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318H Clinical Reminder Extracts; Making Life Easier

Mia_John
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318H Clinical Reminder Extracts; Making Life Easier

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    1. 318H Clinical Reminder Extracts; Making Life Easier

    2. #318H - Clinical Reminder Extracts; Making Life Easier 2 Before we get started we need to take care of some Housekeeping issues. Restrooms are located.. If you have any questions please write them on the 3X5 card provided. Answers to your questions will be posted on the VEHU website. So please check the website when you return home.Before we get started we need to take care of some Housekeeping issues. Restrooms are located.. If you have any questions please write them on the 3X5 card provided. Answers to your questions will be posted on the VEHU website. So please check the website when you return home.

    3. #318H - Clinical Reminder Extracts; Making Life Easier 3 HOUSEKEEPING We want this to be informal and interactive, so if you have a question during the presentation, go ahead and raise your hand and ask, BUT also write the question on the card provided! Other questions that can wait need to be written on the 3X5 card provided. These will be answered at the conclusion of the presentation, time permitting ?. For questions not answered, the question and the answer will be available on the web. Before we get started we need to take care of some Housekeeping issues. Restrooms are located.. If you have any questions please write them on the 3X5 card provided. Answers to your questions will be posted on the VEHU website. So please check the website when you return home.Before we get started we need to take care of some Housekeeping issues. Restrooms are located.. If you have any questions please write them on the 3X5 card provided. Answers to your questions will be posted on the VEHU website. So please check the website when you return home.

    4. #318H - Clinical Reminder Extracts; Making Life Easier 4 Prerequisites Advanced understanding of Reminder terms Reminder definitions

    5. #318H - Clinical Reminder Extracts; Making Life Easier 5 Performance Measures What we do today will be based on LDL Performance Measures: MC2b Effectiveness of Care: Diabetes MC2b4 DM-Outpatient- LDL-C <100 mg/dL MC2b8 DM-Outpatient- LDL-C measured MC2c Effectiveness of Care: Cardiovascular MC2c1 AMI-Outpatient LDL-C measured MC2c2 AMI-Outpatient- LDL-C <100 mg/dL

    6. #318H - Clinical Reminder Extracts; Making Life Easier 6 What Are Reminder Extracts? Extract Definition Rules for building patient lists (this is the first half of the class) Reminder definitions for extracting data (this is the second half of the class)

    7. #318H - Clinical Reminder Extracts; Making Life Easier 7 This is what we are after!

    8. #318H - Clinical Reminder Extracts; Making Life Easier 8 You must have a plan, materials and tools to construct a house

    9. #318H - Clinical Reminder Extracts; Making Life Easier 9 Translating The OQP Methodology To VistA OQP OQP sampling methodology is to select (pull) patients from national files located at Austin Information Technology Center (AITC, formerly the AAC) EPRP review is based on small patient sample pulled from this Austin database VistA Reminder extracts based on site data which is all patients

    10. #318H - Clinical Reminder Extracts; Making Life Easier 10 Extract Terminology Nexus according to Webster, this is a connected group or series of something Qualifying visit Anchor visit Numerator Denominator How many of you have wondered what in the world the word Nexus means???How many of you have wondered what in the world the word Nexus means???

    11. #318H - Clinical Reminder Extracts; Making Life Easier 11 Nexus Cohort Nexus designated clinic List of Stop Codes (TM Appendix C) Primary Care Mental Health Day Programs Qualifying visit An outpatient visit anywhere within the period of time that your extract is retrieving data; better known as the study interval Anchor visit Outpatient visit anywhere in VHA recorded in AAC file SE at least once during the 13-24 months prior to the study interval. SE file is Outpatient Encounter File at Austin Look at technical manual Anchor visit-have to have a visit 13-24 months prior to June, which is our study intervalLook at technical manual Anchor visit-have to have a visit 13-24 months prior to June, which is our study interval

    12. #318H - Clinical Reminder Extracts; Making Life Easier 12 Use Reminder Patient List Functionality To Build The Cohorts Strategy Build general cohort, which is the Nexus cohort good for all Outpatient Performance Measures Refine to measure specific cohort (denominator) Mental Health Nexus cohort with exclusions of short life expectancy and cognitive impairment Diabetes Nexus cohort and patients who have diabetes and who are less than 75 years old IHD Nexus cohort and patients with IHD dx and who are less than 75 years old Etc. A few examples of measure specific denominators or cohortsA few examples of measure specific denominators or cohorts

    13. #318H - Clinical Reminder Extracts; Making Life Easier 13 Constructing a Patient List A patient list is created from a rule set Each rule set is composed of a sequence of steps defined by one or more patient list rules Patient list rule types: Finding rule Patient list rule Reminder rule Operations: ADD PATIENT Like the boolean OR REMOVE Like the boolean AND NOT SELECT Like the boolean AND INSERT FINDING special operation to grab CSUB data for use in demographic reporting How do we go about creating these lists??How do we go about creating these lists??

    14. #318H - Clinical Reminder Extracts; Making Life Easier 14 Hands-On Conventions nn stands for student number Use uppercase for all names of components Dont use student numbers 00 or 99 If during this class, you dont get your component built, you may use any component starting with 00- and the component name To log on to VistA Access code: nnVEHU Verify code: VEHUnn Prefixes to use: nn-FR for finding rule nn-PL for patient list rule nn-RS for rule set

    15. #318H - Clinical Reminder Extracts; Making Life Easier 15 Build The Nexus Cohort Finding rule based on reminder term Reminder terms: build these terms based on the Location Lists and the CF below (5 minutes) nn-NEXUS CLINIC RL.NEXUS CLINIC COHORT FY08 (pre-built for you) nn-ANCHOR VISIT RL.VA-ALL LOCATIONS (national entry) nn-VA-VETERAN CF.VA-VETERAN (pre-built for you) Have to build the pieces first. Similar to dialogs. The reason we dont want you to use student 00, is because if you get lost, you can use student 00 to be able to continue in the class.Have to build the pieces first. Similar to dialogs. The reason we dont want you to use student 00, is because if you get lost, you can use student 00 to be able to continue in the class.

    16. #318H - Clinical Reminder Extracts; Making Life Easier 16 Finding Rules Now that we have the reminder terms which you just built, we need to create the finding rules nn-FR NEXUS COHORT Term nn NEXUS CLINIC No Beginning/End dates nn-FR ANCHOR VISIT Term nn ANCHOR VISIT No Beginning/End dates nn-FR VA-VETERAN Term nn VA-VETERAN No Beginning/End dates This will be Monkey see monkey do for the first two and the students will build the last one-nn-ANCHOR VISITThis will be Monkey see monkey do for the first two and the students will build the last one-nn-ANCHOR VISIT

    17. #318H - Clinical Reminder Extracts; Making Life Easier 17 Hierarchy of a Rule Set in Review Rule Set contains List Rules that make up the Rule Set Finding Rule Contains a reminder term Reminder term contains any type of finding that is mapped to the term If term contains a CF and it is the first sequence in the rule set, the CF must be List type Reminder Rule Contains a reminder definition Usage field must be L type to be used in a reminder definition rule Only the cohort logic is evaluated and if AGE is part of the cohort, it must have a defined age range Patient List Rule Contains an already created patient list For reference only.For reference only.

    18. #318H - Clinical Reminder Extracts; Making Life Easier 18 Create the Nexus Cohort Rule Set nn-RS NEXUS COHORT SBD is the Sequence Beginning Date SED is the Sequence Ending Date BDT is the Beginning Date/Time. This is the date/time specified when creating the patient list from the rule set. Sequences used to build the NEXUS COHORT patient list Sequence 1 nn-FR NEXUS COHORT (ADD PATIENT) Sequence 2 - nn-FR ANCHOR VISIT (SELECT), SBD=BDT-24M, SED=BDT-13M Sequence 3 - VA-FR DATE OF DEATH (REMOVE), SBD=0, SED=BDT-1D Sequence 4 - nn-FR VA-VETERAN (SELECT) Monkey see, Monkey do here. Why did we use BDT-1D on sequence 4?Monkey see, Monkey do here. Why did we use BDT-1D on sequence 4?

    19. #318H - Clinical Reminder Extracts; Making Life Easier 19 Timeline for the Anchor and Qualifying Visit

    20. #318H - Clinical Reminder Extracts; Making Life Easier 20 Rule Set Date Ranges BDT and EDT fields can be defined in: List rule (finding rule, reminder rule) Exception: This does not apply to patient list rules List rule set sequence Reminder Term T = EDT Cannot use BDT and EDT T will take on the value of EDT at the patient list build level Date priorities List Rule Set < List Rule < Reminder Term Why doesnt it apply to patient list rules? Reference SlideWhy doesnt it apply to patient list rules? Reference Slide

    21. #318H - Clinical Reminder Extracts; Making Life Easier 21 Nexus Cohort Rule Set nn-RS NEXUS COHORT Sequence: 1 Operation: ADD PATIENT List Rule: nn-FR NEXUS COHORT Description: Rule Type: FINDING RULE Reminder Term: nn-NEXUS COHORT Sequence: 2 Seq Beginning Date: BDT-24M Seq Ending Date: BDT-13M Operation: SELECT List Rule: nn-FR ANCHOR VISIT Description: Rule Type: FINDING RULE Reminder Term: nn-ALL LOCATIONS Sequence: 3 Seq Beginning Date: 0 Seq Ending Date: BDT-1D Operation: REMOVE List Rule: VA-FR-DATE OF DEATH Description: Date of Death Rule Type: FINDING RULE Reminder Term: VA-DATE OF DEATH Sequence: 4 Operation: SELECT List Rule: nn-FR VA VETERAN Description: Rule Type: FINDING RULE Reminder Term: nn-VA VETERAN Sequence 4, what is going on with that BDT-1D stuff?? Interact with Pat here.Sequence 4, what is going on with that BDT-1D stuff?? Interact with Pat here.

    22. #318H - Clinical Reminder Extracts; Making Life Easier 22 Dates can be Checked with Rule Set Test List Build Beginning Date: 05/01/2008 List Build Ending Date: 05/31/2008 SEQUENCE 1 nn-FR NEXUS COHORT Operation: ADD PATIENT TERM 00-NEXUS CLINICS FINDING 1-RL.NEXUS CLINIC COHORT FY08 Beginning Date/Time: 05/01/2008 Ending Date/Time: 05/31/2008@23:59:59 SEQUENCE 2 nn-FR ANCHOR VISIT Operation: SELECT TERM 00-ANCHOR VISIT FINDING 1-RL.VA-ALL LOCATIONS Beginning Date/Time: 05/01/2006 Ending Date/Time: 03/31/2007@23:59:59 SEQUENCE 3 VA-FR-DATE OF DEATH Operation: REMOVE TERM VA-DATE OF DEATH FINDING 1-CF.VA-DATE OF DEATH Beginning Date/Time: 0 Ending Date/Time: 04/30/2008@23:59:59 SEQUENCE 4 nn-FR VA-VETERAN Operation: SELECT TERM 00-VA-VETERAN FINDING 1-CF.VA-VETERAN Beginning Date/Time: 05/01/2008 Ending Date/Time: 05/31/2008@23:59:59

    23. #318H - Clinical Reminder Extracts; Making Life Easier 23 Making Sense of it All Rule set for Nexus cohort FR for patients with visit to a Nexus clinic - ADD PATIENT FR for anchor visit - SELECT FR to remove deceased patients - REMOVE FR for Veteran - SELECT

    24. #318H - Clinical Reminder Extracts; Making Life Easier 24 Create Nexus Cohort Patient List Rule nn-PL NEXUS COHORT Will use patient list built by Nexus cohort rule set Skip the prompt USE EXISTING PT LIST USE EXTRACT PT LIST NAMED nn-NEXUS COHORT Mnn yyyy ?explicitly type this! Display in VistA Name: nn-PL NEXUS COHORT Class: LOCAL Description: Rule Type: PATIENT LIST Existing Patient List: Extract Patient List: nn-NEXUS COHORT Mnn yyyy

    25. #318H - Clinical Reminder Extracts; Making Life Easier 25 Patient List Rule Discussion Patient list rule is based on previously created patient list Two ways to tell the patient list rule which patient list to use USE EXISTING PT LIST Does not allow for automatic substitution of period and year USE EXTRACT PT LIST NAMED Allows for automatic substitution of period and year Example: M05/2008

    26. #318H - Clinical Reminder Extracts; Making Life Easier 26 Patient List Rule Discussion USE EXISTING PT LIST The patient list has to exist at time of creation of the patient list rule USE EXTRACT PT LIST NAMED The patient list does NOT have to exist at time of creation of the patient list rule Can use automatic name building In either case, when the patient list rule is processed, the patient list must exist

    27. #318H - Clinical Reminder Extracts; Making Life Easier 27 Automatic Name Building What does Mnn yyyy actually imply? At time of extract run, user will be prompted to enter a month and year for the data extraction The month entered will replace the nn piece of the Mnn string and the year entered will replace the yyyy, therefore giving the user unique patient list names Examples: Extract run period M05/2008 IHD Patients Mnn/yyyy ? IHD Patients M05/2008 IHD Patients yyyy Mnn ? IHD Patients 2008 M05 yyyy Mnn IHD Patients ? 2008 M05 IHD Patients Mnn and yyyy can be placed anywhere in the name of the patient list that you desire.

    28. #318H - Clinical Reminder Extracts; Making Life Easier 28 Ready for a break?

    29. #318H - Clinical Reminder Extracts; Making Life Easier 29 Where were we? Weve built the rule set for the Nexus cohort Now we need to refine this for the DM and IHD cohorts

    30. #318H - Clinical Reminder Extracts; Making Life Easier 30 Build DM and AGE<76 Terms Create the DM term using TX.VA-DIABETES Term nn-DIABETES Contains TX.VA-DIABETES as finding Create the AGE term using CF.VA-AGE Term nn-AGE<76 Contains CF.VA-AGE Condition of I V<76

    31. #318H - Clinical Reminder Extracts; Making Life Easier 31 Build DM and AGE<76 FR Create the DM FR nn-FR DIABETES DIAGNOSIS Based on term nn-DIABETES Mapped finding: TX.VA-DIABETES as finding Create the AGE FR nn-FR AGE<76 Based on term nn-AGE<76 Mapped finding: CF.VA-AGE with condition of I V<76 as finding

    32. #318H - Clinical Reminder Extracts; Making Life Easier 32 Create the DM Cohort Rule Set Sequences used to build the DM cohort rule set Sequence 1 nn-PL NEXUS COHORT (ADD PATIENT operation) This is a patient list rule that uses the patient list created by the nn-NEXUS COHORT rule set at time of extract run Sequence 2 nn-FR DIABETES DIAGNOSIS (SELECT operation) Sequence 3 nn-FR AGE<76 (SELECT operation)

    33. #318H - Clinical Reminder Extracts; Making Life Easier 33 VistA View of the DM Rule Set nn-RS DM COHORT Sequence: 1 Operation: ADD PATIENT List Rule: nn-PL NEXUS COHORT Description: Rule Type: PATIENT LIST RULE Use Extract PT List Named: NEXUS COHORT Mnn yyyy Sequence: 2 Operation: SELECT List Rule: nn-FR DIABETES DIAGNOSIS Description: Rule Type: FINDING RULE Reminder Term: nn-DIABETES Sequence: 3 Operation: SELECT List Rule: nn-FR AGE<76 Description: Rule Type: FINDING RULE Reminder Term: nn-AGE<76 Explain this to them, especially the Use Extract PT List Named: nn-NEXUS COHORT yyyy Mnn piece. Why not put BDT-6M at term level?? You cant, for 1 thing, plus we would have to say T-7M because our EDT is 06/30/07 and we would really be looking at 6 months prior to June 1. Explain this to them, especially the Use Extract PT List Named: nn-NEXUS COHORT yyyy Mnn piece. Why not put BDT-6M at term level?? You cant, for 1 thing, plus we would have to say T-7M because our EDT is 06/30/07 and we would really be looking at 6 months prior to June 1.

    34. #318H - Clinical Reminder Extracts; Making Life Easier 34 Making Sense of it All Rule set for DM cohort PL rule for Nexus cohort-ADD PATIENT FR for patients with Diabetes-SELECT FR for patients less than Age of 76-SELECT

    35. #318H - Clinical Reminder Extracts; Making Life Easier 35 Build the IHD Cohort Term Create the IHD DIAGNOSIS term nn-IHD DIAGNOSIS Contains TX.VA-ISCHEMIC HEART DISEASE (national taxonomy)

    36. #318H - Clinical Reminder Extracts; Making Life Easier 36 Build the IHD Cohort FR Create the IHD DIAGNOSIS FR nn-FR IHD DIAGNOSIS Based on term nn-IHD DIAGNOSIS Mapped finding: TX.VA-ISCHEMIC HEART DISEASE Patient list rule will be re-used nn-PL NEXUS COHORT Finding rule for AGE<76 will be re-used nn-FR AGE<76

    37. #318H - Clinical Reminder Extracts; Making Life Easier 37 Create the IHD Cohort Rule Set Sequences used to build the IHD cohort rule set Sequence 1 nn-PL NEXUS COHORT (ADD PATIENT operation) This is a patient list rule that uses the patient list created by the nn-NEXUS COHORT rule set at time of extract run Sequence 2 nn-FR IHD DIAGNOSIS (SELECT operation) Sequence 3 nn-FR AGE<76 (SELECT operation) Should only look back 6 months for sequence 2. Remind students to switch to uppercase after using the yyyy and Mnn characters.Should only look back 6 months for sequence 2. Remind students to switch to uppercase after using the yyyy and Mnn characters.

    38. #318H - Clinical Reminder Extracts; Making Life Easier 38 Rule set for IHD cohort PL rule for Nexus cohort-ADD FR for patients with IHD-SELECT FR for patients less than Age of 76-SELECT Making Sense of it All

    39. #318H - Clinical Reminder Extracts; Making Life Easier 39 Quick Review How many rule sets do we have? How many patient list rules do we have? Do we have a patient list built yet?

    40. #318H - Clinical Reminder Extracts; Making Life Easier 40 Extract Definitions are Similar to Rule Sets A set of sequences For each sequence/step, the extract will: Create a patient list using a rule set Optionally evaluate reminders to extract data

    41. #318H - Clinical Reminder Extracts; Making Life Easier 41 Extracting Data Build a base list of patients (Nexus cohort) Refine the list according to the performance measure you are monitoring to obtain your denominator (people in box) Evaluate relevant reminder(s) for all patients on the list to obtain your numerators Define the frequency the extracts are to be done (monthly, quarterly, yearly)

    42. #318H - Clinical Reminder Extracts; Making Life Easier 42 DM and IHD Extract Strategy Extract sequence 1 will build Nexus cohort patient list and save it for use Accomplished using Nexus cohort rule set Patient list was named nn-NEXUS COHORT Mnn yyyy ? nn-NEXUS COHORT M05 2008

    43. #318H - Clinical Reminder Extracts; Making Life Easier 43 DM and IHD Extract Strategy Extract sequence 1 will build Nexus cohort patient list and save it for use Accomplished using Nexus cohort rule set Patient list was named nn-NEXUS COHORT Mnn yyyy ? nn-NEXUS COHORT M05 2008 Extract sequence 2 will refine Nexus cohort patient list to the DM cohort Accomplished using DM cohort rule set Run reminders against patients Extract sequence 3 will refine Nexus cohort patient list to the IHD cohort Accomplished using IHD cohort rule set Run reminders against patients

    44. #318H - Clinical Reminder Extracts; Making Life Easier 44 Screening Reminders for DM and IHD Cohorts We need to build the reminders required for our DM and IHD extract nn-LDL<100 (X) nn-LDL W/I LAST YEAR (X)

    45. #318H - Clinical Reminder Extracts; Making Life Easier 45 DM and IHD Data Extraction nn-LDL<100 (X) MC2b4 DM-Outpatient- LDL-C <100 mg/dL MC2c2 AMI-Outpatient- LDL-C <100 mg/dL nn-LDL W/I LAST YEAR (X) MC2b8 DM-Outpatient- LDL-C measured MC2c1 AMI-Outpatient LDL-C measured

    46. #318H - Clinical Reminder Extracts; Making Life Easier 46 Details of Extraction Reminders Customized cohort logic = AGE. Baseline frequency 1Y nn-LDL<100 (X)? Name of reminder definition Usage: X Resolve with LT.LDL CHOLESTEROL with condition of I +V<100 nn-LDL W/I LAST YEAR (X)? Name of reminder definition Usage: X Resolve with LT.LDL CHOLESTEROL with condition of I +V=V

    47. #318H - Clinical Reminder Extracts; Making Life Easier 47 Extract Date Ranges An extract must be run for a defined period EBDT Extract Beginning Date and Time EEDT Extract Ending Date and Time These are created automatically based on period BDT and EDT fields can be defined to override the EBDT and EEDT in the following fields: List rule set sequence BDT and EDT List rule BDT and EDT Reminder term BDT and EDT Date priorities Extract < List Rule Set < List Rule < Reminder Term Make a comment about how confusing this is. Pat will tell me that this will become clearer as we go along.Make a comment about how confusing this is. Pat will tell me that this will become clearer as we go along.

    48. #318H - Clinical Reminder Extracts; Making Life Easier 48 Start Building the Extract Definition NAME: nn-DM&IHD MEASURES CLASS: LOCAL TYPE OF TOTALS: COMPLIANCE TOTALS ONLY DESCRIPTION:<ENTER> REPORT FREQUENCY: MONTHLY After this slide has been viewed, we will walk through and explain what is happening hereAfter this slide has been viewed, we will walk through and explain what is happening here

    49. #318H - Clinical Reminder Extracts; Making Life Easier 49 Extract Sequence 1 EXTRACT SEQUENCE LIST RULE SET: nn-RS NEXUS COHORT EXTRACT PT LIST NAME: INCLUDE DECEASED PATIENTS: INCLUDE TEST PATIENTS: Select REMINDER SEQUENCE: Extract sequence 1 builds the Nexus cohort list. Whats up with this yyyy Mnn stuff? Why include deceased patients? William will build extract sequence 1 and then have the class build their extract sequenceExtract sequence 1 builds the Nexus cohort list. Whats up with this yyyy Mnn stuff? Why include deceased patients? William will build extract sequence 1 and then have the class build their extract sequence

    50. #318H - Clinical Reminder Extracts; Making Life Easier 50 Extract Sequence 2 EXTRACT SEQUENCE LIST RULE SET : nn-RS DM COHORT EXTRACT PT LIST NAME: nn-DIABETES PATIENTS Mnn yyyy INCLUDE DECEASED PATIENTS: NO INCLUDE TEST PATIENTS: NO Select REMINDER SEQUENCE: 100 REMINDER SEQUENCE: 100// REMINDER: nn-LDL<100 (X) COUNTING RULE: <ENTER> Select REMINDER SEQUENCE: 105 REMINDER SEQUENCE: 105// REMINDER: nn-LDL W/I LAST YEAR (X) COUNTING RULE:<ENTER> Extract sequence 2 refines the Nexus cohort list to the MH cohort and then we will extract the data. William will build extract sequence 2 and then the class will build extract sequence 2. Extract sequence 2 refines the Nexus cohort list to the MH cohort and then we will extract the data. William will build extract sequence 2 and then the class will build extract sequence 2.

    51. #318H - Clinical Reminder Extracts; Making Life Easier 51 Extract Sequence 3 EXTRACT SEQUENCE LIST RULE SET : nn-RS IHD COHORT EXTRACT PT LIST NAME: nn-IHD PATIENTS Mnn yyyy INCLUDE DECEASED PATIENTS: NO INCLUDE TEST PATIENTS: NO Select REMINDER SEQUENCE: 10 REMINDER SEQUENCE: 10// REMINDER: nn-LDL<100 (X) COUNTING RULE: <ENTER> Select REMINDER SEQUENCE: 20 REMINDER SEQUENCE: 20// REMINDER: nn-LDL W/I LAST YEAR (X) COUNTING RULE:<ENTER> Extract sequence 2 refines the Nexus cohort list to the MH cohort and then we will extract the data. William will build extract sequence 2 and then the class will build extract sequence 2. Extract sequence 2 refines the Nexus cohort list to the MH cohort and then we will extract the data. William will build extract sequence 2 and then the class will build extract sequence 2.

    52. #318H - Clinical Reminder Extracts; Making Life Easier 52 Run Your Extract From the Extract Menu Choose the MA option Navigate to the screen that contains your extract definition Choose your extract by number, then take default of VSE by pressing <ENTER> Choose ME option for manual extract Select EXTRACT PERIOD (Mnn/yyyy): // M05/2008 Are you sure you want to run a nn-DM&IHD MEASURES extract for M05 2008? N// Y Purge Patient List after 5 years?: N//<ENTER> Purge Extract Summary after 5 years?: N//<ENTER> Start the task at: N (this is for NOW)

    53. #318H - Clinical Reminder Extracts; Making Life Easier 53 A Quiz Can you summarize what the extract is doing?

    54. #318H - Clinical Reminder Extracts; Making Life Easier 54 Extract Sequence 1 Sequence 1 Creates the Nexus cohort patient list

    55. #318H - Clinical Reminder Extracts; Making Life Easier 55 Making Sense of it All Rule set for Nexus cohort FR for patients with visit to a Nexus clinic - ADD PATIENT FR for anchor visit - SELECT FR to remove deceased patients - REMOVE FR for Veteran - SELECT

    56. #318H - Clinical Reminder Extracts; Making Life Easier 56 Extract Sequence 2 Sequence 2 Refines the Nexus cohort to the DM cohort Runs the reminders against patient list

    57. #318H - Clinical Reminder Extracts; Making Life Easier 57 Making Sense of it All Rule set for DM cohort PL rule for Nexus cohort-ADD PATIENT FR for patients with Diabetes-SELECT FR for patients less than Age of 76-SELECT

    58. #318H - Clinical Reminder Extracts; Making Life Easier 58 Extract Sequence 3 Sequence 3 Refines the Nexus cohort to the IHD cohort Runs the reminders against patient list

    59. #318H - Clinical Reminder Extracts; Making Life Easier 59 Making Sense of it All Rule set for IHD cohort PL rule for Nexus cohort-ADD FR for patients with IHD-SELECT FR for patients less than Age of 76-SELECT

    60. #318H - Clinical Reminder Extracts; Making Life Easier 60 To summarize Sequence 1 Creates the Nexus cohort patient list Sequence 2 Refines the Nexus cohort to the DM cohort Runs the reminders against patient list Sequence 3 Refines the Nexus cohort to the IHD cohort Runs the reminders against patient list

    61. #318H - Clinical Reminder Extracts; Making Life Easier 61 The Summary of an Extract

    62. #318H - Clinical Reminder Extracts; Making Life Easier 62 Making Sense of it All

    63. #318H - Clinical Reminder Extracts; Making Life Easier 63 Real Life Extract Example

    64. #318H - Clinical Reminder Extracts; Making Life Easier 64 Questions

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