Creating New Surveys

Version 14.19

To create a new Survey:

  1. From the Clinical tab, click the More button (Customize groupand select Surveys from the drop-down menu. The Survey Forms Explorer window is displayed.
  2. Click the + (New) button in the top left corner of the window. 
  3. Click the OK button in the Confirmation pop-up box to confirm that once a survey has been administered, it can no longer be modified. A new Survey (questionnaire) window is displayed.
  1. Enter the survey details in the following Fields:  

Survey Name

Name assigned to the Survey that identifies the information.

Source

Survey can be created within the database or pulled from an external source.

External Name

Auto-populates with the name of the survey pulled from the external source.

Description

For internal use.

Instructions

Visible if a parent takes the survey on the portal.

Default visibility

Make a selection to determine who will be able to see the current survey.

Alert type/Alert value

Once you have created and scored your survey questions, use these fields to have the system alert you if any scores fall above or below or certain value.

Equiv LOINC

Set a default LOINC code for any surveys that correspond to a lab with an identical LOINC code. (ie. a lead risk assessment and lead test would both have XLEAD as their LOINC code to satisfy the need for Lead on a Care Plan).

Default Dx

Diagnosis code associated with the entry of the survey. Used to automatically associate billing when the survey is complete.

Default CPT/Default Mod

CPT code and modifier associated with the entry of the survey. Used to automatically associate billing when the survey is complete.

  1. Click the New button next to Questions to add a new survey question. The Question Properties window is displayed.

  1. From the Define New Question tab, select the This question is required and cannot be skipped checkbox.

  1. Enter the Question in the Question text field.
  2. Click the Answer button.

Text

Create a Text field that can be used for comments or entry to explain.

List

Create a list of option that can be selected for the Questions. May choose to allow single or multiple choice selections.

Integers

Set a numeric answer to the question.

Chars

Answer used to set an alpha character to the question.

Boolean

Boolean answers are used to set a value to an assumed yes/no or true/false response.

Date/Time

Answer will be entered as a date.

Masked Edit

Set the answer to a preset value such as the entry of a phone number.

  1. Click the OK button when you are finished entering your Answer(s).
  2. To add a second question, click the New button next to Questions again and repeat the above procedure.
  3. To modify you can do the following:
  • Rearrange the position of the Questions by clicking the Up and Down buttons in the questions grid.
  • Review the answer type and format. Highlight the Question and click the Answer button. The Answer window is displayed.
  • Reviews the survey question by clicking the Test button in the questions grid.
  • Review the entire Survey by clicking the Test button in the Survey Forms Explorer window. The Answer Wizard (test mode) window is displayed. Select form mode test or grid mode test. 
Version 14.10
Note:  To open the Survey Administrator Tool Bar: Click Utilities > Manage Clinical Features > Survey Administrator.
  1. Open the Survey Administrator Toolbar.
  2. Click the Create button. A new Survey (questionnaire) window is displayed.

  1. Enter information as follows: 

Survey Name

Name assigned to the survey that identifies the information.

Source

Survey can be created within the database or pulled from an external source.

External Name

Auto-populate with the name of the survey pulled from the external source.

Description

For internal use.

Instructions

Visible if a parent takes the survey on the portal.

Default visibility

Drop-down menu to restrict who will be able to see the current survey.

Alert type/Alert value

Once you have created and scored your survey questions, use these fields to have the system alert you if any scores fall above or below or certain value.

Equiv LOINC

Set a default LOINC code for any surveys that correspond to a lab with an identical LOINC code. (ie. a lead risk assessment and lead test would both have XLEAD as their LOINC code to satisfy the need for Lead on a Care Plan).

Default Dx

Diagnosis code to associated with the entry of the survey. Used to automatically associate billing when the survey is complete.

Default CPT/Default Mod

CPT code and modifier associated with the entry of the survey. Used to automatically associate billing when the survey is complete.


  1. Click the Add   button on the Survey Administration toolbar. The Question Properties window is displayed.

  1. From the Define New Question tab, select the This question is required and can not be skipped checkbox.
  2. Enter the Question in the question text field.
  3. Click the Answer button.

Text

Create a text field that can be used for comments or entry to explain.

List

Create a list of choices that can be selected for the questions. May choose to allow single or multiple choice selections.

Integers

Answer used to set a numeric answer to the question.

Chars

Answer used to set an alpha character to the question.

Boolean

Boolean answers are used to set a value to an assumed yes/no or true/false response.

Date/Time

Answer will be entered as a date.

Masked Edit

Set the answer to a preset value such as the entry of a phone number.

  1. Click the OK button when you are finished entering your Answers.
  2. To add a second Question, click the Add button on the Survey Administrator Toolbar and repeat the above procedure.
  3. To make changes you can do the following:
  • Rearrange the position of the questions by clicking the Up and Down buttons on the Survey Administrator toolbar.
  • Review the answer type and format highlight the question and click the Answer button on the Survey Administrator toolbar.
  • The Answer window is displayed.
  • Reviews the Survey by clicking the  on the Survey Administrator toolbar.
  • Review the Survey Test button on the Survey Administrator toolbar.
  • The Answer Wizard (test mode) window displays.
  • Select form mode test or grid mode test.