Monitor progress with the PDSA template: Track improvements in billing completion rates using structured planning.
-
Use filtering options effectively: Practices can filter the action lists in two ways:
-
All eligible patients: Review the full list of patients who have not yet reached their item 10987 limit.
-
Patients with upcoming appointments: Focus on patients already scheduled for an appointment to integrate item 10987 opportunistically.
-
-
Ensure daily review: Encourage the team to check these lists daily. The Possible Service Opportunities Today metric can also be used for Opportunistic Patient Engagement, ensuring eligible services are offered when patients attend appointments.
-
- Historical 10987s
-
List of historical potential 10987 opportunities: A table displaying past nurse appointments where an eligible patient may have received a service but was not billed for item 10987.
-
Review past appointments: Ensure services were performed, documented, and meet MBS/DVA guidelines for billing. Note: Not all listed appointments will qualify for retrospective billing.
-
-
-
-
-
Optimise billing practices: Use this data to refine processes and maximise eligible billing opportunities.
-
Regularly audit historical opportunities: Practices should frequently review this list to identify trends in missed billing opportunities and address any documentation gaps.
-
Cross-check appointment records: When reviewing the historical list, verify whether a service was performed but not billed by checking nurse notes and clinical records.
-
Follow up with Practitioners: If a missed billing opportunity is identified, communicate with the relevant Practitioner or nurse to confirm whether an item 10987 should have been applied.
-
-
Below is a list of other ideas to assist in your Quality Improvement activities to track and optimise the billing of item 10987:
-
Use the metric 'Possible service opportunities today > 10987' to formulate a daily list of patients coming in for an appointment today for item 10987. Provide this list to your nursing team to proactively see patients and bill this item number. Use our care prompts feature to send these opportunities to Best Practice appointments (for Best Practice customers).
-
Create an appointment book column in Best Practice for each member of your Nurse team. This allows easy tracking of how many patients your nursing team is seeing each day.
-
Create a dedicated appointment type for item 10987 so nurses can book patients using this appointment type. This will make it easy to search for and identify any potential missed billings. Use the 'Select Appt Type' filter at the top of the page to refine the list to appointments booked specifically as '10987' only.
QIM: Allergies / ADR
Type: Goal (Suggested: 90% as per RACGP Standards)
What this measures: The proportion of RACGP active patients with recorded Allergies/Adverse Drug Reactions (ADR).
Description: Helps identify gaps in recording Allergy/ADR information and track progress on improving health summaries, aligned with RACGP 5th Edition Standards, Criterion QI2.1 (Health Summaries, p99), which require known allergies/ADRs to be recorded for at least 90% of active patients. Note: Data is available from July 2021 onwards, or from your Cubiko start date.
Measure:
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- Trend of allergy/ ADR recording: This metric shows key measures relating to the practice's recording of allergy/ADR status for the patient cohort. This can be used to determine whether this QI activity would suit the practice and to track progress through a PDSA cycle.
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- Trend of allergy/ ADR recording: This metric shows key measures relating to the practice's recording of allergy/ADR status for the patient cohort. This can be used to determine whether this QI activity would suit the practice and to track progress through a PDSA cycle.
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Below is a list of other ideas to assist in your Quality Improvement activities to increase the number of patients with allergies recorded in your practice:
- Ensure your New Patient Registration form has an area on it for the patient to record their allergies. Provide this form to your clinical team to enter into the patient file.
- Create a process for new patients in your practice to see the nurse team first, so they can record basic clinical information such as allergies and observations before the patient sees the Practitioner.
- Provide a form to patients identified on the list of patients to record allergies, so they can update this while waiting to see the Practitioner.
QIM: Item 699 (Heart Health Check)
Type: Goal (Customisable by Practice)
What this measures: Identification of eligible patients for a Heart Health Check (MBS Item 699) and tracking completion.
Description: In line with Medicare's guidance, patients who have been billed an MBS item restricted to those living in residential aged care facilities have been excluded from this metric. Additionally, patients whose accommodation is marked as a residential aged care facility are also excluded. For further details about item eligibility, please refer to the MBS descriptor. A patient is rendered ineligible for a Heart Health Check (and will not appear on this list) if there have been any Health Assessment services billed in the previous 12 months. The Australian Government announced that from 1 July 2023, restrictions preventing First Nations people claiming a heart health assessment service within 12 months of an Aboriginal and Torres Strait Islander Peoples health assessment service (items 715, 228, 92004, 92011) will be removed. Source: MBS Online fact sheet.For useful resources on a Heart Health Check, Item 699, check out the Heart Foundation's Heart Health Check Toolkit
Measure:
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- Total patients eligible for Item 699s in the selected time period : Total number of RACGP active patients eligible for Item 699s in the selected time period and their asscoiated potential billings.
- Trend of completed Item 699: Overview of the completion of Item 699s over the selected time period
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- List of patients eligible for item 699s coming in today: This list gives the details of all the patients coming in today who may be eligible for a 699. Provide this list to your clinical team daily to action. Use the Exclude Patients eligible for other Health Assessments filter to exclude patients who may be eligible for other health assessments.
- List of all patients eligible for item 699: This list gives the details of all the patients who may be eligible for a 699 filtered by whether they have or do not have an appointment booked. Use the number of appointments the patient has had in the last 2 years to determine an order of priority to get these patients booked in.
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Below is a list of other ideas to assist in your Quality Improvement activities to increase the number of item 699 being performed in your practice:
- Ensure you have a practice meeting so your whole team is aware of what you are trying to achieve and so you are all working together to achieve your target
- Have posters and brochures available in the waiting room at your practice promoting Heart Health Checks
- Use the patient lists to send bulk SMS to patients to invite them to book for a Heart Health Check
- Implement a reminder system to recall patients where clinically necessary every 12 months