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digital.ahrq.gov/ahrq-funded-projects/evaluating-smart-forms-and-quality-dashboards-electronic-health-record-ehr-7
January 01, 2023 - Can a "Smart Form" increase physicians' satisfactions with managing patient health behavior risks? … Can a "Smart Form" increase physicians' satisfactions with managing patient health behavior risks? … 18694145
Principal Investigator
Middleton, Blackford
Project Name
Evaluating Smart Forms
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digital.ahrq.gov/ahrq-funded-projects/patient-centered-informatics-system-enhance-health-care-rural-communities-0
January 01, 2023 - Psychometric assessment of the patient activation measure short form (PAM-13) in rural settings. … Psychometric assessment of the patient activation measure short form (PAM-13) in rural settings.
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digital.ahrq.gov/health-it-tools-and-resources/pediatric-resources/pediatric-documentation-templates/acute-respiratory-infection
January 01, 2023 - Executive Summary
The Partners Pediatric Acute Respiratory Infection (ARI) smart form … The form is designed to assist with the assessment and management of non-specific upper respiratory infections … The form provides check boxes for symptoms and physical examination specifically related to ARIs; therefore … This web site includes views of each page of the ARI smart form, as well as a preview of the note.
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digital.ahrq.gov/health-it-tools-and-resources/evaluation-resources/workflow-assessment-health-it-toolkit/all-workflow-tools/checklist
January 01, 2023 - PDF , 491KB)
Workflow Assessment Checklist ( PDF , 119KB)
Description
A checklist is a form … DESIGN A FORM with clearly labeled categories and sufficient room for data entry. … Make sure the form is easy to read and use.
4. PERFORM DATA COLLECTION during the agreed period. … Disadvantages
Checklist forms are usually specific to a particular situation.
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digital.ahrq.gov/sites/default/files/docs/resource/Dataform_4_ADE_Incident_Identification_Form.pdf
June 16, 2021 - ADE Incident Identification Formatory Pedi Med Study
DATAFORM 4
ADE Incident Identification Form … Excellence for Patient Safety Research and Practice 5/27/05
Dataform 4: ADE Incident Identification Form … 5/27/05
Dataform 4: ADE Incident Identification Form Version 0.8
error? … Unknown (STOP, form is complete)
17. … Version 0.8
DATAFORM 4
ADE Incident Identification Form
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digital.ahrq.gov/ahrq-funded-projects/statewide-implementation-electronic-health-records
January 01, 2023 - Records Document Type: Data Collection Form
ADE and Near Miss Incident Classification Form Description … :
This form is used to classify ADEs and near misses. … Electronic Health Records Document Type: Data Collection Form
Chart Review Form Description: … Type: Data Collection Form
Medication Error and Near Miss Classification Form Description: … of Electronic Health Records Document Type: Data Collection Form
Prescription Screening Form
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digital.ahrq.gov/sites/default/files/docs/resource/C2_Process_Guide_Standard.pdf
June 16, 2021 - Fax Cynthia Scheideman-Miller the following forms to (405) 713-4992
(white multi-page form) from … Completed
(white multi-page form)
Patient Enrollment Form
4. … Cynthia Scheideman-Miller will:
(blue form)
a. … Fax Patient Information Form and Enrollment Form to Consultant
ENROLLMENT:
1. … (tan form) in 72 hours, preferably prior to the first consult.
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digital.ahrq.gov/health-it-tools-and-resources/pediatric-resources/pediatric-documentation-templates/asthma-action-plan
January 01, 2023 - This template exists as a form paragraph which is inserted into the patient’s note in his or her electronic … In its current form, it is meant to be used during a visit to specifically review and/or develop a patient … This web site includes a view of the form paragraph and directions for use.
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digital.ahrq.gov/principal-investigator/friedman-charles
January 01, 2023 - Prevention (IPP) through Scalable Infrastructure Employing the USPSTF Recommendations in Computable Form … Prevention (IPP) through Scalable Infrastructure Employing the USPSTF Recommendations in Computable Form … Prevention (IPP) through Scalable Infrastructure Employing the USPSTF Recommendations in Computable Form … Prevention (IPP) through Scalable Infrastructure Employing the USPSTF Recommendations in Computable Form
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digital.ahrq.gov/sites/default/files/docs/implementation/Porter.ppt
June 16, 2021 - Form Form 8 8 6 4 4 3
Dose Dose Dose 9 10 3 0 5 0
Parent
Physician
Nurse
Levels of Detail
% Valid … 44 mcg
2 puffs
Not sure
4) Recommendations for Steve, age 13 y:
· Prescribe new form … _
*
Chart3
Name Name Name 6 9 7 10 9 9
Route Route Route 7 9 9 9 9 8
Form … Form Form 8 8 6 4 4 3
Dose Dose Dose 9 10 3 0 5 0
Parent
Physician
Nurse
Levels of Detail
% Valid … on the identified needs.
0
10
20
30
40
50
60
70
80
90
100
Name
Route
Form
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digital.ahrq.gov/document-type/informed-consent-document
January 01, 2023 - Informed Consent Document
Focus Group Consent Form (Spanish) … Description
Example consent form used in an AHRQ-funded project involving older adults. … The form is in Spanish. … Research at Memorial Hospital of RI (Brown University)
Description
Example consent form
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digital.ahrq.gov/principal-investigator/ziemer-david-c
January 01, 2023 - CAMPII)
Medication reconciliation: comparing a customized medication history form … to a standard medication form in a specialty clinic (CAMPII 2). … Medication reconciliation: comparing a customized medication history form to a standard medication form
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digital.ahrq.gov/sites/default/files/docs/resource/Dataform_1_Prescription_Screening_Form.pdf
June 16, 2021 - of Excellence for Patient Safety Research and Practice 1/26/08
Dataform 1: Prescription Screening Form … Version 0.10
DATAFORM 1
Prescription Screening Form
1. … Antihistamine (all forms)
12. Antihypertensive
13. Antineoplastic
14. … Antiviral (all forms)
18. Bronchodilator (inhaled)
19. Bronchodilator (oral)
20. … Version 0.10
DATAFORM 1
Prescription Screening Form
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digital.ahrq.gov/sites/default/files/docs/page/2006Muller_052411comp.pdf
June 16, 2021 - standardized patient
medication list to be used in all hospitals
across the metropolitan area
Two forms … discharge
– Wallet size for patient to carry with him/her
An Idea Was Born
Providence had developed a form … color of sheet, adjusted wording
Area for each system to personalize with their
logo
Full Page Form … systems for group
learning
Challenges
Coordination of large group – scheduling
Advertising the form … Improve Communication
Support
Project Summary
An Idea Was Born
Membership
Process
Full Page Form
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digital.ahrq.gov/ahrq-funded-projects/achieving-individualized-precision-prevention-ipp-through-scalable
January 01, 2023 - Prevention (IPP) through Scalable Infrastructure Employing the USPSTF Recommendations in Computable Form … Prevention (IPP) through Scalable Infrastructure Employing the USPSTF Recommendations in Computable Form … Prevention (IPP) through Scalable Infrastructure Employing the USPSTF Recommendations in Computable Form … Prevention (IPP) through Scalable Infrastructure Employing the USPSTF Recommendations in Computable Form
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digital.ahrq.gov/sites/default/files/docs/resource/C7_Intervention_Process_Guide_for_Point_of_Care_Nurse.pdf
June 16, 2021 - Fax Cynthia Scheideman-Miller the following forms to (405) 713-4992
(white multi-page form) from the … Completed
(white multi-page form)
Patient Enrollment Form
e. … Physician Order Form (green)
(blue form)
5. Cynthia Scheideman-Miller will:
a. … Fax Enrollment Form to Consultant
f. … Once the patient is discharged, mail all forms for patient to Cynthia Scheideman-Miller at
3366 NW Expressway
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digital.ahrq.gov/ahrq-funded-projects/evaluating-smart-forms-and-quality-dashboards-electronic-health-record-ehr
January 01, 2023 - User interface accelerators for clinical documentation in Smart Form. … Clinical Decision Support System Population: Individuals with Chronic Care Needs
Can a "Smart Form … Can a "Smart Form" increase physicians' satisfactions with managing patient health behavior risks? … Currently, the dashboard and smart form for acute respiratory patients has been introduced to about 1,000 … The coronary artery disease/diabetes smart form is currently being rolled out to a similar number of
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digital.ahrq.gov/ahrq-funded-projects/improving-population-health-through-enhanced-targeted-regional-decision-support/annual-summary/2012
January 01, 2012 - A clinical messaging system will deliver the forms, allowing them to be integrated more seamlessly into … When forms are flagged as reportable, they will be sent to appropriate clinical providers and public … form on various outcomes. … Baseline data collection began in the second half of 2012 and forms on the project’s seven reportable … The standard pre-populated reporting forms will be implemented in 2013.
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digital.ahrq.gov/ahrq-funded-projects/improving-population-health-through-enhanced-targeted-regional-decision-support/annual-summary/2011
January 01, 2011 - As clinical data is captured increasingly in electronic form, there is potential for more comprehensive … A clinical messaging system will deliver the forms, allowing them to be integrated more seamlessly into … When forms are flagged as reportable, they will be sent to appropriate clinical providers and public … form on various outcomes. … Lastly, a technical project plan to activate the prototype electronic forms generation process was developed
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digital.ahrq.gov/sites/default/files/docs/resource/Helene_Kopal_IQHIT_Q6_HTN_Intervention_Users_Manual.pdf
March 01, 2009 - *Recommended assessments
for elevated BMI and tobacco
use appear as smart forms and
are discussed … Managing the Hypertensive Patient – User’s Manual
v 1.0 11 March 2009
4.2 Smart Forms. … Smart forms are electronic questionnaires that contain logic that facilitate
assessments. … meds and/or fill out
the Fax-to-Quit Form. … Completion of the tobacco control smart
form and/or the Fax-to-Quit form is
automatically inserted