E-POS is a validated screening tool that enables patients to complete a digital questionnaire at home before undergoing surgery. Additionally, E-POS informs patients about anesthetic techniques and procedures, including fasting guidelines. This reduces the need for outpatient visits and frees up time for scarce healthcare providers. Based on scientifically validated algorithms, E-POS advises whether a patient requires a personal consultation with an anesthetist or can be safely evaluated on the day of surgery. 

Nearly 98% of patients complete the questionnaire
To effectively use a questionnaire within the anesthesiology workflow, it is essential that the response rate is as high as possible. E-POS achieves approximately 98% in this regard.

This is important because it means clinicians have access to more accurate and comprehensive information about patients prior to surgery and the preoperative consultation. In turn, this helps healthcare providers make better-informed decisions regarding a patient's suitability and the appropriate next steps. 

However, a questionnaire (physical or digital) is pointless if patients fail to complete it or leave it incomplete. Here is how E-POS increases the response rate:

Measure 1: Login Method
E-POS integrates with most patient portals. Typically, the response rate for questionnaires accessed via the portal plateaus around 55-65%. The highest response rate is achieved by sending the questionnaire via email. After clicking the link in the E-POS email, patients receive an SMS code to verify that the recipient of the email is indeed the patient.

Opting deliberately for email & SMS verification instead of a DigiD login is a significant factor. This way, patients do not have to navigate through both the patient portal and the DigiD portal.

Measure 2: Multilingual Support
The Netherlands is seeing an upward trend in residents whose first language is not Dutch. The healthcare needs of these groups are often substantial. The accessibility of digital healthcare, including medical questionnaires, is frequently relatively low, which is often reflected in questionnaire response rates.

Naturally, this target group does not understand Dutch and sometimes English questionnaires sufficiently due to the language or the way questions are formulated. For this reason, E-POS is designed to make the questionnaire and informational videos simple. As a result, patients at Haaglanden MC and Het Dijklander Ziekenhuis, for example, use the questionnaire in Dutch, English, Spanish, Polish, Turkish, and Arabic.

During target audience research conducted by NovaCair, it appeared that the poor response also had a different cause than a language barrier. Translated questionnaires made available within a patient portal are not always completed by people with a migration background either. This is because while the questionnaire may be translated, the patient portals themselves are often only available in Dutch and occasionally in English.

This is why many clients choose to offer the questionnaires via an email secured with 2-step verification.

Measure 3: Focus on User Experience
What is the biggest difference between checking out for an online store purchase and navigating the average digital medical questionnaire? Exactly… the user experience.

While people easily enter details to buy a product online, many digital questionnaires are relatively difficult to use and therefore not user-friendly.

This is caused by:

• Poor availability of a mobile or tablet version; (healthcare providers only test the questionnaire on a computer during procurement, whereas over 60% of people complete questionnaires on mobile devices).
• Allowing input to be missed or failing to clearly indicate when a question has been skipped;
• Poor usability for the elderly; (small buttons; excessive scrolling; small font size)

During the development of E-POS, NovaCair intentionally chose to hire web developers with a background in UX (user experience) from large online retailers. As a result, the questionnaire is equally easy to complete on any browser version and device.

User experience is difficult to explain, but easy to experience firsthand. A test questionnaire can be requested via this link. Please pay close attention to the following:

• How it is impossible to forget answering questions;
• How effortlessly E-POS scrolls to the next question;
• How the system is accessible on any mobile device;

Additionally, it is always possible to close the questionnaire (for instance, if someone is at the door) and reopen it later. E-POS saves all answers in the meantime, so patients do not need to re-enter any information.

Finally, forgetting to complete a questionnaire is human nature. Fortunately, reminding the patient to fill it out is not. E-POS offers automated (SMS and email) reminders if a patient forgets to start or complete the questionnaire.

Conclusion
In short, the 98% response rate when patients receive the E-POS questionnaire via SMS or email is a key component and advantage of E-POS, demonstrating the effectiveness of the software implementation. E-POS helps streamline the preoperative screening process. 

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