Annual Wellness VisitsJanuary 25, 2011

• Review medical/family history• List current providers and suppliers• Measure ht, wt, BMI, BP ,etc• Detect cognitive impairment• Review risk factors for depression• Review functional ability and safety (based on obs or

questionnaire)• Establish written screening schedule for next 5-10 yrs• Furnish personalized health advice to individual with

appropriate referrals to health education, etc

Guidelines

• Patient Completes Self-Assessment– PHQ-2– Fall Risk Assessment– IADLs– Hearing/Vision/Incontinence– List of all health care and equipment providers– Tablet or Written ROS

• MA– Usual check list– Vital signs including height and weight

Interim Approach

• Review any presenting complaints or changes.

• Review active problems

• Brief review of PMH, PSH, FH, SH– correct and respond if needed.

• Medication reconciliation (of course!)

• Review answers to patient self-assessment form.

• Assess identified risks further and make plans if needed(see below for order set).

• Review BPAs and HM -- update HM as appropriate.

• Do an exam (this is appropriate to patient needs – comprehensive only if you are billing Preventative rather than AWV)

Doctor WorkFlow

• Smart Text documentation template– Documents that the above was done– Section for doctor to select risks that were identified and plan that

was done (fall, hearing, depression, smoking, etc …)

• Orders– PT– Hearing assessment– ???

• Patient Information for AVS– Default in HM with due dates– Smart List – doctor chooses risks and plans for them– Patient education materials doc can choose – next slide

Smart Set

• Fall avoidance• Depression• Incontinence• Cholesterol• Hypertension• Hypertensive Meds• Confusion• Dementia

Patient Education Materials