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The Interview Record Released 2007 Loading Directions Prior to beginning this program it is highly recommended that you have printed copies of the Interview.

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Presentation on theme: "The Interview Record Released 2007 Loading Directions Prior to beginning this program it is highly recommended that you have printed copies of the Interview."— Presentation transcript:

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2 The Interview Record Released 2007 Loading

3 Directions Prior to beginning this program it is highly recommended that you have printed copies of the Interview Record, the Instructions and the Codes List available for review as you go through this training. Skip Directions and go to Menu

4 Directions Advance through this training program by using your mouse to click the “NEXT” button in the lower right-hand corner of each slide. Do NOT use the keyboard to advance through this training as it will cause links to work improperly. Click on any red shaded fields to see information about the shaded field. NEXT Click to continue

5 Directions To return to your previous screen, click on the green back-button in the upper right hand corner. Click on this symbol to see what impact this section might have on the interview. Watch for important “Special Note” boxes throughout the program. NEXT Special Note: ….

6 Directions To close this program press the ESCAPE or ESC key on your keyboard. NEXT

7 Goals of Interview Record: To improve the quality of information gathered in order to enhance disease intervention efforts. To incorporate standardized variables for improved data collection and analysis of patient behaviors. To provide a single standardized form for the management of STD and HIV cases. NEXT

8 Benefits of the 2007 Interview Record Reduces the number of case management forms by incorporating the Original Patient Information Sheet into the Interview Record. Improves HIV/AIDS case management through more comprehensive data collection and analysis. Ensures complete and consistent gathering of case information for improved intervention outcomes. NEXT

9 Benefits of the 2007 Interview Record Dedicated area for interviewer comments. Devoted spaces for DIS’ case management plans and supervisor’s comments. Updated variables to better relate to current trends in STD/HIV cases. NEXT

10 PAGE 1 PAGE 2PAGE 3 PAGE 4PAGE 5PAGE 6 Menu ? F A Q s Click on any PAGE to begin.

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14 Fields located on the right-hand side of page 1 help locate a specific record when more then one case is filed in the same Lot.

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18 The Patient ID Document the patient ID number for this person Special Note: The Patient ID will be a locally generated identification number. It may be the patient’s medical record number or clinic number. Each program will determine what will be used for this field.

19 Conditions Document the specific code(s) for the condition(s), or diseases, interviewed and/or diagnosed Special Note 2: Space is provided for two conditions to be documented should the patient being interviewed be diagnosed with two infections Special Note 1: Codes for the Condition(s) field, as well as all other codes fields, can be found on Codes List.

20 Neurological Involvement: Document the appropriate response: Yes – Confirmed, Yes – Probable, No, or Unknown

21 Case ID Document the case ID number for the corresponding conditions Special Note: Case IDs or numbers will continue to be determined and assigned by local programs.

22 Lot # Locally assigned number utilized by the Lot System in order to group related cases for better case management. Special Note: Related cases should share the same Lot Number.

23 Interview Record ID Document the interview record number for this case. Special Note: This is frequently used by computer systems for linking cases within a database.

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26 Name Document the patient’s last, first and middle names, including known aliases or nicknames

27 Address List complete address where the patient currently resides. Make sure to include apartment number, city county, state and zip code Special Note: If currently institutionalized (jail, group home, mental health facility, etc) do not document the address unless the condition was acquired there

28 Living With Document the relationship(s) of those living with the patient. (spouse, sibling, roommate, parents, etc.) Special Note: The names of those identified in this area should be documented in the Interview Comments section on page 5.

29 Residence Type List appropriate code for type of residence for the address listed above

30 Time At Address Document the length of time the patient has lived at the current address in (w) weeks, (m) months, or (y) years Special Note: If the patient has lived at more than one location during the Interview Period, other addresses are to be documented in the Interview/Investigation Comments section of the Interview Record.

31 Currently Institutionalized? Mark appropriate box, Y-yes, N-No, U- Unknown. List the name of the facility and type of institution

32 Phone/Contact List all phone numbers where the patient might be reached including any addresses. Include emergency contact name, phone number and relationship to patient

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35 Date of Birth Document the patient’s date of birth Age Document the patient’s age at the time of initial exam for the earliest condition reported on this interview record. Document ‘0' if age is less than one year or ’999' if unknown.

36 Sex at Birth and Current Gender Indicate the patient’s gender at birth as well as what gender the patient currently identifies him/herself

37 Marital Status Mark appropriate box indicating martial status at the time of the interview or morbidity report

38 Hispanic or Latino Mark appropriate box to identify the ethnic group the patient self identifies

39 Race Mark as many boxes as applicable which the patient self identifies

40 English Speaking? Mark the appropriate box to indicate if the patient can speak/understand English. Document the patient’s primary language if it is not English

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43 Pregnant at Exam Mark appropriate box to indicate the patient’s pregnancy status at initial exam. If the patient was pregnant at the time of the initial exam document duration of pregnancy in weeks. Special Note: If the patient’s condition is syphilis and she answers ‘Yes’ to this question, complete the Congenital Syphilis Form according to local practices/procedures.

44 Pregnant at Interview Mark appropriate box to indicate the patient’s pregnancy status at the time of Interview. If the patient was pregnant at the time of the interview, document the duration of the pregnancy in weeks at interview. If the duration of the pregnancy is not known, document the patient’s best estimate. Special Note: If the patient’s condition is syphilis and she answers ‘Yes’ to this question, complete the Congenital Syphilis Form according to local practices/procedures.

45 Currently in Prenatal Care? Mark appropriate box to indicate whether the patient is receiving/received prenatal care for this pregnancy.

46 Pregnant in the Past 12 Months Determine if the patient has been pregnant during the last 12 months and place an “X” in the appropriate box. Special Note: If currently pregnant, a “Yes” answer indicates that the patient had another pregnancy within the past 12 months, not including her current pregnancy.

47 Pregnancy Outcome If pregnant in the last 12 months, place an “X” in the appropriate box to indicate the outcome of that pregnancy.

48 Page 1 Special Note: For patients with two conditions, space is provided to document key information about each condition. Condition 1 Condition 2 NEXT Condition 1 Condition 2

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52 Method of Case Detection For each condition, use the appropriate code from the code list to document how the patient first came to the attention of the health department.

53 OP Condition If Patient Referred Partner, Health Department Referred Partner, or Cluster Related is selected as Method of Case Detection, indicate the Index patient’s Condition Code (i.e., 710, 720, etc.) and Case ID Number in the space provided if known.

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56 Type Facility First Tested Document the specific type of facility code where the patient was first tested for each condition.

57 Date of Laboratory Report Document the date that the first laboratory report related to each condition was received. Special Note: If subsequent lab results are available, they should be documented on page 3 in the STD Testing section.

58 Interviewed? Mark appropriate box if patient was not interviewed and document the specific reason why.

59 Interviewed Period Record the Interview Period in whole months. If the Interview Period used had a part of a month (Primary Syphilis – 4 months and 1 week) round UP to the next full month.

60 Place of Interview Mark specific location code where the interview took place for each condition

61 PEMS ID Document the PEMS site ID of the location of the original interview. Special Note: This field is for HIV/AIDS cases only

62 Date First Assigned for Interview Mark the date the case was initially assigned for interview and the worker number of the DIS to whom it was assigned for each condition

63 Date Reassigned for Interview If the case is reassigned to another DIS, indicate the date the case was reassigned for interview and the worker number of the new DIS to whom it was reassigned.

64 Date Original Interview Document the date of the initial interview and the worker number of the DIS that performed the interview for each condition

65 Date First Re-Interview Document the date for the first re-interview and the worker number of the DIS that performed the re-interview for each condition Special Note: ALL re-interview should also be documented on page 4 with the names of the partners and suspect initiated during each re-interview. If no partners or suspects were initiated, NCI (for No Contacts Initiated) should be written in the field for Name.

66 Date Case Closed Document the date of case closure along with the worker numbers of the investigating DIS and Supervisor

67 Imported Case Place an “X” in the appropriate box imported case refers to a case that was acquired outside the jurisdiction where the patient resides. If the case was imported, list city, county, state, and/or country Special Note: An example might be a primary case of syphilis who moved to the area just two weeks ago.

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69 Local Use Area provided for special data collection needs of individual program areas NEXT

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71 Risk Factors - Sexual Behaviors Document the appropriate response for each question NEXT

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73 Risk Factors - Drug Use Behaviors List the appropriate response for each question NEXT

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75 Other Risk Factors List the appropriate response NEXT

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77 Test Results Summarize all STD lab results relevant to this case in chronological order including the provider and specimen source. Special Note: HIV testing is NOT documented here. NEXT

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80 Tested for HIV at this event? Place an “X” in the appropriate box indicating if the patient was tested for HIV at the time of the initial screening that led to this reported condition(s)

81 Previously Tested for HIV? Place an “X” in the appropriate box if the patient has tested for HIV prior to the event that led to the Original Interview

82 HIV Test Results Current and previous HIV testing information is to be documented here.

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84 Signs and Symptoms List all symptoms experienced by the patient and observed by the clinician Include the date signs and symptoms began and anatomical site(s) NEXT

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86 STD History Place an “X” in the appropriate box If yes, document the condition code, diagnosis and treatment date NEXT Special Note: HIV testing history should not be documented here.

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89 Treatment Document all relevant treatment regimen(s) including the date, provider, drug and dosage

90 Incidental Antibiotics Treatment in Last 12 Months Place an “X” in the appropriate box and list the date, drug, dosage, duration and condition for which the antibiotic was prescribed.

91 Anti-Retroviral Therapy for Diagnosed HIV Infection? Indicate therapy in the past 12 months in the appropriate box then indicate if the patient ever had anti- retroviral therapy

92 HIV Counseling at this event? Place an “X” in the appropriate boxes for Pre and Post Test Counseled

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95 Place Met Partners Document the codes for the types of places where the patient met sex partners List names or descriptions of places the patient goes to meet sex partners

96 Places had Sex Document the codes and descriptions for the types of places where the patient had sex with partners

97 Partners in the Last 12 Months Document the number of female, male, and transgender partners claimed by the patient Special Note: This includes initiated partners, marginal partners, and anonymous partners. Select ‘unknown’ if patient is unsure or ‘refused’ if the patient would not answer the question. Document “0” if there are no partners for corresponding gender field.

98 Interview Period Partners Document the total number (includes initiated partners, marginal partners, and anonymous partners) of female, male, and transgender sex partners claimed during the established Interview Period

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100 Partner/Custer Information Space is provided to document information on up to 5 Partners and/or Clusters who are initiated. NEXT Special Note 2: Marginal Partners (those partners with insufficient information to initiate) should NOT be documented here. Space for Marginal Partners is provided on Page 5. Special Note 1: If more than 5 partners, suspects or associates are initiated, another copy of Page 4 should be used.

101 NEXT Contact Initiated from Original Interview Suspect Initiated from Original Interview Associate Initiated from Cluster Interview Contact Initiated from Re-Interview Special Note: Along with partners and suspects initiated from the Original Interview, Re-interview and cluster activities should be documented (each in a separate section). Special Note: Clusters must be identified specifically during an interview activity (Original Interview, Re-interview, or Cluster Interview). Those identified from field screenings or other screening events should not be initiated as clusters.

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104 Name Document the Last and First name, including aliases, if known

105 Jurisdiction Document the county, state or county code or name for where the partner/cluster resides

106 P/CI Document the appropriate identifier code for type of Partner or Cluster

107 Exposure to Original Patient Document the date of the first and last sexual/needle-sharing exposure and frequency to the index patient.

108 Sex of the Partner or Cluster Place an “X” in the appropriate box to indicate the gender of partner or cluster as identified by the person being interviewed

109 Pregnant Document if this partner/cluster is identified as being pregnant

110 Spouse Document if this partner/cluster is the Index patient’s spouse

111 IX Date Document the date the original interview, re- interview or cluster interview was performed Special Note: Information documented in this section for Condition 1 and Condition 2 should correspond with Condition 1 and Condition 2 from Page 1.

112 Init. Date (Initiation Date) Document the date this partner/cluster was initiated for field investigation

113 IX DIS (Interview DIS) Document the worker number of the DIS who conducted the interview for each condition

114 IX Type (Interview Type) Document the type of interview that was the source of the partner/cluster information

115 Referral Indicate how initiated partners and clusters are brought to examination and/or treatment.

116 FR # (Field Record Number) Document the entire field record number(s) for the partner/cluster initiated. The number may be generated by a software system

117 Dispo (Disposition) Document the STD or HIV disposition code from the field record for each condition Dispo Date (Disposition Date) Document the appropriate date as it relates to the examination or treatment situation for each condition

118 Cond (Condition) If partner/cluster is dispositioned as infected, previously or currently, document the diagnosis code for the condition

119 DIS # Document the worker number of the DIS who brought this partner or cluster to disposition for each condition

120 SO/SP (Source/Spread) Document “SO” for source of condition for the index patient or “SP” for spread from the index partner Special Note 1: Source or spread should only be documented for infected partners. Special Note 2: If partner condition is not related to the Index patient, document “U” (Unrelated) in the box. If it is unknown whether a partner condition is related to the Index patient, document “UN” (Unknown) in the box. Do not mark a box if adetermination has not been made.

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122 Marginal Partners Document the name, sex, age, race, height, weight, hair (description) exposure history, and location information for those partners named by the index patient with limited information to initiate NEXT

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124 Interview/Investigation Comments Document any additional information not included in the interview record, such as the attitude of the patient and/or note any inconsistencies during the interview NEXT

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126 Travel History and Internet Use Document travel that occurred within the interview period, include place, dates, reason for travel and companions. Also document any related internet use information such as addresses and user names NEXT

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128 Date Submitted Document the appropriate date when the DIS submitted the Interview Record for initial review to supervisor Initial Review Date Document the appropriate date when the DIS Supervisor initially reviewed the Interview Record NEXT

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130 DIS Investigation Plans Record future planned actions including worker number and date. Each plan of action by the DIS and/or response to supervisory comments should be dated and documented. NEXT

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132 Supervisory Comments The initial review and subsequent reviews by the supervisor and/or response to DIS comment(s) should be dated and documented NEXT

133 Congratulations! You have completed the training for the 2007 version of the Interview Record. We recommend that you keep a copy of the Instructions and Codes readily available for quick reference. Return to Menu or press Esc to end

134  INTERVIEW IMPACT  Interview Format Introduction Patient Assessment Disease Intervention Behaviors Conclusion During the Partner Elicitation portion of the interview DIS should begin by asking a broad question such as “How many partners have you had since you began having sex?”. After obtaining an estimated number, the DIS should then ask the patient for the number of partners the patient had in the last 12 months and what gender they were. The DIS then should ask for the number of partners the patient had during the predetermined Interview Period.

135  INTERVIEW IMPACT  Interview Format Introduction Patient Assessment Disease Intervention Behaviors Conclusion When discussing who the OP lives with in the Patient Assessment section of the interview, note the names and relationships given by the OP and pursue initiating them during the Partner/Cluster Elicitation portion of the Disease Intervention section of the Interview. Keep in mind that these may be sex partners, suspects, or, at very least, good candidates for Cluster Interviews to obtain more information about the OP.

136  INTERVIEW IMPACT  Interview Format Introduction Patient Assessment Disease Intervention Behaviors Conclusion During the Medical portion of the Patient Assessment section, DIS should routinely discuss medical procedures that have changed the patient’s gender.

137  INTERVIEW IMPACT  Interview Format Introduction Patient Assessment Disease Intervention Behaviors Conclusion During the Patient Assessment section, DIS should discuss the behaviors noted on Page 2 of the Interview Record and take note as to whether the patient was involved in these behaviors in the last 3 months as well as in the last 12 months.

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