ZZVA-MHV DIABETES RETINAL EXAM (451)    REMINDER DEFINITION (811.9)

• EDIT DATE:   2009-04-22 12:25:51
  EDIT BY:   USER,SEVENTEEN
  EDIT COMMENTS:   

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This reminder is set to be due yearly in patients with diabetes.  
Reminder terms for HbA1c, insulin and outcomes of prior eye exams are 
included.
 
The reminder is applicable only if 2 instances of diabetes ICD codes are 
found in the chart in the past 2 years.
 
If the patient meets all 3 criteria for a 2 year exam, then the frequency
is changed to every 2 years.
 
The absence of diabetic retinopathy is represented by a reminder term 
that can be used to map any local health factors or exams that indicate 
the absence of diabetic retinopathy.
 

• FINDING ITEM:   VA-MHV DIABETES
  OCCURRENCE COUNT:   2
  NO. OF FOUND TEXT LINES:   21
  NO. NOT FOUND TEXT LINES:   0
  FOUND TEXT:   

  People with diabetes have a higher risk to develop eye problems than 
       Glaucoma - increased pressure in the eye\\
       Cataracts - the lens in the eye becomes less clear\\
       Problems of the retina or back of the eye\\
   
  Here are some ways you can help to prevent eye problems:\\
       Keep your blood sugar in good control\\
       Keep your blood pressure level normal\\
       Do not use tobacco\\
       Get your dilated eye exam regularly\\
       Report new changes in your vision to your primary care team
  people without diabetes.  Some eye problems have no symptoms until it is 
           or to an eye specialist\\
  \\
  too late. A dilated eye exam is recommended every one to two years or 
  more frequently if there is eye disease. An eye specialist puts eye drops 
  into both eyes for the exam. After the test, you will be sensitive to 
  bright light for 2 to 4 hours. Bring sunglasses to wear after the test.
   
  Eye problems caused by diabetes can be treated if caught early.\\ 
    Eye problems that can develop with diabetes are:\\
  

  RANK FREQUENCY:   2
  USE IN PATIENT COHORT LOGIC:   AND
  BEGINNING DATE/TIME:   T-24M
• FINDING ITEM:   VA-MHV RETINAL EXAM FOR DIABETES
  NO. OF FOUND TEXT LINES:   0
  NO. NOT FOUND TEXT LINES:   0
  USE IN RESOLUTION LOGIC:   OR
• FINDING ITEM:   VA-MHV INSULIN
  NO. OF FOUND TEXT LINES:   0
  NO. NOT FOUND TEXT LINES:   0
• FINDING ITEM:   VA-MHV DIABETIC RETINOPATHY

  STATUS LIST:

  • STATUS:   ACTIVE

  NO. OF FOUND TEXT LINES:   3
  NO. NOT FOUND TEXT LINES:   0
  REMINDER FREQUENCY:   1Y
  FOUND TEXT:   

  There is information recorded in your chart that suggests that a prior 
  exam of your eyes showed some changes from diabetes.  Your eyes should be 
  examined at least once per year.
  

• FINDING ITEM:   VA-MHV NO DIABETIC RETINOPATHY
  NO. OF FOUND TEXT LINES:   2
  NO. NOT FOUND TEXT LINES:   0
  FOUND TEXT:   

  There is information in your chart that a recent eye exam showed no
  evidence of changes due to diabetes.
  

• FINDING ITEM:   VA-MHV HBA1C >7.9
  CONDITION:   I V>7.9
  INTERNAL CONDITION:   I V>7.9
  NO. OF FOUND TEXT LINES:   3
  NO. NOT FOUND TEXT LINES:   0
  REMINDER FREQUENCY:   1Y
  FOUND TEXT:   

  Your last HbA1c was 8.0 higher.  This means that your diabetes 
  is not under ideal control.  You should check with your Health Care Team 
  for advice on getting your diabetes under better control.
  

• FINDING ITEM:   VA-MHV HBA1C <8.0
  CONDITION:   I V<8.0
  INTERNAL CONDITION:   I V<8.0
  NO. OF FOUND TEXT LINES:   0
  NO. NOT FOUND TEXT LINES:   0
• FINDING ITEM:   VA-MHV HBA1C ALL RESULTS
  OCCURRENCE COUNT:   4
  NO. OF FOUND TEXT LINES:   3
  NO. NOT FOUND TEXT LINES:   0
  FOUND TEXT:   

  The goal for the hemoglobin A1c is to maintain the level as low as
  possible.   A hemoblogin A1c (HbA1c) level of 7 or lower demonstrates
  excellent control of diabetes.  A level of 9 or higher shows poor control.
  

• FUNCTION FINDING NUMBER:   1
  LOGIC:   FN(1)>1
  USE IN PATIENT COHORT LOGIC:   AND
  FUNCTION STRING:   COUNT(1)>1
  NO. FOUND TEXT LINES:   0
  NO. NOT FOUND TEXT LINES:   0

  FUNCTION LIST:

  • FUNCTION NUMBER:   1
    FUNCTION:   COUNT

    FUNCTION PARAMETER LIST:

• FUNCTION FINDING NUMBER:   2
  FOUND TEXT:   

  Patients who have no evidence of diabetic eye disease can have an eye exam
  every 2 years.
  

  LOGIC:   FN(1)&FN(2)&(FN(3)>FN(4))
  REMINDER FREQUENCY:   2Y
  RANK FREQUENCY:   1
  FUNCTION STRING:   FI(1)&FI(5)&(MRD(5)>MRD(4))
  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:

  • FUNCTION NUMBER:   3
    FUNCTION:   MRD

    FUNCTION PARAMETER LIST:

  • FUNCTION NUMBER:   4
    FUNCTION:   MRD

    FUNCTION PARAMETER LIST:

• URL:   http://www.healthwise.net/myhealthevet/Content/StdDocument.aspx?DOCHWID=tf1308&SECHWID=tf1311
  WEB SITE TITLE:   Diabetic Eye Disease
• URL:   http://www.diabetes.org/type-2-diabetes/eye-complications.jsp
  WEB SITE TITLE:   American Diabetes Association- Eye Complications

No recent eye exam was found in your record that included an examination 
of the retina for complications of diabetes. If you have had a dilated 
eye exam by a Eye doctor outside of the VA, please bring this information 
with you to your next visit.  Otherwise, check with your primary care
team about how to get a detailed exam of your eyes.

• REMINDER FREQUENCY:   1Y
  NO. OF AGE MATCH LINES:   0
  NO. OF AGE NO MATCH LINES:   0

Anyone with diabetes should have a dilated eye exam.

No recent eye exam was found in your record that included an examination
of the retina for complications of diabetes.