Name	Value
NAME	ZZVA-MHV CERVICAL CANCER SCREEN
PRINT NAME	ZZ PAP Smear Screening
DO IN ADVANCE TIME FRAME	6M
INACTIVE FLAG	INACTIVE
INACTIVE CHANGE DATE	2017-12-27 16:27:46
SEX SPECIFIC	FEMALE
CLASS	NATIONAL
SPONSOR	WOMEN VETERANS HEALTH PROGRAM AND NATIONAL CENTER FOR HEALTH PROMOTION AND DISEASE PREVENTION (NCP)
USAGE	CPR
EDIT HISTORY	EDIT DATE: 2013-07-16 10:25:41 EDIT BY: USER,SEVENTEEN EDIT COMMENTS: Exchange Install
DESCRIPTION	VHA recommends screening for cervical cancer with cytology (Pap smear) VHA recommends AGAINST using HPV testing alone or in combination with cytology for cervical cancer screening in women younger than 30 years. VHA recommends AGAINST screening for cervical cancer in women older than 65 years of age if they have had adequate prior screening and are not otherwise at high risk for cervical cancer. VHA recommends AGAINST screening for cervical cancer in women who have had a total hysterectomy (cervix removal) for benign disease. every 3 years for women ages 21-65 that have a cervix OR, for women ages This reminder does not apply to women who have had a hysterectomy where the cervix was removed. Evidence of a PAP smear completed will satisfy the reminder for up to 5 years, depending on the screening frequency specified by the clinician and the presence of HPV screening. The clinician can alter the screening frequency for individual patients based on patient and family history, and discussions with the patient. PAP Smears completed will resolve this reminder and may be recorded as one 30-65 who want to lengthen the screening interval, screening with a of the following: Laboratory result matching Cytology or Surgical Pathology SNOMED Women's Health procedure result Health Factor (Historical outside PAP smear result) PCE CPT procedure code Completed consult order for outside procedure In patients ages 30-65 who have evidence of a recent negative HPV result and no prior abnormal PAP smear, the PAP smear will resolve the reminder for 5 years. combination of cytology and human papilloma virus (HPV) testing every 5 Screening will be resolved by any of the following: PAP smear obtained at this encounter (9 months) Health Factor for an order for PAP Smear screening (9 months) Patient declined PAP smear (4 months) Clinician deferred PAP smear (4 months) Clinicians may manage follow-up screening to occur every 4 or 6 months when PAP smear results are unsatisfactory, or if they feel screening should take place more often than 1, 2, 3 or 5 years. years. Management of an abnormal PAP is included in this screening reminder only if the clinician indicates what frequency is required for an individual patient. A code for abnormal PAP changes the frequency to 1 year. This 1 year frequency if subsequently overridden if any other frequency is chosen by the clinician. VHA recommends AGAINST screening for cervical cancer in women who are younger than 21 years.
FINDINGS	FINDING ITEM: VA-AGE CONDITION: I V>29&(V<66) INTERNAL CONDITION: I V>29&(V<66) NO. OF FOUND TEXT LINES: 0 NO. NOT FOUND TEXT LINES: 0 FINDING ITEM: VA-WH PAP SMEAR SCREEN DEFER NO. OF FOUND TEXT LINES: 0 NO. NOT FOUND TEXT LINES: 0 USE IN RESOLUTION LOGIC: OR BEGINNING DATE/TIME: T-4M FINDING ITEM: VA-WH PAP SMEAR UNSATISFACTORY IN LAB/WH PKG NO. OF FOUND TEXT LINES: 0 NO. NOT FOUND TEXT LINES: 0 USE IN RESOLUTION LOGIC: OR FINDING ITEM: VA-WH PAP SMEAR SCREEN FREQ - 4M NO. OF FOUND TEXT LINES: 0 NO. NOT FOUND TEXT LINES: 0 FINDING ITEM: VA-WH PAP SMEAR SCREEN FREQ - 6M NO. OF FOUND TEXT LINES: 0 NO. NOT FOUND TEXT LINES: 0 FINDING ITEM: VA-WH PAP SMEAR SCREEN FREQ - 1Y NO. OF FOUND TEXT LINES: 0 NO. NOT FOUND TEXT LINES: 0 FINDING ITEM: VA-WH PAP SMEAR SCREEN FREQ - 2Y NO. OF FOUND TEXT LINES: 0 NO. NOT FOUND TEXT LINES: 0 FINDING ITEM: VA-WH PAP SMEAR SCREEN FREQ - 3Y NO. OF FOUND TEXT LINES: 0 NO. NOT FOUND TEXT LINES: 0 FINDING ITEM: VA-WH HYSTERECTOMY NO. OF FOUND TEXT LINES: 0 NO. NOT FOUND TEXT LINES: 0 FINDING ITEM: VA-WH HX CERVICAL CANCER/ABNORMAL PAP NO. OF FOUND TEXT LINES: 0 NO. NOT FOUND TEXT LINES: 0 FINDING ITEM: VA-WH HYSTERECTOMY W/CERVIX REMOVED NO. OF FOUND TEXT LINES: 0 NO. NOT FOUND TEXT LINES: 0 USE IN PATIENT COHORT LOGIC: AND NOT FINDING ITEM: VA-WH HPV TESTING NEGATIVE WITHIN CATEGORY RANK: 0 CONDITION CASE SENSITIVE: NO OCCURRENCE COUNT: 4 USE STATUS/COND IN SEARCH: YES NO. OF FOUND TEXT LINES: 0 NO. NOT FOUND TEXT LINES: 0 BEGINNING DATE/TIME: T-5Y FINDING ITEM: VA-WH HPV TESTING POSITIVE WITHIN CATEGORY RANK: 0 CONDITION CASE SENSITIVE: NO OCCURRENCE COUNT: 2 USE STATUS/COND IN SEARCH: YES NO. OF FOUND TEXT LINES: 0 NO. NOT FOUND TEXT LINES: 0 FINDING ITEM: VA-AGE CONDITION: I V<30 INTERNAL CONDITION: I V<30 NO. OF FOUND TEXT LINES: 0 NO. NOT FOUND TEXT LINES: 0 FINDING ITEM: VA-WH PAP SMEAR SCREEN FREQ - 5Y NO. OF FOUND TEXT LINES: 0 NO. NOT FOUND TEXT LINES: 0 FINDING ITEM: VA-WH PAP SMEAR SCREENING REMINDER DUE NO. OF FOUND TEXT LINES: 5 NO. NOT FOUND TEXT LINES: 0 FOUND TEXT: Although your are over 65 years old, your provider has recommended continued screening. \\ FINDING ITEM: VA-WH PAP SMEAR SCREEN IN WH PKG OCCURRENCE COUNT: 3 NO. OF FOUND TEXT LINES: 0 NO. NOT FOUND TEXT LINES: 0 USE IN RESOLUTION LOGIC: OR FINDING ITEM: VA-WH PAP SMEAR SCREEN IN LAB PKG OCCURRENCE COUNT: 3 NO. OF FOUND TEXT LINES: 0 NO. NOT FOUND TEXT LINES: 0 USE IN RESOLUTION LOGIC: OR FINDING ITEM: VA-WH PAP SMEAR DONE NO. OF FOUND TEXT LINES: 0 NO. NOT FOUND TEXT LINES: 0 USE IN RESOLUTION LOGIC: OR FINDING ITEM: VA-WH PAP SMEAR OBTAINED NO. OF FOUND TEXT LINES: 0 NO. NOT FOUND TEXT LINES: 0 USE IN RESOLUTION LOGIC: OR BEGINNING DATE/TIME: T-7D FINDING ITEM: VA-WH PAP SMEAR SCREEN NOT INDICATED NO. OF FOUND TEXT LINES: 0 NO. NOT FOUND TEXT LINES: 0 USE IN RESOLUTION LOGIC: OR
FUNCTION FINDINGS	FUNCTION FINDING NUMBER: 1 FOUND TEXT: PAP smear screening every 5 years specified for this patient. LOGIC: (FN(1)=FN(2))&(FN(2)>0) MINIMUM AGE: 30 REMINDER FREQUENCY: 5Y FUNCTION STRING: (MRD(9,12,13,14,15,16,23)=MRD(23))&(MRD(23)>0) NO. FOUND TEXT LINES: 1 NO. NOT FOUND TEXT LINES: 0 FUNCTION LIST: FUNCTION NUMBER: 1 FUNCTION: MRD FUNCTION PARAMETER LIST: FUNCTION NUMBER: 2 FUNCTION: MRD FUNCTION PARAMETER LIST: FUNCTION NUMBER: 3 FUNCTION: MRD FUNCTION PARAMETER LIST: FUNCTION FINDING NUMBER: 10 LOGIC: ($P(FN(1),".")'<($P(FN(2),".")))&(FN(1)>0)&((FN(4)&FN(5)>FN(6))!'FN(7)!FN(8)) MINIMUM AGE: 21 MAXIMUM AGE: 65 REMINDER FREQUENCY: 3Y FUNCTION STRING: ($P(MRD(4,5,6),".")'<($P(MRD(7,9,10,11),".")))&(MRD(4,5,6)>0)&((FI(21)&MRD(21)>MRD(20))!'FI(20)!FI(22)) NO. FOUND TEXT LINES: 0 NO. NOT FOUND TEXT LINES: 0 FUNCTION LIST: FUNCTION NUMBER: 1 FUNCTION: MRD FUNCTION PARAMETER LIST: FUNCTION NUMBER: 2 FUNCTION: MRD FUNCTION PARAMETER LIST: FUNCTION NUMBER: 3 FUNCTION: MRD FUNCTION PARAMETER LIST: FUNCTION NUMBER: 4 FUNCTION: FI FUNCTION PARAMETER LIST: FUNCTION NUMBER: 5 FUNCTION: MRD FUNCTION PARAMETER LIST: FUNCTION NUMBER: 6 FUNCTION: MRD FUNCTION PARAMETER LIST: FUNCTION NUMBER: 7 FUNCTION: FI FUNCTION PARAMETER LIST: FUNCTION NUMBER: 8 FUNCTION: FI FUNCTION PARAMETER LIST: FUNCTION FINDING NUMBER: 11 LOGIC: ($P(FN(1),".")'<($P(FN(2),".")))&(FN(1)>0)&(FN(4)&(FN(5)>FN(6))&FN(7)) MINIMUM AGE: 30 MAXIMUM AGE: 65 REMINDER FREQUENCY: 5Y FUNCTION STRING: ($P(MRD(4,5,6),".")'<($P(MRD(7,9,10,11),".")))&(MRD(4,5,6)>0)&(FI(20)&(MRD(20)>MRD(21))&FI(1)) NO. FOUND TEXT LINES: 0 NO. NOT FOUND TEXT LINES: 0 FUNCTION LIST: FUNCTION NUMBER: 1 FUNCTION: MRD FUNCTION PARAMETER LIST: FUNCTION NUMBER: 2 FUNCTION: MRD FUNCTION PARAMETER LIST: FUNCTION NUMBER: 3 FUNCTION: MRD FUNCTION PARAMETER LIST: FUNCTION NUMBER: 4 FUNCTION: FI FUNCTION PARAMETER LIST: FUNCTION NUMBER: 5 FUNCTION: MRD FUNCTION PARAMETER LIST: FUNCTION NUMBER: 6 FUNCTION: MRD FUNCTION PARAMETER LIST: FUNCTION NUMBER: 7 FUNCTION: FI FUNCTION PARAMETER LIST: FOUND TEXT: Negative HPV result, patient < age 30. 5year screening interval is NOT recommended for patients less than age 30. LOGIC: FN(1)&FN(2) FUNCTION STRING: FI(20)&FI(22) NO. FOUND TEXT LINES: 2 NO. NOT FOUND TEXT LINES: 0 FUNCTION LIST: FUNCTION NUMBER: 1 FUNCTION: FI FUNCTION PARAMETER LIST: FUNCTION NUMBER: 2 FUNCTION: FI FUNCTION PARAMETER LIST: LOGIC: FN(1)&'FN(2)&'FN(3) FUNCTION STRING: FI(1)&'FI(20)&'FI(21) NO. FOUND TEXT LINES: 0 NO. NOT FOUND TEXT LINES: 0 FUNCTION LIST: FUNCTION NUMBER: 1 FUNCTION: FI FUNCTION PARAMETER LIST: FUNCTION NUMBER: 2 FUNCTION: FI FUNCTION PARAMETER LIST: FUNCTION NUMBER: 3 FUNCTION: FI FUNCTION PARAMETER LIST: FUNCTION FINDING NUMBER: 4 FOUND TEXT: Annual PAP smear screening specified for this patient. LOGIC: (FN(1)=FN(2))&(FN(2)>0) MINIMUM AGE: 18 REMINDER FREQUENCY: 1Y FUNCTION STRING: (MRD(9,12,13,14,15,16,23)=MRD(14))&(MRD(14)>0) NO. FOUND TEXT LINES: 1 NO. NOT FOUND TEXT LINES: 0 FUNCTION LIST: FUNCTION NUMBER: 1 FUNCTION: MRD FUNCTION PARAMETER LIST: FUNCTION NUMBER: 2 FUNCTION: MRD FUNCTION PARAMETER LIST: FUNCTION NUMBER: 3 FUNCTION: MRD FUNCTION PARAMETER LIST: FUNCTION FINDING NUMBER: 5 FOUND TEXT: PAP smear screening every 2 years specified for this patient. LOGIC: (FN(1)=FN(2))&(FN(2)>0) MINIMUM AGE: 18 REMINDER FREQUENCY: 2Y FUNCTION STRING: (MRD(9,12,13,14,15,16,23)=MRD(15))&(MRD(15)>0) NO. FOUND TEXT LINES: 1 NO. NOT FOUND TEXT LINES: 0 FUNCTION LIST: FUNCTION NUMBER: 1 FUNCTION: MRD FUNCTION PARAMETER LIST: FUNCTION NUMBER: 2 FUNCTION: MRD FUNCTION PARAMETER LIST: FUNCTION NUMBER: 3 FUNCTION: MRD FUNCTION PARAMETER LIST: FUNCTION FINDING NUMBER: 6 FOUND TEXT: PAP smear screening every 3 years specified for this patient. LOGIC: (FN(1)=FN(2))&(FN(2)>0) MINIMUM AGE: 18 REMINDER FREQUENCY: 3Y FUNCTION STRING: (MRD(9,12,13,14,15,16,23)=MRD(16))&(MRD(16)>0) NO. FOUND TEXT LINES: 1 NO. NOT FOUND TEXT LINES: 0 FUNCTION LIST: FUNCTION NUMBER: 1 FUNCTION: MRD FUNCTION PARAMETER LIST: FUNCTION NUMBER: 2 FUNCTION: MRD FUNCTION PARAMETER LIST: FUNCTION NUMBER: 3 FUNCTION: MRD FUNCTION PARAMETER LIST: FUNCTION FINDING NUMBER: 7 FOUND TEXT: PAP smear screening not clinically indicated for this patient. LOGIC: (FN(1)=FN(2))&(FN(2)>0) REMINDER FREQUENCY: 0Y FUNCTION STRING: (MRD(9,12,13,14,15,16,23)=MRD(9))&(MRD(9)>0) NO. FOUND TEXT LINES: 1 NO. NOT FOUND TEXT LINES: 0 FUNCTION LIST: FUNCTION NUMBER: 1 FUNCTION: MRD FUNCTION PARAMETER LIST: FUNCTION NUMBER: 2 FUNCTION: MRD FUNCTION PARAMETER LIST: FUNCTION NUMBER: 3 FUNCTION: MRD FUNCTION PARAMETER LIST: FUNCTION FINDING NUMBER: 8 FOUND TEXT: The most recent PAP smear result in the Lab or Women's Health package was unsatisfactory. The PAP smear needs to be repeated. LOGIC: ($P(FN(1),".")=($P(FN(2),".")))&(FN(2)>0) REMINDER FREQUENCY: 1D FUNCTION STRING: ($P(MRD(4,5,6,7,9,10,11),".")=($P(MRD(11),".")))&(MRD(11)>0) NO. FOUND TEXT LINES: 2 NO. NOT FOUND TEXT LINES: 0 FUNCTION LIST: FUNCTION NUMBER: 1 FUNCTION: MRD FUNCTION PARAMETER LIST: FUNCTION NUMBER: 2 FUNCTION: MRD FUNCTION PARAMETER LIST: FUNCTION NUMBER: 3 FUNCTION: MRD FUNCTION PARAMETER LIST: FOUND TEXT: Prior negative HPV results and no record of any positive HPV results. LOGIC: FN(1)&'FN(2) FUNCTION STRING: FI(20)&'FI(21) NO. FOUND TEXT LINES: 1 NO. NOT FOUND TEXT LINES: 0 FUNCTION LIST: FUNCTION NUMBER: 1 FUNCTION: FI FUNCTION PARAMETER LIST: FUNCTION NUMBER: 2 FUNCTION: FI FUNCTION PARAMETER LIST:
TECHNICAL DESCRIPTION	Technical Description: facility, results can be recorded three ways to satisfy this recorded and the status is not Unsatisfactory. VA-WH PAP SMEAR SCREEN IN LAB PKG No mapping necessary. This term represents PAP Smear results documented in the Laboratory package. Use the new VA-WH PAP SMEAR IN LAB PKG computed finding distributed with this reminder term. This computed finding looks for PAP smear results in the Laboratory package where the Result Status that is not "Unsatisfactory" reminder: This computed finding will only work if the Women's Health WV PROCEDURE TYPE file entry for PAP SMEAR has SNOMED codes defined that are used by your local Lab Service to document PAP Smear results in the Lab Package. The SNOMED codes need to be defined regardless of whether the Women's Health Package is being used. VA-WH PAP SMEAR DONE No mapping necessary. Use the new VA-WH PAP SMEAR SCREEN CODES taxonomy distributed with this reminder term. This taxonomy is similar to the VA-CERVICAL CANCER SCREEN taxonomy distributed to the field with the first reminder package distribution. The new taxonomy should be used, instead of the VA-CERVICAL CANCER SCREEN taxonomy, because it does not include codes such as Q0091 which represent PAP smears obtained by the clinician. Use the new WH PAP SMEAR OUTSIDE health factor to document PAP Smear results completed outside the VA when the PAP Smear * Results, with interpretation, can be entered and verified results are not documented in Lab, Women's Health or Consult packages. VA-WH PAP SMEAR OBTAINED Use the new taxonomy VA-WH PAP SMEAR OBTAINED which contains coded values that represent the clinician's actions taken to obtain the PAP smear. VA-WH PAP SMEAR ORDER HEALTH FACTOR Removed from patient reminder. in the Lab package. VA-WH PAP SMEAR SCREEN NOT INDICATED Use the findings distributed with this reminder term or map any local findings that indicate a PAP smear screen is not indicated for this patient. This term is distributed with mapping to the following health factors: INACTIVATE CERVIX CANCER SCREEN (distributed with the first version of the Clinical Reminder package in 1996 * Results, with interpretation, can be manually entered into the to inactivate the CERVICAL CANCER reminder). WH PAP SMEAR SCREEN NOT INDICATED VA LIMITED LIFE EXPECTANCY and the following taxonomy: VA-TERMINAL CANCER PATIENTS Use in National VA-WH PAP SMEAR SCREENING reminder: This term is used in WH reminders to inactivate PAP Smear screening until a clinician overrides the inactivation by selecting a health factor that is used by function findings WH package. with frequencies of 1Y, 2Y, 3Y or 5Y. Begin date of T-6M has been added to HF.VA LIMITED LIFE EXPECTANCY and TX.VA-TERMINAL CANCER PATIENTS so screening will come due again if the patient lives longer than expected or if the patient has been misdiagnosed. Updated September 2012 to include 2 new health factors: CERVICAL CA SCRN N/A PERMANENTLY (no begin date) CERVICAL CA SCRN N/A 5 YRS (begin date T-5Y) * Summarized results can be entered as a historical entry (health Sites may prefer to use local LIMITED LIFE EXPECTANCY health factors and add their health factors to other reminder terms which cause the PAP Smear Screening reminder to be due without requiring a clinician to select a finding to reactivate the reminder. (e.g., Add the local life expectancy health factor for "LOCAL LIFE EXPECTANCY 6M" to the VA-WH PAP SMEAR SCREEN NOT INDICATED term). VA-WH PAP SMEAR SCREEN DEFER Use the WH PAP SMEAR DECLINED and/or WH PAP SMEAR DEFERRED factor or CPT code) in the patient record. Historical entries health factors distributed with this term, or add any local health factors representing that PAP smear screening should be deferred. VA-WH PAP SMEAR UNSATISFACTORY IN LAB/WH PKG No mapping necessary. This term represents unsatisfactory PAP Smear results documented in the Laboratory and WH packages. Use the new VA-WH PAP SMEAR IN LAB PKG computed finding distributed with this reminder term. This computed finding looks for PAP smear results in the Laboratory should be based on reviewed results, not on patient comments. package where the Result Status is "Unsatisfactory" Use the VA-WH PAP SMEAR IN WH PKG computed finding and the value "UNSATISFACTORY" to find unsatisfactory PAP smear results documented in the WH package. This computed finding will only work if the Women's Health WV PROCEDURE TYPE file entry for PAP SMEAR has SNOMED codes defined that are used by your local Lab Service to document PAP Smear results in the Lab Package. The SNOMED codes need Patient reminder based on copy of the national PAP smear screening to be defined regardless of whether the Women's Health Package is being used. INFORMATION FINDINGS: --------------------- Function Findings (FF) will be used to determine the frequency of this reminder. The following are information reminder terms that are used in Function Findings to alter the baseline Age/Frequency. If the most recent resolution finding is a documented result, the frequency for the next PAP Smear will be based on these reminder terms. Setup of Women's Health package before using this reminder: If multiple findings exist for the same date/time, the finding that makes the reminder due most often will prevail. See the FUNCTION FINDINGS section below for frequency logic. VA-WH PAP SMEAR SCREEN FREQ - 4M VA-WH PAP SMEAR SCREEN FREQ - 6M Removed from patient reminder. VA-WH PAP SMEAR SCREEN FREQ - 1Y Use the WH PAP SMEAR SCREEN FREQ - 1Y health factor =========================================================== distributed with this reminder term, or add any local findings that indicate PAP smear screening should occur every year. The taxonomy for abnormal PAP is included in this term. VA-WH PAP SMEAR SCREEN FREQ - 2Y Use the WH PAP SMEAR SCREEN FREQ - 2Y health factor distributed with this reminder term, or add any local findings that indicate the PAP smear screening should occur every 2 years. This reminder has been developed to interface with the Women's Health VA-WH PAP SMEAR SCREEN FREQ - 3Y Use the WH PAP SMEAR SCREEN FREQ - 3Y health factor distributed with this reminder term, or add any local findings that indicate PAP smear screening should occur every 3 years. The following reminder terms are "information only" terms that are not used to alter the frequency, but provide information that may be helpful to the clinician. (WH) package. The associated reminder dialog will update the WH VA-WH HYSTERECTOMY This reminder term represents hysterectomy related procedures. It is pre-mapped to use the VA-HYSTERECTOMY taxonomy which was distributed to the field in 1996. It is not used to alter the patient cohort because it contains hysterectomy codes that indicate the patients cervix may or may not have been removed. VA-WH HX CERVICAL CANCER/ABNORMAL PAP This reminder term is mapped to the taxonomy VA-CERVICAL package at the same time clinical care is recorded in CPRS GUI, thus CA/ABNORMAL PAP findings. This term represents ICD9, ICD0, and CPT codes that indicate the patient has a history of cervical cancer or a diagnosis for abnormal PAP. Sites may choose to only use documented diagnosis and procedure codes removing mapping to Women's Health. This reminder term is also mapped to the computed finding VA-WH PAP SMEAR SCREEN IN WH PKG with a condition check for "Abnormal" used for the search. If PAP smear results are documented in the Women's Health package, the computed finding eliminating the need for dual data entry. VA-WH PAP SMEAR SCREEN IN WH PKG will find the most recent PAP Smear entry that has an "Abnormal" result. Sites can remove this mapped item if they are not using the Women's Health package to store PAP results. The reminder term may also be mapped to the computed finding VA-WH PAP SMEAR SCREEN IN LAB PKG with a condition check for "Abnormal" Result Type. The Result Type is based on Procedure definitions in the Women's Health Package. VA-WH PAP SMEAR ORDER Removed from patient reminder VA-WH HPV TESTING NEGATIVE Any lab tests that represent negative HPV results on cervical specimens should be included in this term. A sample condition is included in the term definition and in the lab test that is exported with the term. A health factor for outside results or for use for results that are not in Chemistry/Hematology is included in the term. In order for this reminder to interface with the Women's Health (WH) VA-WH HPV TESTING POSITIVE Any lab tests that represent positive HPV results for high or intermediate risk HPV on cervical specimens should be included in this term. A sample condition is included in the term definition. If your lab reports separate lab tests for high/intermediate risk and low risk genotypes, DO NOT include the low risk genotype test in this term. A health factor for outside results or for use for results that package, the WH package must be installed and maintained. Please are not in Chemistry/Hematology is included in the term. FUNCTION FINDINGS: ------------------ Frequency for this reminder will be determined using Function Findings (FF) logic, which differentiates between completed results, short-term (7D, 4M, 6M) and long term (1Y, 2Y, 3Y, 5Y) resolution findings. reminder. refer to the CPRS Integration: Women Veterans Health (WVH) Install & FF1 Was part of the original national reminder and is replaced by FF(10) and FF(11) FF2 Determines whether the most recent finding is VA-WH PAP SMEAR SCREEN FREQ - 4M and changes the screening frequency to every four months (4M). FF3 Determines whether the most recent finding is VA-WH PAP SMEAR SCREEN FREQ - 6M and changes the screening frequency to every Setup Guide for detailed instructions. six months (6M). FF4 Determines whether a finding exists for VA-WH PAP SMEAR SCREEN FREQ 1Y and changes the screening frequency to every year (1Y). FF6 Determines whether a finding exists for VA-WH PAP SMEAR SCREEN FREQ 3Y and changes the screening frequency to every three years (3Y). FF7 Determines whether a finding exists for VA-WH PAP SMEAR SCREEN NOT INDICATED and changes the frequency to 0D, which will stop the reminder from being due until some new activity occurs. FF8 Determines whether the most recent finding is a VA-WH PAP SMEAR UNSATISTACTORY IN LAB PKG, which will make the reminder due again in one day (1D). FF9 The following is a subset of some of the specific features of WH that New in this update; allows text to display for prior negative HPV results and no record of any positive HPV results FF10 New in this update and along with FF11, replaces the old FF1 Most recent finding is a PAP smear result AND 1) patient <30, or 2) HPV done and most recent result positive, or 3) no recent negative result of HPV testing Frequency set to 3Y must be in place in order for this reminder to work as it was FF11 New in this update and along with FF10, replaces the old FF1 Most recent finding is a PAP smear result AND pt is 30-65, and most recent HPV was done in the past 5Y and was negative Frequency set to 5Y designed: * Female veterans should be entered into the WH package. * SNOMED codes are setup for the PAP SMEAR procedure in the WV PROCEDURE TYPE file. * WH parameters should be set up to automatically import PAP smear lab reports into the WH package when they are verified in the VistA Lab package. * The WV NOTIFICATION PURPOSE letters should be customized to reflect site information and the correct letter content for each type of letter. * The Notification Purpose treatment need and treatment need date offset should be defined if appropriate. These new fields will be used to update Women's Health data when purpose of notifications are selected by clinicians from reminder This reminder is based on VHA Performance measures and US dialogs. * The reminder dialog definitions should reference the appropriate WV NOTIFICATION PURPOSE. Setup of reminder terms and reminder dialogs before using this reminder: ============================================================== 1. Use the Reminder Term options to map local representations of findings: Preventative Services Task Force recommendations for cervical cancer PATIENT COHORT FINDINGS: ------------------------ The following reminder terms determine whether the reminder applies to the patient. VA-WH HYSTERECTOMY W/CERVIX REMOVED No mapping necessary. Use the VA-WH HYSTERECTOMY W/CERVIX REMOVED reminder taxonomy distributed with this term. Note the VA-CERVICAL CA/ABNORMAL PAP reminder taxonomy is now used for information only and should not be mapped to this screening. reminder term since it contains codes where the cervix may not have been removed. This reminder term is also mapped to the new health factor WH HYSTERECTOMY W/CERVIX REMOVED. RESOLUTION FINDINGS: -------------------- The following reminder terms resolve the reminder. These resolution terms are defined with a "Use in Resolution Logic", but no Frequency. Frequency for this reminder will be determined by Function Findings (FF) logic, which examines the most recent findings: * If Function Findings determine that the most recent finding is a result, the baseline age and frequency will be used. * If Function Findings determine that an information finding exists that alters the baseline frequency to 1Y, 2Y, 3Y, or 5Y the baseline frequency will be overridden. If the PAP smear is done in the private sector or at another VAMC * FF for 4 month and 6 months screening are removed from the patient version of the reminder VA-WH PAP SMEAR SCREEN IN WH PKG No mapping necessary. This term represents PAP Smear results documented in the Women's Health (WH) Package. Use the new VA-WH PAP SMEAR IN WH PKG computed finding distributed with this reminder term. This computed finding looks for PAP smear results in the Women's Health Package where results have been
CUSTOMIZED COHORT LOGIC	(SEX)&(AGE)&'(FI(2))
INTERNAL PATIENT COHORT LOGIC	(SEX)&(AGE)&'(FI(2))
PATIENT COHORT FINDINGS COUNT	3
PATIENT COHORT FINDINGS LIST	SEX;AGE;2
INTERNAL RESOLUTION LOGIC	(0)!FI(4)!FI(5)!FI(6)!FI(7)!FI(9)!FI(10)!FI(11)
RESOLUTION FINDINGS COUNT	7
RESOLUTION FINDINGS LIST	4;5;6;7;9;10;11
AGE FINDINGS COUNT	8
AGE FINDINGS LIST	FF1;FF4;FF5;FF6;FF7;FF8;FF10;FF11
INFORMATION FINDINGS COUNT	16
INFORMATION FINDINGS LIST	1;3;12;13;14;15;16;17;18;20;21;22;23;FF12;FF13;FF9
WEB SITES	URL: http://www.healthfinder.gov/prevention/ViewTopic.aspx?topicID=13 WEB SITE TITLE: Get tested for Cervical Cancer URL: http://healthfinder.gov/scripts/SearchContext.asp?topic=149 WEB SITE TITLE: Cervical Cancer
GENERAL COHORT FOUND TEXT	Cervical cancer is a cancer of the lower part of the uterus, or womb. It * Women ages 30-65 can either:\\ - be screened for cervical cancer every 3 years with a Pap test; or\\ - for those who want to lengthen the time between screenings, be\\ screened every 5 years with a combination of a Pap test and a\\ test for Human Papillomavirus (HPV). Risk factors increase your chance of getting a disease. The major risk factors for cervical cancer are:\\ * Infection with the Human Papillomavirus (HPV)\\ * Having many sexual partners\\ is a slow-growing cancer that can take many years to develop. In its * Having first sexual intercourse at an early age\\ * Infection with Human Immunodeficiency Virus (HIV)\\ * Smoking\\ If you have any of these risk factors, discuss them with your health care provider.\\ Cervical cancer screening tests (i.e. Pap tests) and HPV tests are not perfect at finding cervical cancer. Many changes found on Pap tests turn out to not be cancer, but you may need more tests to determine if early stages it usually does not cause any changes that you can see or cancer is present. Pap tests may also miss changes that are cancer, but this does not happen often.\\ Also, it is very important to continue to be screened for cervical cancer even if you got the HPV Immunization shot because the shot does not protect you from all types of HPV. Talk with your primary care team (PACT) or other women's health care provider if you have questions. \\ feel. Pap tests can find abnormalities in the cervix that can be successfully treated before they turn into cancer. Also, when cancer is diagnosed early it is more likely to be cured. Most women ages 21-65 should be screened:\\ * Women ages 21-29 should have a Pap test every 3 years.\\
# OF GEN. COHORT FOUND LINES	36
# GEN. COHORT NOT FOUND LINES	0
GENERAL RES. NOT FOUND TEXT	There is no recent report of cervical cancer screening in your medical record. Please contact your primary care team (PACT) to discuss being screened. If you had a recent Pap test and/or HPV test please let your primary care team (PACT) know this at your next visit. \\
# GEN. RES. FOUND LINES	0
# GEN. RES. NOT FOUND LINES	4
RESCISSION DATE	2017-12-27 00:00:00
BASELINE AGE FINDINGS	REMINDER FREQUENCY: 3Y MINIMUM AGE: 21 MAXIMUM AGE: 65 NO. OF AGE MATCH LINES: 0 NO. OF AGE NO MATCH LINES: 0
# SUM. COHORT FOUND LINES	0
# SUM. COHORT NOT FOUND LINES	0
# SUM. RES. FOUND LINES	0
# SUM. RES. NOT FOUND LINES	0

ZZVA-MHV CERVICAL CANCER SCREEN (441) REMINDER DEFINITION (811.9)