TSWF Cardiovascular CPG AIM Form Training May May-Aug 2020 Form Version “Medically Ready Force…Ready Medical Force” 1
Dis isclaimer Content shown is from an AHLTA Training System (ATS) and does not contain actual patient data. “Medically Ready Force…Ready Medical Force”
Recent Changes The following group of slides reflect changes made to the form. The specific training slides for this form follow the change slides. “Medically Ready Force…Ready Medical Force”
CORE Compatible Updates 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.' “Medically Ready Force…Ready Medical Force” 4
CORE Compatible Updates Updated the wording in the 'Self-Reported Level of Functioning' row on the PHQ-9 OLD NEW “Medically Ready Force…Ready Medical Force” 5
CORE Compatible Updates Updated 'Pain Treatment history' section on the Exit CCP tab “Medically Ready Force…Ready Medical Force” 6
CORE Compatible Updates 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’ “Medically Ready Force…Ready Medical Force” 7
Cardiovascular Updates On the 'Initial Assessment' ribbon added a new link labeled ‘2017 ACC/AHA focused update’. “Medically Ready Force…Ready Medical Force” 8
Cardiovascular Updates On the ‘ Afib ’ Tab, added an additional link labeled ‘2019 AHA/ACC focused update’. “Medically Ready Force…Ready Medical Force” 9
Cardiovascular Updates Updates to ‘Antithrombotic Therapy for Patients with Atrial Fibrillation: • Added ‘ edoxaban ’ to list of medications • Added two new statements highlighted below “Medically Ready Force…Ready Medical Force” 10
Cardiovascular Updates 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' “Medically Ready Force…Ready Medical Force” 11
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 “Medically Ready Force…Ready Medical Force”
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 outcomes • Standardizes documentation “Medically Ready Force…Ready Medical Force” 13
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 “Medically Ready Force…Ready Medical Force” 14
Selecting th the Proper Template Select from either your drop-down Select CV-CPG list of favorites or via Navigator “Medically Ready Force…Ready Medical Force” 15
TSWF Navigator Select TSWF Navigator “Medically Ready Force…Ready Medical Force” 16
TSWF Navigator Select the Cardiovascular form TSWF Navigator takes you to the most current version of the TSWF forms “Medically Ready Force…Ready Medical Force” 17
HPI/PFSH Tab Form version, links to MilSuite, TSWF Navigator, TSWF Resources, and Change Log are listed at the top “Medically Ready Force…Ready Medical Force” 18
HPI/PFSH Tab Con ondit ition-Specific Recommendations Summary of interventions that have a positive impact on morbidity and mortality “Medically Ready Force…Ready Medical Force” 19
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. “Medically Ready Force…Ready Medical Force” 20
HPI/PFSH Tab Heart Failu ilure Clas lassific ication A summary of heart failure classifications is provided for reference. “Medically Ready Force…Ready Medical Force” 21
HPI/PFSH Tab Lin Links to o CV References Links to various references: “Medically Ready Force…Ready Medical Force” 22
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 “Medically Ready Force…Ready Medical Force” 23
Screening Tab Travel Sc Screening/Infectious Di Disease Travel l Sc Screen If appropriate or according to local protocol, complete pre-travel counseling and Infectious Disease Travel Screen Note: blue clinical clues about various diseases “Medically Ready Force…Ready Medical Force”
Screening Tab 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). Links to resources on tobacco cessation “Medically Ready Force…Ready Medical Force” 25
Screening Tab 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. “Medically Ready Force…Ready Medical Force” 26
BH/Other Screening Tab This tab is used to screen for depression, suicidality, PTSD, TBI, and sleepiness. Follow Service or local guidance. “Medically Ready Force…Ready Medical Force” 27
BH/Other Screening Tab Epworth Sleepiness Scale “Medically Ready Force…Ready Medical Force” 28
ROS Tab Cardiopulmonary-specific ROS “Medically Ready Force…Ready Medical Force” 29
PE Tab “Medically Ready Force…Ready Medical Force” 30
PE Tab Car ardiovascula lar-focused Se Section “Medically Ready Force…Ready Medical Force” 31
EXIT IT/CCP Tab “Medically Ready Force…Ready Medical Force” 32
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. “Medically Ready Force…Ready Medical Force” 33
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 “Medically Ready Force…Ready Medical Force” 34
Hypertension There are two tabs for Hypertension: VA/DoD CPG & JNC-8 “Medically Ready Force…Ready Medical Force” 35
Hypertension Tabs contain algorithms and tables from the respective sources, and links to the full documents “Medically Ready Force…Ready Medical Force” 36
Dyslipidemia “Medically Ready Force…Ready Medical Force” 37
Ischemic Dis Is isease Tab “Medically Ready Force…Ready Medical Force” 38
Heart Failure Tab “Medically Ready Force…Ready Medical Force” 39
Heart Failure Tab “Medically Ready Force…Ready Medical Force” 40
Atr trial Fib ibrillation Tab “Medically Ready Force…Ready Medical Force” 41
Atr trial Fib ibrillation Tab “Medically Ready Force…Ready Medical Force” 42
Atr trial Fib ibrillation Tab Sa Sample Alg lgorithm “Medically Ready Force…Ready Medical Force” 43
TSWF Resource Material The TSWF repository for training/educational materials and updates: www.tswf-mhs.com/ “Medically Ready Force…Ready Medical Force” 44
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