Number range CHAPTERKEY CLINICAL PERFORMANCE OBJECTIVES

**"Cheat Sheet" for PCC Documentation and Data Entry**

**Recommended Use for This Material: each facility should 1) identify
their three or four key clinical problem areas; 2) review the attached
information; 3) customize the Provider and Data Entry documentation
instructions, if necessary; 4) train staff on appropriate documentation,
and 5) post the 1-2 page Cheat Sheet in exam rooms.**

**NOTE: The purpose of this document is to provide information to both
providers and to data entry on the [most appropriate]{.underline} way to
document key clinical procedures in RPMS. It does not include all of the
codes CRS checks for when determining if an indicator is met. To view
that information, view the CRS short version logic at:**

<http://www.ihs.gov/misc/links_gateway/download.cfm?doc_id=7428&app_dir_id=4&doc_file=CRS_v_5_(2005)_Indicators_(Short)-rev1.pdf>

+----------+---------------+-------------------+-----------------------+
| **Obj    | **Standard**  | **Provider        | **Data Entry**        |
| ective** |               | Documentation**   |                       |
+==========+===============+===================+=======================+
| De       | Adult         | **Primary Care    | Standard PCC data     |
| pression | patients 18   | Providers:**      | entry: *Mnemonic*     |
| S        | years of age  | Enter narrative   | ***PV***: V79.0,      |
| creening | and older     | "Screening for    | Special Screening for |
|          | should be     | Depression" or    | Mental Disorders and  |
|          | screened for  | "Depression       | Developmental         |
|          | depression    | Screening."       | Handicaps, Depression |
|          | *at least     |                   |                       |
|          | annually.*    |                   |                       |
+----------+---------------+-------------------+-----------------------+
|          |               | **Behavioral      | Standard BHS data     |
|          |               | Health            | entry: Enter BHS      |
|          |               | Providers:**      | problem code 14.1 or  |
|          |               | Enter BHS problem | narrative "Screening  |
|          |               | code 14.1 or      | for Depression."      |
|          |               | narrative         |                       |
|          |               | "Screening for    | **NOTE:** BHS code    |
|          |               | Depression."      | 14.1 maps to ICD-9    |
|          |               |                   | V79.0.                |
|          |               | **NOTE:** BHS     |                       |
|          |               | code 14.1 maps to |                       |
|          |               | ICD-9 V79.0.      |                       |
+----------+---------------+-------------------+-----------------------+
| Domestic | Adult females | **Primary Care    | Exam *Mnemonic        |
| (        | should be     | and Behavioral    | **EX***: 34 or        |
| Intimate | screened for  | Health            | INTIMATE PARTNER      |
| Partner) | domestic      | Providers:**      | VIOLENCE SCREEN (AUM  |
| Violence | violence at   |                   | 4.1 patch 1; AUPN     |
| S        | *new          | EXAM---DV (or     | patch 11)             |
| creening | encounter*    | IPV) Screen       |                       |
| (DV/IPV) | and *at least |                   | > N Negative          |
|          | annually*     | > Negative -      | >                     |
|          |               | > denies being a  | > PR Present          |
|          | Prenatal      | > current or past | >                     |
|          | *once each    | > victim of DV    | > PA Past             |
|          | trimester*    | >                 |                       |
|          |               | > Present -       | Refusals *Mnemonic*:  |
|          | (Source:      | > admits being    | ***REF***             |
|          | Family        | > current victim  |                       |
|          | Violence      | > of DV           | > Exam                |
|          | Prevention    | >                 | >                     |
|          | Fund National | > Past - denies   | > Exam Value: **INT   |
|          | Consensus     | > being a current | > (or 34)**           |
|          | Guidelines)   | > victim, but     | >                     |
|          |               | > admits being a  | > Date Refused:       |
|          |               | > past victim of  |                       |
|          |               | > DV              | Unable to Screen:     |
|          |               | >                 | *mnemonic **UAS***    |
|          |               | > Refused -       | (PCC Data Entry patch |
|          |               | > patient         | 7)                    |
|          |               | > declined        |                       |
|          |               | > exam/screen     | > Exam                |
|          |               | >                 | >                     |
|          |               | > Unable to       | > Exam Value: **INT   |
|          |               | > screen          | > (or 34)**           |
|          |               |                   | >                     |
|          |               |                   | > Date Refused:       |
+----------+---------------+-------------------+-----------------------+
| Alcohol  | Pregnant      | Use the CAGE      | *Under mnemonic       |
| S        | women should  | questionnaire,    | **HF**, enter:*       |
| creening | be screened   | which asks the    |                       |
| for      | for alcohol   | following 4       | > CAGE 0/4 (all No    |
| Women    | use at least  | questions:        | > answers)            |
|          | on their      |                   | >                     |
|          | first visit;  | 1\. Have you ever | > CAGE 1/4            |
|          | education and | felt the need to  | >                     |
|          | follow-up     | **Cut** down on   | > CAGE 2/4            |
|          | provided as   | your drinking (or | >                     |
|          | appropriate   | drug use)?        | > CAGE 3/4            |
|          |               |                   | >                     |
|          | Women of      | 2\. Have people   | > CAGE 4/4            |
|          | childbearing  | **Annoyed** you   | >                     |
|          | age should be | by criticizing    | > Level/Severity      |
|          | screened at   | your drinking     | >                     |
|          | least         | (drug use)?       | > Provider            |
|          | annually      |                   | >                     |
|          |               | 3\. Have you ever | > Quantity            |
|          |               | felt bad or       |                       |
|          |               | **Guilty** about  | **[[C) Patients with  |
|          |               | your drinking     | alcohol-related       |
|          |               | (drug use)?       | patient education or  |
|          |               |                   | counseling.]{         |
|          |               | 4\. Have you ever | .underline}]{.mark}** |
|          |               | needed an **Eye** |                       |
|          |               | opener the first  | > **[[2) Alcohol      |
|          |               | thing in the      | > Education: All      |
|          |               | morning to steady | > Patient Education   |
|          |               | your nerves or    | > codes containing    |
|          |               | get rid of a      | > "CD-" *or           |
|          |               | hangover?         | > "-CD*]{             |
|          |               |                   | .underline}]{.mark}** |
|          |               | Tolerance: How    |                       |
|          |               | many drinks does  |                       |
|          |               | it take you to    |                       |
|          |               | get high?         |                       |
|          |               |                   |                       |
|          |               | Based on how many |                       |
|          |               | YES answers were  |                       |
|          |               | received,         |                       |
|          |               | document Health   |                       |
|          |               | Factor on PCC:    |                       |
|          |               |                   |                       |
|          |               | HF -- CAGE 0/4    |                       |
|          |               | (all No answers)  |                       |
|          |               |                   |                       |
|          |               | HF -- CAGE 1/4    |                       |
|          |               |                   |                       |
|          |               | HF -- CAGE 2/4    |                       |
|          |               |                   |                       |
|          |               | HF -- CAGE 3/4    |                       |
|          |               |                   |                       |
|          |               | HF -- CAGE 4/4    |                       |
|          |               |                   |                       |
|          |               | Optional values:  |                       |
|          |               |                   |                       |
|          |               | Level/Severity:   |                       |
|          |               | Mild, Moderate,   |                       |
|          |               | or Severe         |                       |
|          |               |                   |                       |
|          |               | Quantity: \# of   |                       |
|          |               | drinks daily OR\  |                       |
|          |               | T (Tolerance) \-- |                       |
|          |               | \# drinks to get  |                       |
|          |               | high (e.g. T-4)   |                       |
+----------+---------------+-------------------+-----------------------+
| C        | Children      | Standard PCC      | Standard PCC data     |
| alculate | (through age  | documentation     | entry                 |
| BMI      | 18) should    |                   |                       |
| (Body    | have both     | To document       | Refusals: *mnemonic   |
| Mass     | height and    | Refusals on PCC:  | **REF***              |
| Index)   | weight taken  |                   |                       |
|          | [on the same  | Write "Refused"   | > Measurements        |
|          | day           | in Height or      | >                     |
|          | ]{.underline} | Weight boxes at   | > Measurement Type:   |
|          | at least      | upper right       | > **HT** or **WT**    |
|          | annually (at  |                   | >                     |
|          | every visit   |                   | > Date Refused:       |
|          | is            |                   |                       |
|          | recommended)  |                   |                       |
|          |               |                   |                       |
|          | Adults 19-50, |                   |                       |
|          | height and    |                   |                       |
|          | weight at     |                   |                       |
|          | least [every  |                   |                       |
|          | 5             |                   |                       |
|          | years]        |                   |                       |
|          | {.underline}, |                   |                       |
|          | not on same   |                   |                       |
|          | day           |                   |                       |
|          |               |                   |                       |
|          | Adults over   |                   |                       |
|          | 50, height    |                   |                       |
|          | and weight    |                   |                       |
|          | taken [every  |                   |                       |
|          | 2             |                   |                       |
|          | years         |                   |                       |
|          | ]{.underline} |                   |                       |
+----------+---------------+-------------------+-----------------------+
| C        | Children age  | Standard PCC      | Standard PCC data     |
| hildhood | 19-35 months  | documentation for | entry                 |
| Immun    | will be       | immunizations     |                       |
| izations | up-to-date    | performed at the  | For historical, use   |
|          | for all ACIP  | facility          | *mnemonic* ***HIM***  |
|          | recommended   |                   |                       |
|          | immunizations | Ask about         | > Date                |
|          |               | off-site IZ and   | >                     |
|          |               | *record           | > Type                |
|          |               | historical        | >                     |
|          |               | information* on   | > Location of         |
|          |               | PCC:              | > Encounter           |
|          |               |                   | >                     |
|          |               | IZ type           | > Immunization        |
|          |               |                   | > Type(s) and Series  |
|          |               | Date received     |                       |
|          |               |                   | Refusals: *mnemonic   |
|          |               | Location          | **REF***              |
|          |               |                   |                       |
|          |               | To document       | > Immunization        |
|          |               | Refusals on PCC:  | >                     |
|          |               |                   | > Immunization Value: |
|          |               | Write "Refused    | >                     |
|          |               | \[shot type" in   | > Date Refused (can   |
|          |               | POV section OR    | > be month and year   |
|          |               | "Refused" in      | > only)               |
|          |               | appropriate Order |                       |
|          |               | box at right      |                       |
+----------+---------------+-------------------+-----------------------+
| Adult    | All adults    | Standard PCC      | Standard PCC data     |
| Immun    | ages 65 and   | documentation for | entry                 |
| ization: | older should  | immunizations     |                       |
| Flu      | have an       | performed at the  | For historical, use   |
| Vaccine  | annual flu    | facility          | *mnemonic **HIM***    |
|          | shot          |                   |                       |
|          |               | Ask about         | > Date                |
|          | Adults 55-64  | off-site IZ and   | >                     |
|          | are strongly  | *record           | > Type                |
|          | recommended   | historical        | >                     |
|          | to have       | information* on   | > Location            |
|          | annual flu    | PCC:              | >                     |
|          | shot          |                   | > Immunization Type:  |
|          |               | IZ type           | > **88 Inf Virus      |
|          | All adult (18 |                   | > Vaccine NOS (other  |
|          | and older)    | Date received     | > options are 111 Inf |
|          | diabetic      |                   | > Virus Vac           |
|          | patients are  | Location          | > Intranasal; 15 Inf  |
|          | strongly      |                   | > Virus Vac SV; or 16 |
|          | recommended   | To document       | > Inf Virus Vac WV)** |
|          | to have       | Refusals on PCC:  |                       |
|          | annual flu    |                   | Refusals: *mnemonic   |
|          | shot          | Write "Refused    | **REF***              |
|          |               | Flu Shot" in POV  |                       |
|          | Refusals      | section OR        | > Immunization        |
|          | should be     | "Refused" in      | >                     |
|          | documented.   | Influenza Order   | > Immunization Value: |
|          |               | box at right      | >                     |
|          |               |                   | > Date Refused        |
+----------+---------------+-------------------+-----------------------+
| Adult    | All adults    | Standard PCC      | Standard PCC data     |
| Immun    | ages 65 and   | documentation for | entry                 |
| ization: | older will    | immunizations     |                       |
| Pneu     | have a        | performed at the  | For historical, use   |
| mococcal | pneumovax     | facility          | mnemonic ***HIM***    |
| Vaccine  |               |                   |                       |
|          | All adult (18 | Ask about         | > Date                |
|          | and older)    | off-site IZ and   | >                     |
|          | diabetic      | *record           | > Type                |
|          | patients are  | historical        | >                     |
|          | strongly      | information* on   | > Location            |
|          | recommended   | PCC:              | >                     |
|          | to have a     |                   | > Immunization Type:  |
|          | pneumovax     | IZ type           | > **33 Pneumo Polysac |
|          |               |                   | > Vac (other options  |
|          | Refusals      | Date received     | > are 100 Pneumo Conj |
|          | should be     |                   | > Vacc, or 109 Pneumo |
|          | documented.   | Location          | > NOS**               |
|          |               |                   |                       |
|          |               | To document       | Refusals: *mnemonic   |
|          |               | Refusals on PCC:  | **REF***              |
|          |               |                   |                       |
|          |               | Write "Refused    | > Immunization        |
|          |               | Pneumovax" in POV | >                     |
|          |               | section OR        | > Immunization Value: |
|          |               | "Refused" in      | >                     |
|          |               | Pneumo Vax Order  | > Date Refused        |
|          |               | box at right      |                       |
+----------+---------------+-------------------+-----------------------+
| Prevent  | Adults ages   | Standard PCC      | Standard PCC data     |
| co       | 50 and older  | documentation for | entry process for     |
| lorectal | should be     | procedures        | procedures, Lab or    |
| cancer   | screened for  | performed at the  | Radiology             |
| (CRC)    | CRC (USPTF).  | facility          |                       |
|          | IHS           | (Radiology, Lab,  | *Mnemonics for        |
|          | recommends    | provider)         | Historical:*          |
|          | any of the    |                   |                       |
|          | following:    | Guaiac cards      | ***HBE*** Historical  |
|          |               | returned by       | Barium Enema          |
|          | 1.  Fecal     | patients to       |                       |
|          |     occult    | providers should  | ***HCOL*** Historical |
|          |     blood     | be sent to Lab    | Colonoscopy           |
|          |     test      | for processing    |                       |
|          |     (FOBT) or |                   | ***HFOB*** Historical |
|          |     rectal    | Ask and *record   | FOBT (Guaiac)         |
|          |     exam      | historical        |                       |
|          |     annually  | information* on   | ***HSIG*** Historical |
|          |     or at     | PCC: date         | Sigmoidoscopy         |
|          |     least     | received and      |                       |
|          |     every two | location          | > Date                |
|          |     years     |                   | >                     |
|          |               | Telephone visit   | > Type                |
|          | 2.  Flexible  | with patient      | >                     |
|          |               |                   | > Location of         |
|          | sigmoidoscopy | Verbal or written | > Encounter           |
|          |     or double | lab report        |                       |
|          |     contrast  |                   | Refusals Mnemonic:    |
|          |     enema     | Patient's next    | ***REF***             |
|          |     every 5   | visit             |                       |
|          |     years     |                   | > Lab Test Value:     |
|          |               | Discuss with Data | > Fecal Occult Blood  |
|          | 3.  Annual    | Entry staff and   | > Test                |
|          |               | ensure they know  | >                     |
|          |   FOBT/rectal | where refusals    | > Exam: Rectal Screen |
|          |     exam plus | are documented on | >                     |
|          |     flexible  | the PCC form.     | > Exam Value: 14      |
|          |               |                   | >                     |
|          | sigmoidoscopy |                   | > Date Refused:       |
|          |     every 5   |                   |                       |
|          |     years     |                   |                       |
|          |               |                   |                       |
|          | 4.            |                   |                       |
|          |   Colonoscopy |                   |                       |
|          |     every 10  |                   |                       |
|          |     years     |                   |                       |
|          |               |                   |                       |
|          | Refusals      |                   |                       |
|          | should be     |                   |                       |
|          | documented    |                   |                       |
+----------+---------------+-------------------+-----------------------+
| Pr       | Women ages    | Standard PCC      | Data entry through    |
| evention | 18-64 should  | documentation for | Women's Health        |
| of       | have a Pap    | tests performed   | program or standard   |
| cancer   | Smear every 3 | at the facility   | PCC data entry for    |
| of the   | years         |                   | tests performed at    |
| uterine  |               | Ask about         | the facility          |
| cervix   | Refusals      | off-site tests    |                       |
|          | should be     | and *record       | Historical Pap        |
|          | documented.   | historical        | Mnemonic: ***HPAP***  |
|          |               | information* on   |                       |
|          |               | PCC:              | > Date                |
|          |               |                   | >                     |
|          |               | > Date received   | > Location of         |
|          |               | >                 | > Encounter           |
|          |               | > Location        | >                     |
|          |               |                   | > Outside Location    |
|          |               | To document       | >                     |
|          |               | Refusals on PCC:  | > Results             |
|          |               |                   |                       |
|          |               | Write "Refused    | Refusals Mnemonic:    |
|          |               | Pap Smear" in POV | ***REF***             |
|          |               | section OR        |                       |
|          |               | "Refused" in Pap  | > Lab Test Value: Pap |
|          |               | Order box at      | > Smear               |
|          |               | right             | >                     |
|          |               |                   | > Date Refused:       |
+----------+---------------+-------------------+-----------------------+
| Breast   | Women ages    | Standard PCC      | Data entry through    |
| Cancer   | 50-69 should  | documentation for | Women's Health        |
| Pr       | have a        | Radiology         | program or standard   |
| evention | mammogram     | performed at the  | PCC data entry for    |
|          | every 2 years | facility          | tests performed at    |
|          |               |                   | the facility          |
|          | Refusals      | Ask and *record   |                       |
|          | should be     | historical        | Historical            |
|          | documented.   | information* on   | *Mnemonic**: HRAD***  |
|          |               | PCC: date         |                       |
|          |               | received and      | > Date                |
|          |               | location          | >                     |
|          |               |                   | > Location of         |
|          |               | > Telephone visit | > Encounter           |
|          |               | > with patient    | >                     |
|          |               | >                 | > Procedure Type:     |
|          |               | > Verbal or       | > \[76090-76092\]     |
|          |               | > written lab     | >                     |
|          |               | > report          | > Impression          |
|          |               | >                 | >                     |
|          |               | > Patient's next  | > Abnormal            |
|          |               | > visit           |                       |
|          |               |                   | Refusals Mnemonic:    |
|          |               | To document       | ***REF***             |
|          |               | Refusals on PCC:  |                       |
|          |               |                   | > Mammogram           |
|          |               | Write "Refused    | >                     |
|          |               | Mammogram" in POV | > Radiology           |
|          |               | section OR        | > Procedures Value    |
|          |               | "Refused" in      | > (CPT):              |
|          |               | Mammogram Order   | >                     |
|          |               | box at right      | > Date Refused        |
+----------+---------------+-------------------+-----------------------+
| Diabetic | Diabetes      | EXAM---DM Eye     | *Under mnemonic       |
| dilated  | patients will | Exam              | **EX** enter*         |
| eye exam | have had a    |                   |                       |
|          | dilated eye   | To document       | DIABETIC EYE EXAM     |
|          | exam in the   | Refusals on PCC:  |                       |
|          | past 12       |                   | Refusals Mnemonic:    |
|          | months        | Write "Refused DM | ***REF***             |
|          |               | Eye Exam" in POV  |                       |
|          |               | section           | > Exam                |
|          |               |                   | >                     |
|          |               |                   | > Exam Value: **03**  |
|          |               |                   | >                     |
|          |               |                   | > Date Refused:       |
+----------+---------------+-------------------+-----------------------+
| S        | Ask all       | Document on       | *Under mnemonic       |
| creening | patients age  | designated Health | **HF** enter*         |
| for      | five and over | Factors section   |                       |
| tobacco  | about tobacco | of form:          | > NON-TOBACCO USER    |
| use and  | use *at least |                   | >                     |
| exposure | annually*     | >                 | > CURRENT SMOKER      |
| to ETS   |               |  HF---Non-Tobacco | >                     |
|          |               | > User            | > CURRENT SMOKELESS   |
|          |               | >                 | >                     |
|          |               | > HF---Smoker     | > CURRENT SMOKER &    |
|          |               | >                 | > SMOKELESS           |
|          |               | > HF---Smokeless  | >                     |
|          |               | >                 | > PREVIOUS SMOKER     |
|          |               | > HF -- Smoker &  | > \[or SMOKELESS\]    |
|          |               | > Smokeless       | >                     |
|          |               | >                 | > CESSATION SMOKER    |
|          |               | > HF -- Previous  | > \[or SMOKELESS\]    |
|          |               | > Smoker \[or     | >                     |
|          |               | > Smokeless\]     | > SMOKER IN HOME      |
|          |               | > (quit \> 6      | >                     |
|          |               | > months)         | > CEREMONIAL (new)    |
|          |               | >                 | >                     |
|          |               | > HF -- Cessation | > EXPOSURE TO         |
|          |               | > Smoker \[or     | > ENVIRONMENTAL       |
|          |               | > Smokeless\]     | > TOBACCO SMOKE       |
|          |               | > (quit or        | >                     |
|          |               | > actively trying | > SMOKE FREE HOME     |
|          |               | > \< 6 months)    | >                     |
|          |               | >                 | > Level/Severity      |
|          |               | > HF -- Smoker in | >                     |
|          |               | > Home            | > Provider            |
|          |               | >                 | >                     |
|          |               | > HF --           | > Quantity            |
|          |               | > Ceremonial      |                       |
|          |               | >                 | [4) **Tobacco         |
|          |               | > HF -- Exp to    | Screening:** A) Any   |
|          |               | > ETS (Second     | Health Factor for     |
|          |               | > Hand Smoke)     | category Tobacco. B)  |
|          |               | >                 | POV or Current PCC    |
|          |               | > HF -- Smoke     | Problem List 305.1\*, |
|          |               | > Free Home       | V15.82                |
|          |               |                   | (tobacco-related      |
|          |               | NOTE: if your     | diagnosis). C) Dental |
|          |               | site uses other   | code 1320. **[D)      |
|          |               | expressions       | Patient Education     |
|          |               | (e.g.," Chew"     | codes containing      |
|          |               | instead of        | "TO-", "-TO", or      |
|          |               | "Smokeless;"      | *"-SHS*]{.und         |
|          |               | "Past" instead of | erline}*".***]{.mark} |
|          |               | "Previous"), be   |                       |
|          |               | sure Data Entry   |                       |
|          |               | staff know how to |                       |
|          |               | "translate"       |                       |
|          |               |                   |                       |
|          |               | Optional values:  |                       |
|          |               |                   |                       |
|          |               | Level/Severity:   |                       |
|          |               | Mild, Moderate,   |                       |
|          |               | or Severe         |                       |
|          |               |                   |                       |
|          |               | Quantity: e.g.,   |                       |
|          |               | \# of cigarettes  |                       |
|          |               | smoked daily      |                       |
+----------+---------------+-------------------+-----------------------+
| HIV      | Pregnant      | Standard PCC      | Standard PCC data     |
| Testing  | women should  | documentation for | entry for tests       |
| in Women | be tested for | tests performed   | performed at the      |
|          | HIV at least  | at the facility   | facility              |
|          | on their      |                   |                       |
|          | first visit;  | To document       | Refusals Mnemonic:    |
|          | education and | Refusals on PCC:  | ***REF***             |
|          | follow-up     |                   |                       |
|          | provided as   | Write "Refused    | > Lab Test Value:     |
|          | appropriate   | HIV test" in POV  | >                     |
|          |               | section           | > Date Refused:       |
|          |               |                   | >                     |
|          |               |                   | > **[[5) HIV          |
|          |               |                   | > Counseling/Patient  |
|          |               |                   | > Education: POV:     |
|          |               |                   | > V65.44, Patient     |
|          |               |                   | > Education codes     |
|          |               |                   | > containing          |
|          |               |                   | > "HIV-"]{            |
|          |               |                   | .underline}]{.mark}** |
+----------+---------------+-------------------+-----------------------+
| Me       | Patients      | Provider and/or   | *Mnemonic **PED**:*   |
| dication | receiving     | pharmacist should |                       |
| E        | medications   | document **[all   | Education Topic       |
| ducation | should be     | 5]{.underline}**  |                       |
|          | educated      | PFE elements:     | > DMC-IN (Diabetes    |
|          | about         |                   | > medicine - Insulin) |
|          | appropriate   | Disease           | >                     |
|          | use and       | state---Education | > M-I (Medication     |
|          | potential     | Topic -- Level of | > information)        |
|          | risks         | Understanding --  | >                     |
|          |               | Who Taught --     | > M-DI (Drug          |
|          |               | Time spent (in    | > interaction)        |
|          |               | minutes)          | >                     |
|          |               |                   | > M-FU (Medication    |
|          |               | DMC-IN (Diabetes  | > follow-up)          |
|          |               | medicine --       | >                     |
|          |               | Insulin)          | > M-L (Medication     |
|          |               |                   | > patient education   |
|          |               | M-I (Medication   | > literature)         |
|          |               | information)      | >                     |
|          |               |                   | > \[any disease\]-M   |
|          |               | M-DI (Drug        | > (medication)        |
|          |               | interaction)      |                       |
|          |               |                   | Provider              |
|          |               | M-FU (Medication  |                       |
|          |               | follow-up)        | Level of              |
|          |               |                   | Understanding: P, G,  |
|          |               | M-L (Medication   | F, Group, R           |
|          |               | patient education |                       |
|          |               | literature)       | Length of Education   |
|          |               |                   | (minutes)             |
|          |               | \[any disease\]-M |                       |
|          |               | (medication)      |                       |
|          |               |                   |                       |
|          |               | Level of          |                       |
|          |               | Understanding = P |                       |
|          |               | (Poor), F (Fair), |                       |
|          |               | G (Good), Group,  |                       |
|          |               | R (Refused)       |                       |
+----------+---------------+-------------------+-----------------------+