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“Medically Ready Force…Ready Medical Force”
TSWF Cardiovascular CPG AIM Form Training
MayMay-Aug 2020 Form Version
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Disclaimer
Content shown is from an AHLTA Training System (ATS) and does not contain actual patient data.
“Medically Ready Force…Ready Medical Force”
Recent Changes
The following group of slides reflect changes made to the form. The specific training slides for this form follow the change slides.
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CORE Compatible Updates
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Updated the Hepatitis C screening recommendation on the 'Preventive Services Recommendations-All Patients' Ribbon. The new recommendation: 'The USPSTF recommends screening for hepatitis C
virus infection in adults aged 18 to 79 years.'
“Medically Ready Force…Ready Medical Force”
CORE Compatible Updates
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Updated the wording in the 'Self-Reported Level of Functioning' row on the PHQ-9
NEW
OLD
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CORE Compatible Updates
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Updated 'Pain Treatment history' section on the Exit CCP tab
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CORE Compatible Updates
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Updated 'Chronic Pain' ribbon label to say'Pain Management Care Plan' and verbiage updated within section.
Also changed the 'Pain care agreement on file’ to'Pain Care Informed Consent on File’
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Cardiovascular Updates
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On the 'Initial Assessment' ribbon added a new link labeled ‘2017 ACC/AHA focused update’.
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Cardiovascular Updates
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On the ‘Afib’ Tab, added an additional link labeled ‘2019 AHA/ACC focused update’.
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Cardiovascular Updates
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Updates to ‘Antithrombotic Therapy for Patients with Atrial Fibrillation:• Added ‘edoxaban’ to list of medications
• Added two new statements highlighted below
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Cardiovascular Updates
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Added new clinical clue on the right of algorithm:'The decision to use an anticoagulant should not be influenced by whether the AF is paroxysmal or persistent (COR I, LOE B). 2019'
“Medically Ready Force…Ready Medical Force”
Objectives
Cardiovascular Training Objective:Identify the clinical workflows, screeners and tools available in the TSWF Cardiovascular AIM form as they relate to the VA/DoD Clinical Practice Guidelines, ACC/AHA, NYHA, and JNC-8
Cardiovascular Learning Objectives:At the conclusion of today’s activity, the participant will be able to:
• Understand the documentation requirements found on the HPI tab (patient intake/Med Rec/Preventive Services)
• Understand the use of various screeners (Travel/Audit-C/Tobacco use/Annual Questions/Learning Assessment/Military Specific Screening)
• Demonstrate the purpose and use of the Cardiovascular and Metabolic Disorders Chronic Care Plans
• Understand what information can be found on the various reference-only tabs found on the form
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Why Use a TSWF CPG AIM Form?
• Integrates recommendations from VA/DoD CPGs
• Provides easily accessible references for clinical decision-making & patient education
• Improves continuity of care and healthcare outcomes
• Standardizes documentation
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Workflow Key Points
• Clinical Support Staff (CSS) completes CORE or TSWF Cardiovascular CPG Form Screening Sections
• Provider takes ‘ownership’ of the CSS note
• Provider loads the Cardiovascular AIM form
• Provider reviews and completes the note
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Selecting the Proper Template
Select CV-CPG
Select from either your drop-down
list of favorites or via Navigator
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TSWF Navigator
Select TSWF Navigator
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TSWF Navigator
Select the Cardiovascular form
TSWF Navigator takes you to the most current version of the TSWF forms
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HPI/PFSH Tab
Form version, links to MilSuite, TSWF Navigator, TSWF Resources, and Change Log are listed at the top
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HPI/PFSH Tab Condition-Specific Recommendations
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Summary of interventions that have a positive impact on morbidity and mortality
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HPI/PFSH Tab Cardiovascular Disorders CCP
This CCP is intended for patients with CAD, Cerebrovascular disease, peripheral vascular disease, A-fib, and/or heart failure. Pre-populated text is a starting point;
edit the text to fit your needs. The field copies forward to support continuity of care.
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HPI/PFSH Tab Heart Failure Classification
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A summary of heart failure classifications is provided for
reference.
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HPI/PFSH Tab Links to CV References
Links to various references:
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HPI/PFSH Tab Metabolic Disorders CCP
This CCP is intended for patients with hyperlipidemia and/or hypertension (and diabetes). NOTE: no need to use multiple CCPs; feel free to combine
them based on patient’s or your needs.
Link for Diabetic Foot Exam
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If appropriate or according to local protocol, complete pre-travel counseling and Infectious Disease Travel Screen
Note: blue clinical clues about various diseases
Screening TabTravel Screening/Infectious Disease Travel Screen
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Screening Tab
Links to resources on tobacco cessation
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The Single Item Literacy Screener (SILS) for assessing health literacy is in the Annual Questions field. If patient’s response is
either “often” or “always”, conduct a more thorough assessment (see next slide).
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Screening Tab
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If the SILS response is either “often” or “always,” further assessment of the patient’s health literacy is documented here along with an action plan if indicated. While a link to REALM-SF
is provided here, any appropriate assessment can be used.
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BH/Other Screening Tab
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This tab is used to screen for depression, suicidality, PTSD, TBI, and sleepiness. Follow Service or local guidance.
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BH/Other Screening Tab
Epworth Sleepiness Scale
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ROS Tab
Cardiopulmonary-specific ROS
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PE Tab
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PE TabCardiovascular-focused Section
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EXIT/CCP Tab
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Obsolete Terms
Review the Obsolete Terms tab for elements that copy forward from previous encounters. This function is very important when performing Copy Forward!
If obsolete terms are not deselected, you will see past medical history terms in an encounter note that the provider is not aware of when he/she signs the note.
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Reference Tabs
The remaining tabs contain reference information on the disorders covered on this form (and the reference source)
• Hypertension (VA/DoD CPG & JNC-8): 2 tabs
• Dyslipidemia (VA/DoD CPG & ACC/AHA Guidelines)
• Ischemic Heart Disease (ACC/AHA CPG)
• Chronic Heart Failure (ACCF/AHA CPG)
• Atrial Fibrillation (AHA/ACC CPG)
• There’s also a tab listing common medications used to treat cardiovascular conditions in Primary Care in the DoD & VA
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Hypertension
There are two tabs for Hypertension:VA/DoD CPG & JNC-8
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Hypertension
Tabs contain algorithms and tables from the respective sources, and links to the full documents
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Dyslipidemia
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Ischemic Disease Tab
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Heart Failure Tab
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Heart Failure Tab
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Atrial Fibrillation Tab
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Atrial Fibrillation Tab
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Atrial Fibrillation TabSample Algorithm
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TSWF Resource Material
The TSWF repository for training/educational materials and updates:www.tswf-mhs.com/
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Primary Care Clinical Community Content Working Group
▪ DHA - Maj Matthew J Royall▪ ARMY - Dr. Robert Marshall▪ AIR FORCE – Dr. Matthew Barnes
TSWF Feedback https://www.milsuite.mil/book/groups/tswfTSWF Website http://www.tswf-mhs.com/