Migrating Focal assessments to Forms

This guide explains how existing Focal assessments are being converted into Form responses as part of the move to the new Forms experience (Clinical Uplift). We'll cover what's changing, how the migration works, how your clinical data is preserved, how Lookout Assist uses migrated records, and the steps you need to take.

---

Before you start

Before beginning the migration:

• You'll need the Configure templates permission in RBAC to initiate it

• It's worth being familiar with both the older focal assessments feature and the new Forms experience

• No action is needed from individual clinical staff to move historical data - the migration runs automatically once started

---

What's changing?

Previously, the system offered a dedicated set of clinical assessment tools, including:

• Falls Risk Assessment Tool (FRAT)

• Falls Risk for Older People – Community setting (FROP-Com)

• Abbey Pain Scale

• Mini Nutritional Assessment

• Norton Scale

• Psychogeriatric Assessment Scale – Cognitive Impairment Scale (PASCD)

• Braden Scale

• Kessler Psychological Distress Scale (K10)

• Confusion Assessment Method (CAM)

• Caregiver Strain Index

Each of these is now available as a standard Form, and existing records are automatically moved across.

---

How the migration works

The migration runs automatically in the background once initiated by a user with the **Configure templates** permission. Here's what happens behind the scenes:

1. Finding records to move. The system looks for every existing focal assessment that hasn't already been migrated. It processes them in batches and keeps track of which ones are done, so the process can safely run multiple times without creating duplicates.

2. Matching each assessment to the right Form. Each type of assessment is paired with its matching Form template (for example, an old FRAT record is matched to the new FRAT form).

3. Translating the answers. The original answers are carefully mapped into the equivalent fields on the new form. Each assessment type has its own translation rules to make sure the meaning of the original responses is preserved.

4. Recreating the record as a Form response. A new Form response is created, carrying over the original details — who the assessment was about, who completed it, and the original date it was assessed. The original assessment date is preserved, so your timeline and history stay accurate.

5. Keeping a link between old and new. For every assessment that's moved, the system records a permanent link between the original assessment and its new Form response. This is how it avoids migrating the same record twice and provides a clear audit trail.

---

Preserving clinical meaning

A lot of care goes into making sure the converted records mean the same thing they did before. Clinical outcomes and scores are preserved wherever possible.

Assessments that migrate with full fidelity

The following assessments migrate without material changes. The migrated form record reflects the original assessment data exactly, and no special consideration is needed:

• Abbey Pain Scale

• Braden Scale

• Caregiver Strain Index

• FRAT

• Kessler K10

• Mini Nutritional Assessment

• Norton Scale

• PASCD

 

Assessments with expanded schemas

Some new form schemas capture more detail than the original focal assessments did. Where the original assessment didn't collect a particular piece of information, migrated records use neutral or placeholder values. These are designed to preserve the original score and clinical outcome, but may not represent additional clinical detail that was never recorded.

The two assessments with expanded schemas are described below.

CAM (Confusion Assessment Method)

The new CAM form captures 10 clinical indicators. The original focal assessment captured 4.

Additional clinical indicators

The following six indicators were not captured in the original assessment and are set to **Uncertain** in migrated records, to avoid implying they were assessed when they were not:

• Disorientation

• Memory impairment

• Perceptual disturbances

• Psychomotor agitation

• Psychomotor retardation

• Altered sleep-wake cycle

This avoids implying these indicators were assessed when they were not.

Inattention severity

The original assessment captured inattention as present or absent; the new form captures severity as Mild, Marked, or Not present. During migration:

• If inattention was present, it's mapped to Marked

• If inattention was absent, it's mapped to Not present

This preserves the original delirium detection outcome, though the specific severity wasn't captured originally.

 

Inattention fluctuation

The original assessment didn't capture whether inattention fluctuated. During migration, this value is set to match the **acute onset** value, which preserves the original delirium detection logic.

 

Level of consciousness

The original assessment recorded whether consciousness was altered, but not the specific level. The new form captures Alert, Lethargic, Stupor, or Coma. During migration:

• If altered consciousness was recorded, it's mapped to Lethargic

• If altered consciousness wasn't recorded, it's mapped to Alert

This preserves the original score, though the specific level wasn't captured in the original assessment.

 

FROP-Com

The new FROP-Com form captures individual checklist items, whereas the original captured aggregate scores for some sections. To reproduce the original section scores, migrated records may use synthetic checkbox values. These reproduce the original score, but may not reflect the exact items that applied to the client at the time.

Medication types

The original captured an aggregate medication impact score (0–3) but did not record which medications were present. Synthetic checkbox values are selected to reproduce the original score, so the specific medications shown may not reflect the client's actual medications.

Chronic conditions

The original captured an aggregate medical conditions score (0–3) without recording which conditions were present. Synthetic checkbox values reproduce the original score, so the specific conditions shown may not reflect the client's actual conditions.

Cognitive status (AMTS)

The original captured an aggregate cognitive score without recording which AMTS questions were answered correctly. Synthetic checkbox values reproduce the original score, so the specific responses shown may not reflect the client's actual responses.

Fall circumstances

The original didn't capture detailed fall circumstances such as date, time, location, or cause. Where falls were recorded, migrated records use placeholder values based on the assessment date, and a comment is added noting that the exact circumstances weren't recorded and may not be correct.

---

How Lookout Assist uses migrated records

Assist builds a picture of a client's clinical history in two different ways, and migrated forms behave differently in each:

When a new form is submitted

When someone fills in a new form, Lookout Assist interprets it and looks back at the client's most recent previous response of the same form type to add context (for example, noting a falls risk score has increased since last time). A migrated historical form does count as a previous response for this purpose. If the most recent earlier record of that form type is a migrated one, Lookout Assist will reference its data when interpreting the new submission.

When building the overall history summary

Lookout Assist also produces a broader, over-time summary of a client's history for a given form. This is built only from interpretations Lookout Assist itself previously generated - not from raw form data. Because migrated historical forms were imported with their automatic interpretation deliberately skipped, they have no interpretation on file and are not included in the overall history summary. That picture is built from forms submitted after the switch-over.

In short, migrated records aren't invisible to Lookout Assist, but they only surface as point-of-comparison context for the next new form. They don't contribute to the longer-term, history-wide summary.

---

What happens to new assessments?

Once Forms are switched on, the old focal assessment screens are no longer used for creating new records. When someone tries to start a new assessment the old way, they're guided to the new Forms experience instead. If anyone attempts to record one through an integration, they'll receive a message explaining that focal assessments have been replaced by Forms, and that new assessments should be recorded using Forms going forward.

---

What happens next?

• Your historical assessments will appear as Form responses, with their original dates and details intact.

• The migration can safely run more than once without creating duplicates, thanks to the permanent link kept between each original assessment and its new Form response.

• All new assessments should be created using Forms.

• Because a record is kept of every migrated item, any assessment that doesn't appear to have carried over correctly is straightforward to look into.

---

Step-by-step instructions

Step 1: Start the migration

Once you have the correct permission, initiate the migration. It will then run automatically in the background - there's no need to work through records manually.

 

Step 2: Check your migrated records

After the migration has run, your historical assessments will appear as Form responses, carrying over:

• Who the assessment was about

• Who completed it

• The original assessment date

Take a moment to confirm your records have carried across as expected.

 

Step 3: Create all new assessments using Forms

Going forward, use the new Forms experience to create any new assessments. The old focal assessment screens are no longer used, and you'll be guided to Forms automatically if you try the old route.

 

Step 4: Flag anything that looks incorrect

If you notice an assessment that doesn't appear to have carried over correctly, let your support team know. Because the system keeps a record of every migrated item, it's straightforward to investigate.

---

Troubleshooting

I can't start the migration

Check that your account has the Configure templates permission in RBAC. If you don't have it, ask your administrator.

 

A historical assessment doesn't seem to have migrated

Let your support team know. As every migrated item is recorded with a permanent link to its original, it's straightforward to look into.

 

A migrated form shows detail that wasn't in the original assessment

This is expected for CAM and FROP-Com, where the new forms capture more detail. Treat migrated records as accurate for scoring and outcome, but use caution when interpreting newly visible fields that weren't captured originally (see Preserving clinical meaning above).