Introduction

From v7.1, it is possible to design surveys and e-mail them to patients for filling out consents and participant forms. Users can configure these e-mails to be sent to patients based on certain specified conditions.
For example, if a participant's age is less than 18 years, and he is a 'Spanish' speaking native, a Spanish assent and surrogate form should be e-mailed to the participant.

Pre-requisite

You need an EDC plugin installed to use the survey mode option.

Features

Participant forms and consent documents can be emailed.
The email template can be configured as per user needs.
Conditions on when to send the survey emails can be configured per survey.
Emails can be chained based on the conditions specified.
The frequency of reminders to be sent and the expiry of the link can be set up.
The survey invitation can be manually closed if a patient does decline and does not want to receive any more emails.
Surveys can be sent automatically if the specified condition matches participant information while registering.

Data Dictionary

Field	Description	Mandatory	Type

Field	Description	Mandatory	Type
Form	Drop-down having consent and participant forms.	Yes	Drop-down
Title	A one-line description of the survey which appears on the survey list page	Yes	Single row text box
Instructions	Text description that appears before participants start the survey	No	Text area
Completion Message	Text description that appears after participants have completed filling in the survey	No	Text Area
Email Subject	The subject line of the email to be sent to participants	Yes	Single row text box
Email Content	Content of the email to be sent to participants. It can include the following variables to include the respective information: $participantName- Includes the name of the participant in the email body $surveyLink- Survey title, includes the link of the form to be filled in $surveyLinkText- Actual URL of the survey form to be filled $expiryTime- The final DateTime after which the link will be inactive	Yes	Text Area
Send Automatic Invites	Radio-button enabling sending surveys automatically as soon as a participant is registered	No	Radio-button
Enable Chaining	Radio-button which enables chaining of forms to be filled one after the other by clicking on a single link	No	Radio-button
Printing	Radio-button, which enables printing of survey after filling it via email or from OpenSpecimen.	No	Radio-button
The rule for sending invites or chaining	Conditions that enable chaining of forms together and emailing the surveys automatically if the conditions match when a new participant is registered	Depends (mandatory only if 'Sending Automatic Invites' or 'Enable Chaining' is 'Yes')	Text Area
Send Reminders Every	Frequency of the email to be sent either any day of the week or every 'X' days	No	Drop-down
HH: MM	Timestamp at which the reminders will be sent on any day of the week	No	Timestamp
Days	Used when reminders are to be sent every 'X' days	Depends (Mandatory only if the value of 'Send Reminders Every' field is 'X days'	Number
Reminders Limit	No reminders will be sent after this number is reached per participant.	It depends (Mandatory only if the frequency of sending reminders is set)	Number
Invitation Age	The validity of the email link	Yes	Number
Begin Survey	Text fields are used to give the caption to the 'Begin Survey' button. It appears while filling the survey.	No	Text
Next Survey	Text fields are used to give the caption to the 'Next Survey' button. It appears while filling the survey.	No	Text
Print Survey	Text fields are used to give the caption to the 'Print Survey' button. It appears after filling the survey.	No	Text

Configuring a new survey

From the CP Overview, go to Settings > Surveys.
Click on 'Create.'
Click on the 'Form' to select the participant/registration/visit form for which you want to create a survey. Once you start typing the form name, the form will appear in the dropdown suggestion list.
Note: The form should be attached to the CP/CPs at the participant/registration/visit forms level before adding them to the surveys, or else they will not appear in the 'Form' field under surveys.
Provide a title to the survey that will appear on the 'Surveys' list page.
Add the 'Welcome' and 'Completion' message for patients to read before they could start answering the survey questions and after completing the survey. You can format this text using the options from the panel given.
Enter the Logo URL, Display Name, and From Email ID
The screenshot below is of the email with the above settings:
Notes: 1. Logo URL should be accessible, 2. From Email ID → Used to send and received the reply from the above email.
Enter the email subject line
Enter the body of the email to be sent to participants. This can include the participant name, survey links, and the date until which the link will remain active for the participants.
If you want to send the survey forms automatically when a participant is registered, set the 'Send Automatic Invites' to 'Yes.'
Specify the conditions in 'Rule for sending invite or chaining' for sending the emails on registration
Set the value for the day when the reminders are to be sent by clicking the 'Send Reminders Every' dropdown. The reminder settings will apply from the next day.
Enter the timestamp at which the reminder is to be sent for every selected day
Set the limit of total reminders to be sent by entering the value in the 'Reminders Limit' field
Enter a value for the number of days the survey link should be valid. Once the invitation is this many days old, the link will turn inaccessible for the participant.
If you want to select the reminders to be sent every 'X' days, select the 'X days' from the dropdown and enter the value in the 'days' box that appears beside it
Configure the below-highlighted button text. It will appear while filling the survey form.

17. Click on 'Create' to create the final survey. This can be seen on the 'Surveys' list page.

Editing a survey

Go to CP Overview > Settings > Surveys to go to the survey list page
Click on the pencil icon on the right-hand side of the survey to be edited.
Edit the necessary details of the survey. Click on 'Update' to save the changes once done.

Cloning a survey

When you want to create many surveys with minimal or no changes, cloning saves the effort of copy-pasting the same information while creating each survey.

Cloning creates a new survey with the same configuration except for the form and the survey name. You need to select the form name from the drop-down and name the survey.

Cloning is beneficial while creating a chain of survey forms to be filled one after the other using the same link.

Go to CP Overview > Settings > Surveys to go to the survey list page.
Click on the 'Clone' icon beside the survey that is to be cloned.
You will be redirected to the 'Create Survey' page. All details are pre-filled except Form, Title, Logo URL, From Email ID, etc. Also, you can make changes in other settings as well.
After editing the details, click on 'Create' to create the new survey.
You can view the survey on the survey list page at the bottom.

Chaining of surveys

Chaining allows users to add a set of surveys one after the other. When the patient completes one survey, s/he is taken to the next one and so on.
It is useful when multiple forms are to be filled up by participants falling under certain conditions, and all are needed to be filled in continuation using a single link.

Steps to chain one survey to another

Only the main survey should have 'Send Automatic Invites' as 'Yes.' The following surveys should have 'Send Automatic Invites' as 'No' so that individual links for these forms are not emailed.

Create/Edit an already created survey
Scroll down to the option 'Enable Chaining?' radio button and select 'Yes.'
The condition specified for sending automatic invites will be used for chaining as well.
Click on 'Update' to save the changes to the first survey.
Now, create a new survey that is to be chained to this one. You can also edit the survey if already created. You can also clone this first survey so that everything except the form and survey name is copied. Select the required form and survey name
Scroll down. Set the value of 'Send Automatic Invites' to 'No' and 'Enable Chaining' to 'Yes.'

This will prevent multiple individual links from being sent for each follow-up survey. These will continue as soon as the first survey is filled-up
Click on 'Create’/'Update' to save the changes.

Survey Status

The status of the survey forms emailed to participants can be viewed from the participant list page > More > Survey Invitations

Clicking on the 'Survey Invitations' will lead you to the list page of all invitations sent till now.

Columns	Description

Columns	Description
Participant	PPID of the participant along with the first name and last name
Survey	Survey title of the emailed survey
Creation Date	Date when the email was sent
Completed By	Who completed the Survey. If it says 'System' means the survey completed by the patient itself.
Completion Date	The date when the survey is completed
Status	Present status of the survey invitation Completed: The patient has filled in the survey form. Pending: The patient is yet to fill the survey form Expired: The invitation link has expired. Closed: The invitation link was closed by the co-ordinator. Mail Opened: When the patient opened the survey email. Survey Opened: When the patient opened the survey invitation for filling.
Close Invitation	'X' icon on the extreme right side allows the user to close the pending invitation link.

Users can filter the invitation using the above column.

Download survey invitation reports

From version v8.0, OpenSepcimen support to get the survey invitation report from the query module.

OpenSpecimen supports downloading the survey invitation reports based on the filters specified in the below table.

Navigate to participant List Page → More → Survey Invitations → Reports

Columns	Description

Columns	Description
Survey	Select the list of surveys you want the reports for.
Status	Select the survey statuses that you want to generate the reports for
Invitation Date	You can specify the start and end date of the survey.
Reports	Invitation List: Provide the report with all the details (First Name, Last Name, Survey Name, etc.) e.g., Screenshot Invitation Status Count: Generate count-based reports based on the survey status E.g., Screenshot

If you want to download all the survey reports; leave the Survey field and click on the download

Collecting Survey Responses

Users can collect responses for participant forms, consents while registering a participant. Based on the conditions defined in the surveys created for consents, the user will be redirected to the correct set of forms for the registered participant.

The survey responses can be collected in 2 modes:

as signed-in user: The user is not logged out of the application. Clicking on the 'Back' arrow from the browser window or the 'Sign In' option after filling the survey will redirect the user to the recently filled-in form. Login credentials are not required. This mode is used when survey responses are being collected by the
as a participant: User is logged out of the system. This is used when the device is handed over to the participants to fill in the survey forms. Clicking on the 'Sign In' option requires credentials.

Steps to proceed to appropriate consent(s)

From the participant list page, click on 'Add Participant' to start registering a participant.
Fill in the mandatory details.
Scroll down and click on the 'Proceed to Consents' button
A pop-up will be displayed for choosing the mode of the survey.
Keep the 'as signed-in user' if the co-ordinator/consent collector is collecting the responses. Select the 'as participant' mode if the device is to be handed over to the participant to fill in the responses. Click on 'Proceed.'
The user/patient is redirected to the 'Survey' screen. The instructions that were specified while designing the survey are visible here.

Click on 'Begin Survey' to start filling in the responses.
Start entering the responses. Once the form answers are filled, the 'Completion Message' is displayed. Users can also print the survey.
If the mode is as a signed-in user,' the user can directly click on 'Sign In' and will be redirected to the recently filled form. Credentials are not asked.
If the mode is as a participant,' clicking on 'Sign In' will ask for credentials to log in.

Steps to proceed to participant/registration form level

Once done configuration, go to CP → Participant → Forms Tab → Select a specific form for which survey is configured. You can see the 'Survey Mode' is visible under the forms tab.
Click on the 'Survey Mode' button and select a specific user 'as signed-in user'/'as participant' form whom you wish to do the data entry.
Once you select a user existing logged-in user will log out, and below the form, the screen will appear.
Once done with data entry, click on the 'Save' button.
If the mode is as a signed-in user,' users can directly click on 'Sign In' and be redirected to the recently filled form. Credentials are not asked. If the mode is as a participant,' clicking on 'Sign In' will ask for credentials to log in.

Steps to proceed to visit form level

Once done configuration, go to CP → Visit → Forms Tab → Select a specific form for which survey is configured. You can see the 'Survey Mode' is visible under the forms tab.
Click on the 'Survey Mode' button and select a specific user 'as signed-in user'/'as participant' form whom you wish to do the data entry.
Once you select a user existing logged-in user will log out, and below the form, the screen will appear.
Once done with data entry, click on the 'Save' button.
If the mode is as a signed-in user,' users can directly click on 'Sign In' and be redirected to the recently filled form. Credentials are not asked. If the mode is as a participant,' clicking on 'Sign In' will ask for credentials to log in.

Audit trails for filled survey

You can track the audit trails for the filled consent survey as below. You can see the audit trails from the list page as below and the filled consent overview page.

In the below screenshot, you can see all the audits, who updated that consent form.

Emailing Surveys

There are three ways in which surveys can be emailed to participants:

Automatically, as soon as a participant matching the survey conditions is registered
Manually
Using bulk import participant registration

1. Automatic Survey Sending

When the user registers the participant with all the details, OpenSpecimen will check the survey validation(conditions) and send the particular survey based on that. See a few examples below.

Example1:

In the above survey rule, the survey sends when users selected the English language while registering the patient.

Example2:

In the above example, the survey will send when the patent age is greater than 18.

You can refer to the wiki page to see the examples for automatic invites.

2. Manually Survey Sending

by entering the PPIDs from the 'Survey Invitations'> 'Email Survey' option
by selecting multiple participants from the participant list page and clicking 'Email Survey.'

Note: When a user selects a survey which already been sent, OpenSpecimen shows the below warning.

Send to all: Send the selected survey to all the participants add/selected to the list.

Send to a participant without pre-existing invitation: Send survey only to that participant who does not send the same survey before.

This is how a survey email looks:

3. Send Survey using participant bulk import template

Users can use the participant bulk import template to register the participants in bulk and send the survey at the same time.

Pre-requisite: The user needs to provide the mandatory information in participant bulk import CSV to send the survey email. Like Email ID and the conditional field like Language, Date Of Birth, etc to validate which survey sends to which patient.

Example: In the below survey, the user needs to fill in the Email ID, Language, and Date of Birth information in the bulk import file. Once all the below rules are matched, the survey will send to participants automatically when the patient registers.

You can refer to the below bulk import template.

Configure the survey email

You can add the different participant fields to the survey email configuration. Below are the examples to add the fields.

Where to configure: Go to CP Settings→ Survey → Email Content

Below are the list fields you can configure on the survey email

Field	Decription

Field	Decription
`$participantName,`	Shows first and last name
`$cpr.participant.firstName`	Shows first name
`$cpr.participant.lastName`	Shows last name
`$dateFmt.format($cpr.participant.birthDate)`	Shows date of birth
`$surveyLink`	Show survey link
`$surveyLinkText`	Show survey text
`$cpr.ppid`	Show PPID

Example Email:

Rule-Based Survey Email

It is possible to send email content based on a field value at the participant level

Send Content Based on default field values at the registration level
#if ($cpr.participant.vitalStatus.value != 'Alive') Hello Participant Representative #else Hello Participant Name #end
Send Content based on the custom field value attached at registration level.
#if ($cpr.getCustomFieldDisplayValue('type_of_recruitment') != 'Remote') // 'type_of_recruitment' is the variable name of the field. On Premise Consent #else Remote Consent #end

JSON: Show the latest survey status on the participant overview page

Add the below code to the JSON dictionary section; the below code shows the latest survey status among all the surveys sent for that participant.

{
      "name" : "calcCpr.surveyStatus",
      "caption" : "Survey Status",
      "type" : "widget: os_survey_status"
    },

Screenshot:

Surveys