Updates to the Patient Information form Copied

For practices participating in the Enhancing Oncology Model (EOM), the changes to the Patient Information form can help meet the updated EOM requirements around sociodemographic demographic data collection.

Now when patients receive the Patient Information form, they will see the following updates:

Demographics

Preferred Language: When choosing an option from the existing drop-down, users will see more options in the list. A single preferred language must be selected. If they select Other, the system will prompt them to choose a language from the pre-filled list (callout 1).

Race: When choosing an option from the existing drop-down, users will see updates to the list of races.

Ethnicity Expanded: After choosing an ethnicity, patients can use this new field to choose up to 4 additional ethnicity options to better detail their ethnicity (callout 3).

Preferred Pronouns: When choosing an option from the existing radio buttons, users will see updates to the list of pronouns (callout 4).

Disability Status Information

Several new required questions will be displayed for patients to answer regarding potential disabilities such as hearing, vision, or mobility impairment.

Contact Information

Phone Number Type: After entering a phone number, patients can now choose one of the following phone number types from a drop-down: Home, Work, Mobile, Family Member, or Neighbor (callout 1).

Preferred Contact Method: A new required field will display for patients to choose one of the following preferred contact methods from a drop-down: Mobile Phone, Email, Home Phone, or Work Phone (callout 2).