Keeping records accurate and up-to-date
Keeping records accurate and up-to-date will help capture and code fragility fractures and osteoporosis in real-time. It will assist plan follow up investigations and start treatment in time. Practices should:
- Develop systems to capture diagnosis codes from hospital letters and discharge summaries.
- Conduct periodic (monthly or quarterly) case finding searches to identify new patients (example given below).
- Skill up practice administrative teams to recognise fracture types and understand relevant codes.
Example of a monthly/quarterly search protocol
Rule 1 – Patients where age is older than or equal to 50 years.
Rule 2 – Rule 1 + clinical code (fracture upper limb, fracture lower limb, fracture of spine without mention of spinal cord injury).
The cohort of case notes could be evaluated to see if these fractures fit the criteria of fragility fracture.
If they fit the criteria of fragility fracture and are over 75 years – consider osteoporosis and work up as indicated.
If they fit the criteria of fragility fracture and are between 50-75 – consider working up with measuring bone density and other investigations as indicated.
Enter diagnosis codes of normal, osteopenia or osteoporosis as appropriate.