Hi, I wanted to get some idea how we can smartly and effectively perform form consolidation with minimal manual labor. There are many forms within a system that are not categorised into their function , duplicated and similar. These forms are in a mixed data format ( structured and unstructured) which makes analysis more difficult. The aim is to standardise forms so that we don’t have to build unnecessary forms in the new system platform and also to reduce the volume of forms. Any suggestions on the software to use or method or agency to consult with would be amazing ! Please share your experience !
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Hi Dianna, great to have you here on the eHealth Forum.
Would you mind elaborating a bit about your specific situation? We are all swimming in forms (paper or otherwise) and I’m pretty sure that many on the Forum are grappling with how to do it better.
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I think the question probably comes back to a mix of preference and purpose.
Maybe we need a public library of forms? I had a chat with @davidryannz the other week and he has lots of “templates” and maybe forms I wonder where he is at with this question?
Jon
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Hi Dianna, elaborating would be helpful as Nathan suggests but in general this picture is all too common and we end up with a lot of duplication, or the reason for some (or many!) of the forms has been lost. The best way to resolve this in my experience is to find out what workflows the relate to (or related to in the dim and distant past) and work with your clinical colleagues to document the workflows and show where the form is used within that particular workflow. Basic swim-lane diagrams work well for this. From there you can start to categorise the forms and find out which ones you don’t need any more and which can be consolidated and potentially used across multiple clinical areas. Understanding the workflow is key to any technology implementation and unfortunately is does take a fair amount of manual work 
. Hope this helps - happy to discuss further if required. Chris
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Hi Nathan,
The project I am involved in is looking at a system used in the multiple services in the community( such as district nurse, mental health etc) where they have electronic form templates ( structured data) and forms that does not use electronic form templates( PDF, Excel, Word ,Jpg) . We have been trying to categorise these forms so that we are able to map it to the relevant clinical workflow it belongs to and identify those forms that are similar to consolidate it. However , as superusers ( system admin) had authority to amend forms to cater for needs, there are numerous variation of forms being used for all services. There are approximately 500 electronic form templates ( this shouldn’t be hard to extract and categorise) but there are 100000+ forms that does not use electronic form templates in an unstructured data format . As we have huge number of forms, we are unsure where to even start from and also unclear which forms are relevant. Apparently for those forms not using a template, there is very little to categorise them apart from the file type and folder (there are basically 2 fields Description and name and they are free text). As we have huge volume of forms, we were wondering if there is a great AI software which can do initial sorting out to reduce the manual labor…
Hi Chris!
Thank you for the suggestion. We have been talking about mapping it back to the workflow. However the volume of forms we have to categorise is 100000+ potentially ( as there are too many variation of forms from superusers creating new forms whenever they need it ) . Have you ever had an experience of using some sort of smart software to categorise documents initially before manual sorting out? We just don’t have resources to go over all those forms
No, unfortunately I don’t, sorry.
Sorry if this feels a bit too direct, but here is how I would approach the problem.
I think the Pareto principle works here. Before I got to the first form I would be trying to work out “what are the most common workflows”. This might be in the form of interviews with staff (what do they want) and then some clinical audit (what do they do). You now have a target of say 10-100 workflows to start with. You might separate this by service (most services have different workflows - ie. DNs are different to community physios).
Then I would write/run a script to look at when the electronic ones were last accessed.
If not accessed this year then delete/ignore.
Then I would print the rest out.
I would go through them to try and match them to my 10-100 workflows. At this point you don’t need to have a pile for everything, just piles that represent these ones, bind them together and this gives you a reference for what you will build.
I would then build to those and leave the rest until someone wants it (you will need to be responsive at this point).
Hope this helps,
Jon
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Jon, what a sensible approach to use. Perhaps, in light of the extraordinary number of forms, a good place to start is with the metadata (e.g., date of last use/access, user role). That should flesh out a lot of the redundant space-occupying forms that no-one uses.
Once your process has been followed to reduce the number of forms, standardise their structure, and align them with work flows/processes, one should end up with a manageable set. Good idea to share this process with other services and establish a shared repository of forms.
Bear in mind that there is a natural cyclical flow of ‘reduce forms to manageable numbers and standardise them’ to ‘we need to add more forms’, i.e., the forms database will have to be maintained to avoid it exploding again.
All the best with your project @HurD
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Getting everyone to agree on the structure/content of forms (digital and paper) is a big challenge! If forms are in active use, changing them or consolidating them might get push-back from regular users so you might need to think about a collaborative co-design process. We did a review of the design processes used for new nursing documentation: https://onlinelibrary.wiley.com/doi/full/10.1111/jocn.15545. We also designed a new form for monitoring newborns in hospitals - these papers describe the design process and the implementation:
- https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0000624
- https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-021-07030-x
In terms of a centralised national form repository - in the UK, various professional organisations/colleges/etc have collaborated on standardised forms/records through the Professional Record Standards Body (PRSB). Initially they worked on paper forms but more recently most work has been on standardising the data that should be collected for specific purposes. They have lots of information on their processes, etc. on their website that might be of interest: https://theprsb.org/
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Thank you for your comprehensive answer Jon, really helpful.
I think that is the most sensible approach, filter it and map it to the workflow
Hi Karen,
I cannot agree more for the cyclical flow of " we need more forms".
Document control is so important but not commonly performed in each services due to lack of resources, priority etc.
Will raise that up with the team
Thank you Chris for linking those resources! Super helpful.
Such an important task, document control. People at the front line get swamped with forms and their workload increases and then they get burnt out and we all wonder how it happened. Maintenance of forms is core to supporting reasonable workload among the document control team and the front line workers.
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A few years back we recognised the need for software to assist with workflows (clinical, administrative).
During that research it became clear to me that forms and workflow are intertwined.
e.g. Paper forms trigger work by their presence in an in-tray.
Digital forms are useless without also being routed to someone’s digital task list.
The software that orchestrates this is a called workflow engine. Workflow engines typically have features for defining and routing digital forms.
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