Emergency Room (ER) SectionBOX_00 (ER1000) Route Details: 01 Box = BOX_00, BOX_10, BOX_20 04 Single Select = ER20, ER40, ER60 06 Single Select with Fill in Answer Text = ER10 08 Multiple Select = ER50 11 Multiple Select with Add/Edit/Delete = ER30, ER70 Roster 3 = ER30, ER70 BOX_10 (ER1001) Route Details: Context header display instructions: Display PERS.FULLNAME, PROV.LORPNAME, EVNT.EVNTBEGM, EVNT.EVNTBEGD, EVNT.EVNTBEGY. ER10 (ER1010) BLAISE NAME: ERVstCat Context Header: {PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER} {EVN-DT} Question Text: &ER-1. Please look at card ER-1 and tell me which category best describes the care {you/{PERSON}} received during the visit to {PROVIDER} emergency room on {VISIT DATE}. HELP: F1 Responses: DIAGNOSIS OR TREATMENT 1 ER20 (ER1015) EMERGENCY (E.G., ACCIDENT OR INJURY) 2 ER20 (ER1015) PSYCHOTHERAPY OR MENTAL HEALTH COUNSELING 3 ER20 (ER1015) FOLLOW-UP OR POST-OPERATIVE VISIT 4 ER20 (ER1015) IMMUNIZATIONS OR SHOTS 5 ER20 (ER1015) {PREGNANCY-RELATED (INCLUDING PRENATAL CARE AND DELIVERY)} 6 ER20 (ER1015) OTHER 91 ER20 (ER1015) REFUSED RF ER20 (ER1015) DON'T KNOW DK ER20 (ER1015) Display Instructions: Display response option ‘6’ (PREGNANCY-RELATED (INCLUDING PRENATAL CARE AND DELIVERY) ), if person is female and age 15 to 55 inclusive (or age categories 3 to 8). Otherwise, use a null display. ER20 (ER1015) BLAISE NAME: ERSpecCond Context Header: {PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER} {EVN-DT} Question Text: Was this visit related to any specific health condition or were any conditions discovered during this visit? Responses: YES 1 ER30 (ER1020) NO 2 ER40 (ER1023) REFUSED RF ER40 (ER1023) DON'T KNOW DK ER40 (ER1023) Display Instructions: ER30 (ER1020) BLAISE NAME: ERCondRoster Context Header: {PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER} {EVN-DT} Question Text: What conditions were discovered or led {you/{PERSON}} to make this visit? PROBE: Any other condition? ENTER ALL THAT APPLY. CTRL-A: ADD CTRL-E: EDIT CTRL-D: DELETE HELP: F1 Responses: {MEDICAL CONDITION} 1 1 ER50 (ER1025) {MEDICAL CONDITION} 2 2 ER50 (ER1025) {MEDICAL CONDITION} 3 3 ER50 (ER1025) {MEDICAL CONDITION} 4 4 ER50 (ER1025) {MEDICAL CONDITION}N 5 ER50 (ER1025) Programmer Instructions: Roster behavior:
Display Instructions: Roster 3 - add/edit/delete allowed Roster definition: Display the person-medical-conditions-roster for the selection and addition of one or many medical condition(s) associated with this event. Display name of medical condition (COND.CONDNAM) Roster filter: Display all conditions on person's roster; no filter. ER40 (ER1023) BLAISE NAME: ERSurgProc Context Header: {PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER} {EVN-DT} Question Text: Was a surgical procedure performed on {you/{PERSON}} during this visit? HELP: F1 Responses: YES 1 ER50 (ER1025) NO 2 ER50 (ER1025) REFUSED RF ER50 (ER1025) DON'T KNOW DK ER50 (ER1025) Display Instructions: ER50 (ER1025) BLAISE NAME: CodeAllERSvc Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER} {EVN-DT} Question Text: &ER-2. Looking at this card, which of these services, if any, did {you/{PERSON}} have during this visit? ENTER ALL THAT APPLY. HELP: F1 Responses: LABORATORY TESTS 1 ER60 (ER1035) SONOGRAM OR ULTRASOUND 2 ER60 (ER1035) X-RAYS 3 ER60 (ER1035) MAMMOGRAM 4 ER60 (ER1035) MRI OR CATSCAN 5 ER60 (ER1035) EKG, ECG, OR EEG 6 ER60 (ER1035) VACCINATION 7 ER60 (ER1035) NONE OF THESE SERVICES RECEIVED 95 ER60 (ER1035) REFUSED RF ER60 (ER1035) DON'T KNOW DK ER60 (ER1035) Programmer Instructions: Soft Check: If coded ‘4’ (MAMMOGRAM) and person being asked about is male or is female and < or = 17 years of age (or age categories 1-3), display the following message: “UNLIKELY RESPONSE FOR {MALES/CHILDREN 17 AND YOUNGER}. VERIFY AND RE-ENTER.” Display ‘MALE’ in error message if person being asked about is a male > 17 years of age (or age categories 4 through 9). Display ‘CHILDREN 17 AND YOUNGER’ in the error message if person being asked about is male or female and < or = 17 years of age (or age categories 1-3). Allow code '95' (NONE OF THESE SERVICES RECEIVED) , 'RF' (REFUSED), and 'DK' (DON'T KNOW) alone only; these responses may not be selected with any other response. Note: 'NONE OF THESE SERVICES RECEIVED' is not displayed on show card. Hard check: Edit: if coded ‘95’ (NONE OF THESE SERVICES RECEIVED), no other service categories can be coded. If interviewer selects another code with NONE OF THESE SERVICES RECEIVED, display the following message: "NONE OF THESE SERVICES RECEIVED CANNOT BE SELECTED WITH OTHER OPTIONS. VERIFY AND RE- ENTER." Display Instructions: ER60 (ER1035) BLAISE NAME: ERPmed Context Header: {PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER} {EVN-DT} Question Text: During this visit, were any medicines prescribed for {you/{PERSON}}? Please include only prescriptions which were filled. Responses: YES 1 ER70 (ER1040) NO 2 BOX_20 (ER1045) REFUSED RF BOX_20 (ER1045) DON'T KNOW DK BOX_20 (ER1045) Display Instructions: ER70 (ER1040) BLAISE NAME: ERPmedRoster Context Header: {PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER} {EVN-DT} Question Text: Please tell me the names of the prescriptions from this visit that were filled. PROBE: Any other prescribed medicines from this visit that were filled? ENTER ALL THAT APPLY. CTRL-A: ADD CTRL-E: EDIT CTRL-D: DELETE Responses: {PRESCRIBED MEDICINE}1 1 BOX_20 (ER1045) {PRESCRIBED MEDICINE}2 2 BOX_20 (ER1045) {PRESCRIBED MEDICINE}3 3 BOX_20 (ER1045) {PRESCRIBED MEDICINE}4 4 BOX_20 (ER1045) {PRESCRIBED MEDICINE}N 5 BOX_20 (ER1045) Programmer Instructions: Roster behavior:
NOTE: In order for the columns to display properly, 35 allowable characters for the medicines will be accepted for display on the roster. When adding a medicine in the pop-up manipula, a maximum of 60 characters will be allowed. When the CTRL-D or CTRL-E command is called, the pop-up manipula should display 60 characters for the medicine name. General flag rules for medicines: - Round medicine first created (by definition a medicine is selected the same time it is created) - Question number medicine first created - Round medicine selected - Event medicine is linked to (however, this is known by virtue that the medicine was selected at ER70 for this event) Display Instructions: Roster 3 - add/edit/delete allowed Roster definition: This item displays the person's-prescription medicines-roster for selection. Display name of prescribed medicine (DRUG.DRUGNAME). Roster filter: Display all medicines on person's roster; no filter. BOX_20 (ER1045) Route Details: Go to the Charge/Payment (CP) section if it needs to be asked for this emergency room event, i.e. its status wasn’t set to ‘Completed’ because it was part of a Flat Fee situation where the charges were collected in the CP section for another event in that Flat Fee group. Otherwise, go to the event driver (ED) section. |