Research Exam Worksheets
In some instances, the study sponsor will provide specific research exam worksheets that
they want used for study ophthalmologic exams. However, we have come to find out that
in most cases we are left to create our own for use in studies. A standard ophthalmic
clinical note is optimized for ophthalmologist, thus it does not lend itself to be easy to
navigated. Therefore, we have devised a template research exam worksheet that contains
all the elements of a standard exam, yet allows for better flow and interpretability. In
instances where we need to create an exam worksheet, we would like to work with you to
determine the specific items your sponsor expects to be entered from the exam (i.e. What
is in their electronic data capture?). We will then “tailor” our template to best coordinate
with your study and adjust the layout to make it most convenient for data entry.
In addition, we can create the research exam worksheet prior to the first study visit so that
you may have time for the sponsor to review it for use.
Scheduling Visits
Study visits will be scheduled with Jennifer Moorer by phone or email at 325-8674
/ [email protected]. Jennifer will work with you to identify a convenient time that will
coordinate with potentially other research exam(s)/visit(s) that the study participant may
be having on this day. It is strongly suggested to schedule visits at least 2 weeks prior to
the research visit so that you may have the greatest flexibility in scheduling. We have the
ability to schedule exams on short notice, but be advised that this will limit available time
slots. We do ask that if you need to cancel or change a scheduled visit to please contact
Jennifer as soon as possible.
Day of Exam Overview
On the day of the exam, we ask that you send your study participant to the Callahan Eye
Hospital Suite 609. I have attached driving directions if you need them. Jennifer will be
with them during the whole visit as she will provide the initial workup and assist the
Ophthalmologist during the study exam. All data will be captured on the research exam
worksheets.
If they need to park in the parking deck they can, but we do not provide vouchers for
parking. We can validate their ticket during their visit.
Study Document Distribution
We understand that these exams are critical for patient safety; therefore, we will send to
you an electronic version of the completed exam on the same day. For regulatory
compliance, we will deliver the original research exam worksheet to your office on our
weekly document run. Currently, we are delivering study documents on Fridays. All we
ask is that you have someone sign for receipt of these documents. These will be
delivered in interdepartmental mail folders with a signature log attached to the front.
Billing
As Jennifer processes these exams, she will submit an internal service
request/authorization form to you. The form contains date of service along with
identification of exams, imaging and/or testing that may have been done. Angela
McKinney, the Department of Ophthalmology business officer, will also be copied on
this email should you have any questions or concerns.
We look forward to working with you. Please do not hesitate to contact us if you have
questions or concerns during the study.