May May-Aug 2020 Form Version Medically Ready ForceReady Medical - - PowerPoint PPT Presentation

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TSWF Cardiovascular CPG AIM Form Training May May-Aug 2020 Form Version

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Dis isclaimer

Content shown is from an AHLTA Training System (ATS) and does not contain actual patient data.

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Recent Changes

The following group of slides reflect changes made to the form. The specific training slides for this form follow the change slides.

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CORE Compatible Updates

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Updated the Hepatitis C screening recommendation on the 'Preventive Services Recommendations-All Patients' Ribbon. The new recommendation: 'The USPSTF recommends screening for hepatitis C virus infection in adults aged 18 to 79 years.'

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CORE Compatible Updates

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Updated the wording in the 'Self-Reported Level of Functioning' row on the PHQ-9 NEW OLD

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CORE Compatible Updates

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Updated 'Pain Treatment history' section on the Exit CCP tab

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CORE Compatible Updates

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Updated 'Chronic Pain' ribbon label to say 'Pain Management Care Plan' and verbiage updated within section. Also changed the 'Pain care agreement on file’ to 'Pain Care Informed Consent on File’

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Cardiovascular Updates

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On the 'Initial Assessment' ribbon added a new link labeled ‘2017 ACC/AHA focused update’.

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Cardiovascular Updates

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On the ‘Afib’ Tab, added an additional link labeled ‘2019 AHA/ACC focused update’.

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Cardiovascular Updates

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Updates to ‘Antithrombotic Therapy for Patients with Atrial Fibrillation:

• Added ‘edoxaban’ to list of medications
• Added two new statements highlighted below

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Cardiovascular Updates

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Added new clinical clue on the right of algorithm: 'The decision to use an anticoagulant should not be influenced by whether the AF is paroxysmal or persistent (COR I, LOE B). 2019'

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Objectives

Cardiovascular Training Objective: Identify the clinical workflows, screeners and tools available in the TSWF Cardiovascular AIM form as they relate to the VA/DoD Clinical Practice Guidelines, ACC/AHA, NYHA, and JNC-8 Cardiovascular Learning Objectives: At the conclusion of today’s activity, the participant will be able to:

• Understand the documentation requirements found on the HPI tab (patient intake/Med

Rec/Preventive Services)

• Understand the use of various screeners (Travel/Audit-C/Tobacco use/Annual

Questions/Learning Assessment/Military Specific Screening)

• Demonstrate the purpose and use of the Cardiovascular and Metabolic Disorders Chronic

Care Plans

• Understand what information can be found on the various reference-only tabs found on

the form

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Why Use a TSWF CPG AIM IM Form?

• Integrates recommendations from VA/DoD CPGs
• Provides easily accessible references for clinical

decision-making & patient education

• Improves continuity of care and healthcare
• utcomes
• Standardizes documentation

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Workflow Key Points

• Clinical Support Staff (CSS) completes CORE or

TSWF Cardiovascular CPG Form Screening Sections

• Provider takes ‘ownership’ of the CSS note
• Provider loads the Cardiovascular AIM form
• Provider reviews and completes the note

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Selecting th the Proper Template

Select CV-CPG Select from either your drop-down list of favorites or via Navigator

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TSWF Navigator

Select TSWF Navigator

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TSWF Navigator

Select the Cardiovascular form TSWF Navigator takes you to the most current version of the TSWF forms

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HPI/PFSH Tab

Form version, links to MilSuite, TSWF Navigator, TSWF Resources, and Change Log are listed at the top

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HPI/PFSH Tab

Con

• ndit

ition-Specific Recommendations

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Summary of interventions that have a positive impact on morbidity and mortality

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HPI/PFSH Tab

Car ardiovascula lar Di Disorders CCP

This CCP is intended for patients with CAD, Cerebrovascular disease, peripheral vascular disease, A-fib, and/or heart failure. Pre-populated text is a starting point; edit the text to fit your needs. The field copies forward to support continuity of care.

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HPI/PFSH Tab

Heart Failu ilure Clas lassific ication

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A summary of heart failure classifications is provided for reference.

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HPI/PFSH Tab

Lin Links to

• CV References

Links to various references:

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HPI/PFSH Tab

Metaboli lic Di Disorders CCP

This CCP is intended for patients with hyperlipidemia and/or hypertension (and diabetes). NOTE: no need to use multiple CCPs; feel free to combine them based on patient’s or your needs. Link for Diabetic Foot Exam

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If appropriate or according to local protocol, complete pre-travel counseling and Infectious Disease Travel Screen Note: blue clinical clues about various diseases

Screening Tab

Travel Sc Screening/Infectious Di Disease Travel l Sc Screen

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Screening Tab

Links to resources on tobacco cessation

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The Single Item Literacy Screener (SILS) for assessing health literacy is in the Annual Questions field. If patient’s response is either “often” or “always”, conduct a more thorough assessment (see next slide).

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Screening Tab

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If the SILS response is either “often” or “always,” further assessment of the patient’s health literacy is documented here along with an action plan if indicated. While a link to REALM-SF is provided here, any appropriate assessment can be used.

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BH/Other Screening Tab

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This tab is used to screen for depression, suicidality, PTSD, TBI, and sleepiness. Follow Service or local guidance.

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BH/Other Screening Tab

Epworth Sleepiness Scale

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ROS Tab

Cardiopulmonary-specific ROS

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PE Tab

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PE Tab

Car ardiovascula lar-focused Se Section

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EXIT IT/CCP Tab

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Obsolete Terms

Review the Obsolete Terms tab for elements that copy forward from previous

• encounters. This function is very important when performing Copy Forward!

If obsolete terms are not deselected, you will see past medical history terms in an encounter note that the provider is not aware of when he/she signs the note.

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Reference Tabs

The remaining tabs contain reference information on the disorders covered on this form (and the reference source)

• Hypertension (VA/DoD CPG & JNC-8): 2 tabs
• Dyslipidemia (VA/DoD CPG & ACC/AHA Guidelines)
• Ischemic Heart Disease (ACC/AHA CPG)
• Chronic Heart Failure (ACCF/AHA CPG)
• Atrial Fibrillation (AHA/ACC CPG)
• There’s also a tab listing common medications used to treat

cardiovascular conditions in Primary Care in the DoD & VA

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Hypertension

There are two tabs for Hypertension: VA/DoD CPG & JNC-8

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Hypertension

Tabs contain algorithms and tables from the respective sources, and links to the full documents

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Dyslipidemia

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Is Ischemic Dis isease Tab

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Heart Failure Tab

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Heart Failure Tab

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Atr trial Fib ibrillation Tab

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Atr trial Fib ibrillation Tab

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Atr trial Fib ibrillation Tab

Sa Sample Alg lgorithm

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TSWF Resource Material

The TSWF repository for training/educational materials and updates: www.tswf-mhs.com/

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Pri rimary Care Clinical Community Content Working Group

▪ DHA - Maj Matthew J Royall ▪ ARMY - Dr. Robert Marshall ▪ AIR FORCE – Dr. Matthew Barnes

TSWF Feedback https://www.milsuite.mil/book/groups/tswf TSWF Website http://www.tswf-mhs.com/