clinical (ehr) reminders- more than just a memory jogger lcdr susan pierce-richards, msn, arnp...

Clinical (EHR) Reminders-Clinical (EHR) Reminders-More than just a memory joggerMore than just a memory jogger

LCDR Susan Pierce-Richards, MSN, ARNP

Office of Information Technology, EHR Program

[email protected]

What are Clinical (EHR) Reminders?What are Clinical (EHR) Reminders?

““The Clinical Reminders system allows The Clinical Reminders system allows caregivers to track and improve preventive caregivers to track and improve preventive healthcare and disease treatment for patients healthcare and disease treatment for patients and to ensure that timely clinical interventions and to ensure that timely clinical interventions are initiated.” (VA Vista Website)are initiated.” (VA Vista Website)

Clinical (EHR) Reminders does a Clinical (EHR) Reminders does a chart review and tell you what chart review and tell you what

your patient needsyour patient needs

Types of EHR RemindersTypes of EHR Reminders

National Reminders National Reminders PXRM 1.5 Patch 1005 delivers 54 National Reminders and PXRM 1.5 Patch 1005 delivers 54 National Reminders and

dialogsdialogs Delivered to all sitesDelivered to all sites Based on same logic as Health Maintenance remindersBased on same logic as Health Maintenance reminders Many have associated ‘dialogs’ for data entry/note generationMany have associated ‘dialogs’ for data entry/note generation

Local RemindersLocal Reminders Written at a local site to solve a particular clinical problemWritten at a local site to solve a particular clinical problem Can be shared between sitesCan be shared between sites Can also write associated ‘dialogs’ that can be sharedCan also write associated ‘dialogs’ that can be shared

Reminder ReportsReminder Reports Can quickly extract data by providerCan quickly extract data by provider

How are Clinical (EHR) Reminders Similar How are Clinical (EHR) Reminders Similar to Health Maintenance (Health Summary) to Health Maintenance (Health Summary)

Reminders?Reminders?

Both identify groups of patients and related Both identify groups of patients and related unmet interventionsunmet interventions Colorectal screening due for patient over 50Colorectal screening due for patient over 50 Mammogram due for patient over 50Mammogram due for patient over 50

Both are configurable by the local siteBoth are configurable by the local site Site can change the PAP frequency to yearlySite can change the PAP frequency to yearly Site can change the age to begin Mammogram Site can change the age to begin Mammogram

reminder to age 40reminder to age 40

How do EHR Reminders Differ from How do EHR Reminders Differ from Health Maintenance Reminders?Health Maintenance Reminders?

CACs can learn to create local reminders using logic CACs can learn to create local reminders using logic and available “findings”and available “findings”

EHR Reminder DialogsEHR Reminder Dialogs Look like TemplatedLook like Templated Resolve the reminder (enters info into EHR/PCC) Resolve the reminder (enters info into EHR/PCC) Create the noteCreate the note

… … all at the same time!all at the same time! Reminder Dialog TemplatesReminder Dialog Templates

Can create documentation tools that are not tied to a specific Can create documentation tools that are not tied to a specific reminder that create a note and enter data into PCCreminder that create a note and enter data into PCC

Reminders terminology…Reminders terminology…

The Cohort (the “Who”)The Cohort (the “Who”)

- - Patients needing an interventionPatients needing an intervention

- Patients you want to see on a report- Patients you want to see on a report

Cohort ExamplesCohort ExamplesDiabetes HGB A1C Reminder cohortDiabetes HGB A1C Reminder cohort

Patients with an active problem OR visit diagnosis Patients with an active problem OR visit diagnosis of Diabetesof Diabetes

Colon Cancer Screen cohortColon Cancer Screen cohort Patients 50 and olderPatients 50 and older NO history of Colon CancerNO history of Colon Cancer

Cohort Identified

Patients over 50

No history of colon CA

The Resolution (“What”)The Resolution (“What”)

What will turn this reminder OFF?What will turn this reminder OFF? Colon Cancer ScreenColon Cancer Screen

FOBT, Colonoscopy, etcFOBT, Colonoscopy, etc Diabetes HGB A1CDiabetes HGB A1C

HgbA1C resulted in the past yearHgbA1C resulted in the past year

Frequency (“How Often”)Frequency (“How Often”)

How often should this reminder or selected How often should this reminder or selected intervention be dueintervention be due Colon CancerColon Cancer

FOBT yearly OR Colonoscopy q10yr, etc.FOBT yearly OR Colonoscopy q10yr, etc. HBG A1CHBG A1C

HgbA1C yearlyHgbA1C yearly

ApplicableApplicable

A reminder is APPLICABLE to a patient if they A reminder is APPLICABLE to a patient if they meet the definition of the cohortmeet the definition of the cohort They are “in the cohort”They are “in the cohort”

Example: Colon Cancer screen – patient is 52 and has Example: Colon Cancer screen – patient is 52 and has NO visit diagnosis or problem of colon cancer in chartNO visit diagnosis or problem of colon cancer in chart

FindingFinding

A FINDING is a piece of information that the A FINDING is a piece of information that the reminder searches for in the computerreminder searches for in the computer

It’s there or it’s not It’s there or it’s not Found or Not FoundFound or Not Found

Examples: Lab, Pt Ed Topic, POV, Exam, Vital Examples: Lab, Pt Ed Topic, POV, Exam, Vital Measurement, Medication, etcMeasurement, Medication, etc

DueDue

A reminder is DUE for a patient if they are A reminder is DUE for a patient if they are in the cohort (applicable) and have not yet in the cohort (applicable) and have not yet had the intervention (finding) that the had the intervention (finding) that the reminder is seeking.reminder is seeking.

ResolvedResolved A reminder is considered RESOLVED if the A reminder is considered RESOLVED if the

intervention (finding) defined by the reminder intervention (finding) defined by the reminder has been met/foundhas been met/found

FindingFindingA FINDING is a piece of information that the reminder searches A FINDING is a piece of information that the reminder searches

for in the computer. Findings are used in for in the computer. Findings are used in Reminders – to identify Cohorts (who) and Resolution (what)Reminders – to identify Cohorts (who) and Resolution (what) Dialogs – to “Resolve” (with a ‘what’) reminder in PCC and Dialogs – to “Resolve” (with a ‘what’) reminder in PCC and

notesnotes

What can be used as a “finding?”What can be used as a “finding?”Drug, Ed topic, Exam, HF, Imm, Lab test, Measurement, Drug, Ed topic, Exam, HF, Imm, Lab test, Measurement,

Orderable, Rad procedure, Skin test, Generic drug or drug Orderable, Rad procedure, Skin test, Generic drug or drug class, Refusal, ICD9 code, CPT code, Reminder Taxonomy, class, Refusal, ICD9 code, CPT code, Reminder Taxonomy, Reminder TermReminder Term

Computed finding – a routine that a programmer writes to extract Computed finding – a routine that a programmer writes to extract data not otherwise availabledata not otherwise available

TaxonomyTaxonomyReminders Taxonomies are groups of codes that will be used as a Reminders Taxonomies are groups of codes that will be used as a

single finding:single finding: ICD0 procedure codesICD0 procedure codes CPT codesCPT codes ICD9 codesICD9 codes

Reminder Taxonomies are “findings” and can be used to:Reminder Taxonomies are “findings” and can be used to: Identify a cohort of patients (patients with diabetes, asthma, Identify a cohort of patients (patients with diabetes, asthma,

heart disease, etc. should receive a flu vaccine yearly)heart disease, etc. should receive a flu vaccine yearly) Resolve a reminder (diagnosis of depression in past year Resolve a reminder (diagnosis of depression in past year

resolves the Depression Screen reminder)resolves the Depression Screen reminder)

TermTermReminder terms are groups of related information that Reminder terms are groups of related information that

will be used as a single finding:will be used as a single finding: Labs, Patient education, Health Factors, Medications, Labs, Patient education, Health Factors, Medications,

Orderable items, Refusals, Immunizations, Orderable items, Refusals, Immunizations, Measurements, etc.Measurements, etc.

Reminder Terms are “findings” and can be used to:Reminder Terms are “findings” and can be used to: Identify a cohort of patients (patients on a specific Identify a cohort of patients (patients on a specific

medication, patients with last BP over 139/89)medication, patients with last BP over 139/89) Resolve a reminder (HGBA1C resulted in past 1 year Resolve a reminder (HGBA1C resulted in past 1 year

resolved DM HGBA1C reminder)resolved DM HGBA1C reminder)***Terms can incorporate additional logic******Terms can incorporate additional logic***

TermTermSome terms must be mapped to local names by CACSome terms must be mapped to local names by CAC Lab Lab Medications and orderable items Medications and orderable items Quick orders (in dialogs)Quick orders (in dialogs)

Basic Reminder LogicBasic Reminder Logic

Applicable? Does patient meet cohort criteria?

Not Applicable Folder

No Yes

Any Exclusions?

Yes

Fulfills resolution criteria?

No

Yes No

Reminder Resolved Applicable (blue clock)

Reminder DueDue (red clock)

Not Applicable (white clock)

Not Applicable (white clock)

Where are EHR reminders?????Where are EHR reminders?????

Reminder Icon – the “Reminder Clock”Reminder Icon – the “Reminder Clock” Cover sheet reminder listCover sheet reminder list Reminder “drawer” on the Notes tabReminder “drawer” on the Notes tab Ad Hoc Summary on Reports tabAd Hoc Summary on Reports tab

ClickhereAnd this opens….

If due they are here too

Once you pick a note…

The Reminder drawer is

available

What are Reminder Dialogs?What are Reminder Dialogs?

Facilitate documentationFacilitate documentation Enter information in RPMS at the same time Enter information in RPMS at the same time

as writing a note in EHRas writing a note in EHR Generate ordersGenerate orders

MedsMeds LabsLabs ConsultsConsults

etc.etc.

Dialog

Note Text

Entered in RPMS

National RemindersNational Reminders

PXRM 1.5 Patch 1005PXRM 1.5 Patch 1005 Delivers basic set of remindersDelivers basic set of reminders Delivers basic set of dialogsDelivers basic set of dialogs

PXRM 1.5 Patch 1006 PXRM 1.5 Patch 1006 Will update Domestic Violence Screen, Alcohol Screen Will update Domestic Violence Screen, Alcohol Screen

and Tobacco reminder terms and dialog elements with the and Tobacco reminder terms and dialog elements with the 2008 Patient Ed topics after the next dictionary patch is 2008 Patient Ed topics after the next dictionary patch is released (AUMv9.1 p1) released (AUMv9.1 p1)

Will additionally update Patient Ed elements in the Will additionally update Patient Ed elements in the Immunization and DM Foot Exam dialogsImmunization and DM Foot Exam dialogs

National Reminders - National Reminders - ImmunizationsImmunizations

Pediatric and Adult immunizationsPediatric and Adult immunizations Associated dialogs to enter EHR/PCC data and Associated dialogs to enter EHR/PCC data and

write note simultaneouslywrite note simultaneously

National Reminders – National Reminders – Screening Measurements Screening Measurements

Delivered with dialogsDelivered with dialogs Blood PressureBlood Pressure HearingHearing HeightHeight Senior HeightSenior Height WeightWeight VisionVision

National Reminders – National Reminders – Screening/Early DetectionScreening/Early Detection

Delivered with dialogs – some informationalDelivered with dialogs – some informational Alcohol ScreenAlcohol Screen Blood PressureBlood Pressure Depression ScreenDepression Screen DV ScreenDV Screen LipidsLipids HGB/HCTHGB/HCT MammogramMammogram Pap SmearPap Smear PPDPPD

National Reminders –National Reminders –OtherOther

Delivered with information only dialogsDelivered with information only dialogs No Allergy AssessmentNo Allergy Assessment AsthmaAsthma

Primary providerPrimary provider SeveritySeverity PlanPlan SteroidsSteroids

National Diabetes RemindersNational Diabetes Reminders

Basic set of reminders Basic set of reminders Basic set of dialogsBasic set of dialogs Areas and clinics should review and determine if the Areas and clinics should review and determine if the

logic should be made more stringent based on your logic should be made more stringent based on your population’s needspopulation’s needs

CACs can adapt the remindersCACs can adapt the reminders Labor intensiveLabor intensive Can be sharedCan be shared Consider area consensus and deploymentConsider area consensus and deployment

National Reminders –Diabetes CareNational Reminders –Diabetes CareCOHORT: Visit Dx or Problem list entry in past 2 yearsCOHORT: Visit Dx or Problem list entry in past 2 yearsACE/ARBIACE/ARBI

Resolved by active, filled rx for ACEI/ARB so 31 days after last Resolved by active, filled rx for ACEI/ARB so 31 days after last fill will be duefill will be due

Not applicable if verified allergy to ACEI Not applicable if verified allergy to ACEI andand ARB ARB DialogDialog is information only – CAC will need to develop locally is information only – CAC will need to develop locally

AspirinAspirin Resolved by active, filled rx for Aspirin so 31 days after last fill Resolved by active, filled rx for Aspirin so 31 days after last fill

will be duewill be due Not applicable if verified allergy to AspirinNot applicable if verified allergy to Aspirin DialogDialog provides order for Aspirin 81mg, easily adapted to menu of provides order for Aspirin 81mg, easily adapted to menu of

choiceschoices

Blood Pressure – due every 6 monthsBlood Pressure – due every 6 months Unless SBP over 139 OR DBP over 89, then due next visitUnless SBP over 139 OR DBP over 89, then due next visit Resolved by appropriate BP (CAC maps to local terms)Resolved by appropriate BP (CAC maps to local terms) DialogDialog entry of BP entry of BP

National Reminders –Diabetes CareNational Reminders –Diabetes CareCOHORT: Visit Dx or Problem list entry in past 2 yearsCOHORT: Visit Dx or Problem list entry in past 2 years

Dental Exam – due yearlyDental Exam – due yearly Resolved by Dental Exam code, ICD9 or ADA codesResolved by Dental Exam code, ICD9 or ADA codes DialogDialog entry of Dental Exam code or historical dental entry of Dental Exam code or historical dental

examexam

Eye Exam – due yearlyEye Exam – due yearly Resolved by Eye Exam code or CPT codesResolved by Eye Exam code or CPT codes DialogDialog entry of Eye exam code or historical eye exam entry of Eye exam code or historical eye exam

Foot exam – due yearlyFoot exam – due yearly Resolved by Foot Exam codeResolved by Foot Exam code DialogDialog entry of Foot Exam code AND templated entry of Foot Exam code AND templated

documentation of normal/abnormal examinationdocumentation of normal/abnormal examination


HgbA1C – due yearlyHgbA1C – due yearly Resolved by lab (CAC maps to local terms)Resolved by lab (CAC maps to local terms) DialogDialog provides order of lab provides order of lab

Microalbumin – due yearlyMicroalbumin – due yearly Resolved by lab (CAC maps to local terms)Resolved by lab (CAC maps to local terms) Not applicable if has End Stage Renal DiseaseNot applicable if has End Stage Renal Disease DialogDialog provides order of lab provides order of lab

Lipid – due yearlyLipid – due yearly Resolved by lab (CAC maps to local terms)Resolved by lab (CAC maps to local terms) DialogDialog provides order of lab provides order of lab


Tobacco – due yearlyTobacco – due yearly Resolved by Tobacco Health FactorsResolved by Tobacco Health Factors DialogDialog provides entry of Health Factors, Pt Ed, To Clinic consult provides entry of Health Factors, Pt Ed, To Clinic consult

Alcohol – due yearlyAlcohol – due yearly Resolved by Alcohol exam code, CAGE health factors, alcohol Resolved by Alcohol exam code, CAGE health factors, alcohol

related dxrelated dx DialogDialog entry of Alcohol exam code, CAGE health factors entry of Alcohol exam code, CAGE health factors

Depression Screen – due yearlyDepression Screen – due yearly Resolved by Depression exam code or depression screen, Resolved by Depression exam code or depression screen,

depression dxdepression dx DialogDialog entry of Depression screen code, includes display of PHQ- entry of Depression screen code, includes display of PHQ-

2 questions2 questions


Flu – due every season based on Imm Forecaster Flu – due every season based on Imm Forecaster Resolved by Flu vaccineResolved by Flu vaccine Not applicable if NOT forecasted OR verified Egg Not applicable if NOT forecasted OR verified Egg

allergy in ART packageallergy in ART package DialogDialog provides entry of vaccine, historical vaccine, provides entry of vaccine, historical vaccine,

refusal and pt edrefusal and pt ed

Pneumovax – due once based on Imm ForecasterPneumovax – due once based on Imm Forecaster Resolved by Pneumovax vaccineResolved by Pneumovax vaccine DialogDialog provides entry of vaccine, historical vaccine, provides entry of vaccine, historical vaccine,

refusal and pt edrefusal and pt ed

How to look at reminders…How to look at reminders…

The reminders “clock”

How to look at reminders…How to look at reminders…

The VIEW menu allows the user to display various configurations of the folders AND

reminder icon legend displays the icons you will encounter for reference

How to look at reminders…How to look at reminders…Right Click on a reminder:Right Click on a reminder: Clinical MaintenanceClinical Maintenance

Describes reminder, who is in cohort Describes reminder, who is in cohort and what has last resolved and what has last resolved reminderreminder

Ed Topic Definition – links to Ed Topic Definition – links to “standard”“standard”

Reminder Inquiry – technical Reminder Inquiry – technical descriptiondescription

Reference Information – links Reference Information – links to websitesto websites

Evaluate Reminder – Evaluate Reminder – “refreshes” and updates“refreshes” and updates

Reminder Icon LedgedReminder Icon Ledged

Describes cohort and when due

What and how reminder was last resolved

Right clicking on a reminder here or from

the coversheet dialog box (last slide)

will give you these options

You have the same options for viewing reminders on the

Notes tab Reminder Drawer

Clinical Maintenance examplesClinical Maintenance examples

Reminder is applicable –found a DM dx within 2 years.

It then tells you the last resolutions found. The Computed Finding “looks” ever day but if it finds what it is looking for (the ADA codes, it returns a different date.

It also found a ICD code or dental health visit.


Reminder is applicable – both age and DM dx within 2 years.

It then tells you the last resolutions found.

Found Depression Screening Diagnosis.

Found Depression Screening exam.




Found lab test A1C.




Found the ACE however it has been more than 30 days since the last fill so it is DUE again.

National Dialog examplesNational Dialog examples

A Word about National DialogsA Word about National Dialogs Needs of clinicians vary from site to siteNeeds of clinicians vary from site to site Code sets, particularly labs, meds, quick orders, TIU objects Code sets, particularly labs, meds, quick orders, TIU objects

vary dramatically from site to sitevary dramatically from site to site Immunizations, Exams and Health factors are more Immunizations, Exams and Health factors are more

standardized from site to sitestandardized from site to site Immunization dialogs, Exam dialogs, HF dialogs (DV, Immunization dialogs, Exam dialogs, HF dialogs (DV,

ETOH, Depression, Eye, Foot, Dental, Tobacco) are ETOH, Depression, Eye, Foot, Dental, Tobacco) are delivered highly functionaldelivered highly functional

The remaining dialogs are very “vanilla” and will likely The remaining dialogs are very “vanilla” and will likely need to either be enhanced by your CAC or your CAC may need to either be enhanced by your CAC or your CAC may wish to import tools from another sitewish to import tools from another site

Local Reminders …Local Reminders …Endless potentialEndless potential

Clinical (EHR) Reminders – Clinical (EHR) Reminders – a tool in problem identification and interventiona tool in problem identification and intervention

Modifying National Reminder logic to target your populationModifying National Reminder logic to target your population Modifying National Dialogs to your site’s needsModifying National Dialogs to your site’s needs Problem identification and tracking through Reminders and Reminder Problem identification and tracking through Reminders and Reminder

reportsreports Problem intervention through development of local Reminders and/or Problem intervention through development of local Reminders and/or

Reminder dialogsReminder dialogs Problem intervention through development of local Reminder dialogs Problem intervention through development of local Reminder dialogs

converted to Dialog Templates. converted to Dialog Templates. Dialog tool are particularly suited to case managementDialog tool are particularly suited to case management I see a great future for Dialogs in Nursing, DM Education, Nutrition and I see a great future for Dialogs in Nursing, DM Education, Nutrition and

Pharmacy run clinics!Pharmacy run clinics!

I’ll provide you with a couple of examples… but the possibilities are I’ll provide you with a couple of examples… but the possibilities are endless…endless…

Gathering Data – Reminder ReportsGathering Data – Reminder Reports You can utilize reminders with the sole purpose to run a You can utilize reminders with the sole purpose to run a

reportreport Set up cohort and resolution logicSet up cohort and resolution logic Need patients assigned PCPNeed patients assigned PCP Run reportRun report

EXAMPLES:EXAMPLES:

How many patients who are have DM in past 2 years who are How many patients who are have DM in past 2 years who are on ACE/ARB have SBP under 125?on ACE/ARB have SBP under 125?

How many patients who have had a TZD RX in past 3 months How many patients who have had a TZD RX in past 3 months have a HGBA1C done in past 6 months that is <7.have a HGBA1C done in past 6 months that is <7.

Local Reminders – Endless potentialLocal Reminders – Endless potential

PROBLEM:PROBLEM: DM patients on very expensive TZD therapy without DM patients on very expensive TZD therapy without

reduction in HgbA1C. reduction in HgbA1C. Needed a way to easily document interventions. Needed a way to easily document interventions.

INTERVENTION:INTERVENTION: Cohort - Identify patients with DM who have had TZD Cohort - Identify patients with DM who have had TZD

prescription in past 3 mo prescription in past 3 mo Due – if no HgbA1C in past 6 months OR last HgbA1C 9 Due – if no HgbA1C in past 6 months OR last HgbA1C 9

or overor over Resolved – when HgbA1C is <9 AND done in past 6 Resolved – when HgbA1C is <9 AND done in past 6

months OR TZD is d/c’edmonths OR TZD is d/c’ed

Local Reminders – Endless potentialLocal Reminders – Endless potential

PROBLEMPROBLEM Providers/Nurses wanted ALL information required to Providers/Nurses wanted ALL information required to

make decision when ordering labs, meds for DM patientsmake decision when ordering labs, meds for DM patients

INTERVENTIONINTERVENTION Local dialogs enhanced by taking advantage of TIU objects Local dialogs enhanced by taking advantage of TIU objects

and TIU Flow sheet objectsand TIU Flow sheet objects Can order appropriate labs/med accordinglyCan order appropriate labs/med accordingly

The reality of Local Reminders…The reality of Local Reminders…The bad news…The bad news… The package is complex with a steep learning curve.The package is complex with a steep learning curve. Dialogs are cumbersome and time consuming to develop and the Dialogs are cumbersome and time consuming to develop and the

formatting is imperfect.formatting is imperfect.

The good news…The good news… Much work can be shared between sites with some modest Much work can be shared between sites with some modest

modification.modification. Functionality and enhanced logic will be greatly improved when we Functionality and enhanced logic will be greatly improved when we

can move to Version 2.0 after Code Set Versioning is complete.can move to Version 2.0 after Code Set Versioning is complete. We have a robust, growing network of CACs interested in Reminders We have a robust, growing network of CACs interested in Reminders

and have already begun sharing information!and have already begun sharing information!

Find out if someone else has created your desired Reminder intervention Find out if someone else has created your desired Reminder intervention before you create it on your own.before you create it on your own.

If you create a successful intervention through Reminders, SHARE!If you create a successful intervention through Reminders, SHARE!

What questions can you ask reminders?What questions can you ask reminders?These are the findings you can use to COHORT and to RESOLVE reminders:These are the findings you can use to COHORT and to RESOLVE reminders: within these categories, you can define specifics – such as a level or range of values on a within these categories, you can define specifics – such as a level or range of values on a

measurement or lab, a specific exam result, the status of an order, etcmeasurement or lab, a specific exam result, the status of an order, etc

DRUG DRUG VA DRUG CLASS VA DRUG CLASS VA GENERIC VA GENERIC EDUCATION TOPIC EDUCATION TOPIC EXAM EXAM HEALTH FACTOR HEALTH FACTOR IMMUNIZATION IMMUNIZATION LABORATORY TEST LABORATORY TEST MEASUREMENT TYPE MEASUREMENT TYPE ORDERABLE ITEM ORDERABLE ITEM RADIOLOGY PROCEDURE RADIOLOGY PROCEDURE REMINDER COMPUTED FINDING REMINDER COMPUTED FINDING REMINDER TAXONOMY REMINDER TAXONOMY REMINDER TERM REMINDER TERM SKIN TEST SKIN TEST VITAL MEASUREMENT VITAL MEASUREMENT REFUSAL TYPE REFUSAL TYPE

What can you “resolve” in a dialog?What can you “resolve” in a dialog?

In addition to writing a note, the following findings In addition to writing a note, the following findings can be entered into PCC during dialog processing:can be entered into PCC during dialog processing:

EDUCATION TOPICS EDUCATION TOPICS IMMUNIZATION IMMUNIZATION SKIN TEST SKIN TEST EXAM EXAM HEALTH FACTOR HEALTH FACTOR PROCEDURE PROCEDURE ICD9 DIAGNOSIS ICD9 DIAGNOSIS VITAL TYPE VITAL TYPE MEASUREMENT TYPE MEASUREMENT TYPE TAXONOMY ORDER DIALOGTAXONOMY ORDER DIALOG

DemonstrationDemonstration

DiscussionDiscussion

andand

QuestionsQuestions

EHR REMINDERS RESOURCE LINK:EHR REMINDERS RESOURCE LINK:

ftp://ftp.ihs.gov/pubs/EHR/Training/Guides/EHftp://ftp.ihs.gov/pubs/EHR/Training/Guides/EHR%20Reminders/R%20Reminders/

Contact info:Contact info:

LCDR Susan Pierce-Richards, MSN, ARNPLCDR Susan Pierce-Richards, MSN, ARNP

Email: Email: [email protected]@ihs.gov

Cell: 505-975-4233 (Pacific Time Zone)Cell: 505-975-4233 (Pacific Time Zone)

clinical (ehr) reminders- more than just a memory jogger lcdr susan pierce-richards, msn, arnp...

Documents

reminder searches

mammogram reminder

etcduea reminder

specific reminder

resolveda reminder

clinical ehr reminders

clinical reminders system

reminder dialog templatescan