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RAD ONC - Breast Brachytherapy - Workup - Adult - Procedure [4596]

RAD ONC - Breast Brachytherapy - Workup - Adult - Procedure [4596] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, HOD, Radiation Oncology


SmartSet: RAD ONC - BREAST BRACHYTHERAPY WORKUP (ID:4596)
General Information
Display name: RAD ONC - Breast Brachytherapy - Workup - Adult - Procedure
Type: General
Merge priority:
Version comment:
Content source:
Synonyms: 1. DRY RUN
2. .RADONC
SmartSet notes:
Description:
Web information: Title URL
1.
Questionnaire:
Configuration
Diagnostic Tests and Imaging
Diagnostic Tests and Imaging
Page 1 of 3
Printed by STRAKA, KEVIN F [KFS1] at 9/26/2016 1:17:27 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 09/2016CCKM@uwhealth.org

Radiation Oncology Treatment CT/Sim without
Contrast - Supine
Routine
Consent obtained from patient?
Claustrophobia:
Is There a Possibility of Pregnancy:
Last patient height? (will auto pull in value and date in
comment):
Last patient weight? (will auto pull in value and date
in comment):
Diagnosis:
Parameters to Include:
Treatment Same Day as CT/Sim:
Page MD for Setup:
Physics Present at CT/SIM:
Patient Position - Body:
Patient Position - Other:
CT Slice Thickness:
Target Site:
Contrast:
Other Directions to CT Therapists:
Instructions for Patient:
Supine position
Diagnosis
Diagnosis - Breast Cancer
Breast cancer Malignant neoplasm of breast (female),
unspecified site
DCIS (ductal carcinoma in situ) of breast Carcinoma in situ of breast
Metastasis to breast Secondary malignant neoplasm of breast
Metastatic malignant neoplasm to skin of
breast
Secondary malignant neoplasm of skin
Personal history of malignant neoplasm of
breast
Personal history of malignant neoplasm of
breast
S/P mastectomy Acquired absence of breast and nipple
Family history of breast cancer Family history of malignant neoplasm of breast
Criteria
Suggestions: UWHOD ORDERSET SUGGESTION RAD ONC[4500004]
Filter: UWIP ORDER SET RESTRICTOR - NOT TSC/MSC[3000407]
Restrict SmartSet:
Settings
Discontinue action:
Deselect sections for
Pended/Held orders:
Page 2 of 3
Printed by STRAKA, KEVIN F [KFS1] at 9/26/2016 1:17:27 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
09/2016CCKM@uwhealth.org

Pended/Held orders
display:
Release date: Use System Definitions Setting
Disallow user override:
Page 3 of 3
Printed by STRAKA, KEVIN F [KFS1] at 9/26/2016 1:17:27 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
09/2016CCKM@uwhealth.org