Use our readymade template to create your OMPQ-10 screening tool for musculoskeletal pain
Create your care assessments
| OMPQ-10 score | Risk of long-term disability and work absenteeism |
|---|---|
| 0-20 | Low |
| 21-50 | Moderate |
| 51-100 | High |
- Prebuilt template with OMPQ-10 scoring to assess the presence of musculoskeletal pain and predict long-term disability and work absenteeism
- 10-item questionnaire that scores each item from “0” to “10”
- Real-time calculation of OMPQ-10 Score based on the form responses
- Collect patient data and other sensitive healthcare data using our HIPAA compliant online assessment forms
- Compare the scores from the initial screening with that of the followup to track the progression of musculoskeletal pain
- Easily create responsive forms that allow patients to complete their assessments on any device at any time
Collect responses from your patients
| Patient ID | 1004 |
| Patient Name | John W |
| Patient Email | johnw@ymail.com |
| Patient Phone Number | 0987654321 |
| Doctor's Name | Dr. Smith |
| Location | New York |
| 1. How long have you had your current pain problem? | Over 1 year |
| 2. How would you rate the pain that you have had during the past week? | 10 |
| 3. I can do light work (or home duties) for an hour. | 0 |
| 4. I can sleep at night. | 0 |
| 5. How tense or anxious have you felt in the past week? | 10 |
| 6. How much have you been bothered by feeling depressed in the past week? | 10 |
| 7. In your view, how large is the risk that your current pain may become persistent? | 10 |
| 8. In your estimation, what are the chances you will be working your normal duties (at home or work) in 3 months. | 0 |
| 9. An increase in pain is an indication that I should stop what I’m doing until the pain decreases. | 10 |
| 10. I should not do my normal work (at work or home duties) with my present pain. | 10 |
| OMPQ Score | 100 |
- Collect patient details such as patient id, name, email etc in the OMPQ-10 assessment form
- Send an email invitation with a secure link for patients to complete their OMPQ-10 assessment form prior to their visit
- Allow patients to save their progress and complete their OMPQ-10 assessment form at a later time without losing any responses
- Set up an email template for your OMPQ-10 assessment and automatically send invitation emails to multiple patients with ease
- Send a confirmation email to the patients with their OMPQ-10 score, diagnosis, next steps when they submit their OMPQ-10 assessment
Track patient responses in Google Sheets
| A | B | C | D | E | |
|---|---|---|---|---|---|
| 1 | Name | Question | Answer | Score | Total Score |
| 2 | John W | 1. How long have you had your current pain problem? | Over 1 year | 10 | 100 |
| 3 | John W | 2. How would you rate the pain that you have had during the past week? | 10 | 10 | 100 |
| 4 | John W | 3. I can do light work (or home duties) for an hour. | 0 | 10 | 100 |
| 5 | John W | 4. I can sleep at night. | 0 | 10 | 100 |
| 6 | John W | 5. How tense or anxious have you felt in the past week? | 10 | 10 | 100 |
| 7 | John W | 6. How much have you been bothered by feeling depressed in the past week? | 10 | 10 | 100 |
| 8 | John W | 7. In your view, how large is the risk that your current pain may become persistent? | 10 | 10 | 100 |
| 9 | John W | 8. In your estimation, what are the chances you will be working your normal duties (at home or work) in 3 months. | 0 | 10 | 100 |
| 10 | John W | 9. An increase in pain is an indication that I should stop what I’m doing until the pain decreases. | 10 | 10 | 100 |
| 11 | John W | 10. I should not do my normal work (at work or home duties) with my present pain. | 10 | 10 | 100 |
- Export patient responses including the calculated OMPQ-10 score to Google Sheets for easy record-keeping
- Export individual points for 10 items to Google Sheets for data manipulation and analysis for comprehensive insights
- Use pre-built reports to easily keep track of patient progress over time and monitor changes in their musculoskeletal pain symptoms
- Receive a copy of the response and the calculated OMPQ-10 score by email whenever a patient submits their OMPQ-10 assessment
- Use data in Google Sheets to integrate with external EHR systems for seamless data transfer
HIPAA compliance
| Patient ID: | 1004 |
| Patient Name: | ****** |
| Patient Email: | ****** |
| Patient Phone Number: | ****** |
| Doctor's Name: | Dr. Smith |
| Location: | New York |
| 1. How long have you had your current pain problem?: | Over 1 year |
| 2. How would you rate the pain that you have had during the past week?: | 10 |
| 5. How tense or anxious have you felt in the past week?: | 10 |
| 6. How much have you been bothered by feeling depressed in the past week?: | 10 |
| 7. In your view, how large is the risk that your current pain may become persistent?: | 10 |
| 9. An increase in pain is an indication that I should stop what I’m doing until the pain decreases. : | 10 |
| 10. I should not do my normal work (at work or home duties) with my present pain.: | 10 |
| OMPQ Score: | 100 |
| OMPQ Score: | 100 |
- Create a HIPAA compliant OMPQ-10 assessment form to safely collect, store and access patient responses
- Mark fields as Protected Health Information (PHI) to secure sensitive patient data and limit access to PHI
- Automatically mask PHI fields when exporting OMPQ-10 form responses to Google Sheets and sending them on email
- Prepopulate patient details in OMPQ-10 assessments by creating secure prefill links without exposing PHI
- Limit access to patient data only for authorized personnel and minimize the risk of data breaches
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