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National Clinical Guidelinesfor the State of Qatar

USER MANUALUSER MANUALMinistry of Public HealthMinistry of Public HealthP.O. Box : 42Doha - QatarPhone : +974 4407 0969Email : [email protected]

P.O. Box : 42Doha - QatarPhone : +974 4407 0969Email : [email protected]


www.mapofmedicine.com www.moph.gov.qa/national-clinical-guideline

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Contents 1. About the Map of Medicine ................................................................................................................... 4

2. Logging in............................................................................................................................................... 4

3. Navigation tool ...................................................................................................................................... 4

4. Browse by department........................................................................................................................... 4

5. Care maps A to Z .................................................................................................................................... 6

6. Find a care map...................................................................................................................................... 6

7. Mini-widgets .......................................................................................................................................... 7

8. Announcements ..................................................................................................................................... 8

9. Home page toolbar ................................................................................................................................ 8

10. Care maps toolbar .............................................................................................................................. 9

11. Browse widget ................................................................................................................................... 9

12. A to Z widget .................................................................................................................................... 10

13. Local care maps widget .................................................................................................................... 10

14. Find in page widget .......................................................................................................................... 11

15. Other views of this page ................................................................................................................... 11

16. More pages in this care map ............................................................................................................ 12

17. Provenance ...................................................................................................................................... 12

18. Search bar ........................................................................................................................................ 12

19. Search results screen........................................................................................................................ 13

20. Refining this search .......................................................................................................................... 14

21. Care maps ........................................................................................................................................ 15

22. Referrals .......................................................................................................................................... 15

23. Care points leading to other care map pages .................................................................................... 15

24. Care settings .................................................................................................................................... 16

25. Other types of care points ................................................................................................................ 17

26. Information panel ............................................................................................................................ 18

27. Key ................................................................................................................................................... 19

28. Printing ............................................................................................................................................ 20

29. Notifications..................................................................................................................................... 21

30. Leaving Feedback ............................................................................................................................. 21

31. Troubleshooting ............................................................................................................................... 22

32. Frequently asked questions .............................................................................................................. 22



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1. About the Map of Medicine The Map of Medicine is a software solution that is provided to the Ministry of Public Health (MOPH) to display approved National Clinical Guidelines in pathway (care map) format. The National Clinical Guidelines project is a core component of the Qatar National Health Strategy 2011-2016 and aims to improve the quality of care across Qatar by supporting the development of National Guidelines for use by physicians across the country. Each of the National Guidelines has been converted into Map of Medicine format to make them easier to understand and use at the point of care. They have been made accessible to all users across Qatar from the MOPH website. 2. Logging in The Map of Medicine is accessible to all users in Qatar without login access. In order to access the map follow the relevant webpage links from the MOPH website: https://www.moph.gov.qa/national-clinical-guideline If you have trouble accessing the Map of Medicine, please contact the helpdesk at [email protected]. 3. Navigation tool The navigation tool can be used to locate care maps. It is split into three separate methods of navigation:

• Browse by department • Care map A to Z • Find a care map

While navigating, the symbol may appear next to care maps, departments and specialties. This indicates locally developed content - in the case of a care map, that it has been locally developed, or in the case of departments and specialties, that they contain care maps that have been locally developed. 4. Browse by department This method of locating a care map uses the sections Department, Specialty, Care map and Care map page to narrow down your search until you find the required care map. For example, if you were looking for information on managing patients with coeliac disease, you would use the following steps:

1. From the Department list, select Medicine:



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2. From the list of specialties in Medicine, select Gastroenterology:

3. From the list of care maps in Medicine / Gastroenterology, select Coeliac disease:

4. You are now presented with two care map pages that are part of the Coeliac disease care map:

5. You can now select the care map that most closely matches your desired topic to be taken to that care map page.



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5. Care maps A to Z This method of locating a care map uses an alphabetic list to search for the care map you require. For example, if you were looking for the Tonsillitis care map, you would use the following steps:

1. Select Care map A to Z. 2. From the screen that appears, select the T button from the list of characters:

Please note that care maps beginning with a numeral will appear under the hash (#) character.

3. From the list that appears, select Tonsillitis.

4. You will be taken to the first page of the specified care map. 6. Find a care map This method of locating a care map filters your search by your entered criteria. For example, to find the Obsessive compulsive disorder (OCD) care map, use the following steps:

1. Select Find a care map. 2. On the screen that appears, click within the search box, and type obs.

When entering text, please be aware:



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• You must enter three letters for the search to begin. • Any part of the title of available care maps will be searched upon by entered strings. • Entering terms separated by a space will be searched for with an OR filter.

3. All the care map pages that contain the letters ‘obs’ will be returned instantly. 4. From the returned results, select Obsessive compulsive disorder (OCD).

5. You will be taken to the first page of the specified care map. 7. Mini-widgets The mini-widgets are the three boxes below the Navigation tool.

They include the Local care maps, Bookmarks and History widgets. These operate in a similar way as the widgets from the left-hand toolbar, but are constantly visible from the main screen. If a mini-widget is populated with more items than it can fit, the button appears at the bottom of the mini-widget. Clicking this will display further items. For the MOPH version of the Map of Medicine, both the Bookmarks and History widgets have been disabled. Alongside these widgets is the Announcements box, which contains news and updates from the MOPH Guidelines Team.



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8. Announcements The announcement section of the Map of Medicine home screen is used to broadcast important updates and information, from MOPH Guidelines Team. The announcements widget is used to inform users of any updates to guidelines or new pathways published to the Map of Medicine.

If the body of the announcement is larger than can be displayed in the announcement box, the ‘Read more’ button will appear. Clicking this button, will open the reader screen where the full announcement can be read. 9. Home page toolbar The left-hand navigational toolbar contains three buttons when viewing the Map of Medicine home screen and seven when viewing a care map page. The function of the three main buttons does not change: Opens the Browse widget.

From within this widget, you can browse the departments and specialties to find the care map you require. See the Browse widget for more information.

Opens the A to Z widget. From within this widget, you can browse for a care map using an alphabetical list. See A to Z widget for more information.

Opens the Local care maps widget. This widget displays all the care maps that have been locally developed in your view. See Local care maps for more information.



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10. Care maps toolbar When accessing a care map, four further toolbar functions become available:

Find in page. This widget allows you to search all the information within a care map page for a specific word or phrase. See Find in page for more information.

Other views of this page. For the MOPH version of the Map of Medicine, users will be unable to see other versions of the care map developed by other health care systems, as this functionality has been disabled.

More pages in this care map. This widget allows you to view other care map pages within your current care map. See More pages in this care map for more information.

Provenance. This brings up a window containing the Provenance Certificate for the care map currently being viewed. See Provenance for more information.

When in a care map page, it is possible to collapse the toolbar by selecting the button. Clicking it again will expand the toolbar to its original position. 11. Browse widget The Browse widget functions in the same way as the Browse by department section of the main navigation tool.

If you would like to resize the widget, use the icon in the bottom-right of the screen. To close the widget,

use either the or the icon. This method of locating a care map uses the sections Department, Specialty, Care map and Care map page to narrow down your search until you find the required care map.



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12. A to Z widget The A to Z widget functions in the same way as the Care maps A to Z section of the navigation tool.

If you would like to resize the widget, use the icon in the bottom-right of the screen. To close the widget, use either the or the icon. 13. Local care maps widget The Local care maps widget shows a list of all the care maps that have been developed by the MOPH.

If you would like to resize the widget, use the icon in the bottom-right of the screen. To close the widget, use either the or the icon. Use the scroll bar on the right to search available local care maps.



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14. Find in page widget The Find in page widget is useful for searching all the information contained in a care map page for a particular word or phrase.

If you would like to resize the widget, use the icon in the bottom-right of the screen. To close the widget, use either the or the icon.

Enter your search term in the search box, and press enter or select to perform the search. Any care points that are found to contain that search term will be returned in the widget, and selecting any of the links will take you to that care point. To see more information about the care point and where the word(s) appear within it, click the show details button: If your internet browser supports it, the care points that contain that text will also be highlighted on the care map page with an orange ring: 15. Other views of this page The Other views of this page widget displays local views that contain other versions of your current care map page. Whilst users will be able to see a list of alternative versions of the care map, they will not be restricted from reviewing these other versions, as this functionality has been disabled.



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16. More pages in this care map The More pages in this care map widget displays additional care map pages that are part of your current care map. For example, from the Tonsillitis care map, the Recurrent tonsillitis care map page is part of the same care map.

If you would like to resize the widget, use the icon in the bottom-right of the screen. To close the widget, use either the or the icon. Clicking on any of the displayed pages will take you to that care map. 17. Provenance Clicking the Provenance toolbar icon opens a pop-up window containing all the reference information used to create the pathway and the names of contributors who have helped to develop the care map. 18. Search bar The search bar can be used to find words and phrases throughout the care maps of the Map of Medicine.

1. Type your search term(s) into the search box as below:

2. Please note that you can use the inverted commas character (") to indicate a phrase to be searched on exactly. For example, searching for "chest pain" will search for instances when those two words appear sequentially, not "chest" and "pain" individually.

3. Press the enter key, or click the search button to the right of the search box, to submit your search. 4. You will then be taken to the Search results screen.

Note: Boolean search operators are not supported by Map of Medicine search. All search strings containing more than one word will be searched using an AND operator by default.



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19. Search results screen The search results screen displays three tabs of search based on your inputted search terms. The tabs will be:

The Qatar View This tab will display matches to your search term specifically in care maps that have been developed by the MOPH.

The International view This tab will display matches to your search term from the International view, i.e. care maps that have been developed by the Map of Medicine Editorial Team.

Other views This tab will display matches to your search from other locally developed care maps outside of your current view.

A maximum of 100 results has been set for each tab. Under the selected tab, any care maps that match your search criteria are displayed:

Clicking the Show pages button beneath the care map titles will show the care map pages within the care map that specifically contain your search term. A maximum of 20 care maps are displayed per page. Click the next button or a page number to view the further care maps.



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Clicking on any of the care map pages will take you to that page. Clicking on the care map title will take you to the first care map page of the care map. You can show all the care map pages by selecting the show details button in the top-right of the results screen:

If you would like to refine your search further, select the Refine this search button:

20. Refining this search To further refine your search from the search results screen use the following steps:

1. Click the Refine this search button.

2. In the box that opens, add another keyword or filter by department to only see results from a specific department. You can also add both a word and a department to further refine your search.

3. Click the Go button to add your criteria to the search. The new results screen will be displayed. The header bar of the search results screen will have changed to match your refinement:

4. If this does not return the results you require, you can clear your refined search by clicking the Clear button from the Refine this search box: This will take you back to your previous search results.



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21. Care maps The care map screen is made up of care points and connecting lines. Working your way from top to bottom, the care points map out the patient's care journey.

Each care point is coloured according to the setting in which that step takes place, and can contain additional information that may assist you in your diagnosis or management of the condition. See Care Settings for more information about the settings available. The type of information that a care point contains is shown via the icons along the lower edge of the care point. Descriptions of these icons are detailed in the Key. Selecting a care point that has these icons will open the additional information in an information panel. 22. Referrals If a care point is a referral, it will be marked with the icon and indicates that a referral to another facility or provider is indicated.

23. Care points leading to other care map pages Care points with a downwards arrow along their lower side are linking care points to other care maps:

Clicking these care points will take you to the relevant care map.



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24. Care settings Care maps are made up of care points which are coloured to represent the Care setting. In the examples below, the first of each pair is a selected care point with that setting and the latter is an unselected care point.

• Primary care The Primary care setting may represent services delivered by a primary care practice. Examples:

• Secondary care The Secondary care setting may represent services delivered by an acute hospital. Examples:

• Tertiary care The Tertiary care setting may represent specialist services which are available in specialist hospitals. Examples:

• Intermediate care The Intermediate care setting may represent healthcare services provided outside the primary, secondary and tertiary settings. Examples:

• Shared care The Shared care setting may represent situations where responsibility for care lies with more than one provider. Examples:

• Self-care The Self-care setting may represent guidance to the patient to promote self-management of their health.



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Examples:

• Other care The Other care setting may represent non-healthcare services provided as part of the care journey. Examples:

25. Other types of care points In addition to care settings, other types of care points convey valuable information to the end user. These additional care points are:

• Red flag The Red flag care point may represent serious conditions, complications or scenarios that require urgent or immediate medical attention. Examples:

• Information The Information care point may include supplementary information to support care. Examples:

• Formulary The Formulary care point may include information about prescribing in your community. Examples:



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26. Information panel When selecting a care point that contains additional information, the information panel will open displaying that information.

You can print the info displayed in the care point by selecting the button. For more information on printing care maps, see Printing.



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27. Key The key displays what attributes may be relevant to a care point and provides a brief description.

A more detailed description of each icon can be found below:

• More information Each care point tends to have additional information about the diagnosis or treatment of a patient. If this icon is displayed, select the care point to access the Information panel.

• Referral

Care points with this icon indicate that a referral to another care setting is required.

• National info Care points with National information hold additional information that will be available in the Qatar view.

• Local info

These care points that contain additional information created by the MOPH Guidelines Team.

• Notes The ability to add personal notes to a care point has been disabled for the MOPH version of the Map of Medicine, but the icon will still appear in the Key.

• Primary care

Any care points that are considered to be most relevant to Primary care will be outlined in green. Primary care will always be listed in the key.

• Secondary care

Any care points that are considered to be most relevant to Secondary care will be outlined in blue. Secondary care will always be listed in the key.

• Other care settings

If any care settings are included in the page, they will be listed and described in the key.



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28. Printing From within the Map of Medicine, there are two forms of printing – printing a care point, and printing the whole care map page. All printing is done by converting the care map page or point information to a PDF - however, it is not required that Adobe Reader is installed. Printing individual care points To print only the current care point, use the following steps:

1. From the Information panel, select the Print care point (PDF) button from the lower-left of the info panel:

If there are multiple tabs of information (local info and notes, for example), clicking on the button will display the Print options. This allows you to choose which sections to print:

De-select the check boxes to remove that section from the printed output.

2. An easily printable page will be produced, containing both the care map, and the specific information

from the care point that was currently displaying in the info panel, and any sections checked in the Print options.

3. Print the page as according to your Internet browser. Printing the whole care map page To print the care map in its entirety, including all information stored in each care point, use the following steps:

1. Click the Print PDF button from the upper right of the care map:

From the menu that appears, select whether you would like to include your notes when printing,

2. An easily printable page will be produced, containing all the information contained in the care map, including quick, local and national information, and any notes you have added, from each care point.

3. Print the page according to your Internet browser.



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29. Notifications The notifications above the care map page are used to notify the user if there are any possible errors or issues with the data available on the care map, or to inform you the care map page has been localised.

In addition to these, there is a status bar above the Bookmark and Print PDF button that contains the date the care map page was published and when it is valid until. For example:

30. Leaving Feedback If you would like to leave feedback of any kind, either about the Map of Medicine software, website, or clinical information, you can do so using the following steps:

1. Click the Feedback button in the lower right of the Map of Medicine screen:

2. Enter a subject, and under the drop-down menu, choose Ease of use or Clinical content:

3. If the feedback you are leaving is urgent, for example it relates to incorrect information within a care

map that may be clinically inappropriate, tick the Mark as urgent check-box.

4. Enter your feedback in the Comment section and select Submit. Your comments will be sent to a Feedback reviewer, at your local view if available. These comments will be escalated as appropriate from your local Feedback reviewer to Map of Medicine if necessary.



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31. Troubleshooting The Help file can be accessed from any screen on the Map of Medicine by clicking the Help button in the lower-right hand corner:

If you need further assistance, you can contact the team at [email protected] 32. Frequently asked questions Q1 How were the pathway topics selected? The National Clinical Guidelines and their related Pathways were selected following a review of national clinical data including health insurance and hospital data supplied by the Ministry of Public Health (MOPH). Based on an analysis of this data a priority list of topics for guideline development was proposed, subsequently the MOPH made the final selection. Q2 Are these guidelines approved by my organization? The Pathways presented within the Map of Medicine have been approved by the MOPH for use nationally across Qatar. Clicking the Provenance toolbar icon opens a pop-up window containing all the reference information used to create the pathway and the names of contributors who have helped to develop the care map. If you would like to be involved in the development of future National Guidelines or their maintenance, you can contact the MOPH Guidelines Team at [email protected]. Q3 I do not agree with what the Guideline is suggesting. What should I do? National Guidelines have been issued by the MOPH to define how care should be provided in Qatar. Each Guideline and its corresponding Pathway is based upon a comprehensive assessment of the evidence as well as its applicability to the national context of Qatar. Healthcare professionals are expected to take this guidance into account when exercising their clinical judgement in the care of patients presenting to them. The National Guidelines and Pathways do not override individual professional responsibility to take decisions which are appropriate to the circumstances of the patient concerned. Such decisions should be made in consultation with the patient, their guardians, or carers and should consider the individual risks and benefits of any intervention that is contemplated in the patient’s care. Should you wish to leave Feedback related to a Pathway, please refer to Section 30 of this document, for instructions on how to do this.



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Q4 How often will the National Guidelines and Pathways be updated? Each of the National Guidelines and their corresponding Pathways will be reviewed annually against the latest medical evidence. Decisions will then be taken by the relevant experts who contributed to guideline development, on whether any change in medical evidence is relevant to the national context of Qatar and the National Guideline and Pathways should be updated as a result. Once changes have been made and approved by the MOPH, the updated National Guideline and Pathway will be published to the MOPH website. Q5 How will I be informed when new National Guidelines and Pathways are available? The MOPH Guidelines Team will ensure all providers and physicians working in Qatar will be kept informed about the National Guidelines programme, through a series of communications that will be issued nationally. As new Pathways are made available on the Map of Medicine, announcements will also be made in the on the MOPH website

Further information about the project will also be made available periodically on the MOPH website at: https://www.moph.gov.qa/national-clinical-guideline, alternatively specific questions not answered by the above resources can be directed to the MOPH Guidelines Team directly at [email protected]. Q6 How can I review the references used in the development of the Pathway? All references are cited in the Provenance Certificate which will open by clicking the Provenance toolbar icon on the left side of the screen. Q7 I am having trouble accessing the Pathways, what should I do? If you are having trouble accessing the Map of Medicine from the MOPH website, please contact the MOPH helpdesk at [email protected].

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