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− | '''Sample Reminders from the Clinical Decision Support Expert Panel'''
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− | ''Based on content from the Partners HealthCare''
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− | '''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.'''
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− | <u>'''Needs Pneumovax (age > 65 and no Pneumovax ever)
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− | '''</u>
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− | ''' Rule\#: 142 Rule category '''Health Maintenance''' Primary Clinical Area '''Vaccinations
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− | ''' Risk Group Definition '''Age > 65
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− | '''Recommendation Logic: '''No Pneumovax on file
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− | '''Recommendation '''Order pneumovax
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− | '''Needs repeat pneumovax >65
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− | '''
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− | ''' Rule\#: 143 Rule category '''Health Maintenance''' Primary Clinical Area '''Vaccinations
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− | ''' Risk Group Definition '''Age > 65
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− | ''' '''AND one (and only one) pneumovax on file''' '''
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− | '''Recommendation Logic: '''latest pneumovax was performed 5 years ago and when patient was less
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− | ''' ''' than 65 years of age
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− | '''Recommendation '''Order pneumovax
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− | '''Needs Pneumovax (high risk medical condition)
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− | '''
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− | ''' Rule\#: 144 Rule category '''Health Maintenance''' Primary Clinical Area '''Vaccinations
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− | ''' Risk Group Definition '''Age 18-65
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− | ''' '''AND Patient has a high risk medical condition
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− | '''Recommendation Logic: '''No pneumovax on record
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− | '''Recommendation '''Order pneumovax
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− | '''Repeat Pneumovax (high risk medical condition)
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− | '''
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− | ''' Rule\#: 145 Rule category '''Health Maintenance''' Primary Clinical Area '''Vaccinations
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− | ''' Risk Group Definition '''Patient has high risk medical condition
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− | '''Recommendation Logic: '''One and Only One pneumovax given >5 years ago
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− | '''Recommendation '''Perform pneuomax
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− | '''Influenza Vaccination Older Than 50
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− | '''
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− | ''' Rule\#: 146 Rule category '''Health Maintenance''' Primary Clinical Area '''Vaccinations
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− | ''' Risk Group Definition '''Age > 50
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− | '''Recommendation Logic: '''Today is within flu season: Oct, Nov, Dec, Jan, Feb (Oct 1 to March ''' '''1), no previous vacc.
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− | '''Recommendation '''Perform influenza vaccination.
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− | '''Needs Influenza Vaccination 18-50 (high risk)'''
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− | ''' Rule\#: 147 Rule category '''Health Maintenance''' Primary Clinical Area '''Vaccinations
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− | ''' Risk Group Definition '''Age 18-50
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− | ''' '''AND Patient has a high risk medical condition
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− | ''' '''AND Today is within flu season: Oct, Nov, Dec, Jan, Feb
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− | '''Recommendation Logic: '''NO Flu shot during the current flu season
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− | '''Recommendation '''Influenza Vaccine concept ID: 1516
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− | '''
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− | '''
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− | '''Osteoporosis Management for At-Risk Populations
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− | '''
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− | ''' Rule\#: 148 Rule category '''Health Maintenance''' Primary Clinical Area '''Osteoporosis Prevention
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− | ''' Risk Group Definition '''((Female at least 65 years) OR
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− | ''' '''(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))
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− | '''Recommendation Logic: '''No osteoporosis meds on med list and no bone density scan on file
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− | '''Recommendation '''Order bone densitometry
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− | '''Overdue for mammography (High FHx Risk)
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− | '''
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− | ''' Rule\#: 149 Rule category '''Health Maintenance''' Primary Clinical Area '''Cancer Screening
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− | ''' Risk Group Definition '''Rule A
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− | ''' '''Female
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− | ''' '''AND High FHx Risk of Breast cancer
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− | ''' '''AND Bilateral Mastectomy NOT on problem list
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− | ''' '''AND age>40 yrs, <75 yrs
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− | '''Recommendation Logic: '''No mammogram in the past 12 months.
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− | '''Recommendation '''Order mammogram
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− | '''Overdue for mammography (High FHx Risk)'''
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− | ''' Rule\#: 150 Rule category '''Health Maintenance''' Primary Clinical Area '''Cancer Screening
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− | ''' Risk Group Definition '''Rule B
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− | ''' '''Female
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− | ''' '''AND High FHx Risk of Breast cancer
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− | ''' '''AND Bilateral Mastectomy NOT on problem list
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− | ''' '''AND Patient is =< 40 years and > 25 years
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− | ''' '''AND (Age of youngest affected (with Breast cancer) relative - patient\’s age) < = 10 years )
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− | '''Recommendation Logic: '''No mammogram in the past 12 months
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− | '''Recommendation '''Order mammogram
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− | '''Overdue for mammography (Mod FHx Risk)'''
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− | ''' Rule\#: 151 Rule category '''Health Maintenance''' Primary Clinical Area '''Cancer Screening
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− | ''' Risk Group Definition '''Rule A
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− | ''' '''Female
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− | ''' '''AND Mod FHx Risk of Breast cancer
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− | ''' '''AND Bilateral Mastectomy NOT on problem list
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− | ''' '''AND Patient >40 years, <75 yrs
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− | '''Recommendation Logic: '''No mammogram in the past 12 months.
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− | '''Recommendation '''Order''' '''mammogram
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− | '''Overdue for mammography (Mod FHx Risk)'''
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− | ''' Rule\#: 152 Rule category '''Health Maintenance''' Primary Clinical Area '''Cancer Screening
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− | ''' Risk Group Definition '''Rule B
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− | ''' '''Female
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− | ''' '''AND Mod FHx Risk of Breast cancer
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− | ''' '''AND Bilateral Mastectomy NOT on problem list
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− | ''' '''AND Patient is =< 40 and > 25 years of age
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− | ''' '''AND(Age of youngest affected (with Breast cancer) relative - patient\’s age) <= 10 years)
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− | '''Recommendation Logic: '''No mammogram in the past 12 months.
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− | '''Recommendation '''Order mammogram
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− | '''
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− | '''
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− | '''Overdue for mammography (Average Risk)'''
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− | ''' Rule\#: 153 Rule category '''Health Maintenance''' Primary Clinical Area '''Cancer Screening
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− | ''' Risk Group Definition '''Rule A
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− | ''' '''Female
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− | ''' '''AND Avg FHx Risk of Breast cancer
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− | ''' '''AND Bilateral Mastectomy NOT on problem list
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− | ''' '''AND Patient is older than 40 years of age, <75 yrs
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− | '''Recommendation Logic: '''No mammogram in the past 12 months.
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− | '''Recommendation '''Order mammogram
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− | '''Almost due for mammography (High FHx Risk)'''
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− | ''' Rule\#: 155 Rule category '''Health Maintenance''' Primary Clinical Area '''Cancer Screening
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− | ''' Risk Group Definition '''Rule A
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− | ''' '''Female
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− | ''' '''AND High FHx Risk of Breast cancer
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− | ''' '''AND Bilateral Mastectomy NOT on problem list
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− | ''' '''AND Patient is older than 40 years of age, <75 yrs
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− | '''Recommendation Logic: '''Last mammogram 10-12 (inclusive) months ago
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− | '''Recommendation '''Order mammogram
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− | '''Almost due for mammography (High FHx Risk)'''
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− | ''' Rule\#: 156 Rule category '''Health Maintenance''' Primary Clinical Area '''Cancer Screening
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− | ''' Risk Group Definition '''Rule B
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− | ''' '''Female
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− | ''' '''AND High FHx Risk of Breast cancer
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− | ''' '''AND Bilateral Mastectomy NOT on problem list
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− | ''' '''AND Patient is =< 40 and > 25 years of age
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− | ''' '''AND Age of youngest affected (with Breast cancer) relative - patient\’s age) <= 10 years)
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− | '''Recommendation Logic: '''Last mammogram 10-12 (inclusive) months ago
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− | '''Recommendation '''Order mammogram
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− | '''Almost due for mammography (Mod FHx Risk)'''
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− | ''' Rule\#: 157 Rule category '''Health Maintenance''' Primary Clinical Area '''Cancer Screening
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− | ''' Risk Group Definition '''Rule A
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− | ''' '''Female
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− | ''' '''AND Mod FHx Risk of Breast cancer
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− | ''' '''AND Bilateral Mastectomy NOT on problem list
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− | ''' '''AND older than 40 years of age, <75 yrs
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− | '''Recommendation Logic: '''Last mammogram 10-12 (inclusive) months ago
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− | '''Recommendation '''Order mammogram
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− | '''Almost due for mammography (Mod FHx Risk)'''
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− | ''' Rule\#: 158 Rule category '''Health Maintenance''' Primary Clinical Area '''Cancer Screening
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− | ''' Risk Group Definition '''Rule B
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− | ''' '''Female
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− | ''' '''AND Mod FHx Risk of Breast cancer
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− | ''' '''AND Bilateral Mastectomy NOT on problem list
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− | ''' '''AND Patient is =< 40 and > 25 years of age
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− | ''' '''AND Age of youngest affected (with Breast cancer) relative - patient\’s age) <= 10 years
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− | '''Recommendation Logic: '''Last mammogram 10-12 (inclusive) months ago
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− | '''Recommendation '''Order mammogram
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− | '''
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− | '''
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− | '''Almost due for mammography (Average Risk)'''
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− | ''' Rule\#: 159 Rule category '''Health Maintenance''' Primary Clinical Area '''Cancer Screening
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− | ''' Risk Group Definition '''Rule A
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− | ''' '''Female
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− | ''' '''AND Avg FHx Risk of Breast cancer
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− | ''' '''AND Bilateral Mastectomy NOT on problem list
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− | ''' '''AND Patient is older than 40 years of age, <75 yrs
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− | '''Recommendation Logic: '''Last mammogram 10-12 (inclusive) months ago
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− | '''Recommendation '''Order mammogram
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− | '''Overdue for pap smear'''
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− | ''' Rule\#: 161 Rule category '''Health Maintenance''' Primary Clinical Area '''Cancer Screening
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− | ''' Risk Group Definition '''Female
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− | ''' '''AND age > 18 and < 65
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− | ''' '''AND hysterectomy and TAH-BSO not on problem list
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− | '''Recommendation Logic: '''Last pap > 3 years ago
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− | '''Recommendation '''Perform pap
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− | '''Almost due for pap smear'''
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− | ''' Rule\#: 162 Rule category '''Health Maintenance''' Primary Clinical Area '''Cancer Screening
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− | ''' Risk Group Definition '''Female
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− | ''' '''AND age > 18 and < 65
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− | ''' '''AND hysterectomy and TAH-BSO not on problem list
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− | '''Recommendation Logic: '''Last pap 2.5 - 3 years ago
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− | '''Recommendation '''Perform pap smear
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− | '''NO risk factors, almost due for Lipids Assessment (male)'''
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− | ''' Rule\#: 192 Rule category '''Health Maintenance''' Primary Clinical Area '''Lipid creening
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− | ''' Risk Group Definition '''Age '''>35, <80'''
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− | ''' '''AND not diabetic
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− | ''' '''AND no CHD and its equivalents
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− | ''' '''AND FHx for CHD is AVERAGE
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− | ''' '''AND problem list does not contain smoking and hypertension
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− | ''' '''AND '''male'''
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− | ''' RISK GROUP DEFINITION '''No total cholesterol in >54 months or no previous data
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− | ''' '''AND No LDL in >54 months or no previous data
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− | ''' Recommendation '''Order lipid panel
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− | ''' '''
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− | '''NO risk factors, almost due for Lipids Assessment (female)'''
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− | ''' Rule\#: 193 Rule category '''Health Maintenance''' Primary Clinical Area '''Lipid creening
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− | ''' Risk Group Definition '''Age '''>45, <80'''
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− | ''' '''AND not diabetic
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− | ''' '''AND no CHD and its equivalents
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− | ''' '''AND FHx for CHD is AVERAGE
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− | ''' '''AND problem list does not contain smoking and hypertension
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− | ''' '''AND '''female'''
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− | AND No total cholesterol in >54 months or no previous data
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− | ''' '''AND No LDL in >54 months or no previous data
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− | ''' Recommendation '''Order lipid panel
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− | '''Literature/ref.'''
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− | ''' '''1. NCEP/ATP III. Executive Summary of the Third Report of the NCEP Expert Panel on Detection, Evaluation, and
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− | ''' '''Treatment of High Blood Cholesterol in Adults (ATP III). JAMA, Vol 285 (19): 2486-2497.
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− | ''' '''2. USPSTF. Screening Adults for Lipid Disorders. Am J Prev Med. 2001; 20 (3S): 73-76.
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− | '''LMR Reminder: NO risk factors, Overdue for Lipids Assessment (Male)'''
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− | ''' Rule\#: 190 Rule category '''Health Maintenance''' Primary Clinical Area '''Lipid creening
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− | ''' Risk Group Definition '''Age '''>35, <80'''
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− | ''' '''AND not diabetic
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− | ''' '''AND no CHD and its equivalents
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− | ''' '''AND FHx for CHD is AVERAGE (change it to NOT(moderate or high)
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− | ''' '''AND problem list does not contain smoking and hypertension
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− | ''' '''AND '''male'''
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− | ''' '''AND''' '''no total cholesterol in >5 years or no previous data
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− | ''' '''AND No LDL in >5 years or no previous data
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− | ''' Recommendation '''Order lipid panel
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− | '''LMR Reminder: NO risk factors, Overdue for Lipids Assessment (female)'''
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− | ''' Rule\#: 191 Rule category '''Health Maintenance''' Primary Clinical Area '''Lipid creening
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− | ''' Risk Group Definition '''Age '''>45, <80'''
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− | ''' '''AND not diabetic
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− | ''' '''AND no CHD and its equivalents
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− | ''' '''AND FHx for CHD is AVERAGE (change it to NOT(moderate or high)
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− | ''' '''AND problem list does not contain smoking and hypertension
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− | ''' '''AND''' female'''
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− | ''' '''AND''' '''No total cholesterol in >5 years or no previous data
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− | ''' '''AND No LDL in >5 years or no previous data
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− | ''' Recommendation '''Order lipid panel
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− | '''Literature/ref.'''
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− | ''' '''1. NCEP/ATP III. Executive Summary of the Third Report of the NCEP Expert Panel on Detection, Evaluation, and
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− | ''' '''Treatment of High Blood Cholesterol in Adults (ATP III). JAMA, Vol 285 (19): 2486-2497.
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− | ''' '''2. USPSTF. Screening Adults for Lipid Disorders. Am J Prev Med. 2001; 20 (3S): 73-76.
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− | '''LMR Reminder: Risk Factor: Family History, Almost due for Lipids Assessment'''
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− | ''' Rule\#: 188 Rule category '''Health Maintenance''' Primary Clinical Area '''Lipid screening
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− | ''' Risk Group Definition '''Age>20 and <80
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− | ''' '''AND not diabetic
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− | ''' '''AND not CHD equivalent
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− | ''' ''' AND FHx risk for CHD is MODERATE
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− | ''' '''AND no total cholesterol or no previous data
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− | ''' '''AND No LDL or no previous data > 54 months
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− | ''' Recommendation '''Order lipid panel
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− | ''' '''
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− | '''LMR Reminder: Risk Factor: Family History, Almost due for Lipid Assessment'''
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− | ''' Rule\#: 189 Rule category '''Health Maintenance''' Primary Clinical Area '''Lipid screening
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− | ''' Risk Group Definition '''Age>20 and <80
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− | ''' '''AND not diabetic
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− | ''' '''AND not CHD equivalent
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− | ''' '''AND problem list contains HTN OR smoking
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− | AND No total cholesterol in >54 months or no previous data
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− | ''' '''AND No LDL in >54 months or no previous data
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− | ''' Recommendation '''Order lipid panel
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− | '''Literature/ref.'''
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− | ''' '''1. NCEP/ATP III. Executive Summary of the Third Report of the NCEP Expert Panel on Detection, Evaluation, and
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− | ''' '''Treatment of High Blood Cholesterol in Adults (ATP III). JAMA, Vol 285 (19): 2486-2497.
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− | ''' '''2. USPSTF. Screening Adults for Lipid Disorders. Am J Prev Med. 2001; 20 (3S): 73-76.
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