Working with Results Manager Reminders

• Elevated glucose (>200) and no known diagnosis of diabetes - For trigger rules, click here

  This reminder is displayed for any patient older than 18 with a GLU test of greater than 200, provided the active medications list does not include a diabetes-related medication, and the active problem list does not include any of the following entries:

  • Diabetes mellitus type 1

  • Diabetes mellitus type 2

  • Borderline diabetes mellitus

  • Elevated glucose

  • Glucose intolerance

  • Diabetes of pregnancy

  • Metabolic syndrome

• Abnormal TSH without known thyroid disease. Abnornal results should be confirmed - For trigger rules, click here

  This reminder is displayed for any patient older than 18 with a TSH test of less than 0.5 or greater than 5.0, provided the active medications list does not include specific thyroid-related medications, and the active problem list does not include any of the following entries:

  • Thyroidectomy

  • Thyroiditis

  • Thyroid ablation

  • Thyroid biopsy

  • Thyroid cancer

  • Thyroid nodule

  • Thyroid related exophthalmoses

  • High TSH

  • Graves disease

  • Hypothyroidism

  • Hyperthyroidism

• Low HCT with no similar result in the last 24 months - For trigger rules, click here

  This reminder is displayed for any male patient older than 18 with an HCT test of less than 41.0, and no HCT test of less than 41.0 within the past 24 months. It is also displayed for any female patient older than 18 with an HCT test of less than 36.0, and no HCT test of less than 36.0 within the past 24 months.

• Abnormal MCV with no similar result in the last 24 months - For trigger rules, click here

  This reminder is displayed for any patient older than 18 with an MCV test of less than 80 or greater than 100, and no similar results in the past 24 months.

• Elevated creatinine. Patient on med(s) known to cause/affect renal disfunction - For trigger rules, click here

  This reminder is displayed for any patient with a GFR test less than 50, provided the active medications list includes a medication known to cause/affect renal dysfunction (such as Glyburidem or Metformin).

• Elevated potassium. Patient on med(s) known to raise K levels - For trigger rules, click here

  This reminder is displayed for any patient older than 18 with a Potassium test of greater than 5, provided the active medications list includes a medication known to raise K levels (such as a potassium supplement, diuretic, or ACE-I/ARB, or digoxin).

• ALT>3 times the upper limit and patient on statin - For trigger rules, click here

  This reminder is displayed for any patient older than 18 with an ALT test of greater than 156, provided the active medications list includes a statin.

• Abnormal TSH and patient on thyroid related med(s) - For trigger rules, click here

  This reminder is displayed for any patient older than 18 with a TSH test of less than 0.5 or greater than 5.0, provided the active medications list includes a thyroid-related medication.

• LDL above goal. Target LDL is: (<100 (optionally<70), <130 (optionally <100), <130) per AHA guidelines - For trigger rules, click here

  This reminder is displayed for patients older than 18 who are classified as part of the high risk group, with an LDL greater than 70 and FPS greater than 20%, and who include one of the following active problem list entries:

  • MI

  • CAD

  • PVD

  • TIA

  • Angina

  • Coronary stent

  • Angioplasty

  • Cardiac bypass graft surgery

  • Abdominal aortic aneurism

  • Carotid stenosis

  • DM type 1

  • DM type 2

  • Borderline DM

  • Elevated glucose

  • Diabetes of pregnancy

  • Metabolic syndrome

  It is also displayed for patients older than 18 years old who are classified as part of the moderate or low risk group. These are defined as follows:

  Moderate Risk Group - An LDL of greater than 100 and an FPS between 20 - 30%, who do not have one of the previously listed active problem list entries.

  Low Risk Group - An LDL of greater than 160 and an FPS less than 10%, who do not have one of the previously listed active problem list entries.

• Patient is hypertensive and has chronic kidney disease. Recommend ACE-1 ARB - For trigger rules, click here

  This reminder is displayed for any patient older than 18 with a GFR test of between 15 and 60, and an SBP value greater than 130, or an SBP greater than 120 provided the active medications list includes a diabetes-related or anti-hypertensive-related medication. The reminder is only displayed if the patient's active problem list includes either "Chronic renal impairment/Renal insufficiency" or "Chronic renal failure syndrome/Chronic renal dysfunction," and the active allergy list does not indicate a sensitivity toward ACE or ARB class medications.

• To place orders, click the desired orders and click Execute.

• Note: To add an order to your list of favorites, click .

• To add a problem to the problems list, click to select the problem, and click Execute. The Onset Date defaults to the current service date and the Comments field defaults to "Problem Added Using Results Manager Reminders."

• To add a paragraph to a patient letter, first complete any other previously described actions, if desired. Then, click Add Paragraph To Patient Letter and Execute. The LMR displays system-generated letter with appropriate text, based on the abnormal test result. Next, click Save (or Save as Final, Save as Final & Print, as appropriate).

• To edit a medication, click the medication name and then make updates using standard LMR processing.

• Note: In cases where adding an order, problem, or medication would satisfy the reminder, you do not need to do so from the Results Manager module. Reminders can also be suppressed by adding entries using standard LMR processing (such as adding problems from the Problems module, medications from the Medications module, and so on).

You can respond directly to the reminder by selecting any of the following options (if applicable), and then clicking Execute.

• Patient Declined - Selecting this option defers the reminder until the next abnormal result shows up on the chart.

• Issue Addressed Elsewhere - Selecting this option defers the reminder until the next abnormal result shows up on the chart.

• Defer for 1 week - Selecting this option defers the reminder for 1 week.

• Contraindicated - Selecting this option defers the reminder for 1 year.