Measurements
Equipment & Measurements
The patient will need to enter their LDL, HDL and total cholesterol levels. If you have access to the patient's records, make a note of these so you assist with entering them when the test asks for them. If the actual levels are unknown, you can enter ranges such as "normal" or "high." Pull from the records weight, height and waist size. Do this only if the record is recent. Height won't change much, but waist size and weight can vary within just a few weeks, so check those if unsure. You'll need a flexible waist measuring tape, access to a scale and a height measurement device and a blood pressure (BP) device.
Note: Taking measurements is part of the testing procedure, so get the patient started on the PME on a tablet or computer before you take measurements or open an electronic health record to check cholesterol levels–to trigger the PME's timer. Remember, assisted computer-administered testing is billable by time spent, so you should be tracking all time spent taking measurements, reviewing records and getting the patient set up to take the test.
Weight and Height
If you have a recent weight and height from the doctor's notes, you can use those figures. Most folks know their height, but measure (without shoes on) it if the patient is unclear. The new inexpensive digital scales are very accurate. You can weigh a person with clothes on, just subtract 2.5 lbs for men and 2.0 lbs for women. Add a half pound for wearing heavy work boots..
Waist Size
Ask the patient if you can wrap the tape or would he rather do it him or herself– Avoid any unnecessary touching if you take the measurement. Write down the measurements.
For women, wrap the tape at the smallest part of the waist. Ask the patient to slide her hands up and down both sides of her waist to find the smallest dimension with her fingertips, and wrap the tape at that point.
For men wrap the tape just above the top of the pelvic bones. Ask the man to move his hands about until locating the top of these bones with his fingertips, and wrap the tape at that point.
Blood Pressure
The PME requires three separate BP measurements. We recommend the Omron 7 wrist BP monitor. First make sure (two triple-A alkaline) batteries are inserted enter the date into the machine. Then set the date and time as shown in the following video. Assist the patient with attaching the Omron device to their wrist about 1/2 inch below the palm–use the non-preferred hand so the preferred hand is available to write. Tell them to wear the monitor throughout the testing, except during any weighing, of course.
The patient should have been sitting (without standing) with feet flat on the floor for at least five minutes before measuring. This is why the patient is not asked to enter any BP measurements into the PME until they are several minutes into the test. Standby and assist during the first measurement, but most patients will be able to perform the 2nd and 3rd measurements on their own.
Some examples of what the PME looks like and the report it generates, are shown in the next section.