Difference between revisions of "Diabetes order sets"

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Each order set contains a variety of common orders for patients with diabetes.  One of the major questions in order set design is whether a good order set has all of the choices someone might want (which implies that an order set is a tool for making ordering quicker), or whether it should contain the "best" choices (which implies that an order set is a tool for influencing ordering behavior).  These two order sets lean towards the side of inclusiveness, although they do make a careful effort to be evidence-based, and generally contain drugs available in a generic form in the United States.
 
Each order set contains a variety of common orders for patients with diabetes.  One of the major questions in order set design is whether a good order set has all of the choices someone might want (which implies that an order set is a tool for making ordering quicker), or whether it should contain the "best" choices (which implies that an order set is a tool for influencing ordering behavior).  These two order sets lean towards the side of inclusiveness, although they do make a careful effort to be evidence-based, and generally contain drugs available in a generic form in the United States.
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This flow sheet contains a set of lab results useful in the clinical management of a patient with diabetes.  Many clinical information systems allow for the creation of flow sheets like this, so that specific subsets of lab results can be viewed by the user.
 
  
 
=== An order set for Type II Diabetes, with a focus on DM management ===
 
=== An order set for Type II Diabetes, with a focus on DM management ===

Revision as of 18:58, 11 September 2007

These diabetes order sets are based on content released into the public domain by Kaiser Permanente.

Each order set contains a variety of common orders for patients with diabetes. One of the major questions in order set design is whether a good order set has all of the choices someone might want (which implies that an order set is a tool for making ordering quicker), or whether it should contain the "best" choices (which implies that an order set is a tool for influencing ordering behavior). These two order sets lean towards the side of inclusiveness, although they do make a careful effort to be evidence-based, and generally contain drugs available in a generic form in the United States.

An order set for Type II Diabetes, with a focus on DM management

  • Diagnoses (with ICD-9 codes)
      • DM 2 [250.00H]
      • DM 2 W DIABETIC NEPHROPATHY
      • DM 2 W DIABETIC PERIPHERAL NEUROPATHY
  • Medications
      • SURESTEP TEST STRIPS (Sig: Use as directed for diabetes, Disp: 100)
      • ONE TOUCH ULTRASOFT LANCETS (Sig: Use as directed, Disp: 100)
      • ONE TOUCH ULTRA 2 KIT (Sig: Use as directed, Disp: 1)
      • ONE TOUCH ULTRA TEST STRIPS (Sig: Use as directed, Disp: 100)
      • ASPIRIN 81 MG ORAL EC TAB (Sig: TAKE 1 TAB PO ONCE DAILY FOR DIABETES HEART PROTECTION, Disp: 100)
      • ASPIRIN 325 MG ORAL EC TAB (Sig: TAKE 1 TAB PO ONCE DAILY FOR DIABETES HEART PROTECTION, Disp: 100)
      • METFORMIN 500 MG ORAL TAB (Sig: TAKE 1 TAB PO BID FOR DIABETES, Disp: 120)
      • METFORMIN 1,000 MG ORAL TAB (Sig: TAKE 1 TAB PO BID FOR DIABETES, Disp: 120)
      • GLIPIZIDE 5 MG ORAL TAB (Sig: TAKE 1 TAB PO ONE DAILY FOR DIABETES, Disp: 60)
      • GLIPIZIDE 5 MG ORAL TAB (Sig: TAKE 1 TAB PO BID FOR DIABETES, Disp: 120)
      • GLIPIZIDE 10 MG ORAL TAB (Sig: TAKE 1 TAB PO ONE DAILY FOR DIABETES, Disp: 60)
      • GLIPIZIDE 10 MG ORAL TAB (Sig: TAKE 1 TAB PO BID FOR DIABETES, Disp: 120)
      • GLIPIZIDE 10 MG ORAL TAB (Sig: TAKE 2 TABS PO BID FOR DIABETES, Disp: 240)
      • SIMVASTATIN 10 MG ORAL TAB (Sig: take 1 tab po once daily for cholesterol, Disp: 60)
      • SIMVASTATIN 20 MG ORAL TAB (Sig: take 1 tab po once daily for cholesterol, Disp: 60)
      • SIMVASTATIN 40 MG ORAL TAB (Sig: take 1 tab po once daily for cholesterol, Disp: 60)
      • SIMVASTATIN 80 MG ORAL TAB (Sig: take 1 tab po once daily for cholesterol, Disp: 60)
      • LISINOPRIL 10 MG ORAL TAB (Sig: TAKE 1 TAB PO ONCE DAILY FOR BLOOD PRESSURE AND KIDNEY PROTECTION, Disp: 60)
      • LISINOPRIL 20 MG ORAL TAB (Sig: TAKE 1 TAB PO ONCE DAILY FOR BLOOD PRESSURE AND KIDNEY PROTECTION, Disp: 60)
      • LISINOPRIL 40 MG ORAL TAB (Sig: TAKE 1 TAB PO ONCE DAILY FOR BLOOD PRESSURE AND KIDNEY PROTECTION, Disp: 60)
      • LISINOPRIL-HYDROCHLOROTHIAZIDE 10 MG-12.5 MG TAB (Sig: TAKE 1 TAB PO ONCE DAILY FOR BLOOD PRESSURE AND KIDNEY PROTECTION, Disp: 60)
      • LISINOPRIL-HYDROCHLOROTHIAZIDE 20 MG-12.5 MG TAB (Sig: TAKE 1 TAB PO ONCE DAILY FOR BLOOD PRESSURE AND KIDNEY PROTECTION, Disp: 60)
      • LISINOPRIL-HYDROCHLOROTHIAZIDE 20 MG-25 MG TAB (Sig: TAKE 1 TAB PO ONCE DAILY FOR BLOOD PRESSURE AND KIDNEY PROTECTION, Disp: 60)
      • NPH INSULIN 100 UNIT/ML INJ (Sig: INJECT SUBCUTANEOUSLY AS DIRECTED FOR DIABETES, Disp: 20)
      • REGULAR INSULIN 100 UNIT/ML INJ (Sig: INJECT SUBCUTANEOUSLY AS DIRECTED FOR DIABETES, Disp: 20)
  • Immunizations (with CPT codes)
    • Immunization
      • TDaP Vaccination 0.5 ml IM (ages 11-64) [90715A]
      • Td (adult) vaccination, 0.5 mL IM (age 65 and over) [90718C]
      • Pneumococcal Polysaccharide (Pneumovax) vaccination, 0.5 mL IM [90732C]
      • Influenza vaccination, 3 yr - adult, 0.5 mL IM [90658C]
      • Influenza vaccination, 0.5 mL IntraNasal [90660C]
    • Administration Codes
      • VACC ADMIN, FIRST IM OR SUBQ VACCINE TOXOID (Always order) [90471B]
      • VACC ADMIN, EACH ADDITIONAL IM OR SUBQ VACCINE TOXOID (For 2 or more total IMM's select FIRST IMM code above, and this code for each additional administration) [90472B]
      • VACC ADMIN, FIRST INTRANASAL OR PO VACCINE TOXOID [90473B]
  • Lab orders (with CPT codes)
    • Labs today
      • CBC W DIFFERENTIAL, AUTO [85025B]
      • POTASSIUM, SERUM [84132C]
      • CREATININE, SERUM [82565C]
      • GLUCOSE, FASTING [82947B]
      • ELECTROLYTES, SERUM [80051E]
      • TSH W REFLEX TO FT4 [84443K]
      • TSH ONLY [84443B]
      • LIPID PANEL, FASTING [80061B]
      • LIPID PANEL, NON-FASTING [80061D]
      • ALT, SERUM [84460B]
      • PSA [84153B]
      • HEMOGLOBIN A1C [83036B]
      • MICROALBUMIN/CREATININE, URINE [200479]
    • Labs today
      • CBC W DIFFERENTIAL, AUTO [85025B]
      • CREATININE, SERUM [82565C]
      • GLUCOSE, FASTING [82947B]
      • ELECTROLYTES, SERUM [80051E]
      • TSH W REFLEX TO FT4 [84443K]
      • TSH ONLY [84443B]
      • LIPID PANEL, FASTING [80061B]
      • LIPID PANEL, NON-FASTING [80061D]
      • ALT, SERUM [84460B]
      • PSA [84153B]
      • HEMOGLOBIN A1C [83036B]
      • MICROALBUMIN/CREATININE, URINE [200479]
    • Labs in 3-12 months
      • CBC W DIFFERENTIAL, AUTO [85025B]
      • CREATININE, SERUM [82565C]
      • GLUCOSE, FASTING [82947B]
      • ELECTROLYTES, SERUM [80051E]
      • TSH W REFLEX TO FT4 [84443K]
      • TSH ONLY [84443B]
      • LIPID PANEL, FASTING [80061B]
      • LIPID PANEL, NON-FASTING [80061D]
      • ALT, SERUM [84460B]
      • PSA [84153B]
      • HEMOGLOBIN A1C [83036B]
      • MICROALBUMIN/CREATININE, URINE [200479]
    • Standing Lab Orders
      • HEMOGLOBIN A1C (HGB A1C) q 3 months for 1 year [83036B]
  • Procedures (with CPT codes)
      • ANNUAL SCREENING, DM FOOT USING TOUCH PRESSURE QUANT. SENSORY TESTING, PER FOOT [0106TA]

Another order set for diabetes, with a focus on complications

  • Diagnoses (with ICD-9 codes)
    • Diabetes related
      • SENSORY PROBLEM W FEET, HIGH RISK [V49.3H]
      • SENSORY PROBLEM W FEET, LOW RISK [V49.3I]
      • SCREENING, DIABETIC RETINOPATHY [V72.0T]
    • Screening for other conditions
      • SCREENING FOR CA, BREAST, BY MAMMOGRAM [V76.12G]
      • SCREENING FOR CA, CERVIX [V76.2A]
      • SCREENING FOR CA, COLON [V76.51A]
      • SCREENING EXAMINATION FOR CA, PROSTATE [V76.44A]
      • SCREENING, ENDOCRINE, NUTRITIONAL, OR METABOLIC [V77.99G]
      • SCREENING [V82.9B]
  • Diabetes-related Orders (with CPT codes)
    • Lab today
      • HEMOGLOBIN A1C [83036B]
      • LIPID PANEL [80061]
      • LDL DIRECT [83721C]
      • MICROALBUMIN SCREEN URINE [213757]
      • ALT, SERUM [84460B]
      • AST, SERUM [84450B]
      • REF EYE CARE, DIABETIC SCREENING [217755]
    • Lab in 2-6 months
      • HEMOGLOBIN A1C [83036B]
      • LIPID PANEL [80061]
      • LDL DIRECT [83721C]
      • MICROALBUMIN SCREEN URINE [213757]
      • ALT, SERUM [84460B]
      • AST, SERUM [84450B]
    • Lab in 6-12 months
      • HEMOGLOBIN A1C [83036B]
      • LIPID PANEL [80061]
      • LDL DIRECT [83721C]
      • MICROALBUMIN SCREEN URINE [213757]
      • ALT, SERUM [84460B]
      • AST, SERUM [84450B]
  • Other related orders
    • Lab today
      • CBC W DIFFERENTIAL, AUTO [85025B]
      • SODIUM, SERUM [84295A]
      • POTASSIUM BLOOD [84132A]
      • CHLORIDE, SERUM [82435C]
      • BUN, SERUM [84520M]
      • CREATININE, SERUM [82565C]
      • OCCULT BLOOD ST 3 SPECIMENS [82270A]
      • PAP, LIQUID BASE SCREEN [88174C]
      • PSA [84153B]
      • TSH W REFLEX TO FT4 - order if screening [84443K]
      • THYROID STIMULATING HORMONE (TSH ONLY)- order if monitoring [84443A]
      • URINALYSIS W REFLEX TO MICROSCOPY AND CULTURE [81003G]
  • Referral, imaging and reminder orders
      • FLEX SIG [214156]
      • REF COLON CANCER SCREENING HI RISK (aka COLONOSCOPY) [213973]
      • REMIND TO HAVE PAP EXAM [213594]
      • XR MAMMOGRAPHY SCREENING BILATERAL, 2 VIEWS EACH BREAST [77057K]
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