46 Telehealth Section

SpecWriter Data

Form Version:

6/26/2023 10:45:45 AM

Report Type:

Full Detail

Project Database:
Language:

English

WESSQL300.MEPSSpring2024

Spec Label:

This is the cover page. Additional contents currently project specific.

TH - Page 1 of 28

MEPSSpring2024

Telehealth (TH) Section
(Rout

Full Detail Spec
BOX_00

Route Details:

(TH1000)

Item Type: Route

Type Class: If Then

01 Box = BOX_00, BOX_10, BOX_20, BOX_30, BOX_40, BOX_50, BOX_60, BOX_
70, BOX_80
04 Single Select = TH10, TH20, TH30, TH40, TH50, TH60, TH70, TH80, TH100, TH120
05 Single Select with Display Roster = TH130
11 Multiple Select with Add/Edit/Delete = TH90, TH110
20 OS Text Field = TH10OS
23 Text Field = TH150
28 Trigram Lookup = TH30LU
30 Multiple Select with Fill in Answer Text and Display Roster = TH140
Roster 2 = TH140
Roster 3 = TH90, TH110

BOX_10

(TH1005)

Item Type: Route

Type Class: If Then

Context Header:

Context Header Display Instructions:
SEE CONTEXT HEADER SPEC

Route Details:

If provider is flagged as facility provider, also display doctor or department linked to this
facility provider for this event (if available).
Continue with TH10.

TH - Page 2 of 28

MEPSSpring2024

Telehealth (TH) Section
(Ques

Full Detail Spec
TH10
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:

(TH1010)
Question
Enumerated
TVisitType

BLAISE NAME: VisitType
Field kind: Datafield

ArrayMin:

Min value:

Field Size:
Answers allowed: 1

ArrayMax:

Max value:

)

Show Card (

)

Look Up File (

)

{PERSON'S FIRST MIDDLE AND LAST NAME} {EVN-DT} {NAME OF MEDICAL
CARE PROVIDER}-{DOC OR DEPT}

Question Text:
Was {your/{PERSON}’s} visit to {PROVIDER} over the phone, through real-time video, or some other way?

Responses:

PHONE
VIDEO
SOME OTHER WAY
REFUSED
DON'T KNOW

1
2
3
RF
DK

BOX_20
BOX_20
TH10OS
BOX_20
BOX_20

(TH1020)
(TH1020)
(TH1015)
(TH1020)
(TH1020)

Display
Instructions:

BLAISE NAME: VisitTypeOS
Field kind: Datafield
ArrayMin:

TH10OS
Item Type:

(TH1015)
Question

Type Class:

String

Answer Type:

{Continuous Answer.} Answers allowed: 1

Help Available (
Context Header:

)

Min value:

Field Size: 1000

Show Card (

ArrayMax:

Max value:

)

Look Up File (

{PERSON'S FIRST MIDDLE AND LAST NAME} {EVN-DT} {NAME OF MEDICAL
CARE PROVIDER}-{DOC OR DEPT}

Question Text:
SPECIFY:

Responses:
REFUSED
DON'T KNOW

1

BOX_20

(TH1020)

RF
DK

BOX_20
BOX_20

(TH1020)
(TH1020)

TH - Page 3 of 28

)

MEPSSpring2024

Telehealth (TH) Section
(Ques

Full Detail Spec
Programmer
Instructions:

Go to Box_20.

Display
Instructions:

BOX_20

Route Details:

(TH1020)

Item Type: Route

Type Class: If Then

If a provider is flagged as a person-provider and TH20 has already been asked for this
person-provider in this round (for any RU member), auto-code TH20 with the response that
was coded when it was first looped on and go to BOX_30.
Otherwise, continue with TH20.

TH20
Item Type:

(TH1025)
Question

Type Class:

Enumerated

Answer Type:

TYESNO

Help Available (MDDOTypes)
Context Header:

BLAISE NAME: THSeeDoc
Field kind: Datafield

ArrayMin:

Min value:

ArrayMax:

Max value:

Field Size:
Answers allowed: 1

Show Card (

)

Look Up File (

)

{PERSON'S FIRST MIDDLE AND LAST NAME} {EVN-DT} {NAME OF MEDICAL
CARE PROVIDER}-{DOC OR DEPT}

Question Text:
{Is {PROVIDER} a medical doctor?/Did {you/{PERSON}} {talk to/have contact with}a medical doctor during
this particular visit?}
HELP: F1

Responses:

YES
NO
REFUSED
DON'T KNOW

1
2
RF
DK

TH - Page 4 of 28

MEPSSpring2024

Telehealth (TH) Section
(Ques

Full Detail Spec
Programmer
Instructions:

Display
Instructions:

If TH20 is coded ‘1’ (YES) and provider associated with event is a facility-provider, go to
TH30.
If TH20 is coded ‘2’ (NO), ‘RF’ or ‘DK’ and provider associated with event is a facilityprovider, go to TH40.
Otherwise, continue with BOX_30.

Display ‘Is {PROVIDER} a medical doctor?’ if provider linked to this event is flagged as a
‘person- provider’. Otherwise, display ‘Did {you/{PERSON}} {talk to/have contact with} a
medical doctor during this particular visit?’
Display ‘talk to’ if TH10 is coded ‘1’ (PHONE) or ‘2’ (VIDEO). Otherwise, display ‘have
contact with’.

BOX_30

Route Details:

(TH1030)

Item Type: Route

Type Class: If Then

If TH20 is coded ‘1’ (YES) and provider associated with event is a person-provider, and
person-provider already has TH30/30LU (specialty) recorded this round (for any RU
member) or in a previous round (for any RU member) (set THDocSpecFlag), OR
If TH20 is coded ‘2’ (NO), ‘DK’, or ‘RF’ and provider associated with event is a personprovider, and person-provider already has TH40 (provider type) recorded this round (for
any RU member) or in a previous round (for any RU member) (set THMedType Flag), go
to BOX_40.
If TH20 is coded ‘1’ (YES) and provider associated with event is a person-provider, and
person-provider does NOT already have TH30/30LU (specialty) recorded this round (for
any RU member) or in a previous round (for any RU member), go to TH30 (set
THDocSpecFlag).
If TH20 is coded ‘2’ (NO), ‘DK’, or ‘RF’ and provider associated with event is a personprovider, and person-provider does NOT already have TH40 (provider type) recorded this
round (for any RU member) or in a previous round (for any RU member), go to TH40 (set
THMedTypeFlag).

TH - Page 5 of 28

MEPSSpring2024

Telehealth (TH) Section
(Ques

Full Detail Spec
TH30
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:

(TH1035)
Question
Enumerated

BLAISE NAME: THDocSpeclty
Field kind: Datafield

Field Size:
TDRSPLTY_TH_RE Answers allowed: 1
)

ArrayMin:

Min value:

ArrayMax:

Max value:

Show Card (TH-1)

Look Up File (

{PERSON'S FIRST MIDDLE AND LAST NAME} {EVN-DT} {NAME OF MEDICAL
CARE PROVIDER}-{DOC OR DEPT}

Question Text:
 TH-1
Looking at card TH-1, what was the doctor's specialty?
IF TALKED TO MORE THAN ONE DOCTOR, PROBE FOR MAIN PROVIDER.

Responses:

ALLERGY/IMMUNOLOGY
CARDIOLOGY (HEART)
DERMATOLOGY (SKIN)
ENDOCRINOLOGY/METABOLISM
(DIABETES, THYROID)
FAMILY PRACTICE
GASTROENTEROLOGY
GENERAL PRACTICE
GENERAL SURGERY
GYNECOLOGY/OBSTETRICS
INTERNAL MEDICINE (INTERNIST)
NEPHROLOGY (KIDNEYS)
NEUROLOGY
ONCOLOGY (TUMORS, CANCER)
OPHTHALMOLOGY (EYES)
ORTHOPEDICS
OTORHINOLARYNGOLOGY (EAR, NOSE,
THROAT)
PEDIATRICIAN
PSYCHIATRY/PSYCHIATRIST
UROLOGY
OTHER DR SPECIALTY
REFUSED
DON'T KNOW

1
3
4
5
6
7
8
9
11
14
15
16
18
19
20
22
24
28
33
91
RF
DK

TH - Page 6 of 28

)

MEPSSpring2024
Full Detail Spec
Programmer
Instructions:

Telehealth (TH) Section
(Ques

If coded ‘91’ (OTHER DR SPECIALTY), go to TH30LU.
Otherwise, go to BOX_40.

Display
Instructions:

TH - Page 7 of 28

MEPSSpring2024

Telehealth (TH) Section
(Ques

Full Detail Spec
TH30LU
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:

(TH1040)
Question
Enumerated

BLAISE NAME: THDocSpecltyLU

TDRSPLTY
)

Field kind: Datafield

ArrayMin:

Min value:

Field Size:
Answers allowed: 1

ArrayMax:

Max value:

Show Card (

)

Look Up File (

{PERSON'S FIRST MIDDLE AND LAST NAME} {EVN-DT} {NAME OF MEDICAL
CARE PROVIDER}-{DOC OR DEPT}

Question Text:
ENTER OTHER DOCTOR SPECIALTY.
TYPE THE FIRST 3 LETTERS OF THE SPECIALTY, THEN USE ARROW KEYS IF NEEDED TO LOCATE
SPECIALTY, AND PRESS ENTER TO SELECT.

Responses:

ALLERGY/IMMUNOLOGY
ANESTHESIOLOGY
CARDIOLOGY (HEART)
DERMATOLOGY (SKIN)
ENDOCRINOLOGY/METABOLISM
(DIABETES, THYROID)
FAMILY PRACTICE
GASTROENTEROLOGY
GENERAL PRACTICE
GENERAL SURGERY
GERIATRICS (ELDERLY)
GYNECOLOGY/OBSTETRICS
HEMATOLOGY (BLOOD)
HOSPITAL RESIDENCE
INTERNAL MEDICINE (INTERNIST)
NEPHROLOGY (KIDNEYS)
NEUROLOGY
NUCLEAR MEDICINE
ONCOLOGY (TUMORS, CANCER)
OPHTHALMOLOGY (EYES)
ORTHOPEDICS
OSTEOPATHY (DO)
OTORHINOLARYNGOLOGY (EAR, NOSE,
THROAT)
PATHOLOGY
PEDIATRICIAN
PHYSICAL MEDICINE/REHAB
PLASTIC SURGERY
PROCTOLOGY
PSYCHIATRY/PSYCHIATRIST
PULMONARY

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29

TH - Page 8 of 28

)

MEPSSpring2024

Telehealth (TH) Section
(Ques

Full Detail Spec

RADIOLOGY
RHEUMATOLOGY (ARTHRITIS)
THORACIC SURGERY (CHEST)
UROLOGY
OTHER DR SPECIALTY
REFUSED
DON'T KNOW
Programmer
Instructions:

30
31
32
33
91
RF
DK

Go to BOX_40.
Responses listed are part of the provider specialty look-up file that works similar to a trigram
search.
Browser window should be labeled “SELECT SPECIALTY”.
Response code numbers should be stored behind the scenes and not visible in the look-up
window.

Display
Instructions:

TH - Page 9 of 28

MEPSSpring2024

Telehealth (TH) Section
(Ques

Full Detail Spec
TH40
Item Type:
Type Class:
Answer Type:

(TH1045)
Question
Enumerated
TTHMEDPER

Help Available (MPTpHelp)
Context Header:

BLAISE NAME: THMPTp
Field kind: Datafield

ArrayMin:

Min value:

Field Size:
Answers allowed: 1

ArrayMax:

Max value:

Show Card (TH-2)

Look Up File (

)

{PERSON’S FIRST MIDDLE AND LAST NAME} {EVN-DT} {NAME OF MEDICAL
CARE PROVIDER} - {DOC OR DEPT}

Question Text:
 TH-2
Looking at card TH-2, what type of medical person did {you/{PERSON}} {talk to/have contact with} on {VISIT
DATE}?
IF TALKED TO MORE THAN ONE MEDICAL PERSON, PROBE FOR MAIN PROVIDER.
HELP: F1

Responses:

ACUPUNCTURIST
CHIROPRACTOR
DENTIST/DENTAL CARE PERSON
HOMEOPATHIC/NATUROPATHIC/HERBA
LIST/OTHER
ALTERNATIVE/COMPLEMENTARY
CARE PROVIDER
MASSAGE THERAPIST
MENTAL HEALTH
COUNSELOR/MARITAL OR FAMILY
THERAPIST
MIDWIFE
NURSE/NURSE PRACTITIONER
OPTOMETRIST
PHYSICAL/OCCUPATIONAL THERAPIST
PHYSICIAN ASSISTANT
PODIATRIST
PSYCHOLOGIST
SOCIAL WORKER
TECHNICIAN
OTHER
REFUSED
DON'T KNOW

1
2
3
4

5
6

7
8
9
10
11
12
13
14
15
91
RF
DK

TH - Page 10 of 28

MEPSSpring2024

Telehealth (TH) Section
(Ques

Full Detail Spec
Programmer
Instructions:
Display
Instructions:

BOX_40

Route Details:

Go to BOX_40.

Display ‘talk to’ if TH10 is coded ‘1’ (PHONE) or ‘2’ (VIDEO).
Otherwise, display ‘have contact with’.

(TH1050)

Item Type: Route

Type Class: If Then

IF TH20 IS CODED '1' (YES), GO TO BOX_50.

If TH20 is coded ‘2’ (NO), ‘RF’ or ‘DK’ and (TH20 was coded ‘1’ (YES) or TH50 was
coded ‘1’ (YES) for this provider in this round for any RU member), auto code TH50 for
this event as ‘1’ (YES) and go to BOX_50.

If TH20 is coded ‘2’ (NO), ‘RF’ or ‘DK’ and TH50 was coded ‘2’ (NO), ‘RF’ OR ‘DK’ for
this provider in this round for any RU member, auto code TH50 for this event with the
same response (NO, RF, DK) and go to BOX_50.

OTHERWISE, CONTINUE WITH TH50.

TH - Page 11 of 28

MEPSSpring2024

Telehealth (TH) Section
(Ques

Full Detail Spec
TH50
Item Type:
Type Class:
Answer Type:

(TH1055)
Question
Enumerated
TYESNO

Help Available (MDDOTypes)
Context Header:

BLAISE NAME: THDocLoctn
Field kind: Datafield

ArrayMin:

Min value:

Field Size:
Answers allowed: 1

ArrayMax:

Max value:

Show Card (

)

Look Up File (

)

{PERSON’S FIRST MIDDLE AND LAST NAME} {EVN-DT} {NAME OF MEDICAL
CARE PROVIDER} - {DOC OR DEPT}

Question Text:
TYPE OF PERSON HAD CONTACT: {MEDICAL PERSON TYPE FROM TH40}
CODE WITHOUT ASKING IF OBVIOUS. OTHERWISE, ASK:
Do any medical doctors work at {the same location as {PROVIDER}/{PROVIDER}}?
HELP: F1

Responses:

YES
NO
REFUSED
DON'T KNOW

1
2
RF
DK

TH - Page 12 of 28

BOX_50
BOX_50
BOX_50
BOX_50

(TH1060)
(TH1060)
(TH1060)
(TH1060)

MEPSSpring2024

Telehealth (TH) Section
(Ques

Full Detail Spec
Programmer
Instructions:
Display
Instructions:

Go to BOX_50.

Display ‘the same location as {PROVIDER}’ if provider is flagged as
‘PERSON-TYPE-PROVIDER’. Display ‘{PROVIDER}’ if provider is flagged as
‘FACILITY- PROVIDER’.
For ‘MEDICAL PERSON TYPE FROM TH40’, display the following text for each code
selected at TH40 (regardless if TH40 was collected for this RU member or in a previous
round) (Provider.MPTp):
Code ‘1’= ACUPUNCTURIST
Code ‘2’ = CHIROPRACTOR
Code ‘3’ = DENTIST/DENTAL CARE PERSON
Code ‘4’= HOMEOPATHIC/NATUROPATHIC/HERBALIST/ OTHER
ALTERNATIVE/COMPLEMENTARY CARE PROVIDER
Code ‘5’= MASSAGE THERAPIST
Code ‘6’= MENTAL HEALTH COUNSELOR/MARITAL OR FAMILY THERAPIST
Code ‘7’ = MIDWIFE
Code ‘8’ = NURSE/NURSE PRACTITIONER
Code ‘9’ = OPTOMETRIST
Code ‘10’ = PHYSICAL/OCCUPATIONAL THERAPIST
Code ‘11’ = PHYSICIAN ASSISTANT
Code ‘12’ = PODIATRIST
Code ‘13’= PSYCHOLOGIST
Code ‘14’= SOCIAL WORKER
Code ‘15’= TECHNICIAN
Code ‘91’= OTHER
Code ‘RF’= REFUSED PROVIDER TYPE
Code ‘DK’= DON’T KNOW PROVIDER TYPE

BOX_50

Route Details:

(TH1060)

Item Type: Route

Type Class: If Then

If TH60 has already been asked for this provider in this round (for any RU member), autocode TH60 with the response that was coded when it was first looped on and go to TH70.
Note: If provider is a facility provider, check all events to the same facility provider
regardless of the doctor or department linked to the specific events.
Otherwise, continue with TH60.

TH - Page 13 of 28

MEPSSpring2024

Telehealth (TH) Section
(Ques

Full Detail Spec
TH60
Item Type:
Type Class:
Answer Type:

(TH1065)
Question
Enumerated
TYESNO

Help Available (MDDOTypes)
Context Header:

BLAISE NAME: HospOprtd
Field kind: Datafield

ArrayMin:

Min value:

Field Size:
Answers allowed: 1

ArrayMax:

Max value:

Show Card (

)

Look Up File (

)

{PERSON’S FIRST MIDDLE AND LAST NAME} {EVN-DT} {NAME OF MEDICAL
CARE PROVIDER} - {DOC OR DEPT}

Question Text:
Is {the place where} {PROVIDER} {works} owned or operated by a hospital?
HELP: F1

Responses:

YES
NO
REFUSED
DON'T KNOW

Programmer
Instructions:

Go to TH70.

Display
Instructions:

1
2
RF
DK

TH70
TH70
TH70
TH70

(TH1070)
(TH1070)
(TH1070)
(TH1070)

Display ‘the place where’ and ‘works’ if provider is flagged as a person-provider. Otherwise,
use a null display.

TH - Page 14 of 28

MEPSSpring2024

Telehealth (TH) Section
(Ques

Full Detail Spec
TH70
Item Type:
Type Class:
Answer Type:

(TH1070)
Question
Enumerated
TVSTCTGRY

Help Available (VSTCTGRYHelp
Context Header:

BLAISE NAME: THVstCat
Field kind: Datafield

ArrayMin:

Min value:

Field Size:
Answers allowed: 1

ArrayMax:

Max value:

Show Card (TH-3)

Look Up File (

)

{PERSON’S FIRST MIDDLE AND LAST NAME} {EVN-DT} {NAME OF MEDICAL
CARE PROVIDER} - {DOC OR DEPT}

Question Text:
 TH-3
Please look at card TH-3 and tell me which category best describes the care {you/{PERSON}} received on
{VISIT DATE}.
HELP: F1

Responses:

Display
Instructions:

GENERAL CHECKUP
DIAGNOSIS OR TREATMENT
EMERGENCY (E.G., ACCIDENT OR
INJURY)
PSYCHOTHERAPY OR MENTAL HEALTH
COUNSELING
FOLLOW-UP OR POST-OPERATIVE VISIT
IMMUNIZATIONS OR SHOTS
VISION EXAM
{PREGNANCY-RELATED (INCLUDING
PRENATAL CARE AND DELIVERY)}
{WELL CHILD EXAM}
LASER EYE SURGERY
OTHER
REFUSED
DON'T KNOW

1
2
3

TH80
TH80
TH80

(TH1075)
(TH1075)
(TH1075)

4

TH80

(TH1075)

5
6
7
8

TH80
TH80
TH80
TH80

(TH1075)
(TH1075)
(TH1075)
(TH1075)

9
10
91
RF
DK

TH80
TH80
TH80
TH80
TH80

(TH1075)
(TH1075)
(TH1075)
(TH1075)
(TH1075)

Display response option ‘8’ (PREGNANCY-RELATED (INCLUDING PRENATAL CARE
AND DELIVERY)) if person is female and age 15 to 55 inclusive (or age categories 3 to 8).
Otherwise, use a null display.
Display response option ‘9’ (WELL CHILD EXAM) if PERSON IS < 7 YEARS OLD (OR
AGE CATEGORIES 1 THROUGH 3). Otherwise, use a null display.

TH - Page 15 of 28

MEPSSpring2024

Telehealth (TH) Section
(Ques

Full Detail Spec
TH80
Item Type:
Type Class:
Answer Type:

(TH1075)
Question
Enumerated
TYESNO

Help Available (CondHelp)
Context Header:

BLAISE NAME: THSpecCond
Field kind: Datafield

ArrayMin:

Min value:

Field Size:
Answers allowed: 1

ArrayMax:

Max value:

Show Card (

)

Look Up File (

)

{PERSON’S FIRST MIDDLE AND LAST NAME} {EVN-DT} {NAME OF MEDICAL
CARE PROVIDER} - {DOC OR DEPT}

Question Text:
{Other than {your/his/her} {general checkup/well child exam}, was/Was} this {call/contact} related to any
specific health condition or were any conditions discovered during this {call/contact}?
HELP:F1

Responses:

Display
Instructions:

YES
NO
REFUSED
DON'T KNOW

1
2
RF
DK

TH90
TH100
TH100
TH100

(TH1080)
(TH1085)
(TH1085)
(TH1085)

Display ‘Other than {your/his/her} {general checkup/well child exam}, was’ if TH70 was
coded ‘1’ (GENERAL CHECKUP) OR ‘9’ (WELL CHILD EXAM). Otherwise, display
‘Was’.
Display ‘general checkup’ if TH70 was coded ‘1’ (GENERAL CHECKUP). Display ‘well
child exam’ if TH70 was coded ‘9’ (WELL CHILD EXAM).
Display ‘call’ if TH10 is coded ‘1’ (PHONE). Otherwise, display ‘contact’.

TH - Page 16 of 28

MEPSSpring2024

Telehealth (TH) Section
(Ques

Full Detail Spec
TH90
Item Type:
Type Class:
Answer Type:

(TH1080)
Question
Enumerated
TCONDITION

BLAISE NAME: THCondRoster
Field kind: Datafield

Field Size:
Answers allowed: 99 ArrayMax:

Help Available (CondHelp)
Context Header:

ArrayMin:

Show Card (

Min value:
Max value:

)

Look Up File (

)

{PERSON’S FIRST MIDDLE AND LAST NAME} {EVN-DT} {NAME OF MEDICAL
CARE PROVIDER} - {DOC OR DEPT}

Question Text:
What conditions were discovered or led {you/{PERSON}} to make this {call/contact}?
PROBE: Any other condition?
ENTER ALL THAT APPLY.
CTRL-A: ADD
CTRL-E: EDIT
CTRL-D: DELETE
HELP:F1

Responses:

{MEDICAL CONDITION} 1
{MEDICAL CONDITION} 2
{MEDICAL CONDITION} 3
{MEDICAL CONDITION} 4
{MEDICAL CONDITION}N

1
2
3
4
5

TH - Page 17 of 28

MEPSSpring2024

Telehealth (TH) Section
(Ques

Full Detail Spec
Programmer
Instructions:

Go to TH100.
Roster behavior:
1. Multiple select allowed.
2. Multiple add allowed.
3. Limited delete allowed. Interviewer may delete a condition added at this item until CAPI
creates the link between this condition and the event. The link is created when the collection
of utilization and/or charge/payment data is complete.
4. Display the following message if interviewer tries to delete a condition after link is created:
"DELETE ALLOWED ONLY WHEN CONDITION IS FIRST ENTERED."
5. Limited edit allowed. Interviewer may edit a condition name newly added at this item until
CAPI creates the link between this condition and the event. The link is created when the
collection of utilization and/or charge/payment data is complete.
CONDITION LOOKUP SPECIFICATIONS
For complete Condition Lookup specifications, refer to the Global (GL) Specifications.

Display
Instructions:

Display ‘call’ if TH10 is coded ‘1’ (PHONE). Otherwise, display ‘contact’.
Roster 3-add/edit/delete allowed. Roster definition:
Display the Person-Medical-Conditions-Roster for selection and addition of one or many
medical
condition (s) associated with this event. Display name of medical condition
(COND.CONDNAM)
Roster filter:
Display all conditions on person's roster; no filter.

TH - Page 18 of 28

MEPSSpring2024

Telehealth (TH) Section
(Ques

Full Detail Spec
TH100
Item Type:
Type Class:
Answer Type:

(TH1085)
Question
Enumerated
TYESNO

Help Available (MEDPRESHelp)
Context Header:

BLAISE NAME: THPmed
Field kind: Datafield

ArrayMin:

Min value:

Field Size:
Answers allowed: 1

ArrayMax:

Max value:

Show Card (

)

Look Up File (

)

{PERSON’S FIRST MIDDLE AND LAST NAME} {EVN-DT} {NAME OF MEDICAL
CARE PROVIDER} - {DOC OR DEPT}

Question Text:
During this {call/contact}, were any medicines prescribed for {you/{PERSON}}? Please include only
prescriptions which were filled.
HELP:F1

Responses:

Display
Instructions:

YES
NO
REFUSED
DON'T KNOW

1
2
RF
DK

TH110
TH120
TH120
TH120

Display ‘call’ if TH10 is coded ‘1’ (PHONE). Otherwise, display ‘contact’.

TH - Page 19 of 28

(TH1090)
(TH1095)
(TH1095)
(TH1095)

MEPSSpring2024

Telehealth (TH) Section
(Ques

Full Detail Spec
TH110
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:

(TH1090)
Question
Enumerated

BLAISE NAME: THPmedRoster
Field kind: Datafield

ArrayMin:

Field Size:
TPRESCRIBEDMEDS Answers allowed: 99 ArrayMax:
)

Show Card (

Min value:
Max value:

)

Look Up File (

)

{PERSON’S FIRST MIDDLE AND LAST NAME} {EVN-DT} {NAME OF MEDICAL
CARE PROVIDER} - {DOC OR DEPT}

Question Text:
Please tell me the names of the prescriptions from this {call/contact} that were filled.
PROBE: Any other prescribed medicines from this {call/contact} that were filled?
ENTER ALL THAT APPLY.
CTRL-A: ADD
CTRL-E: EDIT
CTRL-D: DELETE

Responses:

{PRESCRIBED MEDICINE}1
{PRESCRIBED MEDICINE}2
{PRESCRIBED MEDICINE}3
{PRESCRIBED MEDICINE}4
{PRESCRIBED MEDICINE}N

1
2
3
4
5

TH - Page 20 of 28

TH120
TH120
TH120
TH120
TH120

(TH1095)
(TH1095)
(TH1095)
(TH1095)
(TH1095)

MEPSSpring2024

Telehealth (TH) Section
(Ques

Full Detail Spec
Programmer
Instructions:

Roster behavior:
1. Multiple select allowed.
2. Multiple add allowed.
3. Limited delete allowed. Interviewer may delete a medicine added at this item until CAPI
creates the link between this medicine and the event. The link is created when the collection
of utilization and/or charge/payment data is complete.
4. Limited edit allowed. Interviewer may edit medicines added at this item until CAPI creates
the link between this medicine and the event. The link is created when the collection of
utilization and/or charge/payment data is complete.
Soft Check:
If 2 or more of the same following text strings are found in a single medicine entry (e.g.
DROXIA 200MG CAPMAXALT 10MG) upon leaving the single entry field by pressing
‘TAB’ or ‘ENTER:
• MG
• ML
• CAP
• MCG
• TAB
• GM
•%
Or if the following text combinations strings are found in a single medicine entry (e.g. aspirin
5mg triamcinolone acetonide .5% ointment) upon leaving the single entry field by pressing
‘TAB’ or ‘ENTER:
• MG and %
• MCG and MG
Display a separate pop-up below the field that triggered the soft check with the message:
“Verify only one medicine per field is entered. If entry is a compound medicine (medicine
label lists two or more different medicines) select ‘Suppress’. If entry error was made, select
‘GoTo’ and re-enter each medicine in a separate field. Press ‘TAB’ between each separate
entry.”
At the top of the pop-up above the message, display the medicine that triggered the soft check.
With the text string that triggered the check displayed in bold.
Prescribed Medicine Soft Check Flag (PMedSoftChk):
The purpose of this flag is to ensure that once the soft check is triggered, that particular entry
row will not trigger the soft check again, even when the text entry of the field has changed.
The flag records whether the interviewer selected “Suppress” or “GoTo”. Suppressing the soft
check may not indicate that the medicine is a compound drug as a medicine name could have
the targeted text string in both the form/strength and drug name, such as “captopril capsule”.
When the interviewer selects ‘GoTo’ to return to the field to make a correction, the soft check
will not run again to check the entry.
Pressing ‘tab’ then selecting ‘Suppress’ or ‘GoTo’ closes the soft check pop-up and moves the
cursor to the next empty field.
Pressing ‘enter’ then selecting ‘Suppress’ closes the soft check pop-up and moves the focus
back to the prescribed medicine roster. Or if ‘GoTo’ is selected moves the cursor back to the
entry field that triggered the soft check
PMED LOOKUP SPECIFICATIONS
For complete PMed Lookup specifications, refer to the Global (GL) Specifications.
TH - Page 21 of 28

MEPSSpring2024

Telehealth (TH) Section
(Ques

Full Detail Spec

Display
Instructions:

Display ‘call’ if TH10 is coded ‘1’ (PHONE). Otherwise, display ‘contact’.
Roster 3- Add/Edit/Delete Allowed Roster definition:
This item displays the Person’s-Prescription-Medicines-Roster for selection. Display name of
prescribed medicine (DRUG.DRUGNAME)
Roster filter:
Display all medicines in person's roster; no filter.

TH120
Item Type:

(TH1095)
Question

Type Class:

Enumerated

Answer Type:

TYESNO

Help Available (
Context Header:

)

BLAISE NAME: RefLabTst
Field kind: Datafield
ArrayMin:

Min value:

Field Size:
Answers allowed: 1
Show Card (

ArrayMax:

Max value:

)

Look Up File (

)

{PERSON’S FIRST MIDDLE AND LAST NAME} {EVN-DT} {NAME OF MEDICAL
CARE PROVIDER} - {DOC OR DEPT}

Question Text:
During this {call/contact}, did {someone at} {PROVIDER} refer {you/{PERSON}} for lab tests? Please include
only lab tests {you/he/she} obtained between {START DATE} and {END DATE}.

Responses:

Display
Instructions:

YES
NO
REFUSED
DON'T KNOW

1
2
RF
DK

BOX_60
BOX_60
BOX_60
BOX_60

(TH1100)
(TH1100)
(TH1100)
(TH1100)

Display ‘call’ if TH10 is coded ‘1’ (PHONE). Otherwise, display ‘contact’.
Display ‘{someone at}’ if provider associated with this event is a facility provider. Otherwise,
use a null display.

TH - Page 22 of 28

MEPSSpring2024

Telehealth (TH) Section
(Rout

Full Detail Spec
BOX_60

(TH1100)

Type Class: If Then

If no condition is associated with this visit to this provider for this person, go to BOX_80.
Otherwise, continue with BOX_70.

Route Details:

BOX_70

Item Type: Route

(TH1105)

Route Details:

Item Type: Route

Type Class: If Then

If 1 or more visits to this provider for this person have not completed the telehealth
utilization module and if this event is not part of a flat fee group, continue with TH130.
Note: If provider is a facility provider, check all events to the same
facility provider regardless of the doctor or department linked to the specific events.
Otherwise, go to BOX_80.

TH130
Item Type:

(TH1110)
Question

Type Class:

Enumerated

Answer Type:

TYESNO

Help Available (
Context Header:

BLAISE NAME: THOthSameCond
Field kind: Datafield
ArrayMin:

Min value:

Field Size:
Answers allowed: 1

)

Show Card (

ArrayMax:

Max value:

)

Look Up File (

{PERSON’S FIRST MIDDLE AND LAST NAME} {EVN-DT} {NAME OF MEDICAL
CARE PROVIDER}

Question Text:
Earlier I recorded that {you/{PERSON}} had some other {calls to/contacts with} {PROVIDER}. {Were any of
these for {your/his/her} {PERSON’S TH MEDICAL CONDITION}?/Were any of the other {calls/contacts} also
for {your/his/her} {PERSON’S TH MEDICAL CONDITION} or {PERSON’S TH MEDICAL CONDITION}
{or {PERSON’S TH MEDICAL CONDITION}}?/ Were any of the other {calls/contacts} also for one of these
conditions (READ CONDITIONS BELOW):}
{CONDITIONS
{PERSON'S TH MEDICAL CONDITION}1
{PERSON'S TH MEDICAL CONDITION}2
{PERSON'S TH MEDICAL CONDITION}3
{PERSON'S TH MEDICAL CONDITION}4
{PERSON'S TH MEDICAL CONDITION}N}

Responses:

YES
NO
REFUSED
DON'T KNOW

1
2
RF
DK
TH - Page 23 of 28

TH140
BOX_80
BOX_80
BOX_80

(TH1115)
(TH1125)
(TH1125)
(TH1125)

)

MEPSSpring2024
Full Detail Spec
Programmer
Instructions:

Telehealth (TH) Section
(Ques

{DOC OR DEPT} should not display in context header.
Display ‘Were any of these for {your/his/her} {PERSON’S TH MEDICAL CONDITION}?’
if only one condition selected or added to Person’s-Medical-Conditions- Roster at TH90.
Display ‘Were any of the other {calls/contacts} also for {your/his/her} {PERSON’S TH
MEDICAL CONDITION} or {PERSON’S TH MEDICAL CONDITION} {or {PERSON’S
TH MEDICAL CONDITION}}?’ if exactly 2 or 3 conditions selected or added to Person’sMedical-Conditions-Roster at TH90. Otherwise, display ‘Were any of the other
{calls/contacts} also for one of these conditions (READ CONDITIONS BELOW):”
Display ‘or {PERSON’S TH MEDICAL CONDITION’ if exactly 3 conditions selected or
added to Person’s-Medical-Conditions-Roster at TH90. Otherwise, use a null display.
For ‘PERSON’S TH MEDICAL CONDITION’ display the condition selected from or added
to Person’s-Medical-Conditions-Roster at TH90.
Display the header ‘CONDITIONS’ and the list of conditions if more than three conditions
selected or added to Person’s-Medical-Conditions-Roster at TH90. Otherwise, use a null
display. For ‘PERSON’S TH MEDICAL CONDITION’, display all conditions selected from
or added to Person’s- Medical-Conditions-Roster at TH90.

Display
Instructions:

Display ‘calls to’ and ‘calls’ if TH10 is coded ‘1’ (PHONE). Otherwise, display ‘contacts
with’ and ‘contacts’.

TH - Page 24 of 28

MEPSSpring2024

Telehealth (TH) Section
(Ques

Full Detail Spec
TH140
Item Type:
Type Class:
Answer Type:
Help Available (
Context Header:

(TH1115)
Question
Enumerated

BLAISE NAME: THRepVstRoster
Field kind: Datafield

ArrayMin:

Field Size:
TMONTHDAYYEAR Answers allowed: 99 ArrayMax:
)

Show Card (

)

Min value:
Max value:
Look Up File (

)

{PERSON’S FIRST MIDDLE AND LAST NAME} {EVN-DT} {NAME OF MEDICAL
CARE PROVIDER}

Question Text:
{Which of the following {calls/contacts} were also for {your/{PERSON}’s} {PERSON’S TH MEDICAL
CONDITION} {{or {your/his/her}/,} {PERSON’S TH MEDICAL CONDITION}} {or {your/his/her}
{PERSON’S TH MEDICAL CONDITION}}?/ Which of the following {calls/contacts} were also for one of these
conditions (READ CONDITIONS BELOW)?}
PROBE: Any other {calls/contacts} for the same condition?
ENTER ALL THAT APPLY.
{CONDITIONS
{PERSON'S TH MEDICAL CONDITION}1
{PERSON'S TH MEDICAL CONDITION}2
{PERSON'S TH MEDICAL CONDITION}3
{PERSON'S TH MEDICAL CONDITION}4
{PERSON'S TH MEDICAL CONDITION}N}

Responses:

{SELECT ALL EVENTS}
{MONTH, DAY, YEAR} {PROVIDER} 1
{MONTH, DAY, YEAR} {PROVIDER} 2
{MONTH, DAY, YEAR} {PROVIDER} 3
{MONTH, DAY, YEAR} {PROVIDER} 4
{MONTH, DAY, YEAR} {PROVIDER} N

0
1
2
3
4
5

TH - Page 25 of 28

MEPSSpring2024

Telehealth (TH) Section
(Ques

Full Detail Spec
Programmer
Instructions:

Go to TH150.
If coded '0' SELECT ALL EVENTS, CAPI should automatically select all of the events
displayed on the roster and flag as being part of the repeat visit group.
Flag each visit selected at TH140 as a repeat visit related to the event being asked about.
(NOTE: The event being cycled on through this TH section administration is the “stem”
repeat visit. The events selected at TH140 are the “leaves”. The event driver (ED) section will
not serve these repeat visits for the TH section.)
Assign next repeat visit number at the household level. (NOTE: Each repeat visit grouping,
whether OP, MV, TH, or HH is assigned this number at a household level. The number will
start over every round.)
Roster behavior:
1. Multiple select allowed.

Display
Instructions:

{DOC OR DEPT} should not display in context header.
Roster 2- No Add/Edit/Delete
Roster definition:
This item displays all medical events (dates) on person's medical- events-roster for selection.
Display event begin date (EVNT.EVNTBEGM,EVNT.EVNTBEGD,EVNT.EVNTBEGY)
Roster filter:
Display only those event with the following characteristics.
1. Event was created this round.
2. Event has not been processed in utilization.
3. Event has event type ‘TH’.
4. Event is associated with the same provider as the event being asked about (regardless of the
doctor or department linked to the specific event if provider is a facility provider).
5. Event is not already flagged as part of a flat fee bundle.
Next to each event date, display the doctor or department linked to that specific visit date.
Display ‘Which of the following {calls/contact} were also for {your/{PERSON}’s}
{PERSON’S TH MEDICAL CONDITION} {{or {your/his/her}/,} {PERSON’S TH
MEDICAL CONDITION}} {or {your/his/her} {PERSON’S TH MEDICAL
CONDITION}}?’ if three or less conditions selected or added to Person’s-MedicalConditions-Roster at TH90. Otherwise display, ‘Which of the following {calls/contact} were
also for one of these conditions (READ CONDITIONS BELOW)?’
Display ‘{or {your/his/her}/,} {PERSON’S TH MEDICAL CONDITION}’ if two or three
conditions selected or added to Person’s-Medical-Conditions-Roster at TH90. Otherwise, use
a null display.
Display “or {your/his/her}” if exactly two conditions selected or added to Person’s-MedicalConditions-Roster at TH90. Otherwise, display ‘,’.
Display ‘or {your/his/her} {PERSON’S TH MEDICAL CONDITION}’ if exactly three
conditions selected or added to Person’s-Medical-Conditions-Roster at TH90. Otherwise, use
a null display.
For ‘PERSON’S TH MEDICAL CONDITION’ display the condition selected from or added
to Person’s-Medical-Conditions-Roster AT TH90.
TH - Page 26 of 28

MEPSSpring2024

Telehealth (TH) Section
(Ques

Full Detail Spec

Display ‘calls’ if TH10 is coded ‘1’ (PHONE). Otherwise, display ‘contacts’.
Display the header ‘CONDITIONS’ and the list of conditions if more than three conditions
selected or added to Person’s-Medical-Conditions-Roster at TH90. Otherwise, use a null
display. For ‘PERSON’S TH MEDICAL CONDITION’, display all conditions selected from
or added to Person’s- Medical-Conditions-Roster at TH90.
For "MONTH,DAY,YEAR" in the response option area, display visit dates as "MON DD,
YYYY". Abbreviate the month name as three letters.
Display the response option '0' SELECT ALL EVENTS when there is more than one event to
display on the roster, otherwise use a null display.

BLAISE NAME: THEvntVstGrp

TH150
Item Type:

(TH1120)
Question

Type Class:

String

Answer Type:

{Continuous Answer.} Answers allowed: 1

Help Available (
Context Header:

Field kind: Datafield

ArrayMin:

Min value:

ArrayMax:

Max value:

Field Size: 1000

)

Show Card (

)

Look Up File (

{PERSON’S FIRST MIDDLE AND LAST NAME} {EVN-DT} {NAME OF MEDICAL
CARE PROVIDER}

Question Text:
INTERVIEWER: RECORD ‘NAME OF REPEAT VISIT GROUP’ FOR EVENTS SELECTED IN PREVIOUS
QUESTION:

1

Responses:
Programmer
Instructions:

Display
Instructions:

Go to BOX_80.
'RF/DK not allowed'.

{DOC OR DEPT} should not display in context header.

TH - Page 27 of 28

)

MEPSSpring2024

Telehealth (TH) Section
(Rout

Full Detail Spec
BOX_80

Route Details:

(TH1125)

Item Type: Route

Type Class: If Then

Go to the Charge/Payment (CP) section if it needs to be asked for this event, i.e. its status
wasn’t set to ‘Completed’ because it was part of a Flat Fee situation where the charges were
collected in the CP section for another event in that Flat Fee group.
If the Charge/Payment (CP) section is completed for this Telehealth (TH) event and TH120
is coded '1' (YES) go to EF section.
Otherwise, go to the Event Driver (ED) section.

[End of TH]

TH - Page 28 of 28