A brief return to Health Maintenance

I've been working on a reasonable review of the new Problem and Diagnosis List functions that will be found in CIS Enhanced View. While I'm quite confident the upgraded version will solve a host of problems we've all encountered with the current version, there are some key changes that I want to make sure I explain so that I can refer you back to this site in the event of any difficulties.

So... I see from the poll and I've heard in conversation that there remains some concern about the Health Maintenance tool. I suggest folks go back to December's and the first half of January's posts to check what I've had to say thus far. I've also added a few major links that take on this topic.

Here are a few issues that I've heard about:

• The addition of the Zostavax vaccination- most of us in adult primary care are aware not only of the "availability" of the vaccine, but of the guideline that recommends a single dose for all adults 60 years and older. While the efficacy data are not exactly compelling and the cost of the vaccine is prohibitive, particularly when payers want no part of it, I included this HM element because it seems reasonable to track and is part of the MHQP preventive health set. Take a look at this slide for one way of handling the RED mark:
  

Uploaded on authorSTREAM by nrk99

• Pneumococcal vaccine does not have a Cancel Permanently selection. I will have this added as soon as technologically feasible.

• Consider changing the due date time frame for certain expectations, e.g. Td/Tdap, to "turn red" earlier. So for Td, the expectation could come due at 9 years rather than 10 years, thereby avoiding that booster being delayed in the event that the patient visits during the 10th year only to return many months after the 10 year expectation. As I've mentioned in an earlier post, the next big upgrade of CIS will include an updated and customizable version of HM that will allow the physician to make these changes based on patient needs rather than set code. For now, I'm glad to entertain this question and would appreciate feedback. I believe it would be practical only for those expectations that have long intervals since this could be a set up for over-testing.

• Prostate Cancer screening - get rid of it... This is a not uncommon suggestion and, as I approach 50, I would love to host a lively if not definitive debate here. For now, the PSA and DRE will remain on the HM tool and, like the Zostavax, can be canceled if you so choose.

Stay tuned for Problem and Diagnosis Lists - Enhanced View style.