National Reminders

National Reminders• National Reminders are delivered in PXRM patches. The

most current patch is 1009• Reminder will look at V LAB, V RAD, V MED in order to

turn or resolve the reminders.• The new reminders are using Best Practice Prompts to

resolve the reminder• Automatically loads the reminders in the reminder

exchange file• Each site will need to install the reminders from the

exchange• Most National reminders are delivered with dialog

National Reminders

• National Reminders CANNOT be edited.• Sites that wish to change the frequency need

to copy the reminder to a new name and edit the copy

• Taxonomies and Reminder terms can be edited

• Reminder terms MUST be edited to add local tests to resolve the reminder

• Reminders must be added to GUI parameters. Only add the reminders that the site is using

Reminder Managers Menu

• Main menu is called PXRM MANAGERS MENU. It is NOT part of AKMOCORE

• Add it to a site’s EHR menu

Reminder Definition Menu

• Options to look at and display all reminders

• Inquire about one reminder

• Make a reminder• Copy a reminder• Inactivate old

reminders

Display a Reminder• -------------------------------------------------------------------------------• IHS-ALCOHOL SCREEN No. 68• --------------------------------------------• Print Name: Alcohol Screen • Class: NATIONAL

• Sponsor: • Review Date:• Usage: CPRS, DATA EXTRACT, REPORTS• Related VA-* Reminder:• Reminder Dialog: IHS-ALCOHOL SCREEN• Priority:• Reminder Description:• Patients are screened annually for alcohol use starting at age 13• Technical Description:• Edit History:• Edit date: May 17, 2005@16:02:25 Edit by: HAGER,MARY G• Edit Comments:

• Edit date: May 12, 2005@08:35:46 Edit by: HAGER,MARY G• Edit Comments:

Display A Reminder• Baseline Frequency: • Do In Advance Time Frame: Do if DUE within 3 months• Sex Specific:• Ignore on N/A:• Frequency for Age Range: 1 year for ages 13Y to 110Y• Match Text:• No Match Text: Patient not in age range for alcohol• screening

• Findings:• • Finding Item: ALCOHOL SCREEN (FI(1)=RT(43))• Finding Type: REMINDER TERM• Use in Resolution Logic: OR• Found Text: Alcohol screen found in the computer within• the past year• Not Found Text: Alcohol screen not found within the past year.• Patients should have yearly alcohol screening•

Display a Reminder• General Patient Cohort Found Text:• General Patient Cohort Not Found Text: • General Resolution Found Text:• General Resolution Not Found Text:• All people over the age of 13 should have a yearly alcohol screen done using the CAGE test. The computer was unable to find this data within the last year

• Default PATIENT COHORT LOGIC to see if the Reminder applies to a patient:• (SEX)&(AGE)• Expanded Patient Cohort Logic:• (SEX)&(AGE)• Default RESOLUTION LOGIC defines findings that resolve the Reminder:• FI(1)• Expanded Resolution Logic:• FI(ALCOHOL SCREEN) • Web Sites:

Alcohol ScreenIHS-ALCOHOL SCREEN• Alcohol screening is done yearly. Users document

the CAGE test health factors on the wellness tab of the EHR to indicate the screening was performed.

• Frequency: Yearly• Cohort: Any person aged 13 and older• Resolved by: – A reminder term consisting of the 4 health factors for the

Cage test. Any one of those 4 health factors documented in the last year will turn the reminder off

– A DX that indicates alcohol screening was done– Education codes that document alcohol education was

done

Alcohol Taxonomy

REMINDER: IHS-ALCOHOL SCREEN ICD9 RANGE ICD0 RANGE CPT RANGE LOW HIGH LOW HIGH LOW HIGH-------------------------------------------------------------------------------- V11.3 V11.3 V79.1 V79.1 303.00 303.90 305.00 305.03 357.5 357.5 291.0 291.9

Alcohol Reminder Term• IHS- Alcohol Education

– Sites need to enter the names of the education topics they use• IHS – Alcohol Screen Class: VISN

Date Created: Sponsor: Review Date: Description: Findings: CAGE 0/4 (FI(1)=HF(19)) CAGE 1/4 (FI(2)=HF(20)) CAGE 2/4 (FI(3)=HF(21)) CAGE 3/4 (FI(4)=HF(22)) CAGE 4/4 (FI(5)=HF(23))

Asthma Plan

ASTHMA PLAN• For patients with asthma, an active asthma plan

should be documented in the asthma registry.• Frequency: Plan must be documented in the last 12

months• Cohort: Patients have a diagnosis using the ICD9

codes found in the reminder taxonomy for asthma• Resolution: A computed finding searching the

asthma registry to see if a plan has been documented

Asthma Primary Provider

ASTHMA PRIM PROV• Patients with asthma need a primary care

provider• Frequency – one time Cohort: Patients have a

diagnosis using the ICD9 codes found in the reminder taxonomy for asthma

• Resolution: A computed finding searching to find a documented primary care provider

Asthma SeverityASTHMA SEVERITY• Patients with asthma who are being seen frequently in clinic or and have

respiratory difficulties should have their severity documented in the asthma registry

• Cohort: Patients who have a diagnosis using the ICD9 codes found in the reminder taxonomy for asthma

• Resolution: This reminder is used in conjunction with the asthma management system.

If the severity of asthma has not been documented in PCC and this patient has had 3 or more asthma visits in the past 6 months or has a

brochodilator/bronchodialtor inflammatory index of >.33 then the reminder

will be due.

Asthma SteroidsASTHMA STEROIDS• Reminder checks for patients with asthma, respiratory difficulties and persistent

severity who are not on steroids. Those patients may benefit from inhaled steroids.

• Cohort: Patients who have a diagnosis using the ICD9 codes found in the reminder

taxonomy for asthma

• Resolution: This reminder is used in conjunction with the asthma tracking package 1.If patient is on register and has a mild persistent, moderate persistent, or severe persistent severity documented and is not on inhaled steroids 2. If patient has had 4 or more fills of asthma medication which includes at least 1 bronchodilator and the bronchodilator/bronchiodilator inflammatory index >.33 3. If patient has had 3 or more asthma visits in the past 6 months

Asthma Taxonomy

ICD9 RANGE ICD0 RANGE CPT RANGE LOW HIGH LOW HIGH LOW HIGH--------------------------------------------------------------------------------

493.00 493.92

Blood Pressure

• Blood pressure needs to be checked regularly. If a patient has a BP > 140/90, it needs to be checked on every visit.

• Frequency: – Every 2 years from 2 until 21– Every year over 21 – Every visit if last BP > 140/90

• Cohort: Everyone EXCEPT pts with a diagnosis of High blood pressure

• Resolution: Blood pressure reading in the time allowed

Blood Pressure TaxonomyICD9 RANGE ICD0 RANGE CPT RANGENAME LOW HIGH LOW HIGH LOW HIGH-------------------------------------------------------------------------- IHS-HYPERTENSION 401.0 405.99

Blood Pressure Reminder Terms

• IHS- High blood pressure– It is setup to trigger at systolic BP >140/90– Sites can make this lower if desired

• IHS – Normal blood pressure– It is setup to trigger at systolic BP <140/90– Sites can make this lower if desired

Colon Cancer• Patients need to be checked for colon cancer after the age of

50.• Frequency:

– Every 2 years if the result is from a fecal occult blood test– Every 5 years for a flexible sigmoidoscopy or a contrast barium enema– Every 10 years for a colonoscopy

• Cohort: People over 50 unless they have a diagnosis of colon cancer

• Resolution:– Fecal occult blood test– Sigmoidoscopy – Barium enema – Colonoscopy

Colon Cancer Taxonomies

ICD9 RANGE ICD0 RANGE CPT RANGENAME LOW HIGH LOW HIGH LOW HIGH-------------------------------------------------------------------------- IHS-BARIUM ENEMA 74270 74280 G0106 G0106 G0120 G0120 IHS-COLONOSCOPY

45.22 45.22 45355 45355 45.23 45.23 45378 45387 45.25 45.25 G0105 G0105 76.51 76.51 G0121 G0121 44388 44394 44397 44397 44394 44394

Colon Cancer Taxonomies ICD9 RANGE ICD0 RANGE CPT RANGENAME LOW HIGH LOW HIGH LOW HIGH--------------------------------------------------------------------------IHS-COLORECTAL CANCER 153.0 153.9 154.0 154.1 197.5 197.5 V10.05 V10.05

IHS-FECAL OCCULT LAB TEST 82270 82270 82274 82274 G0107 G0107 89205 89205

IHS-SIGMOIDOSCOPY 45.24 45.24 45330 45345 45.42 45.42 G0104 G0104

Colon Cancer Reminder Term

• IHS – Fecal occult blood• IF this test is a lab test at the site and NOT a

microbiology test, enter the lab test name in this reminder term

• Fecal occult blood tests should be multi-test kits

Depression Screening

• This reminder is yearly for anyone over the age of 40, those with diabetes or those with heart disease.

• Frequency: Yearly• Cohort: – Patients over 40– Diagnosis of diabetes – Diagnosis of heart disease

• Resolution: – ICD9 code for depression screen – Depression education codes

Depression Screen TaxonomiesICD9 RANGE ICD0 RANGE CPT RANGENAME LOW HIGH LOW HIGH LOW HIGH--------------------------------------------------------------------------HIS- Depression Screen

V79.0 V79.0 IHS-DIABETES DX 250.00 250.90

IHS-ISCHEMIC HEART DISEASE 410.0 412. 414.0 414.9 428.0 428.9 429.2 429.2

Depression Screen Reminder Term

• Reminder Term– IHS Depression Education– Enter the names of the education topics used at

the site

Diabetics – ACE/ARB

DIAB ACE/ARB• Patients with diabetes should be on an ACE or

an ARB to help prevent heart disease• Frequency – Yearly• Cohort: Pts with DX of diabetes in the last 2

years• Resolution: Active prescription for an ACE or

an ARB

Diabetics - Aspirin

DIAB ASPIRIN• Patients with diabetes should be on aspirin to

help prevent heart disease• Cohort: Pts with DX of diabetes in the last 2

years• Resolution: Active prescription for aspirin

Aspirin Reminder Term

• IHS – Aspirin• Each site needs to enter the aspirin

medications from the drug file that would be used to satisfy this reminder

Diabetics – Dental Exam

• Patients with diabetes need a yearly dental exam

• Frequency – yearly• Cohort: Pts with Dx of diabetes in the last 2

years.• Resolution: Dental Exam recorded from the

exam file

Diabetics – Eye Exam

• DIAB EYE EXAM• Patients with diabetes need a yearly dilated pupil

eye exam every year to prevent retinopathy• Frequency: Yearly• Cohort: Pts with Dx of diabetes in the last 2 years• Resolution: – Eye exam from the exam file – CPT code for a fundoscopic eye exam

Eye Exam Codes Taxonomy ICD9 RANGE ICD0 RANGE CPT RANGENAME LOW HIGH LOW HIGH LOW HIGH-------------------------------------------------------------------------- IHS-FUNDOSCOPIC EYE CODES

92012 92012 92014 92015 92002 92002 92004 92004 92250 92250

Diabetics – Foot Exam

• DIAB FOOT EXAM• Patients with diabetes need to have their feet

checked every year to prevent neuropathy• Frequency – yearly• Cohort: Pts with DX of diabetes in the last 2 years• Resolution: – Diabetic foot exam from the exam file or Exam code of– diabetic foot Exam

Diabetics – HgbA1c

• Patients with diabetes need a yearly lab HGBA1c to help keep their diabetes under control and prevent long term complications

• Frequency – yearly• Cohort: Pts with DX of diabetes in the last 2

years• Resolution: Lab result for HgbA1c

Hgba1c Reminder Term

• IHS – HgbA1c• Sites must enter the name so the A1c test(s)

that are used at their facility

Diabetics - Microalbumin

• Patients with diabetes need a urine microalbumin yearly to help prevent nephropathy

• Frequency – yearly• Cohort: Pts with DX of diabetes in the last 2

years• Resolution: Lab test for microalbumin

Microalbumin Reminder Term

• IHS-MICROALBUMIN• Sites need to enter the name of the

microalbumin test used at their site• It may be a urine protein• If the site does not do the test, do not activate

this reminder

Diabetes Taxonomy

ICD9 RANGE ICD0 RANGE CPT RANGENAME LOW HIGH LOW HIGH LOW HIGH-------------------------------------------------------------------------- IHS-DIABETES DX 250.00 250.90

Domestic Violence

• DOMESTIC VIOLENCE• If a site wishes to turn this on, be aware that it

will show up for most women• Frequency: Yearly• Cohort: All women 15 to 40• Resolution:– Documentation of domestic violence exam – Domestic violence education codes

Domestic Violence Reminder Term

• IHS-DOMESTIC VIOLENCE EDUCATIONFindings: DV-DISEASE PROCESS (FI(1)=ED(191)) DV-FOLLOW-UP (FI(2)=ED(192)) DV-PATIENT LITERATURE (FI(3)=ED(193)) DV-PREVENTION (FI(4)=ED(194)) DV-PSYCHOTHERAPY (FI(5)=ED(542)) DV-SAFETY & INJURY PREVENTION

(FI(6)=ED(195)) DV-TREATMENT (FI(7)=ED(196)) • Enter the names of any other education topics that are used

at the site

HCT/HGB

• HCT/HGB• Hematocrits and hemoglobins are checks at

ages 1 and 4• Frequency – Every 3 years for ages 12mos to 5

years• Cohort: all children• Resolution: Lab results for HCT or HGB

HCT/HGB Reminder Term

• IHS-HCT/HGB• Sites need to enter the names of the HGB/HCT

tests used at their facility

Head Circumference

• HEAD CIRCUMFERENCE• Head circumference is checked with decreasing

frequency in infants and children for growth and for diagnosis of hydrocephaly

• Frequency – – 2 months for ages 1D to 6M– 6 months for ages 6M to 27M

• Cohort: everyone in age group• Resolution: Vital measurement of head

circumference documented

Hearing Test

• HEARING TEST• All children need a hearing test at age 4

before going to school• Frequency – One time at age 4 to 5• Cohort – all children between 4 and 5• Resolution - Measurement result for hearing

test documented in computer

Height

• Height is checked in decreasing frequency on infants and children to determine growth patterns.

• Frequency– 2 months for ages 7D to 6M– 6 months for ages 6M to 18M– 1 year for ages 2Y to 18Y

• Cohort: Everyone in age range• Resolution: Measurement result for height

documented in computer

Hep A Adult

• HEP A ADULT• Immunization for adults• Cohort: all adults 18 to 100• Determined by computed finding to check

immunization forecaster• Resolution: Determined by a Hep A

immunization in the immunization file• Can add other immunizations

Hep A Adult Reminder Term

• IHS-HEPADULT IMMUNIZATION Class: VISN Date Created: Sponsor: Review Date: Description: Findings: HEP A, ADULT (FI(1)=IM(168))• Sites can add other immunizations if needed

Hep B Adult

• HEP B ADULT• Immunization for adults• Cohort: all adults 18 to 100• Determined by computed finding to check

immunization forecaster• Resolution: Documentation of a Hep B

immunization in the immunization file

Hep B Adult Reminder Term

• IHS-HEP B ADULT Class: VISN Date Created: Sponsor: Review Date: Description: Findings: HEP B,ADULT (FI(1)=IM(144))• Can add other Immunizations

Influenza• INFLUENZA IMMUNIZATION• Yearly immunization for adults over 50 and all patients with

high risk conditions• Frequency – yearly• Cohort:

– Adult over 50– Anyone with high risk condition determined by taxonomy of ICD9

codes

Determined by computed finding to check immunization forecaster

• Resolution: Documentation of an immunization in the immunization file

Influenza Taxonomy IHS-HIGH RISK FOR FLU/PNEUMONIA 490. 496. 250.00 250.90 V42.0 V42.9 V58.1 V58.1 011.00 011.96 038.2 038.2 042.0 044.9 093.0 093.9 112.81 112.81 130.3 130.3 140.0 208.91 235.0 235.9 280.0 289.9 303.00 303.93 305.00 305.03 331.7 331.7 391.0 391.0 393. 398.99 401.0 405.91 410.0 414.9 415.0 417.9 420.0 438.9 440.1 440.1 500. 508.9 510.0 519.0 570. 572.8 580.0 589.9 590.00 599.9 710.0 710.9 714.0 714.9 720.0 721.41 759.0 785.3 865.00 865.19 996.80 996.89 V08. V08.

Influenza Reminder Term

• IHS-INFLUENZA IMMUNIZATION Class: VISN Date Created: Sponsor: Review Date: Description: Findings: INFLUENZA, NOS (FI(1)=IM(108))• Sites can add other Influenza immunizations

Lipids - Female

• Frequency – – Every 5 years– Every year if pt is diabetic

• Cohort: – Females 45 to 64 – Females with diabetes

• Resolution: Lab test for lipid profile, LDL or HDL

Lipids - Male

• Frequency – – Every 5 years– Every year if diabetic

• Cohort: – Males 35 to 64– Males with diabetes

• Resolution: Lab test for lipid profile, LDL or HDL

Lipids Reminder Term

• IHS-LIPID LAB TESTS• Sites need to add the lipid tests used at their

site• Cholesterol is usually not included, it should

be LDL or HDL• Most sites have multiple tests

Mammograms• Mammograms done yearly on women to screen for

breast cancer• Frequency - Yearly• Cohort:– Women ages 52 to 64– Unless they have had a bi-lateral mastectomy

• Resolution:– Radiology test results for mammogram– CPT codes for mammogram studies– Computed finding checking women’s health package for

results

Mammogram Taxonomies ICD9 RANGE ICD0 RANGE CPT RANGENAME LOW HIGH LOW HIGH LOW HIGH-------------------------------------------------------------------------- IHS-BILATERAL MASTECTOMY 85.42 85.42 19180 19180 85.44 85.44 19200 19200 85.46 85.46 19220 19220 85.48 85.48 19240 19240 IHS-MAMMOGRAM V76.11 V76.12 87.37 87.37 76090 76092 87.36 87.36 G0204 G0204 G0206 G0206 G0202 G0202

Mammogram Reminder Term

• IHS-MAMMOGRAM TERMS• Enter the names of the radiology exams that

are mammograms

Pap Smear

• Pap smears done every 3 years on women to screen for cervical cancer

• Frequency – Every 3 years• Cohort: – Women 21 to 64 – Unless hysterectomy is documented

• Resolution: – CPT codes for pap smear– Pap smear if it’s a lab result– Computed finding to check women’s health for pap smear

Pap Smear Taxonomies ICD9 RANGE ICD0 RANGE CPT RANGENAME LOW HIGH LOW HIGH LOW HIGH--------------------------------------------------------------------------IHS-HYSTERECTOMY 68.4 68.8 51925 51925 56308 56308 58150 58150 58152 58152 58200 58294 58550 58554 58953 58954 59135 59135 59525 59525IHS-PAP

V76.47 V76.47 91.46 91.46 88141 88167 V76.49 V76.49 Q0091 Q0091 V72.3 V72.3 88174 88175 V76.2 V76.2

Pap Smear Reminder Terms

• IHS-PAP SMEAR• Used only if a site has Pap Smear defined as a

lab test

DTAP

• Childhood immunization• Cohort: Determined by computed finding to

check immunization forecaster• Ages 6 wks to 7 years• Resolution: Documentation of immunization

in the immunization file

DTAP Reminder Term

• IHS-DTAP IMMUNIZATION Class: VISN Date Created: Sponsor: Review Date: Description: DTAP immunization from the

immunization file Findings: DTAP (FI(1)=IM(133))Sites can add other immunizations

Hep A Immunization

• Childhood immunization• Cohort: Determined by computed finding to

check immunization forecaster• Ages 24m to 18 years • Resolution: Documentation of immunization

in the immunization file

Hep A Ped Reminder Term• IHS-HEPA IMMUNIZATION Class: VISN Date Created: Sponsor: Review Date: Description: Findings: HEP A, PED/ADOL, 2 DOSE (FI(1)=IM(196)) HEP A, PEDIATRIC, NOS (FI(2)=IM(157))• Sites can add other immunizations

Hep B Immunization

• Childhood immunization• Cohort: Determined by computed finding to

check immunization forecaster• Ages: Birth to 18years• Resolution: Documentation of immunization

in the immunization file

Hep B Ped Reminder Term

• IHS-HEPB IMMUNIZATION Class: VISN Date Created: Sponsor: Review Date: Description: Hep B vaccine from immunization file Findings: HEP B, ADOLESCENT OR PEDIATRIC

(FI(1)=IM(138)) Sites can add other immunizations

Pediatric Flu

• Childhood immunization• Cohort: Determined by computed finding to

check immunization forecaster includes ages and high risk diseases

• Ages: 6 months to 23 months• Resolution: Documentation of immunization

in the immunization file

Influenza Taxonomy IHS-HIGH RISK FOR FLU/PNEUMONIA 490. 496. 250.00 250.90 V42.0 V42.9 V58.1 V58.1 011.00 011.96 038.2 038.2 042.0 044.9 093.0 093.9 112.81 112.81 130.3 130.3 140.0 208.91 235.0 235.9 280.0 289.9 303.00 303.93 305.00 305.03 331.7 331.7 391.0 391.0 393. 398.99 401.0 405.91 410.0 414.9 415.0 417.9 420.0 438.9 440.1 440.1 500. 508.9 510.0 519.0 570. 572.8 580.0 589.9 590.00 599.9 710.0 710.9 714.0 714.9 720.0 721.41 759.0 785.3 865.00 865.19 996.80 996.89 V08. V08.

Influenza Reminder Term

• IHS-INFLUENZA IMMUNIZATION Class: VISN Date Created: Sponsor: Review Date: Description: Findings: INFLUENZA, NOS (FI(1)=IM(108))• Sites can add other Influenza immunizations

Hibtiter Immunization

• Childhood immunization• Cohort: Determined by computed finding to

check immunization forecaster• Ages: 6 wks to 59 months• Resolution: Documentation of immunization

in the immunization file

Hibtiter Reminder Term• IHS-HIBTITER IMMUNIZATION Class: VISN Date Created: Sponsor: Review Date: Description: Hibtiter from the vaccination file Findings: HIB (HBOC) (FI(1)=IM(126))

HIB, NOS (FI(2)=IM(124))

• Sites can add other immunizations if needed

MMR Immunization

• Childhood immunization• Cohort: Determined by computed finding to

check immunization forecaster• Ages 12 mos to 18 years• Resolution: Documentation of immunization

in the immunization file

MMR Reminder Term

• IHS-MMR IMMUNIZATION Class: VISN Date Created: Sponsor: Review Date: Description: MMR vaccinations from the

immunization file Findings: MMR (FI(1)=IM(117))• Sites can add other immunizations if needed

PedVaxHib Immunization

• Childhood immunization• Cohort: Determined by computed finding to

check immunization forecaster• Ages: 6 wks to 59 months• Resolution Documentation of immunization in

the immunization file

PedVaxHib Reminder Term

• IHS-PEDVAXHIB IMMUNIZATION Class: VISN Date Created: Sponsor: Review Date: Description: Findings: HIB (PRP-OMP) (FI(1)=IM(127))

HIB, NOS (FI(2)=IM(124))• Sites can add other immunizations if needed

Pediatric Pneumovax Immunization

• Childhood immunization• Cohort: Determined by computed finding to

check immunization forecaster 2 mos to 60 months

• Resolution: Documentation of immunization in the immunization file

Ped Pneumovax Reminder Term

• IHS-PED PNEUMOVAX IMMUNIZATION Class: LOCAL Date Created: Sponsor: Review Date: Description: Findings: PNEUMOCOCCAL CONJUGATE

(FI(1)=IM(142))• Sites can add other Immunizations if needed

Polio IVP Immunization

• Childhood immunization for IVP • Cohort: Determined by computed finding to

check immunization forecaster• Ages: 6 weeks to 10 years• Resolution: Documentation of immunization

in the immunization file

IPV Reminder Term

• IHS-POLIO IMMUNIZATION Class: LOCAL Date Created: Sponsor: Review Date: Description: Findings: IPV (FI(1)=IM(107))• Sites can add other immunizations if they wish

Pediatric TD Vaccination

• Childhood immunization• Cohort: Determined by computed finding to

check immunization forecaster• Ages: 6 months to 7 years• Resolution: Documentation of immunization

in the immunization file

Ped TD Reminder Term

• IHS-PED TD IMMUNIZATION Class: LOCAL Date Created: Sponsor: Review Date: Description: Findings: DT (PEDIATRIC) (FI(1)=IM(123))• Sites can add other immunizations if they want

Varicella Immunization

• Childhood immunization• Cohort: Determined by computed finding to

check immunization forecaster• Ages: 12 months to 18 years• Resolution: Documentation of immunization

in the immunization file

Varicella Reminder Term

• IHS-VARICELLA IMMUNIZATION Class: VISN Date Created: OCT 6,2004 Sponsor: Review Date: Description: Varicella immunization terms from the

immunization file Findings: VARICELLA (FI(1)=IM(132))• Sites can add other immunizations if desired

Adult Pneumovax

• Immunization for the elderly• Cohort: Determined by computed finding to

check immunization forecaster– Ages: > 65 – High-risk condition

• Resolution: Documentation of immunization in the immunization file

Pneumovax TaxonomyIHS-HIGH RISK FOR FLU/PNEUMONIA 490. 496 250.00 250.90 V42.0 V42.9 V58.1 V58.1 011.00 011.96 038.2 038.2 042.0 044.9 093.0 093.9 112.81 112.81 130.3 130.3 140.0 208.91 235.0 235.9 280.0 289.9 303.00 303.93 305.00 305.03 331.7 331.7 391.0 391.0 393. 398.99 401.0 405.91 410.0 414.9 415.0 417.9 420.0 438.9 440.1 440.1 500. 508.9 510.0 519.0 570. 572.8 580.0 589.9 590.00 599.9 710.0 710.9 714.0 714.9 720.0 721.41 759.0 785.3 865.00 865.19 996.80 996.89 V08. V08.

Pneumovax Reminder Term

• IHS-PNEUMOVAX IMMUNIZATION Class: VISN Date Created: Sponsor: Review Date: Description: Findings: PNEUMOCOCCAL (FI(1)=IM(119))• Sites can add other immunizations if they wish

PPD

• Tuberculosis test• Frequency: 7 years for ages 4 years to 12

years• Cohort: – All children in that age range– Unless they have had a positive result or TB

• Resolution: Documentation of a skin test in the computer

PPD Taxonomy

ICD9 RANGE ICD0 RANGE CPT RANGENAME LOW HIGH LOW HIGH LOW HIGH-------------------------------------------------------------------------- IHS-TB/POS PPD

010.00 018.90 795.5 795.5

Senior Height

• Seniors checked for height deceases due to osteoporosis

• Frequency: yearly• Cohort: People 65 and older• Resolution: Documentation of measurement

in the computer

TD Immunization

• Adult immunization• Frequency: Every 10 years• Cohort: Determined by computed finding to

check immunization forecaster• Ages 10 to 100• Resolution: Documentation of immunization

in the immunization file

TD Reminder Term

• IHS-TD IMMUNIZATION Class: VISN Date Created: Sponsor: Review Date: Description: Findings: TD (ADULT) (FI(1)=IM(102)) • Sites may add other immunizations if they wish

Tobacco Screen

• Yearly screening test for tobacco use• Frequency: yearly • Cohort: Those people 13 and older• Resolution: – Documentation of health factors to determine

smoking status– Documentation of education topics relating to

tobacco use– Diagnosis relating to tobacco use

Tobacco Taxonomy

ICD9 RANGE ICD0 RANGE CPT RANGE

NAME LOW HIGH LOW HIGH LOW HIGH-------------------------------------------------------------------------- IHS-TOBACCO USE 305.1 305.1 V15.82 V15.82

Tobacco Reminder Term • IHS-TOBACCO SCREEN EDUCATION TOPICS Class: LOCAL Date Created: Sponsor: Review Date: Description: Tobacco screening education topics Findings: TO-COMPLICATIONS (FI(1)=ED(94)) TO-DISEASE PROCESS (FI(2)=ED(95)) TO-EXERCISE (FI(3)=ED(96)) TO-FOLLOW-UP (FI(4)=ED(314)) TO-LIFESTYLE ADAPTATIONS (FI(5)=ED(97)) TO-MEDICATIONS (FI(6)=ED(98)) TO-PATIENT LITERATURE (FI(7)=ED(315)) TO-QUIT (FI(8)=ED(99))• Other Education Topics May be added

Tobacco Reminder Term• IHS-TOBACCO SCREEN HEALTH FACTORS Class: LOCAL Date Created: Sponsor: Review Date: Description: All health factors and education topics that encompass a tobacco screen Findings: CURRENT SMOKELESS (FI(1)=HF(3)) CURRENT SMOKER (FI(2)=HF(2)) CURRENT SMOKER & SMOKELESS (FI(3)=HF(14)) PREVIOUS SMOKELESS (FI(4)=HF(5)) PREVIOUS SMOKER (FI(5)=HF(4)) SMOKER IN HOME (FI(6)=HF(12)) SMOKE FREE HOME (FI(7)=HF(13)) EXPOSURE TO ENVIRONMENTAL TOBACCO SMOKE (FI(8)=HF(39)) CESSATION-SMOKELESS (FI(9)=HF(16)) CESSATION-SMOKER (FI(10)=HF(17)) NON-TOBACCO USER (FI(11)=HF(1))

Vision Exam

• Childhood vision exam at age 7• Frequency – once• Cohort: Children ages 7 to 9• Resolution: Documentation of a visual screen

measurements in the computer

Weight• Weight is checked with deceasing frequency in children

and adults.• In children, it is a measure for growth and development• Frequency:

– 1 year for those 16 and older – 6 months for ages 6Y to 16Y – 3 months for ages 1Y to 6Y– 2 months for ages 6M to 12M– 7 days for ages 1D to 6M

• Cohort: Everyone• Resolution: Documentation of weight in the computer

Special Immunization Forecaster

• Call to run the forecaster• Must be the first reminder listed in the GUI

setup• Has no resolution