Electronic Forms or eForms are designed to mimic paper forms but eliminate the need for manual data entry. eForms display information from the database and allow the entry of new information in a similar fashion as the populated paper forms. The advantage of an eForm over a populated form is that the data is "dumped" into the database once the form is approved. Access to eForms is limited by permissions and an Attending is the only user who can approve a form. All eForms can be accessed through the eForms tab.
Select an eForm
Selecting an eForm is similar to the manner in which the paper forms are selected. After selecting the eForm tab, a window is displayed with menus across the top of the screen. Selecting one of the menu items will load the corresponding eForm.
Once an eForm has been selected, a screen will be displayed with a menu along the left side and a details pane to the right. There are three main components to all electronic forms: entry, verification, and narrative report. The entry component is modeled after paper form and consists of sections with data entry fields similar to the Patient Data section. The menu along the left hand side allows a user to navigate between each section or to different parts of the same sections.
This form, the prostatectomy operative eform, has five sections: General, Operative Findings, NVB and Grafts, Surgical Details, and Fluids. These links are specific to this eForm, but menus in general will be used to access related sections of an eForm. As you can see in the image to the left, a section may have any number of related sub-sections. Procedures Performed and Intraop Prostate Exam are both sections of the Operative Findings and clicking on each of these links allows a user to jump to that section. In general, all forms are designed to minimize scrolling, but these menus aid in the navigation from one section to the next.
All of the data entry components of the eForm contain the same kind of entry fields as the Patient Data section plus some additional types to aid in the use of the electronic forms. eForms are being designed with clinician’s needs in mind and in general, clinical requirements are lower than research requirements. When possible, radio buttons and check boxes have been added to reduce the need for scrolling through lists of lookup options. As the use of Tablet PCs become more prevalent, electronic forms will have to take into account the use of styluses in place of a mouse and keyboard. Check boxes, radio buttons, and number pads help with this transition.
The image above displays an example of the stylus friendly interfaces for entering numbers in a text field. Using a stylus, you can select numbers from a keypad or calculator type interface. The number pad has other characters in addition to the numbers. Surrounding the numbers are symbols for “greater than” and “less than” and periods and colons for entering decimals or times. In the lower right hand corner is a “C” for clearing the last selected character, similar to the “Back” button on a keyboard. In the upper right hand corner is a button to close the number pad.
eForm data entry is similar to similar to entry in the Patient Data section. Although similar, there are slight differences in how a user interacts with the eForm. The most significant change is that you no longer need to click Save every time you move to another section. Clicking from section to section automatically saves the changes made in the prior section. Also, the concept of sub forms does not apply because all related sections are displayed on the same screen. Depending on the eForm, the fields available may be a subset of what is available on the main Patient Data screens.
Changes to the eForm are saved when you move between each section of the eForm, but moving outside of the eForm requires a verification that the data should be saved. If you enter data and try to leave the eForm, a prompt will be displayed asking you to verify that the changes should be saved. This prompt will also be displayed if you try to preview the form without saving.
Although data is saved automatically, a save button has been added to the bottom right corner of the eForm for users who prefer to save between sections. Next to the Save button is a Delete button for deleting an eForm. The eForm can be deleted at any time by any user who has access to modify the eForm. To prevent accidental deletions, the prompt below verifies that the user intended to delete the current eForm.
The Cancel button will prevent the deletion of the eForm. If the OK button is selected then the screen below provides links to start a new eForm or return to the Caisis splash screen.
After the eForm is completed, the narrative report can be viewed by clicking the Preview for Approval. If all required sections of the eForm are populated, then the narrative report screen will be displayed. If a required field is not completed, then the Validation screen below displays the missing fields or sections in yellow. In the example below, the ASA Score has to be completed before the narrative can be viewed.
From this screen, you can update the required field and click Save to view the narrative. If you would like to return to the eForm, a Return to eForm button in the bottom left section of the screen allows you to return to the eForm and make additional changes.
eForm: Narrative Report
The eForm Narrative has two interactive states, edit Data and edit Text. In the upper left hand corner of the screen, there are buttons to toggle between Data and Text. The Data view is used to modify information entered into the eForm screen. Items that can be edited in this view are highlighted in yellow and underlined in red, as in the case above for the Nature of Procedure section.
Clicking on one of the highlighted data elements will load a section from the eForm, so you can edit the information in the narrative. The image above displays the screen that loads when an items is clicked in the narrative report. In this case, the procedure was selected, so the Primary Procedures section from the eForm is loaded. Once the record is changed and Save is clicked, the form will close and the new information will be displayed in the narrative. The text that surrounds the eForm data can also be edited to user specifications.
When you click the Text button in the upper left hand corner of the screen, the narrative background color changes to yellow and all text can be edited. The data from the eForm is still underlined in red. Although the text can be edited, data from the eForm cannot be edited when the narrative is in this mode. eForm data can only be edited in the Data mode. Once the changes to the narrative text are complete, the Data button must be clicked save the changes to the text. If all of the information is accurate and complete, the form can be approved by clicking Approve this Form in the lower left hand corner of the screen.
Please note: The Return to eForm button will take you back to the eForm but doing so will also cause the changes to the text to be lost. To remind you of this possibility, the alert below reminds you not to leave the narrative screen unless you are willing to lose changes to the narrative text.
eForm: Approval Confirmation
A confirmation screen, see above, is displayed when an eForm has been approved. The screen also contains a link back to the main splash screen.