Templates: Evaluations

Evaluations Templates are the foundation for your Kipu EMR documentation and are generally more complex than consent forms. They allow for a patient signature, as well as staff (by function), and supervising staff (reviewer). 

Creating an Evaluation

Let's review how to create a new evaluation template.

1. To create Evaluations go to Templates > Evaluations.
2. Selecting the New Evaluation button will bring you to a new page to start your evaluation form. You can also use the Edit icon to make changes to an existing form.
3. Give your evaluation a Name and select the Enabled checkbox.
4. Click Add button to continue onto the body of the form.
5. Next, configure the parameters and options that determine how the form behaves.

General Evaluation Settings

The following options are available for selection:

• Patient Process [Required]: Select which patient process (patient chart tab) this form will be accessible from. 
• Enabled: Check to enable the form, alternatively uncheck to disable it if the evaluation is no longer needed.
• Billable: When checked, this evaluation will be included in the Billing report. This feature is used by organizations with an integrated billing solution like CMD or Avea. All billable evaluations must contain the field Evaluation Start and End Time. 
• Allow tech access: If you would like users with the role of Tech to be able to use/access this form check this box to give them access, otherwise they are not able to access the evaluation.
• Show patient photo in header: Use for identification purposes, this setting displays the patient picture in the top-right corner of the evaluation when added to the patient chart.
• Load manually: Check this box to prevent the form from being added when the Populate with Forms button is selected on the patient chart. When checked, the form can only be added using the Add form button on the patient chart tab. 
• Only one per patient: Stops any user from adding more than one of these evaluation forms to the patient chart for the same episode of care. If a mistake was made on the form, a Super Admin must delete the form before it can be re-added.

• Evaluation type: Choose one of the following:
  • Standard form: Any ongoing assessment/evaluation. This is the most commonly used option.
  • Pre-admission form: Allows you to perform assessments prior to the patient's admission. This type of form does not require the patient record to have an MR Number (chart #_. 
  • Insurance form: These forms will be available next to the built-in Insurance Verification button on the patient facesheet, and can be used to document additional insurance questions or concerns.
  • Important: Once signed, the date and time of the patient's signature will automatically populate the discharge date field on the Face Sheet, thereby discharging the client. 
• Evaluation content: Select one of the following:
  • Standard: Any ongoing assessment/evaluation. This is the most commonly used option.
  • Notes/Logs: Turns the evaluation into an ongoing note or log format. Must be used with field type Notes (notes) or Glucose Log (patient.glucose_log) and cannot have any other items (fields). This evaluation content type does not allow for signatures (the author of the note or log entry gets recorded, along with the date/time of the entry).
  • Treatment plan: Contains built-in functionalities that allow users with the role of Therapist/Other Therapist to work on the evaluation on an ongoing basis until it has been closed. Treatment plans can be categorized by Modalities. Examples: Medical, Clinical, Holistic, etc.
• Locked: No further edits can be made to this template.
• Portal: Check the Available box to share this evaluation to the Patient Portal for review and signature collection.
• When you click the Available button, the Signatures only checkbox will appear. If this box is checked off, patients will only be able to open and sign the form in the Patient Portal, they will not be able to make any other changes.

• Recurring: Allows the evaluation to be automatically populated in the patient's chart at specific intervals. Examples: CIWA-Ar every 4 hours; Nursing Assessment every 24 hours, etc.
  • Daily start time: Select the time when the first form for the day should be populated (e.g., 9 am).
  • Interval in minutes: Enter the number of minutes from 30 to 1440 to set the frequency. If your frequency is in hours, you need to convert it to minutes, e.g. 4 hours is 240 minutes, so you would need to enter 240 in the Interval in Minutes field.
    • Important
      Recurring forms can only be populated with intervals less than 24 hours (1440 minutes).
  • Show as Daily Overview: Check this box to add a dated header to the patient chart tab to house these forms.
• Link evaluation: Allows previously created forms to be linked together, making the linked form into a draft. You can unlink them just as you would a normal draft.

Billing Settings

When you select the Billable checkbox, a new section will appear which allows you to configure the related billing options. Click here to learn more.

Required Signatures

You may require multiple signature levels: Patient (and Guarantor and/or Guardian if listed in the patient's facesheet), Staff who perform the evaluation (listed by Function), and supervisory staff that will Review the evaluation (also listed by functions). Staff signatures are assigned by functions, which are custom to your organization. You may assign all levels of signatures, none, or simply the ones you need. To learn about assigning Functions to Users, click here.

Note: If you do not select the Patient box under Required Signatures, the patient will be able to view the evaluation but not make changes or add their signature.

Force Signatures

Assign signature requirements following your organization's policies. If you require more than one Staff signature or Review signature, you may also select Force Signatures to require a signature of at least one staff member per selected function.

Sign in Any Order

Please note that Evaluation templates with the Evaluation content set to Treatment Plan require a patient, staff, and review signature to be selected in that order to work correctly and move to the status of "In Use". This applies to the regular signing process (patient/guardian/guarantor, staff, review) and the "sign in any order" option.

Important
If you have the same Staff function selected in both the Staff signature box and the Review signature box then they will be required to sign twice, once as staff and second as the reviewer, unless you enable Review Signature Satisfied.

Form Status

Make sure that if you check Staff and/or Review signatures, you select at least one responsible staff function, otherwise, the evaluation will remain In Progress, and you will be unable to close it.

Review Signature Satisfied

Allows users who are selected for both Staff and Review signatures to sign once instead of twice. Click here to learn more.

Treatment Plan Signatures

Treatment Plan Evaluation Templates must have at least one Patient, Staff, and Review Signature selected to ensure the treatment plan evaluation signature requirements can be met and will move to the In Use status correctly.

Users with the Therapist role or the Edit Treatment Plans feature can add goals, objectives, interventions, and statuses to treatment plan evaluations in the edit view even after they're signed and no longer in the In Use status. Other users will only be able to see the read-only view.

Signature Behaviors

For a form that has signature requirements for the Patient, Guardian, and/or Guarantor but does not have a Staff signature requirement:

•  If the form is signed by the Patient before a Guardian/Guarantor is added as a Contact on the facesheet, the form will have fulfilled its requirement of getting the Patient's Signature and will display as Completed.
• The form will not recognize a Guardian or Guarantor being added as a contact after the form has met the Patient signature requirement since, at the time of signing, only a Patient signature was needed and thus the form was set to the completed status. If you need to collect the Guardian/Guarantor signatures, a new form will need to be added and resigned to capture all the intended signatures.

For a form that has the signature requirements of the Patient, Guardian, and/or Guarantor, and Staff signatures:

• The patient can sign the form and as long as the staff signature hasn't been added, the form will not move to a completed status. 
• When the Guardian/Guarantor is added as a contact on the patient's chart after the patient has signed but before the staff member has signed, the guardian/guarantor will be populated as a signer on the form because the form is not in a completed status. 
• Once added as contacts and the form recognizes the need for a Guardian/Guarantor signature, it will then allow them and the Staff to sign.

Choose Locations

Organizations in a Master Instance must also designate where the form is available for use.

Evaluation Items

Evaluation items are your form’s building blocks. They make up each line of your evaluation form. With the item, you can select from a variety of field types (described below) allowing you to build the form according to your specifications e.g., checkbox, text, date, points items, etc. You can add visual formatting options for each item to make the form more visually functional.

To create an evaluation item, click Add Item and complete the following fields, as needed:

• Name: Describes the item. Each name in your form should be unique, otherwise, if you use the edit pencil at the top right of the template you may have a hard time finding which items you want to move around where it shows up in the evaluation. The name is shown when the Form is validated by the user but is not otherwise displayed. The number that appears above the field is unique to that item and can be used to pre-populate the information into subsequent evaluations.
• Label: This is what you want your user to see. For example, a question to be answered, a title, etc.
• Label width: This metric determines the width of the Label. It is measured in percentage (%) of the whole page width.
  • Note: If you select 100% and then have items like checkboxes or radios you will not see them as the Label is being told to take up 100% of that width and leaving none for the items to display.
• Field Type: This dropdown gives you all the options available to create your evaluation. Examples: check box, string, date, matrix, etc. See the Field Type section below for a complete listing of available fields. 
• Points Group: when using a points system (assigning a score to answers to a questionnaire), this field identifies all the Evaluation Items that correspond to the same group of scored answers, that in term will be totaled. This field is used with the field types points_item and points_total, and groups the items that need to be totaled. You may have multiple Points Groups in the same Evaluation.
• CSS Style: the style that governs the evaluation item.
  • Percentages determine the space or size of the following field types (field types explained below):
    • auto_complete
    • check_box & check_box_first_value_none
    • datestamp & timestamp
    • drop_down_list
    • evaluation_date, evaluation_datetime, evaluation_name, evaluation_name_drop_down & evaluation_start_and_end_time
    • patient.admission_datetime, patient.bed, patient.discharge_datetime, patient.discharge_type, patient.employer, patient.ethnicity, patient.height_weight, patient.locker, patient.marital_status & patient.occupation
    • radio_buttons
    • string
  • p, h2, h3, h4 determine the size of the font for field type title. 
    • p = paragraph (standard text size)
    • h2 = largest title size
    • h3 = slightly smaller title size
    • h4 = smallest title size (still larger than p)
  • normal, textarea.small, textarea.long, textarea.inline, textarea.2_lines determine the size of the text box for that field type.
  • check_boxes_as_list turns a checkbox item (created by using the check_box and check_box_first_value_none the field types) into a list
  • Tip: if CSS Style does not abide by the guidelines above, the evaluation may not perform as desired
• Record names: limit with |. Points_items: 'yes'=>'10', 'zero'=>'0'
  • Record names: list the options for field types that require options; options must be separated by the pipe symbol (|). For example, you would separate three options like so: yes|no|maybe.
  • For the text field type, when Optional is selected, you can choose the text that appears next to the checkbox to collapse the text box. For example: N/A, No, Yes, None.
  • Points_items: 'yes'=>'10', 'zero'=>'0': when creating a points items questionnaire, this field is required to enter the answers, with their corresponding points/values; these must use single apostrophes (') and be separated with commas, as with the example above. For example 'yes'=>'10', 'no'=>'0', 'maybe'=>'5'
• Show string (e.g. false|true|false|false): enables you to alter any checkbox field type, so that you can provide a typed response, as opposed to a checked response. To include a typed response, it must be entered as true. Please note:
  • This field is only applicable to the checkbox field types.
  • Typed responses can be combined with checked responses.
  • This field is only applicable if you require a typed response.
  • This field must be used in conjunction with the Record Names field and must have the same amount of options For example, if your checkbox options are No|Yes|If yes, explain (in the Record names field), you would use false|false|true in the Show String field, to allow for a typed response to If yes, explain.
  • Placeholder: you may enter grey or ghost text in the field, to display as a guideline, example, or directive to the user. Once the user starts typing in the field, the placeholder will no longer display.
  • If you select checkboxes_as_a_list and then check the checkbox with strings but leave the string blank, the field will be blank in the form rather than showing n/a text.
  • Dynamic Matrix: This field also allows you to set up a Dynamic Matrix table by entering dynamic fields separated by this symbol (=>) to ensure the system display the evaluation items. (e.g. {drugList}=>1|2|3|4|5|6|7|8|9|10=>1|2|3=>{datePicker}=>{diagnosisCodes}. When creating a dynamic matrix, use the following evaluations items: 
    
    • {drugList}: Pulls drug names from the Substance tab in Settings
      • Example: =>{drugList}=>
    • {datePicker}: Adds a calendar to select a date.
      • Example: =>{datePicker}=>
    • {diagnosisCodes}: Selects diagnosis from ones already entered through Manage Diagnosis Codes form.
      • Example: =>{diagnosisCodes}=>
    • Free Text: Leave a blank box for free typing (Default option).
      • Example:=>=>
    • Dropdown: List options in a drop-down list.
      • Example: =>1|2|3=>

• Show String CSS: determines the width of the string when using a type-in Checkbox. Width is measured in percentage (%) of the whole page width.
• Matrix Column Names: name the columns to be used in your table (matrix or matrix_optional). Please note:
  • Names should be separated by the pipe symbol (|)
  • You can also name the rows in your table, you can do so using the Record Names field, always separated by the pipe symbol (|)
• Matrix No. Empty Records: provides the specified number of empty rows within your table (matrix or matrix_optional)
• Rule: allows for gender-specific conditioning (if male, if female, if transgender). When a Rule is in place, the Evaluation Item will display only when applicable per the rule.
• Default value for text field: allows you to pre-populate a text field with the discharge location.
• Pre-populate with ID: allows an item to be pre-populated with the information from another, previously completed form when an item’s numerical ID is entered into the field. To pre-populate your item with the information from another item within another form, enter that item’s number here. In order for this function to work as intended have in mind:
  • The source evaluation must be completed before the destination evaluation is loaded into the patient's chart
  • The evaluation item must be identical in both the source and destination evaluations - the question must be the same, so the pre-populated answer makes sense. For example, text field checkboxes with identical Record names, etc.
• Divider below: allows for a line (divider) below the selected item.
• Image: allows you to upload an image. It must be used in conjunction with field type image or image_with_canvas.

Additional functions in Add Item:

• Enabled: (at top left) is selected by default, and allows you to turn the item off and on, as to avoid deleting an item that may be useful in the future
• Add Items, Duplicate Item, Delete Item: these functions enable you to:
  • Add multiple blank items below your first item, in order to speed up the process of adding content.
  • Duplicate that specific item, which simplifies reproducing questions
  • Delete that specific item.

Field Types

Field Category/Purpose	Field Type
Attachments and Uploads	attachments: this allows you to attach documentation (PDFs, word documents, etc.) or pictures to your evaluation form. When using a mobile device, you may take a picture that would upload directly to the evaluation, without saving it on the device.
Auto Complete	auto_complete: in a type-in field, allows you to include a list of possible answers, that would autocomplete once the user starts typing.
Case Management	case_management_type: will add a radio button that allows a provider to document if that case management service was rendered directly or indirectly.
Checkboxes	check_box: creates checkboxes, each one defined in Record name check_box_first_value_none: creates checkboxes, where the first one, if checked, unchecks all others – or gets unchecked when any other is checked. This is commonly used for questions with a negative option, for example: Suicidality: Denies, Ideation, Plan, Access to method
Triggering a Subsequent Evaluation	create_evaluation: will add Yes/No radio buttons that, when Yes is selected, will load a subsequent evaluation to the chart. For example, adding the item in an initial assessment, such as Does the patient have difficulty walking? Answering yes would load a Fall Risk Assessment into the chart. Note for Integrated Billing Clients: if a single code is added to the subsequent evaluation, and it is marked as ancillary, the subsequent evaluation will be automatically added to the billing report.
Date and Time	datestamp: prompts a calendar to select a date timestamp: prompts a calendar, with sliding time bars, to select a date and time. This field includes a Now button, that will enter the current date and time
Dropdown Menu	drop_down_list: creates a dropdown menu to select one of your custom options
Evaluation Date and Time	evaluation_date: prompts a calendar to select a date. Once a date is selected, it will be included in your form’s title in the tab’s index page.  Note: This field will not be available if the evaluation is set to Billable. Use either evaluation_date_time or evaluation_start_and_end_time instead. evaluation_date_time: prompts a calendar, with sliding time bars, to select a date and time. Once a date and time are selected, they will be included in your form’s title in the tab’s index page. evaluation_start_and_end_time: prompts a calendar for start and one for end times of your evaluation. This field is used to track time, and for billable items. When this function is used in billable items, the time elapsed between an evaluation’s start and end time is imported into the billable report, and added to the total billable time
Evaluation Name	evaluation_name: creates a text field, to add what is typed to the form’s name evaluation_name_drop_down: creates a menu to select one of your custom options, to add what selected to the form’s name
Formatted Text	formatted_text: use this field type to add a data field to the evaluation, which works like other data fields in Kipu. See the Consents article for a complete list.
Golden Thread	golden_thread_tag: add this field type to any evaluation to be able to link it to any Problem, Treatment Plan, Goal , or Objective using Kipu's Golden Thread. progress_note (Golden Thread): use this field type for progress notes that will be associated with different aspects of the episode of care (Problems, Treatment Plans, Goals, etc.). problem_list (Golden Thread): use this field type in any evaluation where you will assess the patient/client to determine and list the presenting problems. treatment_plan_problem (Golden Thread): use this filed type to build custom treatment plans on the go, using the pre-written content in the settings. This one field type will allow you to build the complete treatment plan, including Modality, Problem, Goals, Objectives, Interventions, and Status.
Image Fields	image: enables you to add an image to your form image_with_canvas: enables you to add an image with a paint option, to draw on top of the image.
Matrix	matrix: allows you to create a table, with custom columns and rows
Dynamic Matrix	Dynamic_matrix: allows you create a dynamic matrix table reducing manual typing for standardized options such as dates, dropdowns items, drug names, free text, and diagnosis codes within a matrix evaluation item.
Notes/Logs	notes: allows you to add notes in string form (such as the Shift notes). String notes are added by the users on an ongoing basis, and display the newest on top. This field type must be used alone and requires the Evaluation Content set as Notes/Logs glucose_log: allows you to record glucose readings on an ongoing basis You can use this field as an ongoing log; for this, it must be used alone, and requires the Evaluation Content set as Notes/Logs You can insert this field in any Standard evaluation
Patient Data Fields	patient.admission_datetime: populates the patient’s admission date and time from the Information tab (Face Sheet), or vice versa. It functions by prompting a calendar, with sliding time bars, to select a date and time. patient.allergies: populates the patient’s allergies entered in the Information tab (Face Sheet), or vice versa patient.assigned_therapist: creates a dropdown with all users with the role Therapist, to select the patients’ primary therapist. It includes an effective date patient.bed: when occupancy is used, creates a field that auto-populates with the patient’s bed assignment patient.bmi: calculates the patient’s Body Mass Index (BMI) using the patient’s height and weight; these values are retrieved from the data in the height and weight fields (patient.height_weight ) that are entered in any evaluation or in the Med Log patient.diagnosis_code: creates a field for diagnoses, that will auto-complete from the ICD-10 Database as the user types; when the patient has been diagnosed already, this field will be pre-filled with the previous diagnoses. In order to record the diagnosing history, this function must be used in conjunction with the evaluation_datetime field patient.diets: populates with the patient’s dietary information from the Information Tab (Face Sheet); additionally, the information can be edited to add or remove dietary information patient.discharge_datetime: allows you to enter a discharge date and time, or, if available, populates with date and time from the Information Tab (Face Sheet). Once the recorded date and time are reached, the patient will be automatically discharged, not being counted in the current census, but still accessible via search or dashboard (when the patient has pending items) patient.discharge_type: displays a dropdown menu for the user to select a discharge type. Discharge types can be reported, in order for your organization to track outcomes. To learn more about Discharge Types, click or tap here. patient.electronic_devices: will allow you to enter a patient’s items and their conditions upon admission. You may customize the device conditions in Settings/Patients/Patient property condition patient.employer: populates the patient’s employer information from the Information tab (Face Sheet) patient.ethnicity: If used, populates with the patient’s race and ethnicity information from the Information tab (Face Sheet). You may customize the races and ethnicities list in Settings/Patients/Race and Settings/Patients/Ethnicity patient.glucose_log: allows you to log the patient’s blood glucose reading in any evaluation patient.height_weight: allows you to enter the patient’s height and weight. In order to record the weight and height history, this function must be used in conjunction with the evaluation_datetime field patient.level_of_care_clinical: allows you to select the patient’s clinical level of care, and effective date of change. This is the level of care determined by the therapist, and may differ with the level of care authorized by the payer (insurance carrier) patient.level_of_care_ur: allows you to select the patient’s UR level of care, and date of change. This is the level of care authorized by the payer (insurance carrier) patient.locker: used at organizations that safe-keep or retain patient property or valuable items, creates a field to enter the designated locker (or other storage method identifier) patient.marital_status: populates with the patient’s marital status from the Information tab (Face Sheet). You may customize the marital status list in Settings/Patients/Marital Status patient.medication_current: creates a list of medications currently ordered, and recorded in the Physician’s Orders tab patient.medication_inventory: allows you to record the medications that the patient provided upon admission, with the quantities; these medications are labeled as brought in on admission. This field is used for inventory purposes only patient.medication_verification: allows you to record the medications that the patient provided upon admission – if a Medication Inventory was made, it will pre-populate with the medications already listed in Medication Inventory. This field type also provides three options for each medication: continue on admission (will populate into the doctor’s orders, and, if used, the Med Log) continue on discharge was destroyed patient.occupation: populates with the patient’s occupation information from the Information tab (Face Sheet) patient.recurring_forms: inserts a toggle mechanism to turn recurring forms on and off patient.toggle_mars_generation: inserts a toggle mechanism to turn the Medication Administration Record (MARs), aka the Med Log, on and off patient.vital_signs: records the patient’s vital signs, and includes pulse, blood pressure, temperature, oxygen saturation, respiration
Points Function	points_item: allows you to assign points to answers to a questionnaire; answers appear in the form of a drop down menu; each questionnaire is defined as a points group, described above. For example, CIWA-Ar, CIWA-B, COWS, etc. points_total: calculates the total points or score in the points group
Radio Buttons	radio_buttons: displays your custom radio buttons. Radio buttons allow you to select only one of all options. For example, a Yes or No question, a 1 through 10 pain score, a satisfaction scale, etc.
Text Fields	string: inserts one line for typing in text text: inserts a text box for typing in text
Title	title: adds hardcoded text within the form. For example, instructions for an assessment, reference information, etc.
Treatment Plan Fields	treatment_plan_column_titles: allows you to create three titles for the three columns above the treatment items treatment_plan_item: enables you to add editable text describing the treatment plan objectives; this item also adds a target date and status for each objective treatment_plan_master_plan: Creates a live summary of all treatment plans currently loaded in a patient’s chart. This item will only function when used alone.