User Guide — Screening Questionnaires

1. Display the Screening Questionnaires page: On the Main Menu, click Settings > Clinicals. In the left menu, under Practice Links — Exam, click Screening Questionnaires.
   Your enabled questionnaires appear under "My Practice's Screening Questionnaires" while all available questionnaires appear under "All Available Screening Questionnaires." The Type column indicates whether the questionnaire is administered in athenaOne (Type is Full), or whether you enter the score for the questionnaire after the patient answers the questions offline (Type is Score Only).
2. Click preview to view a read-only version of a questionnaire.
   Note: You cannot preview questionnaires with a Type of Score Only.
   
3. Click Return to Screening Questionnaires to return to the previous page.
4. Click add to add a screening questionnaire to your practice's Screening Questionnaire list.
   athenaOne adds the questionnaire for use at your practice.
5. Click edit next to a screening questionnaire to edit it.
   Additional fields appear.
6. Display Name — The name that appears in the Screening section of an encounter. You cannot edit this name.
7. Sex — Select the patient gender from the menu, or select Both if the questionnaire is used for both males and females.
8. Age range — Enter a minimum and a maximum age for the patients who can complete the questionnaire.
9. Specialty — Accept the default value, All, to allow all specialties to use this questionnaire, or click Selected and then select the specialties from the list.
10. Note — Enter any notes about this questionnaire.
11. Ordering — Enter a digit to specify the order of the questionnaire in the list that appears at the top of the Screening section.
12. Click Save.
    Note: You can delete screening questionnaires that you no longer use from your practice's list. After you delete a screening questionnaire, you can no longer add it to encounter layouts or encounter plans, and no patients can complete that questionnaire during an encounter. The questionnaire is still available to add from the All Available Screening Questionnaires list, and any previously completed questionnaires remain in the patient chart.

1. Display the Encounter Plans page: On the Main Menu, click Settings > Clinicals. In the left menu, under Practice Links — History/Intake, click Encounter Plans.
2. Click update next to the encounter plan that you want to update.
   The details of the plan appear.
3. In the Encounter Plan Actions area, filter the templates list on the left by entering "SQ" in the filter list text box.
   Only screening questionnaires appear.
4. Select the screening questionnaires to add to the encounter plan.
   The screening questionnaires are added to the Selected list on the right.
   
5. Click Save to update the encounter plan.

1. Display the Self Check-in Questionnaires page: On the Main Menu, click Settings > Communicator. In the left menu, under Practice Links — Patient Portal, click Self Check-In Questionnaires.
2. Click Add new under Self Check-In Questionnaires.
3. Rule name — Enter a rule name.
4. Appointment types — Select the appointment types.
   The appointments are added to the Selected list on the right.
5. Select the screening questionnaires to add to the encounter type.
   The screening questionnaires are added to the Selected list on the right.
   
6. Click Save to update the encounter type.

1. From the Intake stage of an encounter, click the Screening section in the checklist.
2. Click the plus sign to open the section.
   The Screening window appears.
3. Search for and select the questionnaires that you want to administer. You can select multiple questionnaires to add to the encounter. Click X next to a questionnaire to remove it.
   Important: When you remove a questionnaire, any data that was entered into that questionnaire is deleted.
   
   Your top five most frequently used questionnaires are listed alphabetically at the top of the Screening drop-down list under Most Frequently Used Screeners. The remaining screening questionnaires are listed alphabetically under Other Screeners.
4. Click the expand icon to view the questionnaire and enter responses.
5. To see more information about the questionnaire you are working on, click the Background tab.
6. After all questions are answered, click Score.
   The score guidelines appear at the top of the questionnaire. This information remains visible after you collapse the questionnaire.
7. Click Save.
   

When you complete a screening questionnaire that has been mapped to a procedure code, the procedure codes automatically appear next to the questionnaire in the Services section of the Billing tab.

1. Display the Order Type & Procedure Template Mapping page: On the Main Menu, click Settings > Clinicals. In the left menu, under Practice Links — Charge Integration, click Order Type & Procedure Template Mapping.
2. Order/Procedure — Click inside the text box to display the list of available order types, procedures, and screening questionnaires, and select the questionnaire to map.
3. Effective Date — Enter an effective date for the mapping, or leave the field blank if you do not want to restrict the mapping to a date range.
4. Expiration Date — Enter an expiration date for the mapping, or leave the field blank if you do not want to restrict the mapping to a date range.
5. Procedure Code — Click inside the text box and enter the first few characters of the procedure code to map. You can search by procedure name or by CPT code.
   Note: The list of procedure codes is not limited by your fee schedule. You can map orders and procedures to any valid CPT codes.
6. Click Add to save the new mapping.

The new mapping appears in the list of mappings at the bottom of the page. You can use the links to update or delete mappings.

1. Display the patient chart of a patient who has completed screening questionnaires during an encounter.
2. In the Vitals section, all screening questionnaires that the patient has previously completed are visible under Screening.

See the Available Screeners search tool to learn more about:

• Screening questionnaires available in athenaOne.
• New screening questionnaires added to athenaOne this year.
• Status of requested screening questionnaires — You can check whether a questionnaire has been requested and see if it is planned for a future release, under review, or not currently supported.

Many screening questionnaires are self-administered, meaning that the patient completes them on paper. You can enter the score for these self-administered questionnaires in the Screening section of the encounter (see To complete a score-only questionnaire during an encounter).

You can use the Clinical Paper Forms page to create custom clinical paper forms. Be sure to classify screening questionnaires as Encounter Document - Health History Questionnaire. This classification ensures that any uploaded or faxed forms can be associated with an encounter like any other electronically administered screening questionnaire. You can link these forms to individual screening questionnaires within the encounter.

Uploaded or faxed Encounter Document - Health History Questionnaire forms are located in the Visits and Cases section of the patient chart. To view a questionnaire, click Health History Questionnaire under Encounter Document(s) for an encounter.

If your practice plans to continue using paper screening questionnaires, athenahealth recommends that you enter the patient's responses from the paper form into the Screening section during the encounter. When you enter the questionnaire responses into athenaOne, you can:

• Automatically calculate the score.
• View any proposed guidelines.
• Track a patient's questionnaire results over time.

athenaOne supports the FOTO screening questionnaires, which you can use at patient discharge. Using the FOTO questionnaires, you can:

• Screen for functionality in a patient's knee, hip, foot/ankle, low back, shoulder, elbow/wrist/hand, and neck.
• Document a risk-adjusted functional status change residual score (RAFSCRS) in the Score field.

Each FOTO screening questionnaire has two versions: a 10-item short form (paper) and a computerized adaptive testing (CAT) form.

Note: Focus on Therapeutic Outcomes, Inc. (FOTO) is a third-party vendor; these screening questionnaires require the use of the FOTO proprietary patient-reported outcome measures (PROMs). See FOTO online assessments.

Calculating a risk-adjusted functional status change residual score (RAFSCRS)

 

Before you can enter a score in a FOTO screening questionnaire in athenaOne, you must calculate a risk-adjusted functional status change residual score (RAFSCRS). The RAFSCRS is the difference between the patient's functional status score at admission and the patient's functional status score at discharge, corrected for level of severity of the patient.

 

To obtain a RAFSCRS or residual score, you need to complete the following steps. athenahealth recommends that you use the FOTO online assessment to complete each step, but you can also use the short paper form and a spreadsheet of risk adjustment coefficients to manually calculate each value for the steps below.

Note: See FOTO online assessments for links to the online assessments and links to the paper short forms and the coefficients spreadsheets that you can use to manually calculate RAFSCRS.

 

Step 1: Enter the Functional Status Score at Admission: _______

Enter the raw scores (not the risk-adjusted scores) produced when the patient completes the FOTO functional status survey at Admission; this survey generates the Patient's Functional Status Score at Admission.

 

Step 2: Enter the Functional Status Score at Discharge: _______

Enter the raw scores (not the risk-adjusted scores) produced when the patient completes the FOTO functional status survey at or near Discharge; this survey generates the Patient's Functional Status Score at Discharge.

 

Step 3: Enter the Functional Status Change Score: _______

Subtract the Admission score (Step 1) from the Discharge score (Step 2).

 

Step 4: Enter the Predicted (Risk-Adjusted) Functional Status Change Score: _______

This value is the amount of functional improvement (score change) that FOTO predicts for patients of a similar risk profile. This score is calculated automatically and shown as the Predicted Improvement score at the end of the online assessment.

 

Step 5: Enter the Risk-Adjusted Functional Status Change Residual Score: _______

Subtract the patient's raw change score (Step 3) from the predicted score (Step 4). This final score is used to select a performance quality action. Enter this final score in the Score field of the FOTO screening questionnaire in athenaOne during a discharge visit (see To complete a score-only questionnaire during an encounter).

 

FOTO online assessments

 

To calculate the risk-adjusted functional status change residual score (RAFSCRS) that you enter in the FOTO screening questionnaire in athenaOne, you can use the FOTO online assessment.

Note: You can also use the short paper form and a spreadsheet of risk adjustment coefficients to manually calculate each value.

 

Links to the PROM computer adaptive tests

Access the CAT FOTO screening questionnaire and work through a series of questions with your patients to measure their level of function.

• #217 Computer Adaptive Knee Survey
• #218 Computer Adaptive Hip Survey
• #219 Computer Adaptive Foot and Ankle Survey
• #220 Computer Adaptive Low Back/Lumbar Spine Survey
• #221 Computer Adaptive Shoulder Survey
• #222 Computer Adaptive Elbow, Wrist and Hand Survey
• #478 Computer Adaptive Neck Impairments

 

Links to the PROM paper short forms and risk-adjustment coefficient spreadsheets

After you access the short-form screening questionnaire, your patient answers all the questions while the clinician or staff scores the questionnaire.

Note: To access the short-form questionnaire for the first time, you may need to register with the FOTO steward body. A measure steward is an organization that owns a measure and is responsible for maintaining the measure.

• #217 Knee FS PROM Short Form and #217 Knee Risk Adjustment Coefficients
• #218 Hip FS PROM Short Form and #218 Hip Risk Adjustment Coefficients
• #219 Foot & Ankle FS PROM Short Form and #219 Foot & Ankle Risk Adjustment Coefficients
• #220 Low Back FS PROM Short Form and #220 Low Back Risk Adjustment Coefficients
• #221 Shoulder FS PROM Short Form and #221 Shoulder Risk Adjustment Coefficients
• #222 Elbow Wrist Hand FS PROM Short Form and #222 Elbow Wrist Hand Risk Adjustment Coefficients
• #478 Neck FS PROM Short Form and #478 Neck Risk Adjustment Coefficients

The magic word for the Screening section is {{CLINICALSECTION_SCREENING}}.

When you use this magic word, all the information shown in the expanded Screening section is displayed, including the questions, answers, score, and notes for all questionnaires administered during the encounter. The only exception is the Guideline content because this information is automatically generated and is not part of the provider's documentation.

Note: If you place this magic word inside HTML tags, it will not work.

Providers enrolled in quality management programs can automatically satisfy the following measures using screening questionnaires:

Before you can use this section, you must configure your screening questionnaires:

1. Use the Screening Questionnaires page to select the global screening questionnaires to make available at your practice.
2. Use the Encounter Plans page to add the questionnaires to encounter plans. Using this page, you can link encounter reasons or follow-up diagnoses to one or more screening questionnaires. During an encounter, if you select an encounter reason, chief complaint, or follow-up diagnosis that has an associated encounter plan, all of the plan's diagnoses, orders, and templates (including screening questionnaires) are added to the encounter automatically.
3. Use the Order Type & Procedure Template Mapping page to map screening questionnaires to procedure codes (optional). When you complete a screening questionnaire that has been mapped to a procedure code, the procedure codes automatically appear next to the questionnaire in the Services section of the Billing tab.

The Screening Questionnaires Report allows you to report on the clinical information documented in the screening questionnaires during patient encounters. This report is particularly useful for population health management. For example, you can run a report for patients who have high scores on the PHQ-9 questionnaire to ensure that providers follow up with patients who have an increased risk of depression.

You can run two versions of the Screening Questionnaires Report:

• Question and Answer Report — This report returns the full question-and-answer text information from each patient's questionnaire, along with other relevant questionnaire data.
• Questionnaire Summary Report — This report returns a summary of the questionnaire information, including Questionnaire Name, Total Score, and Encounter Date.

For complete information about this report, see Screening Questionnaires Report.