Form Completions

Ocean's forms are used in almost every Ocean product, from kiosks and tablets to secure messages, reminders, and online booking.

The forms are highly configurable. Every form is designed to generate a concise, clinical note summary. Many forms have additional fields designed to insert or update other kinds of data in the patient's chart.

In particular, they may be configured to:

  • Update a patient's contact information
  • Record "PREMs" (Patient Reported Experience Measures) and "PROMs" (Patient Reported Outcome Measures) as an Observation key/value pair
  • Record calculated or quantifiable data as an Observation key/value pair (e.g., a "@PHQ-9" score)
  • Record screening results as an Observation key/value pair (e.g., @CovidScreeningResult: "Positive" or "Negative")
  • Record consent status (e.g., "@EmailConsent: Granted")
  • Update the cumulative patient profile (CPP), such as the patient's problem list, past medical history, or family history)

Since these changes may require a clinical review or other follow-up, the forms may also generate a Task to ensure the follow-up is not missed.

Sequence of Connections With FHIR Resources

All systems must support the following Resource operations to allow kiosks to record clinical notes and update patient demographics:

  • PUT Patient - For any changes made by the patient to contact or demographic information (only if an Ocean form was sent that requests these values)
  • POST DocumentReference - Uploads a styled note reflecting Ocean's summary of the completed form, LOINC 51855-5 ("Patient Note"), with an attachment of type application/pdf

The following Resource operations are not strictly necessary for a basic implementation, but they will result in a richer experience for users:

  • POST Observation - For recording any 'tagged' values in the completed forms which were recorded as an EMR Field Mapping, e.g. a PHQ-9 depression score
  • POST QuestionnaireResponse - To record a key/value summary of the form answers, in case this more structured format is more useful than the text summary alone. The QuestionnaireResponse for example may be used to populate a custom form within the integrated system, or to retain data integrity.
  • POST Task - For recording a follow-up Task for the clinic staff to review the patient's changes in a timely manner.
  • POST Condition - For recording updates to the patient's medical history.
  • POST Immunization - For recording updates to the patient's immunization history.
  • POST Procedure - For recording updates to the patient's procedure history.

The integrated system is free to ignore these optional updates, but it must not fail with an error.