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Does anyone know if it is possible to create a protocol that uses "or" rather than "and"? I would like to create a protocol for Colon Cancer Screening for either:
Ages 50 to 75
Either COLONOSCOPY every 10 years
OR
FIT Test #1 or FIT Test #2 (FECALIMMUN#1 or FECALIMMUN#2) annually.
Is there a way to trigger the FIT only if the Colonoscopy is blank, or by any other mechanism so that the FIT Test does not come across as due if the Colonoscopy meets the protocol?
Posted : January 31, 2014 4:22 am
Not really. The protocols in Centricity are really lacking, and situations like this really show that. The way that I handle these situations is that I set obsterms in the office visits that our clinics use in the background of the visit. Here is an example:
I wanted a protocol for Pap smears, but I didn't want this protocol to show up if the patient had a history of a hysterectomy. So, in the forms if I find that a patient has hysterectomy in their past surgical history, I set pap smear obs term to "Hysterectomy" so that it never shows up under the protocols. I also did this for Mammograms for when the patient has had a bilateral mastectomy.
So for your situation, you could put "Colonoscopy" in the FIT TEST #1 obsterm and vice versa in the COLONOSCOPY obsterm.
Can anyone else do this differently?
Posted : January 31, 2014 5:40 am
Topic starter
Thank you for your suggestion.
Posted : February 7, 2014 4:18 am
Another approach would be to twist the logic a bit, use another OBS Code, and a custom form entry. Perhaps the following, for Colon Cancer Screening:
Colon Cancer Screen
Date of Colonoscopy: __/__/____, Repeat in __ years
Date of FOBT: __/__/__
then, not only post to whatever OBS you usually would, but also do the following
If colonoscopy, write to another OBS, perhaps COLONSCRN. But now the trick, if say 2/1/2014 and five years, create five OBS entries forcing specific OBS dates, like
OBSDATE=2/1/2014, OBSVALUE=Colonoscopy 2/1/2014 for 5 years
OBSDATE=2/1/2015, OBSVALUE=Colonoscopy 2/1/2014 for 5 years
OBSDATE=2/1/2016, OBSVALUE=Colonoscopy 2/1/2014 for 5 years
OBSDATE=2/1/2017, OBSVALUE=Colonoscopy 2/1/2014 for 5 years
OBSDATE=2/1/2018, OBSVALUE=Colonoscopy 2/1/2014 for 5 years
If FOBT on 2/2/2014, simply record
OBSDATE=2/2/2014, OBSVALUE=FOBT 2/2/2014
And now the Protocol 'trick', simply check for that COLONSCRN with a date of one year. The Colonoscopy having all those dates effectively covers the patient's requirement for five years.
As I think about this, I may actually utilize something like this since I am in the process of re-writing some of my manual entry screens for tests and results. So, I would be interested in hearing about any potential issues with this approach.
Posted : February 9, 2014 11:00 pm
One other thought, to address Mike's comment, extend my thought and logic.
Patient had 'xxx', thus no need for future colonoscopy. (Actually not sure if any exclusions, but humor me since I wanted to continue with my above logic.)
Patient is 61 years old, and Colonoscopy Measure thru age 75. Thus, write fourteen records to COLONSCRN like:
OBSDATE=2/1/2014, OBSVALUE=xxx Procedure 2/1/2014, test not needed
OBSDATE=2/1/2015, OBSVALUE=xxx Procedure 2/1/2014, test not needed
And, my same Protocol logic would still work to determine if patient needs a test for colon cancer screening.
Posted : February 9, 2014 11:08 pm
