health maintenance

Health Maintenance: Depression Screening

Depression Screening in Adults

Screening for depression in adults is a grade B recommendation by the U.S. Preventive Services Task Force. The USPSTF recommends screening for depression in the general adult population, including pregnant and postpartum women. Screening should be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up.

This expectation will be recommended for patients age 18 and up that have not had a PHQ-2 or PHQ-9 documented in the last 365 days.

Patients are not recommended for screening if they have an active problem of depression on the Problem List.

 

Health Maintenance: Type II DM Screening

Abnormal Blood Glucose/Type II Diabetes Mellitus Screening

Screening for abnormal blood glucose and Type II Diabetes mellitus is a Grade B expectation of the U.S. Preventive Task Force. The USPSTF recommends screening for abnormal blood glucose as part of cardiovascular risk assessment in adults aged 40 to 70 years who are overweight or obese.

 This expectation will be recommended for patients age 40 – 70 years old that are overweight and do not have an active problem of diabetes mellitus on the Problem List. Satisfiers for the expectation inlcude: 

  • HbgA1c Whole Blood
  • Fasting glucose
  • Hemoglobin A1c
  • Glucose Level
  • Glucose, Whole Blood

The expectation will recur every 3 years.

For patients in high risk demographic groups this expectation can be added manually once and will recur every 3 years. For more information on this expectation see full recommendation statement at USPSTF.

 

 

Health Maintenance - Changes to Colorectal Screening

Changes to Colorectal Cancer Screening in HM have been made to allow us to differentiate between the guaiac cards results and an immunoassay guaiac test. This required minor changes in the Point of Care-Gastrointestinal PowerForm.

Powerform changes: The Point of Care-Gastrointestinal Powerform was modified as shown below.

The highlighted section, Occult Blood Stool by FIT, provides a way to chart occult blood stool results from an immunoassay type test. A FIT or IFOBT only requires a single sample where the old guaiac cards required 3 separate samples. Results should only be charted in the appropriate field that corresponds with the type of test used.  These are not interchangeable fields.

The results from this test will display as shown here.

These changes will be reflected in Health Maintenance as well. The orderable for “POC Fecal Occult Blood Dipstick (Clinic) will be replaced with an orderable that directs the provider to the POC Fecal Occult Blood Testing (Clinic) care set. The provider may then choose which order they would like to place. Each order has a brief description the help differentiate between the orders.

Current view in Health Maintenance:

New view:

POC Fecal Occult Blood Dipstick (Clinic) will be removed and POC Fecal Occult Blood Testing care set will be added.

Care set – no changes were made

Impact:

Staff will need to be instructed on the changes shown above. They will also need to be able to distinguish between the types of POC testing that is available in your clinic and how to document the results appropriately. If the orders shown above are not viewable in your clinic but should be please contact Clinical Transformations, 806.743.4357 as soon as possible so we can verify the orders are virtual viewed appropriately.