ZZVA-MHV MAMMOGRAM SCREENING (456)    REMINDER DEFINITION (811.9)

Name Value
NAME ZZVA-MHV MAMMOGRAM SCREENING
PRINT NAME ZZ Mammogram Screening
DO IN ADVANCE TIME FRAME 2M
INACTIVE FLAG INACTIVE
INACTIVE CHANGE DATE 2017-12-27 16:27:46
IGNORE ON N/A S
SEX SPECIFIC FEMALE
CLASS NATIONAL
SPONSOR VA National Center for Health Promotion and Disease Prevention (NCP)
USAGE CPR
EDIT HISTORY
  1. EDIT DATE:   2013-07-16 10:39:44
    EDIT BY:   USER,SEVENTEEN
    EDIT COMMENTS:   
    Exchange Install
    
DESCRIPTION
This reminder is a copy of the national reminder for Mammography that has
about specific benefits and harms.
 
 
The VA National Center for Health Promotion and Disease Prevention 
(NCP) and the US Preventive Services Task Force (USPSTF) recommend
that women age 50-74 have a mammogram every 2 years.  Individual women 
ages 40-49 may be added to the cohort of this reminder (be entry of 
health factor VA-WH BR CA 40-49 WANTS SCREENING) based on shared decision 
making between provider and patient.
 
been simplified for use by patients.
This reminder does not apply to women who have terminal cancer or have
had a bilateral mastectomy.
 
Evidence of mammography performed will satisfy this reminder for two 
years.  Clinicians can specify annual mammography for individual 
patients, based on patient and family history, and discussions with the 
patient. Documented history of breast cancer or high risk will be 
provided for clinician decision making.
 
Mammograms completed may be documented as one of the following:
 
    Radiology result
    Women's Health procedure result
    Health Factor (Historical outside Mammogram result)
    PCE CPT procedure 
    Completed consult order
The VHA recommends that:
    * Women between the ages of 50 and 74 have a mammogram every two
      years
    * The decision to start regular screening every two years with 
mammography for average risk women ages 40-49 should be an individual 
decision and take the patient's values into account including values 
FINDINGS
  1. FINDING ITEM:   VA-TERMINAL CANCER PATIENT
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
    USE IN PATIENT COHORT LOGIC:   AND NOT
    BEGINNING DATE/TIME:   T-1Y
  2. FINDING ITEM:   VA-WH MAMMOGRAM SCREEN FREQ - 1Y
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
  3. FINDING ITEM:   VA-WH MAMMOGRAM SCREEN FREQ - 2Y
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
  4. FINDING ITEM:   VA-WH MAMMOGRAM ORDER
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
  5. FINDING ITEM:   VA-MAMMOGRAM UNSATISFACTORY IN RAD PKG
    STATUS LIST:
    1. STATUS:   COMPLETE
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
    USE IN RESOLUTION LOGIC:   OR
  6. FINDING ITEM:   VA-WH BILATERAL MASTECTOMY
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
    USE IN PATIENT COHORT LOGIC:   OR NOT
  7. FINDING ITEM:   VA-WH MAMMOGRAM SCREEN IN WH PKG
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
    USE IN RESOLUTION LOGIC:   OR
  8. FINDING ITEM:   VA-WH MAMMOGRAM SCREEN IN RAD PKG
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
    USE IN RESOLUTION LOGIC:   OR
  9. FINDING ITEM:   VA-WH MAMMOGRAM SCREEN DONE
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
    USE IN RESOLUTION LOGIC:   OR
  10. FINDING ITEM:   VA-WH MAMMOGRAM SCREEN NOT INDICATED
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
    USE IN RESOLUTION LOGIC:   OR
  11. FINDING ITEM:   VA-WH MAMMOGRAM SCREEN DEFER
    NO. OF FOUND TEXT LINES:   0
    NO. NOT FOUND TEXT LINES:   0
    USE IN RESOLUTION LOGIC:   OR
    BEGINNING DATE/TIME:   T-4M
FUNCTION FINDINGS
  1. FUNCTION FINDING NUMBER:   1
    LOGIC:   FN(1)=FN(2)&((FN(2)>0))
    MINIMUM AGE:   40
    MAXIMUM AGE:   74
    REMINDER FREQUENCY:   2Y
    FUNCTION STRING:   MRD(3,4,5,7,8)=MRD(3,4,5)&((MRD(3,4,5)>0))
    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:
  2. FUNCTION FINDING NUMBER:   5
    FOUND TEXT:   
    Your provider recommends that you have a mammogram each year.
    
    LOGIC:   FN(1)=FN(2)&((FN(2)>0))
    MINIMUM AGE:   40
    MAXIMUM AGE:   74
    REMINDER FREQUENCY:   1Y
    FUNCTION STRING:   MRD(7,11,12)=MRD(11)&((MRD(11)>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:
  3. FUNCTION FINDING NUMBER:   6
    FOUND TEXT:   
    Your provider recommends that you have a mammogram every two years.
    
    LOGIC:   FN(1)=FN(2)&((FN(2)>0))
    MINIMUM AGE:   40
    MAXIMUM AGE:   74
    REMINDER FREQUENCY:   2Y
    FUNCTION STRING:   MRD(7,11,12)=MRD(12)&((MRD(12)>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:
  4. FUNCTION FINDING NUMBER:   7
    LOGIC:   FN(1)=FN(2)&((FN(2)>0))
    REMINDER FREQUENCY:   0Y
    FUNCTION STRING:   MRD(7,11,12)=MRD(7)&((MRD(7)>0))
    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:
TECHNICAL DESCRIPTION
This reminder is based on the VHA Clinical Prevetive Service Guidance 
satisfy this reminder:
   VA-WH BREAST CARE ORDER HEALTH FACTOR
        Deleted from patient version.
 
   VA-WH MAMMOGRAM SCREEN DEFER
       Use the WH MAMMOGRAM DEFERRED or WH MAMMOGRAM DECLINED health
       factors distributed with this term or add any local health
       factor representing that mammogram screening should be satisfied
       for one week. 
 
   VA-WH MAMMOGRAM SCREEN FREQ - 4M
    * Results, with interpretation, can be entered and verified in the
     Deleted from patient version.
 
   VA-WH MAMMOGRAM SCREEN FREQ - 6M
     Deleted from patient version.
 
   VA-WH MAMMOGRAM UNSATISFACTORY IN RAD PKG
       Mapping is needed.  This term represent Mammogram results 
       documented in the Radiology package.  Map local radiology
       procedures that represent the following procedures:
          MAMMOGRAM BILAT
      Radiology package.  
          MAMMOGRAM UNILAT
          MAMMOGRAM SCREEN
       Each finding should have a condition that checks for
       unsatisfactory results.
 
INFORMATION FINDINGS:
---------------------
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
    * Results, with interpretation, can be manually entered into the WH
the next Mammogram screen will be based on these reminder terms.
 
   VA-WH MAMMOGRAM SCREEN FREQ - 1Y
       Use the WH MAMMOGRAM SCREEN FREQ - 1Y health factor distributed 
       with this term or add any local health factor that represents a 
       mammogram screening should occur every year.  
   
   VA-WH MAMMOGRAM SCREEN FREQ - 2Y
       Use the WH MAMMOGRAM SCREEN FREQ - 2Y health factor distributed 
       with this term or add any local health factor that represents 
      package.
       mammogram screening should take place every two 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.
 
   VA-WH HIGH RISK FOR BREAST CANCER
     Deleted from patient version.
 
   VA-WH HX BREAST CANCER/ABNORMAL MAM
    * Summarized results can be entered as a historical entry (health 
     Deleted from patient version.
 
   VA-WH MAMMOGRAM ORDER
       Map local orderable items that represent mammogram related
       orders (e.g., Consult order to Women's Health Clinic).
       Use the conditions that indicate the order is not completed,
       discontinued, or cancelled. This reminder term represents orders
       pending completion.
 
FUNCTION FINDINGS:
      factor or CPT code) in the patient record. Historical entries 
------------------
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) resolution findings.
 
   FF1
      Determines whether a mammogram result is the most recent finding 
      and defaults to the baseline frequency of two years. FF5 logic 
      will change the frequency to one year if the VA-WH MAMMOGRAM SCREEN
      FREQ - 1Y term is found.
      should be based on reviewed results, not on patient comments.
   FF2
     Deleted from patient version.
   FF3
     Deleted from patient version.
   FF4
     Deleted from patient version.
   FF5
      Determines whether a finding exists for VA-WH MAMMOGRAM SCREEN 
      FREQ - 1Y which changes the frequency to annually if the most    
      recent finding is found in FF1, and FF6 or FF7 do not have more 
 
      recent findings.
   FF6
      Determines whether a finding exists for VA-WH MAMMOGRAM SCREEN 
      FREQ - 2Y which changes the frequency to 2Y if the most    
      recent finding is found in FF1, and FF5 or FF7 do not have more 
      recent findings.
   FF7
      Determines whether a finding exists for VA-WH MAMMOGRAM SCREEN 
      NOT INDICATED which changes the frequency to 0D, which will
      stop the reminder from being due until new activity occurs.
PATIENT COHORT FINDINGS: 
Statement, Performance measures and US Preventive Services Task Force
------------------------
The following reminder terms determine whether the reminder applies 
to the patient.
 
   VA-TERMINAL CANCER PATIENT
       No mapping necessary.  Use the VA-TERMINAL CANCER PATIENTS
       reminder taxonomy that has been previously distributed.  
  
   VA-WH BILATERAL MASTECTOMY
       This term will use the VA-WH BILATERAL MASTECTOMY taxonomy to
recommendations for breast cancer screening.
       find coded bilateral mastectomies. The health factor WH
       BILATERAL MASTECTOMY distributed with this term may be used or
       add any local health factor that represents the patient had a
       bilateral mastectomy and no longer needs mammogram screening.
  
RESOLUTION FINDINGS:
--------------------
The following are reminder terms that resolve the reminder.  These
resolution terms are defined with a "Use in Resolution Logic", 
but no Frequency. Frequency for this reminder will be determined using
 
Function Findings (FF) logic, which uses these terms to determine 
frequency. See the Function Finding header below.
 
   VA-WH MAMMOGRAM SCREEN IN WH PKG
       No mapping necessary. This term represents mammogram results 
       documented in the Women's Health (WH) Package. The term is 
       mapped to the VA-WH MAMMOGRAM IN WH PKG computed finding which 
       only uses WH findings that are normal or abnormal.
 
   VA-WH MAMMOGRAM SCREEN IN RAD PKG
Please see the description of the national mammogram reminder (VA-WH 
       Mapping is needed.  This term represent Mammogram results 
       documented in the Radiology package.  Map local radiology
       procedures that represent the following procedures:
          MAMMOGRAM BILAT
          MAMMOGRAM UNILAT
          MAMMOGRAM SCREEN
       Each finding should have a condition added to exclude 
       unsatisfactory results.
 
   VA-WH MAMMOGRAM SCREEN DONE
MAMMOGRAM SCREENING)
       Some mapping may be appropriate. This reminder term will use the
       previously distributed VA-MAMMOGRAM/SCREEN taxonomy to find 
       ICD DIAGNOSIS or CPT coded results.
 
       Use the new WH MAMMOGRAM OUTSIDE health factor to document 
       Mammogram results completed outside the VA when the Mammogram
       results are not documented in Radiology, Women's Health or 
       Consult packages.
 
       Map local findings, such as consult orders related to
 
       Mammogram Screening.  Use appropriate condition logic to
       indicate Mammogram screening has been completed.
 
   VA-WH MAMMOGRAM SCREEN NOT INDICATED
       Use the findings distributed with this reminder term or map any
       local findings that indicate a Mammogram screen is not indicated
       for this patient.  
 
       This term is distributed with mapping to the following 
       health factors:
If the mammogram is done in the private sector or at another VAMC 
          INACTIVATE BREAST CANCER SCREEN (distributed with the
               first version of the Clinical Reminder package in 1996
               to inactivate the BREAST CANCER reminder).
          WH MAMMOGRAM SCREEN NOT INDICATED
          VA LIMITED LIFE EXPECTANCY 
 
       Use in National VA-WH MAMMOGRAM SCREENING reminder:
       This term is used in WH reminders to inactivate Mammogram 
       screening until a clinician overrides the inactivation by 
       selecting a health factor that is used by function findings
facility, there are three ways the results can be documented to 
       with frequencies of 1Y or 2Y.
 
       Sites may prefer to use local LIMITED LIFE EXPECTANCY health 
       factors and add their health factors to other reminder
       terms which cause the Mammogram 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 1Y" to the VA-WH 
       MAMMOGRAM SCREEN FREQ 1Y term.
 
CUSTOMIZED COHORT LOGIC (SEX)&(AGE)&'(FI(1)!FI(2))
INTERNAL PATIENT COHORT LOGIC (SEX)&(AGE)&'(FI(1)!FI(2))
PATIENT COHORT FINDINGS COUNT 4
PATIENT COHORT FINDINGS LIST SEX;AGE;1;2
INTERNAL RESOLUTION LOGIC (0)!FI(3)!FI(4)!FI(5)!FI(7)!FI(8)!FI(16)
RESOLUTION FINDINGS COUNT 6
RESOLUTION FINDINGS LIST 3;4;5;7;8;16
AGE FINDINGS COUNT 4
AGE FINDINGS LIST FF1;FF5;FF6;FF7
INFORMATION FINDINGS COUNT 3
INFORMATION FINDINGS LIST 11;12;15
WEB SITES
  1. URL:   http://www.healthfinder.gov/prevention/ViewTopic.aspx?topicId=9
    WEB SITE TITLE:   Healthfinder.gov: Get tested for Breast Cancer
  2. URL:   http://healthfinder.gov/scripts/SearchContext.asp?topic=126
    WEB SITE TITLE:   Government sites about Breast Cancer
GENERAL COHORT FOUND TEXT
Mammograms are special x-rays of the breasts. These x-rays can find 
Mammograms are not perfect at detecting breast cancer. They may miss small
breast cancers.  Also, if there are areas on your mammogram that do not
look normal, you may need to get additional tests or pictures taken of
your breasts.  These tests often find that the changes are not breast 
cancer. If you have questions about the risks and benefits of getting a
mammogram, talk with your provider.
changes in the breasts that may not be seen or felt. Screening with
mammograms has been shown to reduce deaths in women due to breast cancer.
Most women 50-74 years should get a mammogram every 2 years.  If you are
between 40-49, breast cancer screening is a choice that you should be
involved in making, not an automatic recommendation.  Please talk with
your provider about the possible benefits and harms of screening as well
as your preferences.
 
# OF GEN. COHORT FOUND LINES 15
# GEN. COHORT NOT FOUND LINES 0
GENERAL RES. NOT FOUND TEXT
There is no recent report of a mammogram in your record.  Please contact 
your primary care team (PACT) to discuss getting this test. If you had a
recent mammogram, please tell your primary care team (PACT) 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:   2Y
    MINIMUM AGE:   40
    MAXIMUM AGE:   74
    NO. OF AGE MATCH LINES:   0
    NO. OF AGE NO MATCH LINES:   0
  2. REMINDER FREQUENCY:   0Y
    MINIMUM AGE:   75
    NO. OF AGE MATCH LINES:   0
    NO. OF AGE NO MATCH LINES:   0
  3. REMINDER FREQUENCY:   0Y
    MAXIMUM AGE:   39
    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