A
Form Approved
OMB No.
0935-XXXX
Exp.
Date XX/XX/20XX
Thank you for agreeing to speak with us today. As you know, we are calling from the Center for Studying Health System Change (HSC), a non-partisan health policy research organization in Washington, DC. (If respondent has participated in previous studies acknowledge participation.)
HSC is conducting this study with funding from the Agency for Healthcare Research and Quality (AHRQ) exploring the effective use of electronic prescribing (“e-prescribing”) in physician practices and pharmacies. We would like to explore:
Selected features of the practice’s e-prescribing system and how they are being used by physicians in the practice including:
physician access to medication histories, formulary information, and generic medication alternatives, and,
ability to send prescriptions electronically to pharmacies; and,
How e-prescribing is affecting communication between physician practices and pharmacies.
Because of the focus on physician practice-pharmacy communication, as we explained when scheduling this interview, we are interviewing practices with e-prescribing that send prescriptions directly from their e-prescribing system to pharmacies electronically, instead of by fax. This is often referred to as electronic data interchange. To confirm, does your practice send prescriptions electronically?
If Yes: Thank you for confirming.
If No: We apologize for the miscommunication. Unfortunately, we will not be able to include you in our study at this time. Thank you for willingness to participate in our study. We would appreciate your referral to a practicing physician who sends prescriptions to pharmacies electronically.
We have 30 minutes scheduled for this call. Does that still work with your schedule?
We plan to publish the results of the study and will be happy to send you a copy of the study when it is released.
Before beginning, we would like to remind you about how we will use the information you provide. We will not reveal your name or your organization’s name or share copies of interview notes with anyone outside of our research team. We may include respondent comments in reports and publications but will not attribute the comments to specific individuals or organizations. We also have a system to mark specific comments as off-limits for public reports. If any of the information we cover today falls into this category, please let us know and we will mark the information as off-limits in our notes. Your participation in this study is voluntary. If at any time you do not feel comfortable answering a question, or do not know the answer, please let us know and we will move on. Do you have any questions before we begin?
Public
reporting burden for this collection of information is estimated to
average 30
minutes per response, the estimated time required to complete
the survey. An agency may not conduct or sponsor, and a person
is not required to respond to, a collection of information unless it
displays a currently valid OMB control number. Send
comments regarding this burden estimate or any other aspect of
this collection of information, including suggestions for reducing
this burden, to: AHRQ Reports Clearance Officer Attention: PRA,
Paperwork Reduction Project (0935-XXXX) AHRQ,
540 Gaither Road, Room # 5036, Rockville, MD 20850.
Q.AEX.A. Physician Practice Background Information [If missing any background information, ask as appropriate]
Q.AEX.A.01. How many locations does the practice have?
Q.AEX.A.02. How many physicians are in the practice?
Q.AEX.A.03. What are the specialties of the physicians in the practice?
Q.AEX.A.04. Is the practice physician-owned, hospital-owned, an academic/faculty practice or other?
Q.AEX.B. Background Information on Practice’s E-Prescribing system:
To start out, we would like to ask you some basic questions about the practice’s e-prescribing system.
Q.AEX.B.01. What e-prescribing vendor and product is being used by the practice?
Q.AEX.B.01.a. What version of the product does the practice have?
Q.AEX.B.02. Is the e-prescribing system a stand-alone system or is it a component of an electronic medical record (EMR) system?
Q.AEX.B.02.a. If it is stand-alone: Does the e-prescribing system have an electronic interface with a practice management system or EMR to transfer patient demographic data?
Q.AEX.B.02.b. If not stand-alone: How is patient demographic data entered into the system?
Q.AEX.B.03. Is the e-prescribing system fully implemented across all the locations and physicians in the practice?
Q.AEX.B.03.a. What month and year was the system first implemented?
Q.AEX.B.03.c. Are all of the physicians in the practice with access to the e-prescribing system using it routinely to write prescriptions for all their patients? If not, why not?
Q.AEX.B.04. How frequently does the physician practice update or upgrade their e-prescribing system?
Q.AEX.B.05. Does the practice have an internet portal or other online technology where patients can manage their prescriptions? [Probe on the main features (e.g. request prescription renewals, view medication list, etc).]
Q.AEX.C. Understanding How E-Prescribing System Features Are Used in Physician Practices [Note to Interviewer: Only ask the questions in the subsections below as needed based on respondents' answers to prior questions and, for vendors, our knowledge of the systems and services they sell. Use text in parentheses as appropriate depending on respondent type.]
Q.AEX.C.01. Could you briefly walk us through how the e-prescribing system is used in your practice to write new prescriptions and transmit them to the pharmacy? (For each step in the process, indicate who in your office uses the system (e.g. office staff, nurses, or physicians).)
Q.AEX.C.01.a. How does the process vary for renewals?
We would like to ask you some more detailed questions about certain features of e-prescribing systems:
Q.AEX.C.A. Access to third-party patient medication histories
Q.AEX.C.A.01. Do physicians have access via the e-prescribing system to information on patient medication history from a third-party vendor, such as Surescripts, at the time they are writing a prescription?
Q.AEX.C.A.01.a. If no: Why not?
Q.AEX.C.A.01.d. If yes: For what proportion of patients is this information available, approximately? Are there any groups of patients for whom data are not available (e.g. Medicare, Medicaid, uninsured, etc)?
Q.AEX.C.A.01.e. If yes: What vendor provides the medication history data and what is the source (e.g. adjudicated claims data, pharmacy dispensed prescriptions)?
Q.AEX.C.A.01.f. If yes: How often is the information that the physicians see updated?
Q.AEX.C.A.02. What are the major factors, if any, facilitating physicians’ use of third-party patient medication histories in this practice?
Q.AEX.C.A.03. What are the major challenges, if any, to physicians in this practice using third-party patient medication histories? [Probe on how, if at all, the practice has addressed these challenges.]
Q.AEX.C.B. Access to patient-specific formulary information
Q.AEX.C.B.01. Do physicians have access via the e-prescribing system to patient formulary information from a third-party vendor at the time they are writing a prescription?
Q.AEX.C.B.01.a. If no: Why not?
Q.AEX.C.B.01.e. If yes: For what proportion of patients is this information available, approximately? Are there any groups of patients for which data are not available (e.g. Medicare, Medicaid, etc)?
Q.AEX.C.B.01.f. If yes: What vendor provides the formulary data and what is the source?
Q.AEX.C.B.01.g. If yes: How often is the information that the physicians see updated?
Q.AEX.C.B.02. What are the major factors, if any, facilitating physicians’ use of patient formulary data in the e-prescribing system?
Q.AEX.C.B.03. What are the major challenges, if any, to physicians using patient formulary data in the e-prescribing system? [Probe on how, if at all, the practice addressed these challenges.]
Q.AEX.C.C. Access to generic medication information
Q.AEX.C.C.01.b. What vendor provides the e-prescribing system’s medication database?
Q.AEX.C.C.01.c. How often is the information that the physicians see updated?
Q.AEX.C.F. Physician practice-pharmacy communication including electronic transmission of prescriptions
Q.AEX.C.F.01. When did your practice start sending prescriptions directly from the e-prescribing system to pharmacies electronically using electronic data interchange?
Q.AEX.C.F.01.c. For prescriptions transmitted electronically, does the practice monitor if the prescription has been received by the pharmacy and if so, how?
Q.AEX.C.F.01.d. Approximately what proportion of the practice’s prescriptions is sent electronically using electronic data interchange? Approximately what proportions of the practice’s prescriptions are sent by other methods such as print, phone, manual or computer-generated fax?
Q.AEX.C.F.01.e. What are the most common reasons for using other methods to send prescriptions other than electronic transmission?
Q.AEX.C.F.01.g. How do the Federal Drug Enforcement Agency’s restrictions on the electronic transmission of prescriptions for controlled substances affect the method the practice uses to send prescriptions (e.g. if one of the patient’s prescriptions is for a controlled substance)?
Q.AEX.C.F.01.f. Of the retail and mail order pharmacies most often requested by patients, which ones accept prescriptions sent electronically and which ones do not?
Q.AEX.C.F.02. Among pharmacies that accept electronic prescriptions, how are renewal authorization requests typically sent to your practice (e.g. electronically via electronic data interchange, by computer-generated fax, by manual fax, by phone or other)?
Q.AEX.C.F.02.a. Does the practice typically receive any (other) electronic communications from pharmacies that accept electronic prescriptions (e.g. delivery confirmation, notification of whether the patient picked up the prescription, change requests)?
Q.AEX.C.F.02.b. Does the practice typically use the e-prescribing system to respond to these notifications electronically via electronic data interchange (e.g. sending electronic renewal authorizations, denials, cancellations, changes)?
Q.AEX.C.F.03. What are the most common reasons physicians and pharmacists communicate about prescriptions that are computer-generated, whether sent electronically via electronic data interchange or by other means? [Probe on how these reasons differ for retail and mail-order pharmacies.]
Q.AEX.C.F.03.a. How do reasons for communications about computer-generated prescriptions differ from non-computer generated prescriptions?
Q.AEX.C.F.03.b. When a prescription that has been sent electronically via electronic data interchange is not received at the pharmacy, what, if any, procedure is used to identify and resolve the transmission problem? [Probe on whether the practice communicates with the e-prescribing system vendor and with the electronic e-prescription routing service provider such as Surescripts (e.g. via the Surescripts website link they provide to report problems).]
Q.AEX.C.F.04. What are the major factors, if any, facilitating use of electronic prescribing with pharmacies?
Q.AEX.C.F.05. What are the major challenges, if any, to using electronic prescribing with pharmacies? [Probe on how, if at all, the practice or pharmacies addressed these challenges.]
Q.AEX.C.F.06. What, if anything, do you hear from pharmacists about the benefits or challenges of electronic prescribing?
Q.AEX.C.G. Other
Q.AEX.C.G.01. What, if any, changes are planned related to the e-prescribing system or how it is used? Are there any other changes you would like to see?
Q.AEX.D. Impact of E-prescribing Feature Use
Q.AEX.D.02. What have been the perceived effects of using electronic prescribing on (practice or pharmacy) operations and patient care? Probe if necessary on:
Q.AEX.D.02.a. Overall practice efficiency?
Q.AEX.D.02.c. Volume and type of phone communications with pharmacies about new prescriptions and renewals?
Q.AEX.L. Wrap Up
Q.AEX.L.01. Are there any other issues you would like to discuss?
Q.AEX.L.02. If needed: Can you suggest other physician practices and/or pharmacies in your community using electronic prescribing that we could speak with?
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | Attachment B1: Interview Protocol 1 – Physician Practice IT Administrator or Office Manager |
| Author | Genna Rebecca Cohen |
| File Modified | 0000-00-00 |
| File Created | 2021-02-03 |