1.Patient Computer Use|
|
| Description:The survey helps determine how the respondent has used computers already for healthcare purposes, interest in using the computer to communicate with their doctor, and reasons for not using the computer for email. |
| Survey Type:Functionality,Questionnaire |
| Respondent Type:Patient |
| Care Setting:Home |
| Technologies:Secure Messaging,Personal Health Records |
| Disclaimer:This is a grantee survey. This survey can be modified and/or replicated to fit your HIT project. |
| User Level:Novice |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_835123_0_0_18/Pt%20CUS%20ALL.docx |
| Acknowledgement:David Mehr |
|
|
2.Qualitative Interview Questions for Electronic Health Record Implementation|
|
| Description:This key informant interview guide provides a set of interview questions for assessing stakeholders' perspectives on planning and implementing an electronic health record system. The interview guide is split up into three sections: pre-implementation, during implementation and post-implementation. |
| Survey Type:Interview Guide |
| Respondent Type:IT Staff,Nurse,Administrators,Physician,Office Staff |
| Care Setting:Across the healthcare system |
| Technologies:Enterprise Systems,Electronic Health Records |
| Disclaimer:This is a grantee survey. This survey can be modified and/or replicated to fit your HIT project. |
| User Level:Intermediate |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_898126_0_0_18/Pohl_Qual_Interview_EHR.pdf |
| Acknowledgement:Joanne Pohl |
|
|
3.MyGroupHealth's Satisfaction Survey|
|
| Description:This is a survey targeted to PHR users (patients) of a specific PHR. The questions cover satisfaction with: on-line services, secure emailing, online appointment scheduling, prescription refill requests, results viewing, a knowledge database, and provider directory. The survey also compares task execution in the PHR versus a non-PHR environment. |
| Survey Type:Satisfaction,Questionnaire |
| Respondent Type:Patient |
| Care Setting:Ambulatory |
| Technologies:Personal Health Records |
| Disclaimer:Permission has been obtained from the survey authors for unrestricted use of this survey. This survey can be modified, and/or replicated to fit your HIT project.
The survey could be modified easily to any PHR program. |
| User Level:Novice |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_811806_0_0_18/MYGROUP_HEALTH_SURVEY.doc |
| Acknowledgement:James Ralston at MyGroupHealth |
|
|
4.Santa Cruz Technical Readiness|
|
| Description:This survey focuses on evaluating organizational readiness for IT. The questions cover: the current state of technology in the office, current computer equipment, network availability, email, software and operational readiness. |
| Survey Type:Current State Assessment,Questionnaire |
| Respondent Type:Office Staff,Not Specified |
| Care Setting:Ambulatory |
| Technologies:Not Specified |
| Disclaimer:This is a grantee survey. This survey can be modified and/or replicated to fit your HIT project. |
| User Level:Intermediate |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_811835_0_0_18/Santa%20Cruz_Technical_Readiness.doc |
| Acknowledgement:Grantee - Eleanor Littman |
|
|
5.Maine Health Management Coalition: Office Systems Survey|
|
| Description:This survey focuses on assessing how ambulatory care providers manage chronic illnesses both generally and using health IT. The questions cover: health risk assessments and corresponding intervention plans, use of clinical guidelines, use of chronic illness registries, patient education/self-management, care/case management for patients at-risk of chronic illness, usage of e-Prescribing and EMRs. |
| Survey Type:Current State Assessment,Questionnaire |
| Respondent Type:Not Specified |
| Care Setting:Ambulatory |
| Technologies:Personal Digital Assistants,Practice Management Systems,Health Information Exchange,Computerized Provider Order Entry,Electronic Health Records,Electronic Prescribing,Clinical Decision Support,Disease Registry |
| Disclaimer:Permission has been obtained from the survey authors for unrestricted use of this survey. This survey can be modified, and/or replicated to fit your HIT project. |
| User Level:Expert |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_811812_0_0_18/Maine_Health_Coalition_OSS_Survey.pdf |
| Acknowledgement:Ted Rooney at Maine Health Management Coalition |
|
|
6.Computer System Usability Questionnaire|
|
| Description:This survey focuses on end-user satisfaction with a computer system. The questions cover: ease of use, alerts, decision support, user interface, negative aspects, and positive aspects. |
| Survey Type:Usability,Questionnaire |
| Respondent Type:Not Specified |
| Care Setting:Not Specified |
| Technologies: |
| Disclaimer:This is not a grantee survey. Please read the website carefully for restrictions of public use, and acknowledgement of survey authors. |
| User Level:Intermediate |
| URL:http://www.acm.org/perlman/question.cgi |
| Acknowledgement: |
|
|
7.Healthcare Provider Survey|
|
| Description:This survey asks providers about their knowledge of hypertension management and how the EMR can help with that in terms of evidence based guidelines. It offers a good set of questions concerning the impact of a medical record system on health care practices, particularly as it relates to chronic disease management. |
| Survey Type:Usability,Attitude Assessment,Questionnaire,Other,Satisfaction |
| Respondent Type:Physician,Nurse,All Clinical Staff |
| Care Setting:Across the healthcare system |
| Technologies:Electronic Health Records |
| Disclaimer:This is a grantee survey. This survey can be modified and/or replicated to fit your HIT project. An institution can utilize a similar format to this. It does need individualization for specific environments. |
| User Level:Expert |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_8969_891163_0_0_18/Healthcare_Provider_Survey.pdf |
| Acknowledgement: |
|
|
8.System Usability Scale (SUS)|
|
| Description:This survey is a reliable, low-cost usability scale that can be used for global assessments of usability. The questions evaluate system effectiveness, efficiency, and satisfaction. The survey is best used when comparing two similar interfaces, but measuring a single interface does provide an objective rating of its usability. The SUS is used most often with Web-based products, but it is not limited to the Web. |
| Survey Type:Usability,Questionnaire |
| Respondent Type:Everyone |
| Care Setting:Across the healthcare system |
| Technologies:General Computing,Not Specified,Enterprise Systems |
| Disclaimer:Permission has been obtained from the survey authors for unrestricted use of this survey. This survey can be modified, and/or replicated to fit your HIT project. |
| User Level:Intermediate |
| URL:http://www.usabilitynet.org/trump/documents/Suschapt.doc |
| Acknowledgement: |
|
|
9.Survey of Health Center use of electronic information|
|
| Description:This survey may serve as a tool to understand the landscape/capabilities, facility readiness, and organizational capabilities forelectronic health information in ambulatory facilities (particularly community health centers). The original intent of the survey is for NACHC members, but many of the questions may be useful to organizations or efforts that need to understand the current state of electronic health information across multiple ambulatory facilities. |
| Survey Type:Questionnaire,Needs Assessment |
| Respondent Type:IT Staff,Physician |
| Care Setting:Ambulatory |
| Technologies:Disease Registry,Telehealth,Electronic Health Records,Clinical Decision Support,Health Information Exchange,Enterprise Systems,Electronic Prescribing |
| Disclaimer:Permission has been obtained from the survey authors for unrestricted use of this survey. This survey can be modified, and/or replicated to fit your HIT project. |
| User Level:Expert |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_835625_0_0_18/HIT%20Survey%2007_16_08_forNORC.doc |
| Acknowledgement:Michael R. Lardiere, LCSW
Director, Health Information Technology
Sr. Advisor, Behavioral Health
National Association of Community Health Centers |
|
|
10.PCIP Post-EHR Implementation Survey of Providers|
|
| Description:This is a post-implementation survey of providers of their experiences with an electronic health record. It looks at overall satisfaction as well as the impact of the HIT on various attributes of work. |
| Survey Type:Benefit,Satisfaction,Questionnaire,Attitude Assessment,Usability |
| Respondent Type:Physician |
| Care Setting:Across the healthcare system |
| Technologies:Electronic Health Records |
| Disclaimer:This is a grantee survey. This survey can be modified and/or replicated to fit your HIT project. An institution can utilize a similar format to this. |
| User Level:Intermediate |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_887511_0_0_18/PCIP_Post-EHR_Implementation_Survey_Providers.pdf |
| Acknowledgement: |
|
|
11.Assessing Adoption of Effective Health Information Technology Questionnaire (MGMA)|
|
| Description:This survey focuses on IT adoption patterns. The questions cover: current IT adoption (scheduling, referrals, CPOE, lab results, ePrescribing, drug alerts, and EHRs), assessment of IT (benefits, barriers, ease of making EHR decision, and communication outside office), and demographics.
|
| Survey Type:Current State Assessment,Questionnaire |
| Respondent Type:IT Staff,Physician,Administrators,Nurse |
| Care Setting:Across the healthcare system |
| Technologies:Practice Management Systems,Computerized Provider Order Entry,Electronic Prescribing,Picture Archiving and Communication System,Electronic Health Records |
| Disclaimer:This is not a grantee survey, Please read the website carefully for restrictions of public use, and acknowledgement of survey authors.
|
| User Level:Novice |
| URL:http://www.mgma.com/WorkArea/showcontent.aspx?id=292 |
| Acknowledgement: |
|
|
12.CCCN USABILITY ASSESSMENT: ONLINE REGISTRY: USER INTERVIEWS/SURVEY QUESTIONS (ONLINE SURVEY)|
|
| Description:This survey is targeted to users of a specific diabetes registry program. The questions cover: ease of use, impact on workflow, challenges in updating the registry, and general computer usage skills. |
| Survey Type:Usability,Current State Assessment,Questionnaire |
| Respondent Type:Physician,Office Staff,Nurse |
| Care Setting:Ambulatory |
| Technologies:Disease Registry |
| Disclaimer:This is a grantee survey. This survey can be modified and/or replicated to fit your HIT project.
An institution can utilize a similar format to tailor their own surveys for a disease registry system. |
| User Level:Novice |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_811801_0_0_18/Littman_CCCN_online_survey.pdf |
| Acknowledgement:Grantee -Eleanor Littman |
|
|
13.Using Data for Measuring Clinical Quality: Provider Attitudes and Experience|
|
| Description:This is a structured interview instrument to elicit provider attitudes about using data for the purposes of quality improvement. It addresses the collection of data, the results of the data collection, the perception of data quality, the value to the practice, and the eventual use of the data. |
| Survey Type:Benefit,Interview Guide,Satisfaction |
| Respondent Type:All Clinical Staff |
| Care Setting:Not Specified |
| Technologies:Electronic Health Records |
| Disclaimer:This is a grantee survey. This survey can be modified and/or replicated to fit your HIT project. |
| User Level:Intermediate |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_846326_0_0_18/Mostashari_Q32008%20Attachment%20D_Semi-structured%20interview%20guide.doc |
| Acknowledgement:Grantee - Farzad Mostashari |
|
|
14.Patient Experience with Shared Med List Survey (PESML)|
|
| Description:This survey focuses on satisfaction with the electronic shared care plan medication list. It is targeted to patients. The questions cover: patients' frequency of checking the list, instances in which patients would add to their list, instances in which patients take the list to their physician, completeness, ease of use, accuracy, and empowerment. |
| Survey Type:Usability,Current State Assessment,Interview Guide |
| Respondent Type:Patient |
| Care Setting:Home |
| Technologies:Personal Health Records |
| Disclaimer:Permission has been obtained from the survey authors for unrestricted use of this survey. This survey can be modified, and/or replicated to fit your HIT project. |
| User Level:Intermediate |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_811825_0_0_18/Peace_Health_Patient_Experience_w_Shared_Med_List_Survey.doc |
| Acknowledgement:Eldon Mahoney at Peace Health |
|
|
15.Clinical Information System Implementation Effectiveness Scale|
|
| Description:This survey focuses on post-implementation assessment of an HIT system. The questions cover: the success of the transition, improved quality, outcomes, and efficiencies, dependability and quality of the system, user support, and improvements in communication. |
| Survey Type:Satisfaction,Questionnaire |
| Respondent Type:Not Specified |
| Care Setting:Not Specified |
| Technologies:Not Specified |
| Disclaimer:Permission has been obtained from the survey authors for unrestricted use of this survey. This survey can be modified, and/or replicated to fit your HIT project. |
| User Level:Novice |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_815589_0_0_18/CISIES1_Trifold-1.doc |
| Acknowledgement:Brian Gugerty |
|
|
16.PDA Survey|
|
| Description:This survey is targeted to clinicians who use PDAs in their clinical practice. The questions cover: experience with PDA, cost of PDA, impact on clinical practice, frequency of use for drug info, availability of information at point of care, past & current software on PDA, potential future uses, barriers and promoters, confidentiality, and training. |
| Survey Type:Functionality,Current State Assessment,Satisfaction,Questionnaire |
| Respondent Type:Physician,Nurse |
| Care Setting:Not Specified |
| Technologies:Personal Digital Assistants,Clinical Decision Support |
| Disclaimer:This is not a grantee survey. Please read the website carefully for restrictions of public use, and acknowledgement of survey authors.
|
| User Level:Intermediate |
| URL:http://www.biomedcentral.com/content/supplementary/1472-6955-5-5-S2.pdf |
| Acknowledgement: |
|
|
17.Telehealth Consultant Satisfaction Survey|
|
| Description:This survey focuses on post-telehealth satisfaction. It is targeted to the consultative physician. The questions cover: ease of scheduling, technical quality, comfort and ease of use of equipment, availability of real-time tech support, and whether a healthcare provider was needed on the far side of the consultation. |
| Survey Type:Satisfaction,Questionnaire |
| Respondent Type:All Clinical Staff |
| Care Setting:Not Specified |
| Technologies:Telehealth |
| Disclaimer:This is not a grantee survey, Please read the website carefully for restrictions of public use, and acknowledgement of survey authors.
This is a brief survey, it is a starting point to the evaluation process and should be expanded upon as expertise develops. |
| User Level:Novice |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_874959_0_0_18/survey_consultant.pdf |
| Acknowledgement: |
|
|
18.IQ Health Survey for Clinicians|
|
| Description:This is a survey of clincians about providers perceptions of the impact of the Internet on their practice when opened to patients. It asks about the clinicians views on increased workload, patient satisfaction, quality of care and other dimensions. |
| Survey Type:Questionnaire,Attitude Assessment |
| Respondent Type:Physician,Nurse |
| Care Setting:Ambulatory |
| Technologies:Personal Health Records |
| Disclaimer:This is a grantee survey. This survey can be modified and/or replicated to fit your HIT project. An institution can utilize a similar format to this. |
| User Level:Intermediate |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_878096_0_0_18/IQHealth_Clinicians.pdf |
| Acknowledgement:David Mehr |
|
|
19.National Survey of Physicians on Practice Experience|
|
| Description:This survey focuses on how physicians incorporate IT into their practice. The questions cover: participation in system redesign, coordination of care and referrals, billing, CPOE, EMR, patient-provider email, decision support, barriers to adoption, compensation, and practice demographic statistics. |
| Survey Type:Questionnaire,Needs Assessment |
| Respondent Type:Physician |
| Care Setting:Ambulatory,Inpatient |
| Technologies:Clinical Documentation,Personal Health Records,Enterprise Systems,Electronic Prescribing,Telehealth,Electronic Health Records,Computerized Provider Order Entry,Clinical Decision Support |
| Disclaimer:This is not a grantee survey. Please read the website carefully for restrictions of public use, and acknowledgement of survey authors.
This survey contains a wide variety of topics that encompass physician experience and all questions may not be relevant. |
| User Level:Intermediate |
| URL:http://www.commonwealthfund.org/Content/Surveys/2003/2003-National-Survey-of-Physicians-and-Quality-of-Care.aspx |
| Acknowledgement:The Commonwealth Fund |
|
|
20.Telehealth Speaker Satisfaction Survey|
|
| Description:This survey focuses on post-telehealth satisfaction. It is targeted to meeting speakers. The questions cover: technical quality, comfort in use, and the availability of real time tech support. |
| Survey Type:Satisfaction,Questionnaire |
| Respondent Type:Not Specified |
| Care Setting:Not Specified |
| Technologies:Telehealth |
| Disclaimer:This is not a grantee survey. Please read the website carefully for restrictions of public use, and acknowledgement of survey authors.
This is a brief survey, it is a starting point to the evaluation process and should be expanded upon as expertise develops. |
| User Level:Novice |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_874967_0_0_18/survey_speaker.pdf |
| Acknowledgement:http://www.utahtelehealth.net |
|
|
21.ACPOE Email Survey|
|
| Description:This survey is targeted to vendors. It focuses on assessing Ambulatory CPOE features. The questions cover: functionality, market focus, costs, benefits, barriers, and best practices. |
| Survey Type:Vendor RFI,Questionnaire |
| Respondent Type:Implementers |
| Care Setting:Ambulatory |
| Technologies:Computerized Provider Order Entry |
| Disclaimer:Permission has been obtained from the survey authors for unrestricted use of this survey. This survey can be modified, and/or replicated to fit your HIT project. |
| User Level:Intermediate |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_811816_0_0_18/CITL_Appendix%201_Methods.doc |
| Acknowledgement:CITL |
|
|
22.Wellness Portal Satisfaction Questionnaire – Clinicians (Year 1 Field Testing)|
|
| Description:This is a survey to assess clincian's perception of the benefits and usability of a patient portal. This could be easily amended to any patient portal or personal health record. |
| Survey Type:Benefit,Attitude Assessment,Satisfaction,Questionnaire |
| Respondent Type:All Clinical Staff |
| Care Setting:Ambulatory |
| Technologies:Personal Health Records |
| Disclaimer:This is a grantee survey. This survey can be modified and/or replicated to fit your HIT project. An institution can utilize a similar format to this. |
| User Level:Novice |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_8969_891166_0_0_18/Wellness_Portal_Satisfaction_Questionnaire.pdf |
| Acknowledgement: |
|
|
23.Telemedicine and Telehealth Survey|
|
| Description:This survey focuses on existing telemedicine programs in Latin America and the Caribbean. The questions cover: institution type, clinical and non-clinical applications using telehealth, hardware and software in use, number of consults, type of consult (store-and-forward vs. real-time), and type of funding
|
| Survey Type:Current State Assessment,Questionnaire |
| Respondent Type:Administrators |
| Care Setting:Telehealth |
| Technologies:Telehealth |
| Disclaimer:This is not a grantee survey, Please read the website carefully for restrictions of public use, and acknowledgement of survey authors.
This survey could easily be modified to groups looking to access telemedicine programs in a region.
|
| User Level:Novice |
| URL:http://atalacc.org/survey/ |
| Acknowledgement: |
|
|
24.Computer Survey|
|
| Description:This survey is targeted to clinicians who use computers in their clinical practice. The questions cover: experience with PDA, cost of PDA, impact on clinical practice, frequency of use for drug information, availability of info at point of care, past & current software on PDA, potential future uses, barriers and promoters, confidentiality, and training. This survey examines how clinicians obtain relevant clinical data at the point of care and whether HIT can help fill gaps that might exist. |
| Survey Type:Functionality,Current State Assessment,Questionnaire,Usability |
| Respondent Type:Physician,Nurse |
| Care Setting:Not Specified |
| Technologies:Clinical Decision Support,Electronic Health Records,General Computing |
| Disclaimer:This is not a grantee survey. Please read the website carefully for restrictions of public use, and acknowledgement of survey authors. |
| User Level:Novice |
| URL:http://www.biomedcentral.com/content/supplementary/1472-6955-5-5-s1.pdf |
| Acknowledgement: |
|
|
25.Provider experiences with and perceptions of current patients’ use of email communication with their doctor|
|
| Description:This survey asks about the nature and the extent to which patients currently use email to communicate with a physician. It also asks for the physician's perceptions about the potential advantages, disadvantages, and any concerns about expanding patients’ opportunity to view selected portions of their medical records and to communicate with physicians through secure messaging. |
| Survey Type:Perception,Questionnaire |
| Respondent Type:Physician,All Clinical Staff |
| Care Setting:Ambulatory |
| Technologies:Secure Messaging |
| Disclaimer:This is a grantee survey. This survey can be modified and/or replicated to fit your HIT project. |
| User Level:Novice |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_835121_0_0_18/Provider%20experiences%20and%20perception%20survey%20PES%202_4_08.doc |
| Acknowledgement:David Mehr |
|
|
26.PCIP Evaluation Provider Survey|
|
| Description:This is a survey intended for physicians practicing in Primary care settings that have not yet implemented an EHR. The survey assesses the satisfaction with current practice and computer skills, and the perceived challenges, barriers, and successes associated with implementation of an EHR. |
| Survey Type:Current State Assessment,Questionnaire,Needs Assessment |
| Respondent Type:Physician |
| Care Setting:Ambulatory |
| Technologies:Electronic Health Records |
| Disclaimer:This is a grantee survey. This survey can be modified and/or replicated to fit your HIT project. An institution can utilize a similar format to this. |
| User Level:Novice |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_887510_0_0_18/PCIP_Evaluation_Provider_Survey.pdf |
| Acknowledgement: |
|
|
27.Document Workflow Assessment Guide - Clinic|
|
| Description:This interview guide is a workflow assessment guide to be used in anticipation of becoming part of an HIE. It asks about current processes around distribution of laboratory, radiology, discharage summaries and surgical reports documents. |
| Survey Type:Current State Assessment,Interview Guide |
| Respondent Type:Physician,Nurse,Office Staff |
| Care Setting:Across the healthcare system |
| Technologies:Electronic Health Records |
| Disclaimer:Permission has been obtained from the survey authors for unrestricted use of this survey. This survey can be modified, and/or replicated to fit your HIT project. |
| User Level:Intermediate |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_898122_0_0_18/Document_Workflow_Assessment_Guide_Clinic.pdf |
| Acknowledgement:Steve Donnelly |
|
|
28.Assessment of Predictors of computerized Protocol Use (APPU)|
|
| Description:This survey assess existing beliefs of clinicians about the use of computerized protocols.
See also:
Phansalkar S, Weir CR, Morris AH, Warner HR. Clinicians' perceptions about use of computerized protocols: a multicenter study. Int J Med Inform. 2008 Mar;77(3):184-93. |
| Survey Type:Satisfaction,Questionnaire |
| Respondent Type:Physician,All Clinical Staff,Nurse |
| Care Setting:Across the healthcare system |
| Technologies:Clinical Decision Support |
| Disclaimer:Permission has been obtained from the survey authors for unrestricted use of this survey. This survey can be modified, and/or replicated to fit your HIT project. |
| User Level:Novice |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_835117_0_0_18/Assessment%20of%20Predictors%20of%20Computerized%20Protocol%20Use.doc |
| Acknowledgement:Shobha Phansalkar at Partners HealthCare |
|
|
29.Canada Health Infoway SYSTEM AND USE ASSESSMENT SURVEY|
|
| Description:This survey focuses on evaluating health information technology targeted to a specific group of users. The questions cover: ease of use, functionality, information quality, service quality, public health efforts and system usage. |
| Survey Type:Benefit,Usability,Satisfaction,Questionnaire |
| Respondent Type:Physician,Office Staff,Administrators,Nurse,All Clinical Staff |
| Care Setting:Across the healthcare system |
| Technologies:Clinical Decision Support,Enterprise Systems,Computerized Provider Order Entry,Electronic Health Records |
| Disclaimer:Permission has been obtained from the survey authors for unrestricted use of this survey. This survey can be modified, and/or replicated to fit your HIT project. |
| User Level:Intermediate |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_811831_0_0_18/Canada_Health_Infoway_SAU.doc |
| Acknowledgement:Nancy Kraetschmer at Canada Health Infoway |
|
|
30.IQHealth: Patient Enrollment Experience and Expectations|
|
| Description:This is a self-administered survey to assess patients' current use of electronic technologies to communicate with their doctor, their experience about a specific personal health record and their perceptions on its benefits. This could be easily amended to any patient portal or personal health record. |
| Survey Type:Current State Assessment,Questionnaire,Satisfaction |
| Respondent Type:Patient |
| Care Setting:Home,Ambulatory |
| Technologies:Personal Health Records |
| Disclaimer:This is a grantee survey. This survey can be modified and/or replicated to fit your HIT project. An institution can utilize a similar format to this. |
| User Level:Intermediate |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_878095_0_0_18/IQHealth_Patients.pdf |
| Acknowledgement:David Mehr |
|
|
31.Telehealth Satisfaction Questionnaire: National First Nations Telehealth Research Project|
|
| Description:These surveys focus on patient satisfaction. One is for telerehab and televisitation and the other for patient care sessions. The questions cover: satisfaction with actual transmission, length of time to get an appointment, treatment by telehealth staff, and perceived quality of the healthcare provided through telehealth. Survey items are based on a 4 point Likert scale, from poor to excellent. |
| Survey Type:Satisfaction,Questionnaire |
| Respondent Type:Patient |
| Care Setting:Ambulatory |
| Technologies:Telehealth |
| Disclaimer:This is not a grantee survey. Please read the website carefully for restrictions of public use, and acknowledgement of survey authors. |
| User Level:Novice |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_874969_0_0_18/telehealthsatisfactionquestionnaireNationalFirstNationsTelehealthResearchProject.pdf |
| Acknowledgement:http://www.hc-sc.gc.ca |
|
|
32.Report on CCD Functionality of Colorado Community Health Center EMR Systems|
|
| Description:This is a survey of EMR vendors about the capabilities of their systems to work with CCD files. |
| Survey Type:Functionality,Questionnaire |
| Respondent Type:Vendors |
| Care Setting:Ambulatory |
| Technologies:Electronic Health Records |
| Disclaimer:This is a grantee survey. This survey can be modified and/or replicated to fit your HIT project. An institution can utilize a similar format to this. |
| User Level:Expert |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_8969_891162_0_0_18/CCD_Functionality_Colorado.pdf |
| Acknowledgement: |
|
|
| 33.Provider Pre-Implementation Survey: Information Needs and Use |
34.Clinical Portal Survey: Mt. Ascutney Hospital and Health Center|
|
| Description:This survey is targeted to providers at an inpatient institution. The questions cover: readiness, provider preferences for electronic clinical documentation, current use and perceived usefulness of HIT, perceived tools required for increased use of the EHR, and potential barriers that must be addressed.
|
| Survey Type:Satisfaction,Needs Assessment,Questionnaire |
| Respondent Type:IT Staff,Physician,Office Staff,Pharmacist,All Clinical Staff,Nurse |
| Care Setting:Inpatient |
| Technologies:Electronic Health Records |
| Disclaimer:This is a grantee survey. This survey can be modified and/or replicated to fit your HIT project.
Some of the questions specifically reference vendor products in place at Mt.Ascutney. |
| User Level:Intermediate |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_811789_0_0_18/Sims_MAH_Provider_Portal_Survey.pdf |
| Acknowledgement:Grantee - Thomas Sims |
|
|
35.National Survey of Safety Features with Pharmacy Computer Systems|
|
| Description:This survey focuses on safety features in pharmacy computer systems. The questions cover: common potential ADE alerts, frequency of updates, and types/value of alerts that appear on the screen
|
| Survey Type:Functionality,Questionnaire |
| Respondent Type:Pharmacist |
| Care Setting:Pharmacy |
| Technologies:Pharmacy Information Systems |
| Disclaimer:This is not a grantee survey. Please read the website carefully for restrictions of public use, and acknowledgement of survey authors.
This report presents only the results the survey. However, this survey has some good questions that could be adapted to your HIT project. |
| User Level:Intermediate |
| URL:http://www.ismp.org/Survey/Survey200505R.asp |
| Acknowledgement: |
|
|
36.Rural Wisconsin Health Cooperative Transforming Healthcare Quality Through Information Technology: Readiness Assessment|
|
| Description:This survey focuses on a wide variety of health IT topics. The questions cover: types of uses of health IT, usage by affiliated physicians for similar functions, specific health IT applications used, network structure and security measures, QA/QC procedures, readiness to adopt, needs and future planning, perceived barriers, key participants, and perceived benefits of HIT, in particular EHR, information exchange, CPOE, and RHIOs.This instrument is likely to produce a very comprehensive assessment of a hospital's HIT infrastructure and needs. |
| Survey Type:Questionnaire,Needs Assessment |
| Respondent Type:Administrators |
| Care Setting:Inpatient |
| Technologies:Practice Management Systems,Clinical Decision Support,Health Information Exchange,Picture Archiving and Communication System,Telehealth,Electronic Health Records,Computerized Provider Order Entry,Enterprise Systems,Bar Coding |
| Disclaimer:This is a grantee survey. This survey can be modified and/or replicated to fit your HIT project.
Although this survey is designed to be completed by hospital administrators, it will require the assistance of the hospital's IT staff to complete. Users might consider taking a subset of very technical questions and creating a separate instrument to be completed by hospital IT staff. |
| User Level:Expert |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_811791_0_0_18/Size_RWHC_Survey.doc |
| Acknowledgement:Grantee - Tim Size |
|
|
37.Computer Literacy Survey|
|
| Description:This is a self-administered survey to assess providers' current level of computer use and training, their perceptions of the benefits of computers in clinical pratice. |
| Survey Type:Benefit,Questionnaire,Needs Assessment,Current State Assessment |
| Respondent Type:Physician,Nurse,All Clinical Staff |
| Care Setting:Not Specified |
| Technologies:Not Specified |
| Disclaimer:This is a grantee survey. This survey can be modified and/or replicated to fit your HIT project. An institution can utilize a similar format to this. |
| User Level:Novice |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_887508_0_0_18/Computer_Literacy_Survey.pdf |
| Acknowledgement: |
|
|
38.Telehealth Patient Satisfaction Survey|
|
| Description:This survey focuses post-telehealth satisfaction. It is targeted to patients. The questions cover: timeliness, technical quality, privacy, and changes in access. |
| Survey Type:Satisfaction,Questionnaire |
| Respondent Type:Patient |
| Care Setting:Not Specified |
| Technologies:Telehealth |
| Disclaimer:This is not a grantee survey. Please read the website carefully for restrictions of public use, and acknowledgement of survey authors.
This is a brief survey, it is a starting point to the evaluation process and should be expanded upon as expertise develops. |
| User Level:Novice |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_874965_0_0_18/survey_patient.pdf |
| Acknowledgement:http://www.utahtelehealth.net |
|
|
39.Medication Administration System Survey – Nurses' Assessment Survey (MAS-NAS)|
|
| Description:This survey is targeted to nurses using a newly implemented medication administration system using barcode technology. The questions cover: ease of use, efficiency, accuracy, safety and online support. |
| Survey Type:Satisfaction,Questionnaire |
| Respondent Type:Nurse |
| Care Setting:Inpatient |
| Technologies:Pharmacy Information Systems,Electronic Prescribing,Bar Coding |
| Disclaimer:This is a grantee survey. This survey can be modified and/or replicated to fit your HIT project. |
| User Level:Intermediate |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_811814_0_0_18/Hurley_MAS_NAS.doc |
| Acknowledgement:Ann Hurley at Center for Nursing Excellence |
|
|
40.Baseline Clinician Interview Script|
|
| Description:Structured interview guide intended to elicit informaton from providers regarding clinical interactions with patients with hypertension, how they keep up-to-date with evidence based guidelines for hypertension, and the potential benefits of using an EMR for hypertension care. |
| Survey Type:Benefit,Satisfaction,Interview Guide,Needs Assessment,Current State Assessment,Usability |
| Respondent Type:Physician |
| Care Setting:Ambulatory |
| Technologies:Electronic Health Records |
| Disclaimer:This is a grantee survey. This survey can be modified and/or replicated to fit your HIT project. An institution can utilize a similar format to this. |
| User Level:Intermediate |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_8969_891161_0_0_18/Baseline_Clinician_Interview_Script.pdf |
| Acknowledgement: |
|
|
41.Clinician Survey on Quality Improvement, Best Practice Guidelines and Information Technology|
|
| Description:This survey is targeted to clinical staff. The questions cover staff perceptions of working conditions (including their use of computers and health IT), and best practices for acute myocardial infarction (AMI), and community acquired pneumonia (CAP).
|
| Survey Type:Questionnaire,Needs Assessment |
| Respondent Type:Physician,All Clinical Staff,Nurse |
| Care Setting:Across the healthcare system |
| Technologies:Enterprise Systems,Telehealth,Electronic Health Records |
| Disclaimer:This is a grantee survey. This survey can be modified and/or replicated to fit your HIT project.
An institution can utilize a similar format to tailor their own surveys as AMI treatment upon ED admission and CAP may not be the top priorities for CDS at a given institution. Institutions can use this survey as a guide for developing their own survey. |
| User Level:Intermediate |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_811161_0_0_18/Huck_RHQN_Survey.doc |
| Acknowledgement:Grantee - Jackie Huck |
|
|
42.Oklahoma Patient Survey|
|
| Description:This survey is targeted to patients. The questions cover: patient perceptions of their providers efficiency in accessing and handling patient health (including lab tests and medications), patient perceptions of computer use, quality of information provided to the patient by their provider, security concerns, and improvement in care.
|
| Survey Type:Other,Needs Assessment,Questionnaire |
| Respondent Type:Patient |
| Care Setting:Ambulatory |
| Technologies:Practice Management Systems,Electronic Health Records |
| Disclaimer:This is a grantee survey. This survey can be modified and/or replicated to fit your HIT project.
|
| User Level:Novice |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_811793_0_0_18/Jones_Patient_Survey.pdf |
| Acknowledgement:Grantee - Mark Jones |
|
|
43.Missouri Current Status Working Group Survey Tool|
|
| Description:This survey focuses on broadening understanding of the current status of healthcare information technology availability, utilization and efficacy in an area. The questions cover: level of adoption, areas of implementation, cost, information exchange, and its impact on satisfaction, reducing duplication and errors, better care coordination, better HIPAA compliance, improved patient access, improved efficiency, and public health reporting. |
| Survey Type:Functionality,Satisfaction,Questionnaire |
| Respondent Type:Not Specified |
| Care Setting:Across the healthcare system,Not Specified |
| Technologies:Pharmacy Information Systems,Enterprise Systems,Picture Archiving and Communication System,Telehealth,Electronic Health Records,Computerized Provider Order Entry,Electronic Prescribing,Health Information Exchange,Disease Registry,Practice Management Systems,Bar Coding,Clinical Decision Support |
| Disclaimer:This is not a grantee survey. Please read carefully for restrictions of public use, and acknowledgement of survey authors. |
| User Level:Intermediate |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_874957_0_0_18/Missouri.attachment.php.doc |
| Acknowledgement: |
|
|
44.CCCN Stakeholder Survey|
|
| Description:This survey is targeted to users of a specific diabetes registry program. The questions cover: adoption, improved effectiveness of care for diabetics, and how the program has facilitated the adoption of HIT. |
| Survey Type:Satisfaction,Questionnaire |
| Respondent Type:Not Specified |
| Care Setting:Ambulatory |
| Technologies:Disease Registry |
| Disclaimer:This is a grantee survey. This survey can be modified and/or replicated to fit your HIT project.
An institution can utilize a similar format to tailor their own surveys for a disease registry system. |
| User Level:Novice |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_811799_0_0_18/Littman_CCCN_Stakeholder_Survey.doc |
| Acknowledgement:Grantee -Eleanor Littman |
|
|
45.PHR Focus Group Questions for Older Adults|
|
| Description:This is a focus group guide designed for older patients to solicit responses concerning their medication management and their feelings about using a personal health record. |
| Survey Type:Interview Guide,Attitude Assessment |
| Respondent Type:Patient |
| Care Setting:Ambulatory |
| Technologies:Personal Health Records,Electronic Medication Administration |
| Disclaimer:This is a grantee survey. This survey can be modified and/or replicated to fit your HIT project. An institution can utilize a similar format to this.
|
| User Level:Intermediate |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_8969_891164_0_0_18/PHR_Focus_Group_Questions.pdf |
| Acknowledgement: |
|
|
| 46.Employee / Staff Pre-Go-Live Expectations / Perceptions Clinical Information Systems Survey DR ONLY |
| 47.Employee / Staff Pre-Go-Live Expectations / Perceptions Clinical Information Systems Survey |
48.Survey of Kentucky Ambulatory Network Members' Use of IT: Office Manager Survey|
|
| Description:This survey focuses on general IT platforms and IT planning for a medical office. The questions cover: plans for IT growth, adequacy of current systems, interest in open-source EMR, practice utilization of computers, technical functionality of existing systems (clinical and administrative databases, interoperability, coding & classification systems, LAN), and staff roles and responsibilities. |
| Survey Type:Questionnaire |
| Respondent Type:Office Staff |
| Care Setting:Ambulatory |
| Technologies: |
| Disclaimer:This is not a grantee survey. Please read carefully for restrictions of public use, and acknowledgement of survey authors. |
| User Level:Novice |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_874955_0_0_18/kentuckyambulatorynetwork_officemanagersurvey.pdf |
| Acknowledgement: |
|
|
49.PCIP Evaluation Patient Survey|
|
| Description:This survey is for patients regarding their experiences with their provider. It includes a section on the EMR. |
| Survey Type:Satisfaction,Questionnaire,Attitude Assessment |
| Respondent Type:Patient |
| Care Setting:Ambulatory |
| Technologies:Electronic Health Records |
| Disclaimer:This is a grantee survey. This survey can be modified and/or replicated to fit your HIT project. An institution can utilize a similar format to this. |
| User Level:Novice |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_887509_0_0_18/PCIP_Evaluation_Patient_Survey.pdf |
| Acknowledgement: |
|
|
50.Baseline - Massachusetts Survey of Physicians and Computer Technology|
|
| Description:This is a survey targeted to physicians using an ambulatory EMR in a particular region. The questions cover: practice characteristics, current HIT capability, barriers to adoption, and perceived impact of HIT in healthcare. |
| Survey Type:Functionality,Questionnaire |
| Respondent Type:Physician |
| Care Setting:Ambulatory |
| Technologies:Practice Management Systems,Clinical Decision Support,Electronic Prescribing,Computerized Provider Order Entry,Electronic Health Records,Picture Archiving and Communication System |
| Disclaimer:This is a grantee survey. This survey can be modified and/or replicated to fit your HIT project.
The survey could be modified easily to any ambulatory EMR program. |
| User Level:Intermediate |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_811808_0_0_18/Bates_FINAL_Baseline_EHR_Provider_Survey.pdf |
| Acknowledgement:Grantee - Dr. Bates |
|
|
51.Community Clinics Initiative Executive Director - Information Management Assessment Survey|
|
| Description:This survey is targeted to administrative decision makers who are examining the level of IT infrastructure at a clinic. The questions cover: IT improvements and their impact in the organization, the ability to generate reports and compare across organizations, IT department budgeting, planning, staffing, training, technical support, level of interconnectivity, types of hardware and software, and IT capabilities.
|
| Survey Type:Questionnaire,Needs Assessment |
| Respondent Type:IT Staff,Researchers,Physician |
| Care Setting:Ambulatory |
| Technologies:Pharmacy Information Systems,Enterprise Systems,Electronic Health Records,Practice Management Systems,Disease Registry |
| Disclaimer:Permission has been obtained from the survey authors for unrestricted use of this survey. This survey can be modified, and/or replicated to fit your HIT project.
|
| User Level:Expert |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_811156_0_0_18/CCI_ED_survey_2005.pdf |
| Acknowledgement:Sarah Frankfurth at Community Clinics Initiative
Justin Louie at Blueprint Research and Design
|
|
|
52.Medical Informatics Needs Assessment|
|
| Description:This survey is targeted to medical staff. It focuses on assessing current use and need for health information technology. The questions cover: computer experience, the use of computers in various work settings, where and how Medline is accessed, and future use and impact of computers in medicine. |
| Survey Type:Questionnaire,Needs Assessment |
| Respondent Type:Physician,Office Staff,Nurse,All Clinical Staff |
| Care Setting:Across the healthcare system |
| Technologies:Practice Management Systems,Clinical Decision Support,Computerized Provider Order Entry,Electronic Health Records,Enterprise Systems |
| Disclaimer:This is not a grantee survey. Please read the website carefully for restrictions of public use, and acknowledgement of survey authors. |
| User Level:Novice |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_846504_0_0_18/medinds3.doc |
| Acknowledgement: |
|
|
53.TAMC Chronic Care Technology Project: Provider Questionnaire - group|
|
| Description:This is a survey targeted to providers. The questions cover: the impact of HIT on delivery system redesign, the use of HIT for patient self management of chronic conditions, the use of decision support, the use of community resources, the organizational focus on quality improvement and technological change, and user perceptions of HIT on quality, workflow, patient and personnel satisfaction, and outcomes.
For more advanced users of HIT, this is a useful tool to make sure the whole system works, not just the HIT component. |
| Survey Type:Current State Assessment,Questionnaire |
| Respondent Type:All Clinical Staff |
| Care Setting:Ambulatory |
| Technologies:Disease Registry,Clinical Decision Support,Health Information Exchange |
| Disclaimer:This is a grantee survey. This survey can be modified and/or replicated to fit your HIT project.
This survey is not specifically for the evaluation of HIT. This is a good practice system survey that will help users assess the other components in addition to HIT that are part of the practice (e.g. Health System Support, Community Linkages). |
| User Level:Expert |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_811810_0_0_18/Branscombe_Provider_Survey.pdf |
| Acknowledgement:Grantee - John Branscombe |
|
|
54.PACS OPINION SURVEY: REFERRING PHYSICIANS|
|
| Description:This survey focuses on evaluating PACS. It is targeted to referring physicians. The questions cover: on image access, patient care, patient transfers, duplicate tests, productivity, case turn around time and satisfaction. |
| Survey Type:Benefit,Satisfaction,Questionnaire |
| Respondent Type:Physician |
| Care Setting:Inpatient |
| Technologies:Picture Archiving and Communication System |
| Disclaimer:Permission has been obtained from the survey authors for unrestricted use of this survey. This survey can be modified, and/or replicated to fit your HIT project. |
| User Level:Intermediate |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_811829_0_0_18/PACSRefPhysician.doc |
| Acknowledgement:Nancy Kraetschmer at Canada Health Infoway. |
|
|
| 55.Health Information Technology Survey for Physicians, Physician Assistants and Nurse Practitioners |
56.Document Workflow Assessment Guide - Hospital|
|
| Description:This is a survey of the costs involved with (paper) document exchange between healthcare delivery institutions. It asks staff about the costs involved with transferring lab data, radiology reports, discharge summaries and surgical reports. The survey also includes a tool to help track these costs. |
| Survey Type:Current State Assessment,Questionnaire |
| Respondent Type:Office Staff |
| Care Setting:Across the healthcare system |
| Technologies:Not Specified |
| Disclaimer:Permission has been obtained from the survey authors for unrestricted use of this survey. This survey has clear instructions about its purpose and intended audience. It also includes a tool to help track document processing costs. |
| User Level:Expert |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_898124_0_0_18/Document_Workflow_Assessment_Guide_Hospital.pdf |
| Acknowledgement:Steve Donnelly |
|
|
57.Telehealth Meeting Satisfaction Survey|
|
| Description:This survey focuses on post-telehealth satisfaction. It is targeted to meeting participants. The questions cover: timeliness, technical quality, whether telehealth made a difference in attendance, and usefulness. |
| Survey Type:Satisfaction,Questionnaire |
| Respondent Type:Not Specified |
| Care Setting:Not Specified |
| Technologies:Telehealth |
| Disclaimer:This is not a grantee survey. Please read the website carefully for restrictions of public use, and acknowledgement of survey authors.
This is a brief survey, it is a starting point to the evaluation process and should be expanded upon as expertise develops. |
| User Level:Novice |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_874963_0_0_18/survey_meeting.pdf |
| Acknowledgement:http://www.utahtelehealth.net |
|
|
58.CCCN: ONLINE PUBLICATION & EDUCATION: USER NEEDS SURVEY (CCCN POC)|
|
| Description:This survey is targeted to users of a specific diabetes registry program. The questions cover: fit into current workflow, completeness of the registry, and usefulness of the registry. |
| Survey Type:Usability,Current State Assessment,Questionnaire |
| Respondent Type:Not Specified |
| Care Setting:Ambulatory |
| Technologies:Disease Registry |
| Disclaimer:This is a grantee survey. This survey can be modified and/or replicated to fit your HIT project.
An institution can utilize a similar format to tailor their own surveys for a disease registry system. |
| User Level:Novice |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_811804_0_0_18/Littman_CCCN_poc_survey.pdf |
| Acknowledgement:Grantee -Eleanor Littman |
|
|
59.Bridges to Excellence Assessment Survey|
|
| Description:This survey focuses on HIT assessment and adoption for outpatient settings. The questions cover: workflow by conventional versus EHR use, patient access and education, office data repository system, and EHR functionality (CPOE, results view, med/allergy list, alerts, chronic care disease registry, e-prescribing). |
| Survey Type:Current State Assessment,Questionnaire |
| Respondent Type:Not Specified |
| Care Setting:Not Specified |
| Technologies:Disease Registry,Personal Health Records,Electronic Health Records,Computerized Provider Order Entry,Clinical Decision Support |
| Disclaimer:This is not a grantee survey. Please read the website carefully for restrictions of public use, and acknowledgement of survey authors. |
| User Level:Expert |
| URL:http://www.ahqa.org/pub/uploads/OSSBTEsurveytool.pdf |
| Acknowledgement: |
|
|
60.PACS OPINION SURVEY: RADIOLOGISTS|
|
| Description:This survey focuses on evaluating PACS. It is targeted to radiologists. The questions cover: access to images, patient care, patient transfers, duplicate tests, productivity, and satisfaction. |
| Survey Type:Benefit,Questionnaire,Satisfaction |
| Respondent Type:Physician |
| Care Setting:Inpatient |
| Technologies:Picture Archiving and Communication System |
| Disclaimer:Permission has been obtained from the survey authors for unrestricted use of this survey. This survey can be modified, and/or replicated to fit your HIT project. |
| User Level:Intermediate |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_811827_0_0_18/PACSRADIO.doc |
| Acknowledgement:Nancy Kraetschmer at Canada Health Infoway. |
|
|
61.Community Clinics Initiative_Medical Director - Information Management Assessment Survey|
|
| Description:This survey is targeted to Medical Directors who are seeking to implement IT improvements. The questions cover: improvements in general operations, data quality/access/reporting, patient care, and external relations, improvements in clinic information management planning, access and use of IT, practice management system capabilities, CPOE and receipt of labs and procedures, EMR and patient notes, provider productivity, improving quality of clinical data, and chronic disease management and registries.
|
| Survey Type:Questionnaire,Needs Assessment |
| Respondent Type:Administrators |
| Care Setting:Ambulatory |
| Technologies:Personal Digital Assistants,Pharmacy Information Systems,Clinical Decision Support,Enterprise Systems,Computerized Provider Order Entry,Electronic Health Records,Electronic Prescribing,Health Information Exchange,Disease Registry |
| Disclaimer:Permission has been obtained from the survey authors for unrestricted use of this survey. This survey can be modified, and/or replicated to fit your HIT project.
|
| User Level:Intermediate |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_811158_0_0_18/CCI_MD_survey_2005.pdf |
| Acknowledgement:Sarah Frankfurth at Community Clinics Initiative
Justin Louie at Blueprint Research and Design
|
|
|
62.HIMSS Leadership Survey - CIO Feb '04|
|
| Description:This survey is targeted to CIO's who are examining the current level of IT in their organization. The questions cover: participant profiles, priorities, barriers, outsourcing, current technologies, future technologies, EMR use, website/intranet, staffing, IT budget, and general budget.
|
| Survey Type:Other,Questionnaire,Satisfaction |
| Respondent Type:Administrators |
| Care Setting:Across the healthcare system |
| Technologies:Personal Digital Assistants,Clinical Decision Support,Picture Archiving and Communication System,Electronic Health Records,Telehealth,Computerized Provider Order Entry,Enterprise Systems,Bar Coding,Practice Management Systems,Personal Health Records |
| Disclaimer:This is not a grantee survey, Please read the website carefully for restrictions of public use, and acknowledgement of survey authors.
This report presents only the results the survey. However, this survey has some good questions that a Healthcare CIO/Administrator should consider when implementing HIT. |
| User Level:Intermediate |
| URL:http://www.himss.org/2004survey/docs/Healthcare_CIO_questionnaire_index.pdf |
| Acknowledgement: |
|
|
63.Telehealth Educational Presentation Satisfaction Survey|
|
| Description:This survey focuses on post-telehealth satisfaction with an educational presentation. The questions cover: timeliness, technical quality, whether telehealth made the difference in attending, and usefulness. |
| Survey Type:Satisfaction,Questionnaire |
| Respondent Type:Not Specified |
| Care Setting:Not Specified |
| Technologies:Telehealth |
| Disclaimer:This is not a grantee survey. Please read the website carefully for restrictions of public use, and acknowledgement of survey authors.
This is a brief survey, it is a starting point to the evaluation process and should be expanded upon as expertise develops. |
| User Level:Novice |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_874961_0_0_18/survey_education.pdf |
| Acknowledgement:http://www.utahtelehealth.net |
|
|
64.FPM Electronic Health Record (EHR) User-Satisfaction Survey – 2007|
|
| Description:This survey focuses on user satisfaction with EMRs. The questions cover: practice characteristics, length of EHR usage, satisfaction with functionality regarding CPOE, ePrescribing, labs, referrals, coding and charge capture, patient education, reporting, and decision support and alerts, interoperability, costs, efficiency, security, customizability, and tech support. |
| Survey Type:Satisfaction,Questionnaire |
| Respondent Type:Physician,Implementers |
| Care Setting:Ambulatory |
| Technologies:Clinical Decision Support,Health Information Exchange,Picture Archiving and Communication System,Electronic Health Records,Computerized Provider Order Entry,Electronic Prescribing |
| Disclaimer:This is not a grantee survey. Please read the website carefully for restrictions of public use, and acknowledgement of survey authors. |
| User Level:Intermediate |
| URL:http://www.aafp.org/fpm/20070400/ehrsurvey.pdf |
| Acknowledgement: |
|
|
65.2002 HIMSS/AstraZeneca Clinician Survey Report|
|
| Description:This survey focuses on the use of computers and information technology in outpatient clinical settings. It is targeted to patients. The questions cover: demographics, infrastructure, hand-held technology, EMRs, email, future spending, and technology improvement. |
| Survey Type:Current State Assessment,Questionnaire |
| Respondent Type:Physician,Administrators |
| Care Setting:Ambulatory |
| Technologies:Personal Digital Assistants,Electronic Health Records,Electronic Prescribing |
| Disclaimer:This is not a grantee survey. Please read the website carefully for restrictions of public use, and acknowledgement of survey authors.
This report presents only the results the survey. However, this survey has some good questions that could be adapted to your HIT project. |
| User Level:Intermediate |
| URL:http://www.himss.org/content/files/surveyresults/Final%20Final%20Report.pdf |
| Acknowledgement: |
|
|
66.Physician Focus Group Guide PHR and Medication Management Activities|
|
| Description:This is a physician targeted focus group guide around PHR and patient Medication Management Acitivities. It assesses attitudes around personal health records and medication management. |
| Survey Type:Interview Guide,Attitude Assessment |
| Respondent Type:Physician |
| Care Setting:Ambulatory,Not Specified |
| Technologies:Personal Health Records,Electronic Medication Administration |
| Disclaimer:This is a grantee survey. This survey can be modified and/or replicated to fit your HIT project. An institution can utilize a similar format to this. |
| User Level:Intermediate |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_8969_891165_0_0_18/Physician_Focus_Group_Guide.pdf |
| Acknowledgement: |
|
|
67.Wellness Portal User Satisfaction Survey – Patients (Year 1 Field Testing)|
|
| Description:This is a satisfaction end user survey that focuses on a wellness portal attempting to elicit responses on usefulness and usability.his could be easily amended to any patient portal or personal health record. |
| Survey Type:Satisfaction,Questionnaire,Attitude Assessment |
| Respondent Type:Patient |
| Care Setting:Home,Ambulatory |
| Technologies:Personal Health Records |
| Disclaimer:This is a grantee survey. This survey can be modified and/or replicated to fit your HIT project. An institution can utilize a similar format to this. |
| User Level:Novice |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_8969_891167_0_0_18/Wellness_Portal_Satisfaction_Survey_Patients.pdf |
| Acknowledgement: |
|
|
68.Oklahoma User Survey|
|
| Description:This survey is targeted to health workers. The questions cover: ease of locating various types of health information, security, ease of locating information on referral patients, ability to prevent medication errors, reduce unnecessary and redundant tests, and the impact of HIT on job satisfaction.
|
| Survey Type:Usability,Questionnaire |
| Respondent Type:Not Specified |
| Care Setting:Not Specified |
| Technologies:Electronic Health Records |
| Disclaimer:This is a grantee survey. This survey can be modified and/or replicated to fit your HIT project.
|
| User Level:Novice |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_811795_0_0_18/Jones_User_Survey.pdf |
| Acknowledgement:Grantee - Mark Jones |
|
|
69.Document Processing Cost Estimation|
|
| Description:This survey is a cost calculator for document processing. It is a sophisticated instrument and could be used for caluculating the return on investments for specific applications. |
| Survey Type:Benefit,Questionnaire |
| Respondent Type:Administrators |
| Care Setting:Not Specified |
| Technologies:Electronic Health Records |
| Disclaimer:Permission has been obtained from the survey authors for unrestricted use of this survey. This survey has clear instructions about its purpose and intended audience. |
| User Level:Expert |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_898128_0_0_18/UHIN_HealthInsight_ROI_Worksheet.xls |
| Acknowledgement:Steve Donnelly |
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70.Information Technology in Primary Care Practice|
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| Description:This survey focuses on assessing the current state IT in an organization. The questions evaluate clinician's opinions around the use of computers in healthcare. |
| Survey Type:Current State Assessment,Needs Assessment,Questionnaire |
| Respondent Type:Physician |
| Care Setting:Ambulatory |
| Technologies:General Computing,Not Specified |
| Disclaimer:This is a grantee survey. This survey can be modified and/or replicated to fit your HIT project. |
| User Level:Intermediate |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_811833_0_0_18/Dixon-Sullivan-Devine_Survey.pub |
| Acknowledgement:David Dixon, MD, University of Western Ontario |
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71.Rhode Island Physician Health IT|
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| Description:This survey is targeted to physicians to assess the degree of health IT functionality in use in their practice, and future plans to implement health technology. |
| Survey Type:Current State Assessment,Questionnaire |
| Respondent Type:Physician |
| Care Setting:Ambulatory |
| Technologies:Electronic Prescribing,Computerized Provider Order Entry,Electronic Health Records |
| Disclaimer:Permission has been obtained from the survey authors for unrestricted use of this survey. This survey can be modified, and/or replicated to fit your HIT project. |
| User Level:Intermediate |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_835119_0_0_18/Rhode%20Island%20Physician%20HIT%20Survey_061108.doc |
| Acknowledgement:Rosa Baier |
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72.Shared Care Plan Satisfaction Survey|
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| Description:This survey is targeted to PHR users (patients). The questions cover: how an individual uses the PHR, its usefulness, ease of use, and their satisfaction with, and perceived importance of, the features of the PHR. |
| Survey Type:Usability,Satisfaction,Questionnaire |
| Respondent Type:Patient |
| Care Setting:Ambulatory |
| Technologies:Personal Health Records |
| Disclaimer:Permission has been obtained from the survey authors for unrestricted use of this survey. This survey can be modified, and/or replicated to fit your HIT project.
The survey could be modified easily to any PHR program. |
| User Level:Novice |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_815278_0_0_18/SatisfactionSurvey.pdf |
| Acknowledgement:Dawn Gauthier at Peace Health |
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73.Development and Validation Medication Administration Error Reporting Survey|
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| Description:This survey focuses on assessing a medication administration error reporting system. The questions cover: why medication errors occur (physician communication, medication packaging, transcription-related, pharmacy processes, nurse staffing) and why medication errors are not reported (disagree with definition, reporting effort, fear, administrative response). |
| Survey Type:Questionnaire,Needs Assessment |
| Respondent Type:Nurse |
| Care Setting:Inpatient |
| Technologies:Electronic Medication Administration |
| Disclaimer:Permission has been obtained from the survey authors for unrestricted use of this survey. This survey can be modified, and/or replicated to fit your HIT project. |
| User Level:Intermediate |
| URL:http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_811818_0_0_18/Wakefield_Request_%20for_MAE_Survey.doc |
| Acknowledgement:Bonnie Wakefield at the VA |
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For a complete list of evaluation resources available from the AHRQ National Resource Center, Access the Library
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