The CHR can automatically produce clinical notes using patient-reported information via Qnaires. Natural language is used to support this and refers to the ability to convert Qnaire responses from patients into a custom paragraph, point form list or clinically relevant summary that can be directly attached to an encounter note.

It is possible to customize exactly how a certain Qnaire response would be formatted in a note. Encounter/note templates can be created where the score a patient receives upon assessment completion can be automatically documented in the note.

One of the pillars of efficiency delivered by the CHR is the conversion of patient responses via Qnaires into a clinical output. This can easily be customized by our clients.

There are two approaches to natural language conversion:

  1. Creating a sentence in the question

  2. Creating unique sentences for each response

Creating a Sentence in the Question

  • To start, head to the question you would like to associate natural language with and click on the question. 

  • In the window that appears, navigate to the field labelled 'Natural Language Conversion'. Use the variable coding (see list at the end of this tutorial) to insert the sentence you would like to appear.

When the above question was completed by the patient who selected "Often",  the output of this response was: 

He often finds it difficult to understand a character's intentions when reading.

Creating Unique Sentences for each Response 

  • For this approach, begin by selecting the question and inserting #answer in the 'Natural Language Conversion' field. This step will "pull" the answer from the selected response. 

  • Select each response option and insert a sentence exactly as you would like it to appear in your clinical notes. 

When the above question was completed by the patient who selected "Often", the output of this response was:

He frequently has difficulty understanding a character's intentions when reading.

Using the natural language in each response, the answer itself can be changed. For example, options such as Often, Never, Always etc. can be customized to create a coherent sentence with relevant information or to remove capitalization.

Below are the current coding options that can be used when formatting natural language:

  • <p> Defines a paragraph, needs to be followed with </p>

  • <br> Line break

  • <li> Bullet point, will automatically insert a line break with </li> if not specified on the same line

  • <br>- hyphen point

  • <em> TEXT : </em> Italics 

  • <strong> TEXT : </strong>Bold

  • <u> TEXT</u> : Underline

  • #heshe

  • #himher

  • #hisher

  • #himherself

  • #first_name

  • #last_name

  • #age

  • #gender

  • #answer (what the patient responds)

  • #patient_title

Question Types:

Using the Qnaire Editor, the output of each response and question type can be customized.

Multi-select

  • By ending the sentence in #answer if there are multiple options selected the system will automatically add commas.

  • If there are follow-ups to each option in the original question, the natural language for the follow up questions must begin with a new sentence

Single Select

  • If the question is a Yes/No response with a follow up question, for Yes, you can “Override Natural Language” in the Yes response and include the corresponding output for the follow up. As a result, if the patient selects Yes it will lead to an output from the follow up response as opposed to stating Yes

Free Text

  • It is recommended to include quotation marks around the answer as follows “#answer” to indicate the patient has dictated the response

Please Note the following:

  • For questions with dates, if individuals do not enter the complete date from the provided options the output appears as “I don’t remember”

  • Natural language cannot be added to the Section header or Image questions

07.24.20

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