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cds.ahrq.gov/sites/default/files/cds/artifact/476/Pain%20Management%20Summary%20Clincial%20Decision%20Support%20Toolkit_for%20Repository_0.xlsx
January 01, 2003 - Summary CDS tool:
• Age >=65 and/or any one of the following:
These pull from the active problem list:
• Depression … Patient Set-up
Patient 1
Problem List: contains qualifying chronic pain diagnosis (active) and depression … PMS displays:
Conditions:
qualifying chronic pain diagnosis and noted date (from PL)
Risk Factors:
depression … Patient Set-up
Patient 1 Problem List: contains qualifying chronic pain diagnosis (active) and depression … resulted (more than 12 months in the past)
Patient 2 Problem List: suicide attempt (active) and depression
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cds.ahrq.gov/sites/default/files/cds/artifact/476/Pilot%20Site%20Training%20for%20Pain%20Management%20Summary%20CDS_for%20Repository_0.pdf
July 23, 2024 - lowest effective dose
▪ Monitor PDMP
– ≤50 MME/day preferred
– ≥90 MME/day is high risk
▪ Urine drug screening … factors for opioid-related harms
Pain Assessments
– Wong-Baker FACES Rating Scale
– PEG & STarT Back Screening … MME amount
– Urine drug screen results
– Benzodiazepine medications
– Naloxone medications
– Risk screenings … Medical History
▪ Conditions associated with chronic pain
▪ Risk factors for opioid-related harms
– Depression … Implemented in the Summary Interface – Part 1
▪ Risk Factors for Opioid-related Harms
– Elements: Depression
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cds.ahrq.gov/sites/default/files/cds/artifact/476/CDS%20Pain%20Management%20Summary%20Quick%20Start%20Guide_final_1.pdf
July 23, 2024 - lookback)
Naloxone Medications - orders and statements with dates
(unrestricted lookback)
Risk Screenings … Pertinent Medical History
Risk factors for Opioid-related Harms: Always flag if any are
present (Depression
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cds.ahrq.gov/sites/default/files/workgroups/246/jul-2017-cholesterol-wg-notes.docx
January 01, 2017 - lot of different aspects to the disease and a lot to keep track of (e.g., when they are due for next screenings … Depression:
Can have a PHQ-9 questionnaire that pops up. … Some specialties have differing opinions on what screening tools to use. … Hepatitis C
There is an option to provide screening CDS. … One organization had great success immediately after enabling CDS to prompt AAA screening and mammograms
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cds.ahrq.gov/sites/default/files/cds/artifact/476/EnhancementofCDSArtifact%20BasedonPilotImplementation10012018.pdf
December 01, 2018 - Risk factors outlined in the
guideline include: depression,
anxiety, substance use disorder,
suicide … The data element was
expressed as a union of value
sets defining each of the
Conditions (e.g., depression … Note: The same approach was not
taken for the STarT Back
Screening Tool, since that has nine … This value set represents varied
assessments to screen for
depression, anxiety, opioid risk,
alcohol … Implementation Decision: Add
both screening questions to the
logic.
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cds.ahrq.gov/sites/default/files/cds/artifact/476/2024_CDS_Connect_IG_Pain_Management_Summary.pdf
January 01, 2024 - The conditions include depression, anxiety, substance use disorder,
suicide attempt, sleep-disordered … and anxiety screening, the risk of opioid misuse). … Much of the data in the Pain Management Summary is comprised of assessments and screenings
(i.e., … Many EHRs, however, do not yet support
returning assessments and screenings via the FHIR API. … Decision aids for people facing health treatment or
screening decisions.
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cds.ahrq.gov/sites/default/files/cds/artifact/logic/2024-08/FactorsToConsiderInManagingChronicPain_Change_Log.txt
January 01, 2024 - value sets for identifying Risk Factors for Opioid-Related
Harms (in addition to existing ones):
- Depression … normalize long LOINC display text for PEG codes to shorter
names
- Added LOINC code for the STarT Back Screening
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cds.ahrq.gov/sites/default/files/cds/artifact/476/CDSConnectPilotFinalReport508gel10012018.pdf
September 01, 2018 - Pertinent Medical History
• Risk factors for Opioid-related Harms: Always flag if any are present (Depression … >>ovone HydtOGnlQni:le 4Q MG/ML NM.JI Spr3Y
Risk Screenings Relevant to Pain Management 0
N~;
Pallant
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cds.ahrq.gov/sites/default/files/cds/artifact/171/Occupational%20Factors%20which%20Impact%20Diabetes,%20%20A%20Final%20Knowledge%20Resource%20Report%20(2015).pdf
January 01, 2015 - recommendation also does not cover other complex factors that often occur
with diabetes (hypertension, depression … which are part of an employee wellness program
(such as a smoking cessation or diabetes detection screening