Reminder Definitions
From VistApedia
Introduction
A "Reminder" is a clinical rule that is typically applied against a particular patient to determine if it is due. Examples:
- Does patient need mammogram now?
- Is colonoscopy due now?
Fileman Structure top
Below is the Fileman data dictionary of the file used to store the reminder definitions. More discussion below the file display
File: REMINDER DEFINITION Branch: 1
REF NODE;PIECE FLD NUM FIELD NAME
===============================================================================
1 0;1 .01 NAME [RF]
2 0;3 1.2 PRINT NAME [F]
3 0;4 1.3 DO IN ADVANCE TIME FRAME [FX]
4 0;5 1.4 RELATED REMINDER GUIDELINE <-Pntr [P811.9']
5 0;6 1.6 INACTIVE FLAG [SX]
6 0;7 1.7 INACTIVE CHANGE DATE [DX]
7 0;8 1.8 IGNORE ON N/A [FX]
8 0;9 1.9 SEX SPECIFIC [S]
9 0;10 1.91 PRIORITY [S]
1;0 2 DESCRIPTION <-WP [811.92]
10 -0;1 .01 -REMINDER DESCRIPTION [W]
2;0 3 TECHNICAL DESCRIPTION <-WP [811.93]
11 -0;1 .01 -TECHNICAL DESCRIPTION [W]
7;0 7 BASELINE AGE FINDINGS <-Mult [811.97]
12 -0;1 .01 -REMINDER FREQUENCY [MFX]
13 -0;2 1 -MINIMUM AGE [NJ3,0]
14 -0;3 2 -MAXIMUM AGE [NJ3,0]
-1;0 3 -AGE MATCH TEXT W:^ <-WP [811.973]
15 --0;1 .01 --AGE MATCH TEXT [W]
-2;0 4 -AGE NO MATCH TEXT W:^ <-WP [811.974]
16 --0;1 .01 --AGE NO MATCH TEXT [W]
17 -3;1 5 -NO. OF AGE MATCH LINES [F]
18 -3;2 6 -NO. OF AGE NO MATCH LINES [F]
20;0 20 FINDINGS <-Mult [811.902V]
19 -0;1 .01 -FINDING ITEM <-Pntr Var [MVX]
20 -0;2 1 -MINIMUM AGE [NJ3,0]
21 -0;3 2 -MAXIMUM AGE [NJ3,0]
22 -0;4 3 -REMINDER FREQUENCY [FX]
-1;0 4 -FOUND TEXT W:^ <-WP [811.9024]
23 --0;1 .01 --FOUND TEXT [W]
-2;0 5 -NOT FOUND TEXT W:^ <-WP [811.9025]
24 --0;1 .01 --NOT FOUND TEXT [W]
25 -0;5 6 -RANK FREQUENCY [NJ3,0]
26 -0;6 7 -USE IN RESOLUTION LOGIC [S]
27 -0;7 8 -USE IN PATIENT COHORT LOGIC [S]
28 -0;8 9 -BEGINNING DATE/TIME [FX]
29 -0;9 10 -USE INACTIVE PROBLEMS [S]
30 -0;10 11 -WITHIN CATEGORY RANK [NJ3,0]
31 -0;11 12 -ENDING DATE/TIME [FX]
32 -0;12 13 -MH SCALE [NJ15,0X]
33 -3;1 14 -CONDITION [FX]
34 -3;2 15 -CONDITION CASE SENSITIVE [S]
35 -0;13 16 -RXTYPE [FX]
36 -0;14 17 -OCCURRENCE COUNT [NJ2,0]
37 -3;3 18 -USE STATUS/COND IN SEARCH [S]
-5;0 21 -STATUS LIST W:^ <-Mult [811.90221]
38 --0;1 .01 --STATUS [MFX]
39 -10;1 22 -INTERNAL CONDITION [F]
40 -11;1 23 -V SUBSCRIPT LIST [F]
41 -6;1 24 -NO. OF FOUND TEXT LINES [F]
42 -6;2 25 -NO. NOT FOUND TEXT LINES [F]
43 -15;E1,245 26 -COMPUTED FINDING PARAMETER [F]
44 -0;15 27 -USE START DATE [S]
45 -0;16 28 -INCLUDE VISIT DATA [S]
25;0 25 FUNCTION FINDINGS <-Mult [811.925I]
46 -0;1 .01 -FUNCTION FINDING NUMBER [MNJ3,0X]
-1;0 1 -FOUND TEXT W:^ <-WP [811.9251]
47 --0;1 .01 --FOUND TEXT [W]
-2;0 2 -NOT FOUND TEXT W:^ <-WP [811.9252]
48 --0;1 .01 --NOT FOUND TEXT [W]
49 -3;1 3 -FUNCTION STRING [FX]
-5;0 5 -FUNCTION LIST <-Mult [811.9255]
50 --0;1 .01 --FUNCTION NUMBER [MNJ3,0]
51 --0;2 .02 --FUNCTION <-Pntr [P802.4'X]
--20;0 20 --FUNCTION ARGUMENT LIST <-Mult [811.9256]
52 ---0;1 .01 ---FINDING NUMBER [MNJ3,0X]
53 -10;1 10 -LOGIC [F]
54 -0;6 11 -USE IN RESOLUTION LOGIC [S]
55 -0;7 12 -USE IN PATIENT COHORT LOGIC [S]
56 -0;2 13 -MINIMUM AGE [NJ3,0]
57 -0;3 14 -MAXIMUM AGE [NJ3,0]
58 -0;4 15 -REMINDER FREQUENCY [FX]
59 -0;5 16 -RANK FREQUENCY [NJ3,0]
60 -40;1 40 -NAME [F]
61 -6;1 41 -NO. FOUND TEXT LINES [F]
62 -6;2 42 -NO. NOT FOUND TEXT LINES [F]
63 30;1 30 CUSTOMIZED COHORT LOGIC [FX]
64 31;1 31 INTERNAL PATIENT COHORT LOGIC [FX]
65 32;1 32 PATIENT COHORT FINDINGS COUNT [NJ2,0X]
66 32;2 33 PATIENT COHORT FINDINGS LIST [FX]
67 34;1 34 CUSTOMIZED RESOLUTION LOGIC [FX]
68 35;1 35 INTERNAL RESOLUTION LOGIC [FX]
69 36;1 36 RESOLUTION FINDINGS COUNT [NJ2,0X]
70 36;2 37 RESOLUTION FINDINGS LIST [FX]
71 40;1 40 AGE FINDINGS COUNT [NJ2,0X]
72 40;2 41 AGE FINDINGS LIST [FX]
73 42;1 42 INFORMATION FINDINGS COUNT [NJ2,0X]
74 42;2 43 INFORMATION FINDINGS LIST [FX]
75 45;1 45 CUSTOM DATE DUE [FX]
76 46;1 46 CUSTOM DATE DUE FUNCTION [F]
77 46;2 47 NUMBER OF ARGUMENTS [NJ2,0]
47;0 48 CUSTOM DATE DUE ARG LIST <-Mult [811.948A]
78 -0;1 .01 -FINDING [NJ3,0]
79 -0;2 .02 -FREQUENCY [F]
50;0 50 WEB SITES <-Mult [811.9002]
80 -0;1 .01 -URL [MF]
81 -0;2 .02 -WEB SITE TITLE [F]
-1;0 1 -WEB SITE DESCRIPTION <-WP [811.90021]
82 --0;1 .01 --WEB SITE DESCRIPTION [W]
83 51;1 51 LINKED REMINDER DIALOG <-Pntr [*P801.41']
60;0 60 GENERAL COHORT FOUND TEXT W:^ <-WP [811.9003]
84 -0;1 .01 -GENERAL COHORT FOUND TEXT [W]
61;0 61 GENERAL COHORT NOT FOUND TEXT W:^ <-WP [811.961]
85 -0;1 .01 -GENERAL COHORT NOT FOUND TEXT [W]
86 62;1 62 # OF GEN. COHORT FOUND LINES [F]
87 62;2 63 # GEN. COHORT NOT FOUND LINES [F]
65;0 65 GENERAL RES. FOUND TEXT W:^ <-WP [811.965]
88 -0;1 .01 -GENERAL RES. FOUND TEXT [W]
66;0 66 GENERAL RES. NOT FOUND TEXT W:^ <-WP [811.966]
89 -0;1 .01 -GENERAL RES. NOT FOUND TEXT [W]
90 67;1 67 # GEN. RES. FOUND LINES [F]
91 67;2 68 # GEN. RES. NOT FOUND LINES [F]
92 0;11 69 RESCISSION DATE [D]
70;0 70 SUMMARY COHORT FOUND TEXT W:^ <-WP [811.9004]
93 -0;1 .01 -SUMMARY COHORT FOUND TEXT [W]
71;0 71 SUMMARY COHORT NOT FOUND TEXT W:^ <-WP [811.971]
94 -0;1 .01 -SUMMARY COHORT NOT FOUND TEXT [W]
95 72;1 72 # SUM. COHORT FOUND LINES [F]
96 72;2 73 # SUM. COHORT NOT FOUND LINES [F]
75;0 75 SUMMARY RES. FOUND TEXT W:^ <-WP [811.975]
97 -0;1 .01 -SUMMARY RESOLUTION FOUND TEXT [W]
76;0 76 SUMMARY RES. NOT FOUND TEXT W:^ <-WP [811.976]
98 -0;1 .01 -SUMMARY RES. NOT FOUND TEXT [W]
99 77;1 77 # SUM. RES. FOUND LINES [F]
100 77;2 78 # SUM. RES. NOT FOUND LINES [F]
101 100;1 100 CLASS [RSX]
102 100;2 101 SPONSOR <-Pntr [P811.6X]
103 100;3 102 REVIEW DATE [D]
104 100;4 103 USAGE [RFX]
110;0 110 EDIT HISTORY <-Mult [811.9001D]
105 -0;1 .01 -EDIT DATE [D]
106 -0;2 1 -EDIT BY <-Pntr [P200']
-1;0 2 -EDIT COMMENTS <-WP [811.90012]
107 --0;1 .01 --EDIT COMMENTS [W]
<> <> <>
Definition Parts top
Main parts of Reminder Definitions
- Findings (patient data)
- Cohort Logic (a logical combination of Findings) -- describes who the reminder applies to
- Resolution Logic. Another logical string that determines how the reminder can be resolved. (e.g. Mammogram 'Performed' would resolve Mammogram 'Due')
Key fields in REMINDER DEFINITION file top
Age & Frequency issues top
- Stored in the BASELINE AGE FINDINGS field (#7), which is a multiple.
- Baseline frequency: how often the reminder needs to be done. E.g. Q 12 months, or Q 2 years
- Stored in REMINDER FREQUENCY sub-field (#.01)
- Age Range: What ages the reminder applies to. E.g. Ages 12-26 yrs
- Stored in MINIMUM AGE sub-field (#1)
- And MAXIMUM AGE sub-field (#2)
- Can have multiple Age/Freq's for each reminder. E.g. Q 1 yr for ages 20-50, then Q 2 yrs for ages 51 yrs and up.
Gender specific top
- Field SEX SPECIFIC (#1.9).
- If left blank, then applies to both genders.
FINDINGS field (#20), (A multiple) top
FINDING ITEM sub-field (#.01) top
- This is variable pointer to data items.
- 50 -- DRUG
- 9999999.09 -- EDUCATION TOPIC
- 9999999.15 -- EXAM
- 9999999.64 -- HEALTH FACTOR
- 9999999.14 -- IMMUNIZATION
- 60 -- LABORATORY TEST
- 601.71 -- MH TESTS AND SURVEYS
- 101.43 -- ORDERABLE ITEM
- 71 -- RADIOLOGY PROCEDURE
- 811.4 -- REMINDER COMPUTED FINDING
- 811.2 -- REMINDER TAXONOMY
- 811.5 -- REMINDER TERM
- 9999999.28 -- SKIN TEST
- 50.605 -- VA DRUG CLASS
- 50.6 -- VA GENERIC
- 120.51 -- VITAL MEASUREMENT
- 810.9 -- REMINDER LOCATION LIST
"Finding Modifiers" -- Applying to all findings top
- Modify how a particular finding is used
- REMINDER FREQUENCY field (#3). See Age Rage discussion 1 line below.
- Min & Max Age Range (fields #1, #2). If this finding is found to be true, then use this Age & Frequency instead of baseline age and frequency. Stored in:
- MINIMUM AGE sub-field (#1)
- MAXIMUM AGE sub-field (#2)
- REMINDER FREQUENCY sub-field (#3)
- E.g. Create a health factor for family history of colon cancer. If health factor is true, then perhaps change starting time from 50 yrs baseline, Q 10 yrs, down to new age and frequency of 40, Q 3 yrs.
- No need to set a value for these fields unless one wants to override the baseline age & freq. to something different.
- RANK FREQUENCE field (#6): used if there will be multiple findings, and more than one specifies an override age & frequency value. This field will then determine which has precedence. Multiple sub-record that is true that has highest index number will be used for the override.
- USE IN RESOLUTION LOGIC subfield (#11)
- Examples: OR (!), AND (&) or NOT (')
- This specifies how finding is to be combined with the overall logic of the net reminder.
- USE IN PATIENT COHORT LOGIC subfield (#12)
- See Resolution logic above.
- BEGINNING DATE/TIME sub-field (#9)
- Beginning time frame to search for data for this finding
- If not provided, then search for patient data goes all the way to the beginning of the patient record.
- Can be a set date, e.g. "5/4/1972"
- Can be a relative date indicator, e.g. "T-1Y". "T" indicates the time when the evaluation is being run.
- ENDING DATE/TIME sub-field (#12)
- Ending time frame to search for data for this finding
- If not provided, then search goes to TODAY
- See above about set vs relative dates.
- OCCURRENCE COUNT sub-field (#17)
- The number of occurrences to search for in the specified date range.
- E.g. 3 --> find the 3 most recent occurrences of the finding
- E.g. -3 --> find the 3 oldest occurrences of the finding
- If only 2 are present, then 2 will be returned. But in this example, more than 3 would not be returned.
Finding Modifiers -- Applicable to only certain fields top
- USE INACTIVE PROBLEMS sub-field (#10)
- Refers to Taxonomies findings e.g. problem list
- WITHIN CATEGORY RANK sub-field (#11)
- Refers to Health Factors findings
- MH SCALE sub-field (#13)
- Refers to mental health tests type of findings
- RXTYPE sub-field (#16)
- Refers to Drug findings.
- Determines whether to search inpatient, outpatient, non-VA meds, or some combination thereof. If blank, all are searched.
- USE START DATE sub-field (#27)
- Refers to Drug findings and Orderable Items
- Date of finding is the Start Date for the Rx (when it was released) instead of the default of the stop date of the Rx (the release date + supply duration).
- INCLUDE VISIT DATA sub-field (#28)
- Refers to Patient Care Encounter (PCE) (V-file) findings
- If value=YES, then data from the PCE instance is available for use in a Condition.
- Visit IEN
- Date visit created
- DFN
- Location of Encounter
- Station Number
- Service Category
- DSS ID
- Outside Location
- Status
- Primary provider
CONDITION sub-field (#14) top
- This is a way to check the value of a data value. E.g. if finding is a potassium lab test, could have condition of "IF (V<2.5)!(V>5.5)"
- If the condition logic string evaluates to false, then the finding that contains it will evaluate to false.
- Sometimes more data is available than just a simple value "V". There can be a subscript for V, called CSUB (condition subscript). E.g. 'IF V("CSUB")<7' OR 'IF V("COLOR")="BLUE"'.
- In PCE description above, the data, such as "DFN" would be available as a condition subscript.
CONDITIONS CASE SENSITIVE sub-field (#15) top
- Same as CONDITION sub-field (#14) above, except it is case sensitive. Allows lower case CSUB's etc.
