Procedure: The payment of pathology to exclude type 2 diabetes

To streamline entry into a Life! course, Diabetes Australia – Victoria can purchase the pathology required to exclude diabetes and measure baseline lipids on behalf of members of the general public.

The procedure below sets out the steps involved in this process; refer also to Pathology Procedure flowchart. You can also download this policy (PDF 500KB).

Facilitators and Providers can order these pathology slips from DA–Vic for the same purpose. Please email Tristan Sherer, Life! Data Support & Referral Officer (DS&RO).

The procedure below sets out the steps involved in this process; refer also to Pathology Procedure flowchart.

1. An individual expresses interest in taking part in a Life! course through community risk testing or social marketing.
2. If the individual is aged 50 years or above, has not had their fasting blood glucose tested in the previous 12 months and scores 15 or more on the Australian Type 2 Diabetes Risk Assessment Tool, they are offered to have the pathology required for Life! course entry paid by DA–Vic.
3. If the individual accepts the offer, a pathology request slip is mailed to them with instructions on required fasting times and the requirement to nominate their usual GP on the slip. Wherever possible the facilitator should ascertain the GP’s details from the individual and nominate them on the slip prior to supplying the individual with the path test. The individual is also notified that the GP at DA–Vic will receive a copy of their pathology results.
4. The facilitator notifies the Data Support & Referral Officer, in writing or via email, with details of the client(s) to expect pathology results from.
5. The DS&RO notifies the nominated GP, in writing, that tests will be carried out. A referral form and GP card are also sent.
6. The pathology tests are performed. The nominated GP and DA–Vic receive the test results.
7. The Director of the Life! program reviews the individual results to ascertain whether diabetes can be excluded.
8. The DA-Vic DS&RO enters test results and the date received into the ‘Pathology database’ and contacts the facilitator to notify results have been received.

Diabetes excluded:

Two weeks after the results are received (if no Life! referral received), the DS&RO contacts the individual and encourages them to make an appointment with their GP to discuss the results and obtain a referral to the Life! course.

On the day of the individual’s GP appointment (if known) or four weeks after the test results were received, the DS&RO makes contact to ensure the individual has seen their GP.

If appointment was attended: DS&RO asks whether the appointment resulted in a Life! referral.

If it did not, the DS&RO asks whether they wish to self refer to a course, provided that they meet the eligibility criteria.

If appointment was not attended: DS&RO again encourages the individual to make an appointment with their GP to discuss results. The DS&RO reinforces the seriousness of diabetes and the effectiveness of the Life! course.

• The DS&RO calls the individual four weeks after the last phone call to find out whether an appointment has been attended. If so, the outcome of the appointment is assessed, and assistance or resources are offered as appropriate.
• If not, the individual is notified that they can contact 13 RISK at any time for support to enter a Life! course or to obtain information on diabetes prevention.

Diabetes diagnosis:

• The DS&RO contacts the individual and encourages them to make an appointment with their GP to discuss the results, if they have not already done so.
• The DS&RO sends a letter to the nominated GP to advise of the test result and that the patient has been contacted and encouraged to make an appointment with the GP.
• The patient will be contacted every two weeks until they have seen their GP. If after three calls the patient has not seen their GP, the response will be escalated to a nurse or GP employed by DA–Vic.

If the pathology test is not carried out:

• If after four weeks from the issuing of the pathology slip, no results have been received, the DS&RO should contact the interested individual to find out if they have been to a pathology appointment.
• If they have, the DS&RO will then follow the procedure from point 6 above.
• If an appointment has not been attended, the DS&RO should encourage the individual to attend a pathology appointment and will reinforce the seriousness of diabetes and the effectiveness of the Life! course.
• If no result is received within an additional four weeks, the DS&RO should contact the individual again. If an appointment has been made or attended, the DS&RO will then follow the procedure from point 6 above.
• If a pathology appointment has not been attended, the individual should be notified that they can contact 13 RISK at any time for support to enter a Life! course or to obtain further information on diabetes prevention.

Privacy requirements:

All pathology results will be kept in a locked filing cabinet for a period of seven years. Only authorised staff will have access to these results, namely the DS&RO and the Director of the Life! program.

Pathology procedure