Annual Wellness Visits January 25, 2011

1. Annual Wellness Visits January 25, 2011

2. Guidelines • 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

3. Interim Approach • 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

4. Doctor WorkFlow • 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)

5. Smart Set • 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

6. Patient Education Materials • Fall avoidance • Depression • Incontinence • Cholesterol • Hypertension • Hypertensive Meds • Confusion • Dementia