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ClinicTracker EMR

Friday, 27 September 2019

The Benefits of Developing Smart Forms for Your Behavioral Health Agency

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I’m Michael Gordon, a clinical psychologist, clinic administrator, and clinical researcher. I’ve been producing these Facebook Live sessions because I have always been interested in the idea of using data and implementing workflows that make clinical life easier and, most importantly, improve patient care. It’s those interests that led me to develop an EHR called ClinicTracker.

Last time, I spent a good deal of time talking about a customized form – a way of collecting data that goes way beyond just storing static information.

Today I want to give you an example of how a smart form can make an enormous difference in how you can get your EHR to manage even complicated workflow requirements. I would like for you to see how sophisticated electronic forms can do far more than a paper form. What you really want is the ability to create forms that are dynamic and intelligent–that can include fields, hide fields, require fields, or perform calculations depending on a range of conditions and circumstances. You also want to embed those forms into the workflows you have for compliance and reporting. It may sound overblown, but smart forms can completely transform how your agency runs.

The best way I can explain the functioning and benefits of a smart form is to give you another actual example, this one showcasing how you can essentially embed logic in the form. So one of our users, a chemical dependency agency, asked us to help them design forms that worked differently depending on responses to some of the items. Here was the situation:

Watch the recorded Facebook Live session with Dr. Michael Gordon.

Listen to Dr. Michael Gordon here or on your favorite podcast player.

The State of New Jersey issued a set of requirements for managing clients who might have tuberculosis – TB. Essentially, the agency was required to ask all individuals who called for services whether they had TB or symptoms of the disease. If the intake worker determines that the caller exhibits none of those symptoms, then the staff member simply has to attest to that fact by signing a form./p>

However, if the caller indicates that they had TB or experienced one or more TB symptoms, a whole different set of steps came into play. The agency had to notify a nurse within four hours. The nurse then had 4 hours to contact the client and tell him or her to head to an emergency room. The nurse was required to sign a form indicating that these steps were followed.

If you didn’t have the ability to develop a smart form -- a form that could change depending on conditions -- it’d be hard to manage the process efficiently. You would need different forms depending on the presence or absence of those TB symptoms. You’d also have to figure out how to notify the nurse and document if the process was complete or not.

But with smart forms, you can build the logic right into the form. You can say, “If the client doesn’t have symptoms, just have the intake person complete and file the form. But if symptoms are detected, display fields that relate to notifying the nurse and then have the system present to that nurse the appropriate form and make sure that process is tracked.”

So, here’s how this all played out.

Step 1

First I want to show you the demographic screen the intake staff member used as he or she handled a phone intake. It’s a standard form that simply takes information in about the person’s contact information. Sure, it makes entering information a lot easier than writing it on a form in that it has date pickers, dropdowns, and the like. But, in and of itself, it’s not all that smart.

But now look at the NEXT STEP Tab, the last tab on the right. The intake worker would know to press that Tab in every instance.

Intake

Step 2

By clicking on NEXT STEPS, the system will display a screen with a link to the mandatory TB assessment form. You can actually have tabs that display links to wherever you wish. For example, you could design a tab that generated a link that said: “Click here to notify your supervisor of a critical incident” or “Click here to generate a report about intakes.”

next step

Step 3

Now here’s where the form can adapt to various conditions – where it gets smart. Now one condition in this scenario is that the client doesn’t show any of these symptoms, in which case the intake worker simply checks the box for “no TB-like symptoms reported or observed” and signs the form. The information gets stored in the patient’s record and that’s that.

conditions

Step 4

But what if the client does have TB or potential symptoms of that disease. What happens then?

Well, the first thing you’d notice is that the form now shows a link to a Nurse Request Form. For those of you who are computer savvy, you’ll know that what we have here is conditional visibility -- the form will only display certain fields and links depending on what the situation calls for. In this case, the workflow involves sending the nurse a notification that he or she has to complete a Nurse Request Form.

Nurse Request Form

Step 5

When the intake person clicks on that link, the system sends the nurse a notification through the internal messaging system, which looks like this:

ClinicTracker Main Screen

Step 6

Now the nurse opens that message and sees that he or she has four hours to contact the client and complete this form:

Complete Nurse Request

At this point, this form becomes down right brilliant because it handles a host of conditions and compliance requirements:

  1. If the nurse fails to attempt a contact within the 4-hour time frame, the system will record that omission in a report to the supervisor
  2. If the nurse successfully contacts the client, the nurse completes the form, signs and then locks it. That form now becomes part of the patient’s record and the system will also mark the task as complete (the nurse is off the hook).
  3. If the nurse attempts a contact but is unable to reach the client, he or she can leave a voicemail suggesting that the client go to an emergency room. The nurse then signs and completes the form after documenting the effort.

It can even get smarter in that an administrator has the option of setting up the system so it prevents users from scheduling an appointment until the TB screen is done. That’s another way our system has your back by helping you prevent errors.

Step 7

And, of course, with our system, you can generate reports that track the process. Here’s a report that this agency designed. It shows the identified symptoms for all the patients who called into the clinic over a certain date range.

TB Report

Creating these forms that transform your workflow is easy using our Form Builder. For example, here’s the tool you would use to configure the form so it shows that link leading to the Next Steps.

form builder

So, I hope it’s now clear how you can develop forms that are indeed very smart in terms of what they’ll display depending on conditions, how they display it, and how they can be part of a workflow that’s designed to make sure the process happens as required. Smart forms are remarkable tools, and they are at your disposal as you customize the system to handle even the most complicated scenarios.

 

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