What is ePAQ?

ePAQ Systems Ltd has been formed out of a partnership of medical and IT professionals, with over 50 years experience of working within the NHS and the UK healthcare industry. Together we have created an "electronic Personal Assessment Questionnaire" system (ePAQ) which comprises a variety of validated health questionnaires designed to be completed easily by patients either in the community or in healthcare settings.

ePAQ has been developed to be simple, secure, flexible and intuitive. It is aimed at reducing the amount of time and number of visits patients would have to make to clinic, while also aiming to help clinicians get as much information as possible about a patient's health and condition.

ePAQ is an interactive Personal Assessment Questionnaire designed for use in the community as well as in normal & specialist medical practice.

Questionnaires can be completed via the internet in a patient's own time, or on computers or tablets in clinic. They are designed with simple questions which mirror those asked by clinicians. This gives clinicians the opportunity to review information about the patient before they arrive in clinic and allows patients the freedom to answer questions without embarrassment, and in their own time.

  • ePAQ offers a reliable and intelligent software analysis from a set of user-friendly questions, designed by clinicians and approved by the Plain English Campaign.
  • ePAQ has combined the accuracy and reliability of validated self-completed patient friendly questionnaires with intelligent computer software analysis and reporting.
More information:
  • For research and academic references click the References link in the More Information section at the bottom of the page.
  • For more information about the Questionnaires roll down or click on the Questionnaires link in the navigation bar. Where available click the questionnaire icons for more information about the questionnaire and it's value to your clinic.


Clinicians & Patients

ePAQ questionnaires have been designed by clinicians to represent the questions they would ask, to find the information they want to know.

  • The questionnaires are designed to help doctors, nurses, physiotherapists and administrators provide a consistent, efficient and comprehensive patient experience.
  • The are aimed at improving diagnosis and outcomes with an emphasis on quality of life in patient care
  • The questions within each of the questionnaires have been designed to get the maximum amount of information as simply as possible.
  • ePAQ pre-op has been approved by the Plain English Campaign and awarded the Crystal Mark.
  • The questionnaires have also been designed to respond to the answers given by a patient, skipping irrelevent questions.
  • Patient responses are compiled into comprehensive reports showing summary and in-depth, question by question information and analysis of their answers.

From a patient's perspective:

  • ePAQ helps patients express their problems.
  • ePAQ aids the communication process, especially where there is the option to write in the patient's own words.
  • patients have found the questionnaires; good, enjoyable, easy and quick, good fun.
  • ePAQ helped patients focus on the urgent and relevant problems.

From a clinicians perspective:

  • ePAQ provides a patient oriented approach.
  • ePAQ allows patients the opportunity to consider all their symptoms.
  • ePAQ bridges the gap between routine consultation and patient expectations.
  • ePAQ enables both patients & clinicians to reach a mutual agreement on targets & treatment
  • ePAQ gives patients freedom to express the quality of life impact of their conditions, as well as their symptoms.

Questionnaires

ePAQ has a number of questionnaires which can be 'plugged in' to the software. Below are the currently available validated questionnaires. Click on the images to find out more.

 

pre-op
ePAQ Pre-Op
 
Pelvic Floor
ePAQ Pelvic Floor
 
MPH
ePAQ Menstrual Pain Hormonal
 
Vulva
ePAQ Vulva
 

ePAQ Technical Summary

ePAQ is an interactive, web based, interview system designed for use in routine clinical care to combine the accuracy and reliability of validated self-completed questionnaires with "intelligent" computer software.

ePAQ is a browser based software application, accessible from any networked computer, smartphone or tablet and supports multiple users simultaneously e.g. a clinic environment. The system can be hosted by ePAQ Systems Ltd or individual Trusts.

The system has been developed from instruments used as Patient Reported Outcomes (PROs) and facilitates communication and consultation, as well as service evaluation, audit research in addition to supporting devolved care e.g. Nurse-led and "Virtual Clinics".

ePAQ comprises separate but integrated questionnaire and management systems, which communicate via secure WCF web services:

  • There are 2 questionnaire systems available which form the basis of the patient-facing interaction, one hosted on N3 and the other on W3. To ensure patient data security, the information in the questionnaire systems is anonymised and only re-identified when imported into the N3 hosted management system.
  • The management system gives access to completed questionnaires, summary and detailed reports, along with demographics, outcome reporting tools and the ability to extract data.

ePAQ can be used both within and external to healthcare settings through the issue of unique voucher code, generated at the time of appointment booking or hospital attendance. Vouchers allow the patient to log-on, utilising their unique voucher code and date of birth. These vouchers are specific to each questionnaire system (N3 or W3) so it is important to understand where the patient will be completing the questionnaire before issuing. Issued vouchers will either allow the patient to complete the questionnaire in clinic (via N3) or they can use a voucher which allows them to complete the questionnaire in their own time, on their own device (via the Internet). Once a questionnaire is completed, a full report of a patient's answers can be viewed with both summary information and detailed question by question responses.

In clinics, Trust-networked computers or portable devices e.g. iPads are generally used for routine clinic use.

Virtual clinics

ePAQ reports can be used in combination with telephone consultation to triage, initiate treatment and follow up patients. Patients with internet access complete ePAQ from home at https://start.epaq.co.uk using a unique code (voucher) issued by their healthcare provider, itself embedded in an explanatory letter (PDF) automatically generated on issuing of a voucher.

Following questionnaire completion, patient response data are imported into the management system, where these data are linked to the patient's demographics, stored securely behind an established firewall which enables the management system to access the system on WWW. This pathway is now being used for new and follow-up patients to realise potential cost savings for both patients and providers in addition to environmental societal benefits through reduced hospital visits.

Software, development and support

ePAQ has been developed to be intuitiveand easy to use for all levels of computer user. The software has different user roles to ensure administrative tasks and usage reporting can only be carried out by specifically authorised personel. Each management system is customisable to suit a particular clinic or hospital and contains a number of different reporting tools. Once complete a full report of a patient's questionnaire answers can be viewed with both summary information and detailed question by question analysis. In the case of Pre-Operative Assessment the report is interactive and editable.

Full software training and support is available.

ePAQ References

Questionnaire development & testing

ePAQ-Pelvic Floor

  • Responsiveness of the electronic Personal Assessment Questionnaire – Pelvic Floor (ePAQ-PF). Jones GL, Lumb J, Radley SC, Farkas AG. Int Urogynecol J Pelvic Floor Dysfunct. (Feb 2009)
  • Quality of life measurement and electronic assessment in urogynaecology. Dua A, Radley SC. The Obstetrician & Gynaecologist. (Oct 2011)
  • Electronic pelvic floor symptoms assessment: tests of data quality of ePAQ-PF. Jones GL, Radley SC, Lumb J, Jha S. Int Urogynecol J Pelvic Floor Dysfunct. (Jun 2008)
  • Computer interviewing in urogynaecology: concept, development and psychometric testing of an electronic pelvic floor assessment questionnaire (e-PAQ) in primary and secondary care. Radley et al. BJOG, 2006
  • Development and psychometric testing of a symptom index for pelvic organ prolapse. Bradshaw HD, Hiller L, Farkas AG, Radley S, Radley SC. J Obstet Gynaecol. (Apr 2006)
  • Measuring quality of life in urogynaecology.Radley SC, Jones GL. BJOG. (Dec 2004)
  • Questionnaires to assess urinary and anal incontinence: review and recommendations. Avery KN, Bosch JL, Gotoh M, Naughton M, Jackson S, Radley SC, Valiquette L, Batista J, Donovan JL. J Urol. 2007 Jan;177(1):39-49.
  • Development and validation of a questionnaire for the assessment of bowel and lower urinary tract symptoms in women. Hiller L, Radley S, Mann CH, Radley SC, Begum G, Pretlove SJ, Salaman JH. BJOG. (Apr 2002)
  • A scoring system for the assessment of bowel and lower urinary tract symptoms in women. Hiller L, Bradshaw HD, Radley SC, Radley S. BJOG. 2002

ePAQ-Vulva

  • Initial experiences of using ePAQ-Vulva in clinical practice. Alexander C, Macdonald M, Gray T, Radley S, Palmer. J. J Low Gen Tract Dis. 2015;19 (3 Suppl 1):S14.
  • ePAQ-Vulva: The Development and Production of a Novel Electronic Personal Assessment Questionnaire to Assess Patients with Vulval Disease: Macdonald M, Alexander C, Gray T, Radley S, Palmer J. J Low Gen Tract Dis. 2015;19 (3 Suppl 1):S14.
  • Development and Psychometric Testing of an Electronic Patient-Reported Outcome Tool for Vulval Disorders (ePAQ-Vulva). Gray TG, Alexander C, Jones GL, Tidy JA, Palmer JE, Radley SC. J Low Genit Tract Dis. 2017 Oct;21(4):319-326.

ePAQ-PO (Pre Operative Assessment)

  • Electronic Personal Assessment Questionnaire Pre Operative: patient experience and face validity of an interactive, electronic questionnaire for the preoperative assessment of patients due to undergo general anaesthesia. ABSTRACT: Goodhart I, Andrzejowski J, Berthoud M et al. British Journal of Anaesthesia 2012; 109: 655- 668.

ePAQ-MPH (Menstrual, Pain & Hormonal)

  • Initial patient experience of an electronic questionnaire for the assessment of menstrual, pain & hormonal disorders. James E, Swami R, Moores K, Jones GL, Connor ME, Radley SC British Society of Gynae Endoscopy. AGM. Cardiff 2012
  • ePAQ-MPH: Patient and clinician responses following its use in the gynaecology clinic. Marcin Klingbajl, Connor ME, Jones GL, Radley SC. Poster ESGE 2013

QQ-10

  • Development of an instrument to measure face validity and feasibility of patient questionnaire use during healthcare: the QQ-10 Moores K, Jones G, Radley SC. Int J Quality in Health Care. 2012

Clinical applications

  • Increasing Discussion Rates of Incontinence in Primary Care: A Randomized Controlled Trial Sophia Miryam Schussler-Fiorenza Rose, Ronald E. Gangnon, Betty Chewning, Arnold Wald. Journal of Women’s Health. Volume 24, Number 11, 2015
  • Understanding women’s experiences of electronic interviewing during the clinical episode in urogynaecology: A qualitative study. Anupreet Dua, Georgina Jones, Hilary Wood, Herjit Sidhu: International Urogynecology Journal. 2013
  • The Virtual Urogynaecology Clinic, Jha et al. IUGA 2008 (Abstract)
  • The use of free text items in electronic questionnaires to record patients’ concerns, goals and questions relating to their condition. Gray TG, Radley SC, Alexander C, Monk A, Maraj H. Abstract: Proceedings of BSUG. Int Urogynecol J 26:1701-1705. 2015

Outcomes research

  • Does Percutaneous Tibial Nerve Stimulation (PTNS) improve global pelvic function in women with faecal incontinence? S. L. Kelly*, S. C. Radley† & S. R. Brown* *Northern General Hospital, Sheffield, UK, † Royal Hallamshire Hospital, Sheffield, UK. In press Colorectal dis. 2016
  • Bowel dysfunction after total abdominal hysterectomy for benign conditions: a prospective longitudinal study. Lashen H, Jones GL, Duru C, Pitsillides C, Radley S, Jacques RM, McAlindon M. Eur J Gastroenterol Hepatol. 2013
  • Does sacral nerve stimulation improve global pelvic function in women? Jadav AM, Wadhawan H, Jones GL, Wheldon LW, Radley SC, Brown SR. Colorectal Dis. 2013
  • Prolapse or incontinence: what affects sexual function the most? Jha S, Gopinath D. Int Urogynecol J. 2015 Nov 19.
  • The effect of posterior colporrhaphy on anorectal function. Dua A, Jha S, Farkas A, Jones GL, Radley SC. International Urogynecology Journal. 2011
  • Constipation, faecal incontinence and urinary symptoms in women awaiting hysterectomy. Mann CH, Radley SC, Begum G, Gkoutzioulis F, Jordan JA, Callender R, Radley S. J Obstet Gynaecol. 2000 Sep;20(5):530-2.
  • Effect of anticholinergics on the overactive bladder and bowel domain of the electronic personal assessment questionnaire (ePAQ). Bulchandani S1, Toozs-Hobson P, Parsons M, McCooty S, Perkins K, Latthe P. Int Urogynecol J. 2015 Apr;26(4):533-7.
  • The personal impact of pelvic floor symptoms and their relationship to age. Dua A, Radley S, Jones G, Farkas A. Int Urogynecol J. 2014
  • Pelvic organ support, symptoms and quality of life during pregnancy: a prospective study. Elenskaia K1, Thakar R, Sultan AH, Scheer I, Onwude J. Int Urogynecol J. 2013 Jul;24(7):1085-90.
  • Effect of childbirth on pelvic organ support and quality of life: a longitudinal cohort study. Elenskaia K1, Thakar R, Sultan AH, Scheer I, Onwude J. Int Urogynecol J. 2013 Jun;24(6):927-37.
  • Incontinence during intercourse: Myths unravelled. Jha S, Strelley K, Radley SC. Int Urogynecol J. 2012 May;23(5):633-7. (Jan 2012).
  • The Effect of Prolapse Repair on Sexual Function in Women. Dua A, Jha S, Farkas A, Radley SC. J Sex Med. (Feb 2012).
  • Factors influencing outcome following the tension-free vaginal tape (TVT). Jha S, Jones GL, Radley SC, Farkas AG. Eur J Obstet Gynecol Reprod Biol. (May 2009)
  • Impact of TVT on Sexual function. Jha S, Radley SC, Farkas AG, Jones GL. Int Urogynecol J Pelvic Floor Dysfunct. (Feb 2009)
  • Department of Health: Delivering the 18 week patient pathway. Practical Examples - success stories: Technology and equipment (including IT). www.18weeks.nhs.uk