ZZVA-MHV CERVICAL CANCER SCREEN (441)    REMINDER DEFINITION (811.9)

Name Value
NAME ZZVA-MHV CERVICAL CANCER SCREEN
PRINT NAME ZZ PAP Smear Screening
DO IN ADVANCE TIME FRAME 6M
INACTIVE FLAG INACTIVE
INACTIVE CHANGE DATE 2017-12-27 16:27:46
SEX SPECIFIC FEMALE
CLASS NATIONAL
SPONSOR Women Veterans Health Program and National Center for Health Promotion and Disease Prevention (NCP)
USAGE CPR
EDIT HISTORY
  1. EDIT DATE:   2013-07-16 10:25:41
    EDIT BY:   USER,SEVENTEEN
    EDIT COMMENTS:   
    Exchange Install
    
DESCRIPTION
VHA recommends screening for cervical cancer with cytology (Pap smear) 
VHA recommends AGAINST using HPV testing alone or in combination with 
cytology for cervical cancer screening in women younger than 30 years.
 
VHA recommends AGAINST screening for cervical cancer in women older than 
65 years of age if they have had adequate prior screening and are not 
otherwise at high risk for cervical cancer. 
 
VHA recommends AGAINST screening for cervical cancer in women who have 
had a total hysterectomy (cervix removal) for benign disease.
 
every 3 years for women ages 21-65 that have a cervix OR, for women ages 
This reminder does not apply to women who have had a hysterectomy where
the cervix was removed.
 
Evidence of a PAP smear completed will satisfy the reminder for 
up to 5 years, depending on the screening frequency specified by the 
clinician and the presence of HPV screening. The clinician can alter the
screening frequency for individual patients based on patient and family
history, and discussions with the patient.
 
PAP Smears completed will resolve this reminder and may be recorded as one
30-65 who want to lengthen the screening interval, screening with a 
of the following:
         Laboratory result matching Cytology or Surgical Pathology SNOMED
         Women's Health procedure result
         Health Factor (Historical outside PAP smear result) 
         PCE CPT procedure code
         Completed consult order for outside procedure
 
In patients ages 30-65 who have evidence of a recent negative HPV result 
and no prior abnormal PAP smear, the PAP smear will resolve the reminder
for 5 years.
combination of cytology and human papilloma virus (HPV) testing every 5 
 
Screening will be resolved by any of the following: 
          PAP smear obtained at this encounter (9 months) 
          Health Factor for an order for PAP Smear screening (9 months)
          Patient declined PAP smear (4 months) 
          Clinician deferred PAP smear (4 months) 
 
Clinicians may manage follow-up screening to occur every 4 or 6 months 
when PAP smear results are unsatisfactory, or if they feel screening 
should take place more often than 1, 2, 3 or 5 years.
years.
 
Management of an abnormal PAP is included in this screening reminder only 
if the clinician indicates what frequency is required for an individual 
patient.  A code for abnormal PAP changes the frequency to 1 year.  This 
1 year frequency if subsequently overridden if any other frequency is 
chosen by the clinician.
 
VHA recommends AGAINST screening for cervical cancer in women who are 
younger than 21 years.
 
FINDINGS
  1. FINDING ITEM:   VA-AGE
    CONDITION:   I V>29&(V<66)
    INTERNAL CONDITION:   I V>29&(V<66)
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
  2. FINDING ITEM:   VA-WH PAP SMEAR SCREEN DEFER
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
    USE IN RESOLUTION LOGIC:   OR
    BEGINNING DATE/TIME:   T-4M
  3. FINDING ITEM:   VA-WH PAP SMEAR UNSATISFACTORY IN LAB/WH PKG
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
    USE IN RESOLUTION LOGIC:   OR
  4. FINDING ITEM:   VA-WH PAP SMEAR SCREEN FREQ - 4M
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
  5. FINDING ITEM:   VA-WH PAP SMEAR SCREEN FREQ - 6M
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
  6. FINDING ITEM:   VA-WH PAP SMEAR SCREEN FREQ - 1Y
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
  7. FINDING ITEM:   VA-WH PAP SMEAR SCREEN FREQ - 2Y
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
  8. FINDING ITEM:   VA-WH PAP SMEAR SCREEN FREQ - 3Y
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
  9. FINDING ITEM:   VA-WH HYSTERECTOMY
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
  10. FINDING ITEM:   VA-WH HX CERVICAL CANCER/ABNORMAL PAP
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
  11. FINDING ITEM:   VA-WH HYSTERECTOMY W/CERVIX REMOVED
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
    USE IN PATIENT COHORT LOGIC:   AND NOT
  12. FINDING ITEM:   VA-WH HPV TESTING NEGATIVE
    WITHIN CATEGORY RANK:   0
    CONDITION CASE SENSITIVE:   NO
    OCCURRENCE COUNT:   4
    USE STATUS/COND IN SEARCH:   YES
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
    BEGINNING DATE/TIME:   T-5Y
  13. FINDING ITEM:   VA-WH HPV TESTING POSITIVE
    WITHIN CATEGORY RANK:   0
    CONDITION CASE SENSITIVE:   NO
    OCCURRENCE COUNT:   2
    USE STATUS/COND IN SEARCH:   YES
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
  14. FINDING ITEM:   VA-AGE
    CONDITION:   I V<30
    INTERNAL CONDITION:   I V<30
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
  15. FINDING ITEM:   VA-WH PAP SMEAR SCREEN FREQ - 5Y
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
  16. FINDING ITEM:   VA-WH PAP SMEAR SCREENING REMINDER DUE
    NO. OF FOUND TEXT LINES:   5
    NO. NOT FOUND TEXT LINES:   0
    FOUND TEXT:   
     
    Although your are over 65 years old, your provider has recommended 
    continued screening.
     
    \\
    
  17. FINDING ITEM:   VA-WH PAP SMEAR SCREEN IN WH PKG
    OCCURRENCE COUNT:   3
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
    USE IN RESOLUTION LOGIC:   OR
  18. FINDING ITEM:   VA-WH PAP SMEAR SCREEN IN LAB PKG
    OCCURRENCE COUNT:   3
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
    USE IN RESOLUTION LOGIC:   OR
  19. FINDING ITEM:   VA-WH PAP SMEAR DONE
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
    USE IN RESOLUTION LOGIC:   OR
  20. FINDING ITEM:   VA-WH PAP SMEAR OBTAINED
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
    USE IN RESOLUTION LOGIC:   OR
    BEGINNING DATE/TIME:   T-7D
  21. FINDING ITEM:   VA-WH PAP SMEAR SCREEN NOT INDICATED
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
    USE IN RESOLUTION LOGIC:   OR
FUNCTION FINDINGS
  1. FUNCTION FINDING NUMBER:   1
    FOUND TEXT:   
    PAP smear screening every 5 years specified for this patient.
    
    LOGIC:   (FN(1)=FN(2))&(FN(2)>0)
    MINIMUM AGE:   30
    REMINDER FREQUENCY:   5Y
    FUNCTION STRING:   (MRD(9,12,13,14,15,16,23)=MRD(23))&(MRD(23)>0)
    NO. FOUND TEXT LINES:   1
    NO. NOT FOUND TEXT LINES:   0
    FUNCTION LIST:
    1. FUNCTION NUMBER:   1
      FUNCTION:   MRD
      FUNCTION PARAMETER LIST:
    2. FUNCTION NUMBER:   2
      FUNCTION:   MRD
      FUNCTION PARAMETER LIST:
    3. FUNCTION NUMBER:   3
      FUNCTION:   MRD
      FUNCTION PARAMETER LIST:
  2. FUNCTION FINDING NUMBER:   10
    LOGIC:   ($P(FN(1),".")'<($P(FN(2),".")))&(FN(1)>0)&((FN(4)&FN(5)>FN(6))!'FN(7)!FN(8))
    MINIMUM AGE:   21
    MAXIMUM AGE:   65
    REMINDER FREQUENCY:   3Y
    FUNCTION STRING:   ($P(MRD(4,5,6),".")'<($P(MRD(7,9,10,11),".")))&(MRD(4,5,6)>0)&((FI(21)&MRD(21)>MRD(20))!'FI(20)!FI(22))
    NO. FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
    FUNCTION LIST:
    1. FUNCTION NUMBER:   1
      FUNCTION:   MRD
      FUNCTION PARAMETER LIST:
    2. FUNCTION NUMBER:   2
      FUNCTION:   MRD
      FUNCTION PARAMETER LIST:
    3. FUNCTION NUMBER:   3
      FUNCTION:   MRD
      FUNCTION PARAMETER LIST:
    4. FUNCTION NUMBER:   4
      FUNCTION:   FI
      FUNCTION PARAMETER LIST:
    5. FUNCTION NUMBER:   5
      FUNCTION:   MRD
      FUNCTION PARAMETER LIST:
    6. FUNCTION NUMBER:   6
      FUNCTION:   MRD
      FUNCTION PARAMETER LIST:
    7. FUNCTION NUMBER:   7
      FUNCTION:   FI
      FUNCTION PARAMETER LIST:
    8. FUNCTION NUMBER:   8
      FUNCTION:   FI
      FUNCTION PARAMETER LIST:
  3. FUNCTION FINDING NUMBER:   11
    LOGIC:   ($P(FN(1),".")'<($P(FN(2),".")))&(FN(1)>0)&(FN(4)&(FN(5)>FN(6))&FN(7))
    MINIMUM AGE:   30
    MAXIMUM AGE:   65
    REMINDER FREQUENCY:   5Y
    FUNCTION STRING:   ($P(MRD(4,5,6),".")'<($P(MRD(7,9,10,11),".")))&(MRD(4,5,6)>0)&(FI(20)&(MRD(20)>MRD(21))&FI(1))
    NO. FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
    FUNCTION LIST:
    1. FUNCTION NUMBER:   1
      FUNCTION:   MRD
      FUNCTION PARAMETER LIST:
    2. FUNCTION NUMBER:   2
      FUNCTION:   MRD
      FUNCTION PARAMETER LIST:
    3. FUNCTION NUMBER:   3
      FUNCTION:   MRD
      FUNCTION PARAMETER LIST:
    4. FUNCTION NUMBER:   4
      FUNCTION:   FI
      FUNCTION PARAMETER LIST:
    5. FUNCTION NUMBER:   5
      FUNCTION:   MRD
      FUNCTION PARAMETER LIST:
    6. FUNCTION NUMBER:   6
      FUNCTION:   MRD
      FUNCTION PARAMETER LIST:
    7. FUNCTION NUMBER:   7
      FUNCTION:   FI
      FUNCTION PARAMETER LIST:
  4. FOUND TEXT:   
    Negative HPV result, patient < age 30.  5year screening interval is NOT 
    recommended for patients less than age 30.
    
    LOGIC:   FN(1)&FN(2)
    FUNCTION STRING:   FI(20)&FI(22)
    NO. FOUND TEXT LINES:   2
    NO. NOT FOUND TEXT LINES:   0
    FUNCTION LIST:
    1. FUNCTION NUMBER:   1
      FUNCTION:   FI
      FUNCTION PARAMETER LIST:
    2. FUNCTION NUMBER:   2
      FUNCTION:   FI
      FUNCTION PARAMETER LIST:
  5. LOGIC:   FN(1)&'FN(2)&'FN(3)
    FUNCTION STRING:   FI(1)&'FI(20)&'FI(21)
    NO. FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
    FUNCTION LIST:
    1. FUNCTION NUMBER:   1
      FUNCTION:   FI
      FUNCTION PARAMETER LIST:
    2. FUNCTION NUMBER:   2
      FUNCTION:   FI
      FUNCTION PARAMETER LIST:
    3. FUNCTION NUMBER:   3
      FUNCTION:   FI
      FUNCTION PARAMETER LIST:
  6. FUNCTION FINDING NUMBER:   4
    FOUND TEXT:   
    Annual PAP smear screening specified for this patient.
    
    LOGIC:   (FN(1)=FN(2))&(FN(2)>0)
    MINIMUM AGE:   18
    REMINDER FREQUENCY:   1Y
    FUNCTION STRING:   (MRD(9,12,13,14,15,16,23)=MRD(14))&(MRD(14)>0)
    NO. FOUND TEXT LINES:   1
    NO. NOT FOUND TEXT LINES:   0
    FUNCTION LIST:
    1. FUNCTION NUMBER:   1
      FUNCTION:   MRD
      FUNCTION PARAMETER LIST:
    2. FUNCTION NUMBER:   2
      FUNCTION:   MRD
      FUNCTION PARAMETER LIST:
    3. FUNCTION NUMBER:   3
      FUNCTION:   MRD
      FUNCTION PARAMETER LIST:
  7. FUNCTION FINDING NUMBER:   5
    FOUND TEXT:   
    PAP smear screening every 2 years specified for this patient.
    
    LOGIC:   (FN(1)=FN(2))&(FN(2)>0)
    MINIMUM AGE:   18
    REMINDER FREQUENCY:   2Y
    FUNCTION STRING:   (MRD(9,12,13,14,15,16,23)=MRD(15))&(MRD(15)>0)
    NO. FOUND TEXT LINES:   1
    NO. NOT FOUND TEXT LINES:   0
    FUNCTION LIST:
    1. FUNCTION NUMBER:   1
      FUNCTION:   MRD
      FUNCTION PARAMETER LIST:
    2. FUNCTION NUMBER:   2
      FUNCTION:   MRD
      FUNCTION PARAMETER LIST:
    3. FUNCTION NUMBER:   3
      FUNCTION:   MRD
      FUNCTION PARAMETER LIST:
  8. FUNCTION FINDING NUMBER:   6
    FOUND TEXT:   
    PAP smear screening every 3 years specified for this patient.
    
    LOGIC:   (FN(1)=FN(2))&(FN(2)>0)
    MINIMUM AGE:   18
    REMINDER FREQUENCY:   3Y
    FUNCTION STRING:   (MRD(9,12,13,14,15,16,23)=MRD(16))&(MRD(16)>0)
    NO. FOUND TEXT LINES:   1
    NO. NOT FOUND TEXT LINES:   0
    FUNCTION LIST:
    1. FUNCTION NUMBER:   1
      FUNCTION:   MRD
      FUNCTION PARAMETER LIST:
    2. FUNCTION NUMBER:   2
      FUNCTION:   MRD
      FUNCTION PARAMETER LIST:
    3. FUNCTION NUMBER:   3
      FUNCTION:   MRD
      FUNCTION PARAMETER LIST:
  9. FUNCTION FINDING NUMBER:   7
    FOUND TEXT:   
    PAP smear screening not clinically indicated for this patient.
    
    LOGIC:   (FN(1)=FN(2))&(FN(2)>0)
    REMINDER FREQUENCY:   0Y
    FUNCTION STRING:   (MRD(9,12,13,14,15,16,23)=MRD(9))&(MRD(9)>0)
    NO. FOUND TEXT LINES:   1
    NO. NOT FOUND TEXT LINES:   0
    FUNCTION LIST:
    1. FUNCTION NUMBER:   1
      FUNCTION:   MRD
      FUNCTION PARAMETER LIST:
    2. FUNCTION NUMBER:   2
      FUNCTION:   MRD
      FUNCTION PARAMETER LIST:
    3. FUNCTION NUMBER:   3
      FUNCTION:   MRD
      FUNCTION PARAMETER LIST:
  10. FUNCTION FINDING NUMBER:   8
    FOUND TEXT:   
    The most recent PAP smear result in the Lab or Women's Health package was
    unsatisfactory.  The PAP smear needs to be repeated.
    
    LOGIC:   ($P(FN(1),".")=($P(FN(2),".")))&(FN(2)>0)
    REMINDER FREQUENCY:   1D
    FUNCTION STRING:   ($P(MRD(4,5,6,7,9,10,11),".")=($P(MRD(11),".")))&(MRD(11)>0)
    NO. FOUND TEXT LINES:   2
    NO. NOT FOUND TEXT LINES:   0
    FUNCTION LIST:
    1. FUNCTION NUMBER:   1
      FUNCTION:   MRD
      FUNCTION PARAMETER LIST:
    2. FUNCTION NUMBER:   2
      FUNCTION:   MRD
      FUNCTION PARAMETER LIST:
    3. FUNCTION NUMBER:   3
      FUNCTION:   MRD
      FUNCTION PARAMETER LIST:
  11. FOUND TEXT:   
    Prior negative HPV results and no record of any positive HPV results.
    
    LOGIC:   FN(1)&'FN(2)
    FUNCTION STRING:   FI(20)&'FI(21)
    NO. FOUND TEXT LINES:   1
    NO. NOT FOUND TEXT LINES:   0
    FUNCTION LIST:
    1. FUNCTION NUMBER:   1
      FUNCTION:   FI
      FUNCTION PARAMETER LIST:
    2. FUNCTION NUMBER:   2
      FUNCTION:   FI
      FUNCTION PARAMETER LIST:
TECHNICAL DESCRIPTION
Technical Description:
    facility, results can be recorded three ways to satisfy this 
           recorded and the status is not Unsatisfactory.
     
        VA-WH PAP SMEAR SCREEN IN LAB PKG 
           No mapping necessary.  This term represents PAP Smear results 
           documented in the Laboratory package. Use the new VA-WH PAP 
           SMEAR IN LAB PKG computed finding distributed with this
           reminder term.
           This computed finding looks for PAP smear results in the 
           Laboratory package where the Result Status that is not 
           "Unsatisfactory" 
    reminder: 
            
           This computed finding will only work if the Women's Health WV 
           PROCEDURE TYPE file entry for PAP SMEAR has SNOMED codes 
           defined that are used by your local Lab Service to document 
           PAP Smear results in the Lab Package.  The SNOMED codes need 
           to be defined regardless of whether the Women's Health 
           Package is being used.
     
       VA-WH PAP SMEAR DONE 
           No mapping necessary.  Use the new VA-WH PAP SMEAR SCREEN 
 
           CODES taxonomy distributed with this reminder term. This
           taxonomy is similar to the VA-CERVICAL CANCER SCREEN taxonomy
           distributed to the field with the first reminder package
           distribution. The new taxonomy should be used, instead of the
           VA-CERVICAL CANCER SCREEN taxonomy, because it does not 
           include codes such as Q0091 which represent PAP smears 
           obtained by the clinician.
     
           Use the new WH PAP SMEAR OUTSIDE health factor to document PAP 
           Smear results completed outside the VA when the PAP Smear 
        * Results, with interpretation, can be entered and verified
           results are not documented in Lab, Women's Health or Consult
           packages.  
     
        VA-WH PAP SMEAR OBTAINED 
           Use the new taxonomy VA-WH PAP SMEAR OBTAINED which contains 
           coded values that represent the clinician's actions taken to 
           obtain the PAP smear.  
       
        VA-WH PAP SMEAR ORDER HEALTH FACTOR 
           Removed from patient reminder.
          in the Lab package.
     
       VA-WH PAP SMEAR SCREEN NOT INDICATED 
           Use the findings distributed with this reminder term or map 
           any local findings that indicate a PAP smear screen is not
           indicated for this patient.
            
           This term is distributed with mapping to the following 
           health factors: 
              INACTIVATE CERVIX CANCER SCREEN (distributed with the 
                   first version of the Clinical Reminder package in 1996 
        * Results, with interpretation, can be manually entered into the
                   to inactivate the CERVICAL CANCER reminder).  
              WH PAP SMEAR SCREEN NOT INDICATED 
              VA LIMITED LIFE EXPECTANCY 
           and the following taxonomy: 
              VA-TERMINAL CANCER PATIENTS 
     
           Use in National VA-WH PAP SMEAR SCREENING reminder: 
           This term is used in WH reminders to inactivate PAP Smear 
           screening until a clinician overrides the inactivation by 
           selecting a health factor that is used by function findings 
          WH package.
           with frequencies of 1Y, 2Y, 3Y or 5Y.   Begin date of T-6M has
           been added to HF.VA LIMITED LIFE EXPECTANCY and
           TX.VA-TERMINAL CANCER PATIENTS so screening will come due
           again if the patient lives longer than expected or if the
           patient has been misdiagnosed.
 
           Updated September 2012 to include 2 new health factors:
             CERVICAL CA SCRN N/A PERMANENTLY   (no begin date)
             CERVICAL CA SCRN N/A 5 YRS         (begin date T-5Y)
     
        * Summarized results can be entered as a historical entry (health 
           Sites may prefer to use local LIMITED LIFE EXPECTANCY health 
           factors and add their health factors to other reminder 
           terms which cause the PAP Smear Screening reminder to be 
           due without requiring a clinician to select a finding to 
           reactivate the reminder. (e.g., Add the local life expectancy 
           health factor for "LOCAL LIFE EXPECTANCY 6M" to the VA-WH PAP
           SMEAR SCREEN NOT INDICATED term).  
            
       VA-WH PAP SMEAR SCREEN DEFER 
           Use the WH PAP SMEAR DECLINED and/or WH PAP SMEAR DEFERRED
          factor or CPT code) in the patient record. Historical entries 
           health factors distributed with this term, or add any local
           health factors representing that PAP smear screening should be
           deferred.
     
        VA-WH PAP SMEAR UNSATISFACTORY IN LAB/WH PKG 
           No mapping necessary.  This term represents unsatisfactory
           PAP Smear results documented in the Laboratory and WH 
           packages. Use the new VA-WH PAP SMEAR IN LAB PKG computed
           finding distributed with this reminder term. This computed
           finding looks for PAP smear results in the Laboratory 
          should be based on reviewed results, not on patient comments. 
           package where the Result Status is "Unsatisfactory"
           
           Use the VA-WH PAP SMEAR IN WH PKG computed finding and the
           value "UNSATISFACTORY" to find unsatisfactory PAP smear 
           results documented in the WH package.
 
           This computed finding will only work if the Women's Health WV 
           PROCEDURE TYPE file entry for PAP SMEAR has SNOMED codes 
           defined that are used by your local Lab Service to document 
           PAP Smear results in the Lab Package.  The SNOMED codes need 
    Patient reminder based on copy of the national PAP smear screening 
         
           to be defined regardless of whether the Women's Health Package
           is being used.
 
    INFORMATION FINDINGS: 
    ---------------------
    Function Findings (FF) will be used to determine the frequency of 
    this reminder.  The following are information reminder terms that are
    used in Function Findings to alter the baseline Age/Frequency.  If the
    most recent resolution finding is a documented result, the frequency
    for the next PAP Smear will be based on these reminder terms. 
    Setup of Women's Health package before using this reminder: 
    If multiple findings exist for the same date/time, the finding that
    makes the reminder due most often will prevail.  See the FUNCTION
    FINDINGS section below for frequency logic.
     
       VA-WH PAP SMEAR SCREEN FREQ - 4M 
       VA-WH PAP SMEAR SCREEN FREQ - 6M 
          Removed from patient reminder.
 
       VA-WH PAP SMEAR SCREEN FREQ - 1Y 
           Use the WH PAP SMEAR SCREEN FREQ - 1Y health factor 
    ===========================================================
           distributed with this reminder term, or add any local findings
           that indicate PAP smear screening should occur every year.
           The taxonomy for abnormal PAP is included in this term.    
 
       VA-WH PAP SMEAR SCREEN FREQ - 2Y 
           Use the WH PAP SMEAR SCREEN FREQ - 2Y health factor 
           distributed with this reminder term, or add any local 
           findings that indicate the PAP smear screening should occur 
           every 2 years.   
     
    This reminder has been developed to interface with the Women's Health 
       VA-WH PAP SMEAR SCREEN FREQ - 3Y 
           Use the WH PAP SMEAR SCREEN FREQ - 3Y health factor 
           distributed with this reminder term, or add any local 
           findings that indicate PAP smear screening should occur every 
           3 years.  
     
       The following reminder terms are "information only" terms that are 
       not used to alter the frequency, but provide information that may
       be helpful to the clinician.
     
    (WH) package. The associated reminder dialog will update the WH 
       VA-WH HYSTERECTOMY 
           This reminder term represents hysterectomy related procedures. 
           It is pre-mapped to use the VA-HYSTERECTOMY taxonomy which was 
           distributed to the field in 1996. It is not used to alter the 
           patient cohort because it contains hysterectomy codes that 
           indicate the patients cervix may or may not have been 
           removed.  
     
       VA-WH HX CERVICAL CANCER/ABNORMAL PAP 
           This reminder term is mapped to the taxonomy VA-CERVICAL 
    package at the same time clinical care is recorded in CPRS GUI, thus
           CA/ABNORMAL PAP findings. This term represents ICD9, ICD0, 
           and CPT codes that indicate the patient has a history of 
           cervical cancer or a diagnosis for abnormal PAP.  Sites may 
           choose to only use documented diagnosis and procedure codes 
           removing mapping to Women's Health.  
           
           This reminder term is also mapped to the computed finding 
           VA-WH PAP SMEAR SCREEN IN WH PKG with a condition check for
           "Abnormal" used for the search. If PAP smear results are
           documented in the Women's Health package, the computed finding
    eliminating the need for dual data entry.
           VA-WH PAP SMEAR SCREEN IN WH PKG will find the most recent PAP
           Smear entry that has an "Abnormal" result. Sites can remove
           this mapped item if they are not using the Women's Health
           package to store PAP results.
     
           The reminder term may also be mapped to the computed finding 
           VA-WH PAP SMEAR SCREEN IN LAB PKG with a condition check for 
           "Abnormal" Result Type.  The Result Type is based on Procedure 
           definitions in the Women's Health Package.  
     
     
       VA-WH PAP SMEAR ORDER 
          Removed from patient reminder
 
       VA-WH HPV TESTING NEGATIVE
           Any lab tests that represent negative HPV results on cervical
           specimens should be included in this term.  A sample condition 
           is included in the term definition and in the lab test that is
           exported with the term.   A health factor for outside results 
           or for use for results that are not in Chemistry/Hematology is 
           included in the term.
    In order for this reminder to interface with the Women's Health (WH) 
 
       VA-WH HPV TESTING POSITIVE 
           Any lab tests that represent positive HPV results for high 
           or intermediate risk HPV on cervical specimens should be 
           included in this term.  A sample condition is included in the
           term definition.  If your lab reports separate lab tests for 
           high/intermediate risk and low risk genotypes, DO NOT include
           the low risk genotype test in this term.  
 
           A health factor for outside results or for use for results that
    package, the WH package must be installed and maintained.  Please 
           are not in Chemistry/Hematology is included in the term.  
 
 
    FUNCTION FINDINGS: 
    ------------------
    Frequency for this reminder will be determined using Function 
    Findings (FF) logic, which differentiates between completed results,
    short-term (7D, 4M, 6M) and long term (1Y, 2Y, 3Y, 5Y) resolution
    findings.  
     
    reminder.
    refer to the CPRS Integration: Women Veterans Health (WVH) Install &
       FF1  
          Was part of the original national reminder and is replaced 
          by FF(10) and FF(11)  
       FF2 
          Determines whether the most recent finding is VA-WH PAP SMEAR 
          SCREEN FREQ - 4M and changes the screening frequency to every 
          four months (4M).  
       FF3 
          Determines whether the most recent finding is VA-WH PAP SMEAR 
          SCREEN FREQ - 6M and changes the screening frequency to every 
    Setup Guide for detailed instructions.
          six months (6M).  
       FF4 
          Determines whether a finding exists for VA-WH PAP SMEAR SCREEN 
          FREQ 1Y and changes the screening frequency to every year 
          (1Y).  
       FF6 
          Determines whether a finding exists for VA-WH PAP SMEAR SCREEN 
          FREQ 3Y and changes the screening frequency to every three 
          years (3Y).
       FF7 
         
          Determines whether a finding exists for VA-WH PAP SMEAR SCREEN 
          NOT INDICATED and changes the frequency to 0D, which will 
          stop the reminder from being due until some new activity 
          occurs.  
       FF8 
          Determines whether the most recent finding is a VA-WH PAP SMEAR 
          UNSATISTACTORY IN LAB PKG, which will make the reminder due 
          again in one day (1D).  
 
       FF9
    The following is a subset of some of the specific features of WH that 
          New in this update; allows text to display for prior negative
          HPV results and no record of any positive HPV results
 
       FF10 
          New in this update and along with FF11, replaces the old FF1
          Most recent finding is a PAP smear result AND
             1) patient <30, or 
             2) HPV done and most recent result positive, or 
             3) no recent negative result of HPV testing
          Frequency set to 3Y
    must be in place in order for this reminder to work as it was 
 
       FF11
          New in this update and along with FF10, replaces the old FF1
          Most recent finding is a PAP smear result AND
          pt is 30-65, and most recent HPV was done in the past 
          5Y and was negative
          Frequency set to 5Y
    designed: 
        * Female veterans should be entered into the WH package.
        * SNOMED codes are setup for the PAP SMEAR procedure in the WV 
          PROCEDURE TYPE file.  
        * WH parameters should be set up to automatically import PAP 
    
          smear 
          lab reports into the WH package when they are verified in the 
          VistA Lab package.  
        * The WV NOTIFICATION PURPOSE letters should be customized to 
          reflect site information and the correct letter content for 
          each type of letter.
        * The Notification Purpose treatment need and treatment need 
          date offset should be defined if appropriate. These new fields 
          will be used to update Women's Health data when purpose of 
          notifications are selected by clinicians from reminder 
    This reminder is based on VHA Performance measures and US 
          dialogs.  
        * The reminder dialog definitions should reference the 
          appropriate WV NOTIFICATION PURPOSE.
     
    Setup of reminder terms and reminder dialogs before using this 
    reminder:  
    ============================================================== 
    1.  Use the Reminder Term options to map local representations of 
        findings: 
     
    Preventative Services Task Force recommendations for cervical cancer
    PATIENT COHORT FINDINGS: 
    ------------------------
    The following reminder terms determine whether the reminder applies 
    to the patient.
     
       VA-WH HYSTERECTOMY W/CERVIX REMOVED 
           No mapping necessary.  Use the VA-WH HYSTERECTOMY W/CERVIX 
           REMOVED reminder taxonomy distributed with this term.  Note 
           the VA-CERVICAL CA/ABNORMAL PAP reminder taxonomy is now 
           used for information only and should not be mapped to this
    screening. 
           reminder term since it contains codes where the cervix may
           not have been removed.
     
           This reminder term is also mapped to the new health factor 
           WH HYSTERECTOMY W/CERVIX REMOVED.  
     
 
    RESOLUTION FINDINGS: 
    --------------------
     The following reminder terms resolve the reminder.  These resolution 
         
     terms are defined with a "Use in Resolution Logic", but no Frequency.
     Frequency for this reminder will be determined by Function Findings 
     (FF) logic, which examines the most recent findings: 
  
          * If Function Findings determine that the most recent finding 
            is a result, the baseline age and frequency will be used.  
  
          * If Function Findings determine that an information finding 
            exists that alters the baseline frequency to 1Y, 2Y,
            3Y, or 5Y the baseline frequency will be overridden.  
    If the PAP smear is done in the private sector or at another VAMC 
 
          * FF for 4 month and 6 months screening are removed from the 
            patient version of the reminder
 
        VA-WH PAP SMEAR SCREEN IN WH PKG 
           No mapping necessary.  This term represents PAP Smear results 
           documented in the Women's Health (WH) Package. Use the new 
           VA-WH PAP SMEAR IN WH PKG computed finding distributed with 
           this reminder term. This computed finding looks for PAP smear
           results in the Women's Health Package where results have been
CUSTOMIZED COHORT LOGIC (SEX)&(AGE)&'(FI(2))
INTERNAL PATIENT COHORT LOGIC (SEX)&(AGE)&'(FI(2))
PATIENT COHORT FINDINGS COUNT 3
PATIENT COHORT FINDINGS LIST SEX;AGE;2
INTERNAL RESOLUTION LOGIC (0)!FI(4)!FI(5)!FI(6)!FI(7)!FI(9)!FI(10)!FI(11)
RESOLUTION FINDINGS COUNT 7
RESOLUTION FINDINGS LIST 4;5;6;7;9;10;11
AGE FINDINGS COUNT 8
AGE FINDINGS LIST FF1;FF4;FF5;FF6;FF7;FF8;FF10;FF11
INFORMATION FINDINGS COUNT 16
INFORMATION FINDINGS LIST 1;3;12;13;14;15;16;17;18;20;21;22;23;FF12;FF13;FF9
WEB SITES
  1. URL:   http://www.healthfinder.gov/prevention/ViewTopic.aspx?topicID=13
    WEB SITE TITLE:   Get tested for Cervical Cancer
  2. URL:   http://healthfinder.gov/scripts/SearchContext.asp?topic=149
    WEB SITE TITLE:   Cervical Cancer
GENERAL COHORT FOUND TEXT
Cervical cancer is a cancer of the lower part of the uterus, or womb. It 
  *  Women ages 30-65 can either:\\
       - be screened for cervical cancer every 3 years with a Pap test; or\\
       - for those who want to lengthen the time between screenings, be\\
           screened every 5 years with a combination of a Pap test and a\\
           test for Human Papillomavirus (HPV).
 
Risk factors increase your chance of getting a disease. The major risk
factors for cervical cancer are:\\
    *      Infection with the Human Papillomavirus (HPV)\\
    *      Having many sexual partners\\
is a slow-growing cancer that can take many years to develop.  In its 
    *      Having first sexual intercourse at an early age\\
    *      Infection with Human Immunodeficiency Virus (HIV)\\
    *      Smoking\\
 
If you have any of these risk factors, discuss them with your health 
care provider.\\
 
Cervical cancer screening tests (i.e. Pap tests) and HPV tests are 
not perfect at finding cervical cancer. Many changes found on Pap tests 
turn out to not be cancer, but you may need more tests to determine if 
early stages it usually does not cause any changes that you can see or 
cancer is present. Pap tests may also miss changes that are cancer, but 
this does not happen often.\\
 
Also, it is very important to continue to be screened for cervical cancer
even if you got the HPV Immunization shot because the shot does not 
protect you from all types of HPV.  Talk with your primary care team 
(PACT) or other women's health care provider if you have questions. \\
feel.  Pap tests can find abnormalities in the cervix that can be 
successfully treated before they turn into cancer. Also, when cancer is 
diagnosed early it is more likely to be cured. 
 
Most women ages 21-65 should be screened:\\
  *  Women ages 21-29 should have a Pap test every 3 years.\\
# OF GEN. COHORT FOUND LINES 36
# GEN. COHORT NOT FOUND LINES 0
GENERAL RES. NOT FOUND TEXT
There is no recent report of cervical cancer screening in your medical 
record.  Please contact your primary care team (PACT) to discuss being 
screened.  If you had a recent Pap test and/or HPV test please let your 
primary care team (PACT) know this at your next visit. \\
# GEN. RES. FOUND LINES 0
# GEN. RES. NOT FOUND LINES 4
RESCISSION DATE 2017-12-27 00:00:00
BASELINE AGE FINDINGS
  1. REMINDER FREQUENCY:   3Y
    MINIMUM AGE:   21
    MAXIMUM AGE:   65
    NO. OF AGE MATCH LINES:   0
    NO. OF AGE NO MATCH LINES:   0
# SUM. COHORT FOUND LINES 0
# SUM. COHORT NOT FOUND LINES 0
# SUM. RES. FOUND LINES 0
# SUM. RES. NOT FOUND LINES 0