portal questionnaires and appointments...in this case, you must create the needed items in the...

PORTAL

QUESTIONNAIRES

AND

APPOINTMENTS

Creating Patient

Questionnaires

Sessions 2 and 6

Creating Patient Questionnaires

Aprima PRM 2015 Patch 2 August 1, 2016

© 2016 Aprima Medical Software, Inc. All rights reserved. Confidential and Proprietary.

Aprima is a registered trademark of Aprima Medical Software. All other trademarks are the property of their respective holders. Reference Number: 1090.03

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Contents

Introduction ................................................................................................. 5

Patient Questionnaires and the Knowledge Database ............................................ 5

Predefined Questionnaires ............................................................................ 6

Questionnaire Structure and Content ................................................................... 6

Sections.................................................................................................. 7

Questions ................................................................................................ 7

Answer Groups and Answers .......................................................................... 8

Answer Control Types ............................................................................. 9

Require an Explanation .......................................................................... 10

Trigger Next Question ............................................................................ 10

Trigger Conditional Section ..................................................................... 11

Framing Questions and Their Answers ............................................................. 11

Considerations for Questions in Specific History Categories ............................... 15

Defining Patient Questionnaires ......................................................................... 15

Identify the Questionnaires Needed ................................................................ 16

Define a Questionnaire and Its Sections ........................................................... 17

Define a Section with Patient Problem Questions ........................................... 19

Define a Section with Family History Questions .............................................. 20

Define a Section with Immunization History Questions ..................................... 22

Questionnaire Practice Task ......................................................................... 23

Create the Practice Questionnaire ............................................................. 23

Create Standard History Sections .............................................................. 24

Create a Patient Problem Section .............................................................. 25

Create a Family History Section ................................................................ 26

Create a Vaccination History Section .......................................................... 28

Review and Order the Questionnaire Sections ............................................... 29

Define a Section’s Questions and Answer Groups ................................................ 30

Questions and Answer Group Practice Tasks ...................................................... 32

Select Tobacco History Questions .............................................................. 32

Select Alcohol History Questions ............................................................... 35

Select Surgical History Questions............................................................... 38

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Select the Answer Group for a Question ........................................................... 40

Create or Edit Answer for KDB Question ...................................................... 41

Create or Edit Answer for ROS Question ...................................................... 42

Create or Edit Answer for None Question ..................................................... 44

Answer Group Practice Tasks ........................................................................ 45

Answer Groups for Tobacco History Questions Practice Task .............................. 45

Answer Groups for Alcohol History Questions Practice Task ............................... 47

Answer Groups for Surgical History Questions Practice Task ............................... 49

Review the Practice Questionnaire ..................................................................... 51

Preview the Practice Questionnaire ................................................................ 51

Create a Test Patient ................................................................................. 51

Create the Patient’s Web Account and Assign the Questionnaire .............................. 52

Complete the Practice Questionnaire .............................................................. 53

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Introduction

The patient questionnaire feature is part of the Aprima PRM Patient Portal functionality. Patient questionnaires offer you the means to capture patient demographic, patient history, and review of systems information directly from the patient, and import it into the patient’s record. Patients can access your questionnaires from the Internet if you are using the optional Patient Portal application. The application includes a number of system-defined patient questionnaires.

You may also define your own patient questionnaires if system-defined questionnaires do not fit your needs. You may define a questionnaire by making a copy of an existing questionnaire, and then modifying your new copy. Or you can create a completely new questionnaire.

This document introduces you to the concepts you must understand and the tasks you must perform in order to create patient questionnaires using the history groups, questions, answer groups, and answers that are already in the application’s knowledge database. This enables you to create a questionnaire by defining the sections you want and selecting the questions that you want to include.

This document does not include instructions for modifying questions and answers or for creating questions and answers of your own. Modifying or creating questions and answers requires first modifying your knowledge database. Information on modifying and adding to the knowledge database is provided in the Administrative User’s Guide and the online help. Creating fully customized patient questionnaires will be explained in another document.

Patient Questionnaires and the Knowledge Database

The patient questionnaire functionality is closely related to the Patient Demographics, Patient History, and Review of Systems functionality, and is dependent on the knowledge database.

Because of the questionnaires’ dependency on the knowledge database, proficiency in editing the knowledge database is necessary to create custom questionnaires. For information about and instructions for editing the knowledge database, please refer to the Aprima PRM Administrative User’s Guide.

The questionnaires that are predefined in the application correspond to the predefined knowledge database. You may want to define custom questionnaires that cover slightly more or less information or that organize the information in a different manner then that predefined questionnaire. In these cases, your custom questionnaire will rely upon items that are predefined in the knowledge database.

If, however, you want to define a custom questionnaire in order to solicit and capture specialized information, your custom questionnaire will rely on items that you have created in the knowledge database, either for the practice as a whole or for a particular care team or provider. In this case, you must create the needed items in the knowledge database prior to

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creating them for the questionnaire. The items must exist in the knowledge database in order for questionnaire responses to be imported into a patient’s chart.

Predefined Questionnaires

The following questionnaires are predefined. You may define additional questionnaires.

Patient demographics

Medical history

Social history

Family and immunization history

Review of systems

For information on setting up and using the predefined questionnaires, please refer to the Patient Questionnaires section of the Administrative User’s Guide.

Questionnaire Structure and Content

Before you define your own patient questionnaire, you must consider the structure and content of that questionnaire. The structure and content of the questionnaire should reflect, as much as possible, the knowledge database. Both the knowledge database and the questionnaire have hierarchical structures for collecting patient history information. The table below shows the two structures, and their corresponding levels. Levels are shown from highest to lowest.

Knowledge Database Structure:

The knowledge database contains…

History groups, which contain…

Questions, which are associated with an…

Answer group, which contains…

Answers.

Questionnaire Structure:

A questionnaire contains…

Sections, which contain…

Questions, which are associated with an…

Questions, which are associated with …

Answers.

Example: New patient questionnaire

Medical history

Cancer Timeframe _ months ago At age _ etc.

Although the question, answer group, and answer levels in the knowledge database and the questionnaire structures are parallel, they can be different because they are held in different tables within the database. You must keep the questions and answers in the questionnaire structure similar to those in the knowledge database to ensure that the patients’ questionnaire responses can be cleanly imported into the application. However, since the

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questionnaires do not actually use the questions and answers from the knowledge database, they need not be worded exactly the same. This enables you to change the wording of questions and answers in the questionnaire so that they are more easily understood by patients.

Sections

A questionnaire section is a grouping of questions that you define and name. Sections enable you to:

Group questions in logical ways that provide context to the patient.

Reuse groups of questions in multiple questionnaires.

Define groups of questions that you want to include only under certain conditions.

Questionnaire sections are similar to the knowledge database’s patient history and review of systems groups in that they are logical groupings of questions. The context of patient history and review of systems groups are from a practitioner’s point of view. Questionnaire sections should be defined so that the context is from a patient’s point of view. Therefore, questionnaire sections and knowledge database groups do not have a direct correlation. You may define a questionnaire section that contains questions from more than one group, and a section may include questions for either history, review of systems, or both. You may also define several questionnaire sections, each of which contains a small number of questions from the same knowledge database group.

Once you have defined a questionnaire section, you may reuse it in any number of questionnaires. This makes it easy to create questionnaires for different purposes without starting from scratch for each one. Each time you use a questionnaire section, it will contain the same questions, answers to those questions, and branching based on selected answers.

A questionnaire section may be a required or conditional. Required sections are always included in the questionnaire, and are presented to each patient asked to complete that questionnaire. A conditional section is only included in the questionnaire for a particular patient when that patient answers a specific question in a certain way. For example, a menstrual history section may be included only if the patient is female, or a surgical history section may be included only if the patient answers “Yes” to the question “Have you ever had surgery”.

Questions

Questionnaire sections that use the Patient Problem Question, Family History Question, or Immunization History Question type of question are not assigned questions. The Patient Problem Question and Family History Question types of question use problem lists that you define from the application’s list of medical problems. The Immunization History Question type of question use a vaccine administration record to define the list of vaccines.

Questionnaire sections that use the Patient Question type of question are assigned questions and answers.

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Most questionnaire questions will have an exact counterpart in the knowledge database question table. The questionnaire questions will be tied to their knowledge database question counterparts so that patient responses can be imported into the patient record. The knowledge database question name is used to tie the questionnaire question to the knowledge database question.

When you use a knowledge database question name to create a questionnaire question, the system sets the questionnaire question name to the same as the knowledge database question name. It also sets the history group for the questionnaire question to the same as the history group for the knowledge database question.

The questionnaire question name does not appear in the questionnaire itself. You can use the Question Text field to define the wording used in the questionnaire. This can be very useful since the knowledge database question names tend to be short and succinct, and may not be easily understood by patients. For example, when using the knowledge database question “Cancer”, you may want to change the question text to “Have you ever had cancer”.

You can set up a questionnaire question that is not tied to a knowledge database question, but the answer to the uncoupled question will not be imported into the patient history in the database. Therefore, questions not tied to a knowledge database question should be used carefully. Such a question is most likely to be used when the knowledge database question and its answers cannot be established in a questionnaire in a one-to-one fashion. Then you may need to use additional questions to lead into a question answer that can be imported into the patient history.

You can also add questions to a history group in the knowledge database if you determine that additional or different questions are needed for the patient questionnaire. Please refer to the online Help for information on modifying the knowledge database.

Answer Groups and Answers

Questionnaire sections that use the Patient Problem Question, Family History Question, or Immunization History Question type of question do not use answer groups and answers. The Patient Problem Question and Family History Question types of question use a list of problems. For patient problems, the patient may enter an onset date. For family problems, the patient may select a family member and enter information about the problem in the same manner that it is entered in the application. The Immunization History Question type of question use a vaccine administration record to define the list of vaccines. The patient simply selects the vaccinations that they have had

Questionnaire sections that use the Patient Question type of question are assigned questions which are then assigned have answer groups and answers.

An answer group is a set of answers to a questionnaire question. By defining answer groups, you can use the same set of answers for different questions. For example, if you have more than one question that is answered either ‘Yes’ or ‘No’, you can define an answer group that includes these answers, and then reuse the same set of answers for several questions.

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The questionnaire answer group and its answers are assigned when you use a knowledge database question name to create a questionnaire question. This ties the questionnaire answers directly with the corresponding answers in the knowledge database. In some cases, this direct tie from questionnaire answer to knowledge database answer works well. In other cases, it will not.

When the knowledge database answer group does not work well for a questionnaire question, you may define a new questionnaire answer group and tie it to the questionnaire question. The answers in the questionnaire answer group do not have to be the same as the answers in the knowledge database answer group. When the questionnaire answers are imported, they are treated similarly to manually entered answers in the patient history. Therefore, while the answers in the questionnaire answer group do not have to be same as the answers in the knowledge database answer group, they should correspond. Please refer to the Framing Questions and Their Answers section of this document for more information.

Answer Control Types

Answers to any given question must be provided in a specific response type, or control type, applicable to that question. There are currently five answer control types. These are

Radio button

Checkbox

Text

Numeric

Date

You must carefully select the control type for an answer group based on how you word the question and the type of answers that may be given to that question. The table below can help you think through the control type needed for a particular question.

If the answer set is And Then use This enables

Discrete — There is a list of specific answers from which patient must choose.

Only one answer is possible.

Radio buttons Specifying a next question based on the answer.

Specifying a conditional section base on the answer.

Multiple answers are possible.

Checkboxes Specifying conditional sections based on the answers.

Not discrete — There is no list of answers. The patient may give any

Only numeric answers are acceptable.

Numeric Only numbers to be entered. Such as, 1, 36, 104.

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If the answer set is And Then use This enables

answer. Only specific dates are acceptable.

Date Only numbers to be entered, and only in mm/dd/yyyy format.

Any answer is acceptable.

Text Any letter, number, or special character to be entered.

Require an Explanation

In a questionnaire, you have the option of requiring an explanation with a radio button or checkbox answer. Requiring an explanation with a checkbox answer causes the questionnaire to present a text box following any answer. Requiring an explanation with a radio button answer causes the questionnaire to present a text field when the patient selects the particular triggering answer. The label on this text field is always ‘Explanation’.

After selecting the triggering answer, the patient then types additional information in the Explanation text field. The questionnaire will not allow the patient to move to the next question until they have made an entry in the text field.

When you require an explanation with an answer, the Explanation text field will be included every time the answer group including that answer is used. Therefore, you may need to create multiple answer groups containing the same answers: one group with an answer requiring an explanation and one without. For example, you may need a Yes/No answer group and a Yes with Explanation/No answer group.

Trigger Next Question

In a questionnaire, an answer to a question can be used to trigger a specific question as the next one presented to the patient taking the questionnaire. This enables you to define branching around one or more questions in the questionnaire that do not apply to patient, based on the triggering answer. To trigger a next question, the answer set must use the radio button control type. Only one of the answers in the set can trigger a next question. The next question triggered must be a subsequent question in the same questionnaire section.

For example, you may have a questionnaire section with several questions on tobacco use followed by several questions on alcohol use. If the first tobacco question is “Do you use tobacco’”, the answer ‘No’ could trigger the question “Do you drink alcohol”. Then, when the patient answers yes to the first tobacco question, the questionnaire will present the remaining tobacco questions in the order you established. When the patient answers no to first tobacco question, the questionnaire will skip the remaining tobacco questions and present the first alcohol question.

When you use an answer to trigger a next question, that answer will trigger the specified question each time the answer group containing it is used. So using the same example, you would need a Yes/No Tobacco Use answer group.

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Trigger Conditional Section

A specific answer to a question can also be used to trigger a conditional questionnaire section. For example, answering “Yes” to the question “Do you or have you ever used tobacco’” could trigger a questionnaire section with questions about when the patient started smoking, how long they smoked, when they quit, and how much they smoke.

A single question and its answers can be used to trigger multiple conditional sections. For example, the answer set for the question “Do you have any allergies” could include Food Allergies, Drug Allergies, and Environmental Allergies. Each of the answers could trigger a section for capturing information about the specific allergies the patient has. If the patient selects more than one answer, then the conditional sections for all the selected answers will be presented by the questionnaire.

When you use an answer to trigger a conditional section, that answer will trigger the specified questionnaire section each time the answer group containing it is used. You may need to create multiple answer groups for a set of answers if those answers will be commonly used, and may or may not be used to trigger a conditional section.

To trigger a conditional question, the answer set must use either the radio button or the checkbox control type. An answer group using the checkbox control type can trigger multiple conditional sections, but each individual answer in the answer group can only trigger a single conditional section.

Framing Questions and Their Answers

A provider entering patient history or review of systems information uses a very different interface than a patient completing a questionnaire. Knowledge database questions are not really questions; they are words or phrases that appear with a list of answers that together prompt the provider to ask a patient a question. In addition, some answers are simply answer shells that require the provider to enter additional information to form a complete answer.

Therefore, some questions and their answers must be framed differently for the questionnaire than they are in the knowledge database. Questions should be phrased in a manner easy for patients to understand. They must also be phrased in a manner that enables patients to enter complete answers.

The following table contains a number of questions from the knowledge database with samples for how they might be handled in a questionnaire. Since the questions in a history area generally use the same answer structure and similar answer groups, determining how you want to handle one question from an area will help you determine how to handle other questions from the same history area.

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History Area KDB Question KDB Answer Group

Possible Questionnaire Question

Possible Questionnaire Answer Group

Social history Number of children

Discrete set of answers, include numbers zero through ten

How many children do you have?

Radio buttons for numbers zero through ten.

Social history Number of children


How many children do you have?

Numeric, allowing any number to be entered.

Social history Tobacco history Discrete set, including

Have never used

Currently smoke

Quit this year

Quit less than 3 years ago

…

In the past only

What is your tobacco history?

Radio buttons using same discrete answer set.

Social history Tobacco history Discrete set, including

Have never used

Currently smoke

Quit this year

Quit less than 3 years ago

…

In the past only

Have you ever used tobacco?

Radio buttons, including Yes requiring explanation and No.

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Food allergies Chocolate Discrete list of possible reactions, including

Abdominal pain

Anaphylaxis

…

Rash

Are you allergic to chocolate?

Radio buttons using same discrete answer set.

Food allergies Chocolate Discrete list of possible reactions, including

Abdominal pain

Anaphylaxis

…

Rash

Are you allergic to chocolate?

A single checkbox for Yes.

Using a checkbox for Yes, rather than radio buttons for Yes and No, means that an entry will be made in the patient record only if the patient is allergic.

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Medication history

Not applicable List of all possible medications and their dispensable doses

Indicate the medications you currently take:

Checkboxes for a list of the most commonly used or most likely to be used medications for your practice and patients. Include one or more ‘Other’ answers requiring an explanation so the patient can specify any other medication taken.

Menstrual history

LMP date Date field On what date did your last menstrual period begin?

Text field.

A text field, rather than a date field, enables the patient to enter an approximate date.

Pregnancy history

Sum of all pregnancies


How many pregnancies have you had?

Numeric, allowing any number to be entered.

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Review of systems

Constitutional -- malaise

Discrete set of answers, including yes, no, and not applicable

Note that all ROS questions must be asked in manner that can be answered with yes, no, or not applicable.

Do you usually feel persistently tired or worn out?

Radio buttons, including Yes, No, and Not Applicable.

Considerations for Questions in Specific History Categories

To include any questions from the menstrual history area, you must first include a question for LMP date. All other information is associated with the LMP date.

To include any questions from the pregnancy history area, you must first include a question for the sum of all pregnancies. All other information is associated with that item.

Defining Patient Questionnaires

To define a patient history or review of systems questionnaire, you must:

1. Identify the questionnaire or questionnaires you want to use. For example, you may want to define a new patient questionnaire or a diabetes questionnaire. A questionnaire may include history questions, review of systems questions, or both.

2. Define the logical sections of questions that a questionnaire will include. Remember that sections are reusable, and so may appear in one or more questionnaires.

3. Define the questions that you want to include in each section, and the answer group associated with each question.

4. Define the specific answers for each answer group.

5. Define branching to a specific question or to another section.

You may find it helpful to review the knowledge database history groups, questions, answer groups, and answers before you begin. You may also want to plan out your questionnaire or questionnaires on paper prior to making entries in the application.

This document presents the tasks of defining a questionnaire in the order in which you must complete them in the system.

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Identify the Questionnaires Needed

Before you begin any tasks within the application, you must first identify the questionnaire or questionnaires that you want to use and the questions that you want to include on each questionnaire. Use the information provided in the previous sections of this document to help you identify how you will need to frame your questions and structure your questionnaire. Writing out a draft or sketching a plan of your questionnaire can be very helpful in thinking through what is needed, and can be a useful reference when performing the necessary tasks within the application.

The practice tasks presented in this document will create a simple cardiology questionnaire. The questionnaire will include the following sections and questions.

Tobacco history

Any prior or current smoking habits?

How many cigarettes do you smoke a day?

Alcohol history

Please tell us about your drinking habits.

How many years have you drunk alcohol?

How frequently do you drink?

Heart disease history, using the following problem list

Angina

Cardiovascular disease

Heart disease

Hypertension

Stroke

Family hears disease history, using the following problem list for first-degree relatives

Angina

Cardiovascular disease

Heart disease

Hypertension

Stroke

Surgical history

Have you had heart surgery, angioplasty, or heart bypass?

Vaccine history, using the system-defined adult vaccine card

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Define a Questionnaire and Its Sections

Use the Questionnaire/Sections window to define a questionnaire, and assign sections to it. This window lists defined questionnaires in the left pane, and the sections associated with a selected questionnaire in the right pane.

1. List Editor ) → Questionnaire → Questionnaire/Sections

2. Select New in the Questionnaire pane of the window.

3. In the Questionnaire window:

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a. Enter a Name for the questionnaire.

b. Enter an ID and Notes, if desired.

c. Select the OK button to save the questionnaire, and return to the Questionnaires/Sections window.

4. In the Questionnaire/Sections window, select the new questionnaire’s name from the list.

5. Select the New button in the Section pane of the Questionnaire/Sections window.

6. Add an existing or new section to the questionnaire.

To add an existing section, search for and select the desired section from the list in the Find window. Go to step 12.

To add a new section, select the New button. This accesses the Questionnaire Section window. Got to step 7.

7. Enter a Name for the questionnaire section.

8. Enter an ID and Notes, if desired.

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9. Identify the section as optional or required.

Leave the Section Optional checkbox unselected to make the section required.

Note: The first section of any questionnaire must have the Section Optional checkbox unchecked so that the questionnaire has a definite starting point.

Select the Section Optional checkbox to make the section optional. This allows patients to skip the section and all of its questions when completing the questionnaire.

10. In the Type of Question area, select the radio button for the type questions to be included in the section.

Patient Question: Use this option for any system-defined history group other than patient problems, family history, and immunization history, and for all custom history groups. Use this option for any ROS system.

Patient Problem Questions: Use this option to define a list of problems and diagnoses from which the patient can select those the patient has or has had in the past. Refer to the Define a Section with Patient Problems Questions process below for instructions.

Family History Questions: Use this option to define a list of problems and diagnoses and a list of family relationships. This enables the patient to select a problem and identify the family members who have or have had that medical problem. Refer to the Define a Section with Family History Questions process below for instructions.

Immunization History Question: Use this option to select a vaccine administration record from which the patient can select the vaccinations the patient has had. . Refer to the Define a Section with Immunization History Questions process below for instructions.

11. Select the OK button to save the questionnaire, and return to the Questionnaires/Sections window.

12. The section name now appears in the Section pane of the Questionnaire/Sections window.

13. Repeat steps 5 through 12 to add each desired section.

14. To change the order of the sections within the questionnaire, use the Up, Down, or Sort Order buttons. The questionnaire will present the sections to the patient in the order established here.

15. Select the Save button to save the questionnaire and its sections.

Define a Section with Patient Problem Questions

Use this process to select or define a problem list to use in a questionnaire section. A problem list is a named subset of items from the database’s list of medical problems.

There are no system-defined problem lists for questionnaires. If you have created a find table named sublist of problems for use in dynamic procedure notes, then you may use that list here. Once you create a sublist of problems, you may use it in any number of questionnaires or procedure notes.

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1. In the Questionnaire Section window, complete the entries described the process above.

2. In the Type of Question area, select the Patient Problem Questions radio button.

3. In the Problem List field, either:

Search for and select a defined problem list.

Got to step 4 to define a new problem list.

4. Select the Find ) icon to access the Find window.

5. Select the New button to access the Find Table – Named Sublist window.

6. Enter a Name for the sublist.

7. In the Find Table field, select Problem.

8. In the List Items field:

a. Select the Find ) icon to access the full list of problems.

b. Search for and select all of the problems that you want to include in your list.

c. Select the OK button once you have selected all the problems desired. This returns to the Find Table – Named Sublist window.

9. Enter an ID and Notes for the sublist, if desired.

10. Select the OK button to save the problem list and return to the Questionnaire Section window.

Define a Section with Family History Questions

Use this process to select or define a problem list and a family relationship list to use in a questionnaire section. A problem list is a named subset of items from the database’s list of medical problems. A family relationship list is a named subset of items from the database’s list of family history relationships.

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There are no system-defined problem lists or family relationship lists for questionnaires. If you have created a find table named sublist of problems or family relationships for use in dynamic procedure notes, then you may use that list here. Once you create a sublist, you may use it in any number of questionnaires or procedure notes.


2. In the Type of Question area, select the Family History Questions radio button.

3. In the Problem List field: either









b. Search for and select all of the problems that you want to include in your list.


9. In the Relationship List field: either

Search for and select a defined family history relationship list.



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13. In the Find Table field, select Family History Relationship.


a. Select the Find ) icon to access the full list of relationships.

b. Search for and select all of the relationships that you want to include in your list.



16. Select the OK button to save the list and return to the Questionnaire Section window.

Define a Section with Immunization History Questions


2. In the Type of Question area, select the Immunization History Questions radio button.

3. In either the Adult Card field or the Pediatric Card field, either:






7. In the Find Table field, select Vaccine Administration.

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a. Select the Find ) icon to access the full list of vaccine administration records.

b. Search for and select the vaccine administration records that you want to use. This defines the list of vaccines included in the questionnaire.




Questionnaire Practice Task

The following practice task creates a new questionnaire with four sections.

Create the Practice Questionnaire


2. Select the New button in the Questionnaire pane of the window.

3. In the Questionnaire window, enter the following information.

a. In the Name field, enter “Practice Cardio Questionnaire”.

b. In the Notes field, enter “This questionnaire created as practice and for testing.”

c. Select the OK button to save the questionnaire.

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Create Standard History Sections

1. In the Questionnaire/Sections window, select the new Practice Cardio Questionnaire from the list.


3. In the Find Sections window, select the New button.

4. In the Questionnaire Section window, enter the following information.

a. In the Name field, enter “Tobacco History”.

b. In the Notes field, enter “This section created as practice and for testing.”

c. Leave the Section Optional checkbox unselected.

d. Select the Patient Question radio button.

e. Select the OK button to save the section.


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a. In the Name field, enter “Alcohol History”.








a. In the Name field, enter “Surgical History”.





Create a Patient Problem Section



3. In the Find Sections window, select the New button. This accesses the Questionnaire Section window.

4. In the Name field, enter “Heart Disease History”.

5. In the Notes field, enter “This section created as practice and for testing.”

6. Leave the Section Optional checkbox unselected.

7. Select the Patient Problem Question radio button.

8. In the Problem List field, select the Find ) icon to access the Find window.


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10. In the Name field, enter “Heart Disease Problem List”.




b. Search for and select the following problems.

Angina

Cardiovascular Disease

Heart Disease

Hypertension

Stroke

c. Select the OK button once you have selected all the problems. This returns to the Find Table – Named Sublist window.

13. Select the OK button to save the section.

Create a Family History Section




4. In the Name field, enter “Family Heart Disease History”.



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7. Select the Family History Question radio button.

8. In the Problem List field, select Heart Disease Problem List. This is the list you created in the previous task.

9. In the Relationship List field, select the Find ) icon to access the Find window.


11. In the Name field, enter “First-Degree Family”.

12. In the Find Table field, select Family History Relationship.


a. Select the Find ) icon to access the full list of relationships.

b. Search for and select all the following first-degree relationships.

Brother

Daughter

Father

Mother

Sister

Son




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Create a Vaccination History Section




4. In the Name field, enter “Vaccination History”.



7. Select the Immunization History Question radio button.

8. In the Adult Card field the Find ) icon to access the Find window.


10. In the Name field, enter “Adult Vaccine Card

11. In the Find Table field, select Vaccine Administration.


a. Select the Find ) icon to access the full list of vaccine administration records.

b. Search for and select the system-defined Adult Vaccine Card. This defines the list of vaccines included in the questionnaire.



14. Select the OK button to save the list and return to the Questionnaire Section window.

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Review and Order the Questionnaire Sections


2. In the Questionnaire Sections pane, select the Surgical History item.

3. Select the down arrow ) icon twice to move the section beneath the Family Heart Disease History section.

4. The Questionnaire/Sections window now displays the new questionnaire and its sections.

5. Select the Save button to save the questionnaire and sections.

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Define a Section’s Questions and Answer Groups

Use the Sections/Question window to assign questions and their answer groups to the sections of a specified questionnaire. The window lists sections in the left pane, and any questions associated with the section in the right pane.

1. List Editor ) → Questionnaire → Sections/Questions

2. Select the desired Questionnaire.

3. Select the desired section from the left pane.

Note: You can add a new section or modify a section definition from this window by selecting New or Modify in the left pane.

4. Select the New button in the Questions pane of the Sections/Questions window.

5. Add an existing or new question to the section.

To add an existing question, search for and select the desired question from the list in the Find window. Got to step 16.

To add a new section, select the New button. This accesses the Questionnaire Question window. Go to step 6.

Ref: 1090.03 31

6. Select the Type of question. This may be:

KDB: This maps to the knowledge database so that the answer can be put in the patient history.

ROS: This maps to the ROS section of the knowledge database so that the answer can be put in the review of systems.

Problem: This maps to the medical problem section of the knowledge database so that the answer can be put in the problem/diagnosis history category.

None: This does not map to the knowledge database. Use it for questions which are necessary to lead to questions that will map to the KDB or ROS.

7. Select the KDB or ROS Name or the Problem for the question. This is the item in the knowledge database that this question corresponds to.

This field will not be available if you selected None as the Type in step 6.

8. The Name field displays the KDB, ROS, or Problem name. You may change this if desired.

9. Enter the Question Text. This is how the question will read in the questionnaire.

10. The History field displays the KDB history group that the question is related to. This field is only used when the Type is KDB or Problem.

11. Select the Answer Group that contains the possible responses to the question.

For a KDB or Problem type, select the appropriate KDB history group.

For an ROS type, you must select ROS.

32 Ref: 1090.03

For a None type, select the appropriate answer group.

12. Select the Control Type that the question will use. You must select the control type appropriate for the answer group selected.


14. Select the Question Optional checkbox if the question is conditional, and thus is used only when a previous question is answered in a specific way.

15. Select the Require Answer checkbox if the question is required.

16. The question name now appears in the Question pane of the Sections/Questions window.

17. Repeat steps 5 through 16 to add each desired question.

18. To change the order of the questions within the section, use the Up, Down, or Sort Order buttons. The questionnaire will present the questions to the patient in the order established here.

Questions and Answer Group Practice Tasks

The following practice tasks assign questions from the knowledge database to the practice questionnaire sections that use the Patient Question type of question. These practice tasks use the system-defined answer groups which are associated with the knowledge database questions.

Questionnaire sections that use the Patient Problem Question, Family History Question, or Immunization History Question type of question are not assigned questions and answer groups. The questions and answers are within the section definition.

Select Tobacco History Questions

This task selects questions for the tobacco history section of the questionnaire.


2. In the Questionnaire field, select the Practice Cardio Questionnaire.

3. Select the Tobacco History section from the left pane.


5. In the Find Questions window:

a. In the Name field, enter “tobacco”.

b. Select the Search button.

c. Select the “Tobacco History” question.

d. Select the OK button to access the Questionnaire Question window.

The Type and Name fields are populated with data from the KDB question, and cannot be changed. The Question Text, History Group, Answer Group, and Control Type fields are also populated with data from the KDB question. These fields can be accepted or changed.

Ref: 1090.03 33

6. The Questionnaire Question window should look like the sample below. Select the OK button to return to the Sections/Questions window.



a. In the Name field, enter “%cigarettes%”. Be sure you include the percentage signs to search for the text string.


c. Select the “Number of Cigarettes/Day” question.


34 Ref: 1090.03

9. The Questionnaire Question window should look like the sample below. Select the OK button to return to the Sections/Questions window.

10. The Sections/Questions window now appears like the sample below.

Ref: 1090.03 35

Select Alcohol History Questions

This task selects questions for the alcohol history section of the questionnaire. If you are continuing from the previous task, go to step 3.



3. Select the Alcohol History section from the left pane.



a. In the Name field, enter “alcohol”.


c. Select the “Alcohol History” question.


6. In the Questionnaire Question, select the OK button to return to the Sections/Questions window.


36 Ref: 1090.03


a. In the Name field, enter “%drink%”. Be sure you include the percentage signs to search for the text string.


c. Select the “Number of Years Drinking Alcohol” question.





a. In the Name field, enter “%drink%”. Be sure you include the percentage signs to search for the text string.


c. Select the “Frequency of Drinks” question.


Ref: 1090.03 37



38 Ref: 1090.03

Select Surgical History Questions

This task selects questions for the surgical history section of the questionnaire. If you are continuing from the previous task, go to step 3.



3. Select the Surgical History section from the left pane.



a. In the Name field, enter “%card%”.


c. Select the “Cardiac Surgery” question.


6. In the Question Text field, type “Have you had heart surgery, angioplasty, or heart bypass?”

Note: This changes the question text for this question in every questionnaire in which the question is used. If you do not want to make this change, then skip step 6.

Ref: 1090.03 39



40 Ref: 1090.03

Select the Answer Group for a Question

Use the Questions/Answers window to modify the answer text in an answer group for a specific question, and to define the questionnaire behavior for specific answers. Questionnaire behaviors include requiring a conditional section, triggering a next question, and requiring an explanation.

This window lists questions in the left pane, and associated answers in the right pane.

1. List Editor ) → Questionnaire → Questions/Answers

2. Select the desired Section.

3. Select the desired Questionnaire Question from the left pane. The answer group and

answers associated with the knowledge database question appear in the right pane.

You can add a new question or modify a question definition from this window by selecting New or Modify in the left pane.

4. Select the New button in the Questionnaire Answer pane.

5. Add an existing or new answer to the question.

To add an existing answer, select the desired answer from the list in the Find window. Then select the Modify button to open the Questionnaire Answer window.

To add a new answer, select the New button. This opens the Questionnaire Answer window.

6. Create or edit the answer using the appropriate task below. Answer definitions are based on the type of question that the answer is for. The types of questions are KDB, ROS, and None. The Problem type is no longer used.

Ref: 1090.03 41

Create or Edit Answer for KDB Question

Use this process to create a new answer for a KDB question. This maps to a history category in the knowledge database so that the answer can be put in the patient history.

1. Questionnaire Answer window

2. To create a new answer, select KDB in the Type field. The type field will display KDB and

will not be editable for an existing answer.

3. Accept or select a KDB Name for the answer. This maps the questionnaire answer to the KDB answer so that when questionnaire responses are imported, the application can identify and select the answer in the patient history.

4. Enter a Name if creating a new answer. You can edit the name for a custom answer, but keep in mind that this will change the name everywhere the answer is used. You cannot edit the name of system-defined answers.

5. Enter or edit the Answer Text. This is the answer that will be displayed to the patient when completing the questionnaire. Keep in mind that editing the answer text will change the answer text everywhere the answer is used.

6. If desired, select the Require Explanation checkbox to include a text box when this answer is selected. The answer set must use either the radio button or checkbox control type.

42 Ref: 1090.03

7. If desired, use the Require Section field to identify a conditional section that is required when this answer is selected. The answer set must use either the radio button or checkbox control type.

8. If desired, use the Require Question field to identify one or more conditional questions that are required when this answer is selected. The answer set must use either the radio button or checkbox control type.

9. To define a specific medication as the answer, the use Find button to enter the desired medication in the Drug field.


11. Select the OK button to save the answer and return to the Questions/Answers window.

12. The answer name now appears in the Questionnaire Answer pane of the Questions/Answers window.

13. To change the order of the answers within the section, use the Up, Down, or Sort Order buttons. The questionnaire will present the answers to the patient in the order established here.

Create or Edit Answer for ROS Question

Use this process to create a new answer for a ROS question. This maps to a system in the knowledge database so that the answer can be put in the patient ROS.


Ref: 1090.03 43

2. To create a new answer, select ROS in the Type field.The type field will display ROS and will not be editable for an existing answer.

3. In the ROS Answer area, select the appropriate radio button for the answer. ROS answers may be N/A, No, or Yes.

4. Enter a Name if creating a new answer. You can edit the name for a custom answer, but keep in mind that this will change the name everywhere the answer is used. You cannot edit the name of system-defined answers.

5. Enter or edit the Answer Text. This is the answer that will be displayed to the patient when completing the questionnaire. Keep in mind that editing the answer text will change the answer text everywhere the answer is used.





44 Ref: 1090.03

Create or Edit Answer for None Question

Use this process to create a new answer for a question that is not mapped to the KDB.


2. To create a new answer, select None in the Type field. The type field will display None

and will not be editable for an existing answer.

3. In the Determined Type field, select None.

4. The Name field will be populated from the knowledge database selection. You may change this if desired.

5. The Answer Text field will be populated from the knowledge database selection. You may change this if desired.





Ref: 1090.03 45

Answer Group Practice Tasks

The following practice tasks review the answer groups for the questions in the practice questionnaire. This practice task does not modify any answer groups or answers since doing so would modify those answer groups and answers for all questions with which they are used.

Questions that have a question type of Patient Problem Question, Family History Question, or Immunization History Question are not assigned questions and answer groups. The questions and answers are within the section definition.

Answer Groups for Tobacco History Questions Practice Task

This task reviews the answer groups for the questions in the tobacco history section of the questionnaire.


2. In the Section field, select Tobacco History.

3. In the Questionnaire Question pane, select the Tobacco History question.

4. In the Questionnaire Answer pane, select the “Has never smoked or chewed tobacco” answer.

5. Select the Modify button in the Questionnaire Answer pane.

46 Ref: 1090.03

6. In the Questionnaire Answer window, review the Answer Text, but do not make any changes.

7. Select the Cancel button to return to the Questions/Answers window.

8. Repeat these steps to review answers for the Tobacco History question and the Number of Cigarettes/Day question.

Ref: 1090.03 47

Answer Groups for Alcohol History Questions Practice Task

This task reviews the answer groups for the questions in the alcohol history section of the questionnaire. If you are continuing from the previous task, go to step 2.


2. In the Section field, select Alcohol History.

3. In the Questionnaire Question pane, select the Alcohol History question.

4. In the Questionnaire Answer pane, select the “Never Drinks Alcohol” answer.


48 Ref: 1090.03



8. Using these steps, review each of the answers for the Alcohol History, the Number of Years Drinking Alcohol, and the Frequency of Drinks questions.

Ref: 1090.03 49

Answer Groups for Surgical History Questions Practice Task

This task reviews the answer groups for the questions in the surgical history section of the questionnaire. If you are continuing from the previous task, go to step 2.


2. In the Section field, select Surgical History.

3. In the Questionnaire Question pane, select the Cardiac Surgery question.

4. In the Questionnaire Answer pane, select the “Before” answer.


50 Ref: 1090.03



8. Using these steps, review each of the answers for the Cardiac Surgery question using steps 4 through 7.

Ref: 1090.03 51

Review the Practice Questionnaire

Now that you have completed your practice questionnaire, assign it to a test patient so that you can review and test it.

Preview the Practice Questionnaire


2. Search for the Practice Cardio Questionnaire entry, and select the Modify button.

3. In the Questionnaire window, select the Preview button.

4. The questionnaire opens in a browser window as shown below. Review your questionnaire to make sure everything is correct.

Create a Test Patient

1. Select the Find Patient ) icon.

2. In the Find Patient window, select the New button. This accesses the Patient window.

3. Enter ZZJohn as the First name.

4. Enter ZZDoe as the Last name.

5. Enter any other information, if any, required by your practice.

6. Select the Additional tab.

7. In the Patient Status field, select Test Patient.

8. Select the OK button to save the patient record.

52 Ref: 1090.03

Create the Patient’s Web Account and Assign the Questionnaire

1. Select the Find Patient ) icon.

2. In the Find Patient window, search for and select the ZZDoe patient, and select the Modify button.

3. In the Patient Demographics window, select the Questionnaire tab.

4. Select the Create Web Account button.

5. The Patient Web Account window displays the User Name and Password. Write this information down so that you can use it in the next task.

6. Select the OK button to return to the Patient Demographics window.

7. Select the Add button to assgin the practice questionnaire to the patient.

8. In the New Questionnaire window:

a. In the Questionnaire Name field, select Practice Cardio Questionnaire.

b. Deselect the One Time Questionnaire checkbox.

c. Select the OK button to return to the Patient Demographics window.

9. Close the Patient Demographics window.

Ref: 1090.03 53

Complete the Practice Questionnaire

To complete this practice task, you must log into your patient self-service kiosk or into your Aprima Patient Portal as the test patient, ZZJohn ZZDoe.

1. Log into your kiosk or Portal using the patient ID and password created in the previous

task.

2. You will be asked to change the password when you log in. Change the password as desired.

3. At the Aprima Consent page:

a. Select the “I have read the consent form” checkbox.

b. Select the Agree button.

4. Select the Forms link.

5. Select the Complete Form button for the Practice Cardio Questionnaire.

6. Complete the questionnaire to review the questions and answers.

portal questionnaires and appointments...in this case, you must create the needed items in the...

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