*Form Code: Enter a unique code for the Patient Form. This code can be alphanumeric. This field does not accept special characters. This is a mandatory field and has a limit of 10 characters.
*Form Name: This name can be alphanumeric and can include special characters. This is a mandatory field and has a limit of 50 characters.
Support Multipage checkbox: Check this checkbox to create a Patient Form with multiple pages. When this checkbox is checked and a Patient Form is configured, then on clicking the Save button, the Seq. No. column is replaced with a Page No. column. The output of the Patient Form varies based on the values entered in this Page No. column:
- If the Page No. column is blank, then the contents of the form will be displayed on a single page.
- If the Page No. column has the same numbers entered in multiple rows, then the following output format is displayed on the Patient Form:
- For Section Row 1 = Page No. 1
- For Section Row 2 = Page No. 1
- For Section Row 3 = Page No. 2
- For Section Row 4 = Page No. 2
- For Section Row 5 = Page No. 2
- Values entered in Rows 1 and 2 are displayed on Page No. 1 of the Patient Form.
- Values entered in Rows 3, 4, and 5 are displayed on Page No. 2 of the Patient Form.
- If the user enters different values under the Page No. column, then the following output format is displayed on the Patient Form:
- For Section Row 1 = Page No. 1
- For Section Row 2 = Page No. 2
- For Section Row 3 = Page No. 3
- Values entered in Section Row 1, Row 2, and Row 3 are displayed on separate pages.
- If the user saves an existing Patient Form by selecting the Support Multipage checkbox, then the Seq. No. column is replaced with the Page No. column, and the column has the value of 0. (All sections will be displayed on one page only.)
Value entered in the respective section:
Value entered in the respective section:
Output displayed on Patient Form:
- When this checkbox is checked and the user clicks the Save button, the system converts the existing fixed-layout Patient Form into a responsive Patient Form with the same Form Name and Form Code.
- When this checkbox is checked and the user clicks the Save As button, a Save As popup is displayed with an Enter New Form Code field and OK and Cancel buttons. The user must enter a new Form Code and click the OK button to convert the existing fixed-layout Patient Form into a new responsive Patient Form having the same Form Name and the new Form Code.
to select and define a process for Lab, Rad, Consult, Procedure, etc., from the popup.
Note:
- Scrubber checks are applicable to a Patient Form if the form has been designed with the EMR Scrubber Checks process option selected. When the respective Patient Form is used from the Encounter TOC, then on clicking Save, the scrubber checks are invoked.
- There is a provision to add Consults and Procedures to the Order Sheet via the Patient Form if the form has been designed with the selection of processes such as Create Consult Order and Message and Create Procedure Order and Message. On saving such Patient Forms, the Consult and/or Procedure record is added for the patient on the Order Sheet.
Seq. No.: Upon selecting a section, a sequence number is assigned to the selected section, which is auto-populated in this field.
Section (+) button: Click the [+] button of the Section to invoke the Section popup.
Columns: Enter a value to edit the number of columns (if required) in the respective Columns field.
G button: Click the button to generate the HTML code for the selected section.
E button: Click the button to edit the generated HTML code (if required) for a particular section.
D button: Click the button to delete a particular record.
Gender: Select the gender from the dropdown to which the section is applicable.
Complaint: Enter a complaint, if any. The limit of this field is 100 characters. The full Complaint Name is displayed in the tooltip when hovering the mouse over the Complaint Name.
Test Exec: Click the Params button to invoke the Params popup.
Select: Click the Search icons to select a Provider and CPT respectively from their respective popups.
Encounter Type: Click the Search icon to select the types of encounters that the Patient Form will be available for.
Make Available on Patient Portal App: Check this checkbox to make the Patient Form available on the PrognoCIS My Health Records app.
Translate to Spanish: Check the Translate to Spanish checkbox to initiate the translation of a patient form into Spanish using ChatGPT, upon entering a valid password.
Spanish: Select this checkbox to determine if this form is designed as a Spanish form.
Reference to Patient Form: This field is used to link a Spanish-language patient form to its corresponding English version. This field is enabled only when the Spanish checkbox is selected. Once active, click the Select Patient Form
icon to open a popup displaying a list of all active patient forms in the system, with two key exceptions: forms that also have the Spanish checkbox selected and the current form being edited are excluded from the list. The field supports the selection of only one patient form from the Patient Form Search popup. After a form is selected, its name is displayed as a hyperlink. Click this link to navigate to the referenced English version of the patient form for review or editing.
This field is not mandatory. If no reference form is selected, the Spanish form behaves like any standard patient form—it is shown to the patient if it is associated with the encounter type. In cases where a patient selects the English patient form linked to the appointment type and no Spanish reference is defined, only the English form is displayed. To allow flexibility, a Clear option is provided next to the Select Patient Form icon, enabling the user to remove a selected reference form if it was linked by mistake.
Row: This field displays the auto-generated unique ID for each test or row. Enter a row number (if required) to fit into the matrix of the design.
Col: Enter a column number (if required) to fit into the matrix of the design.
Class: Enter the character 'B' for bold, 'I' for italics, and 'U' for underlined to apply formatting styles to the entered header in the Class column.
Label: Modify the label (only if required) of the medication name displayed in the Label column. In the case of dependent forms, a complaint name must be provided in this field along with the form code in the Dep. Field column.
Data Type: Modify the displayed data type (if required) to the one required from the dropdown in the Data Type column, preferably CheckBox only.
Note:
- Select the 'Sign' data type to create a Patient Form with only a signature and the 'SignDate' data type to create a Patient Form with a signature and date timestamp.
- Including both of these data types, a maximum of nine data types can be used in one Patient Form. The 'Sign' and 'SignDate' data types are not applicable to Doctor Forms.
- The My Health Records app supports Patient Forms with all data types, including Multi-Select, Pick List, and Master Search, except for Button.
Note:
- The Length column is dependent on the Data Type selected and is applicable only to data types such as Text Field, List Box, Integer, Fraction, and Text Area.
- For the 'Text Area' data type, enter values in the form of (50, 5, 5000), i.e., (length, breadth, and characters).
Field ID: Every data type (CheckBox, Text field) added has its own Field ID generated automatically. These IDs have specific prefixes that are specific to the section selected.
By What: Select the value for By What from the dropdown depending on the selected Data Type. For example, for a CheckBox, select the 'By What' value as 'Code'; for a Text field and Text Area, or for a Master Search data type, select the 'By What' value as 'ID'; and for a Header to a field, select the 'By What' value as 'Label'.
Note: These values are auto-populated correctly; therefore, edit them only if required.
Code/ID: Depending on the value selected in the By What dropdown as Code/Name, the respective value is displayed under the Code/ID column. These Code/ID values are auto-generated unique IDs for each test or row.
Dep. Field: For every REMARK field in the Params popup, a Dependent field ID is automatically generated by the system under the Dep. Field column. If a Form Code is entered in this field, it becomes a dependent form for the parent form, and the complaints entered in the dependent form are displayed as checkboxes on the parent form UI. The complaint becomes hyperlinked when checked, and the complaint-specific dependent form is displayed in a popup upon clicking the hyperlink. The data entered in the form is populated on the HPI screen upon clicking the ACCEPT button on the parent form. The HPI screen displays all the complaints, and upon clicking each complaint, its associated template is populated with the responses entered earlier on the Patient Form. This is useful in cases where a patient has multiple complaints, as the HPI screen is populated with specific details for each complaint in the forms.
Must: Select the checkbox to mark the element/field as mandatory. An asterisk in red (*) will be visible on the design of the Patient Form, and the system does not allow saving the form until the user fills in these fields.
AB: Select the checkbox to prompt the user with an 'Alert Blank' about fields being left blank.
Note: When a field is marked as AB, and a user tries to save the form without entering information in these field(s), the system prompts the user that the field has not been filled.
The user may choose to ignore the prompt and continue saving, or fill in the required details and then save the details.
Alert: Enter the alert message text that should be shown to the user under the Alert column for the respective row.
Del: Select the checkbox to delete the particular record.
Active: Select the checkbox to keep the Patient Form as 'active' and available.
Form Under Test: Select the checkbox to keep the form visible only for users who are logged in from the 'admin' login.
Alert For Tests with Answered: Select the checkbox for 'Yes' and/or 'No' and/or 'Blank' to display a popup to the user upon saving, listing all the questions answered as 'Yes' and/or 'No' and/or left 'Blank'.
Save: Click the button to save the changes to the Patient Form.
Delete: Click the button to delete the HTML; a prompt confirming your delete action is displayed.
Reset: Click the button to reset the recently entered changes in the record before it was saved.
Save As: Click the button to save a copy of the form with a new name in PrognoCIS.
HTML: Click the button to generate HTML for the entire Patient Form.
Note: This is an important step because, unless clicked, you will not be able to see the updated changes on the UI of the Patient Form.
Edit: Click the button to modify the HTML code.
Preview: Click the button to preview the Patient Form.
In cases where a patient has multiple complaints, a Patient Form can be designed in such a way that each complaint on the parent Patient Form has complaint-specific dependent forms. The data entered in those forms is populated on the HPI screen with complaint-specific details. To design a dependent form:
- Create a parent Patient Form as well as complaint-specific child forms (dependent forms).
- Enter the Form Code of the dependent forms in the Dep. Field column on the Patient Forms Master.
- Enter the complaint name in the Label field on the Patient Forms Master.
- Generate the HTML for the form by clicking the G button.
- Save the form.
Notes:
- If the master Patient Form is deleted, its dependent forms are not deleted but must be marked as Inactive manually.
- The dependent forms functionality is applicable to Patient Forms on the PrognoCIS EMR as well as on the Patient Portal, ProCheckIn, ProMeet, and Book Appointment page.
- The dependent forms functionality is NOT applicable to the My Health Records app (Patient Portal App), and so the Make Available on Patient Portal App checkbox must be unchecked while designing the dependent forms for the complaints.