Functional Status Assessment - Year 2

Functional Status Assessments [FSA] describes the content and format of Functional Status Assessments that appear within summary documents.

Summary

The Functional Status Assessment Profile supports the transfer of assessment information between practictioners during transfers of care intra-enterprise. In the context of clinical documentation, the functional status describes the patient’s status of normal functioning at the time the document was created.

This is the second (Year 2) revision of this profile?

Benefits

WSJ (9-5-07)Hospitals around the country are scrambling to put new programs in place to prevent pressure ulcers, commonly known as bedsores, after the federal Centers for Medicare and Medicaid Services announced last month that as of October 2008, it will no longer reimburse hospitals for treating eight "reasonably preventable" conditions. Pressure ulcers are among the most prevalent, costly and dangerous on the list.. . . . To combat this, hospitals are pushing screenings of all incoming patients from head to toe for skin issues that could lead to pressure ulcers.

Kaiser Daily Health Policy Report

Medicare | Medicare Will Not Pay for Preventable Conditions Acquired at Hospitals [Aug 20, 2007]

     Medicare no longer will reimburse hospitals for the treatment of preventable errors, injuries and infections that occur in the facilities under a new rule scheduled for publication this week, a move that CMS officials said could save lives and millions of dollars, the New York Times reports. Under the rule, Medicare no longer will reimburse hospitals for the treatment of certain "conditions that could reasonably have been prevented," and the facilities "cannot bill the beneficiary for any charges associated with the hospital-acquired complication" (Pear, New York Times, 8/19). 

The eight conditions for which Medicare no longer will reimburse hospitals for treatment include: falls; mediastinitis, an infection that can develop after heart surgery; urinary tract infections that result from improper use of catheters; pressure ulcers; and vascular infections that result from improper use of catheters. In addition, the conditions include three "never events": objects left in the body during surgery, air embolisms and blood incompatibility (USA Today, 8/20).

The rule, proposed by CMS in April and mandated by a 2005 law, will take effect in October 2008. CMS officials said that next year they plan to add three additional conditions to the list (Zhang, Wall Street Journal, 8/20).

Details

Functional status includes information concerning:

• Skin assessment
• Physical Functioning Assessment
• Assessment of Activities of Daily Living (bathing, feeding, dressing and grooming)
• Pain Management
• Mood and behavior patterns

1. Long-Term Care to Acute Care - describes a use case for assessment information during transfers of care from long term to acute care.
2. Home or Ambulatory Care into Acute Care - describes a use case for assessment information during multiple care transfers.
3. Behavioral - describes a use case for assessment information during transfers of care where information about depression in an older patient is used.

Systems Affected

<List (in user terms) the types of systems they might expect to have implemented actors from this profile, e.g. RIS, PACS, HIS, CAD Workstation, etc. and for each, how it would participate.>

Not sure I understand this request. Audrey

Since Profiles refer to actors not systems, readers might not immediately realize what kind of systems would be implementing this, or which RFPs readers should consider listing this profile in. Kevin

• PACS systems may store, manage, and/or display Evidence Documents.
• Display systems may query, retrieve and display Evidence Documents.
• Reporting workstations may retrieve, process and include details from Evidence Documents in reports

Actors & Transactions:

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Specification

Profile Status: Final Text <Replace "Final Text" with "Trial Implementation" or "Public Comment" as appropriate.>

Documents:

<Provide direct links to the specific volumes or supplements, and list the volume sections relevant to this profile. This is a simple inventory of official normative and informative text. If you would like to provide a reading guide or walkthrough of what is in each of the different sections for implementers or users, do that in the Profile FAQ or the Profile Implementation Page linked below. If the profile uses transactions from multiple Tech. Frameworks, repeat the structure below.>

IHE Radiology Technical Framework:

• Vol. 1 - Section 5 (SWF Profile)
• Vol. 2 - Sections 4.8 to 4.10, 4.14 to 4.19, and 4.23
• Vol. 3 - Appendix E

Underlying Standards:

<list all the standards on which the profile is based; if possible with links to sources>

• DICOM
• HL7
• ...

See Also

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Related Profiles

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• Reporting Workflow [RWF] may use Evidence Documents as inputs to the reporting process.
• Simple Image & Numeric Reports [SINR] may include data copied from Evidence Documents.
• Cross-enterprise Document Sharing for Imaging [XDS-I] can be used to share Evidence Documents between sites over a network.
• Portable Data for Imaging [PDI] can store Evidence Documents on media such as CDs.
• Import Reconciliation Workflow [IRWF] can fix patient ids, etc. of Evidence Documents when importing.

Consumer Information

The Profile FAQ Template answers typical questions about what the Profile does. <Replace the link with a link to the actual FAQ page for the Profile>

The Profile Purchasing Template describes considerations when purchasing equipment to deploy this Profile. <Replace the link with a link to the actual Purchasing page for the Profile>

Implementer Information

The Profile Implementation Template provides additional information about implementing this Profile in software. <Replace the link with a link to the actual Implementation page for the Profile>

Reference Articles

<List References (good and bad) (with link if possible) to Journal Articles that mention IHE's work (and hopefully include some analysis) >

9.6 References 9.6.1 Numerical Rating Scale Bernstein, S. L., Bijur, P.E., Gallagher, E.J. (2006). Relationship Between Intensity and Relief in Patients with Acute Severe Pain. American Journal of Emergency Medicine, 24(2), 817-828. Bijur, P. E. (2003). Validation of a verbally administered numerical rating scale of acute pain for use in emergency departments. Academic Emergency Medicine, 10(4), 390-392. Bijur, P. E. (2006). Lack of influence of patient self report pain itensity on administration of opioids for suspected long bone fractures. Journal of Pain, 7(6), 438-444. Bryant, H. (2007). Pain: a multifacted phenomenon. Emergency Nursing, 14(10), 6-10. Hartrick, C. T., Kovan, J. P., Shapiro, S. (2003). The Numeric Rating Scale for Clinical Pain Measurement: A Ratio Measure. World Institute of Pain, 3(4), 310-316. Herr, K. (2002). Chronic Pain: challenges and assessment strategies. Journal of Gerontological Nursing, 28 (1), 20-27. Kassalainen, S., Crook, J. (2004). An exploration of seniors' ability to report pain. Clinical Nursing Research, 13(3), 199. Mc Caffery, M., Pasero, C. (1999). Teaching Patients to Use a Numerical Pain-Rating Scale. American Journal of Nursing, 99(12), 22. McCaffery, M., Pasero, C. (1999). Pain: Clinical Manual (Second edition ed.). St. Louis: Mosby. Perreault, K. (2005). Patient-Physiotherapist Agreement in Low Back Pain. Journal of Pain, 6(12), 817-827. Staton, L. J., Panda, M., Chen, I., Genao, I., Kurz, J, Pasanen, M., Mechaber, A.J., Menon, M., O'Rorke, J., Wood, J., Rosenberg, E., Faeslis, C., Carey, T., Calleson, D., Cykert, S. (2007). When Race Matters: Disagreement in Pain Perception between Patients and their Physicians in Primary Care. Journal of National Medical Association, 99(5), 532-538. Williamson, A., Hoggart, B. (2005). Pain: a review of three commonly used pain rating scales. Journal of Clinical Nursing, 14(7), 798-804. 9.6.2 Braden Scale For Predicting Pressure Sore Risk A copy of the Braden Scale For Predicting Pressure Sore Risk can be found on the web at http://wiki.ihe.net/images/1/11/Braden.pdf. A bibliography on the Braden Scale for Predicting Pressure Sore Risk can be found here on the web: http://www.bradenscale.com/bibliography.htm 9.6.3 Geriatric Depression Score A bibliography on the Geriatric Depression Score can be found here on the web: http://www.stanford.edu/~yesavage/GDS.html 9.6.4 Minimum Data Set More information on the Minimum Data Set be found here on the web: http://www.cms.hhs.gov/MinimumDataSets20/