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SPEECH THERAPY EVALUATION - HIS

- 07/06/2017 - 1 Formulaire, 3 Groupes Item, 14 Eléments de données, 2 Langues
Groupes Item: General Info, SPEECH-LANGUAGE TESTING, PLAN OF CARE
Form from HIS OpenVista

KBV Prescription of Hearing Aids Template 15

- 07/09/2017 - 1 Formulaire, 15 Groupes Item, 98 Eléments de données, 1 Langue
Groupes Item: Header, Prescription of Hearing Aids, Ear finding right, Ear finding left, acoustic impedance test, Speech hearing test, Diagnosis, Cost Estimate, Comparison Hearing aids, Device proposal, Cost Estimate, medical certificate, Insurance coverage, Receipt, Comments
Muster 15 - Ohrenärztliche Verordnung einer Hörhilfe (Freigabe 01.09.2014). Formulare für die vertragsärztliche Versorgung - Freigabe durch Dezernat 4 - Ärztliche Leistungen und Versorgungsstruktur Geschäftsbereich Sicherstellung und Versorgungsstruktur Abteilung Sicherstellung Herbert-Lewin-Platz 2 10623 Berlin Tel: + 49 (0) 30 - 4005 -1418 Fax: + 49 (0) 30 - 4005 - 271418 Email: SJohn@KBV.de Web: www.kbv.de Quelle: http://www.kbv.de/html/formulare.php --- Template 15 - Prescription of Hearing Aids (Released 09-01-2014). Released by Department 4 - Medical treatment and structure of supply, division ensurance and structure of supply, department ensurance Herbert-Lewin-Platz 2 10623 Berlin Tel: + 49 (0) 30 - 4005 -1418 Fax: + 49 (0) 30 - 4005 - 271418 Email: SJohn@KBV.de Web: www.kbv.de Source: http://www.kbv.de/html/formulare.php

SPEECH THERAPY PROGRESS NOTE - HIS

- 07/06/2017 - 1 Formulaire, 4 Groupes Item, 29 Eléments de données, 2 Langues
Groupes Item: SUBJECTIVE, OBJECTIVE, ASSESSMENT, PLAN
Form from HIS OpenVista

SPEECH THERAPY CONSULT RESULTS

- 25/07/2015 - 1 Formulaire, 11 Groupes Item, 68 Eléments de données, 2 Langues
Groupes Item: General Info, SPEECH-LANGUAGE TESTING, SPEECH THERAPY CONSULT RESULTS, PRECAUTIONS, FUNCTIONAL STATUS BEFORE ONSET, SUBJECTIVE, OBJECTIVE, BEDSIDE DYSPHAGIA EVALUATION, Speech Therapy GOALS, PROGNOSIS, S.T. PLAN
Form from HIS OpenVistA

KBV Remedy Prescription for Speech Therapy Template 14

- 27/09/2021 - 1 Formulaire, 13 Groupes Item, 79 Eléments de données, 1 Langue
Groupes Item: Header, Prescription, Remedy Prescription, Therapy, Diagnosis, Audiogram, Audiogram left, Audiogram right, Laryngological Finding, Approval, Footer, Receipt, Treatment
Muster 14 - Heilmittelverordnung Maßnahmen der Stimm-, Sprech- und Sprachtherapie (Freigabe 29.04.2016). Formulare für die vertragsärztliche Versorgung - Freigabe durch Dezernat 4 - Ärztliche Leistungen und Versorgungsstruktur Geschäftsbereich Sicherstellung und Versorgungsstruktur Abteilung Sicherstellung Herbert-Lewin-Platz 2 10623 Berlin Tel: + 49 (0) 30 - 4005 -1418 Fax: + 49 (0) 30 - 4005 - 271418 Email: SJohn@KBV.de Web: www.kbv.de Quelle: http://www.kbv.de/html/formulare.php --- Template 14 - Remedy Prescription for Speech Therapy (Released 04-29-2016). Released by Department 4 - Medical treatment and structure of supply, division ensurance and structure of supply, department ensurance Herbert-Lewin-Platz 2 10623 Berlin Tel: + 49 (0) 30 - 4005 -1418 Fax: + 49 (0) 30 - 4005 - 271418 Email: SJohn@KBV.de Web: www.kbv.de Source: http://www.kbv.de/html/formulare.php

openEHR-EHR-OBSERVATION.audiology_speech_test_result.v1

- 10/04/2018 - 1 Formulaire, 1 Groupe Item, 46 Eléments de données, 1 Langue
Groupe Item: openEHR-EHR-OBSERVATION.audiology_speech_test_result.v1.xml
http://openehr.org/ckm/ Use to record the results of audiology speech tests carried out to assess speech discrimination and speech recognition. Use to record the clinical interpretation of audiology speech tests carried out to assess speech discrimination and speech recognition.

AF MS LOGOP LSTM Sub University Hospital Muenster (UKM) Subform

- 01/12/2016 - 1 Formulaire, 1 Groupe Item, 3 Eléments de données, 1 Langue
Groupe Item: Diagnosis and question
Hospital Routine Documentation Subform at the University Hospital Muenster. Original Form name: AF MS LOGOP LSTM Sub.

openEHR-EHR-OBSERVATION.acoustic_reflex_result.v1

- 10/04/2018 - 1 Formulaire, 1 Groupe Item, 35 Eléments de données, 1 Langue
Groupe Item: openEHR-EHR-OBSERVATION.acoustic_reflex_result.v1.xml
http://openehr.org/ckm/ Use to record measurements from a single acoustic reflext test, for diagnostic or screening purposes. Ipsilateral testing, contralateral testing or both, can be recorded per test ear. Use to record the interpretation of all measurements for each single ear test configuration, and an overall interpretation (or audiological diagnosis). Acoustic reflexes measure the eardrum movement generated by the stapedius and tensor tympani reflex in response to intense sound. The acoustic reflex threshold can be helpful in checking for particular types of hearing loss in situations where patient reliability is questionable. Acoustic reflex testing can also be done as part of a battery of tests to investigate central nervous system pathology, although this usage is now uncommon.

NURSING ASSESSMENT (adult) - HIS

- 08/06/2017 - 1 Formulaire, 36 Groupes Item, 383 Eléments de données, 2 Langues
Groupes Item: Nursing Assessment, Neurological status, GLASGOW COMA SCALE, PUPILS, ORIENTATION, Cardiovascular, Eyes Ear Nose & Throat, EYES, EARS, NOSE, THROAT, Respiratory, Gastrointestinal, Genitourinary, Musculoskeletal, Skin, PRESSURE ULCER ASSESSMENT, Wound(s), INCISION(S), Nutrition, IV Therapy, Safety, Hendrich II Fall Risk Assessment, INTERVENTIONS, IMPAIRED MOBILITY RISK, ALTERED ELIMINATION, HIGH RISK FALL MEDICATIONS (ANTIEPILEPTICS & BENZODIAZEPINES), INTERVENTIONS (FOR ONCOLOGY USE ONLY), ONN Unit specific, Antepartum specific, Post partum specific, Post Surgical, ADOLESCENT INTERACTION, GERIATRIC INTERVENTION (65+), Hendrich Fall Risk, SUGGESTED INTERVENTIONS
Form from HIS OpenVista

HNO Aufnahmebogen CI MS University Hospital Muenster (UKM)

- 02/10/2016 - 1 Formulaire, 3 Groupes Item, 32 Eléments de données, 1 Langue
Groupes Item: Deafness, Preoperative diagnostics, Postoperative Procedure
Hospital Routine Documentation Form at the University Hospital Muenster. Original Form name: HNO Aufnahmebogen CI.

NURSING ASSESSMENT (pedi) - HIS

- 20/09/2021 - 1 Formulaire, 32 Groupes Item, 326 Eléments de données, 2 Langues
Groupes Item: Child Nursing Assessment, Neurological status, GLASGOW COMA SCALE ADULT, PUPILS, GLASGOW COMA SCALE CHILD, ORIENTATION, Cardiovascular, Eyes Ear Nose and Throat, EYES, EARS, NOSE, THROAT, Respiratory, Gastrointestinal, Genitourinary, Musculoskeletal, Skin, INCISION(S), Wound(s), Nutrition, IV Therapy, Safety, Pediatric Fall Risk Assessment, INTERVENTIONS, IMPAIRED MOBILITY RISK, ALTERED ELIMINATION, HIGH RISK FALL MEDICATIONS (ANTIEPILEPTICS & BENZODIAZEPINES), Hendrich II Fall Risk Assessment, ONN Unit specific, Post Surgical, ADOLESCENT INTERACTION, GERIATRIC INTERVENTION (65+)
Form from HIS OpenVista

NI Sub CDC HNO University Hospital Muenster (UKM) Subform

- 04/11/2016 - 1 Formulaire, 1 Groupe Item, 55 Eléments de données, 1 Langue
Groupe Item: Checklist ENT infections
Hospital Routine Documentation Subform at the University Hospital Muenster. Original Form name: NI Sub CDC HNO

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