{"aaData": [["ZZVA-BREAST EXAM", "
ZZ Breast Exam
\n", "
0M
\n", "", "
INACTIVE
\n", "
2005-03-11 12:42:51
\n", "", "
FEMALE
\n", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nA breast exam is due yearly for females 40 and older. If the female has a\nhistory of breast cancer, check for ongoing follow-up yearly.\n \nThis reminder is based on guidelines defined by the Ambulatory Care Expert\nPanel.\n
\n
\n", "
\n
\n\n
\n", "", "
\nIf this reminder is not going to be used at your facility, the INACTIVE\nfor local representation of exams.\n \nIf any changes to the reminder definition are needed, copy this reminder\nto a new reminder for your sites use, and make the appropriate\nmodifications.\nFLAG should be set to inactive.\n \nReview the taxonomy findings definition being used to represent breast\ncancer. Use the List Taxonomy Items option to see the coded values defined\nfor the taxonomy.  If a taxonomy needs modifications, copy the taxonomy\nand make appropriate modifications to the new taxonomy item.\n \nCheck the Exam file entries referenced and make modifications as needed \n
\n
\n", "", "
(SEX)&(AGE)
\n", "
2
\n", "
SEX;AGE
\n", "", "
(0)!FI(1)
\n", "
1
\n", "
1
\n", "
0
\n", "", "
1
\n", "
2
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-*PNEUMOCOCCAL VACCINE", "
ZZ Pneumovax
\n", "
3M
\n", "
ZZVA-*PNEUMOCOCCAL VACCINE
\n", "
INACTIVE
\n", "
2005-03-11 12:42:50
\n", "", "", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nThis "VA-*PNEUMOCOCCAL VACCINE" reminder is defined based on the\n    vaccination with pneumococcal vaccine in their lifetime.\n \n    Goal for FY 2000: 80% of individuals 65 and older have received\n    pneumococcal vaccine.\nfollowing "Pneumococcal Vaccine" guidelines specified in the VHA HANDBOOK\n1101.8, APPENDIX A.\n \n    Target Condition: Pneumococcal pneumonia.\n \n    Target Group: Outpatients age 65 and older.\n \n    Recommendation: All persons age 65 and older should receive one\n
\n
\n", "
\n
\n\n
\n", "", "
\nIf this reminder is not going to be used at your facility, the INACTIVE\nshould be given to the patient regardless of the patients age.\n \nPlease review both of these reminder definitions, choose one of them to\nuse.  If local modifications need to be made, copy the preferred reminder\nto a new reminder and make your reminder modifications.\nFLAG should be set to inactive.\n \nThis reminder represents the minimum criteria for checking if the\npneumococcal vaccine has been given to the patient.  \n \nThe Ambulatory Care EP recommends a variation on this reminder represented\nin the "VA-PNEUMOVAX" reminder, which includes a check for diagnoses\ndocumented for the patient that would indicate the pneumococcal vaccine\n
\n
\n", "", "
(SEX)&(AGE)&'FI(3)
\n", "
3
\n", "
SEX;AGE;3
\n", "", "
(0)!FI(1)!FI(2)
\n", "
2
\n", "
1;2
\n", "
1
\n", "
3
\n", "
1
\n", "
4
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-TETANUS/DIPHTHERIA (TD) IMMUNIZATION", "
Td Immunization
\n", "
6M
\n", "", "", "", "", "", "", "
NATIONAL
\n", "
NATIONAL CENTER FOR HEALTH PROMOTION AND DISEASE PREVENTION (NCP)
\n", "", "
CR
\n", "
\n
\n\n
\n", "
\nTd (Tetanus and Diphtheria Toxoids) should be given to adults every 10 \n \n - A history of serious allergic reaction (i.e., anaphylaxis) to any \n   component of the vaccine.\n - A history of a neurologic or severe hypersensitivity reaction \n   following a previous dose.\nyears as booster doses after the primary series of three vaccinations \nagainst diphtheria, tetanus, and pertussis that was received during \ninfancy and childhood. If a dose is given sooner as part of wound \nmanagement, the next booster is not needed until 10 years thereafter. \n \nCONTRAINDICATIONS: A contraindication is a condition in a recipient that \nincreases the risk for a serious adverse reaction. A vaccine should not \nbe administered when a contraindication is present.\n
\n
\n", "
\n
\n\n
\n", "", "
\nThe reminder will apply to all adults aged 19 and older. \nlocally created immunizations that were used for Tdap vaccines. \n \nReminder Term, "VA-TD IMMUNIZATION" includes the standardized \nimmunization for Td.  Sites should also include the immunizations that\nwere used for Td vaccines.\n \nReminder Term, "VA-TD DEFERRALS" should include any Health Factors that \nhave been in use at a VAMC to indicate the following items:\n  Td Immunication Refusal\n  Acute Febrile Illness\nA Td Vaccine is recommended every 10 years.  \nAny finding in this reminder term will resolve the reminder for \npredetermined amount of time.\n \nReminder Term, "VA-TETANUS/DIPHTHERIA CONTRAINDICATION" contains \ncomputed findings looking for allergies to Tetanus or Diphtheria that \nhave been documented in the Allergy/Adverse Drug Reaction package.  If \nfound, the reminder will not apply - AND NOT Cohort Logic.  Health \nFactors in use locally to document allergy to Td should also be included \nin the reminder term.\n \n \nReminder Term, "VA-TETANUS/DIPHTHERIA ORDERS" should contain any orders \nfor the Td vaccine.  Sites should map any orders that are used for the Td \nimmunization.  The reminder will be resolved for 28 days by the order for \nTd vaccine.\n \nCOHORT:\n-Due for patient that have had the Tdap Immunization\n-Not applicable for patients with a Td Contraindication\n \nRESOLUTION:\nThis reminder is applicable only if a prior Tdap has been administered.  \n-Td immunization\n-Td Deferrals\n-Td Order\nThis prevents both the Tdap reminder and this reminder from displaying at\nthe same time in the same patient's record.\n \nReminder Term, "VA-TDAP IMMUNIZATION" includes the \nstandardized immunization for Tdap.  Sites should also include any \n
\n
\n", "
(SEX)&(AGE)&FI(1)&'FI(2)
\n", "
(SEX)&(AGE)&FI(1)&'FI(2)
\n", "
4
\n", "
SEX;AGE;1;2
\n", "
FI(3)!FI(4)!FI(6)
\n", "
FI(3)!FI(4)!FI(6)
\n", "
3
\n", "
3;4;6
\n", "", "", "", "", "", "", "", "", "
\n
\n\n
\n", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-TETANUS/DIPHTHERIA/PERTUSSIS (TDAP) IMMUNIZATION", "
Tdap Immunization
\n", "
6M
\n", "", "", "", "", "", "", "
NATIONAL
\n", "
NATIONAL CENTER FOR HEALTH PROMOTION AND DISEASE PREVENTION (NCP)
\n", "", "
CR
\n", "
\n
\n\n
\n", "
\nA single dose of Tdap (Tetanus Toxoid, Reduced Diphtheria Toxoid and \n  A history of encephalopathy (e.g., coma or prolonged seizures) \n  not attributable to an identifiable cause within 7 days of\n  administration of a vaccine with pertussis components. This\n  contraindication is for the pertussis components, and these persons\n  should receive Td instead of Tdap.\n \nPREGNANT/BREASTFEEDING WOMEN:\n  Women's health care providers should implement a Tdap \n  vaccination program for pregnant women. Health care providers should \n  administer Tdap during each pregnancy, preferably during the third \nAcellular Pertussis vaccine) should be given regardless of when the last \n  trimester (between 27-36 weeks gestation), although Tdap may be given at\n  any time during pregnancy. If Tdap is not administered during pregnancy,\n  Tdap should be administered immediately postpartum.\n  The rationale for repeat vaccination during each pregnancy is \n  that reported cases of pertussis continue to increase, uptake of Tdap \n  vaccine among pregnant women remains low and new data indicate that \n  maternal anti-pertussis antibodies are short-lived, thus Tdap\n  vaccination in one pregnancy will not provide high levels of antibodies\n  to protect newborns during subsequent pregnancies. The rationale for\n  administration during the third trimester (between 27-36 weeks\nTetanus containing product was received in adults who have not previously \n  gestation) is that this would provide the highest concentration of\n  maternal antibodies to be transferred closer to birth, but also allow\n  for the 2 weeks (before birth) required to mount a maximal immune\n  response to the vaccine antigens.\nreceived Tdap.  In addition, pregnant women should receive an additional \ndose during each pregnancy.\n \nTdaP Contraindications:\n  A history of serious allergic reaction (i.e., anaphylaxis) to any \n  component of the vaccine.\n
\n
\n", "
\n
\n\n
\n", "", "
\n**Since Tdap was NOT available before 2005 and was NOT given at this \nhave been in use at a VAMC to indicate the following items:\n  Tdap Immunization Refusal\n  Acute Febrile Illness\nAny finding in this Reminder Term will resolve the reminder for\npredetermined amount of time.  \n \nThe Reminder Term, "VA-TDAP CONTRAINDICATION", contains \nComputed Findings looking for allergies to TETANUS, DIPHTHERIA or \nPERTUSSIS that have been documented in the Allergy/Adverse Drug Reaction\npackage. If found, the reminder will not apply - AND NOT Cohort Logic.\nfacility prior to 2006, any record of Tdap prior to these dates will be \nHealth Factors in use locally to document allergy to Td should also be\nincluded in this Reminder Term.\n   \nReminder Term, "VA-TDAP ORDER" should contain any orders for the Tdap \nvaccine.  Sites should map any orders that are used for the Tdap \nvaccine.  The reminder will be resolved for 28 days by the order for TdaP\nvaccine.  \n   \nCOHORT:\n-Not applicable for patients with a Tdap Contraindication\nignored and assumed to be an incorrect entry.\n \nRESOLUTION:\n-Tdap Immunization\n-Tdap Deferrals\n-Tdap Orders\n \nReminder Term, "VA-TDAP IMMUNIZATION" includes the standardized\nimmunization for Tdap.  Sites should also include any locally \ncreated immunizations that were used for Tdap vaccines.\n \nReminder Term "VA-TDAP DEFERRALS" should include any Health Factors that\n
\n
\n", "
(SEX)&(AGE)&'FI(2)
\n", "
(SEX)&(AGE)&'FI(2)
\n", "
3
\n", "
SEX;AGE;2
\n", "
FI(1)!FI(3)!FI(4)
\n", "
FI(1)!FI(3)!FI(4)
\n", "
3
\n", "
1;3;4
\n", "", "", "", "", "", "", "", "", "
\n
\n\n
\n", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-OEF/OIF MONITOR REPORTING", "
OEF/OIF POST-DEPLOYMENT REPORT
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
OFFICE OF PUBLIC HEALTH AND ENVIRONMENTAL HAZARDS
\n", "", "
R
\n", "
\n
\n\n
\n", "
\nCOHORT: veterans with separation date after 9/11/01, who served in \nSERVICE) then\n \nall the other items are required to resolve the reminder\nand must be completed after the date of the most recent service\nseparation or within 120 days of the most recent service separation date:\n  a) screen for PTSD,\n  b) screen for depression,\n  c) screen for alcohol use,\n  d) all 3 screening questions related to infectious diseases.\n \nOEF/OIF  or whose service is not known and who have had 2 visits to a\nRefusals are valid for one year for alcohol, PTSD and depression.  Since \nthese are yearly screens, these should be addressed at least on a yearly \nbasis using the individual reminders for these screens.  Refusals entered \nprior to service separation are ignored by this reminder.\nNEXUS clinic after the most recent service separation date and at least \none visit in the past 1 year.\n \nPatients with an entry of NO IRAQ/AFGHAN SERVICE are excluded from the \ncohort.\n \nRESOLUTION: If the veteran served in Iraq or Afghanistan (IRAQ/AFGHAN\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "
FI(2)&FI(5)&'FF(1)&FF(23)&(FF(24)!FF(25))&'FI(21)
\n", "
FI(2)&FI(5)&'FF(1)&FF(23)&(FF(24)!FF(25))&'FI(21)
\n", "
7
\n", "
2;5;FF1;FF23;FF24;FF25;21
\n", "
(FF(2)&(FI(16)!FI(7)!(FI(12)&FI(13)&FI(14)&FI(15))))&(FF(3)&(FI(4)!FI(18)))&(FF(4)&(FI(6)!FI(17)))&((FI(20)&FF(5))!(FF(5)&FI(10)&FF(6)&FI(8)&FF(7)&FI(11)))!(FI(22)&FF(10))
\n", "
(FF(2)&(FI(16)!FI(7)!(FI(12)&FI(13)&FI(14)&FI(15))))&(FF(3)&(FI(4)!FI(18)))&(FF(4)&(FI(6)!FI(17)))&((FI(20)&FF(5))!(FF(5)&FI(10)&FF(6)&FI(8)&FF(7)&FI(11)))!(FI(22)&FF(10))
\n", "
23
\n", "
FF2;16;7;12;13;14;15;FF3;4;18;FF4;6;17;20;FF5;FF5;10;FF6;8;FF7;11;22;FF10
\n", "", "", "
4
\n", "
1;3;23;FF9
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-TBI/POLYTRAUMA REHAB/REINTEGRATION PLAN OF CARE", "
TBI/POLYTRAUMA PLAN OF CARE
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
OFFICE OF REHABILITATION SERVICES IN VACO
\n", "", "
C
\n", "
\n
\n\n
\n", "", "", "", "", "", "
(SEX)&(AGE)
\n", "
2
\n", "
SEX;AGE
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-CV ELIG W/HF FOR NO SERVICE", "
CV ELIGIBLE - PT INDICATES NO SVC
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
OFFICE OF PATIENT CARE SERVICES
\n", "", "
R
\n", "
\n
\n\n
\n", "
\nThis reminder is designed to aid sites in identifying patients whose \ncombat veteran eligibility data and data collected from the OEF/OIF \nScreening reminder are not in agreement.\n \nThis reminder is due for patients who CV status is eligible or expired, \nwhose LSSD is >9/11/01 but who have an entry of NO IRAQ/AFGHAN SERVICE.\n \nThe date last done represents that date that the health factor for no \nOEF/OIF service was entered.\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "", "
(SEX)&(AGE)&FI(2)&FI(3)&FI(4)&FF(1)
\n", "
6
\n", "
SEX;AGE;2;3;4;FF1
\n", "", "
(0)!FI(2)
\n", "
1
\n", "
2
\n", "", "", "
1
\n", "
1
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-CV INELG W/HF FOR SERVICE", "
CV INELIGIBLE - PT INDICATES SVC
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
OFFICE OF PUBLIC HEALTH AND ENVIRONMENTAL HAZARDS
\n", "", "
R
\n", "
\n
\n\n
\n", "
\nThis reminder is designed to aid sites in identifying patients whose\ncombat veteran eligibility data and data collected from the OEF/OIF\nScreening reminder are not in agreement.\n \nThis reminder is due for patients who CV status is not eligible,\nwhose LSSD is >9/11/01 but who have an entry of IRAQ/AFGHAN SERVICE.\n \nThe date last done represents that date that the health factor for OEF/OIF\nservice was entered.\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "", "
(SEX)&(AGE)&FI(1)&'FI(3)&FI(4)&FF(1)
\n", "
6
\n", "
SEX;AGE;1;3;4;FF1
\n", "", "
(0)!FI(1)
\n", "
1
\n", "
1
\n", "", "", "
1
\n", "
2
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["PATCH 11 LOCATION LIST", "
PATCH 11 LOCATION LIST
\n", "", "", "", "", "", "", "", "
LOCAL
\n", "", "", "
R
\n", "
\n
\n\n
\n", "", "
\n
\n\n
\n", "", "", "", "
(SEX)&(AGE)
\n", "
2
\n", "
SEX;AGE
\n", "", "", "", "", "", "", "
1
\n", "
1
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-OB TD/TDAP PRIOR VACCINATIONS", "
Recorded Td/Tdap Vaccinations
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
NATIONAL CENTER FOR HEALTH PROMOTION AND DISEASE PREVENTION (NCP)
\n", "", "
R
\n", "
\n
\n\n
\n", "
\nTo be used only as a HS object\nCreated 9/23/14-Dawn O'Connor\n
\n
\n", "
\n
\n\n
\n", "", "", "", "
(SEX)&(AGE)
\n", "
2
\n", "
SEX;AGE
\n", "", "", "", "", "", "", "
1
\n", "
1
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-EBOLA RISK TRIAGE OBJECT LAST RATING", "
Ebola Risk Triage (last)
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
OFFICE OF PUBLIC HEALTH
\n", "", "
R
\n", "
\n
\n\n
\n", "
\nUsed for the data object for 'last rating'\n
\n
\n", "
\n
\n\n
\n", "", "", "
FI(1)&FI(2)&FI(3)&FI(4)&FI(5)&FI(6)&FI(7)&FI(8)&FI(9)
\n", "
FI(1)&FI(2)&FI(3)&FI(4)&FI(5)&FI(6)&FI(7)&FI(8)&FI(9)
\n", "
9
\n", "
1;2;3;4;5;6;7;8;9
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "
\nNo 'Ebola Risk Triage' data found\n
\n
\n", "
0
\n", "
1
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-BL MULTIPLE SSD AND MST YES", "
BL Multiple SSD and MST yes
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "", "", "
R
\n", "
\n
\n\n
\n", "", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "
FI(2)&FF(1)&FF(2)
\n", "
FI(2)&FF(1)&FF(2)
\n", "
3
\n", "
2;FF1;FF2
\n", "", "", "", "", "", "", "
1
\n", "
1
\n", "", "", "", "", "", "", "
\nPatient has more than 1 Service Separation date AND the date of HF.MST \nYES REPORTS is less than the date of most recent Service Separation.\n
\n
\n", "", "
2
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-NATIONAL EPI RX EXTRACT", "
National Hepatitis Med Extract
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nThis reminder is used to identify and extract pharmacy data to send to the\nThe reminder will extract medication data for patients who have any of the\nfindings listed in the patient cohort logic.  There are 8 reminder terms\nfor medications in the patient cohort logic. If a patient has one of the\nmedications in the last 45 days, then the reminder applies to\nthe patient.\n \nWhat resolves this reminder?\nThis reminder does not have any resolution findings so it will always be\ndue.  This allows sites to use the reminder to report on patients who\nhave medication data updating the EPI national database. \nnational EPI database.  This reminder is not for daily clinical care.  It\n \n-----------------------------------------------------------------\nHepatitis Medications:\n \nAll patients receiving one of the medications below will have medication\ninformation sent to the EPI DB. The pharmacy release date is used to\ndetermine if the patient received the medication. The reminder terms are\ndefined to look for medications that were active in the last 45 days.\nThis allows extracts run on the 15th of the month to have medication\ninformation for the prior month.  The reminder terms are distributed with\nis used by an EPI patch, LR*5.2*260, to identify inpatient and outpatient\nmapping to VA GENERIC file #50.6 (aka: national drug file).  If any of\nyour dispensed drugs are not mapped to the national drug file entries,\nyou may either map the dispensed drug to the national drug file or add the\ndispensed drug to the findings for the reminder term.\n \nData collected for Hepatitis treatment is based on the following national\nreminder terms (source of terms is VA GENERIC file):\n   INTERFERON ALFA-2A\n   INTERFERON ALFA-2B\n   INTERFERON ALFA-2B/RIBAVIRIN \nmedications given to patients within a specified date range. The data is \n   INTERFERON ALFA-3N\n   INTERFERON ALFACON-1\n   INTERFERON BETA-1A\n   INTERFERON BETA-1B\n   RIBAVIRIN\n \nBackground:\nOne of the goals of the Healthy People 2000 and 2010 initiatives of the\nDepartment of Health and Human Services is to decrease certain infectious\ndiseases, especially those that are vaccine preventable. Both acute and\nsent to the Austin Automation Center EPI national database. Sites may use\nchronic diseases have significant morbidity and can contribute to\nmortality.  Further, infection with Hepatitis can complicate the medical\ncourse of people with other liver ailments.  As such, surveillance for\nboth acute and chronic diseases is important. \nthis reminder in the reminder reports to get a list of patients with data\nthat the EPI is interested in.\n \nWhat determines whether this reminder applies to a patient? \n
\n
\n", "
\n
\n\n
\n", "", "", "", "
(SEX)&(AGE)!FI(5)!FI(6)!FI(7)!FI(8)!FI(9)!FI(10)!FI(11)!FI(12)
\n", "
10
\n", "
SEX;AGE;5;6;7;8;9;10;11;12
\n", "", "", "
0
\n", "", "
0
\n", "", "
0
\n", "", "", "", "", "", "", "", "
\nThis patient has Hepatitis medication data that will be rolled up to the\nnational EPI data base.\n
\n
\n", "
\nThis patient has no Hepatitis medication data to send to the national EPI\ndata base.\n
\n
\n", "
2
\n", "
2
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-*IHD 412 ELEVATED LDL REPORTING", "
IHD 412 Elevated LDL Reporting
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
OFFICE OF QUALITY & PERFORMANCE
\n", "", "
RX
\n", "
\n
\n\n
\n", "
\nCompliance reporting measures the management of IHD patients with an \n \nThis national IHD 412 Elevated LDL Reporting reminder is used monthly\nto roll up compliance totals for management of a subgroup of IHD \npatients with a 412.nn diagnosis, whose most recent LDL is greater than or\nequal to 120mg/dl.\n \nThis national reminder identifies IHD patients with a documented ICD-9\ncode 412.nn in the last 5 years, who have had a serum lipid panel within\nthe last two years, where the most recent LDL lab test (or documented\noutside LDL) is greater than or equal to 120 mg/dl.\nICD-9 412.nn diagnosis, whose most recent LDL is greater than or equal\n \nIf a more recent record of an UNCONFIRMED IHD DIAGNOSIS is found, the \nreminder will not be applicable to the patient.\nto 120mg/dl as defined by the VA External Peer Review Program (EPRP)\nperformance measure and the maximum guideline recommended below:\n \n   The VHA/DOD Clinical Practice Guideline for Management of Dyslipidemia \n   recommends an LDL goal of <120 mg/dl for patients with Ischemic Heart \n   Disease; and the NCEP Adult Treatment Panel II recommends a more\n   stringent goal of <100 mg/dl.\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "
\nThis reminder is not for use in CPRS, hence there is no related reminder \n                No mapping necessary.  Use the VA-IHD 412\n            most recent visit between the tied facilities.\n         \n    Reporting roll up will send totals for this reminder and facility \n    for: \n      1) Reminder totals based on reminder evaluation:\n         applicable, not applicable, due, not due totals\n          \n    CPRS vs. Reporting usage reminder: This VA-*IHD 412 ELEVATED LDL \n    REPORTING reminder does not include orders placed, refused, or\n    other defer activities which clinicians use in CPRS to manage the\n                reminder taxonomy distributed with this term.  \n    VA-IHD ELEVATED LDL reminder.  This Reporting reminder is restricted\n    to Lab results and Pharmacy medications found during the reminder\n    evaluation for each patient in the denominator patient list.\n         \n   UNCONFIRMED IHD DIAGNOSIS \n                Use the UNCONFIRMED IHD DIAGNOSIS health factor \n                distributed with this term or add any local health \n                factor representing an unconfirmed or incorrect IHD \n                diagnosis.  \n         \n   LDL          Enter the Laboratory Test names from the Lab Package \ndialog.  \n                for calculated LDL and direct LDL with "I +V>0" in\n                the CONDITION field.\n                The Lab tests defined in this term will also be used to \n                update the following reminder terms' findings with the\n                appropriate CONDITION: \n                     LDL <100 \n                     LDL 100-119 \n                     LDL 120-129 \n                     LDL >129 \n     \n         \n    For the following OUTSIDE LDL Reminder Terms, use the health factors \n    distributed with the reminder term or enter the local Health Factor \n    used to represent these values.  \n          OUTSIDE LDL <100 \n          OUTSIDE LDL 100-119 \n          OUTSIDE LDL 120-129 \n          OUTSIDE LDL >129 \n     \n National Roll-up: \n    This national reminder is used by the VA-IHD QUERI Extract run\nSetup issues before using this reminder: \n    monthly to roll up compliance totals for LDL laboratory tests\n    completed within the past 2 years, where the most recent LDL result\n    is greater than or equal to 120 as of the end of the reporting \n    period.\n \n    The patients evaluated for compliance are based on VA EPRP\n    performance measure reporting criteria. The performance measure     \n    reporting criteria are used to create patient lists.  The patient \n    lists created for this reminder for each reporting period are\n    found in the Reminder Patient List file with the following naming\n         \n    convention:\n       VA-*IHD QUERI yyyy Mnn IHD 412 PTS WITH QUALIFY AND ANCHOR VISIT,\n       where yyyy is the calendar year, and nn is the month.\n     \n    The patient lists are based on the VA-*IHD 412 QUERI PTS WITH \n    QUALIFY AND ANCHOR VISIT Extract Finding Rule Set.  The rule set \n    will find IHD 412.nn patients of record within 5 years prior to the\n    beginning of the monthly reporting period who had a qualifying \n    clinic visit and an earlier (anchor) visit 13-24 months prior to the\n    reporting period. \n1. Use the Reminder Term options to map local representations of \n \n    Rules for building the patient list for the reporting patient  \n    denominator used with this reminder are: \n      Rule 1: IHD patients with ICD-9 code 412.nn \n         Start with Patients with an ICD-9 412.nn diagnosis documented \n         within 5 years prior to the beginning of the reporting period.\n      Rule 2: Qualifying Visit \n         Find the subset of patients, from rule 1, who have a Qualifying \n         Visit during the one-month reporting period.  \n         Qualifying Clinic Codes include: \n   findings: \n           Primary Care: 301 (General Internal Medicine), 322 (Women),  \n                         323 (Primary Care/Medicine), 350 (Geriatric),\n                         531 and 563 (Mental Health Primary Care) \n           Specialty Care: 303 (Cardiology), 305 (Endocrinology/ \n                        Metabolism), 306 (Diabetes), 309 (Hypertension),\n                        312 (Pulmonary/Chest)\n           Include patients that had a Qualifying Visit during the \n           reporting period and subsequently died before or after the\n           end of the reporting period.\n      Rule 3:  Exclude patients from the patient subset resulting \n         \n         from Rule 2 that have a primary discharge diagnosis of 410.nn\n         within 60 days prior to the Qualifying Visit.\n      Rule 4: Anchor Visit \n         Find the subset of patients, after rule 3, with an Anchor \n         Visit 13-24 months prior to the beginning of the reporting \n         period. Use the same clinic codes used for the Qualifying Visit\n         in Rule 2.\n      Rule 5:  Associated facility \n         The subset of patients resulting from the rules above are \n         assigned an associated facility that is used to accumulate\n   IHD 412 DIAGNOSIS \n         national counts.\n         The Associated Facility for each patient is based on the\n         following criteria:\n         1) Use the primary care facility assigned to the patient \n         2) If more than one primary care facility is assigned or no\n            primary care facility is assigned, then find which facility\n            has the most visits on the local VistA system in the last two \n            years. \n         3) If the count of the number of visits is the same for \n            multiple facilities, use the facility that has the \n
\n
\n", "
FI(1)&FF(2)
\n", "
FI(1)&FF(2)
\n", "
2
\n", "
1;FF2
\n", "
(FI(3)!FI(4)!FI(5)!FI(6)!FI(7)!FI(8)!FI(9)!FI(10))&FF(1)
\n", "
(FI(3)!FI(4)!FI(5)!FI(6)!FI(7)!FI(8)!FI(9)!FI(10))&FF(1)
\n", "
9
\n", "
3;4;5;6;7;8;9;10;FF1
\n", "", "", "
1
\n", "
11
\n", "", "", "", "", "
\n
\n\n
\n", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-*IHD 412 LIPID PROFILE REPORTING", "
IHD 412 Lipid Profile Reporting
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
OFFICE OF QUALITY & PERFORMANCE
\n", "", "
RX
\n", "
\n
\n\n
\n", "
\nCompliance reporting measures the LDL completed within 2 years as defined \nto roll up LDL compliance totals for a subgroup of IHD patients. This\nreminder identifies IHD patients with a documented ICD-9 code 412.nn\nin the last five years who have not had a serum lipid panel/LDL \n(calculated or direct lab package LDL or documented outside LDL)\nwithin the last two years. If a more recent record of an UNCONFIRMED IHD\nDIAGNOSIS is found, the reminder will not be applicable to the patient.\nby the VA External Peer Review Program (EPRP) performance measure and the \nmaximum guideline recommended below:\n  The VHA/DOD Clinical Practice Guideline for Management of Dyslipidemia \n  recommends that patients with Ischemic Heart Disease have a lipid \n  profile/LDL every one to two years; and that patients taking lipid \n  lowering medications have a lipid profile/LDL at least every year.\n \nThis national IHD 412 Lipid Profile Reporting reminder is used monthly\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "
\nThis reminder is not for use in CPRS, hence there is no related reminder \n                No mapping necessary.  Use the VA-ISCHEMIC HEART 412 \n     The Associated Facility for each patient is based on the following\n     criteria:\n     1) Use the primary care facility assigned to the patient \n     2) If more than one primary care facility is assigned or no\n        primary care facility is assigned, then find which facility has\n        the most visits on the local VistA system in the last two years.  \n     3) If the count of the number of visits is the same for multiple  \n        facilities, use the facility associated with the most recent \n        visit between the tied facilities.\n \n                DISEASE reminder taxonomy distributed with this term.\nReporting roll up will send totals for this reminder and facility for: \n  1) Reminder totals based on reminder evaluation:\n     applicable, not applicable, due, not due totals\n  2) Finding totals for most recent counts from the group of LDL\n     findings, based on Lab or Outside LDL findings:\n         LDL <100 \n         LDL 100-119 \n         LDL 120-129 \n         LDL >129 \n         OUTSIDE LDL <100 \n     \n         OUTSIDE LDL 100-119 \n         OUTSIDE LDL 120-129 \n         OUTSIDE LDL >129 \n     The finding totals are based on reminder evaluation findings for \n     applicable patients using the reminder definition.\n  3) Finding totals for most recent counts from the group of IHD \n     412 Diagnosis and Unconfirmed IHD Diagnosis findings.\n         IHD 412 DIAGNOSIS\n         UNCONFIRMED IHD DIAGNOSIS   \n  4) Finding totals for most recent count of patients who have active\n    UNCONFIRMED IHD DIAGNOSIS \n     Lipid Lowering Agents within the reporting period.\n \nCPRS vs. Reporting reminders: This VA-*IHD 412 LIPID PROFILE REPORTING\nreminder does not include orders placed, refused, or other defer\nactivities which clinicians use in CPRS for Lipid Profile management. \nThis Reporting reminder is restricted to Lab results and Pharmacy\nmedications found during the reminder evaluation for each patient in\nthe denominator patient list.\n                Use the UNCONFIRMED IHD DIAGNOSIS health factor \n                distributed with this term or add any local health \n                factor representing an unconfirmed or incorrect IHD \n                diagnosis.  \n     \n   LDL          Enter the Laboratory Test names from the Lab Package \ndialog.  \n                for calculated LDL and direct LDL with "I +V>0" in the \n                CONDITION field. The Lab tests defined in this term\n                will also be used to update the following reminder \n                terms' findings:\n                     LDL <100 \n                     LDL 100-119 \n                     LDL 120-129 \n                     LDL >129 \n \n   For the following OUTSIDE LDL Reminder Terms, use the health factors \n     \n   distributed with the reminder term or enter the local Health Factor \n   used to represent these values.  \n         OUTSIDE LDL <100 \n         OUTSIDE LDL 100-119 \n         OUTSIDE LDL 120-129 \n         OUTSIDE LDL >129 \n \n   LIPID LOWERING MEDS \n                Enter the formulary drug names for investigation drugs.  \n                Mapping non-investigative formulary drugs to the \nSetup issues before using this reminder: \n                VA-GENERIC drugs will ensure the lipid lowering \n                medications are found. The medications are informational \n                findings for this reminder.  \n     \n \nNational Roll-up: \nThe national reporting criteria for VA-IHD QUERI are defined in the\nReminder Extract Parameter file.\n \nThis national reminder is used by the VA-IHD QUERI Extract run monthly\n     \nto roll up compliance totals for LDL laboratory tests completed within \nthe past 2 years. The patients evaluated for compliance are based on VA\nEPRP performance measure reporting criteria. The performance measure\nreporting criteria are used to create patient lists.  The patient \nlists used with this reminder are found in the Reminder Patient List \nfile with the following naming conventions:\n   VA-*IHD QUERI yyyy Mnn 412 PTS WITH QUALIFY AND ANCHOR VISIT\n   VA-*IHD QUERI yyyy Mnn 412 PTS WITH QUALIFY AND ANCHOR VISIT ON\n       LLA MEDS\n   where yyyy is the calendar year, and nn is the month.\n 1. Use the Reminder Term options to map local representations of \n \nThe patient lists are based on two different Extract Finding Rule Sets:\n   VA-*IHD QUERI 412 PTS WITH QUALIFY AND ANCHOR VISIT\n   VA-*IHD QUERI 412 PTS WITH QUALIFY AND ANCHOR VISIT ON LLA MEDS\nThe rule sets will find IHD patients of record within 5 years prior to\nthe beginning of the monthly reporting period who had a qualifying\nclinic visit and an earlier (anchor) visit 13-24 months prior to the\nreporting period.  The patient list with ON LLA MEDS finds those patients \nwho have had a supply of Lipid Lowering Agent Medications in VistA during \nthe reporting period.\n    findings: \n \nRules for building the patient list for the reporting patient \ndenominator are:\n \n  Rule 1: IHD patients with ICD-9 code 412\n     Start with Patients with an ICD-9 412.nn diagnosis documented \n     within 5 years prior to the beginning of the reporting period.\n  Rule 2: Qualifying Visit\n     Find the subset of patients, from rule 1, who have a Qualifying \n     Visit during the one-month reporting period.  \n     \n     Qualifying Clinic Codes include: \n       Primary Care: 301 (General Internal Medicine), 322 (Women), 323  \n                     (Primary Care/Medicine), 350 (Geriatric), 531 and \n                     563 (Mental Health Primary Care)\n       Specialty Care: 303 (Cardiology), 305 (Endocrinology/ Metabolism), \n                    306 (Diabetes), 309 (Hypertension), 312 \n                    (Pulmonary/Chest)\n       Include patients that had a Qualifying Visit during the \n       reporting period and subsequently died before or after the \n       reporting period.\n   IHD 412 DIAGNOSIS \n  Rule 3:  Exclude patients from the patient subset resulting from  \n     Rule 2 that have a primary discharge diagnosis of 410.nn within \n     60 days of the Qualifying Visit.\n  Rule 4: Anchor Visit \n     Find the subset of patients, after rule 3, with an Anchor \n     Visit 13-24 months prior to the beginning of the reporting period\n     Use the same clinic codes used for the Qualifying Visit in Rule 2. \n  Rule 5:  Associated facility \n     The subset of patients resulting from the rules above are assigned \n     an associated facility that is used to accumulate national counts.\n
\n
\n", "
FI(1)&FF(1)
\n", "
FI(1)&FF(1)
\n", "
2
\n", "
1;FF1
\n", "", "
(0)!FI(2)!FI(3)!FI(4)!FI(5)!FI(6)
\n", "
5
\n", "
2;3;4;5;6
\n", "", "", "
6
\n", "
10;12;13;14;15;16
\n", "", "", "", "", "
\n
\n\n
\n", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-*IHD ELEVATED LDL REPORTING", "
IHD Elevated LDL Reporting
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
OFFICE OF QUALITY & PERFORMANCE
\n", "", "
RX
\n", "
\n
\n\n
\n", "
\nCompliance reporting measures the management of IHD patients whose most \n \nThis national IHD Elevated LDL Reporting reminder is used monthly to\nroll up compliance totals for management of IHD patients whose most \nrecent LDL is greater than or equal to 120mg/dl.\n \nThis national reminder identifies patients with known IHD (i.e., a \ndocumented ICD-9 code for IHD in the last five years) who have had a \nserum lipid panel within the last two years, where the most recent LDL \nlab test (or documented outside LDL) is greater than or equal to 120\nmg/dl. If a more recent record of an UNCONFIRMED IHD DIAGNOSIS is found,\nrecent LDL is greater than or equal t0 120mg/dl as defined by the VA\nthe reminder will not be applicable to the patient.\nExternal Peer Review Program (EPRP) performance measure and the maximum\nguideline recommended below:\n \n   The VHA/DOD Clinical Practice Guideline for Management of Dyslipidemia \n   recommends an LDL goal of <120 mg/dl for patients with Ischemic Heart \n   Disease; and the NCEP Adult Treatment Panel II recommends a more\n   stringent goal of <100 mg/dl.\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "
\nThis reminder is not for use in CPRS, hence there is no related reminder \n                No mapping necessary.  Use the VA-ISCHEMIC HEART DISEASE \nReporting roll up will send totals for this reminder and facility for: \n  1) Reminder totals based on reminder evaluation:\n     applicable, not applicable, due, not due totals\n      \nCPRS vs. Reporting reminders: This VA-*IHD ELEVATED LDL REPORTING\nreminder does not include orders placed, refused, or other defer\nactivities which clinicians use in CPRS to manage the VA-IHD ELEVATED \nLDL clinical reminder. This Reporting reminder is restricted to Lab\nresults found during the reminder evaluation for each patient in the\ndenominator patient list.\n                reminder taxonomy distributed with this term.  \n         \n   UNCONFIRMED IHD DIAGNOSIS \n                Use the UNCONFIRMED IHD DIAGNOSIS health factor \n                distributed with this term or add any local health \n                factor representing an unconfirmed or incorrect IHD \n                diagnosis.  \n         \n   LDL          Enter the Laboratory Test names from the Lab Package \ndialog.  \n                for calculated LDL and direct LDL with "I +V>0" in the\n                CONDITION field.\n                The Lab tests defined in this term will also be used \n                to update the following reminder terms' findings with \n                appropriate CONDITION values:\n \n                     LDL <100 \n                     LDL 100-119 \n                     LDL 120-129 \n                     LDL >129 \n         \n     \n    For the following OUTSIDE LDL Reminder Terms, use the health factors \n    distributed with the reminder term or enter the local Health Factor \n    used to represent these values.  \n          OUTSIDE LDL <100 \n          OUTSIDE LDL 100-119 \n          OUTSIDE LDL 120-129 \n          OUTSIDE LDL >129 \n     \nNational Roll-up: \nSetup issues before using this reminder: \nThe national reporting criteria for VA-IHD QUERI are defined in the\nReminder Extract Parameter.\n \nThis national reminder is used by the VA-IHD QUERI Extract run monthly\nto roll up compliance totals for LDL laboratory tests completed within \nthe past 2 years, where the most recent LDL result is greater than or\nequal to 120 as of the end of the reporting period. The patients \nevaluated for compliance are based on VA EPRP performance measure\nreporting criteria. The performance measure reporting criteria are used\nto create patient lists.  The patient lists used with this reminder are\n         \nfound in the Reminder Patient List file with the following naming\nconvention:\n   VA-*IHD QUERI yyyy Mnn PTS WITH QUALIFY AND ANCHOR VISIT\n   where yyyy is the calendar year, and nn is the month.\n \nThe patient lists are based on the VA-*IHD QUERI PTS WITH QUALIFY\nAND ANCHOR VISIT Extract Finding Rule Set. The rule set will find\nIHD patients of record within 5 years prior to the beginning of the\nmonthly reporting period who had a qualifying clinic visit and an\nearlier (anchor) visit 13-24 months prior to the reporting period.\n1. Use the Reminder Term options to map local representations of \n \nRules for building the patient list for the reporting patient\ndenominator are: \n  Rule 1: IHD Patients\n     Start with Patients with an IHD 410.nn, 411.nn, 412.nn, or 414.nn\n     diagnosis documented within 5 years prior to the beginning of the\n     reporting period.\n  Rule 2: Qualifying Visit\n     Find the subset of patients, from rule 1, who have a Qualifying \n     Visit during the one-month reporting period.  \n   findings: \n     Qualifying Clinic Codes include: \n       Primary Care: 301 (General Internal Medicine), 322 (Women), 323  \n                     (Primary Care/Medicine), 350 (Geriatric), 531 and \n                     563 (Mental Health Primary Care)\n       Specialty Care: 303 (Cardiology), 305 (Endocrinology/ Metabolism), \n                    306 (Diabetes), 309 (Hypertension), 312 \n                    (Pulmonary/Chest)\n       Include patients that had a Qualifying Visit during the reporting\n       period and subsequently died before the end of the reporting\n       period. \n         \n  Rule 3:  Exclude patients from the patient subset resulting from  \n     Rule 2 that have a primary discharge diagnosis of 410.nn within 60\n     days prior to the Qualifying Visit.\n  Rule 4: Anchor Visit \n     Find the subset of patients, after rule 3, with an Anchor \n     Visit 13-24 months prior to the beginning of the reporting period. \n     Use the same clinic codes used for the Qualifying Visit in Rule 2.\n  Rule 5:  Associated Facility \n     The subset of patients resulting from the rules above are assigned \n     an associated facility that is used to accumulate national counts.\n   IHD DIAGNOSIS \n     The Associated Facility for each patient is based on the following\n     criteria:\n     1) Use the primary care facility assigned to the patient \n     2) If more than one primary care facility is assigned or no\n        primary care facility is assigned, then find which facility has\n        the most visits on the local VistA system in the last two years.  \n     3) If the count of the number of visits is the same for multiple  \n        facilities, use the facility associated with the most recent \n        visit between the tied facilities.\n \n
\n
\n", "
FI(1)&FF(2)
\n", "
FI(1)&FF(2)
\n", "
2
\n", "
1;FF2
\n", "", "
(0)!FI(3)!FI(4)!'FI(5)!'FI(6)!'FI(7)!FI(8)!FI(14)!'FI(15)&FF(1)
\n", "
9
\n", "
3;4;5;6;7;8;14;15;FF1
\n", "", "", "
1
\n", "
13
\n", "", "", "", "", "
\n
\n\n
\n", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-*IHD LIPID PROFILE REPORTING", "
IHD Lipid Profile Reporting
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
OFFICE OF QUALITY & PERFORMANCE
\n", "", "
RX
\n", "
\n
\n\n
\n", "
\nCompliance reporting measures the LDL completed within 2 years as defined \nroll up LDL compliance totals for IHD patients. This reminder \nidentifies patients with known IHD (i.e., a documented ICD-9 code for \nIHD in the last five years) who have not had a serum lipid panel/LDL\n(calculated or direct lab package LDL) or documented outside LDL within\nthe last two years. If a more recent record of an UNCONFIRMED IHD\nDIAGNOSIS is found, the reminder will not be applicable to the patient.\nby the VA External Peer Review Program (EPRP) performance measure and the \nmaximum guideline recommended below:\n  The VHA/DOD Clinical Practice Guideline for Management of Dyslipidemia \n  recommends that patients with Ischemic Heart Disease have a lipid \n  profile/LDL every one to two years; and that patients taking lipid \n  lowering medications have a lipid profile/LDL at least every year.\n \nThis national IHD Lipid Profile Reporting reminder is used monthly to \n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "
\nThis reminder is not for use in CPRS, hence there is no related reminder \n                No mapping necessary.  Use the VA-ISCHEMIC HEART DISEASE \n  Rule 4: Anchor Visit \n     Find the subset of patients, after rule 3, with an Anchor \n     Visit 13-24 months prior to the beginning of the reporting period. \n     Use the same clinic codes used for the Qualifying Visit in Rule 2.\n  Rule 5:  Associated Facility \n     The subset of patients resulting from the rules above are assigned \n     an associated facility that is used to accumulate national counts.\n  \n     The Associated Facility for each patient is based on the following\n     criteria:\n                reminder taxonomy distributed with this term.  \n     1) Use the primary care facility assigned to the patient \n     2) If more than one primary care facility is assigned or no\n        primary care facility is assigned, then find which facility has\n        the most visits on the local VistA system in the last two years  \n     3) If the count of the number of visits is the same for multiple  \n        facilities, use the facility associated with the most recent \n        visit between the tied facilities.\n     \nReporting roll up will send totals for this reminder and facility for: \n  1) Reminder totals based on reminder evaluation:\n     \n     applicable, not applicable, due, not due totals\n  2) Finding totals for most recent counts from the group of LDL\n     findings, based on Lab or Outside LDL findings:\n         LDL <100 \n         LDL 100-119 \n         LDL 120-129 \n         LDL >129 \n         OUTSIDE LDL <100 \n         OUTSIDE LDL 100-119 \n         OUTSIDE LDL 120-129 \n    UNCONFIRMED IHD DIAGNOSIS \n         OUTSIDE LDL >129 \n     The finding totals are based on reminder evaluation findings for \n     applicable patients using the reminder definition.\n  3) Finding totals for most recent counts from the group of IHD Diagnosis\n     and Unconfirmed IHD Diagnosis findings.\n         IHD DIAGNOSIS\n         UNCONFIRMED IHD DIAGNOSIS   \n  4) Finding totals for most recent count of patients who have active\n     Lipid Lowering Agents within the reporting period.\n      \n                Use the UNCONFIRMED IHD DIAGNOSIS health factor \nCPRS vs. Reporting reminders: This VA-*IHD LIPID PROFILE REPORTING\nreminder does not include orders placed, refused, or other defer\nactivities which clinicians use in CPRS to manage the VA-IHD LIPID \nPROFILE clinical reminder. This Reporting reminder is restricted to Lab\nresults and Pharmacy medications found during the reminder evaluation \nfor each patient in the denominator patient list.\n                distributed with this term or add any local health \n                factor representing an unconfirmed or incorrect IHD \n                diagnosis.  \n     \n   LDL          Enter the Laboratory Test names from the Lab Package \ndialog.  \n                for calculated LDL and direct LDL with "I +V>0" in the\n                CONDITION field.\n \n                The Lab tests defined in this term will be used to update \n                the following reminder terms findings: \n                     LDL <100 \n                     LDL 100-119 \n                     LDL 120-129 \n                     LDL >129 \n \n     \n   For the following OUTSIDE LDL Reminder Terms, use the health factors \n   distributed with these reminder terms or add local health factors \n   or other findings to the appropriate reminder terms. The findings \n   should represent LDL values from a source outside the local facility.\n \n         OUTSIDE LDL <100 \n             Distributed with health factor OUTSIDE LDL <100\n         OUTSIDE LDL 100-119 \n             Distributed with health factor OUTSIDE LDL 100-119\n         OUTSIDE LDL 120-129\nSetup issues before using this reminder: \n             Distributed with health factor OUTSIDE LDL 120-129\n         OUTSIDE LDL >129\n             Distributed with health factor OUTSIDE LDL <129\n \n   LIPID LOWERING MEDS \n                Enter the formulary drug names for investigation drugs.  \n                Mapping non-investigative formulary drugs to the \n                VA-GENERIC drugs will ensure the lipid lowering \n                medications are found. The medications are informational \n                findings for this reminder.  \n     \n     \n     \nNational Roll-up: \nThe national reporting criteria for VA-IHD QUERI are defined in the\nReminder Extract Parameter file.\n \nThis national reminder is used by the VA-IHD QUERI Extract run monthly\nto roll up compliance totals for LDL laboratory tests completed within \nthe past 2 years. The patients evaluated for compliance are based on VA\nEPRP performance measure reporting criteria. The performance measure\n 1. Use the Reminder Term options to map local representations of \nreporting criteria are used to create patient lists.  The patient \nlists used with this reminder are found in the Reminder Patient List \nfile with the following naming conventions:\n   VA-*IHD QUERI yyyy Mnn PTS WITH QUALIFY AND ANCHOR VISIT\n   VA-*IHD QUERI yyyy Mnn PTS WITH QUALIFY AND ANCHOR VISIT ON LLA MEDS\n   where yyyy is the calendar year, and nn is the month.\n \nThe patient lists are based on two different Extract Finding Rule Sets:\n   VA-*IHD QUERI PTS WITH QUALIFY AND ANCHOR VISIT\n   VA-*IHD QUERI PTS WITH QUALIFY AND ANCHOR VISIT ON LLA MEDS\n    findings: \nThe rule sets will find IHD patients of record within 5 years prior to\nthe beginning of the monthly reporting period who had a qualifying\nclinic visit and an earlier (anchor) visit 13-24 months prior to the\nreporting period.  The patient list with ON LLA MEDS finds those patients \nwho have had a supply of Lipid Lowering Agent Medications in VistA during \nthe reporting period.\n \nRules for building the patient list for the reporting patient \ndenominator are:\n \n     \n  Rule 1: IHD Patients\n     Start with Patients with an IHD 410.nn, 411.nn, 412.nn, or \n     414.nn diagnosis documented within 5 years prior to the beginning of \n     the reporting period. \n  Rule 2: Qualifying Visit\n     Find the subset of patients, from rule 1, who have a Qualifying \n     Visit during the one-month reporting period.  \n     Qualifying Clinic Codes include: \n       Primary Care: 301 (General Internal Medicine), 322 (Women), 323  \n                     (Primary Care/Medicine), 350 (Geriatric), 531 and \n   IHD DIAGNOSIS \n                     563 (Mental Health Primary Care)\n       Specialty Care: 303 (Cardiology), 305 (Endocrinology/ Metabolism), \n                    306 (Diabetes), 309 (Hypertension), 312 \n                    (Pulmonary/Chest)\n       Include patients that had a Qualifying Visit during the reporting \n       period and subsequently died before or after the end of the\n       reporting period.\n  Rule 3:  Exclude patients from the patient subset resulting from  \n     Rule 2 that have a primary discharge diagnosis of 410.nn within 60\n     days prior to the Qualifying Visit.\n
\n
\n", "
FI(1)&FF(1)
\n", "
FI(1)&FF(1)
\n", "
2
\n", "
1;FF1
\n", "", "
(0)!FI(2)!FI(3)!FI(4)!FI(5)!FI(6)
\n", "
5
\n", "
2;3;4;5;6
\n", "", "", "
6
\n", "
10;12;13;14;15;16
\n", "", "", "", "", "
\n
\n\n
\n", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-HERPES ZOSTER (SHINGLES) IMMUNIZATION", "
Herpes Zoster (Shingles) Vaccine
\n", "
3M
\n", "", "", "", "", "", "", "
NATIONAL
\n", "
NATIONAL CENTER FOR HEALTH PROMOTION AND DISEASE PREVENTION (NCP)
\n", "", "
CR
\n", "
\n
\n\n
\n", "
\nHERPES ZOSTER (SHINGLES) IMMUNIZATION:\n- Persons with primary or acquired immunodeficiency including, leukemia,\nlymphomas, or other malignant neoplasms affecting the bone marrow or\nlymphatic system.\n- AIDS or other clinical manifestations of HIV.\n- Persons on immunosuppressive therapy, including high-dose \ncorticosteroids.\n- Persons receiving the recombinant human immune mediators and immune \nmodulators.\n- Persons undergoing hematopoietic stem cell transplantation (HSCT). \n- Pregnant or might be pregnant.\nA single dose of shingles vaccine is recommended for adults 60 years of\n \nPRECAUTIONS:\n- Persons who have severe acute illness should be postponed until \nrecovery.\n- Zoster should be deferred in patients with active, untreated\ntuberculosis.\nage and older who do not have contraindications to the vaccine. \n \nPersons with a history of zoster CAN be vaccinated.\n \nCONTRAINDICATIONS: \n- History of anaphylactic reaction to any component of the vaccine,\nincluding gelatin and neomycin.\n
\n
\n", "
\n
\n\n
\n", "", "
\nReminder is applicable to patients aged 60 and older. The Herpes Zoster \nlocal findings that meet the intent of this term should be mapped.\nFindings in this term will resolve the Herpes Zoster immunization reminder\npermanently.\n \nTerm: VA-ZOSTER DEFERRALS\nThis term is released with the health factors HERPES ZOSTER IMMUN \nPRECAUTION, DECLINES HERPES ZOSTER IMMUNIZATION, and HERPES ZOSTER \nVACCINE UNAVAILABLE. Any local findings that meet the intent of this term\nshould be mapped. Findings in this term will resolve the Herpes Zoster\nimmunization reminder for 3 months.\nvaccine is one-time dose.\n \nTerm: VA-ZOSTER IMMUNIZATION\nThis term is released with the ZOSTER immunization finding. This \nfinding is used to document vaccines given during an encounter and as a\nhistorical encounter. It should not be necessary to add additional\nfindings to this term.\n \nTerm: VA-ZOSTER ORDERS\nThis term is released without findings. Map any orderable items linked to \norder for administering the Herpes Zoster vaccine.\n \n \nTerm: VA-LIFE EXPECTANCY < 6 MONTHS\nThis term is released with the health factor LIFE EXPECTANCY < 6 MONTHS \nand the VA-TERMINAL CANCER taxonomy. Map local findings meeting this \nintent.\n \nCohort: Age>59 & No contraindications\n \nResolution: Herpes Zoster immunization OR Order for administration OR \nDeferral documentation\nSeveral reminder terms are released within the reminder. Descriptions \nare below:\n \nTerm: VA-ZOSTER CONTRAINDICATIONS\nThis term is released with the health factor HERPES ZOSTER IMMUN \nCONTRAINDICATION and documented allergies to Neomycin and gelatin. Any\n
\n
\n", "
(SEX)&(AGE)&'(FI(5)!FI(6)!FI(7)!FI(8)!FI(1))
\n", "
(SEX)&(AGE)&'(FI(5)!FI(6)!FI(7)!FI(8)!FI(1))
\n", "
7
\n", "
SEX;AGE;5;6;7;8;1
\n", "
FI(2)!FI(3)!FI(4)
\n", "
FI(2)!FI(3)!FI(4)
\n", "
3
\n", "
2;3;4
\n", "", "", "", "", "", "", "", "", "
\n
\n\n
\n", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-INFLUENZA H1N1 IMMUNIZATION", "
Influenza H1N1 Vaccine
\n", "", "", "
INACTIVE
\n", "
2010-09-13 11:56:29
\n", "", "", "", "
NATIONAL
\n", "
VA NATIONAL CENTER FOR HEALTH PROMOTION AND DISEASE PREVENTION (NCP)
\n", "", "
*
\n", "
\n
\n\n
\n", "", "
\n
\n\n
\n", "", "", "", "
(SEX)&(AGE)&'FI(3)
\n", "
3
\n", "
SEX;AGE;3
\n", "", "
(0)!FI(2)!FI(4)
\n", "
2
\n", "
2;4
\n", "", "", "
1
\n", "
1
\n", "", "", "", "", "
\n
\n\n
\n", "", "
\nVaccination for H1N1 Pandemic Flu is recommended for all patients.\n
\n
\n", "", "
1
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-INFLUENZA H1N1 IMMUNIZATION HIGH RISK", "
Influenza H1N1 Vaccine
\n", "", "", "
INACTIVE
\n", "
2010-09-13 11:56:35
\n", "", "", "", "
NATIONAL
\n", "
VA NATIONAL CENTER FOR HEALTH PROMOTION AND DISEASE PREVENTION (NCP)
\n", "", "
*
\n", "
\n
\n\n
\n", "", "
\n
\n\n
\n", "", "", "", "
(SEX)&(AGE)&'FI(3)
\n", "
3
\n", "
SEX;AGE;3
\n", "", "
(0)!FI(4)
\n", "
1
\n", "
4
\n", "
1
\n", "
1
\n", "
1
\n", "
2
\n", "", "", "", "", "
\n
\n\n
\n", "", "
\n\\\\\n    All adults ages 18 through 24\\\\\n    Adults ages 25-64 with chronic medical conditions that put them at \nrisk of influenza complications\n \nThird target group:\\\\\n    All patients and staff\n\\\\\nInitial target groups:\\\\\n    HCW and EMS providers with direct patient contact\\\\\n    Pregnant staff and patients\\\\\n    Caregivers and household contacts of infants <6 mos.\\\\\n    Older adolescent patients (up to age 18) or staff with chronic \nmedical conditions that put them at risk of influenza complications\\\\\n \nSecond target group:\\\\\n
\n
\n", "", "
16
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-EMBEDDED FRAGMENTS RISK EVALUATION", "
Evaluation of Embedded Fragments
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
OFFICE OF PUBLIC HEALTH AND ENVIRONMENTAL HAZARDS
\n", "", "
CR
\n", "
\n
\n\n
\n", "
\nThis reminder collects additional information on the potential for \nembedded fragments for those patients who have answered 'yes' to the \nembedded fragments question in the Iraq & Afghan Post-Deployment Screen \nreminder.\n \nResolved by completing the screening.\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "", "
(SEX)&(AGE)&FI(1)&'FI(5)
\n", "
4
\n", "
SEX;AGE;1;5
\n", "
FI(2)!FI(3)!FI(4)!FI(6)!(FI(7)&FI(8))&FF(1)
\n", "
FI(2)!FI(3)!FI(4)!FI(6)!(FI(7)&FI(8))&FF(1)
\n", "
7
\n", "
2;3;4;6;7;8;FF1
\n", "", "", "", "", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-WH PAP SMEAR SCREENING", "
PAP Smear Screening
\n", "
6M
\n", "", "", "", "", "
FEMALE
\n", "", "
NATIONAL
\n", "
VHA NATIONAL CENTER FOR HEALTH PROMOTION AND DISEASE PREVENTION (NCP) AND VHA OFFICE OF WOMEN'S HEALTH
\n", "", "
CR
\n", "
\n
\n\n
\n", "
\nThe main changes with the 2013 update of this reminder include:\nof less than 5 years or severe comorbidities.\n        Addition of branching logic to the dialog\n        Addition of links in the dialog to new VHA screening algorithms \nthat include links to ASCCP guidelines for management of patients with \nabnormal results.       \n \n \nVHA recommends screening for cervical cancer with cytology (Pap smear) \nevery 3 years for women ages 21-65 that have a cervix OR, for women ages \n30-65 who want to lengthen the screening interval, screening with a \n        a change in the age range from 18-65 to 21-65 to match updated \ncombination of cytology and human papilloma virus (HPV) testing every 5 \nyears.\n \nVHA recommends AGAINST screening for cervical cancer in women who are \nyounger than 21 years.\n \nVHA recommends AGAINST using HPV testing alone or in combination with \ncytology for cervical cancer screening in women younger than 30 years.\n \nVHA recommends AGAINST screening for cervical cancer in women older than \nclinical guidance\n65 years of age if they have had adequate prior screening and are not \notherwise at high risk for cervical cancer. \n \nVHA recommends AGAINST screening for cervical cancer in women who have \nhad a total hysterectomy (cervix removal) for benign disease.\n \nThis reminder does not apply to women who have had a hysterectomy where\nthe cervix was removed.\n \nEvidence of a PAP smear completed will satisfy the reminder for \n        addition of a every 5 year frequency option for women ages 30 and \nup to 5 years, depending on the screening frequency specified by the \nclinician and the presence of HPV screening. The clinician can alter the\nscreening frequency for individual patients based on prior results,\npatient and family history, and discussions with the patient.\n \nPAP Smears completed will resolve this reminder and may be recorded as one\nof the following:\n         Laboratory result matching Cytology or Surgical Pathology SNOMED\n         Women's Health procedure result\n         Health Factor (Historical outside PAP smear result) \nolder who are screened with both a Pap test and an HPV test (with \n         PCE CPT procedure code\n         Completed consult order for outside procedure\n \nIn patients ages 30-65 who have evidence of a recent negative HPV result \nand no prior abnormal PAP smear, the PAP smear will resolve the reminder\nfor 5 years.\n \nScreening will be resolved by any of the following:\n         PAP smear obtained at this encounter (7 DAYS)\n         Health Factor for an order for PAP Smear screening (9 months)\nassociated addition of new terms for HPV testing)  \n         Patient declined PAP smear (4 months)\n         Clinician deferred PAP smear (4 months)\n \n  Clinicians may manage follow-up screening to occur every 4 or 6 months \nwhen PAP smear results are abnormal or unsatisfactory, or if they feel\nscreening should take place more often than 3 or 5 years based on\nthe patient's history, risk or strong patient preferences.\n \nManagement of an abnormal PAP is included in this screening reminder only \nif the clinician indicates what frequency is required for an individual \n        addition of health factors that can be used by providers to \npatient.  A code for prior cervical cancer or CIN changes the\nfrequency to 1 year for 5 years.  This 1 year frequency if subsequently\noverridden if any other frequency is chosen by the clinician.\n \n         VA-WH HX CERVICAL CANCER/ABNORMAL PAP \n             \nThis reminder term changes the frequency to every 1 year for 5 years as a \nsafety features so that patients with these diagnoses are not lost to \nfollow-up. This 1 year frequency is subsequently overridden if any other \nfrequency is chosen by the clinician.  \nindicate that screening is not clinically indicated because the patient \n \nThis reminder term is mapped to the taxonomy VA-CERVICAL CA/ABNORMAL PAP\nfindings. This term represents ICD9, ICD0, and CPT codes that indicate the\npatient has a history of cervical cancer or a diagnosis CIN. Sites may\nchoose to only use documented diagnosis and procedure codes removing\nmapping to Women's Health.  \n             \nThis reminder term is also mapped to the computed finding VA-WH PAP SMEAR\nSCREEN IN WH PKG with a condition check for "Abnormal" used for the\nsearch. If PAP smear results are documented in the Women's Health package,\nis unlikely to benefit from screening due to an estimated life expectancy \nthe computed finding VA-WH PAP SMEAR SCREEN IN WH PKG will find the most\nrecent PAP Smear entry that has an "Abnormal" result. Sites can remove\nthis mapped item if they are not using the Women's Health package to store\nPAP results.  \n       \nThe reminder term may also be mapped to the computed finding VA-WH PAP\nSMEAR SCREEN IN LAB PKG with a condition check for "Abnormal" Result\nType.  The Result Type is based on Procedure definitions in the Women's\nHealth Package.  \n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "
\nTechnical Description:\n         \n            exists that alters the baseline frequency to 4M, 6M, 1Y, 2Y,\n            3Y, or 5Y the baseline frequency will be overridden.  \n \n        VA-WH PAP SMEAR SCREEN IN WH PKG \n           No mapping necessary.  This term represents PAP Smear results \n           documented in the Women's Health (WH) Package. Use the new \n           VA-WH PAP SMEAR IN WH PKG computed finding distributed with \n           this reminder term. This computed finding looks for PAP smear\n           results in the Women's Health Package where results have been\n           recorded and the status is not Unsatisfactory.\n    This reminder is recommended for use by clinicians at Primary Care \n     \n        VA-WH PAP SMEAR SCREEN IN LAB PKG \n           No mapping necessary.  This term represents PAP Smear results \n           documented in the Laboratory package. Use the new VA-WH PAP \n           SMEAR IN LAB PKG computed finding distributed with this\n           reminder term.\n           This computed finding looks for PAP smear results in the \n           Laboratory package where the Result Status that is not \n           "Unsatisfactory" \n            \n    Clinics (PACT/Primary Care,Medicine, Geriatric, Women's) and any\n           This computed finding will only work if the Women's Health WV \n           PROCEDURE TYPE file entry for PAP SMEAR has SNOMED codes \n           defined that are used by your local Lab Service to document \n           PAP Smear results in the Lab Package.  The SNOMED codes need \n           to be defined regardless of whether the Women's Health \n           Package is being used.\n     \n       VA-WH PAP SMEAR DONE \n           No mapping necessary.  Use the new VA-WH PAP SMEAR SCREEN \n           CODES taxonomy distributed with this reminder term. This\n    other specialty clinics where primary care is given to female\n           taxonomy is similar to the VA-CERVICAL CANCER SCREEN taxonomy\n           distributed to the field with the first reminder package\n           distribution. The new taxonomy should be used, instead of the\n           VA-CERVICAL CANCER SCREEN taxonomy, because it does not \n           include codes such as Q0091 which represent PAP smears \n           obtained by the clinician.\n     \n           Use the new WH PAP SMEAR OUTSIDE health factor to document PAP \n           Smear results completed outside the VA when the PAP Smear \n           results are not documented in Lab, Women's Health or Consult\n    patients.\n           packages.  \n     \n        VA-WH PAP SMEAR OBTAINED \n           Use the taxonomy VA-WH PAP SMEAR OBTAINED which contains \n           coded values that represent the clinician's actions taken to \n           obtain the PAP smear.  \n       \n        VA-WH PAP SMEAR ORDER HEALTH FACTOR \n           The following health factors are distributed with this term.  \n           WH ORDER PAP SMEAR SCREEN HF (for use when an order menu \n         \n           with a PAP Smear Screen order is used from the reminder \n           dialog) WH ORDER REFER WH CLINIC GYN CARE HF (for use when a\n           quick order is used for WH CLINIC GYN CARE referral in \n           reminder dialogs) WH ORDER REFER GYNECOLOGIST HF (for use \n           when a quick order is used for GYNECOLOGY referral in \n           reminder dialogs) WH ORDER REPEAT PAP HF (for use when an \n           order menu with a Repeat PAP Smear has been ordered)\n                \n           This reminder term represents the action taken from the \n           dialog to indicate the clinician selected an element that \n    If the PAP smear is done in the private sector or at another VAMC \n           could generate an order for PAP Smear. The health factor \n           date will be used to calculate a short resolution frequency,\n           instead of using the Order's Start date.\n     \n           Although these health factors remain in the reminder \n           definition, as requested by Women's Health, these are no\n           longer included in the reminder dialog since women should\n           no longer need to be referred from PC to specialty for Pap\n           smears.\n \n    facility, results can be recorded three ways to satisfy this \n       VA-WH PAP SMEAR SCREEN NOT INDICATED \n           Use the findings distributed with this reminder term or map \n           any local findings that indicate a PAP smear screen is not\n           indicated for this patient.\n            \n           This term is distributed with mapping to the following \n           health factors: \n              INACTIVATE CERVIX CANCER SCREEN (distributed with the \n                   first version of the Clinical Reminder package in 1996 \n                   to inactivate the CERVICAL CANCER reminder).  \n    reminder: \n              WH PAP SMEAR SCREEN NOT INDICATED \n              VA LIMITED LIFE EXPECTANCY \n           and the following taxonomy: \n              VA-TERMINAL CANCER PATIENTS \n     \n           Use in National VA-WH PAP SMEAR SCREENING reminder: \n           This term is used in WH reminders to inactivate PAP Smear \n           screening until a clinician overrides the inactivation by \n           selecting a health factor that is used by function findings \n           with frequencies of 1Y, 2Y, 3Y or 5Y.   Begin date of T-6M has\n \n           been added to HF.VA LIMITED LIFE EXPECTANCY and\n           TX.VA-TERMINAL CANCER PATIENTS so screening will come due\n           again if the patient lives longer than expected or if the\n           patient has been misdiagnosed.\n \n           Updated March 2013 to include 2 new health factor which    \n           both inactivate the reminder for 5 years:\n             WH CERV CA SCRN N/A 5 YRS-COMORBIDITIES\n             WH CERV CA SCRN N/A 5 YRS-LE<5YRS\n     \n    This reminder is based on VHA Performance measures and US \n        * Results, with interpretation, can be entered and verified\n           Sites may prefer to use local LIMITED LIFE EXPECTANCY health \n           factors and add their health factors to other reminder \n           terms which cause the PAP Smear Screening reminder to be \n           due without requiring a clinician to select a finding to \n           reactivate the reminder. (e.g., Add the local life expectancy \n           health factor for "LOCAL LIFE EXPECTANCY 6M" to the VA-WH PAP\n           SMEAR SCREEN NOT INDICATED term).  \n            \n       VA-WH PAP SMEAR SCREEN DEFER \n           Use the WH PAP SMEAR DECLINED and/or WH PAP SMEAR DEFERRED\n          in the Lab package.\n           health factors distributed with this term, or add any local\n           health factors representing that PAP smear screening should be\n           deferred.\n     \n        VA-WH PAP SMEAR UNSATISFACTORY IN LAB/WH PKG \n           No mapping necessary.  This term represents unsatisfactory\n           PAP Smear results documented in the Laboratory and WH \n           packages. Use the new VA-WH PAP SMEAR IN LAB PKG computed\n           finding distributed with this reminder term. This computed\n           finding looks for PAP smear results in the Laboratory \n        * Results, with interpretation, can be manually entered into the\n           package where the Result Status is "Unsatisfactory"\n           \n           Use the VA-WH PAP SMEAR IN WH PKG computed finding and the\n           value "UNSATISFACTORY" to find unsatisfactory PAP smear \n           results documented in the WH package.\n \n           This computed finding will only work if the Women's Health WV \n           PROCEDURE TYPE file entry for PAP SMEAR has SNOMED codes \n           defined that are used by your local Lab Service to document \n           PAP Smear results in the Lab Package.  The SNOMED codes need \n          WH package.\n           to be defined regardless of whether the Women's Health Package\n           is being used.\n \n    INFORMATION FINDINGS: \n    ---------------------\n    Function Findings (FF) will be used to determine the frequency of \n    this reminder.  The following are information reminder terms that are\n    used in Function Findings to alter the baseline Age/Frequency.  If the\n    most recent resolution finding is a documented result, the frequency\n    for the next PAP Smear will be based on these reminder terms. \n        * Summarized results can be entered as a historical entry (health \n    If multiple findings exist for the same date/time, the finding that\n    makes the reminder due most often will prevail.  See the FUNCTION\n    FINDINGS section below for frequency logic.\n     \n       VA-WH PAP SMEAR SCREEN FREQ - 4M \n           Use the WH PAP SMEAR SCREEN FREQ - 4M health factor \n           distributed with this reminder term, or add any local findings\n           that indicate PAP smear screening should occur every 4 months.\n     \n       VA-WH PAP SMEAR SCREEN FREQ - 6M \n          factor or CPT code) in the patient record. Historical entries \n           Use the WH PAP SMEAR SCREEN FREQ - 6M health factor \n           distributed with this reminder term or add any local findings\n           that indicate PAP smear screening should occur every 6 months.\n     \n       VA-WH PAP SMEAR SCREEN FREQ - 1Y \n           Use the WH PAP SMEAR SCREEN FREQ - 1Y health factor \n           distributed with this reminder term, or add any local findings\n           that indicate PAP smear screening should occur every year.\n           The taxonomy for abnormal PAP is included in this term.    \n \n          should be based on reviewed results, not on patient comments. \n       VA-WH PAP SMEAR SCREEN FREQ - 2Y \n           Use the WH PAP SMEAR SCREEN FREQ - 2Y health factor \n           distributed with this reminder term, or add any local \n           findings that indicate the PAP smear screening should occur \n           every 2 years.   \n     \n       VA-WH PAP SMEAR SCREEN FREQ - 3Y \n           Use the WH PAP SMEAR SCREEN FREQ - 3Y health factor \n           distributed with this reminder term, or add any local \n           findings that indicate PAP smear screening should occur every \n         \n           3 years.  \n     \n       The following reminder terms are "information only" terms that are \n       not used to alter the frequency, but provide information that may\n       be helpful to the clinician.\n     \n       VA-WH HYSTERECTOMY \n           This reminder term represents hysterectomy related procedures. \n           It is pre-mapped to use the VA-HYSTERECTOMY taxonomy which was \n           distributed to the field in 1996. It is not used to alter the \n    Setup of Women's Health package before using this reminder: \n           patient cohort because it contains hysterectomy codes that \n           indicate the patients cervix may or may not have been \n           removed.  \n     \n       VA-WH HX CERVICAL CANCER/ABNORMAL PAP \n           This reminder term is mapped to the taxonomy VA-CERVICAL \n           CA/ABNORMAL PAP findings. This term represents ICD9, ICD0, \n           and CPT codes that indicate the patient has a history of \n           cervical cancer or a diagnosis for abnormal PAP.  Sites may \n           choose to only use documented diagnosis and procedure codes \n    ===========================================================\n           removing mapping to Women's Health.  \n           \n           This reminder term is also mapped to the computed finding \n           VA-WH PAP SMEAR SCREEN IN WH PKG with a condition check for\n           "Abnormal" used for the search. If PAP smear results are\n           documented in the Women's Health package, the computed finding\n           VA-WH PAP SMEAR SCREEN IN WH PKG will find the most recent PAP\n           Smear entry that has an "Abnormal" result. Sites can remove\n           this mapped item if they are not using the Women's Health\n           package to store PAP results.\n    Preventative Services Task Force recommendations for cervical cancer\n    Although this reminder has been developed to interface with the\n     \n           The reminder term may also be mapped to the computed finding \n           VA-WH PAP SMEAR SCREEN IN LAB PKG with a condition check for \n           "Abnormal" Result Type.  The Result Type is based on Procedure \n           definitions in the Women's Health Package.  \n     \n       VA-WH PAP SMEAR ORDER \n           Map local orderable items that represent PAP smear related \n           orders (e.g., Consult order to Women's Health Clinic).  \n           Use the conditions that indicate the order is not completed, \n    Women's Health (WH) package, clinical use of the Women's health\n           discontinued, or cancelled. This reminder term represents \n           orders pending completion.  \n     \n       VA-WH HPV TESTING NEGATIVE\n           Any lab test that represents a negative HPV result for high \n           risk or intermediate risk HPV genotypes should be included in\n           this term.  A sample condition is included in the term\n           definition. Do not include lab tests that represent low risk \n           HPV genotypes.\n \n    package is not required in order to use this reminder.  However, use\n           \n           A health factor for outside results or for use for results that\n           are not in Chemistry/Hematology is included in the term.\n \n       VA-WH HPV TESTING POSITIVE\n           Any lab tests that represent positive HPV results for high \n           or intermediate risk HPV on cervical specimens should be\n           included in this term.  A sample condition is included in the\n           term definition.  If your lab reports separate lab tests for\n           high/intermediate risk and low risk genotypes, DO NOT include\n    of the Women's Health package is required in order to use the\n           the low risk genotype test in this term.\n \n           A health factor for outside results or for use for results that\n           are not in Chemistry/Hematology is included in the term.\n \n \n    FUNCTION FINDINGS: \n    ------------------\n    Frequency for this reminder will be determined using Function \n    Findings (FF) logic, which differentiates between completed results,\n    associated Pap Review results reminder. This screening reminder and\n    short-term (7D, 4M, 6M) and long term (1Y, 2Y, 3Y, 5Y) resolution\n    findings.  \n     \n       FF1  \n          Was part of the original national reminder and is replaced \n          by FF(10) and FF(11)  \n       FF2 \n          Determines whether the most recent finding is VA-WH PAP SMEAR \n          SCREEN FREQ - 4M and changes the screening frequency to every \n          four months (4M).  \n    the associated review results reminder dialogs will update the WH The\n       FF3 \n          Determines whether the most recent finding is VA-WH PAP SMEAR \n          SCREEN FREQ - 6M and changes the screening frequency to every \n          six months (6M).  \n       FF4 \n          Determines whether a finding exists for VA-WH PAP SMEAR SCREEN \n          FREQ 1Y and changes the screening frequency to every year \n          (1Y).  \n       FF6 \n          Determines whether a finding exists for VA-WH PAP SMEAR SCREEN \n    associated reminder dialog will update the WH package at the same time\n          FREQ 3Y and changes the screening frequency to every three \n          years (3Y).\n       FF7 \n          Determines whether a finding exists for VA-WH PAP SMEAR SCREEN \n          NOT INDICATED and changes the frequency to 0D, which will \n          stop the reminder from being due until some new activity \n          occurs.  \n       FF8 \n          Determines whether the most recent finding is a VA-WH PAP SMEAR \n          UNSATISTACTORY IN LAB PKG, which will make the reminder due \n    clinical care is recorded in CPRS GUI, thus eliminating the need for\n          again in one day (1D).  \n \n       FF9\n          New in this update; allows text to display for prior negative\n          HPV results and no record of any positive HPV results\n \n       FF10 \n          New in this update and along with FF11, replaces the old FF1\n          Most recent finding is a PAP smear result AND\n             1) patient <30, or \n    dual data entry.\n             2) HPV done and most recent result positive, or \n             3) no recent negative result of HPV testing\n          Frequency set to 3Y\n \n       FF11\n          New in this update and along with FF10, replaces the old FF1\n          Most recent finding is a PAP smear result AND\n          pt is 30-65, and most recent HPV was done in the past \n          5Y and was negative\n          Frequency set to 5Y\n \n \n \n       FF14\n          If a clinician entered frequency is entered more recently\n          than the entry for a hysterectomy, then the hysterectomy \n          finding (FI(2)) does not remove the patient from the cohort.\n          This was done for the unusual cases where continued screening\n          is recommended after removal of the cervix.\n \n \n    screening.  In its first release in 2005, this reminder replaced the\n    In order for this reminder to interface with the Women's Health (WH) \nBranching logic is used in the reminder dialog so that the clinician is \nprompted to reassess frequency periodically if a prior clinician selected \nfrequency rather than the baseline frequency is controlling the \nreminder.  The branching logic also prompts clinician to reassess the \nneed for continued screening for patients who are older than 74 years.  \nContinued screening may be indicated in some cases based on prior \nabnormal results. The reminder VA-BL WH PAP REVIEW FREQ and a new HS \nobject:|PAP SMEAR FREQUENCY| are also distributed with this patch for \nthis purpose.\n \n    package as it was originally designed, the WH package must be\n \n    2.  Use the Reminder Dialog edit option to define the national \n        reminder dialog finding items which should be updated during CPRS\n        GUI reminder processing.\n     \n        Review dialog elements in the national reminder dialog and change \n        any national health factors to local health factors, if \n        necessary. It is not unusual for local findings to be used in \n        your national dialogs. Any local findings used in the national\n        dialogs should be\n    installed and maintained.  Please refer to the CPRS Integration: Women\n        \n     \n        Add order dialogs where appropriate for items the primary care \n        clinician should be able to order for PAP Smear Screening.  \n     \n    3.  Alternately, use the Reminder Dialog options to copy the national \n        dialog, dialog elements, and dialog groups to make local \n        changes.  \n     \n        Add local dialog elements with local Order Dialogs for additional \n    Veterans Health (WVH) Install & Setup Guide for detailed instructions.\n        ordering options for the clinicians. Some sites have clinicians \n        order a consult to a service that provides PAP smears.  If your\n        site does this, copy the reminder dialog to a local reminder\n        dialog, then add the local dialog element for the consult order \n        to the reminder dialog so this practice can continue. \n     \n    4.  If your site chooses not to send letters via the WH package \n        (sending letters is part of the Review results reminder, not this \n        reminder), copy the appropriate national dialog components to\n        local components and remove the findings related to WH\n         \n        notifications.\n    The following is a subset of some of the specific features of WH that \n    must be in place in order for this reminder to work as it was \n    designed: \n        * Female veterans should be entered into the WH package.\n        * SNOMED codes are setup for the PAP SMEAR procedure in the WV \n    following national reminders relating to PAP smears and cervical\n          PROCEDURE TYPE file.  \n        * WH parameters should be set up to automatically import PAP \n          smear \n          lab reports into the WH package when they are verified in the \n          VistA Lab package.  \n        * The WV NOTIFICATION PURPOSE letters should be customized to \n          reflect site information and the correct letter content for \n          each type of letter.\n        * The Notification Purpose treatment need and treatment need \n          date offset should be defined if appropriate. These new fields \n    cancer screening:\n          will be used to update Women's Health data when purpose of \n          notifications are selected by clinicians from reminder \n          dialogs.  \n        * The reminder dialog definitions should reference the \n          appropriate WV NOTIFICATION PURPOSE.\n     \n    Setup of reminder terms and reminder dialogs before using this \n    reminder:  \n    ============================================================== \n    1.  Use the Reminder Term options to map local representations of \n         \n        findings: \n     \n    PATIENT COHORT FINDINGS: \n    ------------------------\n    The following reminder terms determine whether the reminder applies \n    to the patient.\n     \n       VA-WH HYSTERECTOMY W/CERVIX REMOVED \n           No mapping necessary.  Use the VA-WH HYSTERECTOMY W/CERVIX \n           REMOVED reminder taxonomy distributed with this term.  Note \n            VA-*CERVICAL CANCER SCREEN \n           the VA-CERVICAL CA/ABNORMAL PAP reminder taxonomy is now \n           used for information only and should not be mapped to this\n           reminder term since it contains codes where the cervix may\n           not have been removed.\n     \n           This reminder term is also mapped to the new health factor \n           WH HYSTERECTOMY W/CERVIX REMOVED.  \n     \n \n    RESOLUTION FINDINGS: \n            VA-PAP SMEAR  \n    --------------------\n     The following reminder terms resolve the reminder.  These resolution \n     terms are defined with a "Use in Resolution Logic", but no Frequency.\n     Frequency for this reminder will be determined by Function Findings \n     (FF) logic, which examines the most recent findings: \n  \n          * If Function Findings determine that the most recent finding \n            is a result, the baseline age and frequency will be used.  \n  \n          * If Function Findings determine that an information finding \n
\n
\n", "
(SEX)&(AGE)&'(FI(2)&FF(14))
\n", "
(SEX)&(AGE)&'(FI(2)&FF(14))
\n", "
4
\n", "
SEX;AGE;2;FF14
\n", "", "
(0)!FI(4)!FI(5)!FI(6)!FI(7)!FI(8)!FI(9)!FI(10)!FI(11)
\n", "
8
\n", "
4;5;6;7;8;9;10;11
\n", "
11
\n", "
10;FF1;FF2;FF3;FF4;FF5;FF6;FF7;FF8;FF10;FF11
\n", "
16
\n", "
1;12;13;14;15;16;17;18;19;20;21;22;23;FF12;FF13;FF9
\n", "", "", "", "", "
\n
\n\n
\n", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-WH PAP SMEAR REVIEW RESULTS", "
PAP Smear Review Results
\n", "", "", "", "", "
S
\n", "
FEMALE
\n", "", "
NATIONAL
\n", "
VHA NATIONAL CENTER FOR HEALTH PROMOTION AND DISEASE PREVENTION (NCP) AND VHA OFFICE OF WOMEN'S HEALTH
\n", "", "
CR
\n", "
\n
\n\n
\n", "
\nThe VHA recommends that PAP smear results be reviewed and that the\nalgorithms that also include links to 2012 updated ASCCP guidelines for \nmanagement of patients with abnormal cervical cancer screening \nresults.       \n \nThis reminder will be due when PAP smear results are present in the\nWomen's Health package and are pending clinician review.\n \nThis reminder will be satisfied when the clinical review of PAP smear\nresults is recorded in the Women's Health package.\nclinical review be documented in the patient record.\n \nThe main changes to this reminder for the 2013 update are:   \n        Modification of the dialog to require completion of both the \nclinical review as well as the patient notification sections of the \ndialog while also making it possible for staff to use the 'Next' button \nwhen addressing more than one reminder.\n        Addition of links in the dialog to new VHA screening guidance and \n
\n
\n", "
\n
\n\n
\n", "", "
\nThis reminder has been developed to interface with the Women's Health (WH)\npap results by the clinican.\n \nThis reminder is recommended for use by clinicians at Primary Care Clinics\n(PACT/Primary Care, Medicine, Geriatric, Women's) and any other\nspecialty clinics where primary care is given to female patients.\n \nThe reminder was developed to interface with the Women's Health package:\n   * When the reminder is evaluated, PAP results pending review in the\n     Women's health package will be used to determine if the reminder is\n     due.\npackage. The associated reminder dialog will update the WH package at the\n   * The VA-WH PAP SMEAR REVIEW RESULTS reminder dialog will display the\n     PAP smear results and will record clinical review information in the\n     current progress note and in the Women's Health package.\n   * The VA-WH PAP SMEAR REVIEW RESULTS reminder dialog offers selections\n     the clinician can use to document patient notification of PAP smear\n     results in the Women's Health package.\n \nSetup issues before using this reminder: \n     \n1.  Use the Reminder Term options to map local representations of \nsame time clinical care is recorded in CPRS GUI, thus eliminating dual\n    findings:\n     \n    VA-WH PAP SMEAR PENDING REVIEW\n                  No mapping necessary.  A new VA-WH PAP SMEAR PENDING\n                  REVIEW computed finding will be installed with this\n                  reminder term. This computed finding will make the\n                  reminder due when the condition is: I V="Pending".  It\n                  will then return PAP smear results pending clinician\n                  review from the WH package.\n \ndata entry and encouraging synchronization of data.  \n2.  Use the Reminder Dialog edit option to define the national reminder\n    dialog finding items which should be updated during CPRS GUI reminder\n    processing.\n \n    Review dialog elements in the national reminder dialog and change\n    any national health factors to local health factors, if necessary.\n    It is not unusual for local findings to be used in your national\n    dialogs. Any local findings used in the national dialogs should be\n    mapped to the appropriate national reminder term.  \n \n \n3.  Alternately, use the Reminder Dialog options to copy the national \n    dialog, dialog elements, and dialog groups to make local changes.\n \n    Add local dialog elements with local Order Dialogs for additional \n    ordering options for the clinicians. Some sites have clinicians \n    order a consult to a service that provides PAP smears.  If your\n    site does this, copy the reminder dialog to a local reminder\n    dialog and then add the local dialog element for the consult order\n    to the reminder dialog so this practice can continue.\n \nSites that use mechanisms other than the Women's Health package to \n    Some sites have local entries in the Women's Health WV Notification\n    Purpose file.  If your site does this, copy the reminder dialog to \n    a local reminder dialog, then add or modify the notifications \n    so this practice can continue.  Under reminder findings, use the new\n    "WH" finding type to point to the entries.\n \n4.  Use the  AEP  Add/Edit a Notification Purpose & Letter manager\n    option in the Women's Health package to set up entries in the WV \n    Notification Purpose file.  The breast or cervical treatment need and \n    due date should be set and the default letter text should \ngenerate letters for notifying patients of Pap results may copy the \n    modified to explain the reason for the letter.\ndialog and remove or replace the patient notification section.  If this \nis done, this reminder may still be used to trigger a clinical review of \n
\n
\n", "", "
(SEX)&(AGE)&FI(1)
\n", "
3
\n", "
SEX;AGE;1
\n", "", "", "", "", "", "", "", "", "", "", "", "", "
\n
\n\n
\n", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-WH MAMMOGRAM SCREENING", "
Mammogram Screening
\n", "
2M
\n", "", "", "", "
S
\n", "
FEMALE
\n", "", "
NATIONAL
\n", "
VHA NATIONAL CENTER FOR HEALTH PROMOTION AND DISEASE PREVENTION (NCP) AND VHA OFFICE OF WOMEN'S HEALTH
\n", "", "
CR
\n", "
\n
\n\n
\n", "
\nThe VHA recommends that:\n    * A change in the age range from 40-69 to 50-74 to match updated\n  ----    --------------             ----------  ------------ ----------\n  611.5   GALACTOCELE                10/01/1978                   X\n \n Range 611.71-611.72  Adjacent Lower-611.6  Adjacent Higher-611.79\n \n  Code    ICD Diagnosis              Activation  Inactivation Selectable\n  ----    --------------             ----------  ------------ ----------\n  611.71  MASTODYNIA                 10/01/1978                   X\n  611.72  LUMP OR MASS IN BREAST     10/01/1978                   X\n \n      clinical guidance\n Range 611.9-611.9  Adjacent Lower-611.89  Adjacent Higher-612.0\n \n  Code    ICD Diagnosis              Activation  Inactivation Selectable\n  ----    --------------             ----------  ------------ ----------\n  611.9   BREAST DISORDER NOS        10/01/1978                   X\n \n Range 675.10-675.14  Adjacent Lower-675.04  Adjacent Higher-675.20\n \n  Code    ICD Diagnosis              Activation  Inactivation Selectable\n  ----    --------------             ----------  ------------ ----------\n    * Inclusion of women ages 40-49 in the cohort if the woman had \n  675.10  BREAST ABSCESS PREG-UNSP   10/01/1978                   X\n  675.11  BREAST ABSCESS-DELIVERED   10/01/1978                   X\n  675.12  BREAST ABSCESS-DEL W P/P   10/01/1978                   X\n  675.13  BREAST ABSCESS-ANTEPART    10/01/1978                   X\n  675.14  BREAST ABSCESS-POSTPART    10/01/1978                   X\n \n Range 757.6-757.6  Adjacent Lower-757.5  Adjacent Higher-757.8\n \n  Code    ICD Diagnosis              Activation  Inactivation Selectable\n  ----    --------------             ----------  ------------ ----------\n      discussion with her provider about the pros and cons of screening\n  757.6   CONG BREAST ANOMALY NEC    10/01/1978                   X\n \n Range 922.0-922.0  Adjacent Lower-921.9  Adjacent Higher-922.1\n \n  Code    ICD Diagnosis              Activation  Inactivation Selectable\n  ----    --------------             ----------  ------------ ----------\n  922.0   CONTUSION OF BREAST        10/01/1978                   X\n \n Range 793.8-793.8  Adjacent Lower-793.7  Adjacent Higher-793.80\n \n      and made a decision to start screening before age 50.  A new\n  Code    ICD Diagnosis              Activation  Inactivation Selectable\n  ----    --------------             ----------  ------------ ----------\n  793.8   ABNORMAL FINDINGS-BREAST   10/01/1978  10/01/2001       X\n      reminder, VA-WH DISCUSS BREAST CA SCREEN WOMAN 40-49 is distributed\n      to prompt that discussion. \n    * Modification of taxonomy VA-BREAST TUMOR \n    * Addition of health factors that can be used by providers to indicate\n      that screening is not clinically indicated because the patient is\n    * Women between the ages of 50 and 74 have a mammogram every two\n      unlikely to benefit from screening due to an estimated life\n      expectancy of less than 5 years or sever comorbidities. \n    * Addition of branching logic to the dialog\n \nUS Preventive Services Task Force (USPSTF) also recommends that women age\n50-74 have a mammogram every 2 years.\n \nThis reminder does not apply to women who have had a bilateral mastectomy.\n \nEvidence of mammography performed will satisfy this reminder for 1 to \n      years\n2 years depending on the screening frequency specified by the clinician. \nThe clinician can alter the screening frequency for individual patients,\nbased on prior results, patient and family history, and discussions with\nthe patient.\n \nMammograms completed may be documented as one of the following and will \nresolve this reminder:\n    Radiology result\n    Women's Health procedure result\n    Health Factor (Historical outside Mammogram result)\n    * The decision to start regular screening every two years with \n    PCE CPT procedure code \n    Completed consult order for outside procedure\n \nScreening will be resolved for 90 days or until results are recorded to\nindicate the mammogram has been completed:\n    Ordering a mammogram\n    Health factor documenting a mammogram order\n    Patient declined a mammogram \n    Clinician deferred a mammogram\n \n      mammography for average risk women ages 40-49 should be an\nClinicians may manage follow-up screening to occur every 4 or 6 months or \nevery 1 year when a prior mammogram was unsatisfactory or abnormal, or if\nthey feel screening should take place more often than 2 years based on \nthe patient's history, risk or strong patient preferences.\n \nA code for breast cancer or prior abnormal mammogram (VA-WH HX BREAST \nCANCER/ABNORMAL MAM) changes the frequency to q1 year for 5 years as a\nsafety features so that patients with these diagnoses are not lost to\nfollow-up.  \n       Note: The term VA-WH HX BREAST CANCER/ABNORMAL MAM comes\n      individual decision and take the patient's values into account\n             mapped with the previously distributed VA-BREAST TUMOR and\n             VA-MASTECTOMY taxonomies mapped to this term. This term uses\n             computed finding VA-WH MAMMOGRAM ABNORMAL IN WH PKG to search\n             for the existence of any abnormal results in the WH Package.\n             This 1 year frequency is subsequently overridden if any other\n             frequency is chosen by the clinician.\n \nIn the 2013 update, the taxonomy VA-BREAST TUMOR was edited to exclude \ncodes that do not represent \nbreast cancer.  The following codes were deleted:\n      including values about specific benefits and harms\nThis taxonomy was updated in 2013 to include only those codes that \nrepresent cervical cancer or CIN.  \nThe following codes/ranges were deleted:\nRange 217.-217.  Adjacent Lower-216.9  Adjacent Higher-218.0\n \n  Code    ICD Diagnosis              Activation  Inactivation Selectable\n  ----    --------------             ----------  ------------ ----------\n  217.    BENIGN NEOPLASM BREAST     10/01/1978                   X\n \n Range 610.0-610.9  Adjacent Lower-608.9  Adjacent Higher-611.0\n \n \n  Code    ICD Diagnosis              Activation  Inactivation Selectable\n  ----    --------------             ----------  ------------ ----------\n  610.0   SOLITARY CYST OF BREAST    10/01/1978                   X\n  610.1   DIFFUS CYSTIC MASTOPATHY   10/01/1978                   X\n  610.2   FIBROADENOSIS OF BREAST    10/01/1978                   X\n  610.3   FIBROSCLEROSIS OF BREAST   10/01/1978                   X\n  610.4   MAMMARY DUCT ECTASIA       10/01/1978                   X\n  610.8   BENIGN MAMM DYSPLAS NEC    10/01/1978                   X\n  610.9   BENIGN MAMM DYSPLAS NOS    10/01/1978                   X\nThe main changes with the 2013 update of this reminder include:\n \n Range 611.0-611.0  Adjacent Lower-610.9  Adjacent Higher-611.1\n \n  Code    ICD Diagnosis              Activation  Inactivation Selectable\n  ----    --------------             ----------  ------------ ----------\n  611.0   INFLAM DISEASE OF BREAST   10/01/1978                   X\n \n Range 611.5-611.5  Adjacent Lower-611.4  Adjacent Higher-611.6\n \n  Code    ICD Diagnosis              Activation  Inactivation Selectable\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "
\nTechnical Description:\n     \n         * If Function Findings determine that an information finding \n           exists that alters the baseline frequency to 4M, 6M, 1Y or 2Y,\n           the baseline frequency will be overridden.\n     \n       VA-WH MAMMOGRAM SCREEN IN WH PKG \n           No mapping necessary. This term represents mammogram results \n           documented in the Women's Health (WH) Package. The term is \n           mapped to the VA-WH MAMMOGRAM IN WH PKG computed finding which \n           only uses WH findings that are normal or abnormal.  \n     \n    This reminder is recommended for use by clinicians at Primary Care \n       VA-WH MAMMOGRAM SCREEN IN RAD PKG \n           Mapping will be necessary.  This term represent Mammogram \n           results documented in the Radiology package.  Map local\n           radiology procedures that represent the following procedures:\n              MAMMOGRAM BILAT \n              MAMMOGRAM UNILAT \n              MAMMOGRAM SCREEN \n           Each finding should have a condition added to exclude \n           unsatisfactory results.  \n     \n    Clinics (PACT/Primary Care, Medicine, GIMC, Geriatric, Women's) and\n       VA-WH MAMMOGRAM SCREEN DONE \n           Some mapping may be appropriate. This reminder term will use \n           the previously distributed VA-MAMMOGRAM/SCREEN taxonomy to \n           find ICD DIAGNOSIS or CPT coded results.\n     \n           Use the new WH MAMMOGRAM OUTSIDE health factor to document \n           Mammogram results completed outside the VA when the Mammogram \n           results are not documented in Radiology, Women's Health or \n           Consult packages.  \n     \n    any other specialty clinics where primary care is given to female\n           Map local findings, such as consult orders related to \n           Mammogram Screening.  Use appropriate condition logic to \n           indicate Mammogram screening has been completed.  \n     \n       VA-WH BREAST CARE ORDER HEALTH FACTOR \n           Use the health factors distributed with the reminder term if \n           they are appropriate for your facility to track breast care\n           orders.  \n \n           This reminder term represents the action taken from the dialog \n    patients.\n           to indicate the clinician intends to place an order related to \n           mammogram screening. The health factor date will be used to \n           calculate the resolution frequency, instead of the Start date \n           related to the order actually placed.  \n     \n           The following are health factors distributed with this term: \n              WH ORDER MAMMOGRAM SCREEN HF (Use this if an order menu is \n              referenced as the quick order, or use for a quick order \n              for mammogram screening to radiology or consults) \n     \n     \n \n       VA-WH MAMMOGRAM SCREEN NOT INDICATED \n           Use the findings distributed with this reminder term or map \n           any local findings that indicate a Mammogram screen is not\n           indicated for this patient.\n     \n           This term is distributed with mapping to the following \n           health factors: \n              INACTIVATE BREAST CANCER SCREEN (distributed with the \n                   first version of the Clinical Reminder package in 1996 \n    If the mammogram is done in the private sector or at another VAMC \n                   to inactivate the BREAST CANCER reminder).  \n              WH MAMMOGRAM SCREEN NOT INDICATED \n              VA LIMITED LIFE EXPECTANCY \n           and the taxonomy: \n              VA-TERMINAL CANCER PATIENTS \n               Updated March, 2013 to include 2 new health factor which\n               both inactivate the reminder for 5 years: \n               WH BR CA SCREEN N/A 5 YRS-LE<5YRS \n               WH BR CA SCREEN N/A 5 YRS-COMORBIDITIES\n     \n    facility, there are three ways the results can be documented to \n           Use in National VA-WH MAMMOGRAM SCREENING reminder: \n           This term is used in WH reminders to inactivate Mammogram \n           screening until a clinician overrides the inactivation by \n           selecting a health factor that is used by function findings \n           with frequencies of 4M, 6M, 1Y or 2Y. Begin date of T-6M has\n           been added to HF.VA LIMITED LIFE EXPECTANCY and \n           TX.VA-TERMINAL CANCER PATIENTS so screening will come due\n           again if the patient lives longer than expected or if the\n           patient has been misdiagnosed.\n     \n    satisfy this reminder:\n           Sites may prefer to use local LIMITED LIFE EXPECTANCY health \n           factors and add their health factors to other reminder \n           terms which cause the Mammogram Screening reminder to be \n           due without requiring a clinician to select a finding to \n           reactivate the reminder. (e.g., Add the local life expectancy \n           health factor for "LOCAL LIFE EXPECTANCY 6M" to the VA-WH \n           MAMMOGRAM SCREEN NOT INDICATED term).  \n            \n       VA-WH MAMMOGRAM SCREEN DEFER \n           Use the WH MAMMOGRAM DEFERRED or WH MAMMOGRAM DECLINED health \n        * Results, with interpretation, can be entered and verified in \n           factors distributed with this term or add any local health \n           factor representing that mammogram screening should be \n           satisfied for one week.\n          \n       VA-WH MAMMOGRAM UNSATISFACTORY IN RAD/WH PKG \n           Mapping will be necessary for Radiology. This term represent\n           Mammogram results documented in the Radiology and WH packages.\n           Map local radiology procedures that represent the following\n           procedures:\n              MAMMOGRAM BILAT \n    This reminder is based on VHA Clinical Guidance, Performance measures\n          the Radiology package.\n              MAMMOGRAM UNILAT \n              MAMMOGRAM SCREEN \n           Each finding should have a condition that checks for\n           unsatisfactory results.\n           \n           No mapping is necessary for WH.  Use the VA-WH MAMMOGRAM IN\n           WH PKG computed finding and the value "UNSATISFACTORY" to\n           find unsatisfactory results documented in the WH package.\n \n \n        * Results, with interpretation, can be manually entered into the \nINFORMATION FINDINGS: \n    ---------------------\n    The following are informational reminder terms that are used in \n    Function Findings to alter the baseline Age/Frequency.  If the most\n    recent resolution finding is a documented result, the frequency for\n    the next Mammogram screen will be based on these reminder terms. If\n    more than one of these findings are recorded at the same date/time,\n    the finding that makes the reminder due most often will prevail.  See\n    the Function Findings section below for frequency logic.   \n    \n          WH package.\n       VA-WH MAMMOGRAM SCREEN FREQ - 4M \n           Use the WH MAMMOGRAM SCREEN FREQ - 4M health factor \n           distributed with this reminder term, or add any local findings\n           that indicate mammogram screen should occur every 4 months.\n     \n       VA-WH MAMMOGRAM SCREEN FREQ - 6M \n           Use the WH MAMMOGRAM SCREEN FREQ - 6M health factor \n           distributed with this reminder term, or add any local findings\n           that indicate mammogram screening should occur every 6 months.\n \n        * Summarized results can be entered as a historical entry (health \n       VA-WH MAMMOGRAM SCREEN FREQ - 1Y \n           Use the WH MAMMOGRAM SCREEN FREQ - 1Y health factor \n           distributed with this term or add any local health factor that\n           indicates mammogram screening should occur every year.\n       \n       VA-WH MAMMOGRAM SCREEN FREQ - 2Y \n           Use the WH MAMMOGRAM SCREEN FREQ - 2Y health factor \n           distributed with this term or add any local health factor that\n           indicates mammogram screening should occur every two years.\n     \n          factor or CPT code) in the patient record.\n       The following reminder terms are "information only" terms that are \n       not used to alter the frequency of the reminder, but provide\n       information that may be helpful to the clinician.\n     \n     \n       VA-WH MAMMOGRAM ORDER \n           Map local orderable items that represent mammogram related \n           orders (e.g., Consult order to Women's Health Clinic).  \n           Use the conditions that indicate the order is not completed, \n           discontinued, or cancelled. This reminder term represents \n \n           orders pending completion.\n     \n    FUNCTION FINDINGS: \n    ------------------\n    Function Findings (FF) will be used to determine the frequency of \n    this reminder. FF logic has been set up to differentiate between\n    completed results and findings that represent different frequencies\n    (4M, 6M, 1Y, 2Y).  \n    If more than one of the frequency findings are recorded at the same\n    date/time, the finding that makes the reminder due most often will\n    Setup of Women's Health package before using this reminder: \n    prevail.  The frequency can be changed by entering a new frequency\n    with a more recent date. \n     \n       FF1 \n          Determines whether a mammogram result is the most recent \n          finding and defaults to the baseline frequency of two years.\n \n       FF2 \n          Determines whether a finding exists for VA-WH MAMMOGRAM SCREEN \n          FREQ - 4M and changes the screening frequency to every four\n    ===========================================================\n          months (4M).\n \n       FF3 \n          Determines whether a finding exists for VA-WH MAMMOGRAM SCREEN \n          FREQ - 6M and changes the screening frequency to every six\n          months (6M).\n \n       FF4 \n          Determines whether a finding exists for VA-WH MAMMOGRAM SCREEN \n          FREQ - 1Y  and changes the screening frequency to every 1 year\n    Although this reminder has been developed to include an interface with\n          (1Y).\n \n       FF5\n          Determines whether a finding exists for VA-WH MAMMOGRAM SCREEN \n          FREQ - 2Y and changes the screening frequency to every two \n          years (2Y).\n \n       FF6 \n          Determines whether the most recent finding is VA-WH MAMMOGRAM \n          SCREEN NOT INDICATED and changes the frequency to 0Y, which \n    the Women's Health (WH) package and to use/update Mammogram results\n          will stop the reminder from being due until new activity \n          occurs.\n \n       FF7 \n          Determines whether the most recent finding is VA-MAMMOGRAM \n          UNSATISFACTORY IN RAD/WH PKG and changes the frequency to 1D,\n          which will make the reminder due immediately until new activity\n          occurs.  \n     \n          Branching logic is used in the reminder dialog so that the \nand US Preventive Services Task Force recommendations for breast cancer\n    stored in WH for managing breast care and the next breast treatment\n          clinician is prompted to reassess frequency periodically if a\n          prior clinician selected frequency rather than the baseline\n          frequency is controlling the reminder.  The branching logic also\n          prompts clinician to reassess the need for continued screening\n          for patients who are older than 74 years.  Continued screening\n          may be indicated in some cases based on prior abnormal results.\n          The reminder VA-BL WH MAMMO REVIEW FREQ and a new HS\n          object:|MAMMOGRAM FREQUENCY| are also distributed with this\n          patch for this purpose.\n \n    need, clinical use of the Women's health package is not required in\n    2.  Use the Reminder Dialog edit option to define the national \n        reminder dialog finding items which should be updated during CPRS\n        GUI reminder processing.\n     \n        Review dialog elements in the national reminder dialog and change \n        any national health factors to local health factors, if \n        necessary.   It is not unusual for local findings to be used\n        in your national dialogs.\n        Any local findings used in the national dialogs should be mapped \n        to the appropriate national reminder term.\n    order to use this reminder.  However, use of the Women's Health\n     \n    3.  Alternately, use the Reminder Dialog options to copy the national \n        dialog, dialog elements, and dialog groups to make local \n        changes.  \n     \n        Add local dialog elements with local Order Dialogs for additional \n        ordering options for the clinicians. Many sites have clinicians\n        order a consult to a service that provides mammograms.  If your\n        site does this, copy the reminder dialog to a local reminder\n        dialog, then add the local dialog element for the consult order \n    package is required in order to use the associated mammogram Review\n        to the reminder dialog so this practice can continue.\n     \n    4.  If your site chooses not to send letters via the WH package \n        (sending letters is part of the Review Results reminder, not this \n        reminder, copy the appropriate national dialog components to local\n        components and remove the findings related to WH notifications.\n    results reminder- This screening reminder and the associated and\n    review results reminder dialogs will update the WH package at the same\n    time clinical care is recorded in CPRS GUI, thus eliminating the need\n    for dual data entry.\n     \n    In order for this reminder to interface with the Women's Health (WH) \nscreening.  In its first release in 2005, this reminder replaces the\n    package, the Women's Health package must be installed and \n    maintained.  Please refer to the CPRS Integration: Women Veterans\n    Health (WVH) Install & Setup Guide for detailed instructions.\n     \n    The following is a subset of some of the specific features of WH that \n    must be in place in order for this reminder to work in conjunction \n    with the Women's Health package as it was orginally designed: \n        * Female veterans should be entered into the WH package.  \n        * WH parameters should be set up to automatically import mammogram\n          Radiology reports into the WH package when they are verified in\nfollowing national reminders relating to mammograms and breast cancer\n          the VistA Radiology package. \n        * The WV NOTIFICATION PURPOSE letters should be customized to\n          reflect site information and the correct letter content for each\n          type of letter. \n        * The WV NOTIFICATION PURPOSE treatment need and treatment need\n          date offset should be defined if appropriate. These new fields\n          will be used to update Women's Health data when purpose of\n          notifications are selected by clinicians from reminder dialogs.\n        * The reminder dialog definitions should reference the appropriate\n          WV NOTIFICATION PURPOSE.\nscreening:\n     \n    Setup of reminder/dialog before using this reminder: \n    ==================================================== \n    1.  Use the Reminder Term options to map local representations of \n        findings: \n     \n    PATIENT COHORT FINDINGS: \n    ------------------------\n    The following reminder terms determine whether the reminder applies \n    to the patient.\n     \n     \n       WH BR CA 40-49 WANTS SCREENING \n          This is a new term distributed with the 2013 update of this\n          reminder which includes women ages 40-49 in the cohort of this\n          reminder. The health factor WH BR CA 40-49 WANTS SCREENING is\n          pre-mapped and is health factor is generated in the dialog of\n          the new reminder: VA-WH DISCUSS BREAST CA SCREEN WOMAN 40-49.No\n          other health factors need to be mapped to this term.\n \n       VA-WH BILATERAL MASTECTOMY \n            VA-*BREAST CANCER SCREEN \n           This term will use the VA-WH BILATERAL MASTECTOMY taxonomy to \n           find coded bilateral mastectomies. The health factor WH \n           BILATERAL MASTECTOMY distributed with this term may be used or \n           add any local health factor that represents the patient had a \n           bilateral mastectomy and no longer needs mammogram screening.  \n \n       VA-TERMINAL CANCER PATIENT \n           No mapping necessary.  Use the VA-TERMINAL CANCER PATIENTS\n           reminder taxonomy distributed with this term.\n      \n            VA-MAMMOGRAM \n    RESOLUTION FINDINGS: \n    --------------------\n    The following reminder terms resolve the reminder.  These resolution\n    terms are defined with a "Use in Resolution Logic", but no Frequency.\n    Frequency for this reminder will be determined by Function Findings \n    (FF) logic, which examines the most recent findings:\n \n         * If Function Findings determine that the most recent finding \n           is a result, the baseline age and frequency will be used.  \n         \n
\n
\n", "", "
(SEX)&(AGE)!FI(1)&'FI(2)&'FI(3)
\n", "
5
\n", "
SEX;AGE;1;2;3
\n", "", "
(0)!FI(4)!FI(5)!FI(6)!FI(7)!FI(8)!FI(9)!FI(10)!FI(16)
\n", "
8
\n", "
4;5;6;7;8;9;10;16
\n", "
9
\n", "
1;9;FF1;FF2;FF3;FF4;FF5;FF6;FF7
\n", "
5
\n", "
11;12;13;14;15
\n", "", "", "", "", "
\n
\n\n
\n", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-WH MAMMOGRAM REVIEW RESULTS", "
Mammogram Review Results
\n", "", "", "", "", "
S
\n", "
FEMALE
\n", "", "
NATIONAL
\n", "
WOMEN VETERANS HEALTH PROGRAM
\n", "", "
CR
\n", "
\n
\n\n
\n", "
\nThe VHA recommends that mammogram results be reviewed and that the\nThis reminder is based on VHA guidelines for Women Veterans Health and \nthe Integration of Women Veterans Health with CPRS GUI project workgroup.\nThe workgroup reviewed materials from several sources:\n \n   * Guidelines from the VA National Center for Health Promotion and\n     Disease Prevention (NCHPDP) and the US Preventive Services Task \n     Force (USPSTF)\n   * External Peer Review Process (EPRP)\n   * Guidelines from the American Cancer Society \nclinical review be documented in the patient record.\n \nThis reminder will be due when mammogram results are present in the\nWomen's Health package and are pending clinician review.\n \nThis reminder will be satisfied when the clinical review of mammogram\nresults is recorded in the Women's Health package.  \n \n
\n
\n", "
\n
\n\n
\n", "", "
\nThis reminder has been developed to interface with the Women's Health (WH)\nThe reminder was developed to interface with the Women's Health package.\n   * When the reminder is evaluated, mammogram results pending review in \n     the Women's Health package will be used to determine if the reminder \n     is due.\n   * The VA-WH MAMMOGRAM REVIEW RESULTS reminder dialog will display the \n     mammogram results and will record clinical review information in \n     the current progress note and in the Women's Health package.\n   * The VA-WH PAP SMEAR REVIEW RESULTS reminder dialog offers selections \n     the clinician can use to document patient notification information \n     of mammogram results in the Women's Health package.\npackage. The associated reminder dialog will update the WH package at the\n \n    During the clinical review process, clinicians will be directed to use\n    the term "NEM", which stands for No Evidence of Malignancy, in place \n    of the term "Normal".\n \nSetup issues before using this reminder: \n \n1.  Use the Reminder Term options to map local representations of \n    findings:\n \nsame time clinical care is recorded in CPRS GUI, thus eliminating dual\n    VA-WH VA-WH MAMMOGRAM PENDING REVIEW\n                  No mapping necessary.  New VA-WH MAMMOGRAM PENDING \n                  REVIEW  computed finding will be installed with\n                  this reminder. This computed findings will make the\n                  reminder due when the condition is: I V="Pending".\n                  It will then return mammogram results pending\n                  clinician review from the WH package.\n \n2.  Use the Reminder Dialog edit option to define the national reminder\n    dialog finding items which should be updated during CPRS GUI reminder\ndata entry and encouraging synchronization of data.  \n    processing.\n \n    Review dialog elements in the national reminder dialog and change\n    any national health factors to local health factors, if necessary.\n    It is not unusual for local findings to be used in your national\n    dialogs. Any local findings used in the national dialogs should be\n    mapped to the appropriate national reminder term.  \n \n3.  Alternately, use the Reminder Dialog options to copy the national \n    dialog, dialog elements, and dialog groups to make local changes.\n \n            \n    Add local dialog elements with local Order Dialogs for additional \n    ordering options for the clinicians. Some sites have clinicians \n    order a consult to a service that provides PAP smears.  If your\n    site does this, copy the reminder dialog to a local reminder\n    dialog and then add the local dialog element for the consult order\n    to the reminder dialog so this practice can continue.\n \n    Some sites have local entries in the Women's Health WV Notification\n    Purpose file.  If your site does this, copy the reminder dialog to\nThis reminder is recommended for use by clinicians at Primary Care Clinics\n    a local reminder dialog, then add or modify the notifications so\n    this practice can continue.  Under reminder findings, use the new \n    "WH" finding type to point to your entries.\n \n4.  Use the AEP Add/Edit a Notification Purpose & Letter manager\n    option in the Women's Health package to set up entries in the WV \n    Notification Purpose file.  The breast or cervical treatment need and \n    due date should be set and the default letter text should explain the\n    reason for the letter.\n(Primary Care/Medicine, GIMC, Geriatric, Women's) and any other specialty\nclinics where primary care is given to female patients.  \n \n
\n
\n", "", "
(SEX)&(AGE)&FI(3)
\n", "
3
\n", "
SEX;AGE;3
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-*TOBACCO USE SCREEN", "
ZZ Tobacco Use Screen
\n", "
1M
\n", "
ZZVA-*TOBACCO USE SCREEN
\n", "
INACTIVE
\n", "
2005-03-11 12:42:50
\n", "", "", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nThis reminder is based on "Tobacco Use Counseling" guidelines specified\n \n    Goals for FY 2000: 100% of VHA facilities have an intensive smoking\n    cessation program (or access to one) which includes appropriate\n    pharmacological treatment. 75% of primary care providers routinely\n    advise cessation and provide assistance and follow-up for all their\n    patients who use tobacco. Reduce cigarette smoking to a prevalence\n    of no more than 15% among people age 20 and over.\nin the VHA HANDBOOK 1101.8, APPENDIX A.\n \n    Target Conditions: Cancer, pulmonary and cardiovascular disease.\n \n    Target Group: Outpatients who use tobacco.\n \n    Recommendation: Tobacco use cessation counseling should be offered\n    annually to all who use tobacco on a regular basis.\n
\n
\n", "
\n
\n\n
\n", "", "
\nIf this reminder is not going to be used at your facility, the INACTIVE\nincludes a check for smoking cessation education, in addition to the\nscreening.  It also includes target conditions for patients who have\ntobacco related diagnoses or health factors on file.\n \nPlease review both of these reminder definitions, choose one of them to\nuse.  If local modifications need to be made, copy the preferred reminder\nto a new reminder and make your reminder modifications.\nFLAG should be set to inactive.\n \nThis reminder represents the minimum criteria for checking if the patient\nhas received a tobacco use screen. The "VA-TOBACCO USE SCREENING"\neducation topic is the result finding that will satisfy this reminder.\n \nThe Ambulatory Care EP recommends a variation on this reminder\nrepresented in the "VA-TOBACCO EDUCATION" reminder.  This reminder\n
\n
\n", "", "
(SEX)&(AGE)&'FI(2)
\n", "
3
\n", "
SEX;AGE;2
\n", "", "
(0)!FI(1)
\n", "
1
\n", "
1
\n", "
1
\n", "
2
\n", "
1
\n", "
3
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VAL-EHR CUTOVER BANNER", "
EHR Cutover Over Information
\n", "
1D
\n", "", "", "", "", "", "", "
LOCAL
\n", "", "", "
C
\n", "
\n
\n\n
\n", "", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "", "
(SEX)&(AGE)
\n", "
2
\n", "
SEX;AGE
\n", "", "", "", "", "", "", "
2
\n", "
1;FF1
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "
0
\n", "
0
\n"], ["VA-DEPRESSION SCREENING", "
Depression Screening
\n", "
1M
\n", "", "", "
2005-01-18 10:58:47
\n", "", "", "", "
NATIONAL
\n", "
OFFICE OF PATIENT CARE SERVICES
\n", "", "
CR
\n", "
\n
\n\n
\n", "
\nScreening for Depression using a standard tool should be done on a yearly \n \nHealth factors for refusal, acute illness and for chronic cognitive \nimpairment are included in this reminder.\n \nEntry of chronic cognitive impairment makes this reminder NA.\n \nReminder terms for health factors that represent prior depression \nscreening using the PHQ-2 and PHQ-9 are included.  The PHQ-2 has been the \nonly accepted depression screening tool since 12/1/06.  Map any local \nhealth factors for the PHQ-2 to these terms.  Do not include any health \nbasis.   \nfactors for other depression screening tools.\n \nThe reminder term VA-CHRONIC COGNITIVE IMPAIRMENT contains a health \nfactor and also the BOMC from the MH package.  Use this health factor \nwith caution since it turns this reminder off permanently.\n \nUpdate April 2009\n1. update URLs for changes on the OQP web page\n \nA PHQ-2 or a PHQ-9 is required on all patients unless there is a recent \ndiagnosis of depression entered for an outpatient visit.  Patients with a \ndiagnosis of depression need additional f/u and treatment.\n \nThis reminder requires entry of the PHQ2 into the Mental Health package \nafter 1/1/08.  \n
\n
\n", "
\n
\n\n
\n", "", "", "", "
(SEX)&(AGE)&'FI(1)&'FI(2)
\n", "
4
\n", "
SEX;AGE;1;2
\n", "", "
(0)!FI(3)!FI(4)!FI(5)!FI(6)!FI(7)!FI(8)
\n", "
6
\n", "
3;4;5;6;7;8
\n", "", "", "", "", "", "", "", "", "
\n
\n\n
\n", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-GEC REFERRAL CARE RECOMMENDATION", "
GEC REFERRAL CARE RECOMMENDATIONS
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
OFFICE OF GERIATRIC EXTENDED CARE
\n", "", "
C
\n", "
\n
\n\n
\n", "
\nThe Office of Geriatric Extended Care (OGEC) approved the paper-based\nrequired of extended care service are inconsistent.  Some facilities use\nthe VA Form 10-7108, VA Form 10064a (Patient Assessment Instrument) or VA\nForm 1204 (Referral for Community Nursing Home Care), while other sites\nuse various other assessments or consults.  OGEC seeks to standardize the\nprocess of assessment as well as the data set in order to establish a\nbasis upon which program evaluation and quality performance can be\nmanaged.\n \nFour clinical reminder dialogs collect data regarding the need for\nlong-term care services in a standard format across VHA.  This provides\nGEC Referral as the preferred method for assessing and screening patients\na mechanism for clinicians to administer comprehensive long-term care\nassessments, stores the information within the patient medical record and\nallows clinicians to notify local OGEC staff.  The screening data is\ncollected as health factors and is stored in the V Health Factor file.  \nThere is no cohort or resolution logic associated. The four reminder\ndialogs are GEC Referral Social Services, GEC Referral Nursing Assessment,\nGEC Referral Care Recommendations, and GEC Referral Care Coordination. An\nM-based option routine accompanies these reminders that extracts the data\nand makes it available for ad hoc reporting.\nfor long-term and extended care services.  As part of the Long Term Care\nInitiative and the Veterans Millennium Health Care and Benefits Act,\nPublic Law 106-177, OGEC identified this tool as the means to standardize\nlong-term care assessments and to prepare for the national collection of\ndata regarding long-term care needs in the veteran population.\n \nCurrent VHA methods of assessing patients to determine the level of care\n
\n
\n", "", "", "
\nI.      Basics.\nIX.     Training.\nare intended only as TIU templates and do not need to be assigned to the \nCPRS Cover Sheet.  Due to potential complications with reporting and \nduplicate entries, it is recommended that the GEC dialogs not be added to \nthe Reminders drawer/Cover sheet.  The Referral was designed for \ninter-disciplinary use with dialogs created for separate services.  \nHowever, a single user may perform them all.  With only a few exceptions, \neach section of the dialogs is mandatory and is marked with an asterisk \n(*).  The completion of all four dialogs constitutes a discrete episode \nof the GEC Referral.\n \n \nThe VA-GEC REFERRAL SOCIAL SERVICES, VA-GEC REFERRAL NURSING ASSESSMENT \nand VA-GEC REFERRAL CARE RECOMMENDATIONS dialogs comprise the clinical \nscreening.  The VA-GEC REFERRAL CARE COORDINATION dialog is used \nadministratively to record the arrangement of and funding for extended \ncare services.  These dialogs may be performed in any order local \npractices dictate.  However, it is expected the screening portion will be \ncompleted prior to the coordination of services.  When the screen is \ncomplete, a consult order should be placed to the service responsible for \narranging services.\n \nI.      Basics\nA.       GEC Consult Order\nMost sites have either an individual or service responsible for arranging \nand coordinating extended care services.  To accommodate local business \npractices and flexibility, sites may associate any consult service (or \nmenu) they already have in place.  If none exist, the sites may create a \nconsult or establish some alternative practice to ensure that both \nservices are arranged and that the VA-GEC REFERRAL CARE COORDINATION \ndialog is completed.  \n \nA placeholder for this consult is included at the end of the VA-GEC \nThe GEC Referral is comprised of 4 reminder dialogs: VA-GEC SOCIAL \nREFERRAL SOCIAL SERVICES, VA-GEC REFERRAL NURSING ASSESSMENT and VA-GEC \nREFERRAL CARE RECOMMENDATIONS dialogs.  It must be substituted or deleted \nat the time of installation.  \n \nPre-Installation Requirements\n \nSince nationally created orders do not map to local orderable items, \norders do not pass through Reminder Exchange.  Installation of the \nReferral will prompt for a resolution of this dialog element.  Resolution \nwill consist of either replacing the order with a locally created order, \nSERVICES, VA-GEC NURSING ASSESSMENT, VA-GEC CARE RECOMMENDATIONS and \ndeleting the element or skipping the step.\n \nConsult quick orders are existing functionality that are probably in use \nat your site.  It is also possible that an order has already been created \nthat could be used.  To determine this, the installer should contact the \nCPRS CAC prior to installation and determine if an order is available.  \nIf it is, installation will only require entry of the Fileman name-space \nof the order at the prompt.  If it is not, follow the steps in the CAC \nsection below.\n \nVA-GEC CARE COORDINATION.  These dialogs are designed for use as TIU \nDuring installation you will be presented with the following prompt:\n \n        REMINDER DIALOG entry VA-ORDER GEC REFERRAL CONSULT does not\n        EXIST, what do you want to do?\n \n        Select one of the following:\n \n             D   Delete (from the reminder/dialog)\n             P   Replace (in the reminder/dialog) with an existing entry\n             Q   Quit the install\ntemplates to enter data regarding the need for extended care.  Data \n \nThe installer should select P (Replace with an existing entry), and enter\nthe name of the existing quick order provided by the CAC using Fileman\nname.  [NOTE: The same quick order may be used on each of the dialogs].\n \nCAC Section\n1. The CAC should first determine if a Consult Service exists for\nthe management of extended care services.  If it exists, this service can \nbe used for the quick order and you can proceed to step 2.  If one does \nnot exist, the CAC will need to create a Consult Service by using the \nentered via the dialogs are captured as health factors to be used for \n[GMRC Manager] option [GMRC SETUP REQUEST SERVICES].\n     a. Recipients of the consult notifications should be GEC staff \n        responsible for coordinating extended care service (or any\n        appropriate user).\n2. The CAC should create a consult quick order using the [ORCM MGMT] \noption [ORCM MENU].  This order should be associated to the Consult \nService in the Consult to Service/Specialty field of the quick order.\n3. The CAC should then provide the name of the consult quick order \nto the installer.  The installer will then perform the installation and \nenter the name of the order at the prompt as above.\nlocal and national reporting.  The software includes a new report menu \n \nVI.     GEC Interdisciplinary Notes\nThe GEC Referral dialogs are intended for use as TIU templates.  It is \nalso expected that they will be used as part of a TIU Interdisciplinary \n(ID) note.  This will require new TIU Document Definitions or the \nassociation of existing titles to the dialogs.  This project does not \nstipulate the titles to be used, preferring to allow the sites to use \nthose titles that would best suit their business practices.  However, the \nOffice of Geriatrics Extended Care requests that the parent ID note title \nbe:\nthat may be used for local analysis.\n        "GEC EXTENDED CARE REFERRAL"\n \nTo create a TIU Document Definition, perform the following steps:\nA.      Access the TIU IRM MAINTENANCE MENU.\nB.      Select TIUF DOCUMENT DEFINITION MGR.\nC.      Select Create Document Definitions or Edit Document Definitions.\nD.      Select class and create title.\n \n \nTo associate reminder dialogs with TIU templates, perform the following \nII.     GEC Health Factors and their use.\n \nsteps*:\n \nA.      Make the GEC Referral dialogs eligible to be used as a template \n        by using the parameter: TIU TEMPLATE REMINDER DIALOGS.\nB.      Associate the dialog to a TIU Document Definition.\n        1. Go to Shared Templates\n        2. Click "New Template."\n        3. Enter a name.\n        4. Select the Template Type as Reminder Dialog.\n        5. Pick a GEC dialog from the Reminder Dialog field.\nII.     GEC Health Factors\n        6. Under Shared Templates, pick Document Titles.\n        7. In the Associated Title field, pick the Document Definition\n           created or designated for this dialog.\n        8. Click Apply.\n \n(*You will require the Clinical Applications Coordinator User Class.)\n \nVII.    GEC Referral Reports\nThe software includes a new set of reports that provide a variety of GEC \nhealth factor perspectives.  The reports are released as an option within \nThe GEC Referral project distributes a large set of national health \nthe Clinical Reminder namespace and may be assigned as necessary.  The \noption is [PXRM GEC REFERRAL REPORT] and may be added to the PXRM \nMANAGERS MENU.  The reports capture data elements for reporting and \ntracking use of the GEC Referral Screening Tool.   The reports may be \ngenerated in formatted or delimited output.  The Summary (Score) report \nprovides summary (calculated) totals from specific sections of the \nscreening tool identified by the Office of Geriatrics Extended Care.\n \nVIII.   GEC Reminder Terms\nPhase I of the GEC Referral project distributes a set of terms that will \nfactors.  They may be identified by the GEC name-space and constitute the \nbe used with Phase II.  Since Phase II has not yet been initiated, the \nfunctional requirements and design have not been identified.  However, it \nis expected to include the national roll-up of GEC screening data using \nthe Generic Extract Utility released concurrently with Clinical Reminders \nv2.0.  To allow the greatest degree of flexibility in design, one \nreminder term is released for each GEC Referral health factor. The terms \nare mapped to the health factors on the VA-GEC REFERRAL reminder \ndialogs.  The terms will be installed silently and reside dormant until \nPhase II of the GEC Referral project is implemented.  The reminder \ndefinitions used with these terms will be deleted via post-install \nfoundation of the GEC Referral project.  They establish a standard set of \nroutine after installation.\n \nIX.     Training\nThe Office of Geriatric Extended Care (OGEC) will establish a web site to \nprovide training on the GEC screening tool.  This training module is \nbeing developed with assistance from Employee Education Service and built \nby ImageITS, a private firm.  The module will consist of an interactive \ntutorial and reference material.  OGEC will coordinate the training \ninitiative and serve as the custodian of the web site's content.  \nFacilities may contact OGEC to obtain the website's URL or for more \nscreening data, to be used across the Veterans Health Administration, and \ninformation.   \nwill be rolled-up nationally in Phase II.  \n \nThe Health Factor and V Health Factor files include factors and \ncategories.  For this project, each section of the Referral is correlated \nIII.    GEC Status Indicator.\nto a health factor category.  Once entered, the data is stored in the \nPatient Care Encounter files.  The structure of these underlying files \nhas a direct impact on the design of the GEC software.  Extracting, \nviewing and managing this set of data requires the GEC dialogs to remain \nas they are released.  Consequently, the Clinical Reminders package has \nbeen modified to prevent the GEC national reminders from being copied.  \nThis change was made to the Reminder Dialog, Dialog Group and Dialog \nElement levels.  To accommodate local business practices, sites will be \npermitted to add locally created health factors to the GEC dialogs.  A \nnew List Manager screen is included to facilitate additions and any \nIV.     GEC Referral ad hoc reports (CPRS GUI).\nsubsequent edits to those Groups and Elements added locally.  \n \nNOTES:\n \n    -Dialog elements that have an order associated as a finding item \n     will continue to be an editable field using the dialog editor.\n    -Any local changes to the GEC dialogs will not be included with \n     the reports or future national extracts.\n    -GEC health factors are populated with a synonym for \n     identification.\nV.      GEC Referral Reminders and Dialogs.\n    -Sites are discouraged from using the GEC health factors \n     elsewhere. Phase II of the GEC project will involve national roll-up.\n     Since this project has yet to be started, potential extraction rules\n     may not be able to distinguish the data source.\n    -Users should not enter GEC health factors from the Encounter \n     form. While it is possible to do so, Patient Care Encounter only\n     allows one instance of a combination of the health factor, patient\n     and visit IEN.  If one is entered via the Encounter, any subsequent\n     entry of that health factor from the reminder dialog will not be\n     available for the GEC reports.  This is a consequence of the GEC report\n    A.  GEC Consult Order.\n     routines relying on the health factor's Data Source.\n \n \nIII.    GEC Status Check\nThere is no limit to the entry of GEC Referral data.  Thus, there may be \nmultiple entries of the same health factors over time.  Since the data is \nentered via separate dialogs, extraction and viewing requires the data to \nbe discretely identified.  The GEC software depends upon the user to \nindicate when the data from a given referral should be concluded.  The \nreferral is finalized using a new feature called the GEC Status \nVI.     GEC Interdisciplinary Notes.\nIndicator.  This indicator is presented to the user as a modal dialog at \nthe conclusion of the VA-GEC CARE COORDINATION dialog.  It will prompt \nthe user to indicate the conclusion of the Referral with a Yes or NO \nresponse and will list any missing dialogs.  If YES is selected, the data \nfor the current episode of the Referral is closed.  If No is selected, \nthe Indicator is displayed with each succeeding GEC dialog until Yes is \nselected.\n \nTo assist the ongoing management of completing GEC Referrals, the GEC \nStatus Indicator may be added to the CPRS GUI Tools drop-down menu.  The \nVII.    GEC Referral Reports (LM CHUI).\nparameter to activate the Indicator is PXRM GEC STATUS CHECK.  If may be \nset at the User or Team level.  If added to the drop-down menu, the \nIndicator may be viewed at any time and used to close the referral if \nneeded.\n \n \nIV.     GEC Referral Ad hoc Reports\nTwo new health summary components have been created and distributed with \nthis software:  GEC Completed Referral Count (GECC) and GEC Health Factor \nCategory (GECH).  The first displays all GEC referral data according to \nVIII.   GEC Reminder Terms.\nthe occurrence and time limits identified.  The GEC Health Factor \nCategory component, in conjunction with PX*1*123 and GMTS*2.7*63, permits \nGEC data to be viewed by health factor or health factor category.  If a \nuser should have access to these GEC reports, they must have access to \nthe Ad Hoc Health Summary type.  [This can be set using GMTS GUI HS LIST \nPARAMETERS.]\n \nV.      GEC Referral Reminders and Dialogs\nThe GEC reminders are comprised of dialogs and health factors only.  They \nhave neither cohort nor resolution logic and will not become due.  They \n
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(SEX)&(AGE)
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2
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SEX;AGE
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GEC REFERRAL NURSING ASSESSMENT
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NATIONAL
\n", "
OFFICE OF GERIATRIC EXTENDED CARE
\n", "", "
C
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\n
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\nThe Office of Geriatric Extended Care (OGEC) approved the paper-based\nrequired of extended care service are inconsistent.  Some facilities use\nthe VA Form 10-7108, VA Form 10064a (Patient Assessment Instrument) or VA\nForm 1204 (Referral for Community Nursing Home Care), while other sites\nuse various other assessments or consults.  OGEC seeks to standardize the\nprocess of assessment as well as the data set in order to establish a\nbasis upon which program evaluation and quality performance can be\nmanaged.\n \nFour clinical reminder dialogs collect data regarding the need for\nlong-term care services in a standard format across VHA.  This provides\nGEC Referral as the preferred method for assessing and screening patients\na mechanism for clinicians to administer comprehensive long-term care\nassessments, stores the information within the patient medical record and\nallows clinicians to notify local OGEC staff.  The screening data is\ncollected as health factors and is stored in the V Health Factor file.  \nThere is no cohort or resolution logic associated. The four reminder\ndialogs are GEC Referral Social Services, GEC Referral Nursing Assessment,\nGEC Referral Care Recommendations, and GEC Referral Care Coordination. An\nM-based option routine accompanies these reminders that extracts the data\nand makes it available for ad hoc reporting.\nfor long-term and extended care services.  As part of the Long Term Care\nInitiative and the Veterans Millennium Health Care and Benefits Act,\nPublic Law 106-177, OGEC identified this tool as the means to standardize\nlong-term care assessments and to prepare for the national collection of\ndata regarding long-term care needs in the veteran population.\n \nCurrent VHA methods of assessing patients to determine the level of care\n
\n
\n", "", "", "
\nI.      Basics.\nIX.     Training.\nCPRS Cover Sheet.  Due to potential complications with reporting and \nduplicate entries, it is recommended that the GEC dialogs not be added to \nthe Reminders drawer/Cover sheet.  The Referral was designed for \ninter-disciplinary use with dialogs created for separate services.  \nHowever, a single user may perform them all.  With only a few exceptions, \neach section of the dialogs is mandatory and is marked with an asterisk \n(*).  The completion of all four dialogs constitutes a discrete episode \nof the GEC Referral.\n \nThe VA-GEC REFERRAL SOCIAL SERVICES, VA-GEC REFERRAL NURSING ASSESSMENT \n \nand VA-GEC REFERRAL CARE RECOMMENDATIONS dialogs comprise the clinical \nscreening.  The VA-GEC REFERRAL CARE COORDINATION dialog is used \nadministratively to record the arrangement of and funding for extended \ncare services.  These dialogs may be performed in any order local \npractices dictate.  However, it is expected the screening portion will be \ncompleted prior to the coordination of services.  When the screen is \ncomplete, a consult order should be placed to the service responsible for \narranging services.\n \nA.       GEC Consult Order\nI.      Basics\nMost sites have either an individual or service responsible for arranging \nand coordinating extended care services.  To accommodate local business \npractices and flexibility, sites may associate any consult service (or \nmenu) they already have in place.  If none exist, the sites may create a \nconsult or establish some alternative practice to ensure that both \nservices are arranged and that the VA-GEC REFERRAL CARE COORDINATION \ndialog is completed.  \n \nA placeholder for this consult is included at the end of the VA-GEC \nREFERRAL SOCIAL SERVICES, VA-GEC REFERRAL NURSING ASSESSMENT and VA-GEC \nThe GEC Referral is comprised of 4 reminder dialogs: VA-GEC SOCIAL \nREFERRAL CARE RECOMMENDATIONS dialogs.  It must be substituted or deleted \nat the time of installation.  \n \nPre-Installation Requirements\n \nSince nationally created orders do not map to local orderable items, \norders do not pass through Reminder Exchange.  Installation of the \nReferral will prompt for a resolution of this dialog element.  Resolution \nwill consist of either replacing the order with a locally created order, \ndeleting the element or skipping the step.\nSERVICES, VA-GEC NURSING ASSESSMENT, VA-GEC CARE RECOMMENDATIONS and \n \nConsult quick orders are existing functionality that are probably in use \nat your site.  It is also possible that an order has already been created \nthat could be used.  To determine this, the installer should contact the \nCPRS CAC prior to installation and determine if an order is available.  \nIf it is, installation will only require entry of the Fileman name-space \nof the order at the prompt.  If it is not, follow the steps in the CAC \nsection below.\n \nDuring installation you will be presented with the following prompt:\nVA-GEC CARE COORDINATION.  These dialogs are designed for use as TIU \n \n        REMINDER DIALOG entry VA-ORDER GEC REFERRAL CONSULT does not\n        EXIST, what do you want to do?\n \n        Select one of the following:\n \n             D   Delete (from the reminder/dialog)\n             P   Replace (in the reminder/dialog) with an existing entry\n             Q   Quit the install\n \ntemplates to enter data regarding the need for extended care.  Data \nThe installer should select P (Replace with an existing entry), and enter\nthe name of the existing quick order provided by the CAC using Fileman\nname.  [NOTE: The same quick order may be used on each of the dialogs].\n \nCAC Section\n1. The CAC should first determine if a Consult Service exists for \nthe management of extended care services.  If it exists, this service can \nbe used for the quick order and you can proceed to step 2.  If one does \nnot exist, the CAC will need to create a Consult Service by using the \n[GMRC Manager] option [GMRC SETUP REQUEST SERVICES].\nentered via the dialogs are captured as health factors to be used for \n    a. Recipients of the consult notifications should be GEC staff \n       responsible for coordinating extended care service (or any\n       appropriate user).\n2. The CAC should create a consult quick order using the [ORCM MGMT] \noption [ORCM MENU].  This order should be associated to the Consult \nService in the Consult to Service/Specialty field of the quick order.\n3. The CAC should then provide the name of the consult quick order \nto the installer.  The installer will then perform the installation and \nenter the name of the order at the prompt as above.\n \nlocal and national reporting.  The software includes a new report menu \nVI.     GEC Interdisciplinary Notes\nThe GEC Referral dialogs are intended for use as TIU templates.  It is \nalso expected that they will be used as part of a TIU Interdisciplinary \n(ID) note.  This will require new TIU Document Definitions or the \nassociation of existing titles to the dialogs.  This project does not \nstipulate the titles to be used, preferring to allow the sites to use \nthose titles that would best suit their business practices.  However, the \nOffice of Geriatrics Extended Care requests that the parent ID note title \nbe:\n        "GEC EXTENDED CARE REFERRAL"\nthat may be used for local analysis.\n \nTo create a TIU Document Definition, perform the following steps:\nA.      Access the TIU IRM MAINTENANCE MENU.\nB.      Select TIUF DOCUMENT DEFINITION MGR.\nC.      Select Create Document Definitions or Edit Document Definitions.\nD.      Select class and create title.\n \n \nTo associate reminder dialogs with TIU templates, perform the following \nsteps*:\nII.     GEC Health Factors and their use.\n \n \nA.      Make the GEC Referral dialogs eligible to be used as a template \n        by using the parameter: TIU TEMPLATE REMINDER DIALOGS.\nB.      Associate the dialog to a TIU Document Definition.\n        1. Go to Shared Templates\n        2. Click "New Template."\n        3. Enter a name.\n        4. Select the Template Type as Reminder Dialog.\n        5. Pick a GEC dialog from the Reminder Dialog field.\n        6. Under Shared Templates, pick Document Titles.\nII.     GEC Health Factors\n        7. In the Associated Title field, pick the Document Definition\n           created or designated for this dialog.\n        8. Click Apply.\n \n(*You will require the Clinical Applications Coordinator User Class.)\n \nVII.    GEC Referral Reports\nThe software includes a new set of reports that provide a variety of GEC \nhealth factor perspectives.  The reports are released as an option within \nthe Clinical Reminder namespace and may be assigned as necessary.  The \nThe GEC Referral project distributes a large set of national health \noption is [PXRM GEC REFERRAL REPORT] and may be added to the PXRM \nMANAGERS MENU.  The reports capture data elements for reporting and \ntracking use of the GEC Referral Screening Tool.   The reports may be \ngenerated in formatted or delimited output.  The Summary (Score) report \nprovides summary (calculated) totals from specific sections of the \nscreening tool identified by the Office of Geriatrics Extended Care.\n \nVIII.   GEC Reminder Terms\nPhase I of the GEC Referral project distributes a set of terms that will \nbe used with Phase II.  Since Phase II has not yet been initiated, the \nfactors.  They may be identified by the GEC name-space and constitute the \nfunctional requirements and design have not been identified.  However, it \nis expected to include the national roll-up of GEC screening data using \nthe Generic Extract Utility released concurrently with Clinical Reminders \nv2.0.  To allow the greatest degree of flexibility in design, one \nreminder term is released for each GEC Referral health factor. The terms \nare mapped to the health factors on the VA-GEC REFERRAL reminder \ndialogs.  The terms will be installed silently and reside dormant until \nPhase II of the GEC Referral project is implemented.  The reminder \ndefinitions used with these terms will be deleted via post-install \nroutine after installation.\nfoundation of the GEC Referral project.  They establish a standard set of \n \nIX.     Training\nThe Office of Geriatric Extended Care (OGEC) will establish a web site to \nprovide training on the GEC screening tool.  This training module is \nbeing developed with assistance from Employee Education Service and built \nby ImageITS, a private firm.  The module will consist of an interactive \ntutorial and reference material.  OGEC will coordinate the training \ninitiative and serve as the custodian of the web site's content.  \nFacilities may contact OGEC to obtain the website's URL or for more \ninformation.   \nscreening data, to be used across the Veterans Health Administration, and \nwill be rolled-up nationally in Phase II.  \n \nThe Health Factor and V Health Factor files include factors and \ncategories.  For this project, each section of the Referral is correlated \nIII.    GEC Status Indicator.\nto a health factor category.  Once entered, the data is stored in the \nPatient Care Encounter files.  The structure of these underlying files \nhas a direct impact on the design of the GEC software.  Extracting, \nviewing and managing this set of data requires the GEC dialogs to remain \nas they are released.  Consequently, the Clinical Reminders package has \nbeen modified to prevent the GEC national reminders from being copied.  \nThis change was made to the Reminder Dialog, Dialog Group and Dialog \nElement levels.  To accommodate local business practices, sites will be \npermitted to add locally created health factors to the GEC dialogs.  A \nnew List Manager screen is included to facilitate additions and any \nIV.     GEC Referral ad hoc reports (CPRS GUI).\nsubsequent edits to those Groups and Elements added locally.  \n \nNOTES:\n \n      -Dialog elements that have an order associated as a finding item\n       will continue to be an editable field using the dialog editor.\n      -Any local changes to the GEC dialogs will not be included with \n       the reports or future national extracts.\n      -GEC health factors are populated with a synonym for identification.\n      -Sites are discouraged from using the GEC health factors \nV.      GEC Referral Reminders and Dialogs.\n       elsewhere. Phase II of the GEC project will involve national\n       roll-up. Since this project has yet to be started, potential\n       extraction rules may not be able to distinguish the data source.\n      -Users should not enter GEC health factors from the Encounter\n       form. While it is possible to do so, Patient Care Encounter only \n       allows one instance of a combination of the health factor, patient\n       and visit IEN.  If one is entered via the Encounter, any subsequent\n       entry of that health factor from the reminder dialog will not be\n       available for the GEC reports.  This is a consequence of the GEC\n       report routines relying on the health factor's Data Source.\n    A.  GEC Consult Order.\n \n \nIII.    GEC Status Check\nThere is no limit to the entry of GEC Referral data.  Thus, there may be \nmultiple entries of the same health factors over time.  Since the data is \nentered via separate dialogs, extraction and viewing requires the data to \nbe discretely identified.  The GEC software depends upon the user to \nindicate when the data from a given referral should be concluded.  The \nreferral is finalized using a new feature called the GEC Status \nIndicator.  This indicator is presented to the user as a modal dialog at \nVI.     GEC Interdisciplinary Notes.\nthe conclusion of the VA-GEC CARE COORDINATION dialog.  It will prompt \nthe user to indicate the conclusion of the Referral with a Yes or NO \nresponse and will list any missing dialogs.  If YES is selected, the data \nfor the current episode of the Referral is closed.  If No is selected, \nthe Indicator is displayed with each succeeding GEC dialog until Yes is \nselected.\n \nTo assist the ongoing management of completing GEC Referrals, the GEC \nStatus Indicator may be added to the CPRS GUI Tools drop-down menu.  The \nparameter to activate the Indicator is PXRM GEC STATUS CHECK.  If may be \nVII.    GEC Referral Reports (LM CHUI).\nset at the User or Team level.  If added to the drop-down menu, the \nIndicator may be viewed at any time and used to close the referral if \nneeded.\n \n \nIV.     GEC Referral Ad hoc Reports\nTwo new health summary components have been created and distributed with \nthis software:  GEC Completed Referral Count (GECC) and GEC Health Factor \nCategory (GECH).  The first displays all GEC referral data according to \nthe occurrence and time limits identified.  The GEC Health Factor \nVIII.   GEC Reminder Terms.\nCategory component, in conjunction with PX*1*123 and GMTS*2.7*63, permits \nGEC data to be viewed by health factor or health factor category.  If a \nuser should have access to these GEC reports, they must have access to \nthe Ad Hoc Health Summary type.  [This can be set using GMTS GUI HS LIST \nPARAMETERS.]\n \nV.      GEC Referral Reminders and Dialogs\nThe GEC reminders are comprised of dialogs and health factors only.  They \nhave neither cohort nor resolution logic and will not become due.  They \nare intended only as TIU templates and do not need to be assigned to the \n
\n
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(SEX)&(AGE)
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2
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SEX;AGE
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\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-GEC REFERRAL SOCIAL SERVICES", "
GEC REFERRAL SOCIAL SERVICES
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
OFFICE OF GERIATRIC EXTENDED CARE
\n", "", "
C
\n", "
\n
\n\n
\n", "
\nThe Office of Geriatric Extended Care (OGEC) approved the paper-based\nrequired of extended care service are inconsistent.  Some facilities use\nthe VA Form 10-7108, VA Form 10064a (Patient Assessment Instrument) or VA\nForm 1204 (Referral for Community Nursing Home Care), while other sites\nuse various other assessments or consults.  OGEC seeks to standardize the\nprocess of assessment as well as the data set in order to establish a\nbasis upon which program evaluation and quality performance can be\nmanaged.\n \nFour clinical reminder dialogs collect data regarding the need for\nlong-term care services in a standard format across VHA.  This provides\nGEC Referral as the preferred method for assessing and screening patients\na mechanism for clinicians to administer comprehensive long-term care\nassessments, stores the information within the patient medical record and\nallows clinicians to notify local OGEC staff.  The screening data is\ncollected as health factors and is stored in the V Health Factor file.  \nThere is no cohort or resolution logic associated. The four reminder\ndialogs are GEC Referral Social Services, GEC Referral Nursing Assessment,\nGEC Referral Care Recommendations, and GEC Referral Care Coordination. An\nM-based option routine accompanies these reminders that extracts the data\nand makes it available for ad hoc reporting.\nfor long-term and extended care services.  As part of the Long Term Care\nInitiative and the Veterans Millennium Health Care and Benefits Act,\nPublic Law 106-177, OGEC identified this tool as the means to standardize\nlong-term care assessments and to prepare for the national collection of\ndata regarding long-term care needs in the veteran population.\n \nCurrent VHA methods of assessing patients to determine the level of care\n
\n
\n", "", "", "
\nI.      Basics.\nIX.     Training.\nCPRS Cover Sheet.  Due to potential complications with reporting and \nduplicate entries, it is recommended that the GEC dialogs not be added to \nthe Reminders drawer/Cover sheet.  The Referral was designed for \ninter-disciplinary use with dialogs created for separate services.  \nHowever, a single user may perform them all.  With only a few exceptions, \neach section of the dialogs is mandatory and is marked with an asterisk \n(*).  The completion of all four dialogs constitutes a discrete episode \nof the GEC Referral.\n \nThe VA-GEC REFERRAL SOCIAL SERVICES, VA-GEC REFERRAL NURSING ASSESSMENT \n \nand VA-GEC REFERRAL CARE RECOMMENDATIONS dialogs comprise the clinical \nscreening.  The VA-GEC REFERRAL CARE COORDINATION dialog is used \nadministratively to record the arrangement of and funding for extended \ncare services.  These dialogs may be performed in any order local \npractices dictate.  However, it is expected the screening portion will be \ncompleted prior to the coordination of services.  When the screen is \ncomplete, a consult order should be placed to the service responsible for \narranging services.\n \nA.       GEC Consult Order\nI.      Basics\nMost sites have either an individual or service responsible for arranging \nand coordinating extended care services.  To accommodate local business \npractices and flexibility, sites may associate any consult service (or \nmenu) they already have in place.  If none exist, the sites may create a \nconsult or establish some alternative practice to ensure that both \nservices are arranged and that the VA-GEC REFERRAL CARE COORDINATION \ndialog is completed.  \n \nA placeholder for this consult is included at the end of the VA-GEC \nREFERRAL SOCIAL SERVICES, VA-GEC REFERRAL NURSING ASSESSMENT and VA-GEC \nThe GEC Referral is comprised of 4 reminder dialogs: VA-GEC SOCIAL \nREFERRAL CARE RECOMMENDATIONS dialogs.  It must be substituted or deleted \nat the time of installation.  \n \nPre-Installation Requirements\n \nSince nationally created orders do not map to local orderable items, \norders do not pass through Reminder Exchange.  Installation of the \nReferral will prompt for a resolution of this dialog element.  Resolution \nwill consist of either replacing the order with a locally created order, \ndeleting the element or skipping the step.\nSERVICES, VA-GEC NURSING ASSESSMENT, VA-GEC CARE RECOMMENDATIONS and \n \nConsult quick orders are existing functionality that are probably in use \nat your site.  It is also possible that an order has already been created \nthat could be used.  To determine this, the installer should contact the \nCPRS CAC prior to installation and determine if an order is available.  \nIf it is, installation will only require entry of the Fileman name-space \nof the order at the prompt.  If it is not, follow the steps in the CAC \nsection below.\n \nDuring installation you will be presented with the following prompt:\nVA-GEC CARE COORDINATION.  These dialogs are designed for use as TIU \n \n        REMINDER DIALOG entry VA-ORDER GEC REFERRAL CONSULT does not\n        EXIST, what do you want to do?\n \n        Select one of the following:\n        \n             D   Delete (from the reminder/dialog)\n             P   Replace (in the reminder/dialog) with an existing entry\n             Q   Quit the install\n \ntemplates to enter data regarding the need for extended care.  Data \nThe installer should select P (Replace with an existing entry), and enter\nthe name of the existing quick order provided by the CAC using Fileman\nname.  [NOTE: The same quick order may be used on each of the dialogs].\n \nCAC Section\n1.  The CAC should first determine if a Consult Service exists for \nthe management of extended care services.  If it exists, this service can \nbe used for the quick order and you can proceed to step 2.  If one does \nnot exist, the CAC will need to create a Consult Service by using the \n[GMRC Manager] option [GMRC SETUP REQUEST SERVICES].\nentered via the dialogs are captured as health factors to be used for \n    a. Recipients of the consult notifications should be GEC staff \n       responsible for coordinating extended care service (or any\n       appropriate user).\n2. The CAC should create a consult quick order using the [ORCM MGMT] \noption [ORCM MENU].  This order should be associated to the Consult \nService in the Consult to Service/Specialty field of the quick order.\n3. The CAC should then provide the name of the consult quick order \nto the installer.  The installer will then perform the installation and \nenter the name of the order at the prompt as above.\n \nlocal and national reporting.  The software includes a new report menu \nVI.     GEC Interdisciplinary Notes\nThe GEC Referral dialogs are intended for use as TIU templates.  It is \nalso expected that they will be used as part of a TIU Interdisciplinary \n(ID) note.  This will require new TIU Document Definitions or the \nassociation of existing titles to the dialogs.  This project does not \nstipulate the titles to be used, preferring to allow the sites to use \nthose titles that would best suit their business practices.  However, the \nOffice of Geriatrics Extended Care requests that the parent ID note title \nbe:\n        "GEC EXTENDED CARE REFERRAL"\nthat may be used for local analysis.\n \nTo create a TIU Document Definition, perform the following steps:\nA.      Access the TIU IRM MAINTENANCE MENU.\nB.      Select TIUF DOCUMENT DEFINITION MGR.\nC.      Select Create Document Definitions or Edit Document Definitions.\nD.      Select class and create title.\n \n \nTo associate reminder dialogs with TIU templates, perform the following \nsteps*:\nII.     GEC Health Factors and their use.\n \n \nA.   Make the GEC Referral dialogs eligible to be used as a template \n     by using the parameter: TIU TEMPLATE REMINDER DIALOGS.\nB.   Associate the dialog to a TIU Document Definition.\n     1. Go to Shared Templates\n     2. Click "New Template."\n     3. Enter a name.\n     4. Select the Template Type as Reminder Dialog.\n     5. Pick a GEC dialog from the Reminder Dialog field.\n     6. Under Shared Templates, pick Document Titles.\nII.     GEC Health Factors\n     7. In the Associated Title field, pick the Document Definition \n        created or designated for this dialog.\n     8. Click Apply.\n \n(*You will require the Clinical Applications Coordinator User Class.)\n \nVII.    GEC Referral Reports\nThe software includes a new set of reports that provide a variety of GEC \nhealth factor perspectives.  The reports are released as an option within \nthe Clinical Reminder namespace and may be assigned as necessary.  The \nThe GEC Referral project distributes a large set of national health \noption is [PXRM GEC REFERRAL REPORT] and may be added to the PXRM \nMANAGERS MENU.  The reports capture data elements for reporting and \ntracking use of the GEC Referral Screening Tool.   The reports may be \ngenerated in formatted or delimited output.  The Summary (Score) report \nprovides summary (calculated) totals from specific sections of the \nscreening tool identified by the Office of Geriatrics Extended Care.\n \nVIII.   GEC Reminder Terms\nPhase I of the GEC Referral project distributes a set of terms that will \nbe used with Phase II.  Since Phase II has not yet been initiated, the \nfactors.  They may be identified by the GEC name-space and constitute the \nfunctional requirements and design have not been identified.  However, it \nis expected to include the national roll-up of GEC screening data using \nthe Generic Extract Utility released concurrently with Clinical Reminders \nv2.0.  To allow the greatest degree of flexibility in design, one \nreminder term is released for each GEC Referral health factor. The terms \nare mapped to the health factors on the VA-GEC REFERRAL reminder \ndialogs.  The terms will be installed silently and reside dormant until \nPhase II of the GEC Referral project is implemented.  The reminder \ndefinitions used with these terms will be deleted via post-install \nroutine after installation.\nfoundation of the GEC Referral project.  They establish a standard set of \n \nIX.     Training\nThe Office of Geriatric Extended Care (OGEC) will establish a web site to \nprovide training on the GEC screening tool.  This training module is \nbeing developed with assistance from Employee Education Service and built \nby ImageITS, a private firm.  The module will consist of an interactive \ntutorial and reference material.  OGEC will coordinate the training \ninitiative and serve as the custodian of the web site's content.  \nFacilities may contact OGEC to obtain the website's URL or for more \ninformation.   \nscreening data, to be used across the Veterans Health Administration, and \nwill be rolled-up nationally in Phase II.  \n \nThe Health Factor and V Health Factor files include factors and \ncategories.  For this project, each section of the Referral is correlated \nIII.    GEC Status Indicator.\nto a health factor category.  Once entered, the data is stored in the \nPatient Care Encounter files.  The structure of these underlying files \nhas a direct impact on the design of the GEC software.  Extracting, \nviewing and managing this set of data requires the GEC dialogs to remain \nas they are released.  Consequently, the Clinical Reminders package has \nbeen modified to prevent the GEC national reminders from being copied.  \nThis change was made to the Reminder Dialog, Dialog Group and Dialog \nElement levels.  To accommodate local business practices, sites will be \npermitted to add locally created health factors to the GEC dialogs.  A \nnew List Manager screen is included to facilitate additions and any \nIV.     GEC Referral ad hoc reports (CPRS GUI).\nsubsequent edits to those Groups and Elements added locally.  \n \nNOTES:\n \n     -Dialog elements that have an order associated as a finding item\n      will continue to be an editable field using the dialog editor.\n     -Any local changes to the GEC dialogs will not be included with\n      the reports or future national extracts.\n     -GEC health factors are populated with a synonym for identification.\n     -Sites are discouraged from using the GEC health factors elsewhere.\nV.      GEC Referral Reminders and Dialogs.\n      Phase II of the GEC project will involve national roll-up. Since\n      this project has yet to be started, potential extraction rules may \n      not be able to distinguish the data source.\n     -Users should not enter GEC health factors from the Encounter \n      form. While it is possible to do so, Patient Care Encounter only\n      allows one instance of a combination of the health factor, patient\n      and visit IEN.  If one is entered via the Encounter, any subsequent\n      entry of that health factor from the reminder dialog will not be\n      available for the GEC reports.  This is a consequence of the GEC\n      report routines relying on the health factor's Data Source.\n    A.  GEC Consult Order.\n \n \nIII.    GEC Status Check\nThere is no limit to the entry of GEC Referral data.  Thus, there may be \nmultiple entries of the same health factors over time.  Since the data is \nentered via separate dialogs, extraction and viewing requires the data to \nbe discretely identified.  The GEC software depends upon the user to \nindicate when the data from a given referral should be concluded.  The \nreferral is finalized using a new feature called the GEC Status \nIndicator.  This indicator is presented to the user as a modal dialog at \nVI.     GEC Interdisciplinary Notes.\nthe conclusion of the VA-GEC CARE COORDINATION dialog.  It will prompt \nthe user to indicate the conclusion of the Referral with a Yes or NO \nresponse and will list any missing dialogs.  If YES is selected, the data \nfor the current episode of the Referral is closed.  If No is selected, \nthe Indicator is displayed with each succeeding GEC dialog until Yes is \nselected.\n \nTo assist the ongoing management of completing GEC Referrals, the GEC \nStatus Indicator may be added to the CPRS GUI Tools drop-down menu.  The \nparameter to activate the Indicator is PXRM GEC STATUS CHECK.  If may be \nVII.    GEC Referral Reports (LM CHUI).\nset at the User or Team level.  If added to the drop-down menu, the \nIndicator may be viewed at any time and used to close the referral if \nneeded.\n \n \nIV.     GEC Referral Ad hoc Reports\nTwo new health summary components have been created and distributed with \nthis software:  GEC Completed Referral Count (GECC) and GEC Health Factor \nCategory (GECH).  The first displays all GEC referral data according to \nthe occurrence and time limits identified.  The GEC Health Factor \nVIII.   GEC Reminder Terms.\nCategory component, in conjunction with PX*1*123 and GMTS*2.7*63, permits \nGEC data to be viewed by health factor or health factor category.  If a \nuser should have access to these GEC reports, they must have access to \nthe Ad Hoc Health Summary type.  [This can be set using GMTS GUI HS LIST \nPARAMETERS.]\n \nV.      GEC Referral Reminders and Dialogs\nThe GEC reminders are comprised of dialogs and health factors only.  They \nhave neither cohort nor resolution logic and will not become due.  They \nare intended only as TIU templates and do not need to be assigned to the \n
\n
\n", "", "
(SEX)&(AGE)
\n", "
2
\n", "
SEX;AGE
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-*FITNESS AND EXERCISE SCREEN", "
ZZ Exercise Education
\n", "
1M
\n", "
ZZVA-*FITNESS AND EXERCISE SCREEN
\n", "
INACTIVE
\n", "
2005-03-11 12:42:50
\n", "", "", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nExercise education given yearly to all patients.\n \n    Recommendation: Primary care clinicians should encourage all\n    individuals to engage in a program of physical activity tailored to\n    their health status and personal life style.\n \n    Goals for FY 2000: 50% of primary care providers routinely counsel\n    their patients regarding frequency, duration, type and intensity of\n    physical activity. 30% of Veterans engage in regular moderate\n    physical activity for at least 30 minutes three times a week. \n    20% of Veterans engage in vigorous activity that promotes\n \n    cardiorespiratory fitness.\nThis VA-*FITNESS AND EXERCISE SCREEN reminder is based on the following\n"Physical Activity Counseling" guidelines specified in the VHA HANDBOOK\n1101.8, APPENDIX A.\n \n    Target Conditions: Cardiovascular disease, physical function.\n \n    Target Group: General outpatient population.\n
\n
\n", "
\n
\n\n
\n", "", "
\nTo modify this reminder from its distributed definition, copy the reminder\nto a new reminder and then make the modifications necessary to define your\nsites guideline.\n
\n
\n", "", "
(SEX)&(AGE)&'FI(3)
\n", "
3
\n", "
SEX;AGE;3
\n", "", "
(0)!FI(1)!FI(2)
\n", "
2
\n", "
1;2
\n", "
1
\n", "
3
\n", "
1
\n", "
4
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-*COLORECTAL CANCER SCREEN (SIG.)", "
ZZ Flexisigmoidoscopy
\n", "
1M
\n", "
ZZVA-*COLORECTAL CANCER SCREEN (SIG.)
\n", "
INACTIVE
\n", "
2005-03-11 12:42:50
\n", "", "", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nAt least one sigmoidoscopy examination in their lifetime for patients age\n \n    Target Condition: Early detection of colon cancer or its predecessors.\n \n    Target Group: All persons ages 50 and older.\n \n    Recommendation: All persons age 50 and older should receive an annual\n    fecal occult blood test or undergo a sigmoidoscopy examination\n    (periodicity unspecified).\n \n    Goals for FY 2000: For persons age 50 and older, 50 percent of those\n50 and older, or a fecal occult blood test yearly.  This reminder uses 5\n    enrolled in primary care clinics have received fecal occult blood\n    testing within the preceding year and 40 percent have received at\n    least one proctosigmoidosopy examination in their lifetime.\nyears, rather than 99Y for "ONCE" as originally published in the VA\nGuidelines.  The 5 years is a conservative period recommended by a blue\nribbon panel publishing their findings in the February 1997 issue of\n"Gastroenterology" magazine.\n \nThis reminder is based on the "Colorectal Cancer Detection" guidelines\nspecified in the VHA HANDBOOK, APPENDIX A.\n
\n
\n", "
\n
\n\n
\n", "", "
\nThe next time a SIG is due is 1 year from the last FOBT, or 5 years from\nthe SIG is due again.  If the most recent health factor finding, between\nINACTIVATE and ACTIVATE is INACTIVATE with its rank of 1, the reminder\nwill be "N/A" (not applicable to the patient), and the frequency is 0Y.\n \nCheck the Taxonomy Findings entries representing flexisigimoidoscopy and\nFOBT procedures. This represents coded standard entries in the CPT file\nand ICD Operation/Procedure file.  If the taxonomies need modification,\ncopy the taxonomy to a new taxonomy for your site, and make the\nappropriate modifications.  Then, copy this reminder to a new reminder for\nyour local sites modifications, and change the Taxonomy Findings to use\nthe last SIG.\nthe new taxonomies.\n \nThe reminder type is EXAM, and the Baseline AGE RANGE and FREQUENCY is 50\nand older and 1Y - so that the SIG will be due a year from the last FOBT\ndone in the clinic.  The AGE RANGE and FREQUENCY are modified to 50 and\nolder and 5Y if a prior SIG has been received by the patient.  The Rank\nof 2, on the VA-FLEXISIGMOIDOSCOPY taxonomy match fields, will cause a\nmatch of a SIG to take precedence over the FOBT findings to establish when\n
\n
\n", "", "
(SEX)&(AGE)&'FI(5)
\n", "
3
\n", "
SEX;AGE;5
\n", "", "
(0)!FI(1)!FI(2)!FI(3)
\n", "
3
\n", "
1;2;3
\n", "
3
\n", "
2;3;5
\n", "
2
\n", "
4;6
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-HTN ASSESSMENT BP >=140/90", "
HTN Assess for Elevated BP>=140/90
\n", "", "", "", "
2003-02-04 11:39:26
\n", "", "", "", "
NATIONAL
\n", "
OFFICE OF QUALITY & PERFORMANCE
\n", "", "
C
\n", "
\n
\n\n
\n", "
\nThis reminder is due every 6 months for patients who have their last \nThe reminder is resolved for 6 months by any of the interventions listed \nbelow:\n \n  Education  (reminder term HTN EDUCATIONAL INTERVENTIONS) \n     VA-HTN EXERCISE EDUCATION                    (ED)\n     VA-HTN NUTRITION EDUCATION                   (ED)\n     HTN LIFESTYLE MODIFICATIONS RECOMMENDED      (HF) \n     VA-HTN MEDICATION ADHERENCE                  (ED) \n     HTN NO EDUC INTERVENTION WARRANTED           (HF) \n     \nrecorded DBP >89 or the last SBP >139 and the patient has a diagnosis of \n \n  Medication   (reminder term HTN MED & OTHER INTERVENTIONS) \n     HTN MEDICATIONS ADJUSTED                   (HF)\n     HTN REFUSAL OF MED INTERVENTION            (HF)\n     HTN EVALUATION OF RESISTANT/SECONDARY      (HF)\n     HTN NO MED CHANGE - BP CONTROLLED          (HF)\n     HTN NO MED CHANGE - COMORBID ILLNESS       (HF)\n     HTN NO MED CHANGE - SIDE EFFECTS FROM RX   (HF)\n     HTN NO MED CHANGE - LIMITED LIFE EXP       (HF)\n     HTN NO MED CHANGE - NONCOMPLIANCE          (HF)\nHTN in PCE, problem list or PTF in the past 18 months.  \n     HTN NO MED CHANGE - OTHER                  (HF)\n \nThe reminder becomes not applicable if the health factor of INCORRECT HTN \nDIAGNOSIS is entered.  The reminder is reactivated the next time that an \nICD code for HTN is entered.  \n \nThe following findings are included in the reminder to provide additional \ninformation in the clinical maintenance display:\n \nAny diabetes diagnoses, drug classes for HTN meds (CV100, CV150, \n \nCV400, CV490, CV700, CV709, CV800, CV805), patient's BMI.\nThe reminder becomes not applicable if the last BP <140/90 is recorded.  \nIt is also not applicable if the last SBP is >159 or the last DBP is >99 \nsince the "HTN ASSESSMENT BP >160/100" reminder will be applicable for \nthe patient with the higher measured BPs.\n \n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "
\nTo modify this reminder from its distributed definition, copy the \nreminder to a new reminder and then make the modifications necessary to \ndefine your sites guideline.  \n \nThis reminder has customized cohort logic that uses the MRD function to \nuse the INCORRECT DIAGNOSIS heath factor or the ICD code - whichever is \nentered most recently.\n
\n
\n", "
FI(2)&FI(11)&FF(1)&'FI(13)
\n", "
FI(2)&FI(11)&FF(1)&'FI(13)
\n", "
4
\n", "
2;11;FF1;13
\n", "", "
(0)!FI(27)!FI(28)
\n", "
2
\n", "
27;28
\n", "", "", "
2
\n", "
7;9
\n", "", "", "", "", "
\n
\n\n
\n", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-HTN ASSESSMENT BP >=160/100", "
HTN Assess for Elevated BP>=160/100
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
OFFICE OF QUALITY & PERFORMANCE
\n", "", "
C
\n", "
\n
\n\n
\n", "
\nThis reminder is due every 1 month for patients whose last DBP was >99 \n     HTN MEDICATIONS ADJUSTED                   (HF)\n     HTN REFUSAL OF MED INTERVENTION            (HF)\n     HTN EVALUATION OF RESISTANT/SECONDARY      (HF)\n     HTN NO MED CHANGE - BP CONTROLLED          (HF)\n     HTN NO MED CHANGE - COMORBID ILLNESS       (HF)\n     HTN NO MED CHANGE - SIDE EFFECTS FROM RX   (HF)\n     HTN NO MED CHANGE - LIMITED LIFE EXP       (HF)\n     HTN NO MED CHANGE - NONCOMPLIANCE          (HF)\n     HTN NO MED CHANGE - OTHER                  (HF)\n \nor the last SBP was > 159 and the patient has a diagnosis of HTN.  \nEducational interventions are optional:\n  Education  (reminder term HTN EDUCATIONAL INTERVENTIONS)\n     VA-HTN EXERCISE EDUCATION                    (ED)\n     VA-HTN NUTRITION EDUCATION                   (ED)\n     HTN LIFESTYLE MODIFICATIONS RECOMMENDED      (HF)\n     VA-HTN MEDICATION ADHERENCE                  (ED)\n     HTN NO EDUC INTERVENTION WARRANTED           (HF)\n \nThe reminder becomes not applicable if the health factor of INCORRECT HTN \nDIAGNOSIS is entered.  The reminder is reactivated the next time that an \n \nICD code for HTN is entered.  \n \nThe following findings are included in the reminder to provide additional \ninformation in the clinical maintenance display:\n \nAny diabetes diagnoses, drug classes for HTN meds (CV100, CV150, \nCV400, CV490, CV700, CV709, CV800, CV805), patient's BMI.\nThe reminder becomes not applicable if a BP lower than 160/100 is entered.\n \nThe reminder is resolved for 1 month by recording at least one\nintervention from the list below.\n \n  Medication   (reminder term HTN MED & OTHER INTERVENTIONS) \n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "
\nTo modify this reminder from its distributed definition, copy the \nreminder to a new reminder and then make the modifications necessary to \ndefine your sites guideline.  \n \nThis reminder has customized cohort logic that uses the MRD function to \nuse the INCORRECT DIAGNOSIS heath factor or the ICD code - whichever is \nentered most recently.\n
\n
\n", "
(SEX)&(AGE)&FI(2)&FI(13)&FF(1)
\n", "
(SEX)&(AGE)&FI(2)&FI(13)&FF(1)
\n", "
5
\n", "
SEX;AGE;2;13;FF1
\n", "", "
(0)!FI(27)
\n", "
1
\n", "
27
\n", "", "", "
3
\n", "
7;9;28
\n", "", "", "", "", "
\n
\n\n
\n", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-HTN LIFESTYLE EDUCATION", "
HTN Lifestyle Education
\n", "
3M
\n", "", "", "", "", "", "", "
NATIONAL
\n", "
OFFICE OF QUALITY & PERFORMANCE
\n", "", "
C
\n", "
\n
\n\n
\n", "
\nPatients with a diagnosis of HTN should be counseled at least yearly on \nThe reminder term for VA0HTN EXERCISE contains the education topic for \nexercise education.\n \nThe reminder term for VA-HTN NUTRITION contains the education topics for \nnutrition education.\n \nBoth of these reminder terms are required to resolve the reminder. If a \nsite has an education topic that incorporates both of these educational \ninterventions (nutrition and exercise) then that education topic should \nbe mapped to both of these reminder terms.\nthe life style modifications that may improve blood pressure control.  \n \nThe reminder term VA-HTN NO EDUC INTERVENTION WARRANTED contains a health \nfactor of the same name.  Based on the patient's comorbid illnesses and \nlife expectancy, this educational intervention may not be appropriate.  \nThis health factor renders the reminder not applicable for 6 months.  \n \nThe reminder term VA-HTN INCORRECT DIAGNOSIS contains a health factor of\nthe same name.  The reminder becomes not applicable if the health factor\nof INCORRECT HTN DIAGNOSIS is entered based on the MRD function that is\nincluded in the custom cohort logic.  The reminder is reactivated the \n \nnext time that an ICD code for HTN is entered.  \nThis reminder will display for a given patient if they have a diagnosis \nof HTN in the past 18 months and if their last BP is less than 140/90.  \nThe reminder will not display if the last DBP was >90 or if the last SBP \nwas >140 because one of the other 2 HTN reminders will be due and the \neducational intervention can be addressed using that reminder.  \n \n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "
\nTo modify this reminder from its distributed definition, copy the \nreminder to a new reminder and then make the modifications necessary to \ndefine your sites guideline.  \n \nThis reminder has customized cohort logic that uses the MRD function to \nuse the INCORRECT DIAGNOSIS heath factor or the ICD code - whichever is \nentered most recently.\n
\n
\n", "
(SEX)&(AGE)&FI(2)&'FI(11)&'FI(12)&FF(1)
\n", "
(SEX)&(AGE)&FI(2)&'FI(11)&'FI(12)&FF(1)
\n", "
6
\n", "
SEX;AGE;2;11;12;FF1
\n", "", "
(1)&FI(8)&FI(10)
\n", "
2
\n", "
8;10
\n", "", "", "
3
\n", "
7;9;13
\n", "", "", "", "", "
\n
\n\n
\n", "", "", "", "
0
\n", "
0
\n", "", "
\nPatients with HTN should receive counseling on the following lifestyle\n100-proof whiskey) per day for men or 0.5 ounces of alcohol per day for\nwomen and for lighter weight men.\n \n3.      SODIUM INTAKE:  Sodium intake in the patient with HTN should be\nlimited to no more than 100 mmol/day (2.4 g of sodium or 6 g of sodium\nchloride).\n \n4.      EXERCISE:  The target for aerobic exercise should be 30 to 45\nminutes per session, three to five times per week if possible.\n \nmodifications:\n5.      DIET:  An adequate dietary intake of potassium, calcium, and\nmagnesium can be obtained from fresh fruits and vegetables. Other dietary\nadvice should include a heart-healthy diet such as the DASH Diet. This is\none means of satisfying the dietary steps above. See the DASH Diet table\nbelow.\n \n6.      TOBACCO USE CESSATION:  Counsel to stop tobacco use and offer\nsmoking cessation classes or other aids to quit. (See VA/DoD Guideline on\nTobacco Use Cessation).\n \n \n7.      HYPERLIPIDEMIA:  Counsel to reduce intake of dietary saturated\nfats and cholesterol. A diet rich in fresh fruits and vegetables as well\nas low in dietary saturated fats and cholesterol is also beneficial in\nlowering blood pressure.\n1.      WEIGHT REDUCTION:  Overweight patients should reduce their weight\nto within 10 percent of their ideal body weight. However, reduction even\nof 5 to 10 pounds can be helpful in controlling HTN.\n \n2.      ALCOHOL INTAKE:  Alcohol intake should be limited to no more than\none ounce (24 ounces of beer; or 10 ounces of wine; or 2 ounces of\n
\n
\n", "
0
\n", "
33
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-BL LDL DM AND CV DISEASE", "
Diabetes and Cardiovascular disease
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "", "", "
R
\n", "
\n
\n\n
\n", "", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "
(((FI(1)&FF(1))!FI(2)!FI(3))&FF(4))&(FI(5)&FF(6))
\n", "
(((FI(1)&FF(1))!FI(2)!FI(3))&FF(4))&(FI(5)&FF(6))
\n", "
7
\n", "
1;FF1;2;3;FF4;5;FF6
\n", "", "", "", "", "", "", "
2
\n", "
4;6
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-BL LDL CV DISEASE ONLY", "
Cardiovascular disease
\n", "", "", "", "", "", "", "", "
LOCAL
\n", "", "", "
R
\n", "
\n
\n\n
\n", "", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "
(FI(5)&FF(6))&'(((FI(1)&FF(1))!FI(2)!FI(3))&FF(4))
\n", "
(FI(5)&FF(6))&'(((FI(1)&FF(1))!FI(2)!FI(3))&FF(4))
\n", "
7
\n", "
5;FF6;1;FF1;2;3;FF4
\n", "", "", "", "", "", "", "
2
\n", "
4;6
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-BL LDL DIABETES DX ONLY", "
Diabetes
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "", "", "
R
\n", "
\n
\n\n
\n", "", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "
(((FI(1)&FF(1))!FI(2)!FI(3))&FF(4))&'(FI(5)&FF(6))
\n", "
(((FI(1)&FF(1))!FI(2)!FI(3))&FF(4))&'(FI(5)&FF(6))
\n", "
7
\n", "
1;FF1;2;3;FF4;5;FF6
\n", "", "", "", "", "", "", "
2
\n", "
4;6
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-LIPID STATIN RX CVD/DM (VER1.0)", "
Assess Statin Use - Lipids (CVD/DM)
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "", "", "
*
\n", "
\n
\n\n
\n", "
\nApplicable to diabetics and patients with CVD ages 18-75 who have had an \nThe age range is set by using 2 function findings so that if there is a \ndecision to use different age ranges for the different diagnoses, then \nthis functionality is already available in the reminder.\nLDL in the past 2 years.\n \nResolved by LDL<100, moderate or high dose statin, contraindication to\nstatins, other provider actions/documentation.\n \nFrequency: set at 99 years (although this is somewhat arbitrary since the \nreminder would work just as well with this set to anything 2Y or more).\n \n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "
\nCohort logic (inclusion/exclusion criteria):\n \n \n \nUpdate 4  5/25/12\n  Add the national health factors back to the outside LDL dialog elements \nthat are for high and low ranges.\n  Change the age range for both IHD and diabetes to 18-75\n  Remove local lab tests for LDL from the national terms except leave one \nLDL cholesterol with the condition as an example.\n  Remove the age ranges from the branching logic reminders.\n \n \nUpdate 5  7/19/12\n  Update the dialog to include additional informational text in the \nsection on guidance - include moderate dose statin information and also a \nlink to the memo from Dr. Francis in June 2012.\n  Update the definition of the reminder term for lipid panel orderable \nitems since this term is used to resolve the reminder and the old \ndefinition states that the term does not resolve the reminders.\n \nUpdate 6 8/2/12\nFF11 was failing to work if there was no prior statin fill - 0-0'>10\n2.  CVD - any diagnosis of CVD in the past 2 years that is more \nUsing division will work but the strings have to be separated to avoid \n0/0.\n \nChange \nFF11:  FI(10)!FI(11)&(((NUMERIC(11,1,"DAYS \nSUPPLY")-NUMERIC(11,1,"QTY"))'>10)!((NUMERIC(11,2,"DAYS \nSUPPLY")-NUMERIC(11,2,"QTY"))'>10))\n \nResolution Logic:\n((FI(13)!FI(14))&FF(13))!FI(10)!(FI(11)&FF(11))!(FI(24)&FI(27))!FI(20)!FI(\nrecent than any entry of incorrect diagnosis of CVD and age 50-75.  \n21)!FI(22)!FI(23)!FI(25)!FI(26)!(FI(29)&(FI(28)!FF(29)))!FI(30)\n \nTo\nFF11\nFI(10)!FI(11)&((NUMERIC(11,1,"QTY")/NUMERIC(11,1,"DAYS SUPPLY"))>.6) \n \nFF12   \nFI(10)!FI(11)&((NUMERIC(11,2,"QTY")/NUMERIC(11,2,"DAYS SUPPLY"))>.6) \n \n \n \nResolution Logic:\n((FI(13)!FI(14))&FF(13))!FI(10)!(FI(11)&(FF(11)!FF(12)))!(FI(24)&FI(27))!F\nI(20)!FI(21)!FI(22)!FI(23)!FI(25)!FI(26)!(FI(29)&(FI(28)!FF(29)))!FI(30)\n \n \nUpdate 7  8/7/12\nBecause the presence of an LDL in the past 2 years was included in the \ncohort logic as FI(12), patients with only an outside LDL would never \nhave the reminder applicable.\n \n!(FI(VA-IHD AND ASVD)&FF(6)&FI(VA-LDL IHD/ASCVD AGE RANGE))\nReplace FI(12) in the cohort logic with FI(12) or one of the terms for \noutside LDL which are included in FF14.\n \n(((FI(1)&FF(1))!FI(2)!FI(3))&FF(4)&FI(33))!(FI(5)&FF(6)&FI(34))!\n(FI(8)&FF(8))&'FI(7)&FI(12)\n   \n(((FI(1)&FF(1))!FI(2)!FI(3))&FF(4)&FI(33))!(FI(5)&FF(6)&FI(34))!\n(FI(8)&FF( 8)) &'FI(7)&(FI(12)!FF(14))\n \n \n \nUpdate 8 8/27/12\nChange the dialog so that if the reminder is NOT due, no interpretation \nof the LDL values, statin status or diagnosis is included in the header \ninformational text.  When the reminder was not due, that information was \nnot always correct.\n \n3.  Any entry of high risk for CVD entered as a health factor and \nlinked to the CHD RISK>20% reminder term.  Sites that use a CHD \n \ncalculator may have these patients designated and may want to include \nthem in this lipid management reminder. \n \n!(FI(VA-CHD RISK >20%)&FF(8))\n \n \n4. Exclude those with limited life expectancy - a national reminder term \nalready exists for this.\n \n&'FI(VA-LIFE EXPECTANCY <6 MONTHS)\n1.  Diabetes - 2 diagnoses in the past 2 years, or a problem list \n \n \nThe age range is set by using 2 function findings so that if there is a \ndecision to use different age ranges for the different diagnoses, then \nthis functionality is already available in the reminder and these ranges \ncan be adjusted locally if needed.\n \n \n5. Require an LDL done in the past 2 years - if not done, then the local \nsite should have a reminder for doing a lipid panel on a regular basis \nentry, or a prescription of medication for diabetes that was active in the\nand that needs to be done first.  Two years was chosen so that a recent \nlipid panel that was done but not done in the past 12 months, would still \ntrigger the thought and assessment about statin use since this is the \nmost important intervention and treating to goal is less critical.\n \n \nResolution logic:\n1.    LDL - LDL<100 at the VA or LDL <100 outside the VA and this is \n         the most recent value (FF13)\n         Compare date of FI(13) or FI(14) to any prior LDL that was over \nprevious 9 months and the diagnosis or prescription is more recent than\n             99 (Findings 15,17,18,19)\n \n2.   Statin\n  a.    High dose statin tablets prescribed - VA prescription FI(10).\n  b.    Moderate dose statin - VA prescription for a moderate dose and \n         the tablets are not being split (FF11 compares the days supply to\n         the quantity supplied and if there is a large discrepancy, tablet\n         splitting is assumed.  FI(11)&FF(11).\n  c.    Non-VA statin and the verification by staff using a health factor \n          that this is a moderate or high dose of a statin since the dose\nany entry of an incorrect diagnosis (FF4).  And age is 50-75.\n          of non-VA meds could not be evaluated by the reminder.  \n          FI(27)&FI(24).\n \n3.   Other action or documentation\n  a.    FI(20): Add statin or adjust dose health factors, 2 months.\n  b.    FI(21): Patient refusal, 2 months.\n  c.    FI(22): Documentation of non-adherence, 2 months.\n  d.    FI(23): Documentation that the patient is already on the highest\n           tolerated dose, 1 year.\n  e.    FI(25): Order for repeat LDL, T-14 days to T+ 2 months.\n \n  f.    FI(26): Entry of a health factor indicating that a lipid profile \n           was ordered, 1 month.\n  g.    (FI(29)&(FI(28)!FF(29))): Entry of a health factor indicating ADR \n           to all available statins FI(29) entered in the past 1 year\n           (FF29) or the health factor plus an actual entry in the\n           allergy/ADR list (FI28) ever. \n  h.    FI(30): Temporary contraindication to a statin (pregnancy),\n           1 year.\n \nUpdate 1  3/26/12\n(((FI(VA-DIABETES HEDIS)&FF(1))!FI(VA-DIABETES HEDIS PROB \n   \nUpdate 2  5/7/12\n  Use RT.VA-LDL instead of VA-LDL 100-119 and VA-LDL >119 so that the \n     condition can have a +V>0 statement (ignore commented LDLs)\n  Change print name\n  Remove Finding 16 VA-LDL >119\n  Add +V>0 to conditions and use in search set to Yes.\n  Set begin date on FI12 to T-2Y and add to cohort logic\n  Change frequency to 99Y - 1 year will not work since the reminder is \n     resolved by an LDL<100 - at 1 year, it would turn back on unless a\nLIST)!FI(VA-DIABETES MEDICATIONS))&FF(4)&FI(VA-LDL DIABETES AGE RANGE))\n     new LDL was done.\n \n \nUpdate 3  5/23/12\n  Update reminder dialog elements for life expectancy and declines statin \n       adjustment with better text \n  Rename dialog to match reminder (but without 'v1') \n  Text for dialog elements with orders as actions updated to 'see orders' \n  New health factors for declinations - no longer use the more generic HFs\n       that were exported with the IHD QUERI reminders.\n
\n
\n", "
(((FI(1)&FF(1))!FI(2)!FI(3))&FF(4)&FI(33))!(FI(5)&FF(6)&FI(34))!(FI(8)&FF(8))&'FI(7)&(FI(12)!FF(14))
\n", "
(((FI(1)&FF(1))!FI(2)!FI(3))&FF(4)&FI(33))!(FI(5)&FF(6)&FI(34))!(FI(8)&FF(8))&'FI(7)&(FI(12)!FF(14))
\n", "
14
\n", "
1;FF1;2;3;FF4;33;5;FF6;34;8;FF8;7;12;FF14
\n", "
((FI(13)!FI(14))&FF(13))!FI(10)!(FI(11)&(FF(11)!FF(12)))!(FI(24)&FI(27))!FI(20)!FI(21)!FI(22)!FI(23)!FI(25)!(FI(29)&(FI(28)!FF(29)))!FI(30)
\n", "
((FI(13)!FI(14))&FF(13))!FI(10)!(FI(11)&(FF(11)!FF(12)))!(FI(24)&FI(27))!FI(20)!FI(21)!FI(22)!FI(23)!FI(25)!(FI(29)&(FI(28)!FF(29)))!FI(30)
\n", "
18
\n", "
13;14;FF13;10;11;FF11;FF12;24;27;20;21;22;23;25;29;28;FF29;30
\n", "", "", "
9
\n", "
4;6;9;15;17;18;19;26;32
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-PNEUMOCOCCAL IMMUNIZATION PPSV23", "
Pneumococcal PPSV23 (Pneumovax)
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
VA NATIONAL CENTER FOR HEALTH PROMOTION AND DISEASE PREVENTION (NCP)
\n", "", "
CR
\n", "
\n
\n\n
\n", "
\nUpdated guidelines Fall 2014 - patients age 65 and older should received \nanatomic asplenia, CSF leaks, or cochlear implants, and who have not\npreviously received PCV13 or PPSV23, should receive a dose of PCV13 first,\nfollowed by a dose of PPSV23 at least 8 weeks later if <age 65 or \nimmunocompromised and at least 1 year later if 65 or older AND not \nimmunocompromised.\n \nSubsequent doses of PPSV23 should follow current PPSV23 recommendations\nfor adults at high risk. Specifically, a second PPSV23 dose is recommended\n5 years after the first PPSV23 dose for persons aged 19-64 years with\nfunctional or anatomic asplenia and for persons with immunocompromising\none dose of PCV13, if possible, this dose should be given prior to \nconditions. Additionally, those who received PPSV23 before age 65 years\nfor any indication should receive another dose of the vaccine at age 65\nyears, or later if at least 5 years have elapsed since their previous\nPPSV23 dose. \n \nPrevious vaccination with PPSV23. Adults aged >=19 years with \nimmunocompromising conditions, functional or anatomic asplenia, CSF \nleaks, or cochlear implants, who previously have received >=1 doses of \nPPSV23 should be given a PCV13 dose >=1 year after the last PPSV23 dose \nwas received. For those who require additional doses of PPSV23, the first \nPPSV23. Persons vaccinated with PCV13 prior to age 65 do not need a \nsuch dose should be given no sooner than 8 weeks after PCV13 for ages \n<65 or if immunocompromised, no sooner than 1 year after PCV13 for ages 65\nand older, not immunocompromised and at least 5 years after the most\nrecent dose of PPSV23.\n \n \nPneumococcal polysaccharide (PPSV) vaccination - Vaccinate all persons\nwith the following indications:\nMedical: Chronic lung disease (including asthma); chronic cardiovascular \ndiseases; diabetes mellitus; chronic liver diseases; cirrhosis; chronic \nsecond dose after age 65 (this applies to PCV13 only and not to PPSV23).\nalcoholism; functional or anatomic asplenia (e.g., sickle cell disease or \nsplenectomy [if elective splenectomy is planned, vaccinate at least 2 \nweeks before surgery]); immunocompromising conditions (including chronic \nrenal failure or nephrotic syndrome); and cochlear implants and \ncerebrospinal fluid leaks. Vaccinate as close to HIV diagnosis as \npossible.\n \nOther: Residents of nursing homes or long-term care facilities and \npersons who smoke cigarettes. Routine use of PPSV is not recommended for \nAmerican Indians/Alaska Natives or persons aged less than 65 years unless \n \nthey have underlying medical conditions that are PPSV indications. \nHowever, public health authorities may consider recommending PPSV for \nAmerican Indians/Alaska Natives and persons aged 50 through 64 years who \nare living in areas where the risk for invasive pneumococcal disease is \nincreased.\n \nRevaccination with PPSV23\nOne-time revaccination after 5 years is recommended for persons aged 19 \nthrough 64 years with chronic renal failure or nephrotic syndrome; \nfunctional or anatomic asplenia (e.g., sickle cell disease or \nUpdated guidelines October 2012\nsplenectomy); and for persons with immunocompromising conditions. \n \nFor persons aged 65 years and older, one-time revaccination is \nrecommended with PPSV23 if they were vaccinated 5 or more years previously\nand were aged less than 65 years at the time of primary vaccination.\n \nPneumococcal vaccine-nave persons. ACIP recommends that adults aged 19 \nyears of age and older with immunocompromising conditions, functional or\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "
\nFall 2014 - add age >=65 as indication for PCV13.  Adjust this reminder \ndisease) \nwhich compares the date of birth to the date of administration of PCV13.\nThe DTIME_DIFF function in FF(22) and FF(23) compares the date of the most\nrecent dose to today's date.\n \nFF(22)\n  (((DTIME_DIFF(7,1,"DATE",19,1,"DATE","D","A")>55)&(FI(17)!\n(DIFF_DATE(19,1)<23742)))!(DTIME_DIFF(7,1,"DATE",19,1,"DATE","D","A")>364)\n&FI(19))!(FI(15)&'FI(19))\n \n  PCV13 >55 days ago if administered <65 or immunocompromised, \n Chemo=CH : taxonomy and drugs  \n  PCV13 over 1 year ago, or \n  contraindication to PCV13 and has not had PCV13\n \n \nFF(23)\n  ((DTIME_DIFF(7,1,"DATE",19,1,"DATE","D","A")>55)&FI(19))!'FI(19)\n \n  PCV13 over 56 days ago, \n  Or has not had PCV13\n        (since this FF is used only on patients <65, it does not need to \n LTS=Long term steroids \n        explicitly include an age like FF(22) does)\n \n \nThe cohort logic is divided into 2 sections - 1. for patients who need \nPCV13 first and 2. for patients who do not need PCV13.\n \n1. \n(((FI(3)&FF(12))!FI(4)!FI(7)!FI(18)!(FI(16)&(FF(16)!FF(17)!FF(18)!FF(19)))\n)&FF(22))\n \n   \n2.\n!(((FI(2)&FF(13)&FF(23)))&'((FI(3)&FF(12))!FI(4)!FI(7)!FI(18)!(FI(16)&(FF(\n16)!FF(17)!FF(18)!FF(19)))))&'FI(8)\n \nPart 1 will not be true if unless PCV13 was given outside the required \ntime periods (2M for <65 or IC, 1Y for >64 not IC), so PCV13 must be \ngiven and the time period must have elapsed or the patient has a \ncontraindication and then FF(22) will be true.  \n \n \n \nPart 2 will not be true if PCV13 was administered in the past 2 months, \nthis part of the logic only applies to patients less than 65 who do not \nrequire PCV13.\n  Cohort: \n     1. (IC or HstR or CH or LTS) and either already got PCV13 but not in \nthe past 8 weeks or has contraindication to PCV13 \n     2.  Other dx or age>64 and not IC/HstR/CH/LTS or has \ncontraindication to PCV13 \nto be due after that dose is given.\n   \n \nBaseline frequencies \n  1.      >65             99Y \n  2.      IC               5Y \n  3.      HstR            99Y \n  4.      HR              99Y \n  5.      LTS              5Y \n  6.      CH               5Y \n \n \n                                                \nFunction Findings                           Frequency  Rank \n 1    <age 65 and 2 or more doses*:               99Y     1 \n 2    >age 64 and 1 dose after age 64:            99Y     1 \n 3    no dose >64, IC/CH/LTS and no 2nd dose       5Y     2 \n 8    >age 64, IC/CH/LTS, has PCV13, no dose>64    5Y     2 \n \n \n 2    >age 64 and 1 dose after age 64:            99Y     1 \n 4    >age 64,dosed <65, no dose>64, not IC/CH     5Y     2 \nPPSV23 \n 6    (HR or Other dx) not IC/CH and <age 65:     99Y     3 \n    \n \n  *2 doses are counted only if given more than 1460 days apart (4Y) or \none is   marked as a booster dose.  \n   \n \nFor IC/CH/LTS: FF 1,2,3,8 \n \n  FF3 above can be explained this way - Patient is IC and has had a dose \n   \nbefore age 65, needs a second dose 5 years later. FF(3) is true and the \nreminder is due 5Y after the recorded dose.  \n   \n  If that second dose is given, then FF(1) takes over and the reminder is \nresolved (99Y).  \n   \n  If the patient turns 65, then FF(8) is true and the reminder is due \nagain 5Y after the last dose.  Once that dose after age 65 is given, then \nFF(2) takes over and the reminder is resolved (99Y).  \n   \n IC: immunocompromised (HIV, renal failure, nephrotic syndrome, splenic \n   \nFor no IC/CH/LTS \n  Baseline dose due for HR and HstR, FF6 sets for patients <age 65 who \nare not IC/CH/LTS. Once they turn 65, then FF4 is applicable and the \nreminder is due 5 years after the prior dose.  Once a dose is given after \nage 65, then FF2 is applicable and any dose after age 65 will resolve.  \n \n \nResolution: PPSV23 or deferral or an order \n \ndysfx, etc. \n \n \nFF5 provides a message about the need for an additional dose after age 65 \nif the patient's most recent dose was prior to age 65 for non-IC/CH/LTS \npatients.  \n \nFF7 provides a message about the need for an additional dose after age 65 \nfor IC/CH/LTS patients who have already gotten PCV13.  \n  \nFF10 assesses the last 2 doses of pneumococcal vaccine to be sure that \n Highest Risk= HstR: cochlear implant, CSF leak \nthey were more than 4 years apart \n  \nFF16, 17, 18 and 19 look at finding 16 and evaluate to see if it is an \nICD code, an outpatient drug or a non-intravitreal administration of a \nchemotherapy drug.  \n  \nFF20 provides a message if PCV13 is needed.  This is just in case someone \nlooks at this reminder to see why it is NOT due.  \n \n \n High Risk=HR - Other Diagnoses: (cardiac, pulmonary, smoking, liver \nUpdate June 2015 - ACIP changes recommendations to increase time period \nfrom PCV13 to PPSV23 to one year for patients age 65 and older who are \nnot immunocompromised. Remains 8 weeks for patients <65 or who are \nimmunocompromised.\n \nTwo new function findings are added:  FF(22) and FF(23)\n \nThe time period for waiting ((2M for <65 or IC, 1Y for >64 and not IC) \nis based on the age of the patient at the time of the vaccine \nadministration.  In FF(22) this is represented by the DIFF_DATE function \n
\n
\n", "
(((FI(3)&FF(12))!FI(4)!FI(7)!FI(18)!(FI(16)&(FF(16)!FF(17)!FF(18)!FF(19))))&FF(22))!(((FI(2)&FF(13)&FF(23)))&'((FI(3)&FF(12))!FI(4)!FI(7)!FI(18)!(FI(16)&(FF(16)!FF(17)!FF(18)!FF(19)))))&'FI(8)
\n", "
(((FI(3)&FF(12))!FI(4)!FI(7)!FI(18)!(FI(16)&(FF(16)!FF(17)!FF(18)!FF(19))))&FF(22))!(((FI(2)&FF(13)&FF(23)))&'((FI(3)&FF(12))!FI(4)!FI(7)!FI(18)!(FI(16)&(FF(16)!FF(17)!FF(18)!FF(19)))))&'FI(8)
\n", "
25
\n", "
3;FF12;4;7;18;16;FF16;FF17;FF18;FF19;FF22;2;FF13;FF23;3;FF12;4;7;18;16;FF16;FF17;FF18;FF19;8
\n", "
FI(5)!FI(6)!FI(14)
\n", "
FI(5)!FI(6)!FI(14)
\n", "
3
\n", "
5;6;14
\n", "
11
\n", "
2;3;4;16;18;FF1;FF2;FF3;FF4;FF6;FF8
\n", "
12
\n", "
1;9;12;13;15;17;19;FF10;FF20;FF21;FF5;FF7
\n", "", "", "", "", "
\n
\n\n
\n", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-PNEUMOCOCCAL IMMUNIZATION PCV13", "
Pneumococcal PCV13 (Prevnar13)
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
VA NATIONAL CENTER FOR HEALTH PROMOTION AND DISEASE PREVENTION (NCP)
\n", "", "
CR
\n", "
\n
\n\n
\n", "
\nPneumococcal vaccine-nave persons. ACIP recommends that adults aged >=19 \nfor adults at high risk. Specifically, a second PPSV23 dose is recommended\n5 years after the first PPSV23 dose for persons aged 19-64 years with\nfunctional or anatomic asplenia and for persons with immunocompromising\nconditions. Additionally, those who received PPSV23 before age 65 years\nfor any indication should receive another dose of the vaccine at age 65\nyears, or later if at least 5 years have elapsed since their previous\nPPSV23 dose. \n \nPrevious vaccination with PPSV23. Adults aged >=19 years with \nimmunocompromising conditions, functional or anatomic asplenia, CSF \nyears with immunocompromising conditions, functional or anatomic \nleaks, or cochlear implants, who previously have received >=1 doses of \nPPSV23 should be given a PCV13 dose >=1 year after the last PPSV23 dose \nwas received. For those who require additional doses of PPSV23, the first \nsuch dose should be given no sooner than 8 weeks after PCV13 (age <65 or \nimmunocompromised) or no sooner than 1 year after PCV13 (age 65 or older \nand not immunocompromised) and at least 5 years after the most recent dose\nof PPSV23. \n \nIf meningococcal conjgate vaccine (diphtheria conjugate) is given, then \nPCV13 administration should be delayed 4 weeks due to possible reduced \nasplenia, CSF leaks, cochlear implants or age 65 and older, and who have\nantibody response.\nnot previously received PCV13 or PPSV23, should receive a dose of PCV13\nfirst, followed by a dose of PPSV23 at least 8 weeks later if age <65 or \nimmunocompromised and at least 1 year later if age 65 or older AND not \nimmunocompromised.\n \nSubsequent doses of PPSV23 should follow current PPSV23 recommendations\n
\n
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\n
\n\n
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\n
\n\n
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\nAdd age 65 and older - update Fall 2014\nICD code, an outpatient medication or a chemotherapy drug that was not \nintravitreal (FI11 and FF11,12,13,14) \n   \n3.  long term steroids (FI13) or \n   \n   \n4.  history of cochlear implant, CSF leak  (FI4) \n   \nand no Pneumovax in the past year and no contraindication to PCV13 \n   \n \n5. No meningococcal immunization in the past month   \n    \nResolved by immunization, deferral or an order \n \nCohort \n \n1.  Immunocompromised (FI3) and no more recent entry of incorrect dx \n(FF1), \n   \n2.  on chemotherapy or immunosuppressive medication and this entry is an \n
\n
\n", "
((FI(3)&FF(1))!(FI(11)&(FF(10)!FF(11)!FF(12)!FF(13)))!FI(4)!FI(13)!FI(7))&'FI(9)&'FI(8)&'FI(14)
\n", "
((FI(3)&FF(1))!(FI(11)&(FF(10)!FF(11)!FF(12)!FF(13)))!FI(4)!FI(13)!FI(7))&'FI(9)&'FI(8)&'FI(14)
\n", "
13
\n", "
3;FF1;11;FF10;FF11;FF12;FF13;4;13;7;9;8;14
\n", "
FI(10)!FI(6)!FI(12)
\n", "
FI(10)!FI(6)!FI(12)
\n", "
3
\n", "
10;6;12
\n", "", "", "
3
\n", "
1;2;5
\n", "", "", "", "", "
\n
\n\n
\n", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-*CERVICAL CANCER SCREEN", "
ZZ Pap Smear
\n", "", "
ZZVA-*CERVICAL CANCER SCREEN
\n", "
INACTIVE
\n", "
2005-03-11 12:42:50
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S
\n", "
FEMALE
\n", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nThis reminder is based on the "Cervical Cancer Detection" guidelines\n    may be discontinued after age 65 if previous smears have been\n    consistently normal.\n \n    Goal for FY 2000: 95% of women have received at least one Pap test in\n    their lifetime and 85% of women age 65 and under received one in the\n    past three years.\nspecified in the VHA HANDBOOK 1101.8, APPENDIX A. \n \n    Target Condition: Early detection of cervical cancer.\n \n    Target Group: Women age 65 and under.\n \n    Recommendation: Papanicolaou (Pap) smear testing is recommended for\n    all sexually active women every three years until age 65.  Pap testing\n
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\n
\n\n
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\nCopy the reminder to a new reminder for your local site modifications.\n
\n
\n", "", "
(SEX)&(AGE)&'FI(2)
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3
\n", "
SEX;AGE;2
\n", "", "
(0)!FI(1)
\n", "
1
\n", "
1
\n", "
1
\n", "
2
\n", "
1
\n", "
3
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-*SEATBELT AND ACCIDENT SCREEN", "
ZZ Seatbelt and Accident Screen
\n", "
1M
\n", "
ZZVA-*SEATBELT AND ACCIDENT SCREEN
\n", "
INACTIVE
\n", "
2005-03-11 12:42:50
\n", "", "", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nSeatbelt and accident education given yearly to all patients.\n \n    Recommendation: All patients should be urged to use seatbelts in\n    automobiles, wear helmets when riding bicycles or motorcycles, and to\n    refrain from driving after drinking.\n \n    Goal for FY 2000: 85% of Veterans report regular use of seatbelts in\n    automobiles. 80% of motorcyclists and 50% of bicyclists report use of\n    helmets. 50% of primary care providers routinely provide\n    age-appropriate counseling on safety precautions to prevent\n    unintentional injury.\n \nThis "VA-*SEATBELT AND ACCIDENT SCREEN" reminder is based on the\n"Seatbelt Use and Accident Avoidance Counseling" guideline specified in\nthe VHA HANDBOOK 1101.8, APPENDIX A. \n \n    Target Condition: Motor vehicle associated injuries.\n \n    Target Group: General Outpatient population.\n
\n
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\n
\n\n
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\nIf this reminder is not going to be used at your facility, the INACTIVE\nrepresented in the "VA-SEATBELT EDUCATION" reminder. This reminder\nincludes a check for seatbelt use education given to the patient, in\naddition to the screening.\n \nPlease review both of these reminder definitions, choose one of them to\nuse.  If local modifications need to be made, copy the preferred reminder\nto a new reminder and make your reminder modifications.\nFLAG should be set to inactive.\n \nThis reminder represents the minimum criteria for checking if the\npatient has had seatbelt and accident screening.  The "VA-SEAT BELT USE\nSCREENING" education topic is the result finding that will satisfy this\nreminder.\n \nThe Ambulatory Care EP recommends a variation on this reminder,\n
\n
\n", "", "
(SEX)&(AGE)&'FI(3)
\n", "
3
\n", "
SEX;AGE;3
\n", "", "
(0)!FI(1)!FI(2)
\n", "
2
\n", "
1;2
\n", "
1
\n", "
3
\n", "
1
\n", "
4
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-GEC REFERRAL CARE COORDINATION", "
GEC REFERRAL CARE COORDINATION
\n", "", "", "", "", "", "", "", "
NATIONAL
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OFFICE OF GERIATRIC EXTENDED CARE
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C
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\n
\n\n
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\nThe Office of Geriatric Extended Care (OGEC) approved the paper-based\nrequired of extended care service are inconsistent.  Some facilities use\nthe VA Form 10-7108, VA Form 10064a (Patient Assessment Instrument) or VA\nForm 1204 (Referral for Community Nursing Home Care), while other sites\nuse various other assessments or consults.  OGEC seeks to standardize the\nprocess of assessment as well as the data set in order to establish a\nbasis upon which program evaluation and quality performance can be\nmanaged.\n \nFour clinical reminder dialogs collect data regarding the need for\nlong-term care services in a standard format across VHA.  This provides\nGEC Referral as the preferred method for assessing and screening patients\na mechanism for clinicians to administer comprehensive long-term care\nassessments, stores the information within the patient medical record and\nallows clinicians to notify local OGEC staff.  The screening data is\ncollected as health factors and is stored in the V Health Factor file.  \nThere is no cohort or resolution logic associated. The four reminder\ndialogs are GEC Referral Social Services, GEC Referral Nursing Assessment,\nGEC Referral Care Recommendations, and GEC Referral Care Coordination. An\nM-based option routine accompanies these reminders that extracts the data\nand makes it available for ad hoc reporting.\nfor long-term and extended care services.  As part of the Long Term Care\nInitiative and the Veterans Millennium Health Care and Benefits Act,\nPublic Law 106-177, OGEC identified this tool as the means to standardize\nlong-term care assessments and to prepare for the national collection of\ndata regarding long-term care needs in the veteran population.\n \nCurrent VHA methods of assessing patients to determine the level of care\n
\n
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\nI.      Basics.\nIX.     Training.\nCPRS Cover Sheet.  Due to potential complications with reporting and \nduplicate entries, it is recommended that the GEC dialogs not be added to \nthe Reminders drawer/Cover sheet.  The Referral was designed for \ninter-disciplinary use with dialogs created for separate services.  \nHowever, a single user may perform them all.  With only a few exceptions, \neach section of the dialogs is mandatory and is marked with an asterisk \n(*).  The completion of all four dialogs constitutes a discrete episode \nof the GEC Referral.\n \nThe VA-GEC REFERRAL SOCIAL SERVICES, VA-GEC REFERRAL NURSING ASSESSMENT \n \nand VA-GEC REFERRAL CARE RECOMMENDATIONS dialogs comprise the clinical \nscreening.  The VA-GEC REFERRAL CARE COORDINATION dialog is used \nadministratively to record the arrangement of and funding for extended \ncare services.  These dialogs may be performed in any order local \npractices dictate.  However, it is expected the screening portion will be \ncompleted prior to the coordination of services.  When the screen is \ncomplete, a consult order should be placed to the service responsible for \narranging services.\n \nA.       GEC Consult Order\nI.      Basics\nMost sites have either an individual or service responsible for arranging \nand coordinating extended care services.  To accommodate local business \npractices and flexibility, sites may associate any consult service (or \nmenu) they already have in place.  If none exist, the sites may create a \nconsult or establish some alternative practice to ensure that both \nservices are arranged and that the VA-GEC REFERRAL CARE COORDINATION \ndialog is completed.  \n \nA placeholder for this consult is included at the end of the VA-GEC \nREFERRAL SOCIAL SERVICES, VA-GEC REFERRAL NURSING ASSESSMENT and VA-GEC \nThe GEC Referral is comprised of 4 reminder dialogs: VA-GEC SOCIAL \nREFERRAL CARE RECOMMENDATIONS dialogs.  It must be substituted or deleted \nat the time of installation.  \n \nPre-Installation Requirements\n \nSince nationally created orders do not map to local orderable items, \norders do not pass through Reminder Exchange.  Installation of the \nReferral will prompt for a resolution of this dialog element.  Resolution \nwill consist of either replacing the order with a locally created order, \ndeleting the element or skipping the step.\nSERVICES, VA-GEC NURSING ASSESSMENT, VA-GEC CARE RECOMMENDATIONS and \n \nConsult quick orders are existing functionality that are probably in use \nat your site.  It is also possible that an order has already been created \nthat could be used.  To determine this, the installer should contact the \nCPRS CAC prior to installation and determine if an order is available.  \nIf it is, installation will only require entry of the Fileman name-space \nof the order at the prompt.  If it is not, follow the steps in the CAC \nsection below.\n \nDuring installation you will be presented with the following prompt:\nVA-GEC CARE COORDINATION.  These dialogs are designed for use as TIU \n \n          REMINDER DIALOG entry VA-ORDER GEC REFERRAL CONSULT does not\n          EXIST, what do you want to do?\n \n          Select one of the following:\n \n             D   Delete (from the reminder/dialog)\n             P   Replace (in the reminder/dialog) with an existing entry\n             Q   Quit the install\n \ntemplates to enter data regarding the need for extended care.  Data \nThe installer should select P (Replace with an existing entry), and enter\nthe name of the existing quick order provided by the CAC using Fileman\nname.  [NOTE: The same quick order may be used on each of the dialogs].\n \nCAC Section\n1.  The CAC should first determine if a Consult Service exists for \nthe management of extended care services.  If it exists, this service can \nbe used for the quick order and you can proceed to step 2.  If one does \nnot exist, the CAC will need to create a Consult Service by using the \n[GMRC Manager] option [GMRC SETUP REQUEST SERVICES].\nentered via the dialogs are captured as health factors to be used for \n     a. Recipients of the consult notifications should be GEC staff \n        responsible for coordinating extended care service (or any\n        appropriate user).\n2.  The CAC should create a consult quick order using the [ORCM MGMT] \noption [ORCM MENU].  This order should be associated to the Consult \nService in the Consult to Service/Specialty field of the quick order.\n3.  The CAC should then provide the name of the consult quick order \nto the installer.  The installer will then perform the installation and \nenter the name of the order at the prompt as above.\n \nlocal and national reporting.  The software includes a new report menu \nVI.     GEC Interdisciplinary Notes\nThe GEC Referral dialogs are intended for use as TIU templates.  It is \nalso expected that they will be used as part of a TIU Interdisciplinary \n(ID) note.  This will require new TIU Document Definitions or the \nassociation of existing titles to the dialogs.  This project does not \nstipulate the titles to be used, preferring to allow the sites to use \nthose titles that would best suit their business practices.  However, the \nOffice of Geriatrics Extended Care requests that the parent ID note title \nbe:\n        "GEC EXTENDED CARE REFERRAL"\nthat may be used for local analysis.\n \nTo create a TIU Document Definition, perform the following steps:\nA.      Access the TIU IRM MAINTENANCE MENU.\nB.      Select TIUF DOCUMENT DEFINITION MGR.\nC.      Select Create Document Definitions or Edit Document Definitions.\nD.      Select class and create title.\n \n \nTo associate reminder dialogs with TIU templates, perform the following \nsteps*:\nII.     GEC Health Factors and their use.\n \n \nA.      Make the GEC Referral dialogs eligible to be used as a template \n        by using the parameter: TIU TEMPLATE REMINDER DIALOGS.\nB.      Associate the dialog to a TIU Document Definition.\n        1. Go to Shared Templates\n        2. Click "New Template."\n        3. Enter a name.\n        4. Select the Template Type as Reminder Dialog.\n        5. Pick a GEC dialog from the Reminder Dialog field.\n        6. Under Shared Templates, pick Document Titles.\nII.     GEC Health Factors\n        7. In the Associated Title field, pick the Document Definition\n           created or designated for this dialog.\n        8. Click Apply.\n \n(*You will require the Clinical Applications Coordinator User Class.)\n \nVII.    GEC Referral Reports\nThe software includes a new set of reports that provide a variety of GEC \nhealth factor perspectives.  The reports are released as an option within \nthe Clinical Reminder namespace and may be assigned as necessary.  The \nThe GEC Referral project distributes a large set of national health \noption is [PXRM GEC REFERRAL REPORT] and may be added to the PXRM \nMANAGERS MENU.  The reports capture data elements for reporting and \ntracking use of the GEC Referral Screening Tool.   The reports may be \ngenerated in formatted or delimited output.  The Summary (Score) report \nprovides summary (calculated) totals from specific sections of the \nscreening tool identified by the Office of Geriatrics Extended Care.\n \nVIII.   GEC Reminder Terms\nPhase I of the GEC Referral project distributes a set of terms that will \nbe used with Phase II.  Since Phase II has not yet been initiated, the \nfactors.  They may be identified by the GEC name-space and constitute the \nfunctional requirements and design have not been identified.  However, it \nis expected to include the national roll-up of GEC screening data using \nthe Generic Extract Utility released concurrently with Clinical Reminders \nv2.0.  To allow the greatest degree of flexibility in design, one \nreminder term is released for each GEC Referral health factor. The terms \nare mapped to the health factors on the VA-GEC REFERRAL reminder \ndialogs.  The terms will be installed silently and reside dormant until \nPhase II of the GEC Referral project is implemented.  The reminder \ndefinitions used with these terms will be deleted via post-install \nroutine after installation.\nfoundation of the GEC Referral project.  They establish a standard set of \n \nIX.     Training\nThe Office of Geriatric Extended Care (OGEC) will establish a web site to \nprovide training on the GEC screening tool.  This training module is \nbeing developed with assistance from Employee Education Service and built \nby ImageITS, a private firm.  The module will consist of an interactive \ntutorial and reference material.  OGEC will coordinate the training \ninitiative and serve as the custodian of the web site's content.  \nFacilities may contact OGEC to obtain the website's URL or for more \ninformation.   \nscreening data, to be used across the Veterans Health Administration, and \nwill be rolled-up nationally in Phase II.  \n \nThe Health Factor and V Health Factor files include factors and \ncategories.  For this project, each section of the Referral is correlated \nIII.    GEC Status Indicator.\nto a health factor category.  Once entered, the data is stored in the \nPatient Care Encounter files.  The structure of these underlying files \nhas a direct impact on the design of the GEC software.  Extracting, \nviewing and managing this set of data requires the GEC dialogs to remain \nas they are released.  Consequently, the Clinical Reminders package has \nbeen modified to prevent the GEC national reminders from being copied.  \nThis change was made to the Reminder Dialog, Dialog Group and Dialog \nElement levels.  To accommodate local business practices, sites will be \npermitted to add locally created health factors to the GEC dialogs.  A \nnew List Manager screen is included to facilitate additions and any \nIV.     GEC Referral ad hoc reports (CPRS GUI).\nsubsequent edits to those Groups and Elements added locally.  \n \nNOTES:\n      -Dialog elements that have an order associated as a finding item \n       will continue to be an editable field using the dialog editor.\n      -Any local changes to the GEC dialogs will not be included with\n       the reports or future national extracts.\n      -GEC health factors are populated with a synonym for \n       identification.\n      -Sites are discouraged from using the GEC health factors \nV.      GEC Referral Reminders and Dialogs.\n       elsewhere. Phase II of the GEC project will involve national\n       roll-up. Since this project has yet to be started, potential\n       extraction rules may not be able to distinguish the data source.\n      -Users should not enter GEC health factors from the Encounter \n       form. While it is possible to do so, Patient Care Encounter only\n       allows one instance of a combination of the health factor, patient\n       and Visit IEN.  If one is entered via the Encounter, any subsequent\n       entry of that health factor from the reminder dialog will not be\n       available for the GEC reports.  This is a consequence of the GEC\n       report routines relying on the health factor's Data Source.\n    A.  GEC Consult Order.\n \n \nIII.    GEC Status Check\nThere is no limit to the entry of GEC Referral data.  Thus, there may be \nmultiple entries of the same health factors over time.  Since the data is \nentered via separate dialogs, extraction and viewing requires the data to \nbe discretely identified.  The GEC software depends upon the user to \nindicate when the data from a given referral should be concluded.  The \nreferral is finalized using a new feature called the GEC Status \nIndicator.  This indicator is presented to the user as a modal dialog at \nVI.     GEC Interdisciplinary Notes.\nthe conclusion of the VA-GEC CARE COORDINATION dialog.  It will prompt \nthe user to indicate the conclusion of the Referral with a Yes or NO \nresponse and will list any missing dialogs.  If YES is selected, the data \nfor the current episode of the Referral is closed.  If No is selected, \nthe Indicator is displayed with each succeeding GEC dialog until Yes is \nselected.\n \nTo assist the ongoing management of completing GEC Referrals, the GEC \nStatus Indicator may be added to the CPRS GUI Tools drop-down menu.  The \nparameter to activate the Indicator is PXRM GEC STATUS CHECK.  If may be \nVII.    GEC Referral Reports (LM CHUI).\nset at the User or Team level.  If added to the drop-down menu, the \nIndicator may be viewed at any time and used to close the referral if \nneeded.\n \n \nIV.     GEC Referral Ad hoc Reports\nTwo new health summary components have been created and distributed with \nthis software:  GEC Completed Referral Count (GECC) and GEC Health Factor \nCategory (GECH).  The first displays all GEC referral data according to \nthe occurrence and time limits identified.  The GEC Health Factor \nVIII.   GEC Reminder Terms.\nCategory component, in conjunction with PX*1*123 and GMTS*2.7*63, permits \nGEC data to be viewed by health factor or health factor category.  If a \nuser should have access to these GEC reports, they must have access to \nthe Ad Hoc Health Summary type.  [This can be set using GMTS GUI HS LIST \nPARAMETERS.]\n \nV.      GEC Referral Reminders and Dialogs\nThe GEC reminders are comprised of dialogs and health factors only.  They \nhave neither cohort nor resolution logic and will not become due.  They \nare intended only as TIU templates and do not need to be assigned to the \n
\n
\n", "", "
(SEX)&(AGE)
\n", "
2
\n", "
SEX;AGE
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-ANTIPSYCHOTIC MED SIDE EFF EVAL", "
Eval for Abnl Involuntary Movements
\n", "
1M
\n", "", "", "", "", "", "", "
NATIONAL
\n", "
JOHN D DEMAKIS
\n", "", "
CR
\n", "
\n
\n\n
\n", "
\nProlonged use of antipsychotic medications can result in abnormal \ntaking antipsychotic medications. The biggest challenge in defining this \nreminder is the identification of the cohort of patients to whom it is \napplicable. The pharmacy database structure does not make it easy to \nidentify patients who have been on antipsychotics for a prolonged period \nof time. Even if it did, there are some patients who have not received \nantipsychotics from VHA for an extended period but who have been \nreceiving these medications for a long time from non-VHA sources or who \nare receiving depot neuroleptics from ward stock (not recorded in the \npharmacy files.). If the cohort were defined simply as any patients\ncurrently on an antipsychotic, it would be applicable to patients who have\ninvoluntary movement disorders, which can be managed by changing \nbeen on an antipsychotic for a very brief period of time. The solution to\nthe cohort problem taken by the proposed reminder is to limit the\napplicability of the reminder to patients on specific antipsychotic\ndrug classes which do not include those medications commonly used as \nantiemetics.\n \nSites should ensure that the AIMS reminder does not appear for clinicians \nwho are not responsible for the management of antipsychotic medication \nside effects. This can be accomplished by using the CPRS cover sheet \nparameters to display the reminder only to those users who evaluate the \nmedications, altering the dose of a medication, or prescribing \npatients for side effects of antipsychotics.\n \nThe proposed reminder could be resolved in one of three ways: (1) by \nadministering the AIMS, (2) by indicating that the patient was \nnon-compliant with the prescribed medication, or (3) by indicating the \npatient refused the evaluation. Clinician narrative documentation of \nmotor control is not sufficient.\n \nThis national reminder contains reminder terms for the positive and \nnegative evaluation for abnormal involuntary movements. If sites use a \nmedications to control the movement disorder symptoms. Thus, the \nlocal health factor or exam or use the Simpson-Angus and record the \nresults as a health factor, then those sites will need to map the \nfindings to the terms and add appropriate entries to the dialog to match:\n \n  AIM EVALUATION NEGATIVE \n  AIM EVALUATION POSITIVE\n \nThe only findings in these reminder terms that are exported are the \nresults of the AIMS from the Mental Health package.\n \nPsychoses Clinical Practice Guideline recommends an evaluation of \nThe reminder term ANTIPSYCHOTIC MEDICATIONS contains the drug classes \nCN701 and CN709.  In addition, a health factor is included in this term\nfor use in recording that the patient is on a depot antipsychotic that is\nbeing administered in clinic from ward stock. If the medication is not\ndispensed from the pharmacy, then no data is available to the reminder to\ndetermine that the patient is on an antipsychotic unless this health\nfactor is used.  This health factor for depot neuroleptics can be placed \non an encounter form or into a reminder dialog for injections.\nmovement disorder symptoms annually for patients on antipsychotic \nmedications using either the Abnormal Involuntary Movement Scale (AIMS) \nor the Simpson-Angus. The proposed reminder would prompt clinicians to \ncomplete an evaluation of movement disorders once a year on patients \n
\n
\n", "
\n
\n\n
\n", "", "
\nThe reminder terms for this reminder are:\n        from ward stock and the drug classes CN701 AND CN709.\n \n     REFUSED AIM EVALUATION\n        Includes a health factor for refusal of evaluation.  Used in \n        resolution logic to resolve the reminder for 3 months.\n \n     REFUSED ANTIPSYCHOTICS\n        Includes health factor for refusal to take medications.  This \n        finding excludes the patient from the cohort for 1 month.  \n \n     AIM EVALUATION NEGATIVE\n     SCHIZOPHRENIA DIAGNOSIS\n        This term includes the taxonomy for schizophrenia (295.00 - \n        295.95).\n \nThe reminder is due if the patient is on medication (RT:ANTIPSYCHOTIC\nDRUGS).  The finding for the reminder term for the drugs has an effective\nperiod of 30 days. (This means that the reminder will show as due for the \ntime period that the patient has an active supply of drug based on last \nrelease date plus the days' supply and for an additional 30 days.) The\nhealth factor of DEPOT NEUROLEPTIC has an effective period of 60 days.\n        Includes AIMS<=6 as indicated by a score in the MH package.\n \n     AIM EVALUATION POSITIVE\n        Includes AIMS>=7 as indicated by a score in the MH package.\n \n     ANTIPSYCHOTIC DRUGS\n        Includes a health factor for administration of depot neuroleptics\n
\n
\n", "", "
(SEX)&(AGE)&FI(2)&'FI(6)
\n", "
4
\n", "
SEX;AGE;2;6
\n", "", "
(0)!FI(3)!FI(4)!FI(5)
\n", "
3
\n", "
3;4;5
\n", "", "", "
1
\n", "
1
\n", "", "", "", "", "
\n
\n\n
\n", "", "
\nPatients on long-term antipsychotics should have an evaluation for side \neffects by administration of a test for abnormal involuntary movements on \nat least a yearly basis.\n
\n
\n", "", "
3
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-WH DISCUSS BREAST CA SCREEN WOMAN 40-49", "
Discuss Breast CA Screen: Age 40-49
\n", "
2M
\n", "", "", "", "
S
\n", "
FEMALE
\n", "", "
NATIONAL
\n", "
VHA NATIONAL CENTER FOR HEALTH PROMOTION AND DISEASE PREVENTION (NCP) AND VHA OFFICE OF WOMEN'S HEALTH
\n", "", "
CR
\n", "
\n
\n\n
\n", "
\nThis is a new reminder in 2013 with the release of PXRM 2.0*28.\nOne-Time discussion on preferences for mammogram for women ages 40-49\n \nIf the discussion occurs,as indicated by one of the following health \nfactors, the reminder is resolved permanently and the frequency is changed\nto 99Y. \n      VA-WH BR CA 40-49 BEGIN AGE 50 \n      VA-WH BR CA 40-49 WANTS SCREEN\n \nThe health factor VA-WH BR CA 40-49 WANTS SCREEN includes the patient age \n40-49 in the cohort of reminder: VA-WH MAMMOGRAM SCREENING\nIt is intended to facilitate the implementation of the following VHA \n \nIf the patient has or has had a mammogram, the reminder is resolved after \nthe procedure and the frequency changes to 2 years.  The discussion can \noccur at that time (2 years after the most recent mammogram) and then the \ndiscussion would resolve the reminder permanently. \n     VA-WH MAMMOGRAM SCREEN DONE \n     VA-WH MAMMOGRAM SCREEN IN RAD PKG   \n     VA-WH MAMMOGRAM SCREEN IN WH PKG\n \nIf the patient and provider agree to defer the decision/discussion for 6M,\nGuidance: \n1Y or 5Y, then the reminder frequency is changed to that time period but\nthis would be overridden by the performance of a mammogram (resolves for\n2Y) or having the discussion (resolved permanently).\n \n \nThe setting of the Custom Date Due prevents the following problem: \npatient has a mammogram, then 2 years later the reminder shows and the \ndiscussion is deferred 6 months.  Without the CDD, the reminder would be \ndue 2 years later instead of 6 months later.\n \n"The decision to start regular screening every 2 years with mammography \nfor average risk women age 40 to 49 years should be an individual \ndecision and take the patient's values into account including values \nabout specific benefits and harms." \n \n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "
\n  Technical Description: \n      satisfy this reminder: \n         VA-WH MAMMOGRAM SCREEN DONE \n             Some mapping may be appropriate. This reminder term will use \n             the previously distributed VA-MAMMOGRAM/SCREEN taxonomy to \n             find ICD DIAGNOSIS or CPT coded results.  \n       \n             Use the new WH MAMMOGRAM OUTSIDE health factor to document \n             Mammogram results completed outside the VA when the \n             Mammogram results are not documented in Radiology, Women's\n             Health or Consult packages.\n       \n          * Results, with interpretation, can be entered and verified in \n             Map local findings, such as consult orders related to \n             Mammogram Screening.  Use appropriate condition logic to \n             indicate Mammogram screening has been completed.  \n \n        VA-BR CA 40-49 BEGIN AGE 50\n             Distributed health factor\n       \n        VA-BR CA 40-49 WANTS SCREEN\n             No mapping necessary.  This term uses distributed health \n             factor WH BR CA 40-49 WANTS SCREENING\n            the Radiology package.  \n \n        WH BR CA 40-49 DEFER 6M\n             Distributed health factor\n \n        WH BR CA 40-49 DEFER 1Y\n             Distributed health factor\n   \n        WH BR CA 40-49 DEFER 5Y\n             Distributed health factor\n          * Results, with interpretation, can be manually entered into \n            the WH package. \n          * Summarized results can be entered as a historical entry\n            (health factor or CPT code) in the patient record.\n   \n \n      Setup of reminder/dialog before using this reminder: \n       \n      ==================================================== \n       Use the Reminder Term options to map local representations of \n          findings: \n       \n      PATIENT COHORT FINDINGS: \n      ------------------------\n      The following reminder terms determine whether the reminder applies \n      to the patient.  \n       \n  \n      This reminder is recommended for use by clinicians at Primary Care \n         VA-WH BILATERAL MASTECTOMY \n             This term will use the VA-WH BILATERAL MASTECTOMY taxonomy \n             to find coded bilateral mastectomies. The health factor WH\n             BILATERAL MASTECTOMY distributed with this term may be used\n             or add any local health factor that represents the patient\n             had a bilateral mastectomy and no longer needs mammogram\n             screening.\n   \n         VA-TERMINAL CANCER PATIENT \n             No mapping necessary.  Use the VA-TERMINAL CANCER PATIENTS \n      Clinics (PACT/Primary Care, Medicine, GIMC, Geriatric, Women's) and \n             reminder taxonomy distributed with this term.  \n \n         VA-WH MAMMOGRAM SCREEN NOT INDICATED \n             Use the findings distributed with this reminder term or map \n             any local findings that indicate a Mammogram screen is not \n             indicated for this patient.  \n       \n             This term is distributed with mapping to the following \n             health factors: \n                INACTIVATE BREAST CANCER SCREEN (distributed with the \n      any other specialty clinics where primary care is given to female \n                first version of the Clinical Reminder package in 1996 to\n                inactivate the BREAST CANCER reminder).  WH MAMMOGRAM\n                SCREEN NOT INDICATED VA LIMITED LIFE EXPECTANCY and the\n                taxonomy: VA-TERMINAL CANCER PATIENTS Updated March, 2013\n                to include 2 new health factor which both inactivate the\n                reminder for 5 years: \n                   WH BR CA SCREEN N/A 5 YRS-LE<5YRS \n                   WH BR CA SCREEN N/A 5 YRS-COMORBIDITIES\n       \n             Use in National VA-WH MAMMOGRAM SCREENING reminder: \n      patients.  \n             This term is used in WH reminders to inactivate Mammogram \n             screening until a clinician overrides the inactivation by \n             selecting a health factor that is used by function findings \n             with frequencies of 4M, 6M, 1Y or 2Y. Begin date of T-6M has \n             been added to HF.VA LIMITED LIFE EXPECTANCY and \n             TX.VA-TERMINAL CANCER PATIENTS so screening will come due \n             again if the patient lives longer than expected or if the \n             patient has been misdiagnosed.  \n       \n             Sites may prefer to use local LIMITED LIFE EXPECTANCY health \n       \n             factors and add their health factors to other reminder \n             terms which cause the Mammogram Screening reminder to be \n             due without requiring a clinician to select a finding to \n             reactivate the reminder. (e.g., Add the local life \n             expectancy health factor for "LOCAL LIFE EXPECTANCY 6M" to\n             the VA-WH MAMMOGRAM SCREEN NOT INDICATED term).\n        \n      RESOLUTION FINDINGS: \n      --------------------\n      The following reminder terms resolve the reminder.  These \n      If the mammogram is done in the private sector or at another VAMC \n      resolution terms are defined with a "Use in Resolution Logic".\n   \n       \n         VA-WH MAMMOGRAM SCREEN IN WH PKG \n             No mapping necessary. This term represents mammogram results \n             documented in the Women's Health (WH) Package. The term is \n             mapped to the VA-WH MAMMOGRAM IN WH PKG computed finding \n             which only uses WH findings that are normal or abnormal.\n       \n         VA-WH MAMMOGRAM SCREEN IN RAD PKG \n      facility, there are three ways the results can be documented to \n             Mapping will be necessary.  This term represent Mammogram \n             results documented in the Radiology package.  Map local \n             radiology procedures that represent the following \n             procedures: \n                MAMMOGRAM BILAT \n                MAMMOGRAM UNILAT \n                MAMMOGRAM SCREEN \n             Each finding should have a condition added to exclude \n             unsatisfactory results.  \n       \n
\n
\n", "", "
(SEX)&(AGE)&'FI(1)&'FI(7)&'FI(11)
\n", "
5
\n", "
SEX;AGE;1;7;11
\n", "", "
(0)!FI(2)!FI(3)!FI(4)!FI(5)!FI(6)!FI(8)!FI(9)!FI(10)
\n", "
8
\n", "
2;3;4;5;6;8;9;10
\n", "
1
\n", "
FF1
\n", "", "", "", "", "", "", "
\n
\n\n
\n", "", "
\n\\\\\nThe decision to start regular screening every 2 years with mammography for\naverage risk women age 40 to 49 years should be an individual decision and\ntake the patient's values into account including values about specific\nbenefits and harms.\n\\\\\n
\n
\n", "", "
6
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-POS DEPRESSION SCREEN FOLLOWUP", "
Depr Scr Pos - Needs F/U Assessment
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
JOHN D DEMAKIS
\n", "", "
CR
\n", "
\n
\n\n
\n", "
\nThe following reminder terms are included in this reminder.  \n  DEPRESSION THERAPY\n  DEPRESSION TO BE MANAGED IN PC\n  PSYCHOTHERAPY\n  REFERRAL TO MENTAL HEALTH\n  REFUSED DEPRESSION ASSESSMENT\n  REFUSED DEPRESSION RX/INTERVENTION\n  NO DEPRESSIVE SX NEED INTERVENTION\n \nThe reminder is applicable if the patient has positive depression screen \nin the past 1 year (DEPRESSION SCREEN POSITIVE).  If a more recent \n  ANTIDEPRESSANT MEDICATIONS\nnegative depression screen is entered, then the reminder becomes not \napplicable (DEPRESSION SCREEN NEGATIVE).\n \nThe reminder is resolved by DEPRESSION ASSESS COMPLETED IN MHC, which \nincludes the entry of a BDI, CRS or ZUNG depression scale in the mental \nhealth package or by psychotherapy in the past 3 months.\n \nIf the patient has a recent diagnosis of depression and is on medication \nfor depression, the reminder is resolved.\n \n  DEPRESSION DIAGNOSIS\nIf the patient refuses additional assessment of the positive depression \nscreen or refuses recommended therapy for depression, the reminder is \nresolved for 3 months  (REFUSED DEPRESSION ASSESSMENT\n \nA refusal after the assessment is completed resolves the reminder for a \nyear.  (Entry of REFUSED DEPRESSION RX/INTERVENTION can only be done \nin conjunction with a positive, negative or inconclusive assessment - \neach of which resolves the reminder for one year).\n \nIf an entry is made to indicate that the patient is already being treated\n  DEPRESSION ASSESS COMPLETED IN MHC\nfor depression, the reminder is resolved.  DEPRESSION THERAPY\n \nThe reminder is also resolved if it is indicated that the depression will \nbe managed in PC.  (DEPRESSION TO BE MANAGED IN PC)\n \nThe reminder is resolved for 3 months by a referral to Mental Health \n(REFERRAL TO MENTAL HEALTH) or by the presence of a recent code for \npsychotherapy (PSYCHOTHERAPY).    But if the entry of the referral is \nmade in conjuction with the negative, positive, or inconclusive \nassessment then the reminder is resolved for one year.\n  DEPRESSION ASSESS INCONCLUSIVE (? MDD)\n \nAssessment of the patient based on DSM-IV criteria will resolve the \nreminder for one year:\n   DEPRESSION ASSESS NEGATIVE (NOT MDD)\n   DEPRESSION ASSESS POSITIVE (MDD)\n   DEPRESSION ASSESS INCONCLUSIVE\n \nThe reminder is resolved by entry of NO DEPRESSIVE SX NEED INTERVENTION \nwhich is entered in conjunction with a negative assessment.\n  DEPRESSION ASSESS NEGATIVE (NOT MDD)\n  DEPRESSION ASSESS POSITIVE (MDD)\n  DEPRESSION SCREEN NEGATIVE\n  DEPRESSION SCREEN POSITIVE\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "
FI(1)&FF(1)
\n", "
FI(1)&FF(1)
\n", "
2
\n", "
1;FF1
\n", "
(FI(3)&FI(4))!FI(5)!FI(6)!FI(7)!FI(8)!FI(9)!FI(10)!FI(11)!FI(12)!FI(13)!FI(14)!FI(15)
\n", "
(FI(3)&FI(4))!FI(5)!FI(6)!FI(7)!FI(8)!FI(9)!FI(10)!FI(11)!FI(12)!FI(13)!FI(14)!FI(15)
\n", "
13
\n", "
3;4;5;6;7;8;9;10;11;12;13;14;15
\n", "", "", "
1
\n", "
2
\n", "", "", "", "", "
\n
\n\n
\n", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2007-11-01 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-*TETANUS DIPHTHERIA IMMUNIZATION", "
ZZ Tetanus Diphtheria (TD-Adult)
\n", "
6M
\n", "
ZZVA-*TETANUS DIPHTHERIA IMMUNIZATION
\n", "
INACTIVE
\n", "
2005-03-11 12:42:50
\n", "", "", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nTD booster given to all adult patients every ten years.\nRecommendation: A tetanus and diphtheria (TD) toxoid booster should be\nadministered every ten years throughout adult life.  This is commonly\noffered at each half decade (e.g. ages 45,55,65).\n \nGoal for FY 2000: 50% of individuals have received a tetanus immunization\nbooster in the past ten years.\n \nThis reminder is based on "Tetanus and Diphtheria Immunization"\nguidelines specified in VHA HANDBOOK 1101.8, APPENDIX A.\n \nTarget Condition: Infection with tetanus and diphtheria.\n \nTarget Group: General outpatient population.\n \n
\n
\n", "
\n
\n\n
\n", "", "
\nIf this reminder is not going to be used at your facility, the INACTIVE\n \nIf any modifications to the reminder definition are needed, copy the\nreminder to a new reminder for your site's use, and make the appropriate\nmodifications.\nFLAG should be set to inactive.\n \nThis reminder represents the minimum criteria for checking if the patient\nhas been screened for tetanus diphtheria immunization. The "TETANUS\nDIPHTHERIA (TD-ADULT)" and "TETANUS TOXOID" immunizations or their CPT\nequivalent are the result finding that will satisfy this reminder.\n \nThe Ambulatory Care EP endorses this reminder as it is defined.\n
\n
\n", "", "
(SEX)&(AGE)&'FI(4)
\n", "
3
\n", "
SEX;AGE;4
\n", "", "
(0)!FI(1)!FI(2)!FI(3)
\n", "
3
\n", "
1;2;3
\n", "
1
\n", "
4
\n", "
1
\n", "
5
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-MAMMOGRAM", "
ZZ Mammogram
\n", "
1M
\n", "
ZZVA-*BREAST CANCER SCREEN
\n", "
INACTIVE
\n", "
2005-03-11 12:42:51
\n", "
S
\n", "
FEMALE
\n", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nMammogram should be given every 2 years to female patients, ages 50-69\nThis reminder also supports the "Breast Cancer Detection" reminder defined\nin the "Guidelines for Health Promotion and Disease Prevention", M-2, Part\nIV, Chapter 9.\nwith no DX of breast cancer, and yearly for women with a history of breast\ncancer or breast tumors, ages 35 - 69.\n \nThis reminder is based on guidelines provided by the Ambulatory Care\nExpert Panel.  The expert panel recommends a study for patients with "high\nrisk for breast cancer" to occur every 1 to 2 years. A conservative 1 year\nis defined in this reminder definition.\n \n
\n
\n", "
\n
\n\n
\n", "", "
\nThe findings for mammogram are based on defining the CPT codes\ndefined reminder item and make the appropriate modifications.\nrepresenting mammograms in a taxonomy for Mammograms.  The CPT codes are\nused to search the Radiology procedures in the Radiology package, as well\nas checks for existence of a CPT code in the  V CPT file.\n \nCheck the taxonomy findings definition for breast cancer and breast tumor.\nCopy the taxonomies and make modifications if needed.\n \nIf any changes were needed in the findings, copy this reminder to a site\n
\n
\n", "", "
(SEX)&(AGE)&'FI(3)
\n", "
3
\n", "
SEX;AGE;3
\n", "", "
(0)!FI(1)
\n", "
1
\n", "
1
\n", "
2
\n", "
2;3
\n", "
1
\n", "
4
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-*PROBLEM DRINKING SCREEN", "
ZZ Problem Drinking Screen
\n", "
1M
\n", "
ZZVA-*PROBLEM DRINKING SCREEN
\n", "
INACTIVE
\n", "
2005-03-11 12:42:50
\n", "", "", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nThe "VA-*Problem Drinking Screening" education reminder is based on the\n                       attributable to alcohol use.\n \n    Recommendation:    Primary care clinicians should routinely ask their\n                       patients to describe their use of alcohol.\n                       High risk patients (3 or more drinks daily)  \n                       should be referred for counseling.\n \n    Goals for FY 2000: 100% of VHA facilities have an alcohol treatment\n                       program or access to one. 75% of primary\n                       care providers should screen for alcohol\nfollowing "Problem Drinking and Alcohol Moderation Counseling" guidelines\n                       problems yearly and provide counseling and\n                       referral as needed.\nspecified in the VHA HANDBOOK 1101.8, APPENDIX A.\n \n    Target Conditions: Problem drinking, alcohol dependence,\n                       medical complications of alcohol use,\n                       accidents and violence.\n \n    Target Group:      Outpatient experiencing medical or social problems\n
\n
\n", "
\n
\n\n
\n", "", "
\nIf this reminder is not going to be used at your facility, the INACTIVE\nin the "VA-ALCOHOL ABUSE EDUCATION" reminder. This reminder includes a\ncheck for a diagnoses documented for the patient that would indicate the\npatient has a problem related to alcohol abuse.  It also references all of\nthe alcohol abuse education topics that are distributed by PCE, which\ncould satisfy the reminder. \n \nPlease review both of these reminder definitions, choose one of them to\nuse.  If local modifications need to be made, copy the preferred reminder\nto a new reminder and make your reminder modifications.\nFLAG should be set to inactive.\n \nThis reminder represents the minimum criteria for checking if the\npatient has been screened for problem drinking.  The "VA-ALCOHOL ABUSE\nSCREENING" education topic is the result finding that will satisfy this\nreminder.\n \nThe Ambulatory Care EP recommends a variation on this reminder represented\n
\n
\n", "", "
(SEX)&(AGE)&'FI(3)
\n", "
3
\n", "
SEX;AGE;3
\n", "", "
(0)!FI(1)!FI(2)
\n", "
2
\n", "
1;2
\n", "
1
\n", "
3
\n", "
1
\n", "
4
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-PAP SMEAR", "
ZZ Pap Smear
\n", "", "
ZZVA-*CERVICAL CANCER SCREEN
\n", "
INACTIVE
\n", "
2001-04-23 10:19:43
\n", "
S
\n", "
FEMALE
\n", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nPap smear/pelvic exam every three years for female patients, age 65 and\nHealth Promotion and Disease Prevention", M-2, Part IV, Chapter 9.\nunder, with no DX of cervical cancer or abnormal pap smear and no previous\nabnormal pap smear lab test.\n \nIf patient has had hysterectomy for benign disease, no pap smear is\nindicated.\n \nThis reminder is based on the Ambulatory Care EP and supports the\n"Cervical Cancer Screen" guidelines specified in the "Guidelines for\n
\n
\n", "
\n
\n\n
\n", "", "
\nCheck the Taxonomy Findings representing history of hysterectomy for\nbenign disease, and history of cervical cancer or abnormal PAP.\nIf these taxonomies need modifications, copy each to a new taxonomy for\nyour local site, and make the appropriate modifications.\n \nDefine Health Factors that may represent Sexual Activity.  To add new\nHealth Factors use the PCE Table Maintenance option.  \n \nCopy the reminder to a new reminder for your local site modifications.\n
\n
\n", "", "
(SEX)&(AGE)&'FI(1)&'FI(2)&'FI(4)
\n", "
5
\n", "
SEX;AGE;1;2;4
\n", "", "
(0)!FI(3)
\n", "
1
\n", "
3
\n", "
3
\n", "
1;2;4
\n", "
1
\n", "
5
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-DIGITAL RECTAL (PROSTATE) EXAM", "
ZZ Digital Rectal (Prostate) Exam
\n", "
0M
\n", "", "
INACTIVE
\n", "
2005-03-11 12:42:51
\n", "", "
MALE
\n", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nDigital rectal (Prostate) exam should be given yearly to male patients\nages 40-75 with no DX of prostate cancer.\n \nThis reminder is based on guidelines defined by the Ambulatory Care Expert\nPanel.\n
\n
\n", "
\n
\n\n
\n", "", "
\nCheck the Taxonomy Findings entries representing HX of Prostate Cancer.\nmodifications to the reminder to reflect your site's guidelines.\nIf this taxonomy needs modification, copy the taxonomy to a new taxonomy\nfor your site, and make the appropriate modifications.\n \nCheck the Result Findings EXAM entry representing Digital rectal exam.\nMake modifications to the EXAM file via the PCE Table Maintenance option.\n \nIf any modifications were required based on the checks above, then copy\nthe reminder definition to a new reminder, and make the appropriate\n
\n
\n", "", "
(SEX)&(AGE)
\n", "
2
\n", "
SEX;AGE
\n", "", "
(0)!FI(1)
\n", "
1
\n", "
1
\n", "
0
\n", "", "
1
\n", "
2
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-NUTRITION/OBESITY EDUCATION", "
ZZ Nutrition/Obesity Education
\n", "
1M
\n", "
ZZVA-*WEIGHT AND NUTRITION SCREEN
\n", "
INACTIVE
\n", "
2005-03-11 12:42:51
\n", "", "", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nGiven yearly to patients of any age who have a history of a nutrition disorder\nor a history of obesity.  Also given to patients who are considered obese\nbased on a Body Mass Index greater than 27, which represents weight\ngreater than 120% of Ideal Body Weight.\n \nThis reminder is based on guidelines defined by the Ambulatory Care Expert\nPanel. This reminder also supports the "Weight Control and Nutrition\nCounseling" guidelines defined in the "Guidelines for Health Promotion and\nDisease Prevention", M-2, Part IV, Chapter 9.\n
\n
\n", "
\n
\n\n
\n", "", "
\nThe most recent taxonomy finding within a taxonomy is presented for\nthey are evaluated and the most recent of these two factors would also be\nused by the reminder.\nclinical information.\n \nThe most recent health factor finding within a health factor\ncategory is presented for clinical information. If all 6 of the health\nfactors that are from the NUTRITION health factor category were found for\nthe patient, only the most recent health factor within the "NUTRITION"\nhealth factor category would be used by the reminder.  Since the activate\nand inactivate health factors are defined under the "REMINDER CATEGORY"\n
\n
\n", "", "
(SEX)&(AGE)&'FI(12)&FI(14)
\n", "
4
\n", "
SEX;AGE;12;14
\n", "", "
(0)!FI(1)!FI(2)!FI(5)
\n", "
3
\n", "
1;2;5
\n", "
0
\n", "", "
9
\n", "
3;4;6;7;8;9;10;11;13
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-*CHOLESTEROL SCREEN (M)", "
ZZ Cholesterol Screen (Male)
\n", "
3M
\n", "
ZZVA-*CHOLESTEROL SCREEN (M)
\n", "
INACTIVE
\n", "
2005-03-11 12:42:50
\n", "
S
\n", "
MALE
\n", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nThis Cholesterol screen reminder for males is based on the following\n    five years.\n \n    Goal for FY 2000: 75% of males ages 35-65 Primary Care clinic patients\n    have had a blood cholesterol level check within the past five years.\n"Hyperlipidemia Detection" guidelines specified in the VHA HANDBOOK\n1101.8, APPENDIX A.\n \n    Target Conditions: Cardiovascular Disease.\n \n    Target Group: Males ages 35-65.\n \n    Recommendation: Check total cholesterol level within the past\n
\n
\n", "
\n
\n\n
\n", "", "
\nAs distributed, this reminder is based on CPT codes which represent\n \nPLEASE NOTE: Your local version of this reminder will include the search\nbased on the local ancillary Lab package results, it is possible that 5\nyears worth of patient lab history are not on record.\ncholesterol tests the patient has had documented in PCE.  These may be CPT\ncodes for cholesterol done by the Laboratory Service, or a historical\nencounter documented to show when the cholesterol test was last given to\nthe patient.\n \nCopy this reminder to a new reminder for your site. Add the Laboratory\nTests that represent a cholesterol level check in the Result Findings\nmultiple.\n
\n
\n", "", "
(SEX)&(AGE)&'FI(2)
\n", "
3
\n", "
SEX;AGE;2
\n", "", "
(0)!FI(1)
\n", "
1
\n", "
1
\n", "
1
\n", "
2
\n", "
1
\n", "
3
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-FECAL OCCULT BLOOD TEST", "
ZZ Fecal Occult Blood Test
\n", "
1M
\n", "
ZZVA-*COLORECTAL CANCER SCREEN (FOBT)
\n", "
INACTIVE
\n", "
2005-03-11 12:42:51
\n", "", "", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nFecal occult blood test due every year for patients ages 50 and older with\nno DX of colorectal cancer.  This reminder conservatively recommends that\nif a sigmoidoscopy was received, the next fecal occult blood test would be\ndue a year later.\n  \nThis reminder is based on guidelines provided by the Ambulatory Care\nExpert Panel.  It also satisfies the "Colorectal Cancer Screen - FOBT"\nguidelines specified in the "Guidelines for Health Promotion and Disease\nPrevention", M-2, Part IV, Chapter 9.\n
\n
\n", "
\n
\n\n
\n", "", "
\nThis reminder depends on Exam findings where an FOBT is completed in the\nOperation/Procedure file.  If this taxonomy needs modification, copy the\ntaxonomy to a new taxonomy for your site, and make the appropriate\nmodifications.\n \nCopy the reminder to a new reminder for your local site's modifications.\n \nNOTE:  The Laboratory data is not available use in the reminder.  When the\nlab package begins passing CPT codes for fecal occult blood tests to PCE,\nthis reminder is ready to make use of the information.\nclinic, or on Taxonomy Findings representing FOBT.\n \nCheck the Taxonomy Findings entries representing HX of Colorectal Cancer.\nIf this taxonomy needs modification, copy the taxonomy to a new taxonomy\nfor your site, and make the appropriate modifications.\n \nCheck the Taxonomy Findings entries representing Fecal Occult Blood Test.\nThis represents coded standard entries in the CPT file and ICD\n
\n
\n", "", "
(SEX)&(AGE)&'FI(2)&'FI(5)
\n", "
4
\n", "
SEX;AGE;2;5
\n", "", "
(0)!FI(1)!FI(3)!FI(4)
\n", "
3
\n", "
1;3;4
\n", "
2
\n", "
2;5
\n", "
1
\n", "
6
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-FLEXISIGMOIDOSCOPY", "
ZZ Flexisigmoidoscopy
\n", "
1M
\n", "
ZZVA-*COLORECTAL CANCER SCREEN (SIG.)
\n", "
INACTIVE
\n", "
2005-03-11 12:42:51
\n", "", "", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nFlexisigmoidoscopy every 5 years for patients age 50 and older, with no DX\nof colorectal cancer.\n \nThis reminder is based on guidelines provided by the Ambulatory Care\nExpert Panel and satisfies the sigmoidoscopy requirements for the\n"Colorectal Cancer Detection" guidelines specified in the "Guidelines for\nHealth Promotion and Disease Prevention", M-2, Part IV, Chapter 9.\n
\n
\n", "
\n
\n\n
\n", "", "
\nCheck the Taxonomy Findings entries representing HX of Colorectal\n \nCopy the reminder to a new reminder for your local sites modifications.\nCancer. If this taxonomy needs modification, copy the taxonomy to a new\ntaxonomy for your site, and make the appropriate modifications.\n \nCheck the Taxonomy Findings entries representing flexisigimoidoscopy\nprocedures. This represents coded standard entries in the CPT file and ICD\nOperation/Procedure file.  If this taxonomy needs modification, copy\nthe taxonomy to a new taxonomy for your site, and make the\nappropriate modifications.\n
\n
\n", "", "
(SEX)&(AGE)&'FI(3)
\n", "
3
\n", "
SEX;AGE;3
\n", "", "", "
0
\n", "", "
1
\n", "
3
\n", "
3
\n", "
1;2;4
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-INFLUENZA VACCINE", "
ZZ Influenza Vaccine
\n", "
1M
\n", "
ZZVA-*INFLUENZA IMMUNIZATION
\n", "
INACTIVE
\n", "
2005-03-11 12:42:51
\n", "", "", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nInfluenza vaccine given yearly for patients ages 65 and older, and\nfor patients of any age with a history of any of the following: asthma,\nCOPD, DM, ASVCD, CHG, chronic bronchitis, HIV positive or AIDS, renal\ntransplant, or cancer chemotherapy.\n \nThis reminder is defined based on guidelines from the Ambulatory Care\nExpert Panel.  It also supports the "Influenza Immunization" guidelines\nspecified in the "Guidelines for Health Promotion and Disease Prevention",\nM-2, Part IV, Chapter 9.\n
\n
\n", "
\n
\n\n
\n", "", "
\nCheck the Taxonomy Findings representing High Risk for Flu/Pneumonia. If\nthis taxonomy needs modification, copy the taxonomy to a new taxonomy for\nyour site, and make the appropriate modifications.\n \nCopy the reminder to a new reminder for your local sites modifications.\n
\n
\n", "", "
(SEX)&(AGE)&'FI(4)
\n", "
3
\n", "
SEX;AGE;4
\n", "", "
(0)!FI(1)!FI(3)
\n", "
2
\n", "
1;3
\n", "
2
\n", "
2;4
\n", "
1
\n", "
5
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-COVID-19 CPRS STATUS", "", "", "", "", "", "", "", "", "
NATIONAL
\n", "", "", "
R
\n", "
\n
\n\n
\n", "
\nThis reminder definition created to display COVID-19 status in CPRS\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "", "
(SEX)&(AGE)
\n", "
2
\n", "
SEX;AGE
\n", "", "", "", "", "", "", "
17
\n", "
1;2;3;4;5;6;7;FF10;FF20;FF30;FF40;FF50;FF60;FF70;FF80;FF90;FF99
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-DIABETIC EYE EXAM", "
ZZ Diabetic Eye Exam
\n", "
1M
\n", "", "
INACTIVE
\n", "
2005-03-11 12:42:51
\n", "", "", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nPatients with the VA-DIABETES taxonomy should have a diabetic eye exam\ndone yearly.\n
\n
\n", "
\n
\n\n
\n", "", "
\nThis reminder is based on the Diabetic Eye Exam reminder from the New\nYork VAMC which was designed to meet the guidelines defined by the PACT\npanel.  Additional input came from the Saginaw VAMC.\n
\n
\n", "", "
(SEX)&(AGE)&FI(2)
\n", "
3
\n", "
SEX;AGE;2
\n", "", "
(0)!FI(1)
\n", "
1
\n", "
1
\n", "
1
\n", "
2
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-PNEUMOVAX", "
ZZ Pneumovax
\n", "
3M
\n", "
ZZVA-*PNEUMOCOCCAL VACCINE
\n", "
INACTIVE
\n", "
2005-03-11 12:42:51
\n", "", "", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nPneumovax given once to patients 65 and over, and to patients of any\nage with a history of any of the following diagnoses: asthma, COPD,\nDM, ASCVD, CHG, chronic bronchitis, HIV positive or AIDS, renal\ntransplant, or cancer chemotherapy.\n \nThis reminder is defined based on guidelines from the Ambulatory\nCare Expert Panel.  It also supports the "Pneumococcal Vaccine" guidelines\nspecified in the "Guidelines for Health Promotion and Disease Prevention",\nM-2, Part IV, Chapter 9.\n
\n
\n", "
\n
\n\n
\n", "", "
\nIf this reminder is not going to be used at your facility, the INACTIVE\nFLAG should be set to inactive.\n \nCheck the Taxonomy Findings representing High Risk for Flu/Pneumonia.\nIf the taxonomy needs modification, copy the taxonomy to a new taxonomy\nfor your site, and make the appropriate modifications.\n \nCopy the reminder to a new reminder for your local sites modifications.\n
\n
\n", "", "
(SEX)&(AGE)&'FI(4)
\n", "
3
\n", "
SEX;AGE;4
\n", "", "
(0)!FI(1)!FI(3)
\n", "
2
\n", "
1;3
\n", "
2
\n", "
2;4
\n", "
1
\n", "
5
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-PPD", "
ZZ PPD
\n", "
1M
\n", "", "
INACTIVE
\n", "
2005-03-11 12:42:51
\n", "", "", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nPPD given yearly to patients of any age who have a "High risk DX for TB";\nsuch as HIV positive or AIDS, homelessness, or alcohol abuse who do not\nhave a DX of tuberculosis and no prior positive TB skin test.\n \nThis reminder is based on guidelines provided by the Ambulatory Care\nExpert Panel.\n
\n
\n", "
\n
\n\n
\n", "", "
\nCheck the Taxonomy Findings representing High Risk for TB.  If this\ntaxonomy needs modification, copy the taxonomy to a new taxonomy for your\nsite, and make the appropriate modifications.\n \nDefine health factors which may represent high risk for TB in the Health\nFactors file via the PCE Table Maintenance options.\n \nCopy the reminder to a new reminder for your local site modifications.\n
\n
\n", "", "
(SEX)&(AGE)&FI(2)&'FI(3)
\n", "
4
\n", "
SEX;AGE;2;3
\n", "", "
(0)!FI(1)
\n", "
1
\n", "
1
\n", "
2
\n", "
2;3
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-BLOOD PRESSURE CHECK", "
ZZ Blood Pressure Check
\n", "
3M
\n", "
ZZVA-*HYPERTENSION SCREEN
\n", "
INACTIVE
\n", "
2005-03-11 12:42:51
\n", "", "", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nBP due yearly for patients with no DX of hypertension, any age.\nexistence of a Hypertension Screening being asked, and not whether the\nBlood pressure value is documented.\nBP due at all visits for patients with DX of hypertension or\ncardiovascular disease, any age.\n \nThe VA-Blood Pressure Check reminder is based on baseline guidelines\ndefined by the Ambulatory Care Expert Panel and depends on your site\nentering Blood Pressure measurement values into the "Vital Measurement"\nfile.  This reminder is different than the VA-HYPERTENSION SCREEN\nreminder which is an Education type reminder which simply checks for the\n
\n
\n", "
\n
\n\n
\n", "", "
\nReview the Taxonomy definition for hypertension and cardiovascular disease\nin the PCE Taxonomy file.  Use the taxonomies as distributed or copy a new\ntaxonomy for local use and make the appropriate modifications. \n \nEither accept the VA- reminder definition or create a local reminder\ndefinition by copying the VA- reminder definition to a local reminder.\n \nBP for Blood Pressure should be named as the Result Findings item from\nthe Vital Type file.\n
\n
\n", "", "
(SEX)&(AGE)
\n", "
2
\n", "
SEX;AGE
\n", "", "
(0)!FI(1)!FI(3)
\n", "
2
\n", "
1;3
\n", "
2
\n", "
2;3
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-TOBACCO EDUCATION", "
ZZ Tobacco Cessation Education
\n", "
1M
\n", "
ZZVA-*TOBACCO USE SCREEN
\n", "
INACTIVE
\n", "
2005-03-11 12:42:51
\n", "", "", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nTobacco use cessation education should be offered annually to any patient\na new reminder definition.\nwho has a diagnosis or health factor associated with chronic tobacco use.\n \nThis reminder is based on guidelines defined by the Ambulatory Care Expert\nPanel and satisfies the "Smoking and Tobacco Use Counseling" guidelines\nspecified in the "Guidelines for Health Promotion and Disease\nPrevention",M-2, Part IV, Chapter 9. \n \nModifications to these guidelines for your local site may be reflected in\n
\n
\n", "
\n
\n\n
\n", "", "
\nCheck the ICD Diagnosis entries defined in the PCE Taxonomy file for\nVA-TOBACCO USE.  Reflect any changes in a new taxonomy definition.\n \nCheck/Modify the health factors defined within the Tobacco category in the\nHealth Factors file. The Health Factors file can be modified using the PCE\nTable Maintenance options.\n \nIf the reminder needs modifications, copy it and modify the new\nreminder to meet local site guidelines.\n
\n
\n", "", "
(SEX)&(AGE)&'FI(6)&'FI(9)&'FI(13)
\n", "
5
\n", "
SEX;AGE;6;9;13
\n", "", "
(0)!FI(1)!FI(2)!FI(12)
\n", "
3
\n", "
1;2;12
\n", "
2
\n", "
6;9
\n", "
7
\n", "
3;4;5;7;8;10;11
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-ALCOHOL ABUSE EDUCATION", "
ZZ Alcohol Abuse Education
\n", "
1M
\n", "
ZZVA-*PROBLEM DRINKING SCREEN
\n", "
INACTIVE
\n", "
2005-03-11 12:42:51
\n", "", "", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nThe VA-Alcohol Abuse Education reminder is based on guidelines defined by\nthe Ambulatory Care Expert Panel.  This reminder includes the alcohol\nabuse screening criteria to meet the "VA-*Problem Drinking Screening"\nreminder and more education criteria and diagnosis evaluation to determine\nthe need for the reminder.\n \nThis reminder is an "education" type reminder.  It relies on an active\nEDUCATION TOPIC (representing Alcohol Abuse education or screening) and\nuse of PCE TAXONOMY and HEALTH FACTORS related to alcohol abuse.\n
\n
\n", "
\n
\n\n
\n", "", "", "", "
(SEX)&(AGE)
\n", "
2
\n", "
SEX;AGE
\n", "", "
(0)!FI(1)!FI(2)!FI(3)!FI(4)!FI(5)!FI(6)!FI(7)!FI(8)!FI(9)!FI(11)
\n", "
10
\n", "
1;2;3;4;5;6;7;8;9;11
\n", "
0
\n", "", "
8
\n", "
10;12;13;14;15;16;17;18
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-EXERCISE EDUCATION", "
ZZ Exercise Education
\n", "
1M
\n", "
ZZVA-*FITNESS AND EXERCISE SCREEN
\n", "
INACTIVE
\n", "
2005-03-11 12:42:51
\n", "", "", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nExercise education given yearly to all patients.\n \nThis reminder is based on guidelines defined by the Ambulatory Care Expert\nPanel.  It also supports the following "Fitness and Exercise Counseling"\nguidelines specified in the "Guidelines for Health Promotion and Disease\nPrevention",M-2, Part IV, Chapter 9.\n
\n
\n", "
\n
\n\n
\n", "", "
\nFindings to satisfy this reminder are defined in Education Topics and via\n \nTo update the education topics, use the PCE Table Maintenance options.\n \nTo modify this reminder from its distributed definition, copy the reminder\nto a new reminder and then make the modifications necessary to define your\nsites guideline.\ncoded values defined in the VA-EXERCISE COUNSELING taxonomy.\n \nThis reminder can be inactivated for a patient by using the INACTIVATE\nEXERCISE SCREEN health factor.\n \nCheck the Education Topics defined in the Results Findings multiple.  Does\nyour site need to identify new education topics in the Education Topics\nfile to represent Exercise Education? \n
\n
\n", "", "
(SEX)&(AGE)&'FI(4)
\n", "
3
\n", "
SEX;AGE;4
\n", "", "
(0)!FI(1)!FI(2)!FI(3)
\n", "
3
\n", "
1;2;3
\n", "
1
\n", "
4
\n", "
1
\n", "
5
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-EMBEDDED FRAGMENTS SCREEN", "
Screen for Embedded Fragments
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
OFFICE OF PUBLIC HEALTH AND ENVIRONMENTAL HAZARDS
\n", "", "
CR
\n", "
\n
\n\n
\n", "
\nScreening patients who served in OEF/OIF for embedded fragments such as \n \nIf the patient has known service in OEF/OIF and has been screened \npreviously for GI symptoms, rash and unexplained fever, then this \nreminder is applicable.  It is resolved if the patient has been screened \nfor embedded fragments.\nshrapnel or bullet fragments is required by Congressional mandate and \ncreation of a registry of patients who have residual embedded fragments \nis also part of this mandate.\n \nThis reminder prompts for screening those patients who have known service \nin OEF/OIF who underwent post-deployment screening using the VA-IRAQ & \nAFGHAN POST-DEPLOY SCREEN reminder before it was updated in 2009 to \ninclude screening for embedded fragments.\n
\n
\n", "
\n
\n\n
\n", "", "", "
FI(1)&FI(2)&FI(3)&FI(4)
\n", "
FI(1)&FI(2)&FI(3)&FI(4)
\n", "
4
\n", "
1;2;3;4
\n", "", "
(0)!FI(5)
\n", "
1
\n", "
5
\n", "", "", "", "", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-ADVANCED DIRECTIVES EDUCATION", "
ZZ Advanced Directives Education
\n", "
0M
\n", "", "
INACTIVE
\n", "
2005-03-11 12:42:51
\n", "", "", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nAdvanced directives information given to all patients once.\n
\n
\n", "
\n
\n\n
\n", "", "
\nThis reminder is distributed with the PCE package.  The source of this\neducation entry for advanced directive education in the "V Patient Ed."\nfile.  The V Patient Ed. File summarizes the patient education provided by\nclinicians at an encounter/visit.\n \nBy recording the education topic given at an encounter via a scanned\nencounter form (or other interface to PCE), the reminder will be\nconsidered "not indicated". Historical patient education for advanced\ndirectives can be recorded in the PCE User Interface to make the reminder\nnot indicated.\n \nreminder definition is the Ambulatory Care Expert Panel.  It is based on\nThe Clinical Maintenance component in the Health Summary will display the\nlatest date on record where advanced directive education/screening was\nprovided to the patient.\n \nInitial installation comment:\n \nThe PCE package is distributed with a preliminary set of education\ntopics, which includes the VA-ADVANCED DIRECTIVES, and VA-ADVANCED\nDIRECTIVES SCREENING entries. \n \nfeedback from facilities wanting to track Advanced Directive Education.\nThe VA-ADVANCED DIRECTIVES education is defined as this reminders\neducation topic, in lieu of additional/other Advanced Directive education\ntopics you might want to create and activate at your site.\n \nThe VA-ADVANCED DIRECTIVES SCREENING education is defined to help track\nthe fact that an inquiry or screening was made to determine if the\npatient needed Advanced Directive education/counseling.  \n \nIf this reminder is used at your site, you may want to add at a minimum,\nthese two education topics on an encounter form for those clinics who\n \nwould be addressing this reminder.\nThis reminder is an education type reminder.  It relies on an active\neducation topic entry representing the Advanced Directives education in\nthe Education Topics file. \n \nThis reminder will be considered "DUE NOW" if there is no patient\n
\n
\n", "", "
(SEX)&(AGE)
\n", "
2
\n", "
SEX;AGE
\n", "", "
(0)!FI(1)!FI(2)
\n", "
2
\n", "
1;2
\n", "
0
\n", "", "
0
\n", "", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-BREAST SELF EXAM EDUCATION", "
ZZ Breast Self Exam Education
\n", "
0M
\n", "", "
INACTIVE
\n", "
2005-03-11 12:42:51
\n", "", "
FEMALE
\n", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nThe breast self exam education is due yearly for females.  If the female has\na history of breast cancer, check for ongoing follow-up yearly. If the\nfemale has a history of a mastectomy, check for appropriateness of breast\nself exam education.\n \nThis reminder is based on guidelines defined by the Ambulatory Care Expert\nPanel.\n
\n
\n", "
\n
\n\n
\n", "", "
\nThe findings for breast self exam are based on the definition\ntumor, and mastectomy. Copy the taxonomies and make modifications if\nneeded.\n \nIf any changes are needed in the findings definitions, copy this reminder\nto a site defined reminder item and make the appropriate modifications.\nof an education topic in the EDUCATION TOPICS file.  Check the result\nfindings file for breast self exam entry which is distributed with this\nreminder.  If new education topics need to be added, use the PCE Table\nMaintenance options, and then copy this reminder, and make the\nmodifications to the result findings to reference the education topics\ndefined for your site.\n \nCheck the taxonomy findings definitions for breast cancer, breast\n
\n
\n", "", "
(SEX)&(AGE)
\n", "
2
\n", "
SEX;AGE
\n", "", "
(0)!FI(1)
\n", "
1
\n", "
1
\n", "
0
\n", "", "
5
\n", "
2;3;4;5;6
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-WEIGHT", "
ZZ Weight
\n", "
1M
\n", "", "
INACTIVE
\n", "
2005-03-11 12:42:51
\n", "", "", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nThe patient's weight should be documented yearly.\n
\n
\n", "
\n
\n\n
\n", "", "
\nThis reminder is based on guidelines defined by the Ambulatory Care Expert\nPanel.\n
\n
\n", "", "
(SEX)&(AGE)
\n", "
2
\n", "
SEX;AGE
\n", "", "
(0)!FI(1)
\n", "
1
\n", "
1
\n", "
0
\n", "", "
0
\n", "", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-PSA", "
ZZ PSA
\n", "
0M
\n", "", "
INACTIVE
\n", "
2005-03-11 12:42:51
\n", "", "
MALE
\n", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nProstate specific antigen, PSA, due yearly for men ages 50-75, who do not\nhave a history of prostate cancer.\n \nThis reminder is based on guidelines defined by the Ambulatory Care Expert\nPanel.\n
\n
\n", "
\n
\n\n
\n", "", "
\nCheck the Taxonomy Findings entries representing HX of prostate cancer.  If\nthis taxonomy needs modification, copy the taxonomy to a new taxonomy\nfor your site, and make the appropriate modifications.\n \nCopy the reminder to a new reminder for your local sites modifications.\n \nUse the new reminder to update the Result Findings Laboratory Test entry\nrepresenting PSA tests.\n
\n
\n", "", "
(SEX)&(AGE)
\n", "
2
\n", "
SEX;AGE
\n", "", "", "
0
\n", "", "
1
\n", "
1
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-DIABETIC FOOT CARE ED.", "
ZZ Diabetic Foot Care Education
\n", "
1M
\n", "", "
INACTIVE
\n", "
2005-03-11 12:42:51
\n", "", "", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nPatients with the VA-DIABETES taxonomy should have a diabetic foot care\neducation done yearly.\n
\n
\n", "
\n
\n\n
\n", "", "
\nThis reminder is based on the Diabetic care reminders from the New\nYork VAMC which were designed to meet the guidelines defined by the PACT\npanel.  Additional input came from the Saginaw VAMC.\n
\n
\n", "", "
(SEX)&(AGE)&FI(1)
\n", "
3
\n", "
SEX;AGE;1
\n", "", "", "
0
\n", "", "
1
\n", "
1
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-SEATBELT EDUCATION", "
ZZ Seat Belt Education
\n", "
1M
\n", "
ZZVA-*SEATBELT AND ACCIDENT SCREEN
\n", "
INACTIVE
\n", "
2005-03-11 12:42:51
\n", "", "", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nSeat belt education given yearly to all patients.\n    Target Group: General Outpatient population.\n \n    Recommendation: All patients should be urged to use seatbelts in\n    automobiles, wear helmets when riding bicycles or motorcycles, and to\n    refrain from driving after drinking.\n \n    Goal for FY 2000: 85% of Veterans report regular use of seatbelts in\n    automobiles. 80% of motorcyclists and 50% of bicyclists report use of\n    helmets. 50% of primary care providers routinely provide\n    age-appropriate counseling on safety precautions to prevent\n \n    unintentional injury.\nThis reminder is based on guidelines defined by the Ambulatory Care Expert\nPanel and is further supported by the "Seatbelt Use and Accident Avoidance\nCounseling" guideline specified in the "Guidelines for Health Promotion\nand Disease Prevention", M-2, Part IV, Chapter 9.\n \n    Target Condition: Motor vehicle associated injuries.\n \n
\n
\n", "
\n
\n\n
\n", "", "
\nIf this reminder is not going to be used at your facility, the INACTIVE\nthem to use.  If local modifications need to be made, copy the preferred\nreminder to a new reminder and make your reminder modifications.\n \nIt may be useful to add Health Factors that indicate whether the patient\nis still driving, rides motorcycles, or rides bicycles for local site use.\nThis would involve adding new Health Factors to the Health Factor file\n(#9999999.64) and then adding the Health Factors to a local site\ndefinition of the seat belt reminder.\nFLAG should be set to inactive.\n \nThe VA-SEAT BELT EDUCATION" reminder is a variation of the "VA-SEAT BELT\nAND ACCIDENT SCREEN" reminder.  The VA-SEAT BELT EDUCATION" reminder is\nrecommended by the Ambulatory Care EP to check for seat belt use education\ngiven to the patient, in addition to the screening.\n \nPlease review both of these related reminder definitions, choose one of\n
\n
\n", "", "
(SEX)&(AGE)&'FI(4)
\n", "
3
\n", "
SEX;AGE;4
\n", "", "
(0)!FI(1)!FI(2)!FI(3)
\n", "
3
\n", "
1;2;3
\n", "
1
\n", "
4
\n", "
1
\n", "
5
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-*BREAST CANCER SCREEN", "
ZZ Breast Cancer Screen
\n", "
1M
\n", "
ZZVA-*BREAST CANCER SCREEN
\n", "
INACTIVE
\n", "
2005-03-11 12:42:50
\n", "
S
\n", "
FEMALE
\n", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nMammogram should be given every 2 years to female patients, ages 50-69.\n \n     Recommendation:   All women ages 50-69 should receive a mammogram\n                       every two years.\n \n     Goals for FY2000: At least 60% of women ages 50-69 have received a\n                       mammogram within the preceding two years.\n \nThe "VA-*Breast Cancer Screen" reminder is based on the following "Breast\nCancer Detection" guidelines specified in the VHA HANDBOOK 1101.8,\nAPPENDIX A.\n \n     Target Condition: Early detection of breast cancer.\n \n     Target Group:     All women ages 50-69.\n
\n
\n", "
\n
\n\n
\n", "", "
\nThe findings for mammogram screening are based on defining CPT codes\ndocumented to reflect a mammogram/screening done at a current encounter or\na historical encounter within the past two years.\nand V-codes from the ICD Diagnosis file that represent mammograms and\nmammogram screening in a taxonomy for Mammogram/Screen.  The CPT codes are\nused to search the Radiology procedures in the Radiology package, as well\nas checks for existence of a CPT code in the V CPT file.  The V-codes are\nused to search the Problem List, V POV (problems of visits), and Inpatient\nDiagnosis PTF files.\n \nThe reminder will be "DUE NOW" until a procedure or diagnosis (V-code) is\n
\n
\n", "", "
(SEX)&(AGE)&'FI(2)
\n", "
3
\n", "
SEX;AGE;2
\n", "", "
(0)!FI(1)
\n", "
1
\n", "
1
\n", "
2
\n", "
1;2
\n", "
1
\n", "
3
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-HEPATITIS C RISK SCREEN", "
Hepatitis C Risk Screen
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
NATIONAL CENTER FOR HEALTH PROMOTION AND DISEASE PREVENTION (NCP)
\n", "", "
C
\n", "
\n
\n\n
\n", "
\nAll patients should be screened for hepatitis C risk factors.\n  enrolled in hospice, or cancer of esophagus, liver or pancreas.\\\\\n \nVA recommends hepatitis C screening for all patients with a risk factor or\nwho request testing. A documented risk factor will trigger the HEPATITIS \nC TESTING reminder for a provider to complete.\n \nPatients who meet one of the following criteria do not require further\nrisk screening:\\\\\n- A previous laboratory test for hepatitis C,\\\\ \n- A previous diagnosis of hepatitis C,\\\\ \n- Born between 1945 and 1965,\\\\\n- Diagnosis of alcoholic hepatitis or alcohol abuse or dependence,\\\\\n- With terminal illness (life expectancy less than 6 months-1 year),\\\\ \n
\n
\n", "
\n
\n\n
\n", "", "
\nThis reminder is based on VHA National Center for Health Promotion and \n     This term is released with the health factor RISK FACTOR FOR\n     HEPATITIS C.  This term includes national taxonomies for alcohol \n     abuse, drug abuse, and HIV infection. Map any local findings that\n     meet the intent of this term in the REMINDER TERM file (811.5).\n \n   VA-NO RISK FACTORS FOR HEP C\n     This term is released with the health factor NO RISK FACTORS FOR HEP\n     C.  Map any local findings that meet the intent of this term in the\n     REMINDER TERM file (811.5).\n \nDisease Prevention (NCP) Clinical Guidance Statement posted January 22, \n   VA-DECLINED HEP C RISK SCREENING\n     This term is released with the health factor DECLINED HEP C RISK \n     SCREENING.  Map any local findings that meet the intent of this \n     term in The REMINDER TERM file (811.5).\n \n   VA-HEP C OUTSIDE RESULTS\n     This term is released with the health factors PREV POSITIVE TEST FOR\n     HEP C and PREV NEGATIVE TEST FOR HEP C. Map any local findings that \n     identify the patient as previously assessed for Hepatitis C risk \n     factors in the REMINDER TERM file(811.5).\n2014. \n     This term was originally distributed as PREV POSITIVE TEST\n     FOR HEP C, but was changed to provide sites with a way to identify a\n     patient as previously assessed for Hepatitis C risk factors.\n \n     This term will also be used to document historical positive\n     tests completed outside the facility.\n \n   VA-HEP C VIRUS ANTIBODY POSITIVE\n     Map local HCVAb lab tests with a condition in the REMINDER TERM file.\n     An example of the condition field might be: I V="positive"\n \n     or I (V["P")!(V["p"). The text used in the condition definition\n     (I V="text") should be based on the local LABORATORY TEST file (60)\n     print codes when defined, rather than the result in the LAB DATA file\n     (63).\n \n   VA-HEP C VIRUS ANTIBODY NEGATIVE\n     Map local HCVAb lab tests with a condition in the REMINDER TERM file.\n     An example of the condition field might be: I V="negative"\n     or I (V["N")!(V["n"). The text used in the condition definition \n     (I V="text") should be based on the local LABORATORY TEST file (60)\nBEFORE USING THIS REMINDER, sites need to use the Reminder Term\n     print codes when defined, rather than the result in the LAB DATA file\n     (63).\n \n   VA-HEPATITIS C SEROPOSITIVE\n     This term is released with the reminder taxonomy VA-HEPATITIS C\n     SEROPOSITIVE.  \n \n   VA-HEP C LAB TESTS ORDERED\n     Map local HCVAb orderable items in the REMINDER TERM file. The \n     orderable items should have the following status; ACTIVE, PENDING.\nManagement option to define the local findings that are used to\n \n   VA-LIFE EXPECTANCY <6 MONTHS\n     This term is released with the health factor. Map any local\n     findings that identify patients with a terminal illness.\n \n  VA-HEP C RNA\n     Map local HCV RNA lab tests. If the local site cancels lab tests and \n     enters a "cancel" comment as the result, then a condition will need\n     to be added in the REMINDER TERM preventing the cancelled test from\n     resolving the reminder.  Include any RNA tests - HCV Qual, HCV \nrepresent the national reminder terms:\n     Quant, HCV Genotype, etc.\n \n   VA-RISK FACTOR FOR HEPATITIS C\n
\n
\n", "
(AGE)&'(FI(1)!FI(5)!FI(6)!FI(7)!FI(8)!FI(9)!FI(10)!FI(11)!FI(12))
\n", "
(AGE)&'(FI(1)!FI(5)!FI(6)!FI(7)!FI(8)!FI(9)!FI(10)!FI(11)!FI(12))
\n", "
10
\n", "
AGE;1;5;6;7;8;9;10;11;12
\n", "
FI(2)!FI(3)!FI(4)
\n", "
FI(2)!FI(3)!FI(4)
\n", "
3
\n", "
2;3;4
\n", "", "", "", "", "", "", "", "", "
\n
\n\n
\n", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-MH HIGH RISK NO-SHOW FOLLOW-UP", "
High Risk MH No-Show Follow-up
\n", "
99Y
\n", "", "", "", "", "", "", "
NATIONAL
\n", "
MENTAL HEALTH SERVICES
\n", "", "
*
\n", "
\n
\n\n
\n", "
\nThis reminder shall determine whether Mental Health (MH) professionals\nrate of actual suicide than those that stay connected with care.\n \nIf the patient has a completed encounter to a MH appointment on the same\nday, or within 72 hours of the missed MH appointment, follow-up will no\nlonger be necessary.\nhave followed up on a No-Show MH appointment for a patient with an active\nHigh Risk for Suicide Patient Record Flag. \n \nThe reminder requires clinicians to initiate follow-up with the patient to\ninsure his/her safety and to try to get the patient back into care. The\nfollow-up results are documented with health factors.  \n \nStudies show that individuals that get lost to follow-up have a higher \n
\n
\n", "
\n
\n\n
\n", "", "", "", "
(SEX)&(AGE)&FI(1)&FI(2)
\n", "
4
\n", "
SEX;AGE;1;2
\n", "", "
(0)!FI(3)!FI(4)!FI(8)!FI(11)!FI(12)!FI(13)!FI(14)
\n", "
7
\n", "
3;4;8;11;12;13;14
\n", "", "", "
2
\n", "
6;10
\n", "", "", "", "", "", "", "
\nThe patient has an active High Risk for Suicide Patient Record Flag and \nmissed a MH appointment.\n
\n
\n", "
\nThis patient has no missed MH appointment pending follow-up.\n
\n
\n", "
2
\n", "
1
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-NATIONAL EPI LAB EXTRACT", "
National Hepatitis Lab Extract
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nThis reminder is used to identify and extract data to send to the\nThe reminder will extract laboratory data for patients who have any of the\nsuch, surveillance for both acute and chronic diseases is important.  In\norder for the VHA to do surveillance for these diseases, we are looking\nfor laboratory evidence of  infection with Hepatitis B.  This laboratory\nevidence of infection includes the following standard serological markers:\n        Presence of the Hepatitis B surface antigen\n        Presence of antibodies against the Hepatitis B core antigen (in\n           particular, the IgM antibody)\n        Presence of antibodies against the Hepatitis B surface antigen\n        Presence of the Hepatitis B e antigen.\n \nfindings listed in the patient cohort logic.  There are 9 laboratory\nThese are not all of the tests that can be done for Hepatitis B, but they\nare the ones likely to pick up acute cases (new) or those chronic cases\nthat are likely to be infectious to other persons.  Please list only those\ntests at your facility that are in keeping with what addresses the EPI\nHepatitis B target data-acute cases, or those cases likely to be\ninfectious to others.  \n \nNote:  There are advanced polymerase chain reaction (PCR) based tests that\ncan measure the amount of virus in the bloodstream.  These are not done at\nall sites and have not yet been FDA approved.  As such, these PCR tests\nreminder terms in the patient cohort logic:\nwill not be used for case determination.\n \n------------------------------------------------------------\nHepatitis C laboratory tests:\n \nData collected for Hepatitis C is based on the following national reminder\nterms:\n         HEP C VIRUS ANTIBODY NEGATIVE    \n         HEP C VIRUS ANTIBODY POSITIVE    \n                \n     HEP C VIRUS ANTIBODY POSITIVE\nBackground: \nIt is important to identify what differences there are in those\npeople who are positive for Hepatitis C antibody as opposed to those who\ndo not have Hepatitis C antibody present.  Therefore, please review those\nresults that you have designated to be placed into the Hepatitis C\nAntibody Positive portion of the EPI.  Be sure that they truly meet the\ndefinition, as noted in this Reminder definition and the related Reminder\nTerm definitions.\n \nAll the results of Hepatitis C antibody testing that are not considered\n     HEP C VIRUS ANTIBODY NEGATIVE\n"positive" need to be mapped as "negative". Therefore, all of the\nHepatitis C antibody results that your facility reports will be mapped to\neither the HEP C VIRUS ANTIBODY POSITIVE reminder term or the HEP C VIRUS\nANTIBODY NEGATIVE reminder term. reminder term.  Not positive terms may\ninclude "negative," "indeterminant," "indeterminate," "undetectable."  As\nwith the Hepatitis C Antibody Positive component, be sure phrases that\ntruly differentiate results are used (e.g. the results of "present" and\n"not present" are not truly differentiated by computer retrieval as both\ncontain the word "present").\n \n     HAV Ab positive\nTIP on Positive and Negative Conditions to define for laboratory tests:\nWhen defining the condition for the negative results, you could use the\nsame text that was used for the positive results, but add '= (not equal)\nor '[ (not contain), instead of the = or [.\n     HAV IgM Ab positive\n     HAV IgG positive\n     HBs Ag positive\n     HBc Ab IgM positive\nnational EPI database.  The data extracted includes Hepatitis A, B, and C\n     HBs Ab positive\n     HBe Ag positive\n \n \nIf the patient data had one of these lab tests in the extract month, the\nlab test data will go to Austin. When one of the labs above is found, the\nmost recent test for the following lab tests will be sent to Austin:\n         TRANSFERASE (AST) (SGOT)\n         ALANINE AMINO (ALT) (SGPT)\n         BILIRUBIN \nlaboratory tests.  This reminder is not for daily clinical care.  It is\n \nWhat resolves this reminder?\nThis reminder does not have any resolution findings so it will always be\ndue.  This allows sites to use the reminder to report on patients who\nhave data updating the EPI national database. \n \n--------------------------------------------------------------\nHepatitis A Laboratory Tests:\n \nData collected for Hepatitis A is based on the following national reminder\nused by an EPI patch, LR*5.2*260, to identify new data to send to the AAC\nterms which are patient cohort findings in the reminder:\n        HAV Ab positive         Hepatitis A virus antibody total positive\n        HAV IgM Ab positive     Hepatitis A virus antibody immunoglobulin\n                                        M positive\n        HAV IgG positive        Hepatitis A virus antibody immunoglobulin\n                                        G positive\n \nBackground:\nOne of the goals of the Healthy People 2000 and 2010 initiatives of the\nDepartment of Health and Human Services is to decrease certain infectious\nEPI national database. Sites may use this reminder in the reminder reports\ndiseases, especially those that are vaccine preventable.  Acute infection\nwith Hepatitis A is one such disease that has specific objectives present\nin the Healthy People objectives.\n \nThe purpose of surveillance for this disease is to record all cases as\ndiagnosed by the laboratory.  A positive laboratory test for the presence\nof Hepatitis A virus is needed.  Usually this criterion is met by presence\nof antibodies to the Hepatitis A virus.  In particular, the IgM antibody\nagainst hepatitis A is the test most commonly used for determining acute\nHepatitis A infection.  There are other antibody tests available for\nto get a list of patients with laboratory data that the EPI is interested\nHepatitis A.  These tests usually indicate past infection with hepatitis A\n(or in some circumstances may indicate evidence of previous vaccination).\nUsually the IgG antibody against Hepatitis A, OR the Total antibody\nagainst Hepatitis A (a test that does not discriminate between IgM or IgG,\nbut can show evidence of exposure) are the tests done for this purpose.\n \nThe Infectious Disease Program Office, VAHQ, is looking for the presence\nof any positive antibody to Hepatitis A, whether it be recorded as "weakly\npositive," "strongly positive," "positive," or "present."  If other\nphrases are used to describe a test result, you can differentiate\nin.\nresponses upon entry in the term findings via the CONDITION field. As an\nexample, the words "present" and "not present" might be used to designate\n"positive" vs. "negative";  however, they would not allow retrieval of\nonly the positive cases as both phrases contain the word, "present." Also,\nnumerical values of results are not readily useable.  All of the lab tests\nrelated to the Hepatitis A terms above need to be defined as findings for\nthe national reminder terms with the conditions that identify the positive\nlaboratory test results.\n \n--------------------------------------------------------------------\n \nHepatitis B laboratory tests:\n \nData collected for Hepatitis B is based on the following national reminder\nterms which define the patient cohort:\n        HBs Ag positive         Hepatitis B surface antigen positive\n        HBc Ab IgM positive     Hepatitis B core antibody immunoglobulin  \n                                                M positive\n        HBs Ab positive         Hepatitis B surface antibody positive\n        HBe Ag positive         Hepatitis B e antigen positive \n \nWhat determines whether this reminder applies to a patient? \nBackground:\nOne of the goals of the Healthy People 2000 and 2010 initiatives of the\nDepartment of Health and Human Services is to decrease certain infectious\ndiseases, especially those that are vaccine preventable.  Acute and\nchronic infection with Hepatitis B is one such disease that has specific\nobjectives present in the Healthy People objectives.\n \nBoth acute and chronic diseases have significant morbidity and can\ncontribute to mortality.  Further, infection with Hepatitis B can\ncomplicate the medical course of people with other liver ailments.  As\n
\n
\n", "
\n
\n\n
\n", "", "", "", "
(SEX)&(AGE)!FI(1)!FI(2)!FI(13)!FI(14)!FI(15)!FI(17)!FI(18)!FI(19)!FI(20)
\n", "
11
\n", "
SEX;AGE;1;2;13;14;15;17;18;19;20
\n", "", "", "
0
\n", "", "
0
\n", "", "
3
\n", "
3;4;16
\n", "", "", "", "", "", "", "
\nThis patient has Hepatitis laboratory data that will be rolled up to the\nnational EPI data base.\n
\n
\n", "
\nThis patient has no Hepatitis laboratory data to send to the national EPI\ndata base.\n
\n
\n", "
2
\n", "
2
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-AAA SCREENING", "
Screen for Abd Aortic Aneurysm
\n", "", "", "", "", "", "
MALE
\n", "", "
NATIONAL
\n", "
NATIONAL CLINICAL REMINDER COMMITTEE
\n", "", "
*
\n", "
\n
\n\n
\n", "
\nScreen once for AAA in men ages 65-75 who are current or prior smokers.\nis included for this.  The user has an option in the dialog to indicate \nthat the patient smoked <100 total lifetime cigarettes.\n \nIf the procedure was done on or after the 60th birthday, then it will be \ncounted as adequate screening.\n \nMany types of imaging procedures could be adequate to evaluate the status \nof the abdominal aorta if the interpreting Radiologist addresses the \naorta in the reading and the report.  Because it is not always clear from \nthe type of procedure, these procedures are marked as "non-specific" \n \nabdominal imaging in this reminder and a health factor is available to \nbe entered by a user if it is clear from the report that the procedure \nadequately addressed the status of the abdominal aorta from the renal \narteries to the bifurcation of the aorta.\n \nThe following terms are included:\nVA-IMAGING FOR AAA (CPT NON-SPECIFIC PROC)\nThis term is mapped to a taxonomy of procedures that represent radiology \nstudies that could be adequate for screening but may not be depending on \nthe report.\nDeveloped by the National Clinical Reminder Committee in conjunction with \n \nVA-IMAGING FOR AAA (RAD NON-SPECIFIC PROC)\nThis term must be mapped locally and should contain radiology procedures\nONLY.  No CPT codes should be added to this term.  If a diagnostic code \nis added by Radiology to one of the procedures in this term to show that\nAAA screening was completed, then the reminder will be resolved.\n \nVA-IMAGING FOR AAA (RAD SPECIFIC PROC) \nThis term must be mapped locally and should contain radiology procedures \nONLY.  No CPT codes should be added to this term.  Only procedures that \nthe VA National Center for Health Promotion and Disease Prevention and \nare always used to screen for AAA should be added to this term.  Do not \nenter any procedures that may be done for purposes other than AAA \nscreening. This term will resolve the reminder.\n \nA reminder term for orderable items is included.  You will need to map \nyour local orderable items for the procedures in the taxonomy to this \nterm in order for orders to temporarily resolve the reminder.  If a \nprocedure has been ordered in the past 6 months, then this finding will \ntemporarily resolve the reminder.  If a different time period is \npreferable at the local VA, then enter a different date range on the \nDr. Charles Anderson, Director, VHA Radiology Program.\nfindings in this term and those dates will override the 6 month period.\n \nA health factor for outside procedures is included.\n \nPatients with a short life expectancy are excluded.  You may want to add \nany local health factors for short life expectancy to the reminder term \nVA-AAA SCREENING NOT APPLICABLE.\n \nPatients who are not candidates for repair may not be appropriate for \nscreening and may be excluded.\n \n \nPatients with known AAA or with prior repair of an AAA are excluded.\n \nA term is included for refusals and this term permanently resolves the \nreminder.  If a shorter time frame is desired for refusal, then enter \nthat time frame on the health factor in the term.  \nThe reminder applies to all patients who have a history of smoking \nrecorded in their record.  Mapping of all local health factors for \ncurrent or prior smoking history is needed.  The term VA-SMOKING HISTORY \n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "
\nThese 2 health factors were included in a prior local version of a AAA \nIf you use the old version, you may rename your local health factors to \nthe new names to prevent duplication.\nscreening reminder and have been renamed for this national release:\n   ULTRASOUND FOR AAA N/A CURRENTLY\n   ULTRASOUND FOR AAA N/A PERMANENTLY\n \nThe new names are:\n   IMAGING FOR AAA N/A CURRENTLY\n   IMAGING FOR AAA N/A PERMANENTLY \n \n
\n
\n", "", "
(SEX)&(AGE)&FI(1)&'FI(2)&'FI(3)&'FI(7)
\n", "
6
\n", "
SEX;AGE;1;2;3;7
\n", "
FI(8)&FF(8)!(FI(9)&FI(10)&FF(9))!(FI(11)&FF(11))!(FI(12)&FF(12))!FI(13)!FI(15)
\n", "
FI(8)&FF(8)!(FI(9)&FI(10)&FF(9))!(FI(11)&FF(11))!(FI(12)&FF(12))!FI(13)!FI(15)
\n", "
11
\n", "
8;FF8;9;10;FF9;11;FF11;12;FF12;13;15
\n", "", "", "
1
\n", "
14
\n", "", "", "", "", "
\n
\n\n
\n", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-WH HIRISK ORDER CHECK - PREGNANT", "
Teratogenic Meds Order Check
\n", "", "", "", "", "", "
FEMALE
\n", "", "
NATIONAL
\n", "", "", "
O
\n", "
\n
\n\n
\n", "
\nThis reminder definition contains the logic to determine if the Clinical \nReminder Order Check for 'Teratogenic Meds' is applicable to the current \npatient.\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "", "
(SEX)&(AGE)&'FI(1)&'FF(2)
\n", "
4
\n", "
SEX;AGE;1;FF2
\n", "", "", "", "", "", "", "
2
\n", "
4;5
\n", "", "", "", "", "", "", "
\n****************************************************************\n\\\\The 'Teratogenic Medications' Order Check will display for \n\\\\female patients between the ages of 10 and 52, except those\n\\\\with a known exclusion criterion (e.g., hysterectomy), \n\\\\or those with a documented tubal ligation that\n\\\\is more recent than a documented tubal reanastomosis.\n
\n
\n", "", "
6
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-DIABETIC FOOT EXAM", "
ZZ Diabetic Foot Exam
\n", "
1M
\n", "", "
INACTIVE
\n", "
2005-03-11 12:42:51
\n", "", "", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nPatients with the VA-DIABETES taxonomy should have a complete foot exam\ndone yearly.\n
\n
\n", "
\n
\n\n
\n", "", "
\nThis reminder is based on the Diabetic Foot Exam reminder from the New\nYork VAMC which was designed to meet the guidelines defined by the PACT\npanel.  Additional input came from the Saginaw VAMC.\n
\n
\n", "", "
(SEX)&(AGE)&FI(2)
\n", "
3
\n", "
SEX;AGE;2
\n", "", "
(0)!FI(1)
\n", "
1
\n", "
1
\n", "
1
\n", "
2
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-MHTC NEEDS ASSIGNMENT", "
Needs MHTC Assignment
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
MENTAL HEALTH SERVICES
\n", "", "
CRX
\n", "
\n
\n\n
\n", "
\nThis reminder shall determine whether a patient has been assigned a \nMental Health Treatment Coordinator (MHTC) when the patient has kept\n3 or more MH appointments in the past year, where the appointment is\nchecked out and a completed encounter has been documented.\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "", "
(SEX)&(AGE)&FF(1)
\n", "
3
\n", "
SEX;AGE;FF1
\n", "", "
(1)&FI(3)
\n", "
1
\n", "
3
\n", "", "", "
2
\n", "
1;2
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-PTSD REASSESSMENT (PCL)", "
PCL Needed for PTSD
\n", "
30D
\n", "", "", "", "", "", "", "
NATIONAL
\n", "
MENTAL HEALTH AND BEHAVIORAL SCIENCE STRATEGIC GROUP
\n", "", "
*
\n", "
\n
\n\n
\n", "
\nReminder designed by the Office of Mental Health to provide a way to\nwho are no longer in active treatment for PTSD.\n \nResolved by completion of the items in the PCL-5. \nmeasure the outcomes of Veterans being treated for PTSD.\n \nReminder applicable to OEF/OIF service veterans who are in active \ntreatment for PTSD which is defined as 2 visits to a Mental Health clinic \nin the past 120 days + 2 primary diagnoses of PTSD at an outpatient visit \nin the past 120 days.\n \nNot applicable to those who are severely cognitively impaired or those \n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "", "
(SEX)&(AGE)&FI(1)&FI(2)&FI(3)&'FI(4)&FF(2)&FF(3)&FF(12)&FF(13)&FF(22)
\n", "
11
\n", "
SEX;AGE;1;2;3;4;FF2;FF3;FF12;FF13;FF22
\n", "", "
(0)!FI(5)&FI(6)
\n", "
2
\n", "
5;6
\n", "", "", "
4
\n", "
7;8;9;10
\n", "", "", "", "", "", "", "
\n \nOEF/OIF veteran with at least 2 mental health visits and 2 primary \ndiagnoses of PTSD in the last 120 days suggesting that the patient is in \nactive treatment for PTSD.\\\\Patients in treatment for PTSD need to have\nthe PCL done every 90 days.\n \\\\\n
\n
\n", "", "
6
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-MHV CERVICAL CANCER SCREEN", "
ZZ PAP Smear Screening
\n", "
6M
\n", "", "
INACTIVE
\n", "
2017-12-27 16:27:46
\n", "", "
FEMALE
\n", "", "
NATIONAL
\n", "
WOMEN VETERANS HEALTH PROGRAM AND NATIONAL CENTER FOR HEALTH PROMOTION AND DISEASE PREVENTION (NCP)
\n", "", "
CPR
\n", "
\n
\n\n
\n", "
\nVHA recommends screening for cervical cancer with cytology (Pap smear) \nVHA recommends AGAINST using HPV testing alone or in combination with \ncytology for cervical cancer screening in women younger than 30 years.\n \nVHA recommends AGAINST screening for cervical cancer in women older than \n65 years of age if they have had adequate prior screening and are not \notherwise at high risk for cervical cancer. \n \nVHA recommends AGAINST screening for cervical cancer in women who have \nhad a total hysterectomy (cervix removal) for benign disease.\n \nevery 3 years for women ages 21-65 that have a cervix OR, for women ages \nThis reminder does not apply to women who have had a hysterectomy where\nthe cervix was removed.\n \nEvidence of a PAP smear completed will satisfy the reminder for \nup to 5 years, depending on the screening frequency specified by the \nclinician and the presence of HPV screening. The clinician can alter the\nscreening frequency for individual patients based on patient and family\nhistory, and discussions with the patient.\n \nPAP Smears completed will resolve this reminder and may be recorded as one\n30-65 who want to lengthen the screening interval, screening with a \nof the following:\n         Laboratory result matching Cytology or Surgical Pathology SNOMED\n         Women's Health procedure result\n         Health Factor (Historical outside PAP smear result) \n         PCE CPT procedure code\n         Completed consult order for outside procedure\n \nIn patients ages 30-65 who have evidence of a recent negative HPV result \nand no prior abnormal PAP smear, the PAP smear will resolve the reminder\nfor 5 years.\ncombination of cytology and human papilloma virus (HPV) testing every 5 \n \nScreening will be resolved by any of the following: \n          PAP smear obtained at this encounter (9 months) \n          Health Factor for an order for PAP Smear screening (9 months)\n          Patient declined PAP smear (4 months) \n          Clinician deferred PAP smear (4 months) \n \nClinicians may manage follow-up screening to occur every 4 or 6 months \nwhen PAP smear results are unsatisfactory, or if they feel screening \nshould take place more often than 1, 2, 3 or 5 years.\nyears.\n \nManagement of an abnormal PAP is included in this screening reminder only \nif the clinician indicates what frequency is required for an individual \npatient.  A code for abnormal PAP changes the frequency to 1 year.  This \n1 year frequency if subsequently overridden if any other frequency is \nchosen by the clinician.\n \nVHA recommends AGAINST screening for cervical cancer in women who are \nyounger than 21 years.\n \n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "
\nTechnical Description:\n    facility, results can be recorded three ways to satisfy this \n           recorded and the status is not Unsatisfactory.\n     \n        VA-WH PAP SMEAR SCREEN IN LAB PKG \n           No mapping necessary.  This term represents PAP Smear results \n           documented in the Laboratory package. Use the new VA-WH PAP \n           SMEAR IN LAB PKG computed finding distributed with this\n           reminder term.\n           This computed finding looks for PAP smear results in the \n           Laboratory package where the Result Status that is not \n           "Unsatisfactory" \n    reminder: \n            \n           This computed finding will only work if the Women's Health WV \n           PROCEDURE TYPE file entry for PAP SMEAR has SNOMED codes \n           defined that are used by your local Lab Service to document \n           PAP Smear results in the Lab Package.  The SNOMED codes need \n           to be defined regardless of whether the Women's Health \n           Package is being used.\n     \n       VA-WH PAP SMEAR DONE \n           No mapping necessary.  Use the new VA-WH PAP SMEAR SCREEN \n \n           CODES taxonomy distributed with this reminder term. This\n           taxonomy is similar to the VA-CERVICAL CANCER SCREEN taxonomy\n           distributed to the field with the first reminder package\n           distribution. The new taxonomy should be used, instead of the\n           VA-CERVICAL CANCER SCREEN taxonomy, because it does not \n           include codes such as Q0091 which represent PAP smears \n           obtained by the clinician.\n     \n           Use the new WH PAP SMEAR OUTSIDE health factor to document PAP \n           Smear results completed outside the VA when the PAP Smear \n        * Results, with interpretation, can be entered and verified\n           results are not documented in Lab, Women's Health or Consult\n           packages.  \n     \n        VA-WH PAP SMEAR OBTAINED \n           Use the new taxonomy VA-WH PAP SMEAR OBTAINED which contains \n           coded values that represent the clinician's actions taken to \n           obtain the PAP smear.  \n       \n        VA-WH PAP SMEAR ORDER HEALTH FACTOR \n           Removed from patient reminder.\n          in the Lab package.\n     \n       VA-WH PAP SMEAR SCREEN NOT INDICATED \n           Use the findings distributed with this reminder term or map \n           any local findings that indicate a PAP smear screen is not\n           indicated for this patient.\n            \n           This term is distributed with mapping to the following \n           health factors: \n              INACTIVATE CERVIX CANCER SCREEN (distributed with the \n                   first version of the Clinical Reminder package in 1996 \n        * Results, with interpretation, can be manually entered into the\n                   to inactivate the CERVICAL CANCER reminder).  \n              WH PAP SMEAR SCREEN NOT INDICATED \n              VA LIMITED LIFE EXPECTANCY \n           and the following taxonomy: \n              VA-TERMINAL CANCER PATIENTS \n     \n           Use in National VA-WH PAP SMEAR SCREENING reminder: \n           This term is used in WH reminders to inactivate PAP Smear \n           screening until a clinician overrides the inactivation by \n           selecting a health factor that is used by function findings \n          WH package.\n           with frequencies of 1Y, 2Y, 3Y or 5Y.   Begin date of T-6M has\n           been added to HF.VA LIMITED LIFE EXPECTANCY and\n           TX.VA-TERMINAL CANCER PATIENTS so screening will come due\n           again if the patient lives longer than expected or if the\n           patient has been misdiagnosed.\n \n           Updated September 2012 to include 2 new health factors:\n             CERVICAL CA SCRN N/A PERMANENTLY   (no begin date)\n             CERVICAL CA SCRN N/A 5 YRS         (begin date T-5Y)\n     \n        * Summarized results can be entered as a historical entry (health \n           Sites may prefer to use local LIMITED LIFE EXPECTANCY health \n           factors and add their health factors to other reminder \n           terms which cause the PAP Smear Screening reminder to be \n           due without requiring a clinician to select a finding to \n           reactivate the reminder. (e.g., Add the local life expectancy \n           health factor for "LOCAL LIFE EXPECTANCY 6M" to the VA-WH PAP\n           SMEAR SCREEN NOT INDICATED term).  \n            \n       VA-WH PAP SMEAR SCREEN DEFER \n           Use the WH PAP SMEAR DECLINED and/or WH PAP SMEAR DEFERRED\n          factor or CPT code) in the patient record. Historical entries \n           health factors distributed with this term, or add any local\n           health factors representing that PAP smear screening should be\n           deferred.\n     \n        VA-WH PAP SMEAR UNSATISFACTORY IN LAB/WH PKG \n           No mapping necessary.  This term represents unsatisfactory\n           PAP Smear results documented in the Laboratory and WH \n           packages. Use the new VA-WH PAP SMEAR IN LAB PKG computed\n           finding distributed with this reminder term. This computed\n           finding looks for PAP smear results in the Laboratory \n          should be based on reviewed results, not on patient comments. \n           package where the Result Status is "Unsatisfactory"\n           \n           Use the VA-WH PAP SMEAR IN WH PKG computed finding and the\n           value "UNSATISFACTORY" to find unsatisfactory PAP smear \n           results documented in the WH package.\n \n           This computed finding will only work if the Women's Health WV \n           PROCEDURE TYPE file entry for PAP SMEAR has SNOMED codes \n           defined that are used by your local Lab Service to document \n           PAP Smear results in the Lab Package.  The SNOMED codes need \n    Patient reminder based on copy of the national PAP smear screening \n         \n           to be defined regardless of whether the Women's Health Package\n           is being used.\n \n    INFORMATION FINDINGS: \n    ---------------------\n    Function Findings (FF) will be used to determine the frequency of \n    this reminder.  The following are information reminder terms that are\n    used in Function Findings to alter the baseline Age/Frequency.  If the\n    most recent resolution finding is a documented result, the frequency\n    for the next PAP Smear will be based on these reminder terms. \n    Setup of Women's Health package before using this reminder: \n    If multiple findings exist for the same date/time, the finding that\n    makes the reminder due most often will prevail.  See the FUNCTION\n    FINDINGS section below for frequency logic.\n     \n       VA-WH PAP SMEAR SCREEN FREQ - 4M \n       VA-WH PAP SMEAR SCREEN FREQ - 6M \n          Removed from patient reminder.\n \n       VA-WH PAP SMEAR SCREEN FREQ - 1Y \n           Use the WH PAP SMEAR SCREEN FREQ - 1Y health factor \n    ===========================================================\n           distributed with this reminder term, or add any local findings\n           that indicate PAP smear screening should occur every year.\n           The taxonomy for abnormal PAP is included in this term.    \n \n       VA-WH PAP SMEAR SCREEN FREQ - 2Y \n           Use the WH PAP SMEAR SCREEN FREQ - 2Y health factor \n           distributed with this reminder term, or add any local \n           findings that indicate the PAP smear screening should occur \n           every 2 years.   \n     \n    This reminder has been developed to interface with the Women's Health \n       VA-WH PAP SMEAR SCREEN FREQ - 3Y \n           Use the WH PAP SMEAR SCREEN FREQ - 3Y health factor \n           distributed with this reminder term, or add any local \n           findings that indicate PAP smear screening should occur every \n           3 years.  \n     \n       The following reminder terms are "information only" terms that are \n       not used to alter the frequency, but provide information that may\n       be helpful to the clinician.\n     \n    (WH) package. The associated reminder dialog will update the WH \n       VA-WH HYSTERECTOMY \n           This reminder term represents hysterectomy related procedures. \n           It is pre-mapped to use the VA-HYSTERECTOMY taxonomy which was \n           distributed to the field in 1996. It is not used to alter the \n           patient cohort because it contains hysterectomy codes that \n           indicate the patients cervix may or may not have been \n           removed.  \n     \n       VA-WH HX CERVICAL CANCER/ABNORMAL PAP \n           This reminder term is mapped to the taxonomy VA-CERVICAL \n    package at the same time clinical care is recorded in CPRS GUI, thus\n           CA/ABNORMAL PAP findings. This term represents ICD9, ICD0, \n           and CPT codes that indicate the patient has a history of \n           cervical cancer or a diagnosis for abnormal PAP.  Sites may \n           choose to only use documented diagnosis and procedure codes \n           removing mapping to Women's Health.  \n           \n           This reminder term is also mapped to the computed finding \n           VA-WH PAP SMEAR SCREEN IN WH PKG with a condition check for\n           "Abnormal" used for the search. If PAP smear results are\n           documented in the Women's Health package, the computed finding\n    eliminating the need for dual data entry.\n           VA-WH PAP SMEAR SCREEN IN WH PKG will find the most recent PAP\n           Smear entry that has an "Abnormal" result. Sites can remove\n           this mapped item if they are not using the Women's Health\n           package to store PAP results.\n     \n           The reminder term may also be mapped to the computed finding \n           VA-WH PAP SMEAR SCREEN IN LAB PKG with a condition check for \n           "Abnormal" Result Type.  The Result Type is based on Procedure \n           definitions in the Women's Health Package.  \n     \n     \n       VA-WH PAP SMEAR ORDER \n          Removed from patient reminder\n \n       VA-WH HPV TESTING NEGATIVE\n           Any lab tests that represent negative HPV results on cervical\n           specimens should be included in this term.  A sample condition \n           is included in the term definition and in the lab test that is\n           exported with the term.   A health factor for outside results \n           or for use for results that are not in Chemistry/Hematology is \n           included in the term.\n    In order for this reminder to interface with the Women's Health (WH) \n \n       VA-WH HPV TESTING POSITIVE \n           Any lab tests that represent positive HPV results for high \n           or intermediate risk HPV on cervical specimens should be \n           included in this term.  A sample condition is included in the\n           term definition.  If your lab reports separate lab tests for \n           high/intermediate risk and low risk genotypes, DO NOT include\n           the low risk genotype test in this term.  \n \n           A health factor for outside results or for use for results that\n    package, the WH package must be installed and maintained.  Please \n           are not in Chemistry/Hematology is included in the term.  \n \n \n    FUNCTION FINDINGS: \n    ------------------\n    Frequency for this reminder will be determined using Function \n    Findings (FF) logic, which differentiates between completed results,\n    short-term (7D, 4M, 6M) and long term (1Y, 2Y, 3Y, 5Y) resolution\n    findings.  \n     \n    reminder.\n    refer to the CPRS Integration: Women Veterans Health (WVH) Install &\n       FF1  \n          Was part of the original national reminder and is replaced \n          by FF(10) and FF(11)  \n       FF2 \n          Determines whether the most recent finding is VA-WH PAP SMEAR \n          SCREEN FREQ - 4M and changes the screening frequency to every \n          four months (4M).  \n       FF3 \n          Determines whether the most recent finding is VA-WH PAP SMEAR \n          SCREEN FREQ - 6M and changes the screening frequency to every \n    Setup Guide for detailed instructions.\n          six months (6M).  \n       FF4 \n          Determines whether a finding exists for VA-WH PAP SMEAR SCREEN \n          FREQ 1Y and changes the screening frequency to every year \n          (1Y).  \n       FF6 \n          Determines whether a finding exists for VA-WH PAP SMEAR SCREEN \n          FREQ 3Y and changes the screening frequency to every three \n          years (3Y).\n       FF7 \n         \n          Determines whether a finding exists for VA-WH PAP SMEAR SCREEN \n          NOT INDICATED and changes the frequency to 0D, which will \n          stop the reminder from being due until some new activity \n          occurs.  \n       FF8 \n          Determines whether the most recent finding is a VA-WH PAP SMEAR \n          UNSATISTACTORY IN LAB PKG, which will make the reminder due \n          again in one day (1D).  \n \n       FF9\n    The following is a subset of some of the specific features of WH that \n          New in this update; allows text to display for prior negative\n          HPV results and no record of any positive HPV results\n \n       FF10 \n          New in this update and along with FF11, replaces the old FF1\n          Most recent finding is a PAP smear result AND\n             1) patient <30, or \n             2) HPV done and most recent result positive, or \n             3) no recent negative result of HPV testing\n          Frequency set to 3Y\n    must be in place in order for this reminder to work as it was \n \n       FF11\n          New in this update and along with FF10, replaces the old FF1\n          Most recent finding is a PAP smear result AND\n          pt is 30-65, and most recent HPV was done in the past \n          5Y and was negative\n          Frequency set to 5Y\n    designed: \n        * Female veterans should be entered into the WH package.\n        * SNOMED codes are setup for the PAP SMEAR procedure in the WV \n          PROCEDURE TYPE file.  \n        * WH parameters should be set up to automatically import PAP \n    \n          smear \n          lab reports into the WH package when they are verified in the \n          VistA Lab package.  \n        * The WV NOTIFICATION PURPOSE letters should be customized to \n          reflect site information and the correct letter content for \n          each type of letter.\n        * The Notification Purpose treatment need and treatment need \n          date offset should be defined if appropriate. These new fields \n          will be used to update Women's Health data when purpose of \n          notifications are selected by clinicians from reminder \n    This reminder is based on VHA Performance measures and US \n          dialogs.  \n        * The reminder dialog definitions should reference the \n          appropriate WV NOTIFICATION PURPOSE.\n     \n    Setup of reminder terms and reminder dialogs before using this \n    reminder:  \n    ============================================================== \n    1.  Use the Reminder Term options to map local representations of \n        findings: \n     \n    Preventative Services Task Force recommendations for cervical cancer\n    PATIENT COHORT FINDINGS: \n    ------------------------\n    The following reminder terms determine whether the reminder applies \n    to the patient.\n     \n       VA-WH HYSTERECTOMY W/CERVIX REMOVED \n           No mapping necessary.  Use the VA-WH HYSTERECTOMY W/CERVIX \n           REMOVED reminder taxonomy distributed with this term.  Note \n           the VA-CERVICAL CA/ABNORMAL PAP reminder taxonomy is now \n           used for information only and should not be mapped to this\n    screening. \n           reminder term since it contains codes where the cervix may\n           not have been removed.\n     \n           This reminder term is also mapped to the new health factor \n           WH HYSTERECTOMY W/CERVIX REMOVED.  \n     \n \n    RESOLUTION FINDINGS: \n    --------------------\n     The following reminder terms resolve the reminder.  These resolution \n         \n     terms are defined with a "Use in Resolution Logic", but no Frequency.\n     Frequency for this reminder will be determined by Function Findings \n     (FF) logic, which examines the most recent findings: \n  \n          * If Function Findings determine that the most recent finding \n            is a result, the baseline age and frequency will be used.  \n  \n          * If Function Findings determine that an information finding \n            exists that alters the baseline frequency to 1Y, 2Y,\n            3Y, or 5Y the baseline frequency will be overridden.  \n    If the PAP smear is done in the private sector or at another VAMC \n \n          * FF for 4 month and 6 months screening are removed from the \n            patient version of the reminder\n \n        VA-WH PAP SMEAR SCREEN IN WH PKG \n           No mapping necessary.  This term represents PAP Smear results \n           documented in the Women's Health (WH) Package. Use the new \n           VA-WH PAP SMEAR IN WH PKG computed finding distributed with \n           this reminder term. This computed finding looks for PAP smear\n           results in the Women's Health Package where results have been\n
\n
\n", "
(SEX)&(AGE)&'(FI(2))
\n", "
(SEX)&(AGE)&'(FI(2))
\n", "
3
\n", "
SEX;AGE;2
\n", "", "
(0)!FI(4)!FI(5)!FI(6)!FI(7)!FI(9)!FI(10)!FI(11)
\n", "
7
\n", "
4;5;6;7;9;10;11
\n", "
8
\n", "
FF1;FF4;FF5;FF6;FF7;FF8;FF10;FF11
\n", "
16
\n", "
1;3;12;13;14;15;16;17;18;20;21;22;23;FF12;FF13;FF9
\n", "", "", "", "", "
\n
\n\n
\n", "", "
\nCervical cancer is a cancer of the lower part of the uterus, or womb. It \n  *  Women ages 30-65 can either:\\\\\n       - be screened for cervical cancer every 3 years with a Pap test; or\\\\\n       - for those who want to lengthen the time between screenings, be\\\\\n           screened every 5 years with a combination of a Pap test and a\\\\\n           test for Human Papillomavirus (HPV).\n \nRisk factors increase your chance of getting a disease. The major risk\nfactors for cervical cancer are:\\\\\n    *      Infection with the Human Papillomavirus (HPV)\\\\\n    *      Having many sexual partners\\\\\nis a slow-growing cancer that can take many years to develop.  In its \n    *      Having first sexual intercourse at an early age\\\\\n    *      Infection with Human Immunodeficiency Virus (HIV)\\\\\n    *      Smoking\\\\\n \nIf you have any of these risk factors, discuss them with your health \ncare provider.\\\\\n \nCervical cancer screening tests (i.e. Pap tests) and HPV tests are \nnot perfect at finding cervical cancer. Many changes found on Pap tests \nturn out to not be cancer, but you may need more tests to determine if \nearly stages it usually does not cause any changes that you can see or \ncancer is present. Pap tests may also miss changes that are cancer, but \nthis does not happen often.\\\\\n \nAlso, it is very important to continue to be screened for cervical cancer\neven if you got the HPV Immunization shot because the shot does not \nprotect you from all types of HPV.  Talk with your primary care team \n(PACT) or other women's health care provider if you have questions. \\\\\nfeel.  Pap tests can find abnormalities in the cervix that can be \nsuccessfully treated before they turn into cancer. Also, when cancer is \ndiagnosed early it is more likely to be cured. \n \nMost women ages 21-65 should be screened:\\\\\n  *  Women ages 21-29 should have a Pap test every 3 years.\\\\\n
\n
\n", "", "
36
\n", "
0
\n", "", "
\nThere is no recent report of cervical cancer screening in your medical \nrecord.  Please contact your primary care team (PACT) to discuss being \nscreened.  If you had a recent Pap test and/or HPV test please let your \nprimary care team (PACT) know this at your next visit. \\\\\n
\n
\n", "
0
\n", "
4
\n", "
2017-12-27 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-SEXUAL ORIENTATION", "
Sexual Orientation
\n", "
30D
\n", "", "", "", "", "", "", "
NATIONAL
\n", "
POPULATION HEALTH
\n", "", "
*
\n", "
\n
\n\n
\n", "
\nPatients should have sexual orientation documented annually. \n
\n
\n", "
\n
\n\n
\n", "", "", "", "
(SEX)&(AGE)
\n", "
2
\n", "
SEX;AGE
\n", "
FI(1)
\n", "
FI(1)
\n", "
1
\n", "
1
\n", "", "", "", "", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-MH HIGH RISK NO-SHOW ADHOC RPT", "
High Risk MH No-Show Adhoc Rpt
\n", "
99Y
\n", "", "", "", "", "", "", "
NATIONAL
\n", "
MENTAL HEALTH SERVICES
\n", "", "
RX
\n", "
\n
\n\n
\n", "
\nThis reminder is primarily for reporting needs and checks for No-Show MH \n \nThis reminder shall determine whether Mental Health (MH) professionals\nhave followed up on a No-Show MH appointment for a patient with an\nactive High Risk for Suicide Patient Record Flag.\n \nIf the patient has a completed encounter to a MH appointment on the same\nday, or within 72 hours of the missed MH appointment, follow-up will no\nlonger be necessary.\nappointments that occurred between the Beginning Date and Ending Date of \na reporting period, which is different from the VA-MH HIGH RISK NO-SHOW \nFOLLOW-UP reminder which looks back 10 days from the date the reminder is \nbeing run.  This reminder is called by the SD MH NO SHOW AD HOC REPORT\n(High Risk MH No-Show Adhoc Report). For each no-show appointment found \nin the reporting date range, the appointment date is used to run this\nreminder, and the reminder is resolved by any results entered the same day\nas the no-show appointment or within 60 days of the no-show appointment.\n
\n
\n", "
\n
\n\n
\n", "", "", "", "
(SEX)&(AGE)&FI(1)&FI(2)
\n", "
4
\n", "
SEX;AGE;1;2
\n", "", "
(0)!FI(3)!FI(4)!FI(8)!FI(11)!FI(12)!FI(13)!FI(14)
\n", "
7
\n", "
3;4;8;11;12;13;14
\n", "", "", "
2
\n", "
6;10
\n", "", "", "", "", "", "", "
\nThe patient has an active High Risk for Suicide Patient Record Flag and \nmissed a MH appointment.\n
\n
\n", "
\nThis patient has no missed MH appointment pending follow-up.\n
\n
\n", "
2
\n", "
1
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-MHV COLORECTAL CANCER SCREEN", "
ZZ Colon Cancer Screening
\n", "
2M
\n", "", "
INACTIVE
\n", "
2017-12-27 16:27:46
\n", "", "", "", "
NATIONAL
\n", "
NATIONAL CLINICAL PRACTICE GUIDELINE COUNCIL
\n", "", "
CPR
\n", "
\n
\n\n
\n", "
\nPatient reminder for colorectal cancer screening.  \nThis reminder term is for findings that represent 3 values for occult\nblood - enter a test in this term ONLY if it means that all 3 occult\nblood tests are done.  Do NOT enter lab tests here that represent a\nsingle occult blood test.\n \nFor example, if you use 3 tests in your panel OB1, OB2, OB3; then you can \nput OB3 into this reminder term.  If you have a computed finding for 3 \noccult blood tests, then you can use that finding in this term.  Any \nsingle finding that when present would verify that all 3 of the occult \nblood tests had been done can be used in this term.\n \n \n \nVA-MHV OCCULT BLOOD SINGLE TEST\nTerm for individual occult blood tests - in the reminder, the definition \nwill require 3 of these findings to complete the colorectal cancer \nscreening.\nThis reminder contains reminder terms for colonoscopy, sigmoidoscopy and \n2 reminder terms for occult blood testing.  The reminder is resolved for \n10 years by colonoscopy, 5 years by sigmoidoscopy and for one year by \noccult blood testing.  These time frames are determined by the Custom \nDate Due field.\n \nVA-MHV OCCULT BLOOD PANEL  \n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "", "
(SEX)&(AGE)
\n", "
2
\n", "
SEX;AGE
\n", "
FI(1)!FI(2)!(FI(3)&FF(1))!FI(4)
\n", "
FI(1)!FI(2)!(FI(3)&FF(1))!FI(4)
\n", "
5
\n", "
1;2;3;FF1;4
\n", "", "", "
1
\n", "
5
\n", "
MAX_DATE(1+10Y,2+5Y,3+1Y,4+1Y,5+5Y)
\n", "
MAX_DATE
\n", "
5
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "
\nAnyone ages 50 to 75 should be screened for colon cancer on a regular\nbasis.\n
\n
\n", "", "
2
\n", "
0
\n", "", "
\nIt is time for you to have a screening test for colorectal cancer (cancer\nof the large bowel or rectum). There are several tests used for screening\nfor colorectal cancer.  These include a stool test, sigmoidoscopy, or\ncolonoscopy.  Having any of these tests can reduce your chance of\ndeveloping or dying from colorectal cancer. Talk with your primary care\nteam about which test you should have.\n
\n
\n", "
0
\n", "
6
\n", "
2017-12-27 00:00:00
\n", "
\n
\n\n
\n", "
\nAnyone ages 50 to 75 should be screened for colon cancer on a regular\nbasis.\n
\n
\n", "", "
2
\n", "
0
\n", "", "
\nIt is time for you to have a screening test for colorectal cancer (cancer\nof the large bowel or rectum). There are several tests used for screening\nfor colorectal cancer.  These include a stool test, sigmoidoscopy, or\ncolonoscopy.  Having any of these tests can reduce your chance of\ndeveloping or dying from colorectal cancer. Talk with your primary care\nteam about which test you should have.\n
\n
\n", "
0
\n", "
6
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-MHV DIABETES FOOT EXAM", "
ZZ Foot Exam for Diabetes
\n", "
2M
\n", "", "
INACTIVE
\n", "
2017-12-27 16:27:46
\n", "", "", "", "
NATIONAL
\n", "
NATIONAL CLINICAL PRACTICE GUIDELINE COUNCIL
\n", "", "
CPR
\n", "
\n
\n\n
\n", "
\nPatient reminder for complete foot exam yearly in diabetics.\namputee.\n \nA reminder term for a complete diabetic foot exam resolves this \nreminder.   There are also indivudal reminder terms for each part of a \ncomplete diabetic foot exam (monofilament, pulses, inspection) and if all \n3 portions have been done, the reminder is also resolved.  Map local \nfindings accordingly.\n \nThe reminder is not applicable for patients with an entry of bilateral \n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "", "
(SEX)&(AGE)&FI(1)&'FI(8)&FF(1)
\n", "
5
\n", "
SEX;AGE;1;8;FF1
\n", "
FI(7)!(FI(11)&FI(9)&FI(10))
\n", "
FI(7)!(FI(11)&FI(9)&FI(10))
\n", "
4
\n", "
7;11;9;10
\n", "", "", "
1
\n", "
6
\n", "", "", "", "", "
\n
\n\n
\n", "", "
\nAnyone with diabetes should have their feet checked by their provider or\nother clinician at least once a year. This is needed to find out if there\nare signs of nerve damage and poor blood flow to the feet.  Problems can\nbe detected by a physical examination of the feet, checking the pulses in\nthe feet, and testing the ability of the feet to feel with a special\ntool.  A foot problem can worsen and cause serious problems in people with\ndiabetes.  If you have not had a complete exam of your feet in the past 12\nmonths, please talk to your provider or clinician about it.\\\\ \n
\n
\n", "", "
8
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2017-12-27 00:00:00
\n", "
\n
\n\n
\n", "
\nAnyone with diabetes should have their feet checked by their provider or\nother clinician at least once a year.\n
\n
\n", "", "
2
\n", "
0
\n", "", "
\nIt is time for a complete exam of your feet. Signs of problems can be\ndetected by a physical examination, pulse check, and a test with a\nspecial tool used to check sensation.\n
\n
\n", "
0
\n", "
3
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-POLYTRAUMA MARKER", "
Combat Polytrauma Confirmation
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
OFFICE OF PATIENT CARE SERVICES
\n", "", "
CR
\n", "
\n
\n\n
\n", "
\nThis reminder was activated through an algorithm which identifies \n \nHealth factors are collected for each of the yes/no responses to the 4 \nquestions.  A 'yes' response to all 4 questions is a positive.\n \nHEALTH FACTORS:\nPOLYTRAUMA OEF/OIF - YES\nPOLYTRAUMA OEF/OIF - NO\nPOLYTRAUMA SINGLE EVENT - YES\nPOLYTRAUMA SINGLE EVENT - NO\nPOLYTRAUMA EVACUATION - YES\npatients who may have experienced severe Polytrauma due to OEF/OIF combat \nPOLYTRAUMA EVACUATION - NO\nPOLYTRAUMA IMPAIRMENT HISTORY - YES\nPOLYTRAUMA IMPAIRMENT HISTORY - NO\n \nCombinations of the following reminder terms and associated taxonomies\ndefine which patients may have experienced polytrauma and therefore need\nto be asked about those injuries.\n \nVA-POLYTRAUMA AMPUTATION\nVA-POLYTRAUMA AUDITORY\nrelated injuries.  By definition, Polytrauma occurs due to a single event \nVA-POLYTRAUMA BRAIN INJURY\nVA-POLYTRAUMA BURN\nVA-POLYTRAUMA INPT REHAB\nVA-POLYTRAUMA ORTHO\nVA-POLYTRAUMA PTSD\nVA-POLYTRAUMA SCI\nVA-POLYTRAUMA VISION\nVA-POLYTRAUMA WAR INJURY\n \nThe reminder is resolved by a negative response to questions 1-4 or a \nwith injuries to more than one physical region or organ system, one of \npositive response to question 4.   The health factors that represent \nthese responses are included in a reminder term:\n \nVA-POLYTRAUMA MARKER COMPLETED\nwhich may be life threatening, and which results in physical, cognitive, \npsychological, or psychosocial impairments and functional disability.  \nThe following questions will serve as the clinical confirmation that the \ninjuries experienced by this patient meet the definition of severe \nPolytrauma related to OEF/OIF combat.  \n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "
FI(11)&FI(14)&(FI(1)!(FI(2)&FF(2))!(FI(3)&FF(3))!(FI(4)&FF(4))!(FI(5)&FF(5))!(FI(6)&FF(6))!(FI(7)&FF(7))!(FI(8)&FF(8))!(FI(9)&FI(10)))
\n", "
FI(11)&FI(14)&(FI(1)!(FI(2)&FF(2))!(FI(3)&FF(3))!(FI(4)&FF(4))!(FI(5)&FF(5))!(FI(6)&FF(6))!(FI(7)&FF(7))!(FI(8)&FF(8))!(FI(9)&FI(10)))
\n", "
19
\n", "
11;14;1;2;FF2;3;FF3;4;FF4;5;FF5;6;FF6;7;FF7;8;FF8;9;10
\n", "", "
(0)!FI(13)
\n", "
1
\n", "
13
\n", "", "", "
1
\n", "
12
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-MHV DIABETES HBA1C", "
ZZ HbA1c for Diabetes
\n", "
2M
\n", "", "
INACTIVE
\n", "
2017-12-27 16:27:46
\n", "", "", "", "
NATIONAL
\n", "
NATIONAL CLINICAL PRACTICE GUIDELINE COUNCIL
\n", "", "
CPR
\n", "
\n
\n\n
\n", "
\nReminder due yearly for patients with diabetes - the reminder requires 2 \ninstances of a CPT code for diabetes in the past 2 years in order to be \napplicable to the patient.\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "", "
(SEX)&(AGE)&FI(1)&FF(1)
\n", "
4
\n", "
SEX;AGE;1;FF1
\n", "", "
(0)!FI(2)
\n", "
1
\n", "
2
\n", "", "", "", "", "", "", "", "", "
\n
\n\n
\n", "", "
\nYour provider may order a blood test called glycated hemoglobin, or\nhemoglobin A1c.  This test can be taken any time of day, even right after\na meal.  It measures your average blood glucose (sugar) for the past 2 to\n3 months.  The goal is to have your A1c below 9.  If your level is below\n7, it shows good diabetes control.  By carefully controlling your blood\nglucose levels and practicing other healthy habits, you will feel better\nand may prevent or delay diabetes complications such as nerve, eye,\nkidney, and blood vessel damage.\n
\n
\n", "", "
8
\n", "
0
\n", "", "
\nNo recent hemoglobin A1c was found in your VA record.  If you have had a \nHbA1c done outside the VA, please bring the results with you to your next \nVA appointment.  Otherwise, please check with your primary care team about\ngetting this test done.\n
\n
\n", "
0
\n", "
4
\n", "
2017-12-27 00:00:00
\n", "
\n
\n\n
\n", "
\nPatients with diabetes should have a blood test for Hemoglobin A1c \nchecked on a regular basis. The level of A1c measures your average blood\nglucose (sugar) for the past few months.  It is a good way to know how\nwell your diabetes is controlled.\n
\n
\n", "", "
4
\n", "
0
\n", "", "
\nNo recent hemoglobin A1c was found in your VA record.  If you have had a\nHbA1c done outside the VA, please bring the results with you to your next\nVA appointment.  Otherwise, please check with your primary care team about\ngetting this test done.\n
\n
\n", "
0
\n", "
4
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-MHV DIABETES RETINAL EXAM", "
ZZ Eye Exam for Diabetes
\n", "
1M
\n", "", "
INACTIVE
\n", "
2017-12-27 16:27:46
\n", "", "", "", "
NATIONAL
\n", "
NATIONAL CLINICAL PRACTICE GUIDELINE COUNCIL
\n", "", "
CPR
\n", "
\n
\n\n
\n", "
\nThis reminder is set to be due yearly in patients with diabetes.  \nReminder terms for HbA1c, insulin and outcomes of prior eye exams are \nincluded.\n \nThe reminder is applicable only if 2 instances of diabetes ICD codes are \nfound in the chart in the past 2 years.\n \nIf the patient meets all 3 criteria for a 2 year exam, then the frequency\nis changed to every 2 years.\n \nThe absence of diabetic retinopathy is represented by a reminder term \nthat can be used to map any local health factors or exams that indicate \nthe absence of diabetic retinopathy.\n \n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "", "
(SEX)&(AGE)&FI(1)&FF(1)
\n", "
4
\n", "
SEX;AGE;1;FF1
\n", "", "
(0)!FI(2)
\n", "
1
\n", "
2
\n", "
3
\n", "
4;6;FF2
\n", "
4
\n", "
3;5;7;8
\n", "", "", "", "", "
\n
\n\n
\n", "", "", "", "
0
\n", "
0
\n", "", "
\nNo recent eye exam was found in your record that included an examination \nof the retina for complications of diabetes. If you have had a dilated \neye exam by a Eye doctor outside of the VA, please bring this information \nwith you to your next visit.  Otherwise, check with your primary care\nteam about how to get a detailed exam of your eyes.\n
\n
\n", "
0
\n", "
5
\n", "
2017-12-27 00:00:00
\n", "
\n
\n\n
\n", "
\nAnyone with diabetes should have a dilated eye exam.\n
\n
\n", "", "
1
\n", "
0
\n", "", "
\nNo recent eye exam was found in your record that included an examination\nof the retina for complications of diabetes.\n
\n
\n", "
0
\n", "
2
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-MHV HYPERTENSION", "
ZZ Hypertension (High Blood Pressure)
\n", "", "", "
INACTIVE
\n", "
2017-12-27 16:27:46
\n", "", "", "", "
NATIONAL
\n", "
NATIONAL CLINICAL PRACTICE GUIDELINE COUNCIL
\n", "", "
CRP
\n", "
\n
\n\n
\n", "
\nPatient reminder due on anyone with 2 entries of a diagnosis of HTN in \nthe past 3 years.  This reminder does not resolve.  Additional text is \ndisplayed to the patient if the last 3 BPs were <= 130/80, if the last BP \nwas >140/90 or if any of the last 3 BPs was >=160/100.\n \nIf you use a different taxonomy for HTN or for renal diseases, you can \nsubstitute you local taxonomies into the national reminder term.\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "
FI(1)&FF(1)
\n", "
FI(1)&FF(1)
\n", "
2
\n", "
1;FF1
\n", "", "", "", "", "", "", "
8
\n", "
2;3;4;5;6;7;FF2;FF3
\n", "", "", "", "", "
\n
\n\n
\n", "", "
\nBlood pressure or BP is the pressure of blood inside the blood vessels as \nmeasuring equipment. High blood pressure increases the risk for heart \ndisease and stroke. It can also cause other problems such as heart \nfailure, kidney disease, and blindness.  In most cases, high blood \npressure can be controlled but not cured.  Good control prevents \ncomplications. \n \nHigh blood pressure can be lowered with changes in lifestyle and \nmedications. Here are some things you can do.  \\\\\n    Work with your provider and dietitian to develop a\\\\ \n         healthy eating plan.  \\\\\nit flows within the body. A BP reading is expressed as a high number over \n    Eat less salt. \\\\\n    Keep a normal weight. Lose weight if you need to. \\\\\n    Engage in physical activity for at least 30 minutes on\\\\\n         most days.  Check with your provider for an activity\\\\\n         good for you. \\\\\n    Do not smoke cigarettes or tobacco. \\\\\n    Consult your provider about drinking alcohol. \\\\\n    Take your medications as prescribed.   \\\\\n    Talk to your provider about measuring your BP at home. \\\\\na low number such as 139/89. The high number is the pressure as the heart \nbeats and the low number is the pressure as the heart rest between beats. \nWhen either or both pressures stay high over time, it is called high \nblood pressure or hypertension.  \n \nHigh blood pressure is a serious illness that usually does not have any \nsymptoms. Therefore, a BP reading should be taken regularly with BP \n
\n
\n", "", "
28
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2017-12-27 00:00:00
\n", "
\n
\n\n
\n", "
\nAnyone with high blood pressure or hypertension should aim to keep his or \noutside the VA, and discuss these with your primary care team.\nher blood pressure reading less than 140/90.  For most patients with high \nblood pressure, a lower blood pressure is better so maintaining a blood \npressure reading of 130/80 or lower is likely to be beneficial to you.  \nPlease check with your primary care team about your specific blood \npressure goals.\\\\\nThis blood pressure goal may be lower if you have other conditions such \nas diabetes and kidney disease.  Please review your blood pressure \nreadings below and any other blood pressure readings you may have from \n
\n
\n", "", "
10
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-MHV INFLUENZA VACCINE", "
ZZ Influenza Vaccine
\n", "", "", "
INACTIVE
\n", "
2017-12-27 16:27:46
\n", "", "", "", "
NATIONAL
\n", "
NATIONAL CLINICAL PRACTICE GUIDELINE COUNCIL
\n", "
2009-08-31 00:00:00
\n", "
CPR
\n", "
\n
\n\n
\n", "", "
\n
\n\n
\n", "", "
\nThe reminder is due for all patients.  \nany entries made for Sept to resolve the reminder (entries made for\nimmunizations for just the month and year are recorded as MO/00/YR). The\nreminder is resolved by the reminder term for flu vaccine or by the \nreminder term for contraindications.\nThe reminder term for flu vaccination will need to be updated yearly to\nreset the start date of the flu vaccine so that it is due each fall for\npatients in the cohort no matter when they received their last\nimmunization.\nA few weeks prior to beginning flu vaccinations each fall, change the \nstart date for each finding in the vaccination term to a recent date.  For\nexample, if flu vaccines in the community are to begin around September\n20, then change the start date to August 31 in order to be sure to allow\n
\n
\n", "", "
(SEX)&(AGE)!FI(2)&'FI(3)
\n", "
4
\n", "
SEX;AGE;2;3
\n", "", "
(0)!FI(1)
\n", "
1
\n", "
1
\n", "
1
\n", "
2
\n", "
1
\n", "
4
\n", "", "", "", "", "
\n
\n\n
\n", "", "
\nAll persons should get the seasonal flu shot every year.  This vaccine \nwill protect you from getting the seasonal flu in most cases. The vaccine\nwill also help prevent the spread of the flu to your family members.\\\\\n \nInfluenza or "flu" is a serious disease that spreads easily. It causes \nfever, chills, cough, fatigue, aches, or loss of appetite. It can lead to \nbronchitis, pneumonia or death.  Flu causes thousands of deaths each year \nin the US.  Flu shots could prevent many of these deaths.\\\\\n
\n
\n", "", "
8
\n", "
0
\n", "
\nYour medical record shows that you received the seasonal flu shot \nrecently.  That's great!  You should continue to get this shot every year.\n
\n
\n", "
\nOur records show that you have not received your seasonal flu shot for \n*     Anyone who has a weak immune system from HIV/AIDS, steroid\ntreatment, or cancer treatment.\\\\\n*     Residents of nursing homes or other long-term care facilities.\\\\\n*     Pregnant women.\\\\ \n \nSome flu vaccines are not recommended for people who are allergic to eggs\nor who had a severe reaction to flu shot in the past.  Tell your primary\ncare team if you have any of these problems.  There may be a different\nvaccine that you can take.  Also, tell your provider if you have a history\nof Guillain-Barre Syndrome (GBS) or if you feel sick or have a high fever\nthis year. Please get your seasonal flu shot soon or tell your primary \non the day of your flu shot. \\\\\n \nThe flu shot or vaccine protects most people from the flu. Some may still\ncatch the flu after having the shot but are likely to have a milder case.\n \nThe flu shot does NOT cause the flu. It protects one from the flu. The\nvaccine is safe and it works. Most people will not have side effects. A\nfew may feel sore at the site where the shot was given. Fewer may have\nfever, chills, headaches, or muscle aches. The best time to get a flu shot\nis in October or November. However, getting the flu shot later in December\ncare team if you already got one.\nthru March will still give very good protection. VA Clinics offer flu\nshots usually from September thru March.\n \nEveryone should get a seasonal flu shot.  Some people are at higher \nrisk of serious complications from the seasonal flu:\\\\\n*     People who are age 50 and older\\\\\n*     Anyone with long-term health problems of the lungs, heart, or\nkidney, asthma, or diabetes.\\\\\n
\n
\n", "
2
\n", "
31
\n", "
2017-12-27 00:00:00
\n", "
\n
\n\n
\n", "
\nYou should receive a seasonal flu shot every year.\n
\n
\n", "", "
1
\n", "
0
\n", "", "
\nIt is time for your yearly "seasonal flu shot" to protect you from \ncatching the seasonal flu.  Please call your VA Clinic to find out how you\ncan get your seasonal flu shot. If you already had your seasonal flu shot\nthis year, please tell your primary care team  at your next visit.\n
\n
\n", "
0
\n", "
4
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-MHV LDL CONTROL", "
ZZ Control of Your Cholesterol
\n", "", "", "
INACTIVE
\n", "
2017-12-27 16:27:46
\n", "", "", "", "
NATIONAL
\n", "
NATIONAL CLINICAL PRACTICE GUIDELINE COUNCIL
\n", "", "
CPR
\n", "
\n
\n\n
\n", "
\nThis reminder is set to display the most recent lab values to the patient \nif their last LDL was >99.\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "
(FI(2)!FI(3))&(FI(4)!FI(5))&FF(1)
\n", "
(FI(2)!FI(3))&(FI(4)!FI(5))&FF(1)
\n", "
5
\n", "
2;3;4;5;FF1
\n", "", "", "", "", "", "", "
6
\n", "
1;6;7;8;9;10
\n", "", "", "", "", "
\n
\n\n
\n", "", "
\nEveryone should have a blood test for elevated cholesterol or blood fats \nLipids are needed by the body to promote healthy cells, make certain \nhormones, and absorb Vitamin D.  They are naturally made by the body and \nalso come from food.  Abnormal lipid levels increase the risk for heart\ndisease, heart attack, or stroke because of their effect on blood\nvessels.  Patients with diabetes should aim to keep their lipid levels\nwithin the recommended ranges. How often the blood test for lipids needs\nto be done depends on what the levels have been. What your lipid levels\nshould be depends on your risk for heart disease. Talk with your primary\ncare team about your blood lipid levels.                               \n \nat some time. This test measures the level of four types of lipids: total \nThe four kinds of lipids are: \\\\\n   Low Density Lipoprotein or LDL, also known as "bad" cholesterol. The \nlevel should be less than 120 mg/dl in patients with heart disease or\ndiabetes.  LDL at high levels can narrow, harden, or close off the walls\nof blood vessels that supply vital parts of the body such as the heart\ncausing a heart attack or the brain causing a stroke. \\\\   High Density\nLipoprotein or HDL, also known as "good" cholesterol. The higher the\nnumber the better. HDL prevents the build-up of lipids on the walls of\nblood vessels. \\\\   Triglycerides. High levels increase the risk of heart\ndisease and stroke.\\\\   Total cholesterol. High levels increase the risk\ncholesterol, LDL cholesterol, HDL cholesterol, and triglycerides.  \\\\\nof heart disease and stroke.\\\\   \\\\There are things you can do to keep or\nbring lipid levels to a desired range.\\\\   Work with your provider to\nmake a plan that will work for you.\\\\   Work with your provider and\ndietitian to develop a healthy eating plan.\\\\    Eat less food high in\nsaturated fat or cholesterol, such as fatty portions of meat, butter,\neggs, lard, shortening, foods with coconut oil or palm oil, liver, organ\nmeats, whole milk, and ice cream. \\\\   Choose lean meats, fish, and low\nor fat-free dairy products.\\\\   Use olive, canola, corn, or sunflower\noil.\\\\   Eat foods high in fiber such as fruits, vegetables, and oat\nbran.\\\\   Keep your weight at desired levels or lose weight if you need\n \nto.\\\\   Engage in a physical activity for at least 30 minutes on most\ndays.  Check with your provider for an activity good for you.\\\\   Do not\nsmoke cigarettes or tobacco. \\\\   Keep your blood sugar controlled.\\\\\nConsult your provider about drinking alcohol. \\\\   Talk to your provider\nabout lipid-lowering medications that may be appropriate for you. \\\\  \nTo prepare for this test, you should not eat or drink anything for at \nleast 9 hours before blood is drawn to get a correct reading.  You may \ntake your pills and drink water prior to the blood test but you should \nnot have any coffee, other drinks or any food.\\\\\n \n
\n
\n", "", "
44
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2017-12-27 00:00:00
\n", "
\n
\n\n
\n", "
\nEveryone should have a blood test for elevated cholesterol or blood fats\n \nAbnormal lipid levels increase the risk for heart disease, heart attack,\nor stroke because of their effect on blood vessels.  How often the blood\ntest for lipids needs to be done depends on what the levels have been\nbefore.  Your goal for control of your lipid levels depends on your risk\nfor heart disease. Talk with your primary care team about your blood lipid\nlevels and what your goals should be.\nat regular intervals.  This test measures the level of four types of\nlipids: total cholesterol, LDL cholesterol, HDL cholesterol, and\ntriglycerides.  \\\\ \n \nTo prepare for this test, you should not eat or drink anything for at\nleast 9 hours before blood is drawn to get a correct reading.  You may\ntake your pills and drink water prior to the blood test but you should not\nhave any coffee, other drinks or any food.\\\\ \n
\n
\n", "", "
16
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-MHV LIPID MEASUREMENT", "
ZZ Lipid Measurement (Cholesterol)
\n", "
3M
\n", "", "
INACTIVE
\n", "
2017-12-27 16:27:46
\n", "", "", "", "
NATIONAL
\n", "
NATIONAL CLINICAL PRACTICE GUIDELINE COUNCIL
\n", "", "
CPR
\n", "
\n
\n\n
\n", "
\nThis reminder is set to prompt for a lipid panel every 2 years for \nsites.  \npatients ages 51 to 75 and every 5 years between the ages of 35 and 50 \nfor men and 45 and 50 for women.  Patients with diabetes (2 entries of an \nICD code) will have the reminder due every 2 years and patients with IHD \nor atherosclerosis will have it due every one year.\n \nThe reminder is resolved by a local LDL in the lab package or by an \noutside LDL entered as a health factor.  The reminder term - VA-LDL - was \nexported with the IHD reminders and should already be mapped at all \n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "
(SEX)&(AGE)!(FI(2)&FF(1))!FI(3)
\n", "
(SEX)&(AGE)!(FI(2)&FF(1))!FI(3)
\n", "
5
\n", "
SEX;AGE;2;FF1;3
\n", "", "
(0)!FI(4)!FI(5)
\n", "
2
\n", "
4;5
\n", "
3
\n", "
1;3;FF1
\n", "
1
\n", "
6
\n", "", "", "", "", "
\n
\n\n
\n", "", "
\nEveryone should have a blood test for elevated cholesterol or blood fats \nalso come from food.  Abnormal lipid levels increase the risk for heart \ndisease, heart attack, or stroke because of their effect on blood \nvessels.  Patients with diabetes should aim to keep their lipid levels \nwithin the recommended ranges. How often the blood test for lipids needs \nto be done depends on what the levels have been. What your lipid levels \nshould be depends on your risk for heart disease. Talk with your primary \ncare team about your blood lipid levels. \n \nThe four kinds of lipids are: \\\\\n   Low Density Lipoprotein or LDL, also known as "bad" cholesterol. The \nat some time. This test measures the level of four types of lipids: total \nlevel should be less than 120 mg/dl in patients with heart disease or \ndiabetes.  LDL at high levels can narrow, harden, or close off the walls \nof blood vessels that supply vital parts of the body such as the heart \ncausing a heart attack or the brain causing a stroke. \\\\   High Density \nLipoprotein or HDL, also known as "good" cholesterol. The higher the \nnumber the better. HDL prevents the build-up of lipids on the walls of \nblood vessels. \\\\   Triglycerides. High levels increase the risk of heart \ndisease and stroke.\\\\   Total cholesterol. High levels increase the risk \nof heart disease and stroke.\\\\   \\\\\n\\\\\ncholesterol, LDL cholesterol, HDL cholesterol, and triglycerides.  \\\\\nThere are things you can do to keep or bring lipid levels to a desired\nrange.\\\\\n   Work with your provider to make a plan that will work for you.\\\\\n   Work with your provider and dietitian to develop a healthy\\\\\n        eating plan.\\\\\n   Eat less food high in saturated fat or cholesterol, such as\\\\\n        fatty portions of meat, butter, eggs, lard, shortening,\\\\\n        foods with coconut oil or palm oil, liver, organ meats,\\\\\n        whole milk, and ice cream. \\\\\n   Choose lean meats, fish, and low or fat-free dairy products.\\\\\nTo prepare for this test, you should not eat or drink anything for at \n   Use olive, canola, corn, or sunflower oil.\\\\\n   Eat foods high in fiber such as fruits, vegetables, and\\\\\n        oat bran.\\\\   \n   Keep your weight at desired levels or lose weight if you\\\\\n        need to.\\\\\n   Engage in a physical activity for at least 30 minutes\\\\\n        on most days.  Check with your provider for an activity\\\\\n        level good for you.\\\\\n   Do not smoke cigarettes or tobacco. \\\\\n   Keep your blood sugar controlled.\\\\\nleast 9 hours before blood is drawn to get a correct reading.  You may \n   Consult your provider about drinking alcohol. \\\\\n   Talk to your provider about lipid-lowering medications that\\\\\n        may be appropriate for you. \\\\\ntake your pills and drink water prior to the blood test but you should \nnot have any coffee, other drinks or any food.\\\\\nLipids are needed by the body to promote healthy cells, make certain \nhormones, and absorb Vitamin D.  They are naturally made by the body and \n
\n
\n", "", "
52
\n", "
0
\n", "", "
\nEveryone should have a blood test for elevated cholesterol or blood fats \n(lipids) at some time.  Please talk with your primary care team about \nyour blood lipid levels and what your personal goal should be.\n
\n
\n", "
0
\n", "
3
\n", "
2017-12-27 00:00:00
\n", "
\n
\n\n
\n", "
\nEveryone should have a blood test for elevated cholesterol or blood fats \nlipids needs to be done depends on what the levels have been before.  Your\ngoal for control of your lipid levels depends on your risk for heart\ndisease. Talk with your primary care team about your blood lipid levels\nand what your goals should be.\nat regular intervals.  This test measures the level of four types of\nlipids: total cholesterol, LDL cholesterol, HDL cholesterol, and\ntriglycerides.  \\\\ To prepare for this test, you should not eat or drink\nanything for at least 9 hours before blood is drawn to get a correct\nreading.  You may take your pills and drink water prior to the blood test\nbut you should not have any coffee, other drinks or any food.\\\\ Abnormal\nlipid levels increase the risk for heart disease, heart attack, or stroke\nbecause of their effect on blood vessels.  How often the blood test for\n
\n
\n", "", "
13
\n", "
0
\n", "", "
\nEveryone should have a blood test for elevated cholesterol or blood fats \n(lipids) at some time.  Please talk with your primary care team about \nyour blood lipid levels and what your personal goal should be.\n
\n
\n", "
0
\n", "
3
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-MHV MAMMOGRAM SCREENING", "
ZZ Mammogram Screening
\n", "
2M
\n", "", "
INACTIVE
\n", "
2017-12-27 16:27:46
\n", "
S
\n", "
FEMALE
\n", "", "
NATIONAL
\n", "
VA NATIONAL CENTER FOR HEALTH PROMOTION AND DISEASE PREVENTION (NCP)
\n", "", "
CPR
\n", "
\n
\n\n
\n", "
\nThis reminder is a copy of the national reminder for Mammography that has\nabout specific benefits and harms.\n \n \nThe VA National Center for Health Promotion and Disease Prevention \n(NCP) and the US Preventive Services Task Force (USPSTF) recommend\nthat women age 50-74 have a mammogram every 2 years.  Individual women \nages 40-49 may be added to the cohort of this reminder (be entry of \nhealth factor VA-WH BR CA 40-49 WANTS SCREENING) based on shared decision \nmaking between provider and patient.\n \nbeen simplified for use by patients.\nThis reminder does not apply to women who have terminal cancer or have\nhad a bilateral mastectomy.\n \nEvidence of mammography performed will satisfy this reminder for two \nyears.  Clinicians can specify annual mammography for individual \npatients, based on patient and family history, and discussions with the \npatient. Documented history of breast cancer or high risk will be \nprovided for clinician decision making.\n \nMammograms completed may be documented as one of the following:\n \n    Radiology result\n    Women's Health procedure result\n    Health Factor (Historical outside Mammogram result)\n    PCE CPT procedure \n    Completed consult order\nThe VHA recommends that:\n    * Women between the ages of 50 and 74 have a mammogram every two\n      years\n    * The decision to start regular screening every two years with \nmammography for average risk women ages 40-49 should be an individual \ndecision and take the patient's values into account including values \n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "
\nThis reminder is based on the VHA Clinical Prevetive Service Guidance \nsatisfy this reminder:\n   VA-WH BREAST CARE ORDER HEALTH FACTOR\n        Deleted from patient version.\n \n   VA-WH MAMMOGRAM SCREEN DEFER\n       Use the WH MAMMOGRAM DEFERRED or WH MAMMOGRAM DECLINED health\n       factors distributed with this term or add any local health\n       factor representing that mammogram screening should be satisfied\n       for one week. \n \n   VA-WH MAMMOGRAM SCREEN FREQ - 4M\n    * Results, with interpretation, can be entered and verified in the\n     Deleted from patient version.\n \n   VA-WH MAMMOGRAM SCREEN FREQ - 6M\n     Deleted from patient version.\n \n   VA-WH MAMMOGRAM UNSATISFACTORY IN RAD PKG\n       Mapping is needed.  This term represent Mammogram results \n       documented in the Radiology package.  Map local radiology\n       procedures that represent the following procedures:\n          MAMMOGRAM BILAT\n      Radiology package.  \n          MAMMOGRAM UNILAT\n          MAMMOGRAM SCREEN\n       Each finding should have a condition that checks for\n       unsatisfactory results.\n \nINFORMATION FINDINGS:\n---------------------\nThe following are information reminder terms that are used in\nFunction Findings to alter the baseline Age/Frequency.  If the most\nrecent resolution finding is a documented result, the frequency for\n    * Results, with interpretation, can be manually entered into the WH\nthe next Mammogram screen will be based on these reminder terms.\n \n   VA-WH MAMMOGRAM SCREEN FREQ - 1Y\n       Use the WH MAMMOGRAM SCREEN FREQ - 1Y health factor distributed \n       with this term or add any local health factor that represents a \n       mammogram screening should occur every year.  \n   \n   VA-WH MAMMOGRAM SCREEN FREQ - 2Y\n       Use the WH MAMMOGRAM SCREEN FREQ - 2Y health factor distributed \n       with this term or add any local health factor that represents \n      package.\n       mammogram screening should take place every two years.  \n \n   The following reminder terms are "information only" terms that are not \n   used to alter the frequency, but provide information that may be\n   helpful to the clinician.\n \n   VA-WH HIGH RISK FOR BREAST CANCER\n     Deleted from patient version.\n \n   VA-WH HX BREAST CANCER/ABNORMAL MAM\n    * Summarized results can be entered as a historical entry (health \n     Deleted from patient version.\n \n   VA-WH MAMMOGRAM ORDER\n       Map local orderable items that represent mammogram related\n       orders (e.g., Consult order to Women's Health Clinic).\n       Use the conditions that indicate the order is not completed,\n       discontinued, or cancelled. This reminder term represents orders\n       pending completion.\n \nFUNCTION FINDINGS:\n      factor or CPT code) in the patient record. Historical entries \n------------------\nFrequency for this reminder will be determined using Function Findings \n(FF) logic, which differentiates between completed results, short-term\n(7D, 4M, 6M) and long term (1Y, 2Y) resolution findings.\n \n   FF1\n      Determines whether a mammogram result is the most recent finding \n      and defaults to the baseline frequency of two years. FF5 logic \n      will change the frequency to one year if the VA-WH MAMMOGRAM SCREEN\n      FREQ - 1Y term is found.\n      should be based on reviewed results, not on patient comments.\n   FF2\n     Deleted from patient version.\n   FF3\n     Deleted from patient version.\n   FF4\n     Deleted from patient version.\n   FF5\n      Determines whether a finding exists for VA-WH MAMMOGRAM SCREEN \n      FREQ - 1Y which changes the frequency to annually if the most    \n      recent finding is found in FF1, and FF6 or FF7 do not have more \n \n      recent findings.\n   FF6\n      Determines whether a finding exists for VA-WH MAMMOGRAM SCREEN \n      FREQ - 2Y which changes the frequency to 2Y if the most    \n      recent finding is found in FF1, and FF5 or FF7 do not have more \n      recent findings.\n   FF7\n      Determines whether a finding exists for VA-WH MAMMOGRAM SCREEN \n      NOT INDICATED which changes the frequency to 0D, which will\n      stop the reminder from being due until new activity occurs.\nPATIENT COHORT FINDINGS: \nStatement, Performance measures and US Preventive Services Task Force\n------------------------\nThe following reminder terms determine whether the reminder applies \nto the patient.\n \n   VA-TERMINAL CANCER PATIENT\n       No mapping necessary.  Use the VA-TERMINAL CANCER PATIENTS\n       reminder taxonomy that has been previously distributed.  \n  \n   VA-WH BILATERAL MASTECTOMY\n       This term will use the VA-WH BILATERAL MASTECTOMY taxonomy to\nrecommendations for breast cancer screening.\n       find coded bilateral mastectomies. The health factor WH\n       BILATERAL MASTECTOMY distributed with this term may be used or\n       add any local health factor that represents the patient had a\n       bilateral mastectomy and no longer needs mammogram screening.\n  \nRESOLUTION FINDINGS:\n--------------------\nThe following are reminder terms that resolve the reminder.  These\nresolution terms are defined with a "Use in Resolution Logic", \nbut no Frequency. Frequency for this reminder will be determined using\n \nFunction Findings (FF) logic, which uses these terms to determine \nfrequency. See the Function Finding header below.\n \n   VA-WH MAMMOGRAM SCREEN IN WH PKG\n       No mapping necessary. This term represents mammogram results \n       documented in the Women's Health (WH) Package. The term is \n       mapped to the VA-WH MAMMOGRAM IN WH PKG computed finding which \n       only uses WH findings that are normal or abnormal.\n \n   VA-WH MAMMOGRAM SCREEN IN RAD PKG\nPlease see the description of the national mammogram reminder (VA-WH \n       Mapping is needed.  This term represent Mammogram results \n       documented in the Radiology package.  Map local radiology\n       procedures that represent the following procedures:\n          MAMMOGRAM BILAT\n          MAMMOGRAM UNILAT\n          MAMMOGRAM SCREEN\n       Each finding should have a condition added to exclude \n       unsatisfactory results.\n \n   VA-WH MAMMOGRAM SCREEN DONE\nMAMMOGRAM SCREENING)\n       Some mapping may be appropriate. This reminder term will use the\n       previously distributed VA-MAMMOGRAM/SCREEN taxonomy to find \n       ICD DIAGNOSIS or CPT coded results.\n \n       Use the new WH MAMMOGRAM OUTSIDE health factor to document \n       Mammogram results completed outside the VA when the Mammogram\n       results are not documented in Radiology, Women's Health or \n       Consult packages.\n \n       Map local findings, such as consult orders related to\n \n       Mammogram Screening.  Use appropriate condition logic to\n       indicate Mammogram screening has been completed.\n \n   VA-WH MAMMOGRAM SCREEN NOT INDICATED\n       Use the findings distributed with this reminder term or map any\n       local findings that indicate a Mammogram screen is not indicated\n       for this patient.  \n \n       This term is distributed with mapping to the following \n       health factors:\nIf the mammogram is done in the private sector or at another VAMC \n          INACTIVATE BREAST CANCER SCREEN (distributed with the\n               first version of the Clinical Reminder package in 1996\n               to inactivate the BREAST CANCER reminder).\n          WH MAMMOGRAM SCREEN NOT INDICATED\n          VA LIMITED LIFE EXPECTANCY \n \n       Use in National VA-WH MAMMOGRAM SCREENING reminder:\n       This term is used in WH reminders to inactivate Mammogram \n       screening until a clinician overrides the inactivation by \n       selecting a health factor that is used by function findings\nfacility, there are three ways the results can be documented to \n       with frequencies of 1Y or 2Y.\n \n       Sites may prefer to use local LIMITED LIFE EXPECTANCY health \n       factors and add their health factors to other reminder\n       terms which cause the Mammogram Screening reminder to be\n       due without requiring a clinician to select a finding to \n       reactivate the reminder. (e.g., Add the local life expectancy\n       health factor for "local LIFE EXPECTANCY 1Y" to the VA-WH \n       MAMMOGRAM SCREEN FREQ 1Y term.\n \n
\n
\n", "
(SEX)&(AGE)&'(FI(1)!FI(2))
\n", "
(SEX)&(AGE)&'(FI(1)!FI(2))
\n", "
4
\n", "
SEX;AGE;1;2
\n", "", "
(0)!FI(3)!FI(4)!FI(5)!FI(7)!FI(8)!FI(16)
\n", "
6
\n", "
3;4;5;7;8;16
\n", "
4
\n", "
FF1;FF5;FF6;FF7
\n", "
3
\n", "
11;12;15
\n", "", "", "", "", "
\n
\n\n
\n", "", "
\nMammograms are special x-rays of the breasts. These x-rays can find \nMammograms are not perfect at detecting breast cancer. They may miss small\nbreast cancers.  Also, if there are areas on your mammogram that do not\nlook normal, you may need to get additional tests or pictures taken of\nyour breasts.  These tests often find that the changes are not breast \ncancer. If you have questions about the risks and benefits of getting a\nmammogram, talk with your provider.\nchanges in the breasts that may not be seen or felt. Screening with\nmammograms has been shown to reduce deaths in women due to breast cancer.\nMost women 50-74 years should get a mammogram every 2 years.  If you are\nbetween 40-49, breast cancer screening is a choice that you should be\ninvolved in making, not an automatic recommendation.  Please talk with\nyour provider about the possible benefits and harms of screening as well\nas your preferences.\n \n
\n
\n", "", "
15
\n", "
0
\n", "", "
\nThere is no recent report of a mammogram in your record.  Please contact \nyour primary care team (PACT) to discuss getting this test. If you had a\nrecent mammogram, please tell your primary care team (PACT) at your next\nvisit.\n
\n
\n", "
0
\n", "
4
\n", "
2017-12-27 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-MHV PNEUMOVAX", "
ZZ Pneumonia Vaccine
\n", "", "", "
INACTIVE
\n", "
2017-12-27 16:27:46
\n", "", "", "", "
NATIONAL
\n", "
VA NATIONAL CENTER FOR HEALTH PROMOTION AND DISEASE PREVENTION (NCP)
\n", "", "
CPR
\n", "
\n
\n\n
\n", "", "
\n
\n\n
\n", "
\n
\n\n
\n", "
\n  Reminder due for patients ages 19-64 with certain chronic medical \nVA-PNEUMOCOCCAL IMMUNIZATION PCV13 \nVA-PNEUMOCOCCAL IMMUNIZATION PPSV23\nconditions or high risk diagnosis  and all patients age 65 and older.  \n \n  The reminder is resolved if neither of the 2 national reminder for \npneumococcal vaccination are due.  Since this MHV reminder is dependent \non those 2 reminders for evaluation, the 2 national reminders listed below\nSHOULD NOT BE INACTIVATED.\n \n \n
\n
\n", "", "
(SEX)&(AGE)!FI(3)!FI(4)!FI(7)!FI(8)!FI(9)
\n", "
7
\n", "
SEX;AGE;3;4;7;8;9
\n", "
FI(5)&FI(6)
\n", "
FI(5)&FI(6)
\n", "
2
\n", "
5;6
\n", "
5
\n", "
3;4;7;8;9
\n", "
3
\n", "
1;2;FF1
\n", "", "", "", "", "
\n
\n\n
\n", "", "
\n\\\\\nstream.\n \n    There are two different pneumonia vaccines: POLYSACCHARIDE\n(Pneumovax) and CONJUGATE (Prevnar 13).  Talk with your Primary care\n(PACT) team about whether you should receive one or both of these\nvaccines.    \n \n    You may need a second dose of the Pneumovax vaccine depending on your\nmedical conditions and when you received the first pneumonia vaccine.  If\nyou need a second dose, it is usually administered at least 5 years after\n    There are now two pneumococcal vaccines: Pneumovax and Prevnar 13.  \nthe first dose.  \n \n    Please call your primary care team (PACT) to find out how you can get \nyour pneumonia Vaccine. If you already had a pneumonia vaccine, please\ntell your Primary care team (PACT) which vaccine you had at your next\nvisit.  Please bring a written record from the place that gave you the \nvaccine to your next visit.\n\\\\\nTalk with your health care team to find out if you should receive one or\nboth of these vaccines.\n \n    Many different types of bacteria and viruses can cause pneumonia.  \nPneumococcal vaccines will help to protect you against one of the most \ncommon types of bacteria.  These vaccines help prevent the pneumonia from\nbecoming severe and help to keep the bacteria from going into the blood\n
\n
\n", "", "
27
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2017-12-27 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-PROJECT ARCH VISN CONTRACT CARE PILOT ELIGIBILITY", "
Project ARCH Pilot Eligible
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
VHA OFFICE OF THE ASSISTANT DEPUTY UNDER SECRETARY FOR HEALTH FOR POLICY AND PLANNING
\n", "", "
C*
\n", "
\n
\n\n
\n", "
\nThis reminder definition is used to identify patients who are eligible \nfor the Access Received Closer to Home (ARCH) pilot program. Project ARCH\nis a contract care pilot program designed to improve access to needed\nhealth care through contracted providers that are closer to the Veteran's\nresidence.\n
\n
\n", "
\n
\n\n
\n", "", "", "
FI(1)
\n", "
FI(1)
\n", "
1
\n", "
1
\n", "
FI(4)!FI(6)
\n", "
FI(4)!FI(6)
\n", "
2
\n", "
4;6
\n", "", "", "
3
\n", "
2;3;5
\n", "
RANK_DATE(2+0D)
\n", "
RANK_DATE
\n", "
1
\n", "
\n
\n\n
\n", "", "", "", "
\nThis reminder only applies to patients in VISNs 1, 6, 15, 18, and 19 who \nare determined to be eligible for the Project ARCH contract care pilot \nprogram.  This reminder is not useful outside of the listed VISNs.\n
\n
\n", "
0
\n", "
3
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-MHV BMI > 25.0", "
ZZ Body Mass Index more than 25
\n", "", "", "
INACTIVE
\n", "
2017-12-27 16:27:46
\n", "", "", "", "
NATIONAL
\n", "
VA NATIONAL CENTER FOR HEALTH PROMOTION AND DISEASE PREVENTION (NCP)
\n", "", "
PCR
\n", "
\n
\n\n
\n", "", "
\n
\n\n
\n", "", "", "", "
(SEX)&(AGE)&FI(1)!FI(2)
\n", "
4
\n", "
SEX;AGE;1;2
\n", "", "", "", "", "", "", "", "", "", "", "", "", "
\n
\n\n
\n", "", "
\nThe more excess weight a person carries, the higher the risk of\nhealth  problems. Excess weight leads to heart disease, diabetes,\nhigh blood  pressure, stroke, some forms of cancer, osteoarthritis,\nsleep apnea, lower quality of life, and shorter life expectancy.\nOverweight is measured by the Body Mass Index (BMI), which is a measure of\nweight for height. A BMI of 25 to 29.9 is considered "overweight." Above\n30 is considered "obese." \\\\\n\\\\\n
\n
\n", "", "
8
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2017-12-27 00:00:00
\n", "
\n
\n\n
\n", "
\nThe more excess weight a person carries, the higher the risk of\nhealth  problems. Excess weight leads to heart disease, diabetes,\nhigh blood  pressure, stroke, some forms of cancer, osteoarthritis,\nsleep apnea, lower quality of life, and shorter life expectancy.\nOverweight is measured by the Body Mass Index (BMI), which is a measure of\nweight for height. A BMI of 25 to 29.9 is considered "overweight." More \nthan 30 is considered "obese." \\\\ \\\\\n
\n
\n", "
\nThe more excess weight a person carries, the higher the risk of\nhealth  problems. Excess weight leads to heart disease, diabetes,\nhigh blood  pressure, stroke, some forms of cancer, osteoarthritis, sleep\napnea, lower quality of life, and shorter life expectancy. Overweight is\nmeasured by the Body Mass Index (BMI), which is a measure of weight for\nheight. A BMI of 25 to 29.9 is considered "overweight." More than 30 is\nconsidered "obese." \\\\\n\\\\\n
\n
\n", "
7
\n", "
8
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-HT PERIODIC EVALUATION", "
HT Periodic Evaluation
\n", "
14D
\n", "", "", "", "", "", "", "
NATIONAL
\n", "
VHA OFFICE OF CONNECTED CARE (10P8)
\n", "", "
*
\n", "
\n
\n\n
\n", "
\nThis HT (Home Telehealth) clinical reminder is due every 180 days (OR on a\ndifferent timeframe as determined by the VA facility) on a current\nHT-enrolled Veteran. This reminder is currently set for a frequency of\nevery 180 days.\n \nThis reminder is resolved by completion of the HT PERIODIC EVALUATION\nnote template, via the health factor HT PERIODIC EVALUATION DONE.\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "
\nSite CAC: if your site does not use 180 days as the frequency of this \nrecurrent reminder, then change the baseline frequency of this reminder \nto what it should be for your site (e.g., 90 days, or 120 days) using \nVISTA option [PXRM HT DEFINITION EDIT] "Edit Reminder Definition \nFrequency".\n
\n
\n", "
FI(1)&FF(3)
\n", "
FI(1)&FF(3)
\n", "
2
\n", "
1;FF3
\n", "
(FI(1)&FF(4))!(FI(3)&FF(5))
\n", "
(FI(1)&FF(4))!(FI(3)&FF(5))
\n", "
4
\n", "
1;FF4;3;FF5
\n", "", "", "
4
\n", "
2;5;FF1;FF2
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-*HYPERTENSION SCREEN", "
ZZ Hypertension Detection
\n", "
3M
\n", "
ZZVA-*HYPERTENSION SCREEN
\n", "
INACTIVE
\n", "
2005-03-11 12:42:50
\n", "", "", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nBP due every two years to detect hypertension. \n \n    Recommendation: Check blood pressure at least once every two years\n    for all Primary Care clinic patients.\n \n    Goal for FY2000: 90% of Primary Care clinic patients have had their\n    blood pressure checked in the past two years.\n \nThis VA-*HYPERTENSION SCREEN reminder is defined based on the following\n"Hypertension Detection" guidelines specified in the VHA HANDBOOK 1101.8,\nAPPENDIX A.\n \n    Target Condition: Hypertension, Cardiovascular Disease\n \n    Target Group: General outpatient population\n
\n
\n", "
\n
\n\n
\n", "", "
\nIf this reminder is not going to be used at your facility, the INACTIVE\nThe Ambulatory Care EP recommends a variation on this reminder\nrepresented in the "VA-BLOOD PRESSURE CHECK" reminder.  This reminder\nincludes an alteration of the blood pressure reminder guidelines when the\npatient has a history of hypertension on file.\n \nPlease review both of these reminder definitions, choose one of them to\nuse.  If local modifications need to be made, copy the preferred reminder\nto a new reminder and make your reminder modifications.\nFLAG should be set to inactive.\n \nThis reminder represents the minimum criteria for checking if the patient\nhas received a blood pressure check.  As distributed, the reminder checks\nfor an ICD Diagnosis or a CPT procedure code representing "Hypertension\nScreen", or a record of a blood pressure (BP) in the Vitals/Measurements\npackage.\n \n
\n
\n", "", "
(SEX)&(AGE)
\n", "
2
\n", "
SEX;AGE
\n", "", "
(0)!FI(1)!FI(2)
\n", "
2
\n", "
1;2
\n", "
1
\n", "
2
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-HT CAREGIVER RISK ASSESSMENT", "
HT Caregiver Risk Assessment
\n", "", "", "", "
2008-08-14 12:54:11
\n", "", "", "", "
NATIONAL
\n", "
VHA OFFICE OF CONNECTED CARE (10P8)
\n", "", "
*
\n", "
\n
\n\n
\n", "
\nThis HT (Home Telehealth) clinical reminder is triggered when the Veteran\nhas an unpaid caregiver (Health Factor HT CCF UNPAID CAREGIVER-YES), and\nthe reminder is resolved by completing the template.\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "
FI(1)&FF(2)&'FF(3)
\n", "
FI(1)&FF(2)&'FF(3)
\n", "
3
\n", "
1;FF2;FF3
\n", "
(FI(4)!FI(2))&FF(1)
\n", "
(FI(4)!FI(2))&FF(1)
\n", "
3
\n", "
4;2;FF1
\n", "", "", "
2
\n", "
3;6
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-HT CONTINUUM OF CARE (INITIAL)", "
HT Continuum of Care (Initial)
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
VHA OFFICE OF CONNECTED CARE (10P8)
\n", "", "
*
\n", "
\n
\n\n
\n", "
\nThis is the trigger to do the HT (Home Telehealth) Continuum of Care form\ninitially on a patient with a new HT enrollment start date.\n \nThis reminder is resolved with completing the HT Continuum of Care \nreminder dialog.\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "
FI(1)&FF(1)&FF(8)
\n", "
FI(1)&FF(1)&FF(8)
\n", "
3
\n", "
1;FF1;FF8
\n", "
FI(2)&FF(5)
\n", "
FI(2)&FF(5)
\n", "
2
\n", "
2;FF5
\n", "", "", "
9
\n", "
5;6;7;8;9;FF3;FF4;FF6;FF7
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-BL OEF/OIF COHORT", "
VA-BL OEF/OIF COHORT
\n", "", "", "", "", "", "", "", "
LOCAL
\n", "", "", "
R
\n", "
\n
\n\n
\n", "", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "
((FI(2)!FI(4))&'FF(1))!(FI(3)&FF(20))&'FI(1)
\n", "
((FI(2)!FI(4))&'FF(1))!(FI(3)&FF(20))&'FI(1)
\n", "
6
\n", "
2;4;FF1;3;FF20;1
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-IRAQ & AFGHAN POST-DEPLOY SCREEN", "
Iraq&Afghan Post-Deployment Screen
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
OFFICE OF PUBLIC HEALTH AND ENVIRONMENTAL HAZARDS
\n", "", "
CR
\n", "
\n
\n\n
\n", "
\nPatients who served in combat in either Operation Iraqi Freedom (Iraq, \npart of the reminder term: VA-IRAQ/AFGHAN PERIOD OF SERVICE and is \ndetermined by a computed finding.\n \nAn additional reminder term VA-ACTIVE DUTY is also available to cause \npatients to be part of the cohort.  If a site wishes to screen active \nduty patients then the computed finding for VA-PATIENT TYPE should be \nadded to the term with a condition of I V="ACTIVE DUTY".\n \nPatients who have OEF/OIF service as recorded in the patient registration \ndata are automatically part of the cohort and patients who did not serve\nKuwait, Saudi Arabia, Turkey) or in Operation Enduring Freedom\nin OEF/OIF are not included in the denominator.\n \nRESOLUTION: entry of a health factor for NO IRAQ/AFGHAN SERVICE which is\nfound in the reminder term IRAQ/AFGHAN SERVICE NO will resolve the \nreminder only if the patient does not have an entry of OEF/OIF service in \nthe patient file.\nIf the Veteran is known to have OEF/OIF service, based on the \nregistration data then the location of service is not required.\n \nIf the veteran served in Iraq or Afghanistan as recorded in the\n(Afghanistan, Georgia, Kyrgyzstan, Pakistan, Tajikistan, Uzbekistan, The\npatient registration data (File 1), then the patient must be screened or\nthe registration data must be updated.\n \nFor all applicable patients who are not cognitively impaired: \nall the other items are required to resolve the reminder\nand must be completed after the date of the most recent service \nseparation:\n  a) screen for PTSD, \n  b) screen for depression, \n  c) screen for alcohol use,\nPhilippines) should be screened for illnesses related to their service.  \n  d) all 3 screening questions related to infectious diseases.\n   (The 4th question for embedded fragments is new as of the summer of \n2008 and because of this, cannot be required at this time by the reminder \nlogic).\n \nThe clinical maintenance will display information on which portions of \nthe screen are not yet completed.\n \nAll of the individual elements of the screening tool are exported with\nattached health factors and reminder terms.\nScreening for PTSD, depression, problem alcohol use, infectious diseases,\n \nPTSD, depression and alcohol screening must be recorded in the MH package \nand the dialog for this rmeinder requires use of the MH instruments for \nthese screens.  Screens done prior to 10/1/08 using health factors will \nstill resolve the reminder since those health factors are in the reminder \nterms that are part of the logic in this reminder.\n \nThe HFs for all of these screens should be entered in the site parameters\nas ones that cannot be added outside of a reminder dialog.  Use the\nparameter ORWPCE EXCLUDE HEALTH FACTORS to exclude these from the\nand embedded fragments should be part of the initial evaluation of these\nelectronic encounter forms.  Entry of these health factors should ONLY \noccur during reminder dialog use.\n \nUpdate October 2008 - patch PXRM*2*11\n1. Health factors for PTSD screening, depression screening and alcohol \nscreening are not allowed after 10/1/08 per the Office of Mental Health.\n2. A HF for done elsewhere is included.\n3. Combat vets need to be screened\n4. The computed finding was rmeoved from the reminder term for VA-ACTIVE \nDUTY since only a few sites screen active duty patients and patch 11 \nVeterans.\nrequired an overwrite of this term.\n5. Add embedded fragments question and remove other symptoms.\n \nUpdate January 2009 - patch PXRM*2*12\n1. Change combat vet screening requirement to OEF/OIF service based on \nrecent data that these fields are more accurate.\n2. Fix problem that active duty patients who did not serve in OEF/OIF \nhave reminder continue to show as due.\n3. Refusals of screening must be done after the most recent service \nseparation.\n \nCOHORT: veterans with separation date after 9/11/01.  This finding is \n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "
((FI(2)!FI(19))&'FF(1))!(FI(3)&FF(20))&'FI(21)
\n", "
((FI(2)!FI(19))&'FF(1))!(FI(3)&FF(20))&'FI(21)
\n", "
6
\n", "
2;19;FF1;3;FF20;21
\n", "
((FI(16)&FF(16))!(FF(2)&(FI(16)!FI(7)!(FI(12)&FI(13)&FI(14)&FI(15)))))&(((FF(3)&FI(4))!(FI(18)&FF(18))))&((FF(4)&FI(6))!(FI(17)&FF(17)))&((FI(20)&FF(5))!(FF(5)&FI(10)&FF(6)&FI(8)&FF(7)&FI(11)))!(FI(22)&FF(10))
\n", "
((FI(16)&FF(16))!(FF(2)&(FI(16)!FI(7)!(FI(12)&FI(13)&FI(14)&FI(15)))))&(((FF(3)&FI(4))!(FI(18)&FF(18))))&((FF(4)&FI(6))!(FI(17)&FF(17)))&((FI(20)&FF(5))!(FF(5)&FI(10)&FF(6)&FI(8)&FF(7)&FI(11)))!(FI(22)&FF(10))
\n", "
27
\n", "
16;FF16;FF2;16;7;12;13;14;15;FF3;4;18;FF18;FF4;6;17;FF17;20;FF5;FF5;10;FF6;8;FF7;11;22;FF10
\n", "", "", "
6
\n", "
1;5;9;23;FF8;FF9
\n", "", "", "", "", "
\n
\n\n
\n", "", "
\nPatients who served in combat in either Iraq (Operation Iraqi Freedom) or \nin Afghanistan (Operation Enduring Freedom) should be screened for \nillnesses related to their service.  Screening for PTSD, depression, \nproblem alcohol use, infectious diseases, and chronic symptoms should be\npart of the initial evaluation of these Veterans.\n
\n
\n", "", "
5
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-*COLORECTAL CANCER SCREEN (FOBT)", "
ZZ Fecal Occult Blood Test
\n", "
1M
\n", "
ZZVA-*COLORECTAL CANCER SCREEN (FOBT)
\n", "
INACTIVE
\n", "
2005-03-11 12:42:50
\n", "", "", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nFecal occult blood test due every year for patients ages 50 and older, or\n    Target Condition: Early detection of colon cancer or its predecessors.\n \n    Target Group: All persons ages 50 and older.\n \n    Recommendation: All persons age 50 and older should receive an annual\n    fecal occult blood test or undergo a sigmoidoscopy examination\n    (periodicity unspecified).\n \n    Goals for FY 2000: For persons age 50 and older: 50 percent of those\n    enrolled in primary care clinics have received fecal occult blood\n5 years after the last Sigmoidoscopy.  The 5 years is a conservative\n    testing within the preceding year and 40 percent have received at\n    least one proctosigmoidoscopy examination in their lifetime.\nperiod recommended by a blue ribbon panel publishing their findings in the\nFebruary 1997 issue of "Gastroenterology" magazine. \n  \nThis VA-*COLORECTAL CANCER SCREEN - FOBT reminder is based on the\n"Colorectal Cancer Detection" guidelines specified in the VHA HANDBOOK\n1101.8, APPENDIX A.\n \n
\n
\n", "
\n
\n\n
\n", "", "
\nThis reminder is based on Taxonomy Findings from FOBT, "or" SIG cancer\nto due every 5 years for patients 50 and older (note the rank of 2). After\na SIG has been received by the patient, if the clinician determines the\nFOBT should be given to this patient again annually, the FOBT can be\nactivated again by entering the Health Factor "ACTIVATE FOBT CANCER\nSCREEN" for the patient (Note the rank of 1).\n \nCheck the Taxonomy Findings entries representing Fecal Occult Blood Test\nand VA-FLEXISIGMOIDOSCOPY. The taxonomies represent coded standard entries\nin the CPT file and ICD Operation/Procedure file.  If one of these\ntaxonomies need modification, copy the taxonomy to a new taxonomy for your\nscreening, "and" FOBT exam results recorded from a clinic encounter as\nsite, and make the appropriate modifications. THAN, copy the reminder to a\nnew reminder to add your local sites modifications.\n \nThis reminder cannot make use of the Laboratory package data at this time\nbecause the Occult Blood results are Microbiology tests that do not\nreflect the Laboratory Test done, or the related CPT code.\nan EXAM. See the definition for VA-*COLORECTAL CANCER SCREEN (SIG.)\nalso. These two reminders work together for assessing cancer screening. \n \nThe FOBT is due annually, unless a SIG is found. The SIG found changes the\nfrequency to due once in a lifetime (99Y) according to the M-2 document,\nbut a more conservative approach is encouraged by the National Center for\nHealth Promotion to use 5 years (5Y).  The SIG found changes the frequency\n
\n
\n", "", "
(SEX)&(AGE)&'FI(5)
\n", "
3
\n", "
SEX;AGE;5
\n", "", "
(0)!FI(1)!FI(2)!FI(3)
\n", "
3
\n", "
1;2;3
\n", "
2
\n", "
3;6
\n", "
1
\n", "
4
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-VANOD SKIN REASSESSMENT", "
VANOD SKIN REASSESSMENT
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "", "", "
R
\n", "
\n
\n\n
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-VANOD SKIN ASSESSMENT", "
VANOD SKIN ASSESSMENT
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "", "", "", "
\n
\n\n
\n", "", "", "", "", "", "
(SEX)&(AGE)
\n", "
2
\n", "
SEX;AGE
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-HT OBJ EMERGENCY PRIORITY RATING LAST", "
Emergency Priority Rating (last)
\n", "", "", "", "
2012-05-25 14:39:40
\n", "", "", "", "
NATIONAL
\n", "
VHA OFFICE OF CONNECTED CARE (10P8)
\n", "", "
R
\n", "
\n
\n\n
\n", "
\nThis reminder definition is used in HT (Home Telehealth) templates for the\nHT EMERGENCY PRIORITY RATING (LAST) data object.\n
\n
\n", "
\n
\n\n
\n", "", "", "", "
(SEX)&(AGE)&FI(1)
\n", "
3
\n", "
SEX;AGE;1
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-HOMELESSNESS SCREENING", "
Homelessness Screening
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
HOMELESSNESS OFFICE
\n", "", "
*
\n", "
\n
\n\n
\n", "
\nThe Secretary of the Department of Veterans Affairs has made it a \nwill guide staff to refer Veterans for further assessment and the\nappropriate intervention to prevent or quickly end homelessness.\npriority to eliminate homelessness in our Veteran population.\n \nThe objective of the VA-Homelessness Screening Clinical Reminder is to: \n(a) identify Veterans and their families who are at imminent risk of \nhomelessness or who have very recently become homeless; (b) ensure that \nthose who are at-risk or who are currently homeless are referred for the\nappropriate assistance; and (c) update the current living situation for\nVeterans. Information collected by the VA-Homelessness Screening reminder\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "
\nThe reminder applies to all Veterans, EXCEPT any Veteran where one of\n3. Those that have had a Progress Note written with a SPECIFIC Title (that\nis already entered into the logic of the Computed Finding [VA-PROGRESS\nNOTE]) by a provider in a NON-Homelessness Stop Code clinic, who provided\nthose services.\n \nEntering a Beginning Date/Time of T-6M on that Reminder Term is a logic\ntrick to ensure that only visits in those locations, or the Specific\nHealth Factor, or the specific Progress Note Title IN THE PAST 6 MONTHS\nare evaluated.\n \nthe following findings in the Reminder Term (Finding #1) apply: \nThis reminder's frequency is set to 1 year, but this required somewhat\ncomplex resolution logic so that various findings and conditions resolve\nthe reminder for different time frames.\n \nNegative Screens result in resolution for 6 Months. This was accomplished \nby creating a Function Finding - FF(#1), that sets the frequency.\n \n ---- Begin: FF(1) ----------------------------------------------\n              Function String: MAX_DATE(3,5)'<MAX_DATE(2,4) \n     Expanded Function String: \n1. Those who have had a visit in one of the specific Stop Code Clinics\n      MAX_DATE(POSITIVE - HAS WORRIES ABOUT HOUSING, \n      POSITIVE - HAS NO STABLE HOUSING)'<MAX_DATE(\n      NEGATIVE - HAS STABLE HOUSING,NEGATIVE - HAS NO HOUSING CONCERNS)\n          Match Frequency/Age: 6 months for all ages \n                   Found Text: Positive Screen more recent than Negative\n                   Screen. Frequency changed to 6M.\n ---- End: FF(1) ----------------------------------------------\n \nFinding #9 - NURSING HOME RESIDENT - resolves the reminder for 2 years \n(Frequency set on that finding, but Beginning Date/Time set to T-2Y, so \n(Homelessness-related) listed in the Reminder Location List ; or \nthat after 2 years, the finding no longer applies, and normal frequency \n(1Y) applies), until and if that living arrangement is documented again.\n \nFindings #2 & #4 - NEGATIVE - HAS STABLE HOUSING and NEGATIVE - HAS NO \nHOUSING CONCERNS - are BOTH Required for Negative Screen. If BOTH are\nfound, the reminder is resolved for 1 year, but if 3 consecutive screens\nare negative, and the Computed Finding that looks at the Reminder\nDefinition VA-HOMELESSNESS FREQUENCY 2Y is evaluated as TRUE, it is\nresolved for 2 years.\n \n \nA Positive Screen (Finding #5 - POSITIVE - HAS NO STABLE HOUSING; or\nFinding #3 -POSITIVE - HAS WORRIES ABOUT HOUSING ) resolves for 6 months,\nas does documenting UNABLE TO PERFORM HOMELESS SCREEN (Finding #7).\n \nFinding #6 (Declines Homeless Screen) Resolves for 1 year.\n                                 \nCustomized RESOLUTION LOGIC defines findings that resolve the Reminder:\n FI(9)!(FI(2)&FI(4))!FI(6)!FI(3)!FI(5)!FI(7)\n \nExpanded Resolution Logic:\n2. Those who have had the Health Factor, ALREADY RECEIVING ASSIST WITH\n FI(NURSING HOME RESIDENT)!(FI(NEGATIVE - HAS STABLE HOUSING)&\n FI(NEGATIVE - HAS NO HOUSING CONCERNS))!FI(DECLINES HOMELESS SCREEN)!\n FI(POSITIVE - HAS WORRIES ABOUT HOUSING)!\n FI(POSITIVE - HAS NO STABLE HOUSING)!\n FI(UNABLE TO PERFORM HOMELESS SCREEN)\nHOUSING entered into a visit by using the corresponding option in the\ndialog; or \n \n
\n
\n", "", "
(SEX)&(AGE)&'FI(1)
\n", "
3
\n", "
SEX;AGE;1
\n", "
FI(9)!(FI(2)&FI(4))!FI(6)!FI(3)!FI(5)!FI(7)
\n", "
FI(9)!(FI(2)&FI(4))!FI(6)!FI(3)!FI(5)!FI(7)
\n", "
7
\n", "
9;2;4;6;3;5;7
\n", "
3
\n", "
9;10;FF1
\n", "", "", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-HOMELESSNESS FREQUENCY 2Y", "
Homelessness Frequency 2y
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
HOMELESSNESS OFFICE
\n", "", "
R
\n", "
\n
\n\n
\n", "
\nThis Reminder Definition was created for the sole purpose of setting a \nnew Frequency of every 2 years for Homelessness Screening, IF the Veteran \nhas had 3 consecutive NEGATIVE SCREENS. It required 6 Function Findings \nto do so, (comparing dates of three negative, versus any positive \nscreens). The MUMPS string would have been in excess of 255 characters in \nthe Customized Patient Resolution Logic - not allowed in MUMPS fields.\nSo, this alternative was developed. All the Function Findings are found in\nthis Reminder Definition, which is then entered as a Computed Finding in \nthe main Reminder Definition (VA-HOMELESSNESS SCREENING).\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "
\nThe frequency of the main reminder (VA-HOMELESSNESS SCREENING) is set to 1\nand more recent than any positive Health Factor finding. \n \nFinding #2 (Current Stable Housing) and Finding #4 (No concerns about\nhousing in the near future) are required for a NEGATIVE Screen, which \nresolves for 1 year. If three consecutive screens are negative, the \nreminder will be resolved for 2 years - using the complex number of \nFunction Findings - the sole reason for this Reminder Definition.\n \nFunction Finding 1 looks for 3 negative screens.\n \nyear, but somewhat complex resolution logic was necessary, so that various\nFunction Findings #2 - #6 ensure that the NEGATIVE Screens are both \nconsecutive and more recent than any negative screen.\n \n  ---- Begin:\nFF(1)--------------------------------------------------------- \n               Function String: (COUNT(2)>2)&(COUNT(4)>2) \n      Expanded Function String: \n       (COUNT(NEGATIVE - HAS STABLE HOUSING)>2)&(COUNT( \n       NEGATIVE - HAS NO HOUSING CONCERNS)>2) \n           Match Frequency/Age: 2 years for all ages \nfindings and conditions resolve the reminder for different time frames.\n       Use in Resolution Logic: OR \n                    Found Text: The last three (3) screens were negative -\n                                homelessness screening now set to every 2\n                                years. \n---- End: FF(1)\n----------------------------------------------------------\n \n  ---- Begin: \nFF(2)--------------------------------------------------------- \n               Function String: DTIME_DIFF(2,3,"DATE",3,1,"DATE","D")>0 \n \n      Expanded Function String: \n       DTIME_DIFF(NEGATIVE - HAS STABLE HOUSING,3,"DATE", \n       POSITIVE - HAS WORRIES ABOUT HOUSING,1,"DATE","D")>0 \n  ---- End: FF(2) \n---------------------------------------------------------- \n  \n  \n  ---- Begin: \nFF(3)--------------------------------------------------------- \n               Function String: DTIME_DIFF(4,3,"DATE",3,1,"DATE","D")>0 \nFunction Finding #1 was used to ensure that if the Veteran screened \n      Expanded Function String: \n       DTIME_DIFF(NEGATIVE - HAS NO HOUSING CONCERNS,3,"DATE", \n       POSITIVE - HAS WORRIES ABOUT HOUSING,1,"DATE","D")>0 \n  ---- End: FF(3) \n---------------------------------------------------------- \n  \n  \n  ---- Begin: \nFF(4)--------------------------------------------------------- \n               Function String: DTIME_DIFF(4,3,"DATE",5,1,"DATE","D")>0 \nnegative 3 times, the reminder frequency is changed to 2 years instead of\n      Expanded Function String: \n       DTIME_DIFF(NEGATIVE - HAS NO HOUSING CONCERNS,3,"DATE", \n       POSITIVE - HAS NO STABLE HOUSING,1,"DATE","D")>0 \n  ---- End: FF(4) \n---------------------------------------------------------- \n  \n  \n  ---- Begin: \nFF(5)--------------------------------------------------------- \n               Function String: DTIME_DIFF(2,3,"DATE",5,1,"DATE","D")>0 \nannually. But several more Function Findings (comparing the dates of the\n      Expanded Function String: \n       DTIME_DIFF(NEGATIVE - HAS STABLE HOUSING,3,"DATE", \n       POSITIVE - HAS NO STABLE HOUSING,1,"DATE","D")>0 \n  ---- End: FF(5) \n---------------------------------------------------------- \n  \n  \n  ---- Begin: \nFF(6)--------------------------------------------------------- \n               Function String: (COUNT(3)=0)&(COUNT(5)=0) \nvarious occurrences of negative and positive screening Health Factors) was\n      Expanded Function String: \n       (COUNT(POSITIVE - HAS WORRIES ABOUT HOUSING)=0)&(COUNT( \n       POSITIVE - HAS NO STABLE HOUSING)=0) \n  ---- End: FF(6) \n---------------------------------------------------------- \n \nWith no resolution logic set on this Reminder Definition, it serves as a\nmeans for resolving the main reminder (VA-HOMELESSNESS SCREENING) for 2\nyears . If this reminder evaluates as TRUE, then the main reminder is\nresolved for 2 years, because the CF has a Match Frequency/Age of 2 years.\nnecessary to ensure that the three negative screens were both consecutive,\n
\n
\n", "
(FF(1)&FF(2)&FF(3)&FF(4)&FF(5))!(FF(1)&FF(6))
\n", "
(FF(1)&FF(2)&FF(3)&FF(4)&FF(5))!(FF(1)&FF(6))
\n", "
7
\n", "
FF1;FF2;FF3;FF4;FF5;FF1;FF6
\n", "", "", "", "", "", "", "
4
\n", "
2;3;4;5
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-BL ALCOHOL WITHIN SAFE LIMIT", "
MIGHT DRINK IN SAFE LIMIT
\n", "", "", "", "", "", "
MALE
\n", "", "
NATIONAL
\n", "
OFFICE OF PATIENT CARE SERVICES
\n", "", "
R
\n", "
\n
\n\n
\n", "
\nThis reminder is used for branching logic in the VA-ALCOHOL AUDIT-C \nPOSITIVE F/U EVAL reminder to determine if the patient might be drinking \nwithin safe limits. \n \nSome patients with an AUDIT-C of 5 can still be drinking within safe \nlimits and so these patients should be asked specifically if they drink \nwithin safe limits.  This reminder is DUE NOW for those patients and the \nquestion is presented in the reminder dialog.\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "
(SEX)&(FI(1)!FF(1))
\n", "
(SEX)&(FI(1)!FF(1))
\n", "
3
\n", "
SEX;1;FF1
\n", "", "", "", "", "", "", "
3
\n", "
2;3;4
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-OB PNEUMOCOCCAL PCV13 INDICATIONS", "
Diagnoses and Medications
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "", "", "
R
\n", "
\n
\n\n
\n", "", "
\n
\n\n
\n", "", "", "", "
(SEX)&(AGE)&FI(1)!FI(2)!FI(3)!FI(4)!FI(5)
\n", "
7
\n", "
SEX;AGE;1;2;3;4;5
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "
\nNo indication for PCV13 found.\n
\n
\n", "
0
\n", "
1
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-*CHOLESTEROL SCREEN (F)", "
ZZ Cholesterol Screen (Female)
\n", "
3M
\n", "
ZZVA-*CHOLESTEROL SCREEN (F)
\n", "
INACTIVE
\n", "
2005-03-11 12:42:50
\n", "
S
\n", "
FEMALE
\n", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nThis Cholesterol screen reminder for females is based on the following\n    five years.\n \n    Goal for FY 2000: 75% of females ages 45-65 Primary Care clinic\n    patients have had a blood cholesterol level check within the past\n    five years.\n"Hyperlipidemia Detection" guidelines specified in the "VHA HANDBOOK\n1101.8, APPENDIX A.\n \n    Target Conditions: Cardiovascular Disease.\n \n    Target Group: Females 45-65.\n \n    Recommendation: Check total cholesterol level within the past\n
\n
\n", "
\n
\n\n
\n", "", "
\nAs distributed, this reminder is based on CPT codes which represent\n \nPLEASE NOTE: Your local version of this reminder will include the search\nbased on the local ancillary Lab package results, it is possible that 5\nyears worth of patient lab history are not on record.\ncholesterol tests the patient has had documented in PCE.  These may be CPT\ncodes for cholesterol done by the Laboratory Service, or a historical\nencounter documented to show when the cholesterol test was last given to\nthe patient.\n \nCopy this reminder to a new reminder for your site. Add the Laboratory\nTests that represent a cholesterol level check in the Result Findings\nmultiple.\n
\n
\n", "", "
(SEX)&(AGE)&'FI(2)
\n", "
3
\n", "
SEX;AGE;2
\n", "", "
(0)!FI(1)
\n", "
1
\n", "
1
\n", "
1
\n", "
2
\n", "
1
\n", "
3
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-IHD LIPID PROFILE", "
IHD Lipid Profile
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
OFFICE OF QUALITY & PERFORMANCE
\n", "", "
*
\n", "
\n
\n\n
\n", "
\nThe VHA/DOD Clinical Practice Guideline for Management of Dyslipidemia \napplicable to the patient.  \n \nA completed LDL lab test (calculated LDL or direct LDL) or documented\noutside LDL satisfies the reminder for 12 months.\n \nA documented order lipid profile health factor satisfies the reminder for\n1 month.\n \nA patient's refusal to have an LDL level drawn satisfies the reminder\nfor 6 months.\nrecommends that patients with Ischemic Heart Disease have a lipid \n \nDeferring the lipid profile for other reasons satisfies the reminder for\n6 months.\nprofile/LDL every one to two years; and that patients taking lipid \nlowering medications have a lipid profile/LDL at least every year.\n \nThis national reminder identifies patients with known IHD (i.e., a \ndocumented ICD-9 code for IHD on or after 10/01/99) who have not had a\nserum lipid panel within the last year. If a more recent record\nof an UNCONFIRMED IHD DIAGNOSIS is found, the reminder will not be\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "
\nThis reminder is recommended for use by clinicians at Primary Care Clinics\n   IHD DIAGNOSIS\n   the clinician finds in a patient's record.  If your site has this\n   method in place, copy the reminder dialog to a local reminder \n   dialog and then add the local dialog element for the consult order\n   to the reminder dialog so this practice can continue.\n                No mapping necessary.  Use the VA-ISCHEMIC HEART DISEASE \n                reminder taxonomy distributed with this term.\n \n   UNCONFIRMED IHD DIAGNOSIS\n                Use the UNCONFIRMED IHD DIAGNOSIS health factor\n                distributed with this term or add any local health\n                factor representing an unconfirmed or incorrect IHD\n                diagnosis.\n \n(Primary Care/Medicine, GIMC, Geriatric, Women's), Cardiology, Cholesterol\n   LDL          Enter the Laboratory Test names from the Lab Package \n                for calculated LDL and direct LDL with "I +V>0" in \n                the CONDITION field.\n \n   For the following OUTSIDE LDL Reminder Terms, use the health factors\n   distributed with the reminder term or enter the local Health Factor\n   used to represent these values.\n     OUTSIDE LDL <100\n     OUTSIDE LDL 100-119\n     OUTSIDE LDL 120-129\nScreening and any other specialty clinics where primary care is given.\n     OUTSIDE LDL >129 \n \n   ORDER LIPID PROFILE HEALTH FACTOR\n                Use the health factor distributed with this term or add\n                any local health factor representing the order action. \n                Do not add orderable items to this reminder term (see\n                LIPID PROFILE ORDERABLE).  This represents the date the\n                order was placed, not the date the order will be done in\n                the future.  The order placement will cause the reminder \n                to be resolved for 1 month.  (Alternatively, copy this\n \n                reminder and add LIPID PROFILE ORDERABLE to the \n                resolution findings if you want the next due date to be\n                calculated based on the future date the order is to be \n                done.)\n \n   LIPID PROFILE ORDERABLE\n                Enter orderable items for lipid panels that include LDL\n                tests (calculated LDL and direct LDL).\n                The orderable items are informational findings for\n                this reminder. The order will not resolve the reminder,\nSetup issues before using this reminder:\n                but it will display in the clinical maintenance.  \n                Ideally, the clinician will look at the clinical\n                maintenance display to avoid entering duplicate orders.\n                This reminder term is not used in the resolution logic\n                since the future order could be for a long distance in \n                the future. (Copy this reminder and add LIPID PROFILE\n                ORDERABLE to the resolution findings if you want the\n                next due date to be calculated based on the future date\n                the order is to be done.)\n \n \n   OTHER DEFER LIPID PROFILE\n                Enter any local health factors or other findings that \n                should defer the reminder for 6 months.  For example, \n                "LIFE EXPECTANCY < 6M".\n \n   REFUSED LIPID PROFILE\n                Use the health factor distributed with this term or add\n                any local health factor representing refusal of lipid \n                profile test.\n \n 1. Use the Reminder Term options to map local representations of\n   LIPID LOWERING MEDS\n                Enter the formulary drug names for investigation drugs.\n                Mapping non-investigative formulary drugs to the\n                VA-GENERIC drugs will ensure the lipid lowering \n                medications are found. The medications are informational \n                findings for this reminder.\n \n2. Use the Reminder Dialog edit option to define the national reminder\n   dialog finding items which should be updated during CPRS GUI reminder\n   processing.\n    findings:\n \n   Add local Order Dialog entries to the Dialog elements used for\n   ordering a calculated LDL and/or direct LDL.\n \n   Review dialog elements in the national reminder dialog and change any \n   national health factors to local health factors, if necessary.  It is \n   not unusual for local findings to be used in your national dialogs.\n   Any local findings used in the national dialogs should be mapped to \n   the appropriate national reminder term.\n \n \n3. Alternatively, use the Reminder Dialog options to copy the national\n   dialog, dialog elements, and dialog groups to make local changes.\n \n   If your site has a Lipid Panel TIU Object, add this TIU Object to the \n   local dialog element header text.  The TIU Object should include Chol,\n   Trigly, HDL, LDL-C, Direct LDL values and dates.\n \n   Add local dialog elements with local Order Dialogs for additional      \n   ordering options for the clinicians. Some sites have clinicians \n   order a consult to a service that corrects unconfirmed diagnoses\n
\n
\n", "
FI(1)&FF(1)
\n", "
FI(1)&FF(1)
\n", "
2
\n", "
1;FF1
\n", "", "
(0)!FI(2)!FI(3)!FI(4)!FI(5)!FI(6)!FI(7)!FI(8)!FI(9)
\n", "
8
\n", "
2;3;4;5;6;7;8;9
\n", "", "", "
3
\n", "
10;12;14
\n", "", "", "", "", "
\n
\n\n
\n", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-OB PNEUMOCOCCAL PPSV23 INDICATIONS", "
Diagnoses and Medications
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
VA NATIONAL CENTER FOR HEALTH PROMOTION AND DISEASE PREVENTION (NCP)
\n", "", "
R
\n", "
\n
\n\n
\n", "", "
\n
\n\n
\n", "", "", "", "
(SEX)&(AGE)&FI(1)!FI(2)!FI(3)!FI(4)!FI(5)
\n", "
7
\n", "
SEX;AGE;1;2;3;4;5
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "
\nNo indication for PPSV23 found.\n
\n
\n", "
0
\n", "
1
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-BL PNEUMOC RECENT CHEMO/IMMUNOSUPPRESSION", "
Chemotherapy/Immunosuppressive Drug
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "", "", "
R
\n", "
\n
\n\n
\n", "
\nDue if Chemotherapy drug on file in the past 30 days (active supply of \ndrug in the past 30 days), or an ICD code for chemotherapy in the past 60 \ndays or if the reminder looking for long term steroids is due.\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "
(FI(1)&(FF(1)!FF(2)))!FI(2)!FI(3)
\n", "
(FI(1)&(FF(1)!FF(2)))!FI(2)!FI(3)
\n", "
5
\n", "
1;FF1;FF2;2;3
\n", "", "", "", "", "", "", "
2
\n", "
FF3;FF4
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-IHD ELEVATED LDL", "
IHD Elevated LDL
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
OFFICE OF QUALITY & PERFORMANCE
\n", "", "
*
\n", "
\n
\n\n
\n", "
\nThe VHA/DOD Clinical Practice Guideline for Management of Dyslipidemia \nIf a more recent record of an UNCONFIRMED IHD DIAGNOSIS is found, the \nreminder will not be applicable to the patient.\n \nDocumenting an outside LDL <120 mg/dl satisfies the reminder for 12 \nmonths from the lab test date.\n \nOrdering initial lipid lowering medications or adjusting current lipid \nlowering medications satisfies the reminder for 2 months. (This is \ntracked by Health Factors, not the order.)\n \nrecommends an LDL goal of <120 mg/dl for patients with Ischemic Heart \nA patient's refusal of lipid lowering therapy satisfies the reminder\nfor 6 months.\n \nDocumenting that no treatment change is needed based on patient's current\nclinical status, that lipid management is provided by another VA or non-VA\nfacility, or deferring lipid treatment for other reasons satisfies the\nreminder for 6 months.\n \nDocumenting that lipid lowering medications are contraindicated satisfies \nthe reminder for 12 months.\nDisease; and the NCEP Adult Treatment Panel II recommends a more stringent\ngoal of <100 mg/dl.\n \nThis national reminder identifies patients with known IHD (i.e., a \ndocumented ICD-9 code for IHD on or after 10/01/99) who have had a\nserum lipid panel within the last year, where the most recent LDL lab\ntest (or documented outside LDL) is greater than or equal to 120 mg/dl.\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "
\nThis reminder is recommended for use by clinicians at Primary Care Clinics\n       IHD DIAGNOSIS \n     \n    2. Use the Reminder Dialog edit option to define the national \n       reminder dialog finding items which should be updated during CPRS\n       GUI reminder processing.\n    \n       Review dialog elements in the national reminder dialog and change \n       any national health factors to local health factors, if\n       necessary.  It is not unusual for local findings to be used in \n       your national dialogs. \n \n               No mapping necessary. Use the VA-ISCHEMIC HEART DISEASE\n       Any local findings used in the national dialogs should be mapped\n       to the appropriate national reminder term.\n \n       Add local Order Dialog items to the Dialog elements used for \n       ordering a calculated LDL and/or direct LDL, and AST/ALT.\n     \n       Add local Order Dialog items to the Dialog Elements for clinicians\n       to order initial lipid lowering medications or lab work. The\n       dialog group contains a sampling of orders related to starting the\n       patient on lipid lowering medication, which includes future lab\n               reminder taxonomy distributed with this term.\n       orders to monitor liver function and lipid levels. The distributed\n       group contains:\n     \n          Order Simvastatin --  Note:  Sites using a different first line\n               lipid lowering agent should replace Simvastatin with that\n               medication (e.g., Pravastatin), which will require \n               copying the national dialog reminder, and editing the\n               local copy with local dialog elements.\n \n          Order baseline LFTs today (if not available w/in past year).  \n \n          Order LFTs in 60 days after starting therapy.  \n          Order fasting Lipid Profile in 60 days.  \n                 \n       The Adjust lipid lowering medication dialog group contains a\n       dialog element that recommends using the meds and order tab to\n       cancel old and order new medications.  It also includes dialog\n       elements for future lab orders to monitor liver function and\n       lipid levels.\n \n          Order LFTs today (if not available w/in past year).  \n       UNCONFIRMED IHD DIAGNOSIS \n          Order LFTs in 60 days after starting therapy.  \n          Order fasting Lipid Profile in 60 days.  \n \n 3. Alternatively, use the Reminder Dialog options to copy the national\n    dialog, dialog elements, and dialog groups to make local changes.\n \n    If your site has a Lipid Panel and AST/ALT TIU Object, add this\n    TIU Object to the dialog element header text.  The TIU Object\n    should include Chol, Trigly, HDL, LDL-C, direct LDL, AST, and ALT\n    values and dates.\n               Use the UNCONFIRMED IHD DIAGNOSIS health factor \n \n    Some sites have clinicians order a consult to a service that \n    corrects unconfirmed diagnoses the clinician finds in a patient's\n    record.  If your site has this method in place, copy the reminder\n    dialog to a local reminder dialog and then add a local dialog element\n    for the consult order to the reminder dialog so this practice can\n    continue.\n               distributed with this term or add any local health \n               factor representing an unconfirmed or incorrect IHD\n               diagnosis.  \n \n(Primary Care/Medicine, GIMC, Geriatric, Women's), Cardiology, Cholesterol\n       LDL >119\n               Enter the Laboratory Test names from the Lab Package \n               for calculated LDL and direct LDL with a CONDITION to \n               identify LDL values > 119. Although the condition is \n               defined in the reminder, also define the condition in\n               the term so the term can be used for uses that don't\n               involve the reminder definition. If your site uses \n               comments frequently you may want to change the condition\n               to check for specific text.\n \nScreening and any other specialty clinics where primary care is given.\n       LDL <120    \n               Enter the Laboratory Test names from the Lab Package \n               for calculated LDL and direct LDL with a CONDITION to \n               identify LDL values < 120. Although the condition is \n               defined in the reminder, also define the condition in\n               the term so the term can be used for uses that don't\n               involve the reminder definition. If your site uses \n               comments frequently you may want to change the condition\n               to check for specific text.     \n \n \n       For the following OUTSIDE LDL Reminder Terms, use the \n       health factors distributed with these terms or add any local\n       health factors or other findings to the appropriate reminder\n       terms. The findings should represent LDL values from a source \n       outside the local facility.\n \n         OUTSIDE LDL <100\n            Distributed with health factor: OUTSIDE LDL <100 \n         OUTSIDE LDL 100-119\n            Distributed with health factor: OUTSIDE LDL 100-119\nSetup issues before using this reminder:\n         OUTSIDE LDL 120-129\n            Distributed with health factor: OUTSIDE LDL 120-129           \n         OUTSIDE LDL >129\n            Distributed with health factor: OUTSIDE LDL >129\n     \n       LIPID LOWERING THERAPY MGMT - 2M\n               Use the health factors distributed with this reminder term\n               or enter any local health factors or other findings that\n               should defer the reminder for 2 months. Health Factors\n               distributed with this reminder term are:\n     \n                   LIPID LOWERING MEDS INITIAL ORDER\n                   LIPID LOWERING MEDS ADJUSTED\n \n       LIPID LOWERING THERAPY MGMT - 6M\n               Use the health factors distributed with this reminder term\n               or enter any local health factors or other findings that\n               should defer the reminder for 6 months.  Health Factors\n               distributed with this reminder term are: \n                   NO CHANGE IN IHD LIPID TREATMENT\n                   OTHER DEFER ELEVATED LDL THERAPY\n     1. Use the Reminder Term options to map local representations of \n                   LIPID MGMT PROVIDED OUTSIDE \n     \n       REFUSED ELEVATED LDL THERAPY \n               Use the REFUSED ELEVATED LDL THERAPY health factor \n               distributed with this term or add any local health\n               factor representing the patient's refusal to have \n               elevated LDL therapy provided.  \n \n       LIPID MEDS CONTRAINDICATED \n               Use the LIPID MEDS CONTRAINDICATED health factor\n        findings:\n               distributed with this term or add any local health\n               factors representing contraindication to lipid lowering\n               medications.  \n     \n       LIPID LOWERING MEDS \n               Enter the formulary drug names for investigation drugs.\n               Mapping non-investigative formulary drugs to the\n               VA-GENERIC drugs in the Pharmacy Package will ensure\n               the lipid lowering agents are found. The medications\n               are informational findings for this reminder.\n \n \n       TRANFERASE (AST) (SGOT) \n               This reminder term should already be mapped at your site\n               from the Hepatitis C EPI patch setup. The AST lab test\n               is an informational finding in this reminder.  \n     \n       ALANINE AMINO (ALT) (SGPT) \n               This reminder term should already be mapped at your site\n               from the Hepatitis C EPI patch setup. The ALT lab test\n               is an informational finding in this reminder.  \n
\n
\n", "
FI(1)&FF(1)&(FI(5)!FI(6)!FI(7))&FF(2)
\n", "
FI(1)&FF(1)&(FI(5)!FI(6)!FI(7))&FF(2)
\n", "
6
\n", "
1;FF1;5;6;7;FF2
\n", "", "
(0)!FI(9)!FI(10)!FI(11)!FI(12)
\n", "
4
\n", "
9;10;11;12
\n", "", "", "
7
\n", "
3;4;8;13;14;15;16
\n", "", "", "", "", "
\n
\n\n
\n", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-BL PNEUMOC RISK IMMUNOCOMPROMISED", "
Immunocompromised
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
VA NATIONAL CENTER FOR HEALTH PROMOTION AND DISEASE PREVENTION (NCP)
\n", "", "
R
\n", "
\n
\n\n
\n", "
\nThis reminder is used to determine if the patient has a diagnosis, \nchemotherapy or long term steroid use that would indicate an \nimmunocompromised condition and the need for PCV13 vaccination.  The \nreminder is used in the PPSV23 reminder to determine the need for a dose \nof PPSV23 after a prior PCV13 dose.\n \nNot used in branching logic in the dialogs.  Used in reminder term VA-BL \nPNEUMOC RISK IC/CH which is in the reminder VA-PNEUMOCOCCAL IMMUNIZATION \nPPSV23.\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "
\ncopy of VA-PNEUMOCOCCAL IMMUNIZATION PCV13\n
\n
\n", "
((FI(3)&FF(1))!(FI(11)&(FF(11)!FF(12)!FF(13)!FF(14)))!FI(2))
\n", "
((FI(3)&FF(1))!(FI(11)&(FF(11)!FF(12)!FF(13)!FF(14)))!FI(2))
\n", "
8
\n", "
3;FF1;11;FF11;FF12;FF13;FF14;2
\n", "", "", "", "", "", "", "
2
\n", "
1;7
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-BL OEF/OIF GI SX", "
GI SX BRANCHING LOGIC
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
OFFICE OF PUBLIC HEALTH AND ENVIRONMENTAL HAZARDS
\n", "", "
R
\n", "
\n
\n\n
\n", "", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "", "
(SEX)&(AGE)
\n", "
2
\n", "
SEX;AGE
\n", "
FI(2)&FF(1)
\n", "
FI(2)&FF(1)
\n", "
2
\n", "
2;FF1
\n", "", "", "
1
\n", "
1
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-BL OEF/OIF OTHER SX", "
OTHER SX BRANCHING LOGIC
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
OFFICE OF PUBLIC HEALTH AND ENVIRONMENTAL HAZARDS
\n", "", "
R
\n", "
\n
\n\n
\n", "", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "
(FI(1)!FI(3))&FF(1)
\n", "
(FI(1)!FI(3))&FF(1)
\n", "
3
\n", "
1;3;FF1
\n", "", "", "", "", "
1
\n", "
3
\n", "
1
\n", "
2
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-OB ZOSTER VACCINE DATE", "
Date of last Zoster Vaccine
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
VA NATIONAL CENTER FOR HEALTH PROMOTION AND DISEASE PREVENTION (NCP)
\n", "", "
R
\n", "
\n
\n\n
\n", "", "
\n
\n\n
\n", "", "", "", "
(SEX)&(AGE)
\n", "
2
\n", "
SEX;AGE
\n", "", "
(0)!FI(1)
\n", "
1
\n", "
1
\n", "", "", "", "", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-BL OEF/OIF SKIN SX", "
SKIN SX BRANCHING LOGIC
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
OFFICE OF PUBLIC HEALTH AND ENVIRONMENTAL HAZARDS
\n", "", "
R
\n", "
\n
\n\n
\n", "", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "", "
(SEX)&(AGE)
\n", "
2
\n", "
SEX;AGE
\n", "
FI(2)&FF(1)
\n", "
FI(2)&FF(1)
\n", "
2
\n", "
2;FF1
\n", "", "", "
1
\n", "
1
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-PTSD SCREENING", "
Screen for PTSD
\n", "
3M
\n", "", "", "
2004-05-21 11:44:26
\n", "", "", "", "
NATIONAL
\n", "
OFFICE OF PATIENT CARE SERVICES
\n", "", "
CR
\n", "
\n
\n\n
\n", "
\nPTSD screening due every 5 years for all patients. The reminder is set to \n     1. An entry of a health factor that indicates that all 4 PTSD \nquestions were answered (PTSD SCREEN NEGATIVE or PTSD SCREEN POSITIVE)\n     2. Entry of health factors that indicated that all 4 questions were \nasked and answered.\n     3. Entry of a health factor indicating that the patient \ndeclined/refused to answer the PTSD questions (resolves the reminder for \n1 year).\n     4. Entry of a PC-PTSD screen in the Mental Health package.\n \nNon-veterans do not need to be screened repeatedly for PTSD. \nalso be due every year for the first 5 years after the last service \nseparation date in the patient file.  This facilitates repeated screening \nof patients after a recent period of military service.\n \nThe reminder is not applicable to patients who have had a diagnosis of\nPTSD entered in the past 1 year.\n \nThe reminder is resolved if the patient has had:\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "", "
(SEX)&(AGE)&'FI(11)&'FI(12)&'FI(13)
\n", "
5
\n", "
SEX;AGE;11;12;13
\n", "
FI(1)!FI(2)!FI(3)!FI(4)!(FF(2)&FI(8))!FI(14)
\n", "
FI(1)!FI(2)!FI(3)!FI(4)!(FF(2)&FI(8))!FI(14)
\n", "
7
\n", "
1;2;3;4;FF2;8;14
\n", "
3
\n", "
9;FF1;FF3
\n", "
5
\n", "
5;6;7;10;15
\n", "", "", "", "", "
\n
\n\n
\n", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-BL OEF/OIF FEVER", "
FEVER BRANCHING LOGIC
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
OFFICE OF PUBLIC HEALTH AND ENVIRONMENTAL HAZARDS
\n", "", "
R
\n", "
\n
\n\n
\n", "", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "", "
(SEX)&(AGE)
\n", "
2
\n", "
SEX;AGE
\n", "
FI(2)&FF(1)
\n", "
FI(2)&FF(1)
\n", "
2
\n", "
2;FF1
\n", "", "", "
1
\n", "
1
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-HT OBJ EDUCATION TOPICS ALL", "
HT patient education sessions
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
VHA OFFICE OF CONNECTED CARE (10P8)
\n", "", "
R
\n", "
\n
\n\n
\n", "
\nThis reminder definition is used for the HT (Home Telehealth) object to \ndisplay only HT Education Topics.\n
\n
\n", "
\n
\n\n
\n", "", "", "
FI(1)!FI(2)!FI(3)!FI(4)
\n", "
FI(1)!FI(2)!FI(3)!FI(4)
\n", "
4
\n", "
1;2;3;4
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-BL ALCOHOL SCREEN", "
Alcohol Abuse Screen (AUDIT-C)
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
OFFICE OF PUBLIC HEALTH AND ENVIRONMENTAL HAZARDS
\n", "", "
R
\n", "
\n
\n\n
\n", "
\nUsed for branching logic for the OEF/OIF reminder dialog.  If this\nreminder is due, then the patient has not been screened for alcohol since\ntheir most recent service separation date.\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "", "
(SEX)&(AGE)
\n", "
2
\n", "
SEX;AGE
\n", "
FI(2)&FF(1)
\n", "
FI(2)&FF(1)
\n", "
2
\n", "
2;FF1
\n", "", "", "
1
\n", "
1
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-BL DEPRESSION SCREEN", "
Depression Screening
\n", "", "", "", "
2005-01-18 10:58:47
\n", "", "", "", "
NATIONAL
\n", "
OFFICE OF PUBLIC HEALTH AND ENVIRONMENTAL HAZARDS
\n", "", "
R
\n", "
\n
\n\n
\n", "
\nUsed for branching logic for the OEF/OIF reminder dialog.  If this\nreminder is due, then the patient has not been screened for depression\nsince their most recent service separation date.\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "", "
(SEX)&(AGE)
\n", "
2
\n", "
SEX;AGE
\n", "
(FI(2)!FI(3))&FF(1)
\n", "
(FI(2)!FI(3))&FF(1)
\n", "
3
\n", "
2;3;FF1
\n", "", "", "
1
\n", "
1
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-BL PTSD SCREEN", "
Screen for PTSD
\n", "", "", "", "
2004-05-21 11:44:26
\n", "", "", "", "
NATIONAL
\n", "
OFFICE OF PUBLIC HEALTH AND ENVIRONMENTAL HAZARDS
\n", "", "
R
\n", "
\n
\n\n
\n", "
\nUsed for branching logic for the OEF/OIF reminder dialog.  If this \nreminder is due, then the patient has not been screened for PTSD since \ntheir most recent service separation date.\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "", "
(SEX)&(AGE)
\n", "
2
\n", "
SEX;AGE
\n", "
(FI(2)&FF(1))!(FI(5)&FI(6)&FI(7)&FI(8)&FF(2))
\n", "
(FI(2)&FF(1))!(FI(5)&FI(6)&FI(7)&FI(8)&FF(2))
\n", "
7
\n", "
2;FF1;5;6;7;8;FF2
\n", "", "", "
1
\n", "
1
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-HT OBJ CATEGORY OF CARE LAST", "", "", "", "", "", "", "", "", "
NATIONAL
\n", "
VHA OFFICE OF CONNECTED CARE (10P8)
\n", "", "
R
\n", "
\n
\n\n
\n", "
\nThis reminder definition is used in HT (Home Telehealth) templates for the\nHT CATEGORY OF CARE LAST data object.\n
\n
\n", "
\n
\n\n
\n", "", "", "
FI(1)
\n", "
FI(1)
\n", "
1
\n", "
1
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-BL OEF/OIF SERVICE INFO ENTERED", "
OEF/OIF SERVICE INFO ENTERED
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
OFFICE OF PUBLIC HEALTH AND ENVIRONMENTAL HAZARDS
\n", "", "
R
\n", "
\n
\n\n
\n", "", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "
FI(1)!FI(3)
\n", "
FI(1)!FI(3)
\n", "
2
\n", "
1;3
\n", "", "
(0)!FI(2)&FF(1)
\n", "
2
\n", "
2;FF1
\n", "
1
\n", "
3
\n", "", "", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-HT OBJ NIC/CCM RATING LAST", "", "", "", "", "", "", "", "", "
NATIONAL
\n", "
VHA OFFICE OF CONNECTED CARE (10P8)
\n", "", "
R
\n", "
\n
\n\n
\n", "
\nThis reminder definition is used in HT (Home Telehealth) templates for the\nHT NIC (Non-Institutional Care)/CCM (Chronic Care Management) RATING LAST\ndata object.\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "
(FI(1)&FF(1))!FI(4)
\n", "
(FI(1)&FF(1))!FI(4)
\n", "
3
\n", "
1;FF1;4
\n", "", "", "", "", "", "", "
2
\n", "
2;3
\n", "", "", "", "", "", "", "", "
\nNo 'NIC/Chronic Care Mgmt last rating' data found\n
\n
\n", "
0
\n", "
1
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-HT OBJ CAREGIVER NAME/RELATIONSHIP", "
HT unpaid caregiver
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
VHA OFFICE OF CONNECTED CARE (10P8)
\n", "", "
R
\n", "
\n
\n\n
\n", "
\nThis reminder definition is used in HT (Home Telehealth) templates for the\nHT CAREGIVER data object.\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "
FI(1)&FI(2)&FF(1)
\n", "
FI(1)&FI(2)&FF(1)
\n", "
3
\n", "
1;2;FF1
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-TBI SCREENING", "
TBI Screening
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
OFFICE OF PATIENT CARE SERVICES
\n", "", "
CRX
\n", "
\n
\n\n
\n", "
\nReminder is applicable once in a lifetime of all patients whose date of \nSigford and based on a reminder from Minneapolis built by Ronald Patire \nand Dr. Brian Neil.\n \nRevisions June 2007:\n  1. Refusal can be entered\n  2. URLs added for information\n  3. Screening done at another VA option added.\n  4. Additional choices for head injury added.\n \nRevisions October 2008 - PXRM*2*11\nseparation from the service is 9/11/01 or later and have had service in \n  1. Combat vet patients need screening\n  2. Cognitive impairment exclusion added\n \nRevisions April 2009 - PXRM*2*12\n  1. Change from use of Combat Vet to OEF/OIF from patient file\n  2. Add documentation of discussion of positive screen with the patient\n  3. remove cognitive impairment per TBI Committee as exclusion\nOEF/OIF.  If Service Date of Separation is more recent than last TBI \nScreening, then reminder will be due again for patient.\n \nReminder is resolved by completing the screen.\n \nReminder creation requested by the Office of Patient Care \nServices.  Designed by the TBI Screening Workgroup chaired by Dr. Barbara \n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "
\nReminder is due for all patients with Last Service Separation date of\n9/11/01 or later.   Reminder is resolved by any of the health factors\nassociated with the responses of section 1; OR health factor for Previous\nTBI Diagnosis; OR health factor TBI PT Refused.\n
\n
\n", "
(FI(5)&FF(4))!(FI(1)&'FF(1))!(FI(2)&'FI(4))
\n", "
(FI(5)&FF(4))!(FI(1)&'FF(1))!(FI(2)&'FI(4))
\n", "
6
\n", "
5;FF4;1;FF1;2;4
\n", "
(FI(3)!FI(6)!FI(7))&FF(2)
\n", "
(FI(3)!FI(6)!FI(7))&FF(2)
\n", "
4
\n", "
3;6;7;FF2
\n", "", "", "
3
\n", "
8;9;FF3
\n", "", "", "", "", "
\n
\n\n
\n", "", "
\nPatients who served in combat in either Iraq (Operation Iraqi Freedom) or \nin Afghanistan (Operation Enduring Freedom) should be screened for \nTraumatic Brain Injury.\n
\n
\n", "
\n\\\\\nPatients who were discharged from the service prior to 9/11/01 or who did\nNOT serve in OEF or OIF do NOT need to be screened for TBI.\n\\\\\n
\n
\n", "
3
\n", "
4
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-*INFLUENZA IMMUNIZATION", "
ZZ Influenza Immunization
\n", "
1M
\n", "
ZZVA-*INFLUENZA IMMUNIZATION
\n", "
INACTIVE
\n", "
2005-03-11 12:42:50
\n", "", "", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nThe "VA-*Influenza Immunization" reminder is based on the following\n    the late fall to all persons age 65 and older.\n \n    Goal for FY 2000: 60% of those persons over age 65 have received\n    influenza vaccine in the past year.\n"Influenza Immunization" guidelines specified in the VHA HANDBOOK 1101.8,\nAPPENDIX A.\n \n    Target Condition: Influenza and its complications.\n  \n    Target Group: Outpatients age 65 and older.\n \n    Recommendation: Influenza vaccine should be administered annually in\n
\n
\n", "
\n
\n\n
\n", "", "
\nIf this reminder is not going to be used at your facility, the INACTIVE\nrepresented in the "VA-INFLUENZA VACCINE" reminder.  This reminder\nincludes an alteration of the influenza reminder guidelines when the\npatient has a diagnosis which could cause the patient to be at a high\nrisk for flu or pneumonia.\n \nPlease review both of these reminder definitions, choose one of them to\nuse.  If local modifications need to be made, copy the preferred reminder\nto a new reminder and make your reminder modifications.\nFLAG should be set to inactive.\n \nThis reminder represents the minimum criteria for checking if the patient\nhas received an influenza immunization. As distributed, the reminder\nchecks for an "Influenza" immunization in the V Immunization file or its\nCPT code equivalent in the V CPT file.\n \nThe Ambulatory Care EP recommends a variation on this reminder\n
\n
\n", "", "
(SEX)&(AGE)&'FI(3)
\n", "
3
\n", "
SEX;AGE;3
\n", "", "
(0)!FI(1)!FI(2)
\n", "
2
\n", "
1;2
\n", "
1
\n", "
3
\n", "
1
\n", "
4
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-HT OBJ MEDICATION RECONCILIATION", "", "", "", "", "", "", "", "", "
NATIONAL
\n", "
VHA OFFICE OF CONNECTED CARE (10P8)
\n", "", "
R
\n", "
\n
\n\n
\n", "
\nThis reminder definition is used in HT (Home Telehealth) templates for the\nHT MED RECON data object.\n
\n
\n", "
\n
\n\n
\n", "", "", "
FI(1)&FI(2)&FI(3)
\n", "
FI(1)&FI(2)&FI(3)
\n", "
3
\n", "
1;2;3
\n", "", "", "", "", "", "", "
2
\n", "
4;5
\n", "", "", "", "", "", "", "", "
\nNo 'HT Medication Reconciliation' data found\n
\n
\n", "
0
\n", "
1
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-MST SCREENING", "
MST Screening
\n", "", "", "", "", "
*
\n", "", "", "
NATIONAL
\n", "
MENTAL HEALTH SERVICES AND WOMEN VETERANS HEALTH PROGRAM
\n", "", "
*
\n", "
\n
\n\n
\n", "
\nAll veterans should be screened at least once in their lifetime and after \n      threat of force to have sex with you against your will?\n \nDocumenting YES, NO, or Declined to Answer responses to Screening\nQuestions:\n \n  A YES response should be documented in progress notes, the MST History\n  file, and local findings that represent the MST status (e.g.,health \n  factors). A follow-up consult order for counseling should be considered \n  for the veteran.\n \neach deployment for Military Sexual Trauma.\n  A NO or DECLINES TO ANSWER response should be documented in progress\n  notes, the MST History file, and local findings that represent the MST \n  status (e.g., health factors).\n \nThis national clinical reminder will ensure the VIA has the ability to\nmeet congressional military sexual trauma treatment and reporting\nmandates by providing accurate data collection through the sharing of\nMST data between facilities and data collection agencies.\n \nThis national clinical reminder will ensure the appropriate and timely\n \ncounseling and treatment of individuals with an incidence of military\nsexual trauma.\nSample Screening Questions.\n   1. When you were in the military, did you ever receive uninvited\n      and unwanted sexual attention (i.e. touching, cornering, pressure\n      for sexual favors, verbal remarks)?\n \n   2. When you were in the military, did anyone ever use force or the\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "
\nChanges made with MST update:\n    b.  Added FF(4) to check if MST YES REPORTS health factor or \npositive CF VA-MST status with Y value is more recent than latest service\nseparation date\n    c.  Changed Resolution Logic from FI(1)!FI(2)!FI(3) to  \n(FI(1)&FF(4))!(FI(2)&FF(1))!(FI(3)&FF(3))\n    d.  Changed Cohort Logic from (SEX)&(AGE)&FI(4) to \n(FI(4))!(FI(4)&FF(2))\n \n      \n \n1.  Reminder definition changes\n2.  Reminder Dialog changes\n    a.  Created new dialog group VA-TEXT MST STATUS QUESTIONS >1 SSD.  \nThis is used on the replacement dialog if the branching term evaluates \nTRUE.\n    b.  Created new element VA-HF MST NO, PREVIOUS YES\n    C.  Created new group VA-HF MST RECENT NO WITH PRIOR EVER YES.  This \ngroup is used in the replacement dialog if the branching term evaluates \nTRUE.\n    d.  Created new group VA-HF MST YES RECENT YES PRIOR.  This group is \nused in the replacement dialog if the branching term evaluates TRUE.\n    a.  Created new reminder definition to be used in branching logic \n    e.  Set MST SCREENING dialog PATIENT SPECIFIC field entry to TRUE.  \nThis controls whether or not the branching logic works correctly.\nterm evaluation.  The name of the definition is VA-BL MULTIPLE SSD AND \nMST YES.  Reminder term VA-BL MULTIPLE SSD AND MST YES was also created.  \nThis term has a mapped item of CF.VA-REMINDER DEFINITION.  The CF \nparameter entry is reminder definition VA-BL MULTIPLE SSD AND MST YES.  \nThe condition is set to I V="DUE NOW".  If this term evaluates as true, \nthe replacement dialog group will be used.\n
\n
\n", "
(FI(4))!(FI(4)&FF(2))
\n", "
(FI(4))!(FI(4)&FF(2))
\n", "
3
\n", "
4;4;FF2
\n", "
(FI(1)&FF(4))!(FI(2)&FF(1))!(FI(3)&FF(3))
\n", "
(FI(1)&FF(4))!(FI(2)&FF(1))!(FI(3)&FF(3))
\n", "
6
\n", "
1;FF4;2;FF1;3;FF3
\n", "", "", "
4
\n", "
5;6;7;8
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "
\nAll veterans should be screened at least once in their lifetime for\n    threat of force to have sex with you against your will?\\\\\n \nDocument YES, NO, or DECLINED TO ANSWER responses to Screening.\nMilitary Sexual Trauma.\n\nSample Screening Questions:\\\\\n 1. When you were in the military, did you ever receive uninvited\\\\\n    and unwanted sexual attention (i.e. touching, cornering, pressure\\\\\n    for sexual favors, verbal remarks)?\\\\\n \n 2. When you were in the military, did anyone ever use force or the\\\\\n
\n
\n", "
0
\n", "
12
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-HEP C RISK FACTOR OBJECT", "
Hepatitis C Risk Factors
\n", "", "", "", "", "", "", "", "
LOCAL
\n", "", "", "
R
\n", "
\n
\n\n
\n", "", "
\n
\n\n
\n", "", "", "
FI(1)
\n", "
FI(1)
\n", "
1
\n", "
1
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-HT CONTINUUM OF CARE (FOLLOW-UP)", "
HT Continuum of Care (Follow-up)
\n", "
14D
\n", "", "", "", "", "", "", "
NATIONAL
\n", "
VHA OFFICE OF CONNECTED CARE (10P8)
\n", "", "
*
\n", "
\n
\n\n
\n", "
\nThis HT (Home Telehealth) clinical reminder is due every 6 months on\nVeterans that are enrolled in HT (Home Telehealth) and who continue to\nmeet either NIC (Non-Institutional Care) criteria or CCM (Chronic Care\nManagement) criteria.\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "
(FI(2)&FF(5))!(FI(4)&FF(5))&'FF(6)
\n", "
(FI(2)&FF(5))!(FI(4)&FF(5))&'FF(6)
\n", "
5
\n", "
2;FF5;4;FF5;FF6
\n", "
FI(8)&FF(3)
\n", "
FI(8)&FF(3)
\n", "
2
\n", "
8;FF3
\n", "
1
\n", "
8
\n", "
7
\n", "
1;3;5;6;7;9;FF1
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-HT OBJ BARRIERS TO LEARNING", "
HT barriers to learning
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
VHA OFFICE OF CONNECTED CARE (10P8)
\n", "", "
R
\n", "
\n
\n\n
\n", "", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "
(FI(1)!FI(2)!FI(3)!FI(4)!FI(5)!FI(6)!FI(7)!FI(8)!FI(9)!FI(10)!FI(11)!FI(12)!FI(13)!FI(14)!FI(15)!FI(16))&FF(1)&FF(2)
\n", "
(FI(1)!FI(2)!FI(3)!FI(4)!FI(5)!FI(6)!FI(7)!FI(8)!FI(9)!FI(10)!FI(11)!FI(12)!FI(13)!FI(14)!FI(15)!FI(16))&FF(1)&FF(2)
\n", "
18
\n", "
1;2;3;4;5;6;7;8;9;10;11;12;13;14;15;16;FF1;FF2
\n", "", "", "", "", "", "", "
2
\n", "
17;18
\n", "", "", "", "", "", "", "", "
\nNo 'HT barriers to learning' found for current enrollment.\n
\n
\n", "
0
\n", "
1
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-HT OBJ CCM RATING LAST", "
HT CCM rating last
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
VHA OFFICE OF CONNECTED CARE (10P8)
\n", "", "
R
\n", "
\n
\n\n
\n", "
\nThis reminder definition is used for the HT CCM RATING LAST data object.\n
\n
\n", "
\n
\n\n
\n", "", "", "", "
(SEX)&(AGE)&FI(1)
\n", "
3
\n", "
SEX;AGE;1
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["ZZVA-*WEIGHT AND NUTRITION SCREEN", "
ZZ Weight and Nutrition Screen
\n", "
1M
\n", "
ZZVA-*WEIGHT AND NUTRITION SCREEN
\n", "
INACTIVE
\n", "
2005-03-11 12:42:50
\n", "", "", "", "
NATIONAL
\n", "", "", "
C
\n", "", "
\nThis VA-*WEIGHT AND NUTRITION SCREEN reminder is based on the following\n    with periodic counseling or referral for counseling regarding dietary\n    intake of calories, fat (especially saturated fat), cholesterol, and\n    fiber.  A nutrition counseling service should be available at each VHA\n    facility.\n \n    Goals for FY 2000: Reduce dietary fat intake to an average of 30 of\n    calories and saturated fats to less than 10%. Increase complex\n    carbohydrate and fiber-containing foods in the diet to 5 or more daily\n    servings for vegetables and fruits and 6 or more daily servings for\n    grain products. Reduce overweight to a prevalence of no more than 20%\n"Weight Control and Nutrition Counseling" guidelines defined in the\n    among people age 20 and older.  Women should be encouraged to consume\n    1000 mg/day of calcium until menopause and 1500 mg/day thereafter.\n    100% of VHA facilities should have formal nutrition counseling\n    available for outpatients.\nVHA HANDBOOK 1101.8, APPENDIX A.\n \n    Target condition: Obesity and associated conditions.\n \n    Target Group: General outpatient population.\n \n    Recommendation: Primary care clinicians should provide their patients\n
\n
\n", "
\n
\n\n
\n", "", "
\nIf this reminder is not going to be used at your facility, the INACTIVE\nrepresented in the "VA-NUTRITION/OBESITY EDUCATION" reminder.  This\nreminder includes a check for nutrition education, in addition to\nthe screening.  It also includes target conditions for patients who have\nnutrition or obesity related diagnoses or health factors on file.\n \nPlease review both of these reminder definitions, choose one of them to\nuse.  If local modifications need to be made, copy the preferred reminder\nto a new reminder and make your reminder modifications.\nFLAG should be set to inactive.\n \nThis reminder represents the minimum criteria for checking if the patient\nhas received a weight and nutrition screen. The "VA-NUTRITION/WEIGHT\nSCREENING" education topic is the result finding that will satisfy this\nreminder.\n \nThe Ambulatory Care EP recommends a variation on this reminder\n
\n
\n", "", "
(SEX)&(AGE)&'FI(3)
\n", "
3
\n", "
SEX;AGE;3
\n", "", "
(0)!FI(1)!FI(2)
\n", "
2
\n", "
1;2
\n", "
1
\n", "
3
\n", "
1
\n", "
4
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "
2005-02-04 00:00:00
\n", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-BL WH PAP REVIEW FREQ", "
Pap Frequency Needs Review
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "", "", "
R
\n", "
\n
\n\n
\n", "", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "", "
(SEX)&(AGE)
\n", "
2
\n", "
SEX;AGE
\n", "", "", "", "", "
2
\n", "
FF1;FF2
\n", "
9
\n", "
1;2;3;4;5;6;7;8;9
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-ALCOHOL AUDIT-C POSITIVE F/U EVAL", "
Positive AUDIT-C Needs Evaluation
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
OFFICE OF PATIENT CARE SERVICES
\n", "", "
*
\n", "
\n
\n\n
\n", "
\nThis reminder is due for patients who have a Positive Alcohol Use \n \nIt resolves by documentation of direct alcohol related advice and \neducation about alcohol related medical problems.  Options for further \nassessment and referral are also included.\n \nIt is intended for use by providers.\n \nUpdate March 2009\n1. Add SUD stop codes as an exclusion if the patient was seen during the \n90 days prior to the most recent positive AUDIT-C or is a current patient \nScreen.  It becomes due with an AUDIT-C score of 5 or more.\nin an SUD clinic.\n2. Make advice and feedback to the patient consistent and not forced.\n3. Reverse the sequence of the feeback and the advice.\n4. Update the reminder term for No Alcohol in the past year to represent \ninclude only the HF.  Remove the AUDC from this term to prevent an \nincorrect entry of AUDC=0 to override a positive AUDC entered for the \nsame visit.\n \nThis setting of AUDIT-C of 5 or higher is for the national performance \nmeasure.  There are still patients who have lower scores who drink above \nthe safe limit and these patients should also be counseled.\n \nThe dialog includes assessment tools and documentation of advice,\ncounseling and referral\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "
\nThis reminder is triggered by the AUDIT-C score generated from the\nALCOHOL USE SCREEN clinical reminder.  It uses branching logic and \nwill display different screens depending on the AUDIT-C score.  A score \nof 8 or more will display a screen geared towards patients with a higher \nrisk of alcohol abuse or dependence.  A score of less than 8 will display \na screen to guide counseling and assessment for those with a lower risk \nof dependence.\n
\n
\n", "", "
(SEX)&(AGE)&FI(1)&FF(3)&'FF(6)&'FF(7)
\n", "
6
\n", "
SEX;AGE;1;FF3;FF6;FF7
\n", "
(FI(3)&FI(4))&(FF(1)!FF(4))&(FF(2)!FF(5))
\n", "
(FI(3)&FI(4))&(FF(1)!FF(4))&(FF(2)!FF(5))
\n", "
6
\n", "
3;4;FF1;FF4;FF2;FF5
\n", "", "", "
5
\n", "
2;5;6;7;8
\n", "", "", "", "", "
\n
\n\n
\n", "", "
\nPatients with no prior history of alcohol related problems or prior\nPatients with prior alcohol problems and ANY positive AUDIT-C score should\nbe considered for referral to a Substance Abuse program.  These patients\nare at high risk of dependence.\n \nStandard drinks:   \\\\\n     0.5 fluid ounces of absolute alcohol  \\\\\n     12 ounces of beer                      \\\\\n     5 ounces of wine                       \\\\\n     1.5 ounces of 80-proof spirits         \\\\\ntreatment for alcohol abuse or dependence who have an AUDIT-C score of\n4-7 (score of 3-7 for women) should be advised to stay within recommended\ndrinking limits.\n \nRECOMMENDED LIMITS:\n    Men:   <= 14 drinks/wk and maximum of 4 drinks/occasion\n    Women: <=  7 drinks/wk and maximum of 3 drinks/occasion\n \n
\n
\n", "", "
18
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-ALCOHOL USE SCREEN (AUDIT-C)", "
Alcohol Use Screen (AUDIT-C)
\n", "
1M
\n", "", "", "", "", "", "", "
NATIONAL
\n", "
OFFICE OF PATIENT CARE SERVICES
\n", "", "
CR
\n", "
\n
\n\n
\n", "
\nAlcohol Screen Due yearly for all patients.\n \nThe AUDIT-C is needed on all patients on a yearly basis.  A reminder term \nis included in this reminder VA-ALCOHOL USE SCREEN to represent entries \nof the AUDIT-C as health factors or exams or for health factors that \nrepresent NO ALCOHOL IN THE PAST YEAR.  After 1/1/08, this term is not \nused to resolve the reminder and the AUDIT-C tool in the MH package must \nbe used.\n
\n
\n", "
\n
\n\n
\n", "", "", "", "
(SEX)&(AGE)&'FI(6)
\n", "
3
\n", "
SEX;AGE;6
\n", "", "
(0)!FI(1)!FI(3)!FI(4)!FI(5)
\n", "
4
\n", "
1;3;4;5
\n", "", "", "
1
\n", "
2
\n", "", "", "", "", "
\n
\n\n
\n", "", "", "", "
0
\n", "
0
\n", "", "
\nAsk the patient how many days a week he or she usually has alcohol and how\nmany drinks the patient usually has each day.  Three or more drinks a day\nare usually a trigger for counseling. \n \nAdminister the AUDIT-C screening tool.  Men with a score of 4 or more and \nwomen with a score of 3 or more should be counseled regarding their \nalcohol use.\n
\n
\n", "
0
\n", "
7
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-BL WH MAMMOGRAM REVIEW FREQ", "
Mammogram Frequency Needs Review
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
WOMEN VETERANS HEALTH PROGRAM AND NATIONAL CENTER FOR HEALTH PROMOTION AND DISEASE PREVENTION (NCP)
\n", "", "
R
\n", "
\n
\n\n
\n", "", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "", "
(SEX)&(AGE)
\n", "
2
\n", "
SEX;AGE
\n", "", "", "", "", "
2
\n", "
FF1;FF2
\n", "
7
\n", "
1;2;3;4;6;7;9
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["LONG TERM STEROID USE", "
Long Term Steroid Use
\n", "", "", "", "", "", "", "", "
LOCAL
\n", "", "", "
R
\n", "
\n
\n\n
\n", "
\nUsed to identify patients on long term steroids that put them at risk of \nfor days supply and not for duration.\n \nThe reminder also looks for any recent Rx that has a days supply of >70 \ndays - and counts this as long term steroid use also.\npneumococcal disease.  Per CDC, those patients should receive PCV13 \nvaccination.\n \nThis reminder is sent out set to look for 3 prescriptions for steroids \n  the most recent one with a days supply of >21 and 2 prior prescriptions \nwith durations of >21 days.  Current prescriptions could have a very \nshort duration since the duration is the start date to today for an \nactive prescription.  This is why for the most recent Rx, the search is \n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "
FI(1)&FF(1)!(FI(1)&FI(2)&FI(3)&FF(4)&FF(2)&FF(3))
\n", "
FI(1)&FF(1)!(FI(1)&FI(2)&FI(3)&FF(4)&FF(2)&FF(3))
\n", "
8
\n", "
1;FF1;1;2;3;FF4;FF2;FF3
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-HT OBJ CONTINUUM OF CARE LAST DONE", "
Continuum of Care last done
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
VHA OFFICE OF CONNECTED CARE (10P8)
\n", "", "
R
\n", "
\n
\n\n
\n", "", "
\n
\n\n
\n", "", "", "", "
(SEX)&(AGE)&FI(1)
\n", "
3
\n", "
SEX;AGE;1
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "", "
\nNo 'Continuum of Care last done' data found\n
\n
\n", "
0
\n", "
1
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-OB PNEUMOCOCCAL PRIOR VACCINATIONS", "
Recorded Pneumococcal Vaccinations
\n", "", "", "", "", "", "", "", "
NATIONAL
\n", "
VA NATIONAL CENTER FOR HEALTH PROMOTION AND DISEASE PREVENTION (NCP)
\n", "", "
R
\n", "
\n
\n\n
\n", "", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "", "
(SEX)&(AGE)
\n", "
2
\n", "
SEX;AGE
\n", "", "", "", "", "", "", "
7
\n", "
1;2;FF2;FF4;FF6;FF8;FF9
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-BL OEF/OIF EMBEDDED FRAGMENTS", "
EMBEDDED FRAGMENTS BRANCHING LOGIC
\n", "", "", "", "", "", "", "", "
LOCAL
\n", "", "", "
R
\n", "
\n
\n\n
\n", "", "
\n
\n\n
\n", "
\n
\n\n
\n", "", "", "
(SEX)&(AGE)
\n", "
2
\n", "
SEX;AGE
\n", "
FI(2)&FF(1)
\n", "
FI(2)&FF(1)
\n", "
2
\n", "
2;FF1
\n", "", "", "
1
\n", "
1
\n", "", "", "", "", "", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""], ["VA-HEPATITIS C TESTING", "
Hepatitis C Testing
\n", "
3M
\n", "", "", "", "", "", "", "
NATIONAL
\n", "
NATIONAL CENTER FOR HEALTH PROMOTION AND DISEASE PREVENTION (NCP)
\n", "", "
C
\n", "
\n
\n\n
\n", "
\nVA recommends a Hepatitis C virus (HCV) screen for all patient at risk for\n   - Blood transfusion before universal blood screening (1992).\n \nPatients with continued or a new risk for HCV infection (e.g., injection\ndrug users) should be screened periodically. There is no evidence about \nhow often screening should occur in persons who continue to be at risk \nfor new HCV infection.\n \nIn individuals with a positive serologic screening test for HCV \ninfection, the Centers for Disease Control and Prevention recommend \nconfirmatory testing with reflex RNA testing to confirm the diagnosis of\ninfection, including patients born between 1945-1965. Risk assessment \nHCV infection and determine viral status.\noccurs at least once.  Periodic reassessment may be considered, the \noptimal interval for reassessment is unknown.\n \nLab testing for Hepatitis C virus (HCV) for patients in the following\ngroups who are not otherwise at risk need to be screened only once: \n   - Birth cohort (1945-1965)\n   - Vietnam-era Veteran status\n
\n
\n", "
\n
\n\n
\n", "
\n
\n\n
\n", "
\nThis reminder is based on VHA National Center for Health Promotion and \n     This term is released with the health factor RISK FACTOR FOR\n     HEPATITIS C.  This term includes national taxonomies for alcohol \n     abuse, drug abuse, and HIV infection. Map any local findings that\n     meet the intent of this term in the REMINDER TERM file (811.5).\n \n   VA-DECLINED HEP C SCREEN\n     This term is released with the health factor DECLINED HEP C SCREEN.  \n     Map any local findings that meet the intent of this term in The\n     REMINDER TERM file (811.5).\n \nDisease Prevention (NCP) Clinical Guidance Statement posted January 22, \n   VA-HEP C OUTSIDE RESULTS\n     This term is released with the health factors PREV POSITIVE TEST FOR\n     HEP C and PREV NEGATIVE TEST FOR HEP C. Map any local findings that \n     identify the patient as previously assessed for Hepatitis C risk \n     factors in the REMINDER TERM file(811.5).\n     This term was originally distributed as PREV POSITIVE TEST\n     FOR HEP C, but was changed to provide sites with a way to identify a\n     patient as previously assessed for Hepatitis C risk factors.\n \n     This term will also be used to document historical positive\n2014. \n     tests completed outside the facility.\n \n   VA-HEP C VIRUS ANTIBODY POSITIVE\n     Map local HCVAb lab tests with a condition in the REMINDER TERM file.\n     An example of the condition field might be: I V="positive"\n     or I (V["P")!(V["p"). The text used in the condition definition\n     (I V="text") should be based on the local LABORATORY TEST file (60)\n     print codes when defined, rather than the result in the LAB DATA file\n     (63).\n \n \n   VA-HEP C VIRUS ANTIBODY NEGATIVE\n     Map local HCVAb lab tests with a condition in the REMINDER TERM file.\n     An example of the condition field might be: I V="negative"\n     or I (V["N")!(V["n"). The text used in the condition definition \n     (I V="text") should be based on the local LABORATORY TEST file (60)\n     print codes when defined, rather than the result in the LAB DATA file\n     (63).\n \n   VA-HEP C LAB TESTS ORDERED\n     Map local HCVAb orderable items in the REMINDER TERM file. The \nBEFORE USING THIS REMINDER, sites need to use the Reminder Term\n     orderable items should have the following status; ACTIVE, PENDING.\n \n   VA-LIFE EXPECTANCY <6 MONTHS\n     This term is released with the health factor. Map any local\n     findings that identify patients with a terminal illness.\n \n  VA-HEP C RNA\n     Map local HCV RNA lab tests. If the local site cancels lab tests and\n     enters a "cancel" comment as the result, then a condition will need\n     to be added in the REMINDER TERM preventing the cancelled test from\nManagement option to define the local findings that are used to\n     resolving the reminder.  Include any HCV RNA tests such as HCV Qual, \n     HCV Quant, HCV Genotype, etc.\n \n  VA-HEPATITIS C SEROPOSITIVE\n     This term includes the national taxonomy VA-HEPATITIS C \n     SEROPOSITIVE. Codes for HCV infection and HCV seropositive\nrepresent the national reminder terms:\n \n   VA-RISK FACTOR FOR HEPATITIS C\n
\n
\n", "
(FI(4)!FI(5)!FF(1))&'(FI(10)!FI(1)!FI(12))
\n", "
(FI(4)!FI(5)!FF(1))&'(FI(10)!FI(1)!FI(12))
\n", "
6
\n", "
4;5;FF1;10;1;12
\n", "
FI(2)!FI(6)!FI(7)!FI(8)!FI(9)!FI(13)!FI(14)
\n", "
FI(2)!FI(6)!FI(7)!FI(8)!FI(9)!FI(13)!FI(14)
\n", "
7
\n", "
2;6;7;8;9;13;14
\n", "", "", "
1
\n", "
3
\n", "", "", "", "", "
\n
\n\n
\n", "", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "
\n
\n\n
\n", "", "", "
0
\n", "
0
\n", "", "", "
0
\n", "
0
\n", "", "", "", "", "", "", "", "", "", "", "", "", "", ""]]}