TABLE OF CONTENTS
The Possible Vitamin B12 deficiency template helps to guide the clinician as to when to request B12 testing as well as guidance on how to interpret the results.
The B12 deficiency template provides a neat format for reviewing patients who are starting or have already commenced either oral or IM B12 supplementation.
Both templates host a B12 formulary which includes guidance on when to choose oral or IM supplementation, loading doses and maintenance doses.
To access these templates, search in the F12 launcher or bottom left of SystmOne, or navigate to:
Auto-Consultation > Ardens HAEMATOLOGY.
Possible B12 Deficiency
Age from 16 years onwards
The home page provides a useful summary of relevant information within the patients record.
Consultation page
For use when no blood tests have been requested yet.
The template is split into three main areas; Assessment, Impression and Management.
Assessment provides text boxes to record symptoms & signs, common risk factors and identify any complications.
Each free text box has preset text available:
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Impression
It is necessary to select a box within the impression section to access the relevant guidance provided in the Management section below. Ticking the appropriate box will highlight the management steps for each option.
Management
By selecting the appropriate checkbox within Impression, the corresponding areas will become active providing guidance on next actions. The tick boxes are designed for documenting the actions taken and include links to appropriate follow-up such as the Oral B12 replacement therapy formulary, resources or to request bloods.
Use the 'Bloods requested' preset to efficiently document these requests without the need for extensive typing. A link to the Phlebotomy template is also available, allowing access to ICE and the review of recent blood results.
Results pages
Reference ranges are available on the home page, accompanied by hyperlinks for normal, indeterminate, and low results. Navigate to the relevant page for further guidance on the interpretation of results.
Each page is structured similarly to the consultation format. Blood results will be displayed on the far right side of the template. Utilise the preset text for documenting symptoms, signs, and interfering factors.
Record the actions taken within the management area and utilise the formulary page to prescribe oral or intramuscular treatments. The resources link provides access to patient information leaflets, which are available as hyperlinks and can be forwarded to patients electronically.
B12 deficiency
Age from 16 years onwards
The home page provides a useful summary of relevant information within the patients record.
Diagnosis page
Provides various diagnosis codes to select from.
Review - oral and Review - IM pages
Use these pages to review the patients treatment for B12 deficiency.
The pages are split into three main areas; Assessment, Impression and Management. In addition, blood results will be displayed on the far right side of the template.
Assessment
There is a tick box to record 'B12 deficiency monitoring' and text boxes to record symptoms & signs and identify any complications.
Each free text box has preset text available:
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Impression
It is necessary to use the 'Response' drop and add the appropriate code, then select 'Yes' or 'No' for the 'Cause of deficiency known + resolved'. This action will highlight the relevant guidance for the chosen options.
Management
By selecting the appropriate codes within Impression, the corresponding areas will become active providing guidance on next actions. The tick boxes are designed for documenting the actions taken and include links to appropriate follow-up such as prescribing using the formulary or providing patient information leaflets using the resources link.
Further Tests page
For patients on oral treatment who have new or worsening symptoms.
For information on using the template for administering Vitamin B12 injection, please see our support article.