Use our readymade template to create your Örebro Musculoskeletal Pain Questionnaire (ÖMPQ) screening tool for predicting long-term disability and failure to return to work following a soft tissue injury
Create your care assessments
| ÖMPQ score | Disability Level | Proposed treatment |
|---|---|---|
| 0-104 | Low disability | May not need treatment |
| 105-130 | Moderate disability | Consider counseling |
| 131 and above | High disability | Active treatment |
- Prebuilt template with ÖMPQ scoring to assess the risk of long-term disability and failure to return to work
- 25-item questionnaire that scores each item from “0” to “10”
- Real-time calculation of ÖMPQ Score and disability level 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 |
| Where do you have pain? | Neck,Shoulder |
| How many days of work have you missed because of pain during the past 18 months? | 15 - 30 days |
| How long have you had your current pain problem? | 3 - 6 months |
| Is your work heavy or monotonous? | 5 |
| How would you rate the pain that you have had during the past week? | 6 |
| In the past three months, on average, how bad was your pain on a 0-10 scale? | 7 |
| How often would you say that you have experience pain episodes, on average, during the past three months? | 8 |
| Based on all things you do to cope, or deal with your pain, on an average day, how much are you able to decrease it? | 3 |
| How tense or anxious have you felt in the past week? | 4 |
| How much have you been bothered by feeling depressed in the past week? | 5 |
| In your view, how large is the risk that your current pain may become persistent? | 6 |
| In your estimation, what are the chances that you will be able to work in six months? | 7 |
| If you take into consideration your work routines, management, salary, promotion possibilities and work mates, how satisfied are you with your job? | 8 |
| Physical activity makes my pain worse. | 9 |
| An increase in pain is an indication that I should stop what I’m doing until the pain decreases. | 10 |
| I should not do my normal work with my present pain. | 9 |
| I can do light work for an hour. | 8 |
| I can walk for an hour. | 7 |
| I can do ordinary household chores. | 6 |
| I can do the weekly shopping. | 5 |
| I can sleep at night. | 4 |
| OMPQ Score | 105 |
| Disability Level | Moderate disability |
- Pre-populate patient details such as patient id, name, email etc in the ÖMPQ assessment form before sharing it with the patients
- Send an email invitation with a secure link for patients to complete their ÖMPQ assessment form prior to their visit
- Allow patients to save their progress and complete their ÖMPQ assessment form at a later time without losing any responses
- Set up an email template for your ÖMPQ assessment and automatically send invitation emails to multiple patients with ease
- Send a confirmation email to the patients with their ÖMPQ score, diagnosis, next steps when they submit their ÖMPQ assessment
Track patient responses in Google Sheets
| A | B | C | D | E | |
|---|---|---|---|---|---|
| 1 | Name | Question | Answer | Score | Total Score |
| 2 | John W | Where do you have pain? | Neck,Shoulder | 105 | |
| 3 | John W | How many days of work have you missed because of pain during the past 18 months? | 15 - 30 days | 5 | 105 |
| 4 | John W | How long have you had your current pain problem? | 3 - 6 months | 7 | 105 |
| 5 | John W | Is your work heavy or monotonous? | 5 | 5 | 105 |
| 6 | John W | How would you rate the pain that you have had during the past week? | 6 | 6 | 105 |
| 7 | John W | In the past three months, on average, how bad was your pain on a 0-10 scale? | 7 | 7 | 105 |
| 8 | John W | How often would you say that you have experience pain episodes, on average, during the past three months? | 8 | 8 | 105 |
| 9 | John W | Based on all things you do to cope, or deal with your pain, on an average day, how much are you able to decrease it? | 3 | 7 | 105 |
| 10 | John W | How tense or anxious have you felt in the past week? | 4 | 4 | 105 |
| 11 | John W | How much have you been bothered by feeling depressed in the past week? | 5 | 5 | 105 |
| 12 | John W | In your view, how large is the risk that your current pain may become persistent? | 6 | 6 | 105 |
| 13 | John W | In your estimation, what are the chances that you will be able to work in six months? | 7 | 3 | 105 |
| 14 | John W | If you take into consideration your work routines, management, salary, promotion possibilities and work mates, how satisfied are you with your job? | 8 | 2 | 105 |
| 15 | John W | Physical activity makes my pain worse. | 9 | 9 | 105 |
| 16 | John W | An increase in pain is an indication that I should stop what I’m doing until the pain decreases. | 10 | 10 | 105 |
| 17 | John W | I should not do my normal work with my present pain. | 9 | 9 | 105 |
| 18 | John W | I can do light work for an hour. | 8 | 2 | 105 |
| 19 | John W | I can walk for an hour. | 7 | 3 | 105 |
| 20 | John W | I can do ordinary household chores. | 6 | 4 | 105 |
| 21 | John W | I can do the weekly shopping. | 5 | 5 | 105 |
| 22 | John W | I can sleep at night. | 4 | 6 | 105 |
- Export patient responses including the calculated ÖMPQ score and disability level to Google Sheets for easy record-keeping
- Export individual points for 25 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 ÖMPQ score by email whenever a patient submits their ÖMPQ 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 |
| Where do you have pain? : | Neck, Shoulder |
| How many days of work have you missed because of pain during the past 18 months?: | 15 - 30 days |
| How long have you had your current pain problem?: | 3 - 6 months |
| Is your work heavy or monotonous?: | 5 |
| How would you rate the pain that you have had during the past week? : | 6 |
| In the past three months, on average, how bad was your pain on a 0-10 scale?: | 7 |
| How often would you say that you have experience pain episodes, on average, during the past three months?: | 8 |
| Based on all things you do to cope, or deal with your pain, on an average day, how much are you able to decrease it?: | 3 |
| How tense or anxious have you felt in the past week?: | 4 |
| How much have you been bothered by feeling depressed in the past week?: | 5 |
| In your view, how large is the risk that your current pain may become persistent?: | 6 |
| In your estimation, what are the chances that you will be able to work in six months?: | 7 |
| If you take into consideration your work routines, management, salary, promotion possibilities and work mates, how satisfied are you with your job?: | 8 |
| Physical activity makes my pain worse.: | 9 |
| An increase in pain is an indication that I should stop what I’m doing until the pain decreases.: | 10 |
| I should not do my normal work with my present pain.: | 9 |
| I can do light work for an hour.: | 8 |
| I can walk for an hour.: | 7 |
| I can do ordinary household chores.: | 6 |
| I can do the weekly shopping.: | 5 |
| I can sleep at night.: | 4 |
| OMPQ Score: | 105 |
| Disability Level: | Moderate disability |
| OMPQ Score: | 105 |
| Disability Level: | Moderate disability |
- Create a HIPAA compliant ÖMPQ 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 ÖMPQ form responses to Google Sheets and sending them on email
- Prepopulate patient details in ÖMPQ 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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