PHQ-9 and GAD-7 Scoring Inside the Chart

Yes. In Ona, PHQ-9 and GAD-7 ship ready to import with canonical 0-27 and 0-21 scoring, five severity bands and a preconfigured suicidality flag on item 9. The server scores the form at submission, the result lands on the patient record, and only clinicians see it. There is no cross-patient reporting or score trending yet.

Quick answer:

What works: both instruments import with their scoring, bands and flags already attached, the score is computed server-side the moment the patient submits, and the result reaches the chart carrying a severity badge and any flags.
What the patient sees: an ordinary form. No point values, no severity labels, no clinical framing, by design.
What does not exist today: cross-patient reporting and score trending. Each result lives on its form, in Ona's own wording on its own help page.

What "scoring inside the chart" actually means

Most practices score screeners one of two bad ways: a paper sheet totaled by hand and typed into a note, or a separate questionnaire tool whose results arrive as a PDF somebody re-keys. Both fail the same way. The number exists, but not in the record the clinician is working in.

Scoring inside the chart means the arithmetic happens where the answers land. In Ona, a form can be turned into an instrument: each answer carries a point value, and when the patient submits, Ona totals the points, matches the total against severity bands you define, and raises any flags you have configured, automatically, at the moment of submission.

Ona is a general ambulatory EHR that scales from solo clinics to enterprise systems, and screening is a general feature of the forms and interviews builder, not a behavioral health module bolted on the side. Behavioral health leans on it hardest, which is why PHQ-9 and GAD-7 ship ready-made, but the same machinery scores a fall-risk sheet in primary care.

What ships ready-made

Two screeners sit in the form library under Library, then Forms. The fastest start is not to build anything.

PHQ-9 Depression Screening. The nine-item Patient Health Questionnaire, with the canonical 0-27 scoring, all five severity bands, and a preconfigured suicidality flag on item 9.

GAD-7 Anxiety Screening. The seven-item anxiety scale, scored 0-21 with its standard bands.

Importing copies one into your own forms with the full scoring setup attached. The cutoffs are the published ones, so nobody transcribes a scoring key and gets a band boundary one point wrong, and the item-9 rule is already written, so nobody forgets to write it.

Delivery is the same as any other form: a secure one-time link that needs no sign-in, expires and can only be used once, or a tablet at the desk in a locked-down "fill on this device" mode that records which staff member witnessed it. Attach a form to a service once and booking that service sends it automatically, which is how a screener becomes routine rather than something somebody remembers.

How a score gets built

If you are building your own instrument, the mechanics are short enough to describe in full.

Flip the Screening toggle near the top of the form editor. Every single-choice question becomes scoreable, and each option gets a point value beside the label, seeded 0, 1, 2 in option order and editable to anything. Per question you get two extra toggles next to "Required to submit": Scored, for whether the question counts at all, and Reverse scored, which flips the value within the question's own range for instruments that mix positively and negatively worded items. Only single-choice questions can be scored, so an instrument can never quietly depend on a free-text answer nobody can total.

With screening on, a Screening panel appears below the blocks, and this is where points become a result:

The total scale sums every scored question, with a live maximum beside its name. The label you give it, "PHQ-9 Total" for instance, is what clinicians see on the result.
Unanswered questions are a policy, not an accident. "Require all answers" refuses to produce a score if anything is missing, the right choice for most instruments. "Prorate the score" scales up from the answered questions, up to a number of missing answers you allow, and marks the result as prorated.
Severity bands map score ranges to labels. Each band is an inclusive range with a label and a severity level, and the severity drives the color of the result badge, from calm green through amber and orange to red. The builder warns about overlapping or gapped ranges as you type.
Flags fire when a question's value or a scale's score crosses a threshold. The PHQ-9 template ships the canonical example: item 9 answered above "Not at all" raises a critical suicidality risk flag.

For unusual instruments there is an Advanced section per scale that transforms the raw score through a formula or a lookup table, and an Add subscale button for instruments reporting more than one number. Most practices never open either.

What the patient sees

An ordinary form. The same review, agree and sign flow, the same drawn signature and audit trail, and no scores, no point values and no clinical labels anywhere in the patient's view. The builder's preview pane shows exactly what they will see, which means no numbers in the preview either.

This is deliberate, and Ona's help page explains why rather than leaving it a setting: it follows how these instruments are administered on paper. The official PHQ-9 form says "Patient Health Questionnaire", not "depression test". Telling a patient what a form measures changes how they answer it, which undermines the validated cutoffs, so the patient-facing view carries only the questions.

Where the result lands

The moment a screening form is submitted, the score is everywhere the form is.

On the patient's Forms list, the submitted row carries a colored badge in the shape "27/27 · Severe depression", plus a red warning icon if any flags fired. Opening the form shows flags first, in a red callout carrying the guidance you wrote into the rule, then the score card: each scale's total, its maximum and its severity band. The answers follow below, with the signature record at the foot. The form submitted notification, in-app always and by email if enabled, includes the score and any flags, so whoever sent the form knows the result without opening it.

And the guardrail, in Ona's own words on its own help page: "A flag is information, not a diagnosis. It tells you a threshold was crossed so you can follow your clinical protocol - it doesn't interpret the answer for you." The software does arithmetic; the clinical judgment stays with the clinician.

Three details that change how you would use this:

Scoring is fixed at send time. Each sent form snapshots the scoring configuration along with the questions, so editing the template later never changes a form already out or submitted. A score from March is still the March instrument.

A result can be "Not scored." Under "Require all answers", a form submitted with a scored question skipped shows why, instead of a misleading number. Prorated results say so on their face.

Scores are computed once, by the server. There is no way to hand-edit a score or recompute it afterwards, so the score card always reflects exactly what the patient answered.

What Ona does not do yet

There is no cross-patient reporting and no score trending. Each result lives on its form. That sentence is on Ona's help page, and it is the honest limit of this feature today.

In practice you can open a patient's Forms list and read the badge on every screener they have submitted, but Ona will not draw a line through those numbers, and it will not tell you how many patients scored above a threshold this quarter. If a caseload-level view of screener results is the reason you are buying software, this is the gap, and it is better found in an article than on day four of a migration.

The other boundaries are smaller. Only single-choice questions score. Scores cannot be hand-corrected afterwards, a feature if you care about defensibility and an annoyance if a patient misclicked. And the ready-made library is two instruments, not a catalogue.

How this compares

One axis only, and narrow on purpose: how much of the screener round trip is already configured and automatic, from sending the form to a scored, banded result on the patient record. It is not a quality ranking, and it deliberately does not rank on library size or on what happens to scores across visits, because those are separate questions rather than the order. Every figure below was checked on each vendor's own product, pricing and help pages in September 2026.

Order	Platform	Ready-made PHQ-9 and GAD-7	How the score is produced	What it costs to have it
1	Ona	Both import ready-made: canonical 0-27 and 0-21 scoring, five severity bands on the PHQ-9, preconfigured item-9 flag	Server-scored at submission, no hand-editing; severity badge and flag callout on the record; clinician-only	Included in the seat: $130 per practitioner, $45 per staff, monthly
2	TherapyNotes	PHQ-9, GAD-7 and about 43 other instruments, completed in English or Spanish	"Auto-scored" per its own feature page; results saved and viewable at any time	Solo $69, Group $79 first clinician plus $50 each additional, monthly; outcome measures are not listed as a paid add-on
3	SimplePractice	22 scored measures, including GAD-7, PHQ-9 and the C-SSRS	Scored automatically with a scoring interpretation and a linked scoring guide; affirmative PHQ-9 suicidality answers raise a high-risk flag	Included from the Starter plan, $49; Essential $79; Plus $99
4	ICANotes	"More than 100" built-in assessment tools and rating scales, PHQ-9 and GAD-7 among them	Administered inside the chart; the page states all the tools are available at no additional cost	$55 notes only, $75 non-prescribing, $213 prescribing, per full-time clinician, plus $99 activation
5	Valant	"80+ Outcome Measures with Automatic Assignment", assigned by program, provider or level of care	Auto-assigned and auto-scheduled, with completion tracking for what has been sent, started or completed	No prices published; the pricing page routes to a quote

Read the order for what it is. If the number of ready-made instruments decides your purchase, the ranking inverts: ICANotes publishes more than 100 built-in assessment tools and rating scales at no extra cost, TherapyNotes roughly 45. If what happens to the scores across visits decides it, Ona loses outright. Valant publishes "80+ Outcome Measures with Automatic Assignment" with results "tracked over time", and SimplePractice graphs repeat scores against baseline on the client's Measures tab. Ona does neither today, and no framing changes that.

Two things this page does not decide. TherapyNotes publishes 24/7 phone and email support with every plan; Ona's human support is in-app chat and email from a primarily business-hours team. And most of these products sell the scoring inside a behavioral-health-only system, while Ona carries it inside a general ambulatory platform that also runs scheduling, billing and the insurance cycle on the same record. Which helps depends on what else you are replacing.

What it costs

Screening is part of forms, and Ona's pricing page states that every feature is included on every plan, so there is no screener add-on and no per-assessment charge. A practitioner seat is $130 a month, a staff seat $45, with 10% off the whole bill annually. Two practitioners and one staff member come to $305 a month, or $274.50 billed annually.

The add-ons are the genuinely separate products: e-prescribing at $45 per prescribing practitioner, EPCS at $25 more on top, calls with transcription and recording at $25 a month, omnichannel messaging at $150 a month and free at two practitioners or fewer, the AI receptionist by included minutes, from $100 a month for 400 minutes, and an Ona Clearing House plan from $69 a month if the practice bills insurance, which a cash-pay practice does not need. None of them are needed to score a PHQ-9.

No setup fees, no long-term contract, and a 14-day trial with no credit card. Migration from any EHR is free and usually done inside one business day, with a full cutover of one to three weeks for smaller practices.

Frequently asked questions

Can I score a PHQ-9 without leaving the chart in Ona?

Yes. PHQ-9 and GAD-7 ship in the form library and import with their scoring already attached. Send the form, and when the patient submits it Ona totals the points on the server, matches the total against a severity band, and raises any flags you configured. The score, the band and the answers all sit on the patient record.

Does Ona flag PHQ-9 item 9?

Yes. The PHQ-9 template ships a preconfigured rule: item 9 answered above "Not at all" raises a critical suicidality risk flag. The flag appears first when you open the result, in a red callout carrying the guidance you wrote into the rule, and it travels into the form submitted notification. Ona's help page is blunt about the limit of that: "A flag is information, not a diagnosis."

Do patients see their PHQ-9 or GAD-7 score?

No. Scores are visible to clinicians only. The patient fills in an ordinary form with no point values, no severity labels and no clinical framing anywhere in their view, and the builder's live preview shows exactly that. Ona's help page gives the reason: telling a patient what a form measures changes how they answer it, which undermines the validated cutoffs.

Can I see a patient's PHQ-9 scores across visits in Ona?

Not today. Ona's own help page states there is no cross-patient reporting or score trending yet, and that each result lives on its form. You can open every submitted screener from the patient's Forms list and read the badge on each row, but Ona does not draw a line through them and does not report across a caseload.

Can I score an instrument other than PHQ-9 and GAD-7?

Yes. The Screening toggle turns any form into a scored instrument. Every single-choice question becomes scoreable, each option carries a point value, and you set your own severity bands and flag rules. Text, free-text and multiple-choice blocks never carry points. Per question you can switch scoring off, or reverse score it for mixed-wording instruments.

Does screener scoring cost extra in Ona?

No. Screening is part of forms, and Ona's pricing page states that every feature is included on every plan. A practitioner seat is $130 per month and a staff seat is $45, with 10% off the whole bill on annual billing. There are no setup fees and no long-term contract, and the trial is 14 days with no credit card.

Next step

The honest test takes five minutes: import the PHQ-9, attach it to a service, and send it to yourself. Watch the badge, the flag callout and the score card land on the record, then decide whether the missing history view is a dealbreaker. Read how screening forms are built and what else lands on the chart before a visit, or book a 15-minute demo and bring your current intake pack. The 14-day free trial needs no credit card.