# Presentation: 662086

## Documenting Intimate Partner Violence/Domestic ViolenceScreeningin RPMS

- Denise Grenier, MSW, LISW
- CIMTAC
- April 13, 2004

## GPRA Clinical Indicator:Intimate Partner Violence/Domestic Violence (IPV/DV)

- Objective – IPV/DV *Screening *
- Standard – Adult females should be screened for domestic violence at a *new encounter *and *at least annually*; prenatal *once each trimester* (Source: Family Violence Prevention Fund National Consensus Guidelines)

## Why Screen?

- US Preventive Services Task Force (USPTF) acknowledges that the effectiveness of screening has not been validated, however, they also state that screening is justifiable on other grounds including:
- High prevalence of undetected abuse among female patients
- Low cost and low risk of screening
- Adverse economic and social impact of abuse
- DV is a chronic, life-threatening condition that is treatable; if abuse is left untreated the severity and frequency of abuse can worsen

## Why Screen?

- DV screening is recommended by:
- American Academy of Family Physicians
- American College of Physicians
- American Medical Associations
- American College of Obstetricians and Gynecologists
- DV Screening is a JCAHO Mandate
- JCAHO Mandate
- GPRA Clinical Performance Indicator
- Women want to be asked!

## RPMSIPV/DV ScreeningExam Mnemonic:  EX 34 or IPV Screen

- AUM 4.1 Patch 1; AUPN  Patch 11 Released Nov ‘03

## Current IPV/DV Screening Exam Code Data Entry

- Exam Mnemonic:  EX 34 or IPV Screen (AUM 4.1 patch 1; AUPN patch 11)
- Allowable results:
- N	Negative
- PR	Present
- PA	Past

## EX 34Data Entry

- Refusals Mnemonic:  REF
- Exam
- Exam Value:  INT (or INT)
- Date Refused:

## EX 34Data Entry

- Unable to Screen
- Mnemonic:  UAS (PCC Data Entry patch 7)
- Exam
- Exam Value:  INT (or 34)
- Date Refused:

## IPV/DV Screening Exam Code # 34Provider Documentation

- EXAM – DV (or IPV) Screen
- Negative – denies being a current or past victim of DV
- Present – admits being current victim of DV
- Past – denies being a current victim, but admits being a past victim of DV

## Provider DocumentationContinued

- Refused – patient declined exam/screen
- Unable to screen -- acceptable reasons for UAS include partner present, verbal child present

## Proposed RPMS IPV/DV Screening Documentation and Data CollectionImprovements

- IPV/DV Screening Exam Code
- PCC Management Reports
- Health Maintenance Reminder

##  Enhancements to IPV/DV Screening Exam Code

- Initials – who administered the exam (“Ordering Provider” added to DE template)
- Capture comments (245 characters)
- for Exam results (Negative, Present, Past)
- for Refusal
- for Unable to Screen

## PCC Management ReportsIPV/DV Requests 

- Date Range
- Age Range
- Count by Provider
- Count by Response (N, PR, PA)
- List of Exam Results with comments (Do we want option of listing with patient identifier?)
- Sort by ?? (community, tribe, location of encounter, clinic, etc.)
- Need firm specifications for programmer

## Development of IPV/DV Health Maintenance Reminder

- Display on Health Summary
- Screen on Gender
- Screen on Age
- Screen on current dx of pregnancy; key off of EDC (problematic because of persistent data)
- Frequency – Standard is annual; once per trimester for prenatal