VA-IRAQ & AFGHAN POST-DEPLOY SCREEN (568022)    REMINDER DEFINITION (811.9)

• EDIT DATE:   2009-11-18 10:04:10
  EDIT BY:   USER,SEVENTEEN
  EDIT COMMENTS:   

  Exchange Install
  

Patients who served in combat in either Operation Iraqi Freedom (Iraq, 
part of the reminder term: VA-IRAQ/AFGHAN PERIOD OF SERVICE and is 
determined by a computed finding.
 
An additional reminder term VA-ACTIVE DUTY is also available to cause 
patients to be part of the cohort.  If a site wishes to screen active 
duty patients then the computed finding for VA-PATIENT TYPE should be 
added to the term with a condition of I V="ACTIVE DUTY".
 
Patients who have OEF/OIF service as recorded in the patient registration 
data are automatically part of the cohort and patients who did not serve
Kuwait, Saudi Arabia, Turkey) or in Operation Enduring Freedom
in OEF/OIF are not included in the denominator.
 
RESOLUTION: entry of a health factor for NO IRAQ/AFGHAN SERVICE which is
found in the reminder term IRAQ/AFGHAN SERVICE NO will resolve the 
reminder only if the patient does not have an entry of OEF/OIF service in 
the patient file.
If the Veteran is known to have OEF/OIF service, based on the 
registration data then the location of service is not required.
 
If the veteran served in Iraq or Afghanistan as recorded in the
(Afghanistan, Georgia, Kyrgyzstan, Pakistan, Tajikistan, Uzbekistan, The
patient registration data (File 1), then the patient must be screened or
the registration data must be updated.
 
For all applicable patients who are not cognitively impaired: 
all the other items are required to resolve the reminder
and must be completed after the date of the most recent service 
separation:
  a) screen for PTSD, 
  b) screen for depression, 
  c) screen for alcohol use,
Philippines) should be screened for illnesses related to their service.  
  d) all 3 screening questions related to infectious diseases.
   (The 4th question for embedded fragments is new as of the summer of 
2008 and because of this, cannot be required at this time by the reminder 
logic).
 
The clinical maintenance will display information on which portions of 
the screen are not yet completed.
 
All of the individual elements of the screening tool are exported with
attached health factors and reminder terms.
Screening for PTSD, depression, problem alcohol use, infectious diseases,
 
PTSD, depression and alcohol screening must be recorded in the MH package 
and the dialog for this rmeinder requires use of the MH instruments for 
these screens.  Screens done prior to 10/1/08 using health factors will 
still resolve the reminder since those health factors are in the reminder 
terms that are part of the logic in this reminder.
 
The HFs for all of these screens should be entered in the site parameters
as ones that cannot be added outside of a reminder dialog.  Use the
parameter ORWPCE EXCLUDE HEALTH FACTORS to exclude these from the
and embedded fragments should be part of the initial evaluation of these
electronic encounter forms.  Entry of these health factors should ONLY 
occur during reminder dialog use.
 
Update October 2008 - patch PXRM*2*11
1. Health factors for PTSD screening, depression screening and alcohol 
screening are not allowed after 10/1/08 per the Office of Mental Health.
2. A HF for done elsewhere is included.
3. Combat vets need to be screened
4. The computed finding was rmeoved from the reminder term for VA-ACTIVE 
DUTY since only a few sites screen active duty patients and patch 11 
Veterans.
required an overwrite of this term.
5. Add embedded fragments question and remove other symptoms.
 
Update January 2009 - patch PXRM*2*12
1. Change combat vet screening requirement to OEF/OIF service based on 
recent data that these fields are more accurate.
2. Fix problem that active duty patients who did not serve in OEF/OIF 
have reminder continue to show as due.
3. Refusals of screening must be done after the most recent service 
separation.
 
COHORT: veterans with separation date after 9/11/01.  This finding is 

• FINDING ITEM:   VA-IRAQ/AFGHAN SERVICE NO
  NO. OF FOUND TEXT LINES:   0
  NO. NOT FOUND TEXT LINES:   0
  USE IN RESOLUTION LOGIC:   OR
• FINDING ITEM:   VA-GI SYMPTOMS (IRAQ/AFGHANISTAN)
  NO. OF FOUND TEXT LINES:   0
  NO. NOT FOUND TEXT LINES:   3
  NOT FOUND TEXT:   

  Screen for diarrhea or other GI complaints that might suggest giardia, 
  amoebiasis or other GI infection.
  \\
  

• FINDING ITEM:   VA-PERSISTENT RASH (IRAQ/AFGHANISTAN)
  NO. OF FOUND TEXT LINES:   0
  NO. NOT FOUND TEXT LINES:   3
  NOT FOUND TEXT:   

  Screen for persistent rash that might represent infection with
  leishmaniasis.
  \\
  

• FINDING ITEM:   VA-PTSD AVOIDANCE ALL
  WITHIN CATEGORY RANK:   0
  NO. OF FOUND TEXT LINES:   0
  NO. NOT FOUND TEXT LINES:   0
• FINDING ITEM:   VA-PTSD DETACHMENT ALL
  WITHIN CATEGORY RANK:   0
  NO. OF FOUND TEXT LINES:   0
  NO. NOT FOUND TEXT LINES:   0
• FINDING ITEM:   VA-PTSD NIGHTMARES ALL
  WITHIN CATEGORY RANK:   0
  NO. OF FOUND TEXT LINES:   0
  NO. NOT FOUND TEXT LINES:   0
• FINDING ITEM:   VA-PTSD ON GUARD ALL
  WITHIN CATEGORY RANK:   0
  NO. OF FOUND TEXT LINES:   0
  NO. NOT FOUND TEXT LINES:   0
• FINDING ITEM:   VA-REFUSED PTSD SCREEN
  NO. OF FOUND TEXT LINES:   1
  NO. NOT FOUND TEXT LINES:   0
  FOUND TEXT:   

  Refused PTSD Screen
  

• FINDING ITEM:   VA-REFUSED ALCOHOL SCREENING
  NO. OF FOUND TEXT LINES:   1
  NO. NOT FOUND TEXT LINES:   0
  FOUND TEXT:   

  Refused Alcohol Screening
  

• FINDING ITEM:   VA-REFUSED DEPRESSION SCREENING
  NO. OF FOUND TEXT LINES:   1
  NO. NOT FOUND TEXT LINES:   0
  FOUND TEXT:   

  Refused Depression Screening
  

• FINDING ITEM:   VA-ACTIVE DUTY
  NO. OF FOUND TEXT LINES:   0
  NO. NOT FOUND TEXT LINES:   0
  USE IN PATIENT COHORT LOGIC:   OR
• FINDING ITEM:   VA-IRAQ/AFGHAN PERIOD OF SERVICE
  NO. OF FOUND TEXT LINES:   0
  NO. NOT FOUND TEXT LINES:   1
  NOT FOUND TEXT:   

  Last Service Separation Date prior to 9/11/01 or missing.
  

  USE IN PATIENT COHORT LOGIC:   AND
  BEGINNING DATE/TIME:   SEP 11, 2001
• FINDING ITEM:   VA-REFUSED ID & OTHER SX SCREEN
  WITHIN CATEGORY RANK:   0
  NO. OF FOUND TEXT LINES:   3
  NO. NOT FOUND TEXT LINES:   0
  FOUND TEXT:   

  The patient declined to answer some or all of the infectious disease and 
  other symptom questions.  Please ask these screening questions again if 
  they remain unaddressed.
  

  BEGINNING DATE/TIME:   T-1Y
• FINDING ITEM:   VA-COGNITIVE IMPAIRMENT
  NO. OF FOUND TEXT LINES:   0
  NO. NOT FOUND TEXT LINES:   0
  BEGINNING DATE/TIME:   T-2Y
• FINDING ITEM:   VA-OEF/OIF SCREEN DONE ELSEWHERE
  NO. OF FOUND TEXT LINES:   0
  NO. NOT FOUND TEXT LINES:   0
• FINDING ITEM:   VA-OTHER SYMPTOMS (IRAQ/AFGHANISTAN)
  NO. OF FOUND TEXT LINES:   0
  NO. NOT FOUND TEXT LINES:   0
• FINDING ITEM:   VA-IRAQ/AFGHAN SERVICE
  NO. OF FOUND TEXT LINES:   0
  NO. NOT FOUND TEXT LINES:   0
• FINDING ITEM:   VA-DEPRESSION SCREEN OEF/OIF
  NO. OF FOUND TEXT LINES:   0
  NO. NOT FOUND TEXT LINES:   0
• FINDING ITEM:   VA-COMBAT VET
  NO. OF FOUND TEXT LINES:   4
  NO. NOT FOUND TEXT LINES:   0
  FOUND TEXT:   

  Combat Vet eligible or prior Combat Vet eligibility found.  
   
  Update the patient's demographic data as needed.
  \\
  

• FINDING ITEM:   VA-ALCOHOL USE SCREEN
  NO. OF FOUND TEXT LINES:   0
  NO. NOT FOUND TEXT LINES:   5
  NOT FOUND TEXT:   

  Screening for at risk alcohol use using the AUDIT-C screening tool should
  be performed yearly for any patient who has consumed alcohol in the past
  year. No record of prior screening for alcohol use was found in this 
  patient's record.
  \\
  

• FINDING ITEM:   VA-PTSD SCREEN
  NO. OF FOUND TEXT LINES:   0
  NO. NOT FOUND TEXT LINES:   0
• FINDING ITEM:   VA-UNEXPLAINED FEVER (IRAQ/AFGHANISTAN)
  NO. OF FOUND TEXT LINES:   0
  NO. NOT FOUND TEXT LINES:   3
  NOT FOUND TEXT:   

  Screen for unexplained fevers that might represent occult malaria or 
  infection with leishmaniasis.
  \\
  

• FINDING ITEM:   VA-EMBEDDED FRAGMENTS (IRAQ/AFGHANISTAN)
  NO. OF FOUND TEXT LINES:   0
  NO. NOT FOUND TEXT LINES:   0

• LOGIC:   FN(1)>FN(2)
  FUNCTION STRING:   MRD(1)>MRD(2)
  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:

• FOUND TEXT:   

  OEF/OIF Post-Deployment Screening was completed at another site.
  

  LOGIC:   FN(1)>FN(2)
  FUNCTION STRING:   MRD(22)>MRD(2)
  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:

• LOGIC:   FN(1)>FN(2)
  FUNCTION STRING:   MRD(16)>MRD(2)
  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:

• LOGIC:   FN(1)>FN(2)
  FUNCTION STRING:   MRD(17)>MRD(2)
  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:

• LOGIC:   FN(1)>FN(2)
  FUNCTION STRING:   MRD(18)>MRD(2)
  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:

• FOUND TEXT:   

  1. PTSD Screening completed since service discharge
  

  LOGIC:   FN(1)>FN(2)!(FN(3)<120)!(FN(4)<120)
  NOT FOUND TEXT:   

  1. PTSD Screen NEEDED
  

  FUNCTION STRING:   MRD(7,12,13,14,15)>MRD(2)!(DIFF_DATE(7,2)<120)!(DIFF_DATE(12,2)<120)
  NO. FOUND TEXT LINES:   1
  NO. NOT FOUND TEXT LINES:   1

  FUNCTION LIST:

  • FUNCTION NUMBER:   1
    FUNCTION:   MRD

    FUNCTION PARAMETER LIST:

  • FUNCTION NUMBER:   2
    FUNCTION:   MRD

    FUNCTION PARAMETER LIST:

  • FUNCTION NUMBER:   3
    FUNCTION:   DIFF_DATE

    FUNCTION PARAMETER LIST:

  • FUNCTION NUMBER:   4
    FUNCTION:   DIFF_DATE

    FUNCTION PARAMETER LIST:

• LOGIC:   FN(1)>FN(2)
  FUNCTION STRING:   MRD(3)>MRD(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:

• FOUND TEXT:   

  2. Depression Screening completed since service discharge
  

  LOGIC:   FN(1)>FN(2)!(FN(3)<120)
  NOT FOUND TEXT:   

  2. Depression Screening NEEDED
  

  FUNCTION STRING:   MRD(4)>MRD(2)!(DIFF_DATE(4,2)<120)
  NO. FOUND TEXT LINES:   1
  NO. NOT FOUND TEXT LINES:   1

  FUNCTION LIST:

  • FUNCTION NUMBER:   1
    FUNCTION:   MRD

    FUNCTION PARAMETER LIST:

  • FUNCTION NUMBER:   2
    FUNCTION:   MRD

    FUNCTION PARAMETER LIST:

  • FUNCTION NUMBER:   3
    FUNCTION:   DIFF_DATE

    FUNCTION PARAMETER LIST:

• FOUND TEXT:   

  3. Alcohol Screening completed since service discharge
  

  LOGIC:   FN(1)>FN(2)!(FN(3)<120)
  NOT FOUND TEXT:   

  3. Alcohol Screening NEEDED
  

  FUNCTION STRING:   MRD(6)>MRD(2)!(DIFF_DATE(6,2)<120)
  NO. FOUND TEXT LINES:   1
  NO. NOT FOUND TEXT LINES:   1

  FUNCTION LIST:

  • FUNCTION NUMBER:   1
    FUNCTION:   MRD

    FUNCTION PARAMETER LIST:

  • FUNCTION NUMBER:   2
    FUNCTION:   MRD

    FUNCTION PARAMETER LIST:

  • FUNCTION NUMBER:   3
    FUNCTION:   DIFF_DATE

    FUNCTION PARAMETER LIST:

• FOUND TEXT:   

  4A. Screen for GI symptoms done or not required.
  

  LOGIC:   FN(1)>FN(2)!'(FN(3)!FN(4))!(FN(5)<120)!(FN(6)<120)
  NOT FOUND TEXT:   

  4A. Screen for GI symptoms NEEDED
  

  FUNCTION STRING:   MRD(10,20)>MRD(2)!'(FI(2)!FI(19))!(DIFF_DATE(10,2)<120)!(DIFF_DATE(20,2)<120)
  NO. FOUND TEXT LINES:   1
  NO. NOT FOUND TEXT LINES:   1

  FUNCTION LIST:

  • FUNCTION NUMBER:   1
    FUNCTION:   MRD

    FUNCTION PARAMETER LIST:

  • FUNCTION NUMBER:   2
    FUNCTION:   MRD

    FUNCTION PARAMETER LIST:

  • FUNCTION NUMBER:   3
    FUNCTION:   FI

    FUNCTION PARAMETER LIST:

  • FUNCTION NUMBER:   4
    FUNCTION:   FI

    FUNCTION PARAMETER LIST:

  • FUNCTION NUMBER:   5
    FUNCTION:   DIFF_DATE

    FUNCTION PARAMETER LIST:

  • FUNCTION NUMBER:   6
    FUNCTION:   DIFF_DATE

    FUNCTION PARAMETER LIST:

• FOUND TEXT:   

  4B. Screen for Fevers done or not required.
  

  LOGIC:   FN(1)>FN(2)!'(FN(3)!FN(4))!(FN(5)<120)!(FN(6)<120)
  NOT FOUND TEXT:   

  4B. Screen for Fevers NEEDED
  

  FUNCTION STRING:   MRD(8,20)>MRD(2)!'(FI(2)!FI(19))!(DIFF_DATE(8,2)<120)!(DIFF_DATE(20,2)<120)
  NO. FOUND TEXT LINES:   1
  NO. NOT FOUND TEXT LINES:   1

  FUNCTION LIST:

  • FUNCTION NUMBER:   1
    FUNCTION:   MRD

    FUNCTION PARAMETER LIST:

  • FUNCTION NUMBER:   2
    FUNCTION:   MRD

    FUNCTION PARAMETER LIST:

  • FUNCTION NUMBER:   3
    FUNCTION:   FI

    FUNCTION PARAMETER LIST:

  • FUNCTION NUMBER:   4
    FUNCTION:   FI

    FUNCTION PARAMETER LIST:

  • FUNCTION NUMBER:   5
    FUNCTION:   DIFF_DATE

    FUNCTION PARAMETER LIST:

  • FUNCTION NUMBER:   6
    FUNCTION:   DIFF_DATE

    FUNCTION PARAMETER LIST:

• FOUND TEXT:   

  4C. Screen for Skin Rash done or not required.
  

  LOGIC:   FN(1)>FN(2)!'(FN(3)!FN(4))!(FN(5)<120)!(FN(6)<120)
  NOT FOUND TEXT:   

  4C. Screen for Skin Rash NEEDED
  

  FUNCTION STRING:   MRD(11,20)>MRD(2)!'(FI(2)!FI(19))!(DIFF_DATE(11,2)<120)!(DIFF_DATE(20,2)<120)
  NO. FOUND TEXT LINES:   1
  NO. NOT FOUND TEXT LINES:   1

  FUNCTION LIST:

  • FUNCTION NUMBER:   1
    FUNCTION:   MRD

    FUNCTION PARAMETER LIST:

  • FUNCTION NUMBER:   2
    FUNCTION:   MRD

    FUNCTION PARAMETER LIST:

  • FUNCTION NUMBER:   3
    FUNCTION:   FI

    FUNCTION PARAMETER LIST:

  • FUNCTION NUMBER:   4
    FUNCTION:   FI

    FUNCTION PARAMETER LIST:

  • FUNCTION NUMBER:   5
    FUNCTION:   DIFF_DATE

    FUNCTION PARAMETER LIST:

  • FUNCTION NUMBER:   6
    FUNCTION:   DIFF_DATE

    FUNCTION PARAMETER LIST:

• FOUND TEXT:   

  4D. Screen for Embedded Fragments done or not required.
  

  LOGIC:   FN(1)>FN(2)!'(FN(3)!FN(4))
  NOT FOUND TEXT:   

  4D. Screen for Embedded Fragments NEEDED
  

  FUNCTION STRING:   MRD(9,20)>MRD(2)!'(FI(2)!FI(19))
  NO. FOUND TEXT LINES:   1
  NO. NOT FOUND TEXT LINES:   1

  FUNCTION LIST:

  • FUNCTION NUMBER:   1
    FUNCTION:   MRD

    FUNCTION PARAMETER LIST:

  • FUNCTION NUMBER:   2
    FUNCTION:   MRD

    FUNCTION PARAMETER LIST:

  • FUNCTION NUMBER:   3
    FUNCTION:   FI

    FUNCTION PARAMETER LIST:

  • FUNCTION NUMBER:   4
    FUNCTION:   FI

    FUNCTION PARAMETER LIST:

• FOUND TEXT:   

  The patient's most recent service separation date is more recent than
  their last screening - rescreening is needed after any new period of
  service.
  

  LOGIC:   FN(1)>FN(2)
  FUNCTION STRING:   MRD(2)>MRD(1,8,10,11,22)
  NO. FOUND TEXT LINES:   3
  NO. NOT FOUND TEXT LINES:   0

  FUNCTION LIST:

  • FUNCTION NUMBER:   1
    FUNCTION:   MRD

    FUNCTION PARAMETER LIST:

  • FUNCTION NUMBER:   2
    FUNCTION:   MRD

    FUNCTION PARAMETER LIST:

• URL:   http://www.oqp.domain.ext/cpg/cpg.htm
  WEB SITE TITLE:   VA/DOD Guidelines - Office of Quality and Performance
• URL:   http://www.oqp.domain.ext/cpg/MDD/MDD_Base.htm
  WEB SITE TITLE:   VA/DOD Depression Guideline
• URL:   http://www.oqp.domain.ext/cpg/cpgn/mus/mus_base.htm
  WEB SITE TITLE:   VA/DOD Medically Unexplained Symptoms: Pain and Fatigue
• URL:   http://www.oqp.domain.ext/cpg/PDH/PDH_base.htm
  WEB SITE TITLE:   Post Deployment Health Evaluation and Management
• URL:   http://www.oqp.domain.ext/cpg/SUD/SUD_Base.htm
  WEB SITE TITLE:   VA/DOD Substance Abuse Guideline
• URL:   http://vaww.domain.ext/environagents/
  WEB SITE TITLE:   VA Environmental Agents Service

Patients who served in combat in either Iraq (Operation Iraqi Freedom) or 
in Afghanistan (Operation Enduring Freedom) should be screened for 
illnesses related to their service.  Screening for PTSD, depression, 
problem alcohol use, infectious diseases, and chronic symptoms should be
part of the initial evaluation of these Veterans.

• REMINDER FREQUENCY:   99Y
  NO. OF AGE MATCH LINES:   0
  NO. OF AGE NO MATCH LINES:   0