Advanced questionnaire features
- James Price
Advanced questionnaires can be built with a number of new question types and capabilities, including calculated fields (scoring), branching, and assigning clinical codes to the questionnaire, questions, and patients' answers.
We can build advanced questionnaires with all of these features now. Please contact your Success PM if you have a questionnaire that you would like us to build.
Scoring
Questionnaire scoring allows clinical teams to send scored questionnaires, such as the PHQ9, to patients. These scored questionnaires will apply simple calculations to patients' responses and generate an overall score, which can be viewed in the questionnaire response or retrieved via our APIs.
The formula used to calculate a score will be viewable in the UI, in the Questionnaire resource and in the CSV export. This ensures the user can verify that the calculation was carried out correctly.
Branching
Organisations can configure sections of questionnaires to be displayed conditionally to patients, based on their answers to previous questions. For example, showing a set of pregnancy-related questions to a patient only after they had responded ‘Yes’ to a question asking if they are pregnant.
Where appropriate, branching logic can also be used to conditionally display messages or advice to patients.
Coded data
Questions in Advanced Questionnaires can be mapped to clinical codes. For example, a question asking a patient for their blood pressure can be mapped to the clinical code for blood pressure.
When PKB creates the questionnaire template, we can add a clinical code for a question and/or a list of coded answer options. Organisations can then extract the relevant coded fields into their local systems via the FHIR R4 Questionnaire resource (see image above). The questionnaire questions are linked to the relevant responses in the QuestionnaireResponse resource via the ‘linkId’.
Where clinical codes are assigned to questions, FHIR Observation resources can be generated for the answers to these questions. In the future, these Observation resources can be displayed in the patient’s PKB record. For example, a FHIR Observation resource would be generated for a patient’s GAD7 score after completing a questionnaire and this GAD7 Anxiety Score would be visible in the patient’s Measurements section.
Mandatory questions
Organisations will be able to set individual questionnaire questions as mandatory, meaning the patient will not be able to submit the questionnaire if they are not complete. This will reduce time spent by clinical teams communicating with the patient if an important field is left unanswered. The patient will see an error message if they click Submit on a form with unanswered mandatory questions.
Drafts
Patients will be able to save their questionnaire in draft form and exit the questionnaire, before returning later and carrying on where they left off.
When a patient clicks ‘Save’ on a questionnaire, they will be directed back to the PKB home screen (if logged in) or the PKB login screen. Draft questionnaires will have an associated questionnaire response with a status of ‘In progress’.
When a patient returns to the questionnaire, they can continue completing the questionnaire and their previous responses will be saved. When the patient clicks ‘Submit’, the associated questionnaire response will have a status of ‘Completed’.
Images
Embedded images
Organisations will be able to embed images in questionnaires. Clinical teams can use images in questionnaires to guide the patient how to answer the questions and provide additional information and context to the questions.
Patient-uploaded images
Patients will be able to upload images in response to questions in questionnaires. This can be used by clinical teams, for example, when collecting information about the patient, where they can upload a photograph of themselves, or for uploading images related to their health such as injuries or skin rashes.
Patient-uploaded images can be viewed in the PKB UI by clicking ‘View’ on the questionnaire in the patient’s Events & Messages section or in the professional Inbox.
Sending questionnaires to unregistered patients
Patients can complete questionnaires without first registering for PKB, as long as they have a PKB record that contains an email address and a date of birth.
Unregistered patients are sent an email explaining that they have been sent a questionnaire, which contains a link to the questionnaire. When they click on the link, they are asked to provide their date of birth. This is to confirm they are the patient that the questionnaire has been sent to..
Once the date of birth check is complete, the patient is taken to the questionnaire. If the patient has no date of birth, they will be prompted to register via NHS login on the page where they would otherwise be asked for their date of birth.
When the patient clicks ‘Save and close’ or ‘Submit’, they are redirected to a confirmation page, with instructions about how to register. The completed questionnaire is saved in their PKB record even if they do not go on to register. This response can be viewed in the patient’s record, in the CSV export, or retrieved via the FHIR API.