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Primary Care: Family Health History Documentation Template

Description

The intent of the “Family Health History Documentation Template” is to facilitate documentation of a patient’s family health history.

Artifact Type
Creation Date
Version
1.0
Unique Identifier
a5da18a9-4ee9-5531-8fe7-99ae417cdab2
Status
Experimental
True

Artifact Creation and Usage

Contributors
Angela Denietolis, MD, Primary Care Physician James A. Haley Veterans Hospital Tampa VAMC Tampa, FL 33612
Pat Dumas, RN, Clinical Program Director VACO 810 Vermont Ave NW Washington, DL 20420
Manish Merchant, MD, Health Informatician Albany VAMC 113 Holland Ave. Albany, NY 12208
Timothy Dresselhaus, MD, San Diego VAMC - MEDS 3350 La Jolla Village Drive San Diego, CA 92161
David Douglas, MD, Portland VAMC Portland, OR E-Consult Expert

Please contact Mr. Apurva Desai Apurva.desai@va.gov for additional information.

License
IP Attestation The author asserts that this artifact has been developed in compliance with the intellectual property rights attributed to the source material.
Copyrights

Copyright © 2018 Veterans Health Administration, Department of Veterans Affairs. All rights reserved. Contributions from external parties are property of respective copyright holders.

Implementation Details
Technical Files
Repository Information
Approval Date
Publication Date
Last Review Date
Knowledge Level

Structured code that is interpretable by a computer (includes data elements, value sets, logic)

Purpose and Usage
Usage

 

Target User
Provider to include Primary Care
Workflow Setting
Primary Care
Clinical Venue
Outpatient
Patient Age Group
Adult Patients

 

Cautions

THE CLINICAL CONTENT IN THIS DOCUMENT IS NOT DIRECTLY SUITABLE FOR CLINICAL USE AS PRESENTED SINCE IT HAS NOT BEEN TESTED IN A CLINICAL ENVIRONMENT. IT HAS NEVER BEEN PILOTED, NEVER 100% REPRESENTS THE INTENT OF THE CLINICAL SUBJECT MATTER EXPERTS, AND MAY CAUSE HARM IF APPLIED AS-IS. THIS WORK IS MADE AVAILABLE WITHOUT ANY WARRANTY WHATSOEVER, AND WITHOUT CLAIMS, EXPRESSED OR IMPLIED, OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE.

Supporting Evidence
Source Description

 

See attached resource files for additional details. Department of Veterans Affairs, Veterans Health Administration, Office of Informatics and Information Governance, Clinical Decision Support (CDS) Content and Health Level 7 (HL7)-Compliant Knowledge Artifacts (KNARTs) Eye Care Clinical Content White Paper, VA118-16-D-1008, Task Order VA-118-16-F-1008-0007, June, 2018.

Eligible Professional Meaningful Use Menu Set Measures: Measure 4 of 6: Stage 2: Family Health History: Center for Medicare and Medicaid ; cited October 2012. Available from: https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/downloads/Stage2_EPMenu_4_FamilyHealthHistory.pdf
https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/downloads/Stage2_EPMenu_4_FamilyHealthHistory.pdf
Family health history: SMARTForm use case, version 1.2. SMARTForms Family Health History Use Case: U.S. Department of Veteran Affairs study; cited September 8, 2017. Available from: V1.2_20150602.docx
V1.2_20150602.docx
My Family Health Portrait: A tool from the Surgeon General: U.S. National Institutes of Health cited December 21, 2017. Available from: https://familyhistory.hhs.gov/FHH/html/index.html
https://familyhistory.hhs.gov/FHH/html/index.html

 

References

 

See attached resource files for additional details. Department of Veterans Affairs, Veterans Health Administration, Office of Informatics and Information Governance, Clinical Decision Support (CDS) Content and Health Level 7 (HL7)-Compliant Knowledge Artifacts (KNARTs) Eye Care Clinical Content White Paper, VA118-16-D-1008, Task Order VA-118-16-F-1008-0007, June, 2018.

Eligible Professional Meaningful Use Menu Set Measures: Measure 4 of 6: Stage 2: Family Health History: Center for Medicare and Medicaid ; cited October 2012. Available from: https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/downloads/Stage2_EPMenu_4_FamilyHealthHistory.pdf
https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/downloads/Stage2_EPMenu_4_FamilyHealthHistory.pdf
Family health history: SMARTForm use case, version 1.2. SMARTForms Family Health History Use Case: U.S. Department of Veteran Affairs study; cited September 8, 2017. Available from: V1.2_20150602.docx
V1.2_20150602.docx
My Family Health Portrait: A tool from the Surgeon General: U.S. National Institutes of Health cited December 21, 2017. Available from: https://familyhistory.hhs.gov/FHH/html/index.html
https://familyhistory.hhs.gov/FHH/html/index.html

 

Artifact Representation
Testing Experience
Pilot Experience

None