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&acirc;&euro;&trade;s Hospital,
+
   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 &acirc;&euro;&ldquo; it is provided as is and must be reviewed for correctness
+
   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&acirc;&euro;&trade;s age) &lt; = 10 years
+
     Breast cancer) relative - patient's age) &lt; = 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&acirc;&euro;&trade;s age) &lt;= 10
+
     Breast cancer) relative - patient's age) &lt;= 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&acirc;&euro;&trade;s age) &lt;= 10
+
     Breast cancer) relative - patient's age) &lt;= 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&acirc;&euro;&trade;s age) &lt;= 10 years</span></p>
+
     Breast cancer) relative - patient's age) &lt;= 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.