Send patient's questionnaire to complete before/after appointment (measurement based care)
under review
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Ayan Dey
Specific to psychiatry, practice guidelines have strongly advocated for the use of measurement based scales to track progress. Scales such as the PHQ9, GAD7, YBOC for OCD, etc. These scales could be completed by patients before appointments and then used for context for a consult or progress note. An example of an AI scribe service that has implemented this is MD Hub, which I currently use before this trial.
Phil from Heidi
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under review
A
Ayan Dey
This is how it looks on MDHub when I open up a questionnaire that has been completed by a patient.
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Ayan Dey
1) I think it would be helpful to have the option of either which is set by the clinician. It depends on the questionnaire in question. It would also be great if the clinician could trigger the scale even during an appointment if using their desktop so that it can be done in real time.
2) Do you need the raw item-by-item responses stored, or just the total score + severity band (and ideally trend over time)?
- Both since clinicians sometimes use sub-scores for the item. Again this depends on the questionnaire.
3) How would you want the results to land in Heidi — inserted into the progress note template, saved as a form/file in the chart, and/or pushed into your EHR?
- Inserted into progress note template. Pushing into EHR would be great as well if that is an option but I think just adding it to the progress note is enough. Clinicians when revising the note can then decide whether to include the scale or not.
4) In MDHub, the clinicians have the ability to upload or create their own questionnaires built into the system. It is very helpful for intake and also relieves the burden of creating these questionnaires from the development team.
- Most common scales I use are: PHQ9, GAD7, Epworth Sleepiness Scale, YBOC for OCD, ASRS for ADHD symptoms, Wender Utah for ADHD. All these scales are in the public domain and free to access.
Phil from Heidi
Ayan Dey: Thanks for these responses. Really love this idea and something we've talked about internally.
My understanding is that many EHRs will have this functionality built in natively to send out this questionnaire pre-visit and store it in the Encounter. Can I confirm your EHR doesn't have this built in?
Also out of interest but how often do you find patients take the time to fill in these surveys?
A
Ayan Dey
Phil from Heidi
- Cerner and Accuro do not have this functionality built in at least in the various places I do work. No EHR I have worked with in a hospital system in toronto (outside of those with EPIC) have the ability to send out questionnaires.
- If I ask patient's to fill it out, it generally is completed. Especially if they are given a reminder and informed how it can help influence their care. I do review the results of the questionnaires with them which they appreciate. I have published on this topic as well.
Heidi Team
Thanks for taking the time to share this — measurement-based care (PHQ-9/GAD-7/Y-BOCS etc.) is a really thoughtful workflow, and having scores available before the consult would be super useful context for notes.
I’ll share this with the team. A couple quick questions so we understand what would work best in your practice:
1) Would you want questionnaires sent automatically (e.g., X days before + a reminder), or triggered manually per appointment?
2) Do you need the raw item-by-item responses stored, or just the total score + severity band (and ideally trend over time)?
3) How would you want the results to land in Heidi — inserted into the progress note template, saved as a form/file in the chart, and/or pushed into your EHR?
If you have an example of how MD Hub presents the results (even a screenshot with patient info removed), that’d be really helpful too.