Telux PS Suite Clinical Resources
This listing displays many of the clinical resources available for TELUS PS Suite® from the Ocean Forms Library. To open a preview window and download the resources listed below, click on the title.
This form can act as a replacement for PS Suite’s built in ‘Absentee Note’ feature in the Data menu. The advantage of this form is its customizability and the ability to change this form after the initial print.
Woman Abuse Screening Tool (WAST)
“A validated tool for screening women at risk of abuse. It consists of a series of self-reported questions. The first two questions can be used as a quick screening tool that warrants further followup and consideration of a safety plan. Developed by the Centre for Studies in Family Medicine, The University of Western Ontario London, Ontario. Keywords: WAST intimate partner violence domestric abuse physical abuse screening tool survey questionnaire”
Brief Pain Inventory
“The Brief Pain Inventory is a medical questionnaire used to measure pain, developed by the Pain Research Group of the WHO Collaborating Centre for Symptom Evaluation in Cancer Care. It is often used for patients with chronic pain to assess their symptom severity, level of function, and response to therapy.”
Edmonton Symptom Assessment Scale (ESAS)
“A simple method for the assessment of palliative care patients. This tool assists in the assessment of nine symptoms common in cancer patients: pain, tiredness, nausea, depression, anxiety, drowsiness, appetite, well-being, and shortness of breath.
Created by the Regional Palliative Care Program, Capital Health, Edmonton, Alberta, 2006 Keywords: palliative care Edmonton Symptom Asessment Scale cancer pain dyspnea cachexia”
Alcohol CAGE Questionnaire
“This form assists in the screening for problem drinking and alcoholism. It can be used via the View Form (F2) feature, which will lock the screen and allow the user to complete the questionnaire alone in the examination room.
CAGE is a validated screening technique for alcohol abuse and alcohol dependence. A score of 2 or higher is considered a positive screen for men, and a score of 1 or higher is positive for women [1,2]. The CAGE questionnaire has a reported sensitivity of 93% and a specificity of 76% for problem drinkers . Keywords: alcohol alcoholism screening tool drinking”
Atrial Fibrillation Initial Assessment
“A fast, comprehensive way to provide an initial assessment for your patients with atrial fibrillation. This tool incorporates the latest guideline-recommended components of the initial assessment of a patient with AFIB in a structured and simple way, incorporating check boxes where possible to maximize efficiency and with the option of creating a concise summary note for your chart that includes a plan for next steps. It also interfaces with the Atrial Fibrillation Stroke and Bleeding Risk Tool for a seamless, complete initial assessment.
Keywords: atrial fibrillation cardiology cardiologist warfarin anticoagulation CHADS2 CHADS2-VASC dabigatran afib”
Disease Activity Score (DAS 28) + SDAI + CDAI
“This form assists with the calculation and tracking of a rheumatoid patient’s Disease Activity Score (DAS). It provides customized homunculi for the TEN28 joint tenderness scale and the SW28 swollen joint scale, as well as a patient self-assessment scale. The DAS-28 score is auomatically calculated. The score uses the patient’s most up-to-date ESR value in the calculation.
This form will also calculate the SDAI and CDAI if the evaluator provides an assessment using a separate VAS. An additional graphing functionality is provided that superimposes the prednisone dose in conjunction with the DAS-28 score. This rheumatology form is the result of a joint project between Cognisant MD and the Ontario Rheumatology Association (ORA). This form could not have been created without the input and expertise of the ORA. Keywords: Rheumatology rheumatoid arthritis score”
Immunization Record 2013
“* Updated July 2013 to include Men-C-ACYW and Rotavirus *
This form reproduces the patient’s immunization record in a format equivalent to the standard Ontario ‘Immunization Record’ yellow card. It is designed to print on standard 8.5′ x 11′ paper. The immunization table is built and formatted directly from the immunizations in the patient’s chart. Due to the variable ways to enter the TB skin tests and contraindications, these fields are left as editable text fields for you to fill in. The TB skin tests can also be automatically populated, but only if the tests are recorded in the following manner. They must be recorded using the Perform Treatment dialog, matched to the PPD or Mantoux entries. Positive or negative results must be recorded by adding a Report under Diagnostic Test->Mantoux Test. The report content should be entered as ‘Positive’ or ‘+’ or ‘Negative’ or ‘-‘. Alternatively, you can just fill in the TB skin test results on the form directly.”
Major (ICD-10) Depression Inventory
“The Major (ICD-10) Depression Inventory (MDI) is a freely available screening tool for major depression distributed by the World Health Organization. It is used as both a depression rating scale and as an ICD-10 compatible questionnaire for diagnosing major depression according to DSM-IV criteria.
This form is an adaptation of the MDI designed as a self-administered questionnaire. You can either complete the form with the patient, or the patient can complete the form alone in the examination room. The system will safely lock out the patient from the rest of the EMR system if you use the ‘View Form’ menu item. If you would like to use this form to track the severity of the patient’s symptoms, the value on the form can be graphed as ‘MDI’ or plotted on a flowsheet using the Numeric Vital ‘@MDI’. The DSM-IV diagnosis of major depression is applicable when the patient meets at least five of the nine DSM-IV symptoms (questions 4 and 5 are considered to be the same symptom), and when the first two symptoms are both present (low mood and interest). A patient is considered to have a symptom when the score is at least ‘most of the time’ for questions 1-3 and ‘slightly more than half the time’ for questions 5-10. Keywords: Major Depressive Disorder, dysthymic dysthymia”
Health Assessment Questionnaire
“This form assists in the assessment and monitoring of symptoms and general health in patients with chronic disease. It is used most frequently by rheumatologists for assessing rheumatoid arthritis severity. The results of this questionnaire can be graphed or tracked over time using a flowsheet.
Keywords: HAQ rheumatology rheumatoid arthritis osteoarthritis disease disability symptoms severity score health assessment lupus scleroderma rheumatologist”
SAD PERSONS scale
“This tool assists in the evaluation and management of patients at risk of suicide. It is based on the Modified SAD PERSONS Scale.
Note that this tool is meant merely as an adjunct to a full assessment. No one system has been shown to reliably predict which patients will attempt suicide. When in doubt, refer or admit for full evaluation and treatment.”
Geriatric Depression Score
“An implementation of the Geriatric Depression Score.
Keywords: depression geriatrics depression psychiatry psychology geriatrician cognitive impairment GDS”
Palliative Performance Scale v2
“The Palliative Performance Scale version 2 is a tool to measure performance status in palliative care.
The PPS may be used for several purposes. First, it succinctly describes a patient’s performance status, allowing physicians to communicate the amount of support a patient may need. Second, it may be used to quantitatively assess a patient’s progression over time. Third, it appears to have some prognostic value. The score is assigned a value ranging from 100% to 0, in increments of 10%. This implementation attempts to guess the ‘best fit’ of the score by choosing the lowest score selected on the form. Physicians are free to override this score using their clinical judgment of the true score. The Palliative Performance Scale version 2 (PPSv2) tool is copyright to Victoria Hospice Society. It replaces the first PPS published in 1996 [J Pall Care 9(4): 26??32]. Reference: Anderson F, Downing G, Hill J, Casorso L, Lerch N. Palliative performance scale: A new tool. J Palliat Care 1996;12(1):5??11. Keywords: pain palliative symptom score scale prognosis tool Karnofsky Performance functional status support disease ?? Victoria Hospice Society”
Visual Analog Scale (VAS)
“This form presents the standardized visual analog scale, which allows the patient to visually mark the severity of their symptoms on a scale of 0 to 100. To minimize bias, the actual numeric value of the score is not displayed.
Values from the VAS can be graphed using ‘VAS’ and displayed in a flowsheet using the criterion Vitals->Specify Numeric Vital->’VAS’”
“This form displays up to three clickable homunculi: tender joints, swollen joints, and damaged/replaced joints. The total involved joint count is automatically calculated for each homunculi. A text area is available for notes.
Keywords: rheumatology rheumatologist rheumatoid arthritis arthralgia CTD connective tissue disease lupus gout pseudogout This rheumatology form is the result of a joint project between Cognisant MD and the Ontario Rheumatology Association (ORA). This form could not have been created without the input and expertise of the ORA.”
Chest Pain Consultation
“This form generates a basic consultation letter for referrals regarding chest pain. It is meant to be adapted by a cardiologist to meet his or her specific consult structure and letter style. Please note that this form serves as more of a proof-of-concept for a cardiologist than a genuine referral letter. However, feedback is welcome, and the form is easily customizable within PS Suite.
Keywords: chest pain unstable angina heart disease cardiac cardiology EMR adaptation ?? 2012 Cognisant MD”
Palliative Prognostic Index (PPI)
“The Palliative Prognostic Index (PPI) is a tool to assess prognosis in cancer patients.
It uses the Palliative Performance Scale (PPS), along with oral intake, edema, dyspnea at rest, and delirium. If the PPI is greater than 6.0, survival is less than three weeks (Sensitivity 80%; Specificity 85%). Note that this tool requires the preceding evaluation of the PPS (also available from Cognisant MD), and is only applicable in patients with cancer In the study, patients were classified into three groups: group A (PPI< or =2.0), group B (2.04.0). Group B survived significantly longer than group C, and group A survived significantly longer than either of the others. Also, when a PPI of more than 6 was adopted as a cut-off point, 3 weeks’ survival was predicted with a sensitivity of 80% and a specificity of 85%. When a PPI of more than 4 was used as a cutoff point, 6 weeks’ survival was predicted with a sensitivity of 80% and a specificity of 77%. The study concluded that patient prognosis, judged to be longer than 3 or 6 weeks, can be acceptably predicted by the PPI. Keywords: prognosis prognostic palliative care palliation metastatic cancer life expectancy prediction”
Atrial Fibrillation Consult
“This form generates a basic consultation letter for referrals regarding atrial fibrillation. It is meant to be adapted by a cardiologist to meet his or her specific consult structure and letter style.
Keywords: consultation consult letter specialist specialty template atrial fibrillation afib”
“An implementation of the PHQ-9 score, a popular self-reporting scale for depression.
This form can be used within PS Suite using the View Form function (press F2), which locks the screen, allowing you to leave the room while the patient completes the form. Keywords: depression patient health PHQ-9 PHQ9 self-reporting inventory scale questionnaire questionaire”
“This form generates a basic consultation letter for referrals regarding a murmur. It is meant to be adapted by a cardiologist to meet his or her specific consult structure and letter style. Feedback is welcome.
Keywords: arrhythmia murmur SEM S3 S4 cardiac cardiology murmur aortic stenosis tricuspid mitral pulmonic regurgitation incompetent valve rheumatic fever congenital heart disease EMR adaptation ?? 2012 Cognisant MD”
“This form provides useful links and shortcuts to commonly used features. It is designed to be displayed at the bottom of the CPP using PS Suite’s reminder-to-custom-form linking feature. To display it in the CPP, create a reminder that will trigger for all relevant patients, e.g. ‘age <= 110’, or for a specific user, e.g. ‘user initials = DGK’.
Keywords: toolbar utility bar profile cardiology cardiologist cardiac”
Model for End-Stage Liver Disease (MELD) Score
“This tool calculates the MELD (Model for End-Stage Liver Disease) score for assessing the severity of chronic liver disease. It is often used to prioritize for receipt of a liver transplant. The score was originally developed at the Mayo Clinic.
Keywords: gastroenterology liver transplant primary biliary cirrhosis sclerosing cholangitis cirrhosis ascites encephalopathy”
Numeric 0-10 Pain Intensity Scale
A simple numeric 0-10 rating scale for quantifying patient symptom or disease severity.
“This form calculates the Bishop Score, a pre-labour scoring system that assists in predicting whether induction of labour will be necessary. It can also predict the likelihood of success with induction and the odds of spontaneous preterm delivery.
Keywords: obstetrics obstetricians pregancy induction labor labour ob/gyn obgyn”
Reynolds Risk Score for 10-Year CVD Risk
“This tool calculates the Reynolds Risk 10-Year cardiovascular disease risk for a selected patient.
Keywords: cardiology cardiologist cardiovascular disease risk CVDRISK calculator”
Child-Pugh Score for Liver Disease
“This tool calculates the Child-Pugh score for assessing the prognosis of patients with chronic liver disease, typically due to cirrhosis. In particular, it is used to predict general mortality, abdominal surgery-related mortality, the strength of required treatment, and the necessity of liver transplantation.
Keywords: gastroenterology primary biliary cirrhosis sclerosing cholangitis cirrhosis ascites encephalopathy”
CHA2DS-VASc Score + HAS-BLED
“This form assists in the management of patients with atrial fibrillation. It contains two decision assistance tools:
1) The CHA2DS2-VASc score, a clinical prediction formula for estimating the risk of stroke in patients with non-rheumatic atrial fibrillation. It assists in determining the necessity of anticoagulation. It is an expansion of the original CHADS2 formula that includes an additional assignment of 2 points when the patient’s age is over 75 as well as additional criteria for vascular disease and female sex. 2) The HAS-BLED score, used for therapeutic bleeding risk stratification. Note that this tool has not been externally validated at the time of this writing. Keywords: HASBLED Atrial fibrillation stroke risk bleeding calculator CHADS2 CHA2DS2 VASc cerebral hemorrhage warfarin dibatran oral anticoagulant antiplatelet NOTE: A more up-to-date, guideline-based version of this tool is available: “”Risk Calculator for Atrial Fibrillation”””
Atrial Fibrillation Cardiology Toolbar
This is a sample PSS toolbar that cardiologists may use for quick links to common tools and templates. Toolbars can be configured to show in the CPP for targeted patient populations using the Reminder-based custom forms feature in PSS.
Atrial Fibrillation Flowsheet
This flowsheet assists in the monitoring of patients with atrial fibrillation. This tool was developed in conjunction with the Centre for Innovation in Complex Care (CICC).
“This form provides useful links and shortcuts to commonly used features. It is designed to be displayed at the bottom of the CPP using PS Suite’s reminder-to-custom-form linking feature. To display it in the CPP, create a reminder that will trigger for all relevant patients, e.g. ‘age <= 110’, or for a specific user, e.g. ‘user initials = DGK’.
Keywords: rheumatology rheumatologist specialty toolbar”
“The Wells Criteria are a set of clinical prediction rules used for estimating the risk of deep vein thrombosis, first published in 2006. It assists in the evaluation and management of patients at risk of DVT.
Each criterion is assigned one point, except for the last question which assesses whether an alternative diagnosis is at least as likely, which counts for -2 points. Keywords: Deep Vein Thrombosis pulmonary embolism doppler”
McIsaac Sore Throat Score
“The McIsaac sore throat score is a clinical prediction rule that assists in the management of patients presenting with sore throat by assessing the probability of streptococcal pharyngitis.
It was developed and validated in a Toronto family health clinic. The sensitivity of the score for identifying GAS infection was 83.1%, compared with 69.4% for usual physician care (p = 0.06) Proportion of patients receiving initial antibiotic prescriptions would have been reduced 48% by following score-based recommendations compared with observed physician prescribing (p < 0.001) Keywords: sore throat streptococcal pharyngitis GAS group A strep MacIsaac McIsaac”
“A form for documenting colposcopies.
** This form is a proof-of-concept and has not been peer-reviewed. Feedback is welcome. Keywords: colposcopy gynecology gynecologist pap abnormal cervix cervical cancer”
International Prostate Symptom Scale (IPSS)
“‘A symptom index for benign prostatic hyperplasia (BPH) was developed and validated by a multidisciplinary measurement committee of the American Urological Association (AUA). Validation studies were conducted involving a total of 210 BPH patients and 108 control subjects. The final AUA symptom index includes 7 questions covering frequency, nocturia, weak urinary stream, hesitancy, intermittence, incomplete emptying and urgency. On revalidation, the index was internally consistent (Cronbach’s alpha = 0.86) and the score generated had excellent test-retest reliability (r = 0.92). Scores were highly correlated with subjects’ global ratings of the magnitude of their urinary problem (r = 0.65 to 0.72) and powerfully discriminated between BPH and control subjects (receiver operating characteristic area 0.85). Finally, the index was sensitive to change, with preoperative scores decreasing from a mean of 17.6 to 7.1 by 4 weeks after prostatectomy (p < 0.001). The AUA symptom index is clinically sensible, reliable, valid and responsive. It is practical for use in practice and for inclusion in research protocols.’
Keywords: BPH benign prostatic hyperplasia hypertrophy LUTS lower urinary tract symptoms males PSA prostate cancer IPSS”
Atrial Fibrillation Followup Visit
“This tool incorporates the necessary parameters required to assess both symptom burden and quality of life for the AF patient as well as stroke prevention and bleeding as recommended by the latest Canadian guidelines with the option of creating a concise summary note for your chart. It interfaces with the Atrial Fibrillation Stroke and Bleeding Risk Tool to streamline the assessment and ensure comprehensive review while minimizing the time required.
Keywords: afib a-fib atrial fibrillation fibrilation”
Atrial Fibrillation Toolbar
“This toolbar is intended for patients with atrial fibrillation. It provides easy access to the Initial Assessment, Follow up, and the Stroke and Bleeding risk tools as well as provide links to useful patient education sheets.
It is designed to be displayed at the bottom of the CPP using PS Suite’s reminder-to-custom-form linking feature. To display it in the CPP, create a reminder that will trigger for relevant patients, e.g. “”CPP->Problem List->contains “”afib””. Keywords: afib atrial fibrillation”
OBRI Rheumatoid Arthritis Forms
“These forms are the electronic version of the Ontario Biologics Research Initiative Safety and Effectiveness Study Form.
When completing the OBRI forms, start with this form and use the links to insert pages 2 and 3. When you have completed the forms, click the Print button on each page. The program will check to ensure all mandatory fields on the form have been completed before printing. This rheumatology form is the result of a joint project between Cognisant MD and the Ontario Rheumatology Association (ORA). This form could not have been created without the input and expertise of the ORA. Keywords: rheumatology rheumatologist rheumatic rheumatoid arthritis biologics DMARDs OBRI UHN”
Dermatology Life Quality Index (DLQI)
“This is a questionnaire form for the Dermatology Life Quality Index, a validated tool for assessing the severity of skin conditions such as psoriasis. It is often used to determine a patient’s candidacy for drug funding assistance.
A Y Finlay, G K Khan April 1992 www.dermatology.org.uk Keywords: psoriasis psoriatic skin condition rash quality of life QOL dermatology dermatologist dermatologic DLQI derm References: 1. Finlay A Y, Khan G K. Dermatology Life Quality Index (DLQI): A simple practical measure for routine clinical use. Clinical and Experimental Dermatology 1994; 19: 210-216. 2. Lewis V L, Finlay A Y. Ten years experience of the Dermatology Life Quality Index (DLQI) J Investig Dermatol Symp Proc 2004; 9(2):169-180.”
Risk of Malignancy Index (RMI) for Ovarian Cancer
“This tool assesses the risk of ovarian malignancy given the CA125, menopausal status, and ultrasound findings.
The formula used is: RMI = U x M x CA125 U = 1 (for U/S score of 0 or 1) U = 3 (for U/S score of 2-5) Ultrasound score (U/S) = 1 point for each of: multilocularity, bilaterality, solid components, ascites, evidence of metastases M = 1 if premenopausal M = 3 if postmenopausal A score over 200 suggests a high risk of malignancy.”
Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)
“The BASDAI score is a validated patient questionnaire form for assessing and tracking the severity of symptoms related to ankylosing spondylitis.
This rheumatology form is the result of a joint project between Cognisant MD and the Ontario Rheumatology Association (ORA). This form could not have been created without the input and expertise of the ORA.”
Warfarin / INR Management Form
“This form is a flowsheet that aids in the entry and management of INR doses. It can automatically pull in the latest INR value from PS Suite and provides automatic graphing of INR values.
It was developed by Dr. Kavanagh and a team of pharmacists and nurses at Toronto Western Hospital. Keywords: warfarin anticoagulation INR graphing atrial fibrillation thrombosis anticoagulant management”
Vaginal Delivery Note
“This form is used to generate a consult letter for a standard vaginal delivery. It has not been validated but may serve as a useful starting point for consultation letters for practicing obstetricians.
Keywords: obstetrics pregnancy consult referral Cesarean section Caesarean C-section C/S delivery”
Body Surface Area (BSA) calculation with
“This form assists with the calculation of body surface area (BSA) for prescription dosing. It uses the Mosteller formula to calculate the BSA. The Mosteller formula is as follows:
BSA(m^2) = SquareRoot( weight(kg) x height(cm) / 3600 ) BSA dosing is often used for chemotherapy, and corticosteroids. The form also contains quick links to prepopulate the prescription dialog with drugs that are commonly prescribed with BSA dosing. The form works with metric units only. However, pre-recorded values will automatically populate the form, and these pre-recorded values can be recorded in imperial units such as lbs, feet and inches. Keywords: BSA body surface area dosing medication prednisone methotrexate 5-FU fluorouracil chemotherapy DuBois formula Boyd Gehan George formula Haycock”
Audiogram Interactive Chart
“This form provides an interactive recording tool for pure tone audiograms.
Keywords: audiology audiogram sensorineural conductive hearing loss otolaryngology ENT ear nose throat”
Chronic Kidney Disease Management
This is an encounter form to assist with the assessment and management of patients with chronic kidney disease. It is based on the 2011 Canadian guidelines for CKD management.
Helpful tips are provided on the form as indicated by yellow circles. When the form is complete, clicking Finish results in the form producing a concise progress note. Keywords: CKD CDM CRF chronic renal failure kidney disease nephrology nephrologist creatinine egfr”
Canadian Lung Health Test
This form is used as a screening test for patients at risk of chronic obstructive pulmonary disease (COPD). Any patients older than age 40 with a smoking history should undergo this brief questionnaire. Patients who answer yes to one or more questions should proceed to receive spirometry.
Keywords: COPD emphysema chronic bronchitis screening CLHQ”
Hamilton Rating Scale for Depression
A popular depression rating scale for assessing symptom severity.
Keywords: depression hamilton rating scale self-rated inventory symptom score depressed mood disorder anxiety pscyhology psychiatry psychiatric”
Dermatology Consultation Form
Keywords: This form provides a basic template for dermatology consultations.
Dermatology Pigmented Lesion Assessment
An assessment template for pigmented lesions, e.g. for mole checks.”
This form generates a psychiatry consultation letter. It can be used as-is, or it can be built upon to create a consultation report template specific to a particular reason for referral.
Keywords: psychiatry psychiatrist consultation referral psychiatric assessment psychology DSM”
Ottawa Knee Rule
Keywords: This simple guideline aids family and emergency doctors in deciding when to use radiography with injuries to the knee. It has been shown to be effectively 100% sensitive.
Growth Percentile Calculation Adjusted for EDC
This form uses the ‘adjusted birth date for prematurity’ (calculated on another custom form available on this site) to adjust the percentile calculations within PS Suite to compensate for the prematurity.
Keywords: prematurity adjusted birth date EDC pediatrics pediatrician neonatal infant growth charts percentiles”
Keywords: This form documents a cumulative patient profile (CPP) for a pscyhiatric patient. It contains fields pertinent for ongoing care.
In addition to the convenience of seeing all four graphs at once, this form displays the percentiles at the top right of each graph.”
Prostate Assessment Form
In addition to providing a means for documentation, this form provides quick links to:
* the IPSS form (a separate tool also available on this site) * a prostate flowsheet (a separate tool also available on this site) * graphs for PSA and Free PSA * a link to generate a letter”
Urology and Prostate Flowsheet
Psychiatry DSM-IV Multi-Axial Diagnosis
Keywords: This form assists in the generation of the DSM-IV multi-axial diagnosis. The DSM-IV organizes each psychiatric diagnosis into five dimensions (axes)
Adjusted Birth Date for Prematurity
This form automatically calculates the ‘adjusted’ birth date, i.e. the predicted birth date, or EDC, of a premature infant. The EDC provides a better estimate of an infants growth status when plotted on growth charts.
This form is best used in combination with the ‘Growth Charts (With Prematurity Adjustment)’ form, also available on this site. Author: D. Kavanagh Keywords: premature neonatal growth chart adjusted birth date EDC for prematurity”
SNAP-IV 26 Rating Scale for ADHD
This is the standardized SNAP-IV 26 Rating Scale for the assessment of ADHD and ODD. It can be completed either by the physician on the parent/teacher’s behalf, or by the parents using the View Form feature to lock the screen.”
This is a powerful template and letter generator for recording ophthalmology consultations. In addition to providing basic entry slots for the history, physical exam, impression, and plan, this form can automatically complete the diagnosis based on a partial type and automatically populate a customizable management plan. For example, ‘DED’ will prompt you to select the type of DED, and consequently choose a focused management plan specific to the diagnosis.”
Ottawa Ankle Assessment
The Ottawa ankle rules are an internationally recognized set of guidelines to aid family and emergency doctors in evaluating the need for an X-ray of individuals with foot or ankle injuries. Evidence shows it has almost 100% sensitivity, moderate specificity, and reduces unnecessary radiographs by 30-40%.”
This form generates a consultation letter for physiatry.
Keywords: physiatrist physiatry rehabilitation rehab rehabilitative medicine physiotherapy chronic pain non-cancer”
Dermatology General Assessment
Keywords: This is a general assessment form for dermatology. It consists of a focused history and physical template. It also contains quick links to relevant diagram templates.
Diabetes Report Card
This form can serve as a ‘report card’ for a diabetic patient’s health status. It can be printed off and handed to the patient as a communication and motivation tool.
Keywords: diabetes diabetic DM2 T2DM DMII endocrinology endocrinologist handout”
Growth Chart (With Prematurity Adjustment)
Keywords: growth chart neonatal infant percentile adjusted EDC prematurity premature pediatrics pediatrician”
COPD Action Plan
Due to copyright restrictions, this form is only available via personal request. For more information contact [email protected].“
This form supports basic spreadsheet functionality. It is potentially useful for the construction of medical calculators such as BMI and Cockcroft-Gault. Up to 10 fields are supported. Formulas can be entered in standard BEDMAS format, supporting all of the standard mathematical characters ‘().*/+-‘. Formulas can refer to any field or answer cell on the sheet using ‘F[x]’ or ‘A[x]’, where x is the row number from 1 to 10.
Examples of valid formulas include: 20 + 5 F * 3.3 F + (F * 2) + 5 F > 50 F >= 140 F == -10 Formulas that result in ‘true’ or ‘false’ answers, that is, propositional formulas, are available through the use of the following comparison operators: <, >, <=, >=, == (‘equal to’), != (‘not equal to’). The fourth column on the sheet, ‘Shown if answer is ‘true”, allows you to show a particular message based on a predefined value. For example, a BP warning could be shown if F represents the systolic BP and the formula is set to ‘F > 140’. In this case the conditional message could be ‘BP above target’. This spreadsheet is built to be customizable to your specific worksheet. It can be duplicated to create multiple different sheets. You can hide, show, and rename any field. You can change the layout of the form and change the Text value of any field. However, the scripting functionality in this form cannot be ported to other, pre-existing forms, so you will have to migrate the other form’s content by copying and pasting items into this sheet.”
Psoriasis Area and Severity Index (PASI)
This form calculates the PASI score (Psoriasis Area and Severity Index). It is used to measure the severity and extent of psoriasis.
The PASI can be used to track the severity over time. Results can be graphed using ‘PASI’ as the descriptor. They can also be tracked in a flowsheet by choosing the Vitals->Specific Numeric Vital->’PASI’. Keywords: psoriasis dermatology dermatologic psoriatic rash decision assitance tool calculator”
CDM COPD – 2011 Update
Keywords: This form improves upon the PSS version by embedding a flowsheet on the right-hand side of the form.
Gay Abuse Screening Protocol
This tool assists in the screening of gay men at risk of domestic abuse. It is a self-administered questionnaire. This form can be accessed via the View Form command in the EMR, which will lock the screen and allow the patient to complete the questionnaire alone in the examination room.
For positive results on the highly-sensitive GASP-short, i.e. question 1 = ‘some’ or ‘a lot’ of tension and question 2 = ‘some’ or ‘great’ difficulty, further assessment and management is indicated. Keywords: Domestic Violence, Intimate Partner Abuse, Physical Abuse, Sexual Abuse, Emotional Abuse, WAST WAST* GASP homosexual intimate partner violence”
The Generalized Anxiety Disorder 7-item (GAD-7) scale is a quick self-reporting questionnaire that can be used to assess and monitor anxiety symptom severity.
http://www.psychotherapy-center.com/GAD_7.html Keywords: generalized anxiety disorder GAD GAD7 GAD-7 psychology stress symptom severity self-reporting scale”
Congestive Heart Failure Management
This form assists in the chronic disease management of patients with congestive heart failure.
It links to the 2011 guidelines and provides helpful management tooltips (indicated by a small yellow circle next to each item). Keywords: CHF congestive heart failure systolic diastolic CDM flowsheet table chff”
This form calculates the CHADS2 score, which is a clinical prediction formula for estimating the risk of stroke in patients with non-rheumatic atrial fibrillation. It assists in determining the necessity of anticoagulation and provides an estimate of an annual stroke risk.
NOTE: A more up-to-date, guideline-based version of this tool is available: “”Risk Calculator for Atrial Fibrillation”” Keywords: Atrial fibrillation stroke risk calculator CHADS2 CHA2DS2 VASc warfarin oral anticoagulant antiplatelet”
WSIB Form REO8 (Ontario)
Keywords: Health Professional Continuity Report (Form RE08)
WSIB Form 26
Keywords: Health Professional’s Progress Report (Form 26) – an Ontario WSIB form for WSIB progress reports.
Hip and Knee Assessment Referral Form
Special Investigation Requisition
Atrial Fibrillation Stroke and Bleeding Risk Assessment
This tool will allow the user to easily assess the atrial fibrillation-related risk of stroke and bleeding using the latest Canadian guideline recommended methods. Furthermore, the tool will also provide a comprehensive summary of the recommended treatment, with links to dosing recommendations and practical summaries of the most frequently encountered questions during the calculation of a patientï¿½Ûªs risk of both stroke and bleeding.
Keywords: CHADS2 chads-2 chads2-vasc afib stroke risk assessment bleeding risk has-bled hasbled”
Diabetes Visit Form and Flowsheet
This form represents a minimalist redesign of the Diabetes CDM form provided with PS Suite. It incorporates the key elements of a focused diabetes visit and presents itself in a compact, easy-to-read format for quick chart entry and review.
Advantages of this diabetes form include: * Direct link to the accompanying PSS Diabetes Flowsheet (available as a separate free download from Ocean) * Automatic BMI calculation * Calculation of CVD risk (by tabbing through the <> item in the assessment section) * Tooltips to provide quick tips based on the latest Canadian DM2 guidelines * Quick at-a-glance viewing of prior visits (using the Command-3 ‘View Notes Containing…’DM2’) * Compact, short, easy-to-read format to minimize use of screen real estate Keywords: diabetes flowsheet diabetic flowsheet DM2 DMII type 2 diabetes Keywords: DM2 DMII diabetic flowsheet diabetes”
This guideline-based tool assists in the initial assessment and management of patients presenting with memory problems or other forms of cognitive impairment.
It also provides links to the Geriatric Depression Scale, MMSE, and MoCA (downloaded separately). Keywords: dementia MCI mild cognitive impairment memory loss Alzheimer’s cognition”
Ocean Family Medicine Toolbar
This custom form is a new “”PSS Toolbar”” that will appear right below the CPP. It contains useful shortcuts for inserting predefined stamps or custom forms, hyperlinks to websites, flowsheets, handouts, and more.
To configure the toolbar to show in the CPP, create a new reminder (Settings menu -> Edit Reminders) and define the reminder to trigger for all patients (e.g. “”Other->User Initials = ‘dgk’ or ‘Demographics->Age < 100’). Then, at the bottom of the Edit Reminders Dialog, choose the Family Medicine Toolbar to show as a custom form. You can customize the toolbar for your own shortcuts using the PSS custom form editor. For each shortcut, change the Click Event property to point to the desired resource. e.g.: stamp(“”mystampname””) insertForm(“”my custom form name””) viewForm(“”my custom form name””) showURL(“”www.cognisantmd.com””) showFlowsheet(“”my flowsheet name””) showGraph(“”BP””)”
Diabetic Risk Calculator
Keywords: This is a useful tool for assessing the risk of diabetes as well as the appropriate follow up for that level of risk. It follows the most current recommendations.
Keywords: This is a stepwise guide to assessing syncope. It is only a guide and designed to help one think about the different aspects related to sycnope.
Annual Health/Preventative Care Adult
Keywords: This is a guideline for an annual assessment. It contains a comprehensive list of questions for a systems review which can be used alone for other problems. It also contains issues related to preventative care.
Concussion/traumatic brain injury
Keywords: This is version 1 of a guideline for assessing a brain injury/concussion. It is extremely useful when used in conjunction with Ocean’s SCAT2 questionnaire.
RMH – Diagnostic Imaging Requisition (2012)
Keywords: Diagnostic imaging requisition for Ross Memorial Hospital in Lindsay
RMH – CT Requisition (2012)
Keywords: CT requisition for Ross Memorial Hospital in Lindsay
RMH – MRI Requisition (2012)
Keywords: MRI Requisition for Ross Memorial Hospital in Lindsay
Life Labs – Cytology & HPV Testing Requisition (2013)
Keywords: Custom form of the Life Labs Cytology & HPV Testing Requisition (‘new’ PAP form released in 2013)
This eform is designed to provide information about the patient visit if the problem is not known ahead of time.
This form is also available for the Ocean Wave tablet.”
Public Health Ontario General Lab Requisition (2013)
Keywords: Public Health General Lab Requisition (2013)
EDC for Premature Infants
This form automatically calculates the “”adjusted”” birth date, i.e. the predicted birth date, or EDC, of a premature infant. The EDC provides a better estimate of an infants growth status when plotted on growth charts.
This form is best used in combination with the “”Growth Charts (With Prematurity Adjustment)”” form, also available on this site. Keywords: premature neonatal growth chart adjusted birth date EDC for prematurity EMR adaptation ï¿½ 2013 Cognisant MD Developed by D. Kavanagh, MD. All rights reserved.”
Toolbar – Female Preventive Care
Provides a summary of standard screening-based recommendations for adult women, including: – last mammogram – last pap smear – last bone mineral densitometry (BMD) – last FOBT – last colonoscopy – last LDL – last FBS”
Toolbar – Male Preventive Care
Provides a summary of standard screening-based recommendations for adult men, including: – last FOBT – last colonoscopy – last bone mineral densitometry (BMD) – last PSA – last LDL – last FBS”
Gestational Age (GA) from EDC
**BETA: This form has not yet been thoroughly tested. Please confirm its accuracy by cross-checking its results, and please let us know if you detect any errors.
This form calculates the patient’s effective gestational age based on the current date and the patient’s EDC. Keywords: pediatrics pediatrician neonatal neonate premature neonatal growth chart adjusted birth date EDC for prematurity GA gestational age”
Keywords: Keywords: Hamilton Depression Scale HAMD7 depression low mood
Keywords: TESTING FILE
Knee – Chronic Pain Consult
The Opioid Manager is designed to be used as a point-of-care tool for providers prescribing opioids for chronic non-cancer pain. It condenses key elements from the Canadian Opioid Guideline and can be used as a chart insert.
To access the Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain, and to download the Opioid Manager, visit http://nationalpaincentre.mcmaster.ca/opioid/ The Opioid Manager is ï¿½ Toronto Rehab-UHN and was developed with funds from the MOHLTC Alternative Funding Plan Innovation Fund. The developers of the Opioid Manager include Toronto Rehab (A. Furlan MD PhD), Centre for Effective Practice, and the National Opioid Use Guideline Group (NOUGG). This version is current as of February 2011. ï¿½ 2013 Cognisant MD Developed by D. Kavanagh, MD. All rights reserved. Opioid Manager designed by the Centre for Effective Practice (CFEP) and Dr. Andrea Furlan. Keywords: opiate addiction abuse management chronic pain control”
Periodic Health Exam
A guideline-based periodic health exam encounter assistant. It is designed for reasonably quick entry of information pertinent to periodic health exams. With the increasing de-emphasis on the annual physical, the form attempts to be reasonably comprehensive and evidence-based while acknowledging the real-world expectations of patients coming in for their “”physical””.
The form optionally works well with the Physical questionnaire available for patients to complete in advance of their appointment on Ocean Wave or via Ocean Web Questionnaires. Keywords: CPX DK-CPX Physical AHE periodic health exam annual health exam”
Framingham Risk and Cardiovascular Age
This tool allows the user to calculate the patient’s 10-year Modified Framingham cardiovascular disease risk according to the 2012 Canadian Cardiovascular Society guidelines. It also calculates the cardiac age by comparing the patient’s risk to age-related ideal scores.
Keywords: modified framingham risk score cardiac risk cardiovascular disease risk score calculator cardiac age cardiovascular age cvdrisk cvd risk”
Visual Analog Scale (VAS 0-10)
Benzodiazepine Medication Treatment Agreement
CHF Encounter Assistant
An encounter assistant that allows quick and flexible entry of data for congestive heart failure patients. Unlike the CDM custom forms, this form has the advantage of converting into a flexible, concise progress note after Finish is clicked.
Keywords: congestive heart failure flowsheet CDM”
Congestive Heart Failure CDM Form
Predictor for 1-Year Mortality After Hospital Admission
Keywords: palliative care goals of care end-of-life mortality prognosis prediction
Adult Tetanus / Td Reminder
Bone Mineral Density Initial Reminder (Choosing Wisely)
Keywords: Keywords: osteoporosis osteopenia fracture risk screening
Mammogram Screening Reminder
Keywords: Keywords: mammo breast cancer screening
Flu Shots Reminder
Keywords: Keywords: flu shots influenza
Pap Smear Reminder
Keywords: Keywords: cytology cervical cancer screening
Pap Smear Reminder 2
This is another example of pap smear reminder. Note the complexity involved with handling multiple test reporting types and abnormal follow-ups. Users will likely have to tweak the criteria match their own pap results.
Keywords: pap cytology cervical cancer screening”
Pneumococcal 2013 Reminder
Keywords: Keywords: pneumovax vaccination
Smoking Cessation Reminder
A simple reminder for smoking cessation that recommends Ontario billing codes.
Keywords: smoker cessation tobacco cigarette”
Diabetes MACR Reminder
Warfarin INR Overdue
Keywords: Keywords: warfarin coumadin thrombosis afib atrial fibrillation tc
Asthma Action Plan
This is a custom form for quick completion of an asthma action plan for patients.
Recent guidelines suggest that written action plans are an important component of care for all patients with asthma and COPD. In contrast to verbal action plans, which have not been shown to be of significant benefit, written action plans are highly effective therapeutic tools, particularly when combined with asthma education, self-monitoring and regular review. The evidence of effectiveness is strong for adults and emerging for children.”
Repeat Colonoscopy Reminder
Keywords: Keywords: CCC colon cancer screening colorectal
Keywords: Keywords: CCC colon cancer screening colorectal FOBT fecal occult blood
Initial Colon Cancer Screen Reminder
Keywords: Keywords: CCC colon cancer screening colorectal
Shingles / Herpes Zoster Vaccine Reminder
Keywords: A reminder for patients over age 60 to counsel regarding the zoster vaccine.
Meningococcal ACYW Vaccine Reminder
A reminder for young patients to receive the meningococcal ACYW vaccine.
Keywords: Menveo Menjugate Menactra”
LifeLabs – Surgical Pathology Requisition