National Reminders - Diabetic Foot Exam

Introduction The national reminders are in Patch 1005 of clinical reminders. The site manager should load this patch at your site. This will put all the national reminders into the Reminder Exchange file.

Preparation Document pxrm contains setup of each reminder. Check the taxonomy Check for reminder terms Check for orders

Reminder Exchange – Install Reminder Choose the Diabetic Foot Exam reminder

Reminder Installation Select IFE to install the reminder Review the reminder

Install the Components REMINDER TAXONOMY entry IHS-DIABETES DX 2007 already EXISTS, what do you want to do? Select one of the following: C Create a new entry by copying to a new name I Install or Overwrite the current entry Q Quit the install S Skip, do not install this entry Enter response: S//

Error on Taxonomy If there is an error in the taxonomy, you need to build it manually The screen shows what this error would look like Use the pxrm o document to determine what codes are in this taxonomy. REMINDER TAXONOMY entry IHS-ASTHMA 2007 is NEW, what do you want to do? Select one of the following: C Create a new entry by copying to a new name I Install or Overwrite the current entry Q Quit the install S Skip, do not install this entry Enter response: I// nstall or Overwrite the current entry The update failed, UPDATE^DIE returned the following error message: MSG("DIERR")=1^1 MSG("DIERR",1)=701 MSG("DIERR",1,"PARAM",0)=3 MSG("DIERR",1,"PARAM",3)= MSG("DIERR",1,"PARAM","FIELD")=.01 MSG("DIERR",1,"PARAM","FILE")= MSG("DIERR",1,"TEXT",1)=The value ' ' for field SELECTABLE DIAGNOSIS in SE LECTABLE DIAGNOSIS SUB-FIELD in file REMINDER TAXONOMY is not valid. MSG("DIERR","E",701,1)= REMINDER TAXONOMY entry IHS-ASTHMA 2007 did not get installed! Examine the above error message for the reason.

Taxonomy Creation

Give it the SAME name as the one in the reminder NAME: IHS-DIABETES DX 2007 Replace BRIEF DESCRIPTION: CLASS: LOCAL// SPONSOR: REVIEW DATE: PATIENT DATA SOURCE: EN,PL// USE INACTIVE PROBLEMS: INACTIVE FLAG: ICD0 Range of Coded Values Select ICD0 LOW CODED VALUE: ICD9 Range of Coded Values Select ICD9 LOW CODED VALUE: // ICD9 LOW CODED VALUE: // ICD9 HIGH CODED VALUE: // Select ICD9 LOW CODED VALUE:

Taxonomy Creation After the taxonomy is created Re-load the reminder and use SKIP when you reach the taxonomy installation

Template Fields TIU TEMPLATE FIELD entry GEN NORM/ABNORM already EXISTS, what do you want to do? Select one of the following: C Create a new entry by copying to a new name I Install or Overwrite the current entry Q Quit the install S Skip, do not install this entry

Template Fields TIU TEMPLATE FIELD entry GEN TEXT BOX already EXISTS, what do you want to do? Select one of the following: C Create a new entry by copying to a new name I Install or Overwrite the current entry Q Quit the install S Skip, do not install this entry

New Template Fields TIU TEMPLATE FIELD entry IHS DIAB SENSATION already EXISTS, what do you want to do? Select one of the following: C Create a new entry by copying to a new name I Install or Overwrite the current entry Q Quit the install S Skip, do not install this entry

Reminder Definition REMINDER DEFINITION entry IHS-DIAB FOOT EXAM 2007 already EXISTS, what do you want to do? Select one of the following: C Create a new entry by copying to a new name I Install or Overwrite the current entry Q Quit the install S Skip, do not install this entry Enter response: S// i Install or Overwrite the current entry Are you sure you want to overwrite? N// y YES

Installing the Dialog Install the dialog after the reminder is installed It may appear that you are installing the reminder again Look to the upper left to see where you are

Installing the Dialog Look here for directions Select IA again for dialog pieces

Attach to the Reminder You are usually asked to attach the dialog to a reminder I have named the dialogs and the reminders the same If you are not asked during the install, you can manually attach them when you activate the dialog

Dialog Installation An X should be by all the pieces of the dialog

Activate the Dialog All dialogs installed through reminder exchange are disabled. Exit out of Reminder Exchange and go to the DM (Dialog Management) Select Reminder Managers Menu Option: DM Reminder Dialog Management DP Dialog Parameters... DI Reminder Dialogs Choose DI (Reminder Dialogs)

Activate the Dialog The initial View is of reminders, use CV and Select D to go to dialogs

Activate Dialogs

Activate the Dialog Choose the dialog by number then ED

Activate Dialog Select Sequence: Quit// ed Edit/Delete Dialog NAME: IHS-DIAB FOOT EXAM 2007 Replace DISABLE: DISABLED IN EXCHANGE SURE YOU WANT TO DELETE? Y (Yes) CLASS: LOCAL// SPONSOR: REVIEW DATE: SOURCE REMINDER: IHS-DIAB FOOT EXAM

Activate Dialog

GUI Setup – First Time If your site has never setup reminders in the past, the following steps need to be undertaken to “turn on” the GUI reminders These steps do NOT make sense but they do need to be followed in the correct sequence DO NOT SKIP A STEP

First Time – Step 1 Using the steps in the above sequence, install at least 2 reminders. The immunization forecaster and one other that is commonly used such as the tobacco reminder

First Time-Step 2 Use the Parameters menu on the Reminder Setup menu to TURN ON the reminders Use the ACT (Reminder GUI Resolution Active) parameter and set to YES at the system level

First Time – Step 3 Set up the CAC to configure in the GUI Set the CFG- Allow EHR Configuration in GUI parameter from the same menu Set it by class for the CAC class

First Time – Step 4 Set the parameter CVR – EHR Cover Sheet reminder list This list will only have the 2 reminders you have installed

First Time –Step 5 You should now be able to access the GUI Select a patient for whom the reminder will be due If the alarm clock is RED and the X is gone, you are ready to proceed

Add to GUI Click on the alarm clock Select the action drop down menu

Add to GUI Choose Edit Cover Sheet Reminder List

Add to GUI Select where you are going to add them. The choices are in the middle section The available reminders are on the bottom left. Move them over using the arrows Click apply when finished

Add to GUI

First Time – Step 6 Make the immunization forecaster the first item in your list on the right Log out of the GUI

First Time – Step 7 Go back to the reminder parameters Select NEW – New reminder parameters Turn this on to YES for the system Log back into the GUI For now, this will look the same, but as you add more reminders to the GUI, they should appear

TEST, TEST, TEST Pick patients where the reminder is not applicable – (non-diabetics) Pick patients where the reminder is applicable but not due Pick patients where the reminder is applicable and due Is it correct??

Testing Use reminder maintenance to see what the computer found Right click on the reminder and choose clinical maintenance

Check the dialog Start a note Find the reminder in the reminders drawer Double click on the reminder and review the dialog

Check the Dialog

Complete the dialog and click FINISH Review the note Do the PCC items you entered appear below the note? Are the on the Wellness tab as well?

Check the dialog

Check the Dialog