Memo from CAHPS team 13 oct 2009_1

To: Doris Lefkowitz

From: CAHPS HIT Project Team

Re: Revisions to survey instrument following meeting with OMB about CAHPS HIT module

Date: October 13, 2009

CC: Christine Crofton, Gregg Taliaferro

In response to our conference call with OMB on October 7, 2009, and their earlier written comments to us we have made the following changes to the CAHPS HIT instruments.

1. We changed skip patterns so that a respondent who has not had any in-person visits with their doctor can still answer questions about possible electronic communication with the doctor and with the personal health record. As suggested by OMB, we implemented this with the Internet-based mode but not for the mail survey. Thus we have provided 4 instruments, two for the Internet-based (a 4 point-response and a 6 point-response) and two for the mail survey (4-point and 6-point responses).

2. In all versions we have added six open-ended items that were recommended by OMB, to get at the following issues:

• Why respondent didn’t use email or website to make appointment?

• Why didn’t respondent make an appointment based on the electronic reminder received?

• Why didn’t respondent look for lab or test results on the website?

• Why didn’t the respondent look at their list of medicines online?

• Why didn’t respondent look at visit notes?

• What kinds of HIT may have been missed in this survey?

3. We added item 13a, to learn whether doctors seem more informed about basic medical history. This is in response to OMB’s comment that if patients are providing medical history electronically then the frequency with which patients are asked about their medical history will decline.

4. We added item 21a to assess whether patients are acting on the information that they are receiving electronically. It asks about whether patients made an appointment for the tests or treatment that was recommended to them in an electronic reminder.

5. Please note that in the Internet survey versions, we have taken out the item that asked if the respondent ever uses email or the Internet, because the answer is known for those taking the Internet survey.

6. Attached, in addition to the 4 instruments, is the report of additional cognitive testing that was done. With our first response to OMB comments this report was inadvertently left out. There were a total of 17 cognitive interviews, 11 described in the attached report, and 6 which were described in the first report we sent to OMB.

7. Also attached is a revised Attachment A. As recommended by OMB we clarify on page 4 that the primary purpose of this field test is to assess the usability of the new items