*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 character limit of 10 characters.
*Form Name: This name can be alphanumeric and can include special characters. This is a mandatory field and has a character limit of 50 characters.
Support Multipage checkbox: Check this checkbox to create a Patient Form having multiple pages. When this checkbox is checked and 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 upon 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
- Value entered in Row 1 and 2 is displayed on Page No.1 of the Patient Form.
- Value entered in Row 3, 4 and 5 is 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 the section Row 1, Row 2 and Row 3 are displayed on a separate page.
- If the User saves an existing Patient Form by selecting the Support Multipage checkbox, then the Seq. No. column is replaced with Page No. column and the column has the values as 0. (All the 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 User clicks on the save button, the system converts the existing fixed layout Patient Form into a responsive Patient Form having the same Form Name and Form Code.
- When this checkbox is checked and User clicks on the save as button, a Save As popup is displayed with a Enter new Form Code field and ok and cancel buttons. 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 on Patient Form if the form has been designed with the process, EMR Scrubber Checks option selected. When the respective Patient form is used from Encounter TOC then on click of save the Scrubber checks are invoked.
- There is a provision to add Consults and Procedures to the Order Sheet via 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 save of such Patient Forms, the Consult and/or Procedure record is added for the Patient on the Order Sheet.
Seq. No: On selection of a section, a sequence number is assigned to the selected section which is auto populated in this field.
Section (+) button: Click on [+] button of Section to invoke Section popup.
Columns: Enter the value to edit the number of column value (if required) from respective Columns field.
G button: Click the button to generate HTML code for the selected section.
E button: Click the button to edit the generated HTML code (if required) of a particular section.
D button: Click the button to delete the particular record.
Gender: Select the gender from the dropdown to which the section is applicable.
Complaint: Enter a complaint, if any. The character limit of this field is 100 characters. The full Complaint Name is displayed in the tooltip on hovering the mouse over the Complaint Name.
Test Exec: Click the Params button to invoke Params popup.
Select: Click the Search icons to select Provider and CPT respecively from their respective popup.
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 PrognoCIS My Health Records app.
Row: This field displays the auto-generated unique id for each test or row. Enter row number (if required) to fit into the matrix of design.
Col: Enter column number (if required) to fit into the matrix of 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 label (only if required) of the medication name displayed in 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 displaying data type (if required) to the one required from the dropdown in Data Type column, preferably CheckBox only.
Note:
- Select 'Sign' data type to create a Patient Form with only signature and 'SignDate' data type to create a Patient Form with signature and date timestamp.
- Including these both data types, maximum of 9 data types can be used in one Patient Form. 'Sign' and 'SignDate' data types are not applicable for 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 on data types such as Text field; List Box; Integer; Fraction; and Text Area.
- For data type, ‘text area', 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 upon selected Data Type. For example, for a CheckBox select ‘By What' value as ‘Code'; for a Text field and Text Area; for a Master Search data type, select ‘By What' value as ‘Id'; and for a Header to a field, select ‘By What' value as ‘Label'.
Note: These values are auto-populated correctly therefore edit them only if required.
Code/Id: Depending upon the value selected in By What dropdown as Code/Name, the respective value is displayed under Code/Id column. These Code/Id are auto-generated unique id for each test or row.
Dep. Field: For every REMARK field in Params popup, a Dependent field id is automatically generated by the system under 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 on clicking the hyperlink. The data entered in the form is populated on the HPI screen on clicking the ACCEPT button on the parent form. The HPI screen displays all the complaints and on clicking on 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 (*) could be seen on the design of Patient Form and system does not allow saving of form till User fills in these fields.
AB: Select the checkbox to prompt the User with an ‘Alert Blank' about fields being left as blank.
Note: When a field is marked as AB then when 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 to see under the column Alert 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 either Yes' and/or ‘No' and/or Blank to display to the User on save a popup listing out all the questions answered as ‘Yes' and/or ‘No' and/or left as ‘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 the copy of form with new name in PrognoCIS.
html: Click the button to generate HTML for the entire Patient form.
Note: This is an important step as unless clicked you will not be able to see the updated changes from UI front of 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 on the G button.
- Save the form.
Notes:
- If the master Patient Form is deleted, then its dependent forms are not deleted but will have to be marked as Inactive manually.
- The dependent forms functionality is applicable for Patient Forms on PrognoCIS EMR as well as on Patient Portal, ProCheckIn, ProMeet and Book Appointment Page.
- The dependent forms functionality is NOT applicable for 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.
