ID
11252
Description
Form from HIS OpenVista
Keywords
Versions (5)
- 3/9/12 3/9/12 -
- 8/7/14 8/7/14 - Martin Dugas
- 8/9/14 8/9/14 - Martin Dugas
- 8/11/14 8/11/14 - Martin Dugas
- 6/26/15 6/26/15 - Martin Dugas
Uploaded on
June 26, 2015
DOI
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License
Creative Commons BY-NC 3.0 Legacy
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PHYSICAL THERAPY INITIAL EVALUATION
HIS
- StudyEvent: HIS
Description
SOCIAL/HEALTH HABITS(PAST & CURRENT)
Description
Living Situation, Dwelling
Description
Assisted Living
Data type
boolean
Alias
- UMLS CUI 2011AA
- C1456630
Description
Home (Lives Alone)
Data type
boolean
Description
Home with parent(s)
Data type
boolean
Description
Home w/Significant Other
Data type
boolean
Description
Home w/Spouse
Data type
boolean
Description
Home w/Family (Children)
Data type
boolean
Description
Home w/Friend (Caretaker)
Data type
boolean
Description
Dependent in ADLs
Data type
boolean
Description
Independent in ADLs
Data type
boolean
Description
Nursing Home
Data type
boolean
Alias
- UMLS CUI 2011AA
- C0028688
- SNOMED CT 2011_0131
- 42665001
- LOINC Version 232
- MTHU015917
- HL7 V3 2006_05
- N
Description
Retirement Center/ Assisted Living Facility
Data type
boolean
Alias
- UMLS CUI 2011AA
- C0872103
- HL7 V3 2006_05
- 310400000X
Description
Requires Assistance with ADLs
Data type
boolean
Description
Other
Data type
boolean
Description
Stairs to enter
Data type
boolean
Description
Stairs indoors
Data type
boolean
Description
REMAIN ON FIRST FLOOR
Data type
boolean
Description
OTHER OBSTACLES OF CONCERN
Data type
string
Description
Medical history
Alias
- UMLS CUI-1
- C0262926
Description
PREMORBID FUNCTIONAL STATUS
Data type
string
Description
Family history
Data type
text
Alias
- SNOMED CT 2011_0131
- 57177007
- UMLS CUI-1
- C0241889
Description
Medical/surgical history
Data type
text
Alias
- SNOMED CT 2011_0131
- 417662000
- LOINC Version 232
- MTHU027722
- SNOMED CT 2011_0131
- 161615003
- UMLS CUI-1
- C0262926
- UMLS CUI-2
- C0455610
Description
MEDICATIONS REVIEWED
Data type
boolean
Description
PERTINENT MEDICATIONS AFFECTING THERAPY
Data type
string
Description
CLINICAL TESTS
Data type
string
Description
I.D. VERIFIED BY
Data type
string
Description
I.D. VERIFICATION
Data type
string
Description
Review of systems
Alias
- UMLS CUI-1
- C0489633
Description
Height
Data type
float
Measurement units
- cm
Alias
- LOINC Version 232
- MTHU005354
- UMLS CUI-1
- C0005890
Description
Body weight
Data type
float
Measurement units
- kg
Alias
- SNOMED CT 2011_0131
- 107647005
- MedDRA 14.1
- 10047890
- LOINC Version 232
- LP18015-5
- UMLS CUI-1
- C0005910
Description
Pulse
Data type
integer
Measurement units
- beats/min
Alias
- SNOMED CT 2011_0131
- 78564009
- MedDRA 14.1
- 10037485
- UMLS CUI-1
- C0232117
Description
Respiration rate, Breathing rate (BR)
Data type
integer
Measurement units
- /min
Alias
- SNOMED CT 2011_0131
- 86290005
- MedDRA 14.1
- 10038709
- LOINC Version 232
- MTHU008344
- UMLS CUI-1
- C0231832
Description
Blood pressure (BP)
Data type
integer
Measurement units
- mmHg
Alias
- SNOMED CT 2011_0131
- 75367002
- LOINC Version 232
- MTHU008342
- UMLS CUI-1
- C0005823
Description
Edema
Data type
boolean
Alias
- UMLS CUI 2011AA
- C0013604
- SNOMED CT 2011_0131
- 423666004
- MedDRA 14.1
- 10030095
- LOINC Version 232
- MTHU019803
- ICD-10-CM Version 2010
- R60.9
- ICD-9-CM Version 2011
- 782.3
Description
Ankle Edema (L/R)
Data type
text
Alias
- SNOMED CT 2011_0131
- 344001
- SNOMED CT 2011_0131
- 423666004
- MedDRA 14.1
- 10030095
- LOINC Version 232
- MTHU019803
- ICD-10-CM Version 2010
- R60.9
- ICD-9-CM Version 2011
- 782.3
- UMLS CUI-1
- C0235439
Description
Foot Edema
Data type
text
Alias
- SNOMED CT 2011_0131
- 56459004
- LOINC Version 232
- MTHU002679
- SNOMED CT 2011_0131
- 423666004
- MedDRA 14.1
- 10030095
- LOINC Version 232
- MTHU019803
- ICD-10-CM Version 2010
- R60.9
- ICD-9-CM Version 2011
- 782.3
- UMLS CUI-1
- C0574002
Description
Hand Edema
Data type
text
Alias
- UMLS CUI-1
- C0239819
Description
Knee Edema
Data type
text
Alias
- UMLS CUI-1
- C0522045
Description
Leg oedema, Edema of leg
Data type
text
Alias
- SNOMED CT 2011_0131
- 102574007
- MedDRA 14.1
- 10024127
- UMLS CUI-1
- C0235886
Description
INTEGUMENTARY within normal limits
Data type
boolean
Alias
- UMLS CUI-1
- C0558145
Description
Integument
Data type
string
Alias
- UMLS CUI 2011AA
- C1123023
- SNOMED CT 2011_0131
- 39937001
- LOINC Version 232
- MTHU001414
Description
MUSCULOSKELETAL WNL
Data type
boolean
Alias
- UMLS CUI-1
- C0430745
Description
Musculoskeletal System, Musculo-skeletal system
Data type
text
Alias
- SNOMED CT 2011_0131
- 26107004
- LOINC Version 232
- MTHU001411
- UMLS CUI-1
- C0026860
Description
ROM/STRENGTH
Data type
string
Description
NEUROMUSCULAR WNL
Data type
boolean
Description
Neuromuscular
Data type
text
Alias
- UMLS CUI-1
- C1979768
Description
Gait, Manner of walking
Data type
text
Alias
- SNOMED CT 2011_0131
- 63448001
- LOINC Version 232
- MTHU015039
- UMLS CUI-1
- C0016928
Description
BALANCE
Data type
text
Alias
- UMLS CUI-1
- C0560184
Description
MOTOR CONTROL
Data type
text
Alias
- UMLS CUI-1
- C0517961
Description
COMMUNICATION WNL
Data type
boolean
Description
COMMUNICATION
Data type
text
Alias
- UMLS CUI-1
- C0009452
Description
LANGUAGE
Data type
string
Alias
- UMLS CUI 2011AA
- C1145677
Description
ORIENTATION
Data type
string
Alias
- UMLS CUI 2011AA
- C0029266
- SNOMED CT 2011_0131
- 43173001
Description
Memory loss
Data type
string
Alias
- UMLS CUI 2011AA
- C0751295
- MedDRA 14.1
- 10027176
- LOINC Version 232
- MTHU013522
- ICD-9-CM Version 2011
- 780.93
Description
EMOTIONAL/BEHAVIORAL RESPONSES WNL
Data type
boolean
Description
Emotional / Behavioral responses
Data type
string
Description
LEARNING BARRIERS
Data type
boolean
Description
Hearing impaired
Data type
boolean
Alias
- UMLS CUI-1
- C1384666
Description
Language/Needs interpreter
Data type
boolean
Description
unable to read
Data type
boolean
Alias
- UMLS CUI-1
- C0586741
Description
Vision impaired
Data type
boolean
Alias
- UMLS CUI-1
- C3665347
Description
EDUCATION NEEDS
Data type
boolean
Description
Education ADLs
Data type
boolean
Alias
- SNOMED CT 2011_0131
- 129025006
- UMLS CUI-1
- C0013622
- UMLS CUI-2
- C0001288
Description
Education Disease
Data type
boolean
Alias
- SNOMED CT 2011_0131
- 64572001
- UMLS CUI-1
- C0013622
- UMLS CUI-2
- C0012634
Description
Education Equipment
Data type
boolean
Description
Education Exercise Program
Data type
boolean
Description
Education Safety
Data type
boolean
Description
Education Transfers
Data type
boolean
Description
other Education needs
Data type
string
Description
KEYS TO TEST AND MEASURES
Description
AEROBIC CAPACITY/ENDURANCE
Data type
string
Description
AROUSAL, ATTENTION, AND COGNITION
Data type
string
Description
ASSISTIVE AND ADAPTIVE EQUIPMENT
Data type
string
Description
CIRCULATION
Data type
string
Description
GAIT, LOCOMOTION, AND BALANCE
Data type
string
Description
INTEGUMENTARY INTEGRITY
Data type
string
Description
MOTOR FUNCTION (MOTOR CONTROL AND MOTOR LEARNING)
Data type
string
Description
MUSCLE PERFORMANCE (STRENGTH,POWER,AND ENDURANCE)
Data type
string
Description
NEUROMOTOR DEVELOPMENT AND SENSORY INTEGRATION
Data type
string
Description
ORTHOTIC, PROTECTIVE, AND SUPPORTIVE DEVICES
Data type
string
Description
PAIN
Data type
string
Alias
- UMLS CUI 2011AA
- C0030193
- SNOMED CT 2011_0131
- 22253000
- MedDRA 14.1
- 10033371
- LOINC Version 232
- MTHU029813
- ICD-10-CM Version 2010
- R52
- ICD-9-CM Version 2011
- 338-338.9
- CTCAE 1105E
- E11167
Description
POSTURE
Data type
text
Alias
- UMLS CUI-1
- C1262869
Description
RANGE OF MOTION (INCLUDING MUSCLE LENGTH)
Data type
string
Description
REFLEX INTEGRITY
Data type
text
Alias
- UMLS CUI-1
- C0596002
Description
SENSORY INTEGRITY
Data type
text
Alias
- UMLS CUI-1
- C2735300
Description
SELF CARE AND HOME MANAGEMENT
Data type
string
Description
WORK REINTEGRATION
Data type
string
Description
EVALUATION
Data type
string
Description
Diagnosis
Alias
- UMLS CUI-1
- C0011900
Description
Cardiovascular Pattern(s)
Data type
boolean
Description
Integumentary Pattern(s)
Data type
boolean
Description
Musculoskeletal Pattern(s)
Data type
boolean
Description
Neuromuscular Pattern(s)
Data type
boolean
Description
Diagnosis text
Data type
string
Alias
- UMLS CUI 2011AA
- C0011900
- SNOMED CT 2011_0131
- 439401001
- LOINC Version 232
- MTHU008876
Description
PROGNOSIS, Goals, Interventions, Plan
Description
Prognosis
Data type
string
Alias
- UMLS CUI 2011AA
- C0033325
- SNOMED CT 2011_0131
- 20481000
Description
Goals
Data type
string
Alias
- UMLS CUI 2011AA
- C0018017
- SNOMED CT 2011_0131
- 410518001
- LOINC Version 232
- MTHU036445
Description
Interventions
Data type
text
Alias
- UMLS CUI-1
- C0184661
Description
TODAYS
Data type
string
Description
Educated - family
Data type
boolean
Description
Educated - patient
Data type
boolean
Description
Educated - significant other
Data type
boolean
Description
Educated - returns Demonstration
Data type
boolean
Description
Educated - Verbalizes understanding
Data type
boolean
Description
DISCHARGE PLANS
Data type
text
Alias
- UMLS CUI-1
- C2735970
Description
DISCHARGE STATUS
Data type
string
Alias
- UMLS CUI 2011AA
- C0586514
- SNOMED CT 2011_0131
- 309039003
- LOINC Version 232
- MTHU031549
Description
FREQUENCY OF VISITS/DURATION OF EPISODE OF CARE
Data type
string
Similar models
HIS
- StudyEvent: HIS
MTHU001399 (LOINC Version 232)
C0332162 (UMLS CUI 2011AA)
77374008 (SNOMED CT 2011_0131)
15167005 (SNOMED CT 2011_0131)
10001584 (MedDRA 14.1)
LP36309-0 (LOINC Version 232)
F10.1 (ICD-10-CM Version 2010)
305.0 (ICD-9-CM Version 2011)
42665001 (SNOMED CT 2011_0131)
MTHU015917 (LOINC Version 232)
N (HL7 V3 2006_05)
310400000X (HL7 V3 2006_05)
C0241889 (UMLS CUI-1)
MTHU027722 (LOINC Version 232)
161615003 (SNOMED CT 2011_0131)
C0262926 (UMLS CUI-1)
C0455610 (UMLS CUI-2)
10047890 (MedDRA 14.1)
LP18015-5 (LOINC Version 232)
C0005910 (UMLS CUI-1)
10037485 (MedDRA 14.1)
C0232117 (UMLS CUI-1)
10038709 (MedDRA 14.1)
MTHU008344 (LOINC Version 232)
C0231832 (UMLS CUI-1)
423666004 (SNOMED CT 2011_0131)
10030095 (MedDRA 14.1)
MTHU019803 (LOINC Version 232)
R60.9 (ICD-10-CM Version 2010)
782.3 (ICD-9-CM Version 2011)
423666004 (SNOMED CT 2011_0131)
10030095 (MedDRA 14.1)
MTHU019803 (LOINC Version 232)
R60.9 (ICD-10-CM Version 2010)
782.3 (ICD-9-CM Version 2011)
C0235439 (UMLS CUI-1)
MTHU002679 (LOINC Version 232)
423666004 (SNOMED CT 2011_0131)
10030095 (MedDRA 14.1)
MTHU019803 (LOINC Version 232)
R60.9 (ICD-10-CM Version 2010)
782.3 (ICD-9-CM Version 2011)
C0574002 (UMLS CUI-1)
10024127 (MedDRA 14.1)
C0235886 (UMLS CUI-1)
43173001 (SNOMED CT 2011_0131)
10027176 (MedDRA 14.1)
MTHU013522 (LOINC Version 232)
780.93 (ICD-9-CM Version 2011)
C0013622 (UMLS CUI-1)
C0001288 (UMLS CUI-2)
C0013622 (UMLS CUI-1)
C0012634 (UMLS CUI-2)
22253000 (SNOMED CT 2011_0131)
10033371 (MedDRA 14.1)
MTHU029813 (LOINC Version 232)
R52 (ICD-10-CM Version 2010)
338-338.9 (ICD-9-CM Version 2011)
E11167 (CTCAE 1105E)
20481000 (SNOMED CT 2011_0131)