============================================================================= Run Date: OCT 18, 2012 Designation: PXRM*2*27 Package : PXRM - CLINICAL REMINDERS Priority: Mandatory Version : 2 SEQ #20 Status: Released Compliance Date: OCT 25, 2012 ============================================================================= Subject: HOMELESSNESS SCREENING REMINDER & LIPID STATIN REMINDER Category: - Routine - Other Description: ============ This patch is to correct potential oversights in clinical reminders where Veterans could be unaware of homeless programs by implementing the VA-HOMELESSNESS SCREENING reminder. Also, drug therapy complications are addressed by clinical reminder LIPID STATIN RX CVD/DM. NOTE: +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ Because of the urgency of this patch to be released according to the President of the United States and the Secretary of the Department of Veterans Affairs, it will be released with a shortened compliance date of 7 calendar days. +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ Associated Remedy ticket(s): ============================ HD000000734940 - VA-HOMELESSNESS SCREENING HD000000765018 - VA-LIPID STATIN RX CVD/DM (VER 1.0) Associated NSR(s): ================= N/A Participating Test Sites: ========================= LEBANON, PA ORLANDO, FL PROVIDENCE, RI UPSTATE NEW YORK HCS VA GREATER LOS ANGELES HCS REMEDY OVERVIEW: =============== 1. HD000000734950 - VA-HOMELESSNESS SCREENING Problem: -------- The Government has mandated that a VA homeless screening be implemented as follows: The objectives of the VA-Homelessness Screening clinical reminder are to: (a)identify Veterans and their families who are at imminent risk of homelessness or who have very recently become homeless; (b)ensure that those who are at-risk or who are currently homeless are referred for appropriate assistance; and (c)update documentation in the medical record regarding the current living situation for these at-risk Veterans. It is anticipated that this new screening reminder will help to identify Veterans who might not otherwise seek assistance or who may not be aware of homeless programs offered by VHA. The VA-HOMELESSNESS SCREENING reminder is a NATIONALLY-MANDATED reminder - similar to the VA-TBI and VA-IRAQ&AFGHAN POST DEPLOYMENT screening reminders. It MUST be placed on the Cover Sheet at all facilities and is intended to be completed by any staff person. Resolution: ----------- Created the necessary VA-Homelessness Screening reminder 2. HD000000765018 - VA-LIPID STATIN RX CVD/DM (VER 1.0) Problem: -------- Recent analysis of cardiovascular prevention studies, as well as the growing appreciation of the downsides of aggressive lipid treatment with high dose statins or non-statin cholesterol-lowering medications, have raised concerns about performance measures for lipid management based solely on achieving a target value of Low Density Lipoprotein Cholesterol(LDL-C)(Hayward and Krumholz, 2012). The use of statin drugs can provide significant patient benefit even if LDL-C values remain above 100. Professional societies now recommend that the adequacy of lipid management be judged by the appropriateness of the therapy and not solely by LDL value(ACCF/AHA/AMA-PCPI,2011). Performance measures that recognize appropriate clinical prescribing provide a better balance of patient benefit and risk and may reduce complications of overzealous drug therapy(e.g., muscle breakdown). Resolution: ----------- This national clinical reminder has been created to address the concerns concerns outlined above and to support updated VHA Performance Measures for FY12 and FY13(ihd18hns and dmg25hs) that assess LDL-C values in patients with cardiovascular disease or with diabetes mellitus or whether the patient is on at least a moderate dose of a statin medication. The reminder replaces previous national lipid reminders that were based on threshold LDL-C values. It was created by the VHA National Clinical Reminders Committee with input from multiple national VA experts on lipid management, diabetes mellitus, ischemic heart disease, and quality measurement. The reminder is intended to be used by providers with prescribing privileges. Please refer to PXRM_2_0_27_IG.PDF for more details concerning these clinical reminders. Build Components: ================= N/A Data Dictionary: ================ REMINDER EXCHANGE (#811.8) file Software & Documentation Retrieval Instructions: ================================================ This patch is being distributed as a host file. The name of the host file is PXRM_2_0_27.KID. This file should be downloaded in ASCII format. The preferred method for obtaining these files is to use File Transfer Protocol (FTP) to download them from: ftp://download.vista.med.va.gov/. This transmits the files from the first available FTP server. Sites may also elect to retrieve the files directly from a specific server as follows: Albany ftp.fo-albany.med.va.gov ftp://ftp.fo-albany.med.va.gov Hines ftp.fo-hines.med.va.gov Salt Lake City ftp.fo-slc.med.va.gov ftp://ftp.fo-slc.med.va.gov Install guide and Release Notes are also available on the above servers. They are available as .pdf format. These files should be downloaded in BINARY format. The names of the documentation files are as follows: PXRM_2_0_27_IG.PDF PXRM_2_0_27_RN.PDF Documentation can also be found on the VistA Documentation Library (VDL) at: http://www.va.gov/vdl/ Installation: ============= This patch can be loaded with users on the system. Installation will take five to ten minutes. Refer to the Install Guide, PXRM_2_0_27_IG.PDF, for complete details. 1. Use the "Load a Distribution' option on the KIDS installation menu. When prompted to enter a host file type in PXRM_2_0_27.KID 2. On the KIDS menu under the 'INSTALLATION' menu, use the following options, as desired: Print Transport Global Compare Transport global to Current System Verify Checksums in Transport Global Backup a Transport Global 3. On the KIDS menu under the 'INSTALLATION' menu, use the following option to install the patch: Install Package(s) When prompted for INSTALL NAME, use PXRM*2.0*27 4. When prompted "Want KIDS to INHIBIT LOGONs during the install? NO//," respond 'NO'. 5. When prompted "Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO// respond 'NO'. 6. After successful installation, the following init routines may be deleted PXRMP27E PXRM27I Routine Information: ==================== The second line of each of these routines now looks like: ;;2.0;CLINICAL REMINDERS;**[Patch List]**;Feb 04, 2005;Build 188 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: PXRMP27E Before: n/a After: B1845195 **27** Routine Name: PXRMP27I Before: n/a After: B7410427 **27** ============================================================================= User Information: Entered By : GRIMES,NANCY Date Entered : JUL 25, 2012 Completed By: LEANORD,TATIANA Date Completed: OCT 17, 2012 Released By : MONTGOMERY,ALAN Date Released : OCT 18, 2012 ============================================================================= Packman Mail Message: ===================== No routines included