Using Electronic Forms in the NHS

We have had a lot of interest in electronic forms of late, with the potential these offer for improving organisational processes coinciding with even greater emphasis on QIPP and cost saving. This newsletter talks about our approach to eForms and how to create them without the expense of deploying Microsoft Enterprise Client Access Licences (if you don’t have them already).

InfoPath or Forms Server

Until recently we have recommended delivering eForms directly through the browser using Microsoft Forms Server, however this requires trusts to have Enterprise Client Access Licences (ECALs). The cost of this is often prohibitive, so we now recommend an alternative…eForms can be developed rapidly in Microsoft InfoPath, which is part of Micorosoft Office and fully licenced across the NHS. These forms can then be presented to users either in the InfoPath Filler client application or directly in a browser using SharePoint Forms Server.
Forms Server provides the advantage of not needing to deploy any new software to desktop PCs and of keeping the entire user experience within the browser. There are a couple of disadvantages however:
1. A few features are not supported by the browser – handwriting recognition for example as well as a few other features
2. Forms Server requires use of Enterprise Clients Access Licences (ECALs), which are an additional cost of around £37 per user InfoPath Filler is the alternative. It runs as a client application, so needs installing on users’ PCs. However it has several advatnages compared with Forms Server, including support for offline working, handwriting recognition and a number of other advanced features that the browser cannot offer. The user experience is very simple as the Filler hides any complexity, providing a UI that is otherwise identical to the browser. It is included as part of the Office 2010 Professional Plus licence which the NHS retains in perpetuity.Where trusts have not purchased ECALs we recommend that they deploy and adopt InfoPath Filler as their client for eForms; deployment is simple, the user experience is excellent (generally requiring no training) and there is no cost for use of this technology due to previous investments the NHS has made. Please contact us if you need to understand more about licensing now the Enterprise Agreement has lapsed – it’s not as bad as you might think. See the full InfoPath product guide

Rapid eForm Development

Trusts typically have around 500 paper forms in routine use. The task of converting these to eForms is a substantial one, so the process for doing this needs to be efficient.Cloud2 have developed a Rapid eForm Development process to expedite this, built on 3 pillars:

1. Technical Dimension
2. Business Dimension
3. Project Dimension

Technical Dimension

• Use rapid prototyping
• Do early and frequent reviews with the stakeholders to quickly hone and enhance
• Use Smart forms with expandable sections plus Views so that a single form to perform many roles
• Use Smart workflow

Business Dimension

• Clarify your RACI
• establish a sign off process that is simple but accepted by the user community
• Ensure process/change leadership & appoint an effective Project Lead
• Consider the Process Change implications  – avoid replicating forms that represent poor business processes, leading to disenchanted users
• Identify planned benefits and track them

Project Dimension

• Run parallel development
• Focus on 2 to 3 directorates, 3 to 4 eForms each
• Deploy early and iterate – don’t wait for it to be perfect; go live soon and push the learning into a second phase development
• Don’t over engineer – just because it can be done doesn’t mean it should be done
• Use the Pareto principle

What is Microsoft InfoPath 2010?

Microsoft InfoPath 2010 is Microsoft’s high-end tool for developing data entry forms.
It is part of Microsoft Office 2010 and comprises 2 key parts: an eForm Designer and an eForm Filler. Either or both can be installed on end-users’ computers, according to their needs and skills.
InfoPath can read and write XML documents and it supports custom defined XML schema, pull and write data from other data sources, create smart forms that can simplify and aggregate complex paper forms and has excellent interaction with SharePoint. InfoPath Filler supports offline form completion and handwriting input.

10 advantages of InfoPath and eForms:

SharePoint integration

InfoPath is commonly integrated with Microsoft SharePoint, using Form Services. A SharePoint forms library is used to host the individual forms, with InfoPath fields exposed as SharePoint columns. These columns can be directly read or used as a part of web services by the Microsoft SharePoint.

Quickly and efficiently create forms and minimize training time.

Create forms to support business processes using the familiar Microsoft Office tools, such as fonts, bullets and numbering, table design, and clip art. The familiar tools and environment help minimize training time and speed forms creation.
The Fluent user interface, introduced in many 2007 Office system applications, is included in InfoPath 2010. Based on extensive usability data and recent advancements in hardware and software, the Fluent user interface is designed to make it easier for you to find and use the full range of features in Office applications—and get the results you want.

Easily create sophisticated forms without writing code.

For example, you can:
• Quickly create and deploy forms using improved rules management, quick rules, styles, and dynamic layout sections.
• Set rules for conditional formatting.
• Create forms that include actions, such as alerts, calculated values, and data validation. Create validations, formatting, or actions based on user roles or create validations and actions that show based on the type of field.

Give participants the ability to fill out forms online or offline.

With InfoPath 2010, people can fill out forms online or offline with a native integration of forms in the Microsoft SharePoint Workspace interface. A user can easily take a SharePoint library with InfoPath forms offline in the SharePoint Workspace environment. Information entered in the forms will be automatically synchronized to the SharePoint library once the participant is back online, so people can be productive whether they’re connected to a network or not.

Build modular, extensible, and portable SharePoint applications

Use SharePoint Server 2010 and InfoPath 2010 to create SharePoint applications. SharePoint applications can be built, for use at the departmental or enterprise level, using little or no code. These solutions are modular (you can build from existing list or library), extensible (you can add capabilities with code), and portable (you can publish using .wsp format to move the application from site to site or server to server). Description

Make browser forms conform to standards.

InfoPath 2010 forms on SharePoint Server 2010 are now compliant with Web Content Accessibility Guidelines 2.0 (WCAG 2.0) AA to help you create forms that are accessible to users with disabilities. In addition, forms powered by SharePoint Server 2010 are now fully XHTML 1.0 compliant.

Enjoy more powerful Web browser forms

Improved parity between InfoPath 2010 client forms and InfoPath forms in SharePoint Server 2010 ensures greater consistency for users who are filling out forms. For example, functionality available in both environments include bulleted, numbered, and plain lists; multiple-selection list boxes; combo boxes; picture buttons; hyperlink capabilities; choice group and section; filtering functionality; date and time controls, and people pickers.

Embed forms in Web Parts

In SharePoint Server 2010, it’s easier than ever to host your forms on Web pages using the new InfoPath Form Web Part. In SharePoint Server 2007, users who wanted to host their InfoPath forms on Web pages had to write code in Visual Studio. Now, without writing a single line of code, you can simply add the InfoPath Form Web Part to a Web Part page and point it to your published form.
You can use the Web Part to host any InfoPath browser form that has been published to a SharePoint list or form library. You can also connect it to other Web Parts on the page to send or receive data.

Enhance forms with code

Although you can customize many aspects of InfoPath forms without writing code, you can also enhance InfoPath forms with code if declarative logic does not meet the needs for implementing your solution functionality.
You can enhance InfoPath 2010 forms using Visual Studio Tools for Applications (VSTA), which ships with InfoPath 2010. VSTA provides a light-weight version of the Visual Studio Integrated Development Environment. You can use VSTA to write managed code in C# or VB.NET. The code is then embedded in the InfoPath form template (.xsn file). For example, if you want to include the ability for calculating interest in a form, you can embed code in the form itself and InfoPath Filler or InfoPath Forms Services will run this code when the form is opened or edited.

Connect forms with line-of-business information and REST Web Services

SharePoint Server 2010 offers an extensible architecture for managing user access to data connections and systems. InfoPath 2010 also integrates with Business Connectivity Services (BCS) of SharePoint Server 2010. BCS enhances Office applications and SharePoint platform capabilities with out-of-box features, services, and tools that streamline development of solutions with deep integration of external data and services. Also, InfoPath 2010 now supports getting XML data from REST Web Services. REST Web Services use input parameters that are passed in through a URL. Form designers can now change the URL parameters dynamically in the InfoPath form without any code using rules to get desired data from the REST Web Service

More easily manage forms on the server

InfoPath forms can be monitored as a true component of SharePoint Server 2010. New SharePoint Maintenance Engine Rules ensure that InfoPath forms are correctly configured in their farms. You can also manage InfoPath forms using Windows PowerShell command line shell and scripting language, which is included in SharePoint Server 2010.

Filling in eForms

Inevitably your staff need access to a PC to complete their new, efficient eForms. For office based staff this is rarely an issue, however for staff on the wards, in the field or highly mobile across the organsation there may be challenges due to the need to share computers, the inability to take the computer to the point of care etc.

Cloud2 are one of the first companies in the UK to offer a Windows based slate computer, the Zoostorm SL8. With an 11.6 inch (1366 x 768) multi-touch screen, WiFi, SSD drive and a weight less than 1 kg it is the perfect tool for use by staff who need to be mobile, such as clinical ward staff, infection control teams, doctors and hands on managers. On the wards we propose to dedicate these for use as eForms appliances, ensuring their availability for clinical use.

Talk to us about how the SL8 can help you or come play with one during our presentation on eForms and Rapid eForm Development at EHI Live.

What next

We have lots more to say about eForms in the NHS.

We have a growing library of existing forms we can share with our clients, including clinical forms for VTE and eDischarge and a broad set of HR and Finance forms, including ESR integration where required.