Guide to Building eForms

• • To get started, Login to the Ocean Portal. Click the "Menu" button in the top left corner and select "eForms".
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  • From here, you can search for existing eForms, edit them to your liking, and/or create new eForms from scratch.

• The Core Ocean eForm Library

  • Use the search bar to search through our extensive core library of Ocean eForms. You can download a spreadsheet with the full list of forms available to your site by selecting "Export All Forms Accessible to This Site" from the "More" menu. To preview some of our favourite forms, please visit our eForms product page.
  • Once you've found a form that you want to use, you can edit it to your liking by clicking on the form title and selecting "Edit". Once you've edited a form, its title will appear in blue (rather than the default black).

• The Shared Ocean eForm Library

  • If you cannot find the form that you're looking for, you can view the shared library of Ocean eForms that contains all forms that our Ocean users have created.
  • You can access this more extensive library of forms by selecting "View Shared Forms" from the "More" menu.
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  • If you find a form that you'd like to use, click on its title and the click on the "Import" button to make it available to your site.
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  • Imported forms can be edited (to customize it for your site), severed from the source site (if you want to make edits to the form, independent of its original source) and can also be synced with the form in the source site (if you'd like to capture any updates the the source site has made to the form).
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• Creating New Ocean eForms

  • If you still can't find the form you're looking for, you are welcome to create a new form from scratch by selecting the "Create New Form" button and then following the steps in "Creating a New Ocean eForm".

Follow the steps below to create a new Ocean eForm.

When you select Add Item, you will see a menu similar to the one displayed in the screenshot below.

The basic options include: General tab, Note Formatting tab, and Scripting and More tab.

When you add a section, the menu options are similar those in the Add Item menu. In this article, we explain the key differences between the "Add Item" and "Add Section" options.

Below you will find the full list of item types available in the eForm Editor that you can choose from to add to your Ocean eForms.

Diagrams can be useful tools for patients to demonstrate where they are perceiving discomfort. The Body Pain Diagram is a great eForm for this purpose, but you can also customize your own diagram. This article describes how to create your own diagram.

1. Add a "Diagram" item.

   • Open your eForm in the eForm editor.
   • Click the blue plus (+) sign and select "Diagram".
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   • Rename your diagram and choose a picture background for your diagram.
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2. Add "Labels" to your diagram.

   • Once you've uploaded your picture, you can add labels at various locations on the diagram. You can do this by clicking "Add Item".
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   • Move the 'X' to the appropriate spot on the background picture and label it using the "Caption" field.
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   • Continue adding items until you're happy with all your diagram's labels.
   • Save your eForm and your diagram will be ready for use!

You can add a hyperlink to an eForm using the "Label" item type.

eForms are often long and complicated, which can be overwhelming for patients. To prevent this, you may wish to break your eForm up into separate eForms and link them together in a favourites group, through eForm Actions, or using tablet rules.

Sometimes, it may be easier to just show a small set of questions on separate pages, mimicking the presentation of multiple eForms - i.e. multi-page support in the Ocean eForm Editor. Multi-page eForms will appear as multiple forms to patients, while generating a single encounter note in your EMR.

Enabling the Multi-Page eForms Feature

Follow the steps below to to structure your form so that each of your eForm sections appears as a new page to the patient.

Now, the form will look more or less the same in the eForm Editor, making it easier to edit. Just treat top-level sections in your eForm as new pages. Later, when you preview or load the form on a tablet, you will see these sections shown as discrete pages.

For example, check out the 2015 version of the Health Quality Ontario patient experience survey.

eForm formatting can be useful to make your Ocean eForms and Ocean-generated clinical notes easier for the reader to efficiently interpret. The following describes a few methods you can use to format your eForms and the generated clinical notes.

Use HTML to apply formatting styles

In the eForm editor, you can use simple HTML tags in captions to make parts of the clinical note that is generated from your eForm either bold, underlined or italicized.

For Example:

This <b>word</b> will appear bold, these <i>two words</i> will appear italicized and these <u>last words</u> will appear underlined.

The above will appear in the clinical note in your EMR as:

This word will appear bold, these two words will appear italicized and these last words will appear underlined

Create a title in the clinical note

If you would like to add a title to the top of your clinical note, follow these steps:

1. Open your form in the eForm Editor.
2. Click "Add item", and drag the item to the top of the eForm, above all the other text.
3. In the "Caption" field, type the title you would like to appear at the top of your clincal note with simple HTML tags. For "Type", select "Label".

   For Example:

   • <b><u>Preventative Care Visit</u></b><br>

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   • The <b></b> tags make the title bold.
   • The <u></u> tags make the title underlined.
   • The <br> tag adds a line break after the title.
4. In the "Note Formatting" tab, find the "Create a note for this item" option and select "always" from the dropdown menu.
5. In the "Scripting and More" tab, enter the value of "false" into the "Show this field if" input box. This will disable the title from being visible to the patient and only visible to the clinician reviewing the note.

Show an item's value in a caption or custom note

In order to access an item's value in the caption or custom note field you can add the special string "$$". This is particularly useful when using formula fields. If you would like to display the resulting formula so that the patient can also see it you can add a caption such as "Score: $$" to the "Caption" field. If you would like to add a custom note to an item you can also use "$$" tag in the "Custom Note" field.

Include messages or simple text as labels

Add item(s) in your eForms as "Labels" for messages, such as instructions or consent information (as opposed to section captions, which are bolded automatically and can be overwhelming to read through).

Add blank space(s) between question items within forms

Add a Blank Line Item

Add White Space to an Item

Alternatively, you can format a custom note in order to put additional white space before or after an item. To do so:

1. Open your form in the eForm Editor.
2. Click on the item that you want to surround with white space.
3. To insert a blank line before the item, copy and paste the item caption (from the General tab) into the "Custom Note" field (in the Note Formatting tab).
   • Move your cursor to the beginning of the text in the "Custom Note" field and tap the "Enter" key on your keyboard to add a blank line before the caption text.
4. To insert a blank line after the section, copy and paste the item caption (from the General tab) in the "Custom Note" field (in the Note Formatting tab).
   • Move your cursor to the end of the text in the "Custom Note" field and tap the "Enter" key on your keyboard to add a blank line after the text.

Other Customizations

There are many customizable formatting options for the Ocean-generated clinical note possible. These include changing the colour, order, spacing, etc. of eForm answers in the clinical note. These changes can be configured in the Note Formatting tab of the eForm Editor. For more on this, please refer to "Note Formatting Tab" in: "Guide to the eForm Editor - Add Item".

Formatting Before and After Entire eForms

Note: This formatting is only really useful for PS Suite or OSCAR users.

You can set up Ocean to add default text or spacing before or after all clinical notes generated by completed eForm at your site, or in between individual eForm notes.

Note Prefix

This text is inserted at the start of the patient's Ocean-generated notes.

To have a tag that appears before an Ocean-generated note, you can enter something like:

@OceanNote: Completed

Note Delimiter

This text is inserted in between individual eForm notes, applicable when two or more eForms have been completed back-to-back for a single patient.

To insert a blank line between eForm notes, enter a blank line:

Note Suffix

This text is inserted at the end of the patient's Ocean-generated notes.

To have a tag that appears after an Ocean-generated note, you can enter something like:

(note created using Ocean)

Formatting Before and After eForm Sections

Within an individual eForm, you may want to put additional white space before or after a section note.

To do so, open up your form in the eForm Editor, click on the section, and enter the Note Formatting tab.

• To insert a blank line before the section, insert a blank line before the section header in the "Custom Note" field.
• To insert a blank line after the section, type $$ in the "Custom Note" field, then a blank line afterward (tap Enter on your keyboard twice).

Note: $$ is a special tag in Ocean that represents the embedded note of the section. It will be replaced by whatever the patient answered on the form.

You are able to add translations for your eForm items by following the steps below. If you add new items to your eForm after performing the initial translation, you will need to repeat the steps below to translate the newly added items.

1. Specify your desired language

   • Open your form in the eForm editor.
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   • From the Action menu at the top right, select "Internationalize".
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   • Enter your desired standard ISO language two-character code (e.g. French is "FR"; Spanish is "ES").
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2. Provide string translations

   • Return to the Action menu, and select "String Translations...".
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   • The 'String Translations' window provides one line per eForm item for translation under the 'Text' column, with the default placeholder translation as "FR: {original English string}".
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   • Replace the entire placeholder string (including the "FR:" portion) with the proper language translation.

     Note: Ocean does not perform automatic language translation. You must provide the equivalent translated language to enter into the 'Text' field for each item in your eForm.

   • Once you have replaced all of the placeholder strings with your translated language, press "OK", and then press 'Save Changes' in the eForm editor to save your work.

3. Test your translations

   • To test the eForm after it's been translated, choose "Preview" in the eForm Action menu and then add "&locale=fr" to the end of the preview link in the address bar. (Ensure the language code is in lowercase letters.)

     For example, to preview the PHQ-9 in French, visit: https://ocean.cognisantmd.com/questionnaires/preview/QuestionnairePreview.html?ref=phq9&locale=fr

There a handful of useful keyboard shortcuts that can be utilized in the eForm Editor. Below is a list of key combinations that are available to shortcut various actions.

Name John Smith
Age 40
Gender male

• Create A New Section Item

  • In the Ocean eForm Editor, create a new section item.
  • With the section selected, open the “Note Formatting” tab
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  • Check the box next to the field labelled “Separate list items in the note using:”
  • In the dropdown the appears, select “(space)”
  • Create applicable form items within the section

• Edit Each Form Item

  • Select each individual form item and open the “Note Formatting” tab
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  • Under the “Show the note for this item:” field, check off the box labelled “on the same line as other notes”

Name John SmithAge 40Gender male

• Write a Custom Note

  • Select the applicable form item and open the “Note Formatting” tab
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  • Check off the box next to “Custom Note” and enter text
  • Note: The content written in the custom note area will only be visible in the final encounter note and will not be visible to the patient completing the form.

[The patient's name is ]John Smith[, a ]40[ year old ]male

The patient's name is John Smith, a 40 year old male