Forms Software Review
By: Jeneane A. Brian, BSN, MBA, CEO, VNAHHS
Jeneane Brian is a nurse executive and creator of a handheld
based clinical documentation system in use by VNA Home
Health Systems, the industry leader in home health and
hospice services for Southern California.
Jeneane used Pendragon Forms to create an enterprise
wide solution for the VNAHHS
Forms Software is an easy to use forms and data acquisition
system for the Palm OS versions 3.1 or higher. It is an excellent
rapid application development platform that does not require hard
coding expertise. There are two versions using either desktop software
or the Internet.
Pendragon runs on Windows 95/98, Windows NT and Windows 2000/XP
operating systems. It uses Active Server Pages to provide access
via a web browser and proprietary synchronization technology. It
is not compatible with Windows Pocket PC or the Mac OS.
The PC Application (3.2)
The three main components:
1. A Microsoft Access (either 97 or later) desktop interface
for forms development which lets you create forms, associated
tables and assign form properties.
2. A synchronization conduit added to the standard Palm
Hot Sych manager, sends the form designs and data back and forth
to the PDA and the desktop software.
3. A PDA application which collects and stores data for
(click on image to enlarge)
The Internet Application
The Internet version is called Pendragon Internet Forms. Forms
development is accomplished online via any Web browser, with proper
software permissions. Form designs and data are synchronized across
a TCP/IP network to the PDA using a proprietary encryption process.
Synchronized data can then be accessed, viewed, and edited via the
web browser. Pendragon has posted a technical white paper, available
on its website, that can explain the technical structure of its
(click on image to enlarge)
In either case, desktop or Internet, Pendragon presents an easy
way for non technical developers to create easy to use and powerful
PDA software for a mobile workforce.
From a practitioner's point of view, I divide the use of the Pendragon
system into three categories (you will never see this type of discussion
on a techie page!).
1. Use by one clinician to replicate commonly used paper
forms-to save time, to catalog patient data for later review and
research, and to have some fun. Examples include: physical therapists
or other clinicians who work for multiple home health agencies that
require paper forms for clinical documentation or nurse consultants
such as wound care specialists who work for multiple organizations
and can design and submit forms of their own making. These clinicians
can use the desktop version 3.2 with a single user license, the
cost is approximately $150.00. The paper counterpart of the forms
is best if written as a report in Microsoft Access.
2. Use by a small group of clinicians- to serve as the basis
for billing, clinical documentation, time and attendance, inventory
monitoring and research of the group's activities. Pendragon 3.2,
the desktop version, can be used for these purposes, with the same
$150 software expense, but multiple user fees would also apply.
Desktop software is installed on a central computer that becomes
the database/server. In order to synchronize the computer must be
on and online (Pendragon does not require modem pools for synchronization)
although it does not have to be fully dedicated to the Pendragon
system. (Note, the trial version allows only one user to synchronize
at a time. This is one reason that the trial desktop version is
inefficient for use with a large group. Assigning synchronization
time windows can help avoid system congestion while you are experimenting
with it.) Server synchronization software is available and allows
for multiple user synchs to a single server via TCP/IP.
Users cannot access synchronized data once it leaves the PDA. Users
synchronize data to the central server and do not retain data on
their home PC. The only way synchronized data can be reviewed after
it leaves the pda is to do so via the server PC (usually at the
office).While this approach provides the convenience of a centralized
master database that can be manipulated for all types of reasons,
it is a drawback for some. Although data retention properties can
be set by the forms designer those who are accustomed to saving
personal paper or electronic copies of documentation or timesheets,
for example, will not be able to do so. The software's PDA print
feature is very limited and unsatisfactory.
3. Use by large clinical groups- primarily mobile and highly
distributed. Used for collection of business and clinical data when
a laptop or PC is not readily available or practical. When the user
group exceeds 20-30, the enterprise edition of Pendragon, Internet
Forms, begins to make sense. Internet software is licensed by user,
and there are a variety of pricing structures. Pendragon offers
hosting for small companies at what I believe to be a very reasonable
price. Or, one can purchase the software system and install it on
the company's own server, which is what VNAHHS chose to do.
With the Internet version comes many additional user convenience
features that go far to make the system more comfortable to rely
on for clinical data. The Internet version allows for easy access
via any Internet capable PC. Access is password and permission based.
In our experience, user satisfaction is much higher with this version.
Users are able to see, edit, review, and input data after synchronization
via our website. Depending on user assigned access rights, paper
versions of the forms and/or the data tables can be printed. VNAHHS
does not rely on the website tables for conversion of our forms
to paper (when this is necessary) but it can be done. A user can
select any record, view it as a form, and can screen print the results.
Once again, it does not seem that Pendragon focused much on the
printing feature, doing so requires a 'screen print' right mouse
click. The printed result is lengthy, and not optimally formatted
for 8 ½" X 11" paper- but it works.
The Handheld User:
Installation is easy and automatic via CD. As a nice surprise,
the user manual is bound and comes with the CD! One drawback, however,
is that there is a picture of a rat on the front cover (a strategy
to keep mom from fooling with the kid's computer book)? There is
a printed version available for purchase that has a more traditional
cover, though, The Official Pendragon Forms for Palm OS ($40) written
by Ivan Phillips (Pendragon's CEO) and Debra Sancho. It comes with
a trial version of the software and a $40 coupon for the desktop
version. It offers little more information than the reference manual.
The purchased handbook and the reference manual are focused mostly
on forms development instruction rather than on use of the PDA applications.
I had to write a VNAHHS user manual to describe how clinicians should
use the VNA FreeForms clinical documentation PDA applications.
Forms synchronize based on form properties set by the forms developer.
There are 21 field types pre-formatted by the Pendragon software.
PDA data can be sorted, filtered, and there is a very convenient
search function for large lookup tables (such as active patient
lists). Data entry is quick and easy. Skip logic can be scripted,
forms can be nested, preloaded with demographic data, and linked
in various ways, even to the Palm address book. The forms have the
familiar Palm OS application layout with drop down menus and other
features that do not require a great deal of user training once
one is comfortable with using the native Palm applications.
Pendragon Forms are compatible only with Microsoft Access, 97 or
2000. VNAHHS has not found this problematic, since we have a Windows
NT shop and Pendragon easily swaps data with our AS-400 platform
via mapping. It is ODBC compliant and we have been able to build
a robust back end system off our SQL server.
A single user without much experience configuring Access reports
will find Access (not Pendragon) awkward to use and must have expertise
in linking data tables to the reports, etc. However, the Pendragon
database can be used to merge with any MS Office document such as
Word, so this barrier can be minimized. I would not recommend using
a mail merge feature for high volume business use, however.
The character length restrictions inherent in a pre-formatted software
system such as Pendragon are what make it simple and easy to use,
but also make it frustrating for enterprise users such as ourselves
who push the software to its limits. VNAHHS is a Medicare certified
home health agency and hospice. Many of our documentation requirements
are regulated and character lengths imposed by the software have
required us to invest considerable time in customizing backend processes
to build complex reports from the data.
Technical problems with Pendragon Forms have been minimal. Our
clinicians are synchronizing over 10,000 records per month with
very few glitches that are not attributable to user error. When
we have found the occasional software problem, the Pendragon service
representatives have been very responsive.
I've included some screen shots from the solution
that we use daily to help illustrate the flexibility and power of
this development tool:
Single field view pick lists
Multiple fields view
Records can be clustered by program
and then by patient to reduce screen clutter.
Sorting and lookup feature for individual
Pendragon Forms has delivered on all its promises
to VNA Home Health Systems, and more. We find it flexible enough
to meet our mobile computing needs, easy to teach and use, affordable,
If you are a professional desirous of developing
a mobile solution, and you don't happen to be a "code warrior",
this is the system to use.
Jeneane can be reached via email
Editors Note: For additional articles
on/by Jeneane A. Brian click
|Do you have a question
or comment about this review? Discuss IT with Jeneane