Difference between revisions of "Preventive care reminders"
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<p><b><span style='font-family:Arial;color:red'>It is important to note that, although | <p><b><span style='font-family:Arial;color:red'>It is important to note that, although | ||
we make this content available in good faith (and use much of it ourselves), neither | we make this content available in good faith (and use much of it ourselves), neither | ||
− | the expert panel, the CERT-HIT, Brigham and Women | + | the expert panel, the CERT-HIT, Brigham and Women's Hospital, |
Partners HealthCare or the Agency for Healthcare Research and Quality guarantee this | Partners HealthCare or the Agency for Healthcare Research and Quality guarantee this | ||
− | content | + | content; it is provided as is and must be reviewed for correctness |
and completeness by any potential user.</span></b></p> | and completeness by any potential user.</span></b></p> | ||
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<p><span style='font-size:10.0pt;color:black'>AND (Age of youngest affected (with | <p><span style='font-size:10.0pt;color:black'>AND (Age of youngest affected (with | ||
− | Breast cancer) relative - patient | + | Breast cancer) relative - patient's age) < = 10 years |
)</span></p> | )</span></p> | ||
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<p><span style='font-size:10.0pt;color:black'>AND(Age of youngest affected (with | <p><span style='font-size:10.0pt;color:black'>AND(Age of youngest affected (with | ||
− | Breast cancer) relative - patient | + | Breast cancer) relative - patient's age) <= 10 |
years)</span></p> | years)</span></p> | ||
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<p><span style='font-size:10.0pt;color:black'>AND Age of youngest affected (with | <p><span style='font-size:10.0pt;color:black'>AND Age of youngest affected (with | ||
− | Breast cancer) relative - patient | + | Breast cancer) relative - patient's age) <= 10 |
years)</span></p> | years)</span></p> | ||
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<p><span style='font-size:10.0pt;color:black'>AND Age of youngest affected (with | <p><span style='font-size:10.0pt;color:black'>AND Age of youngest affected (with | ||
− | Breast cancer) relative - patient | + | Breast cancer) relative - patient's age) <= 10 years</span></p> |
<p><b><u><span style= | <p><b><u><span style= |
Revision as of 20:27, 17 August 2010
Sample Reminders from the Clinical Decision Support Expert Panel
Based on content from the Partners HealthCare
It is important to note that, although we make this content available in good faith (and use much of it ourselves), neither the expert panel, the CERT-HIT, Brigham and Women's Hospital, Partners HealthCare or the Agency for Healthcare Research and Quality guarantee this content; it is provided as is and must be reviewed for correctness and completeness by any potential user.
Needs Pneumovax (age > 65 and
no Pneumovax ever)
Rule#: 142 Rule category Health Maintenance Primary Clinical Area Vaccinations
Risk Group Definition Age > 65
Recommendation Logic: No Pneumovax on file
Recommendation Order pneumovax
Needs repeat
pneumovax >65
Rule#: 143 Rule category Health Maintenance Primary Clinical Area Vaccinations
Risk Group Definition Age > 65
AND one (and only one) pneumovax on file
Recommendation Logic: latest pneumovax was performed 5 years ago and when patient was less
than 65 years of age
Recommendation Order pneumovax
Needs
Pneumovax (high risk medical condition)
Rule#: 144 Rule category Health Maintenance Primary Clinical Area Vaccinations
Risk Group Definition Age 18-65
AND Patient has a high risk medical condition
Recommendation Logic: No pneumovax on record
Recommendation Order pneumovax
Repeat
Pneumovax (high risk medical condition)
Rule#: 145 Rule category Health Maintenance Primary Clinical Area Vaccinations
Risk Group Definition Patient has high risk medical condition
Recommendation Logic: One and Only One pneumovax given >5 years ago
Recommendation Perform pneuomax
Influenza
Vaccination Older Than 50
Rule#: 146 Rule category Health Maintenance Primary Clinical Area Vaccinations
Risk Group Definition Age > 50
Recommendation Logic: Today is within flu season: Oct, Nov, Dec, Jan, Feb (Oct 1 to March 1), no previous vacc.
Recommendation Perform influenza vaccination.
Needs Influenza Vaccination 18-50 (high risk)
Rule#: 147 Rule category Health Maintenance Primary Clinical Area Vaccinations
Risk Group Definition Age 18-50
AND Patient has a high risk medical condition
AND Today is within flu season: Oct, Nov, Dec, Jan, Feb
Recommendation Logic: NO Flu shot during the current flu season
Recommendation Influenza Vaccine concept ID: 1516
Osteoporosis
Management for At-Risk Populations
Rule#: 148 Rule category Health Maintenance Primary Clinical Area Osteoporosis Prevention
Risk Group Definition ((Female at least 65 years) OR
(Female 50-64 has risk factors for osteoporosis [smoking, past smoking, prior fracture since age 45, use of oral glucocorticoids for >=3 months or family history of osteoporosis))
Recommendation Logic: No osteoporosis meds on med list and no bone density scan on file
Recommendation Order bone densitometry
Overdue for
mammography (High FHx Risk)
Rule#: 149 Rule category Health Maintenance Primary Clinical Area Cancer Screening
Risk Group Definition Rule A
Female
AND High FHx Risk of Breast cancer
AND Bilateral Mastectomy NOT on problem list
AND age>40 yrs, <75 yrs
Recommendation Logic: No mammogram in the past 12 months.
Recommendation Order mammogram
Overdue for mammography (High FHx Risk)
Rule#: 150 Rule category Health Maintenance Primary Clinical Area Cancer Screening
Risk Group Definition Rule B
Female
AND High FHx Risk of Breast cancer
AND Bilateral Mastectomy NOT on problem list
AND Patient is =< 40 years and > 25 years
AND (Age of youngest affected (with Breast cancer) relative - patient's age) < = 10 years )
Recommendation Logic: No mammogram in the past 12 months
Recommendation Order mammogram
Overdue for mammography (Mod FHx Risk)
Rule#: 151 Rule category Health Maintenance Primary Clinical Area Cancer Screening
Risk Group Definition Rule A
Female
AND Mod FHx Risk of Breast cancer
AND Bilateral Mastectomy NOT on problem list
AND Patient >40 years, <75 yrs
Recommendation Logic: No mammogram in the past 12 months.
Recommendation Order mammogram
Overdue for mammography (Mod FHx Risk)
Rule#: 152 Rule category Health Maintenance Primary Clinical Area Cancer Screening
Risk Group Definition Rule B
Female
AND Mod FHx Risk of Breast cancer
AND Bilateral Mastectomy NOT on problem list
AND Patient is =< 40 and > 25 years of age
AND(Age of youngest affected (with Breast cancer) relative - patient's age) <= 10 years)
Recommendation Logic: No mammogram in the past 12 months.
Recommendation Order mammogram
Overdue for mammography (Average Risk)
Rule#: 153 Rule category Health Maintenance Primary Clinical Area Cancer Screening
Risk Group Definition Rule A
Female
AND Avg FHx Risk of Breast cancer
AND Bilateral Mastectomy NOT on problem list
AND Patient is older than 40 years of age, <75 yrs
Recommendation Logic: No mammogram in the past 12 months.
Recommendation Order mammogram
Almost due for mammography (High FHx Risk)
Rule#: 155 Rule category Health Maintenance Primary Clinical Area Cancer Screening
Risk Group Definition Rule A
Female
AND High FHx Risk of Breast cancer
AND Bilateral Mastectomy NOT on problem list
AND Patient is older than 40 years of age, <75 yrs
Recommendation Logic: Last mammogram 10-12 (inclusive) months ago
Recommendation Order mammogram
Almost due for mammography (High FHx Risk)
Rule#: 156 Rule category Health Maintenance Primary Clinical Area Cancer Screening
Risk Group Definition Rule B
Female
AND High FHx Risk of Breast cancer
AND Bilateral Mastectomy NOT on problem list
AND Patient is =< 40 and > 25 years of age
AND Age of youngest affected (with Breast cancer) relative - patient's age) <= 10 years)
Recommendation Logic: Last mammogram 10-12 (inclusive) months ago
Recommendation Order mammogram
Almost due for mammography (Mod FHx Risk)
Rule#: 157 Rule category Health Maintenance Primary Clinical Area Cancer Screening
Risk Group Definition Rule A
Female
AND Mod FHx Risk of Breast cancer
AND Bilateral Mastectomy NOT on problem list
AND older than 40 years of age, <75 yrs
Recommendation Logic: Last mammogram 10-12 (inclusive) months ago
Recommendation Order mammogram
Almost due for mammography (Mod FHx Risk)
Rule#: 158 Rule category Health Maintenance Primary Clinical Area Cancer Screening
Risk Group Definition Rule B
Female
AND Mod FHx Risk of Breast cancer
AND Bilateral Mastectomy NOT on problem list
AND Patient is =< 40 and > 25 years of age
AND Age of youngest affected (with Breast cancer) relative - patient's age) <= 10 years
Recommendation Logic: Last mammogram 10-12 (inclusive) months ago
Recommendation Order mammogram
Almost due for mammography (Average Risk)
Rule#: 159 Rule category Health Maintenance Primary Clinical Area Cancer Screening
Risk Group Definition Rule A
Female
AND Avg FHx Risk of Breast cancer
AND Bilateral Mastectomy NOT on problem list
AND Patient is older than 40 years of age, <75 yrs
Recommendation Logic: Last mammogram 10-12 (inclusive) months ago
Recommendation Order mammogram
Overdue for pap smear
Rule#: 161 Rule category Health Maintenance Primary Clinical Area Cancer Screening
Risk Group Definition Female
AND age > 18 and < 65
AND hysterectomy and TAH-BSO not on problem list
Recommendation Logic: Last pap > 3 years ago
Recommendation Perform pap
Almost due for pap smear
Rule#: 162 Rule category Health Maintenance Primary Clinical Area Cancer Screening
Risk Group Definition Female
AND age > 18 and < 65
AND hysterectomy and TAH-BSO not on problem list
Recommendation Logic: Last pap 2.5 - 3 years ago
Recommendation Perform pap smear
NO risk factors, almost due for Lipids Assessment (male)
Rule#: 192 Rule category Health Maintenance Primary Clinical Area Lipid creening
Risk Group Definition Age >35, <80
AND not diabetic
AND no CHD and its equivalents
AND FHx for CHD is AVERAGE
AND problem list does not contain smoking and hypertension
AND male
RISK GROUP DEFINITION No total cholesterol in >54 months or no previous data
AND No LDL in >54 months or no previous data
Recommendation Order lipid panel
NO risk factors, almost due for Lipids Assessment (female)
Rule#: 193 Rule category Health Maintenance Primary Clinical Area Lipid creening
Risk Group Definition Age >45, <80
AND not diabetic
AND no CHD and its equivalents
AND FHx for CHD is AVERAGE
AND problem list does not contain smoking and hypertension
AND female
AND No total cholesterol in >54 months or no previous data
AND No LDL in >54 months or no previous data
Recommendation Order lipid panel
Literature/ref.
1. NCEP/ATP III. Executive Summary of the Third Report of the NCEP Expert Panel on Detection, Evaluation, and
Treatment of High Blood Cholesterol in Adults (ATP III). JAMA, Vol 285 (19): 2486-2497.
2. USPSTF. Screening Adults for Lipid Disorders. Am J Prev Med. 2001; 20 (3S): 73-76.
LMR Reminder: NO risk factors, Overdue for Lipids Assessment (Male)
Rule#: 190 Rule category Health Maintenance Primary Clinical Area Lipid creening
Risk Group Definition Age >35, <80
AND not diabetic
AND no CHD and its equivalents
AND FHx for CHD is AVERAGE (change it to NOT(moderate or high)
AND problem list does not contain smoking and hypertension
AND male
AND no total cholesterol in >5 years or no previous data
AND No LDL in >5 years or no previous data
Recommendation Order lipid panel
LMR Reminder: NO risk factors, Overdue for Lipids Assessment (female)
Rule#: 191 Rule category Health Maintenance Primary Clinical Area Lipid creening
Risk Group Definition Age >45, <80
AND not diabetic
AND no CHD and its equivalents
AND FHx for CHD is AVERAGE (change it to NOT(moderate or high)
AND problem list does not contain smoking and hypertension
AND female
AND No total cholesterol in >5 years or no previous data
AND No LDL in >5 years or no previous data
Recommendation Order lipid panel
Literature/ref.
1. NCEP/ATP III. Executive Summary of the Third Report of the NCEP Expert Panel on Detection, Evaluation, and
Treatment of High Blood Cholesterol in Adults (ATP III). JAMA, Vol 285 (19): 2486-2497.
2. USPSTF. Screening Adults for Lipid Disorders. Am J Prev Med. 2001; 20 (3S): 73-76.
LMR Reminder: Risk Factor: Family History, Almost due for Lipids Assessment
Rule#: 188 Rule category Health Maintenance Primary Clinical Area Lipid screening
Risk Group Definition Age>20 and <80
AND not diabetic
AND not CHD equivalent
AND FHx risk for CHD is MODERATE
AND no total cholesterol or no previous data
AND No LDL or no previous data > 54 months
Recommendation Order lipid panel
LMR Reminder: Risk Factor: Family History, Almost due for Lipid Assessment
Rule#: 189 Rule category Health Maintenance Primary Clinical Area Lipid screening
Risk Group Definition Age>20 and <80
AND not diabetic
AND not CHD equivalent
AND problem list contains HTN OR smoking
AND No total cholesterol in >54 months or no previous data
AND No LDL in >54 months or no previous data
Recommendation Order lipid panel
Literature/ref.
1. NCEP/ATP III. Executive Summary of the Third Report of the NCEP Expert Panel on Detection, Evaluation, and
Treatment of High Blood Cholesterol in Adults (ATP III). JAMA, Vol 285 (19): 2486-2497.
2. USPSTF. Screening Adults for Lipid Disorders. Am J Prev Med. 2001; 20 (3S): 73-76.