709 2013 709 MyHealthVet Survey May 2013

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Overview

Current Model Qsts
Current Custom Qsts

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Sheet 1: Current Model Qsts

Model Instance Name: VA - My HealtheVet
MID:	NJxFtMU9UosBkJZRd48x9Q==
Date:	7/21/2008
MID: MODEL QUESTION LIST
Model questions utilize the ACSI methodology to determine scores and impacts
	ELEMENTS (drivers of satisfaction)		CUSTOMER SATISFACTION		FUTURE BEHAVIORS
	Content (1=Poor, 10=Excellent, Don't Know)		Satisfaction		Likelihood to Return (1=Not Very Likely, 10=Very Likely)
1	Please rate the accuracy of information on this site.	21	What is your overall satisfaction with this site? (1=Very Dissatisfied, 10=Very Satisfied)	24	How likely are you to return to this site?
2	Please rate the quality of information on this site.	22	How well does this site meet your expectations? (1=Falls Short, 10=Exceeds)		Recommend (1=Not Very Likely, 10=Very Likely)
3	Please rate the freshness of content on this site.	23	How does this site compare to your idea of an ideal website? (1=Not Very Close, 10=Very Close)	25	How likely are you to recommend this site to someone else?
	Functionality (1=Poor, 10=Excellent, Don't Know)				Organization Satisfaction (1=Not Very Likely, 10=Very Likely)
4	Please rate the usefulness of the services provided on this site.			26	Considering all of your experiences to date, how satisfied are you with the My HealtheVet program overall?
5	Please rate the convenience of the services on this site.
6	Please rate the ability to accomplish what you wanted to on this site.
	Look and Feel (1=Poor, 10=Excellent, Don't Know)
7	Please rate the ease of reading this site.
8	Please rate the clarity of site organization.
9	Please rate the clean layout of this site.
	Navigation (1=Poor, 10=Excellent, Don't Know)
10	Please rate the degree to which the number of steps to get where you want is acceptable.
11	Please rate the ability to find information you want on this site.
12	Please rate the clarity of site map/directory.
13	Please rate the ease of navigation on this site.
	Site Performance (1=Poor, 10=Excellent, Don't Know)
14	Please rate the speed of loading the page on this site.
15	Please rate the consistency of speed on this site.
16	Please rate the reliability of site performance on this site.
	Search (1=Poor, 10=Excellent, Don't Know)
17	Please rate the usefulness of search results on this site.
18	Please rate how this site provides comprehensive search results.
19	Please rate the organization of search results on this site.
20	Please rate how the search feature helps you to narrow the results to find the information you want.

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Sheet 2: Current Custom Qsts

Model Instance Name: VA - My HealtheVet			red & strike-through: DELETE
MID:	NJxFtMU9UosBkJZRd48x9Q==		underlined & italicized: RE-ORDER
			pink: ADDITION
Date:	6/23/2009		blue + -->: REWORDING
			violet (bold): SKIP-LOGIC
MID: CUSTOM QUESTION LIST
QID	Skip Logic Label	Question Text	Answer Choices (limited to 50 characters)	Skip to	Type (select from list)	Single or Multi	Required Y/N	Special Instructions	Question Label
ALM0170		Which of the following best describes you?	Active duty		Checkbox, one-up vertical	Multi	Y		Role
			National Guard/Reserve
			Veteran
			Family member of a veteran or Servicemember
			Caregiver of a Veteran or Servicemember (other than family)
			Veteran Service Organization member
			VA employee
			Non-VA federal government employee
			State/local government employee
			General public
			Other role
RJB00048		Please indicate your military period(s) of service:	Global War on Terror (OEF/OIF/OND)		Check-boxes	Multi	N		Military Service
			Desert Shield/Desert Storm
			Vietnam War
			Korean War
			World War II
			Peacetime Service
			Other
			Not Applicable
AED02714		What is your age range?	Under 20		Dropdown (Select-one)	Single	N		Age
			20-24
			25-29
			30-34
			35-39
			40-44
			45-49
			50-54
			55-59
			60-64
			65-69
			70-74
			75-79
			80-84
			85 or older
JIC00267		What is your gender?	Male		Dropdown (Select-one)	Single	N		Gender
			Female
CAS0028939		Which of the following best describes the highest level of education you have completed?	Did not complete high school		Radio button, one-up vertical	Single	Y		Education
			High school graduate
			Some college or vocational school
			College graduate
			Some postgraduate school
			Graduate or professional degree
JIC00178		In general, how would you rate your overall health?	Excellent		Dropdown (Select-one)	Single	Y		Overall Health
			Very Good
			Good
			Fair
			Poor
RJB00026		Are you a registered user on the MyHealtheVet web site?	Yes	A	Checkbox, one-up vertical	Single	Y	Skip Logic	Registered User
			No
			Not sure
CAS0028940	A	Your member log-in box now includes an icon for your account type. What type of My HealtheVet account do you have?	Basic (B)		Checkbox, one-up vertical	Single	Y	Skip Logic	User Type
			Advanced (A)
			Premium (authenticated or IPA’d)(P)
			Not sure
ALM0169		How frequently do you visit the My HealtheVet web site?	First time		Dropdown (Select-one)	Single	Y		Visit Frequency
			Daily
			More than once a day
			About once a week
			About once a month
			About every 6 months
			Less than every 6 months
RJB00022		What were you trying to accomplish today in My HealtheVet? (please select all that apply)			Checkbox, one-up vertical	Multi	Y		Reason
			Learn more about features that are available
			Request a prescription refill
			View my medication history
			Use Secure Messaging to communicate with my VA health care team
			Use the Blue Button (Download My Data)
			View my VA Appointments
			Look up information about a health condition or medication
			View my lab or other test results
			View my VA Wellness Reminders
			View my VA Notes (written by my health care team)
			Enter my personal information (emergency contacts, etc.)
			Enter data that I track myself such as weight, blood pressure, blood sugar, etc.
			Enter information about my non-VA medications or supplements
			Find a VA facility
			Find information about VA Health Benefits
			Find information about VA Benefits other than health benefits
			Other (please specify)	A
RJB00022other	A	Other - trying to accomplish			Text field, <100 char	Single	N
ALM0172		Did you accomplish what you wanted to in My HealtheVet?	Yes		Dropdown (Select-one)	Single	Y		Task Accomplishment
			No
			Partially
			Not finished yet
CAS0028943		Do you get care at a VA facility?	Yes	A,B	Checkbox, one-up vertical	Single	Y	Skip Logic	VA facility for Care
			No
			Not Sure
CAS0028944	A	In the past year, how often did you use a VA medical facility or service for your health care needs?	Never		Checkbox, one-up vertical	Single	N	skip logic	VA Facility frequency
			Once in the past year
			2 to 11 times in the past year
			12 or more times in the past year
CAS0028945	B	How much time does it take for you to travel to the nearest VA facility?	Less than 15 minutes		Checkbox, one-up vertical	single	N	skip logic	VA Facility Travel Time
			15 minutes to less than 1/2 hour
			1/2 hour to less than an hour
			An hour to less than 1 1/2 hours
			1 1/2 hours to less than two hours
			Two hours or more
			Not sure
NEW VA OPEN NOTES QUESTION ROTATION
CAS0028946		VA Notes written by providers and other members of the health care team since January 1, 2013 are now available to veterans with a Premium My HealtheVet account. Which best describes your knowledge about VA patients being able to view clinic and hospital visit notes (VA Notes) using the Blue Button. (Please choose one)	I knew that visit notes can be viewed by VA patients with a Premium Account		Radio button, one-up vertical	Single	Y		Open Notes Knowledge
			I didn’t know that visit notes can be viewed by VA patients with a Premium Account
			I’m not sure
CAS0028947		Which best describes your use of the VA Blue Button to access your visit notes (VA Notes)?	I viewed my visit notes using the Blue Button at least once	A	Radio button, one-up vertical	Single	Yes	Skip Logic	Visit notes
			I tried to view visit notes using Blue Button but was not able to do so	C, D
			I don’t have a Premium My HealtheVet account	D
			I don’t know what Blue Button is or have never used it	D
			I’m not sure	D
CAS0028948	A	What information from your VA health record have you viewed using the Blue Button in My HealtheVet? (Choose ALL that apply)	Visit notes from a clinic visit with a primary care provider (doctor, nurse practitioner or physician assistant)	B1 - B10	Radio button, one-up vertical	Multi	Yes	Skip Logic	VA Notes Info Viewed
			Visit notes from a clinic visit with a specialist (medical or surgical specialty)	B1-B10
			Visit notes from a mental health professional	B1-B10
			Notes from a hospital visit or stay (emergency room visit or discharge summary)	B1-B10
			VA Notes from Secure Messaging
			None of the above/ Don't remember	D1
CAS0028949	B1	Why did you read your visit notes (VA Notes)? (Check ALL that apply)	I did not read any visit notes (VA Notes)	D2	Radio button, one-up vertical				VA Notes Reason
			I tried to read my visit notes (VA Notes) but was not able to	C1, D2
			I was curious
			I wanted to remember what happened in the visit
			I wanted to know more about my health
			I wanted to check the notes to see if they were right
			I wanted to be sure I understood what my provider (or other member of the health care team) said
			I wanted to know what my provider (or other member of the health care team) was thinking
			Other reason (please explain)	B1A
CAS0028935	B1A	Other - reason read VA Notes			Text area, no char limit		N	Skip Logic	VA Notes OE_Reason read
CAS0028956	B2	What did you do with your notes (VA Notes) using the Blue Button? (Check ALL that apply)	I read it		Radio button, one-up vertical	Multi	Y	Skip Logic	VA Notes Use
			I printed it
			I downloaded it to keep a copy for myself
			I shared it with a family member, relative or friend who helps take care of me
			I discussed it with a VA provider or other health care team member
			I shared it with a health care provider outside of VA
			Other, please explain	B2A
			I don’t remember
CAS0028957	B2A	Other - What you did with your notes			Text area, no char limit		N	Skip	VA Notes OE_Other Use
CAS0028958	B3	Did you talk to or contact your provider or health care team about the notes (VA Notes), or have a plan to do so? (Choose one)	No, I did not talk to or contact my provider or health care team about the notes	B3A	Radio button, one-up vertical	Single	Y	Skip	VA Notes Contact
			I plan to contact my provider or health care team about the notes	B3B
			Yes, I did contact my provider or health care team about the notes	B3B
CAS0028952	B3A	If you did not contact or don’t plan to contact your provider or health care team, why not? (Check all that apply)	I had no reason to contact my provider or health care team about the notes		Radio button, one-up vertical	Multi	Y	Skip Logic	VA Notes Did not Contact
			I didn’t think it was important
			I didn’t want to waste my provider or health care team’s time
			I didn’t want my provider or health care team to be upset with me
			I did not feel I knew enough to talk with my doctor about my concerns
			It was too much of a bother for me
			Other reason (please explain)	B3AA
CAS0028953	B3AA	Other - reason did not contact			Text area, no char limit		N		VA Notes OE_Did not contact
CAS0028954	B3B	Why did you contact, or plan to contact, your provider or health care team about the notes (VA Notes)? (Check all that apply)	To get an explanation about something in the note		Radio button, one-up vertical	Multi	Y	Skip	VA Notes Did Contact
			To learn more about my health issue, medications or test results
			To discuss something I was worried about in the note
			To discuss something that I thought was not correct in the note
			To ask about removing or changing something in the note
			Other reason (please explain)	B3BA
	B3BA	Other - reason did contact			Text field, <100 char		N	skip	VA Notes Did Contact OE
CAS0028976	B4	Please think about what it is like to access and view the visit notes (VA Notes) written by your provider and health care team using the Blue Button “Download My Data” on My HealtheVet.   How easy is it to find the visit notes (VA Notes) using the Blue Button “Download My Data” on My HealtheVet?	Very hard		Radio button, one-up vertical	Single	Y	Skip	VA Notes Access
			Somewhat hard
			Somewhat easy
			Very easy
			I don’t know
CAS0028977	B5	The display of my visit notes (VA Notes) is easy to read.	Disagree		Radio button, one-up vertical	Single	Y	Skip	VA Notes Display
			Somewhat disagree
			Somewhat agree
			Agree
			I don’t know
CAS0028959	B6	What information were you trying to find in your visit notes (VA Notes)? (Check all that apply):	I’m not sure what I was looking for			Multi	Y	Skip	VA notes Trying to find
			The note written by a provider or health care team after a clinic visit
			The note written by a provider or health care team after an emergency room visit
			The note written by a provider or health care team after a hospital stay
			What my provider or health care team thinks about my health issues
			Changes that were discussed during a visit
			Recommendations or treatment advice from my provider or health care team
			When I’m supposed to come back for my next appointment
			A referral to a specialist or for further testing
			Other, please explain	B6A
CAS0028960	B6A	Other- information trying to find in my visit notes			Text area, no char limit		N		VA Notes OE_ Trying to find
CAS0028961	B7	I did not understand the information in my VA Notes (for example, there were too many abbreviations, acronyms or words I did not understand).	Disagree		Radio button, one-up vertical	Single	Y	skip	VA Notes not understand
			Somewhat disagree
			Somewhat agree
			Agree
			I don’t know
CAS0028962	B8	In your opinion, how much do the visit notes (VA notes) correctly describe your clinic or hospital visit?	Notes don’t describe the visit correctly		Radio button, one-up vertical	single	Y	Skip	VA Notes Opinion
			Notes mostly describe the visit correctly
			Notes describe the visit pretty well
			I don't know
CAS0028963	B9	There is too much information in my visit notes (VA notes).	Disagree		Radio button, one-up vertical	Single	Y	skip	VA notes Level of Information
			Somewhat disagree
			Somewhat agree
			Agree
			I don’t know
CAS0029000	B10	What is your overall satisfaction with access to your visit notes using Blue Button? Select a number from 1 to 10, with 1 the lowest and 10 the highest level of satisfaction.	1=Not at all Satisfied		Radion button, scale, no don't know	Single	Y	Skip	VA Notes Satisfaction Level
			2
			3
			4
			5	Matthew Castillo: Somewhat satisfied was removed just due to technological implications on the backend.
			6
			7
			8
			9
			Extremely Satisfied=10
Attempters ONLY
CAS0028964	C	Why do you think you were not able to view your notes (VA Notes)? (Check all that apply)	I couldn’t figure out where to look for the visit notes		Checkbox, one-up vertical	Multi	Yes	Skip Logic	VA Notes Unable to view
			It’s too hard to use the Blue Button feature
			I requested the notes, but the Blue Button feature was updating my information
			I was looking for notes that were written before January 1, 2013
			I tried to get the notes before they were available to me (7 days after a note is completed)
			I don’t know why
			Other reason ( please explain)	CA
CAS0028965	CA	Other- reason I was unable to view my VA Notes:			Text area, no char limit		N	Skip Logic	VA Notes OE_unable to view
CAS0028933	C1	Why do you think you were not able to view your notes (VA Notes)? (Check all that apply)	I couldn’t figure out where to look for the visit notes		Checkbox, one-up vertical	Multi	Yes	Skip Logic	VA Notes Unable to view1
			It’s too hard to use the Blue Button feature
			I requested the notes, but the Blue Button feature was updating my information
			I was looking for notes that were written before January 1, 2013
			I tried to get the notes before they were available to me (7 days after a note is completed)
			I don’t know why
			Other reason ( please explain)	CA
CAS0028934	CA1	Other- reason I was unable to view my VA Notes:			Text area, no char limit		N	Skip Logic	VA Notes OE_unable to view1
NON USERS and Attempters ONLY
CAS0029002	D	If you were to look at your visit notes from your VA health record, which information would most interest you? (Choose all that apply)	Visit notes from a clinic visit with a primary care provider (doctor, nurse practitioner or physician assistant)		Radio button, one-up vertical	Multi	Y	Skip Logic	VA Notes_info Would Like
			Visit notes from a clinic visit with a specialist (medical or surgical specialty)
			Visit notes from a mental health professional
			Notes from a hospital visit or stay (emergency room visit or discharge summary
			Laboratory test results (blood, urine or other lab test)
			Radiology test results (X-ray, MRI, ultrasound or other imaging test)
			Problem list (conditions or diagnoses)
			Other (please explain)	DA
			I don’t know
	DA	Other- most interested in visit notes			Text area, no char limit		N		VA Notes OE_Would Like
CAS0028966	D1	If you were to look at your visit notes from your VA health record, which information would most interest you? (Choose all that apply)	Visit notes from a clinic visit with a primary care provider (doctor, nurse practitioner or physician assistant)		Checkbox, one-up vertical	Multi	Y	Skip Logic	VA Notes_info Would Like1
			Visit notes from a clinic visit with a specialist (medical or surgical specialty)
			Visit notes from a mental health professional
			Notes from a hospital visit or stay (emergency room visit or discharge summary
			Laboratory test results (blood, urine or other lab test)
			Radiology test results (X-ray, MRI, ultrasound or other imaging test)
			Problem list (conditions or diagnoses)
			Other (please explain)	DA
			I don’t know
CAS0029001	DA1	Other- most interested in visit notes			Text area, no char limit		N		VA Notes OE_Would Like1
CAS0028950	D2	If you were to look at your visit notes from your VA health record, which information would most interest you? (Choose all that apply)	Visit notes from a clinic visit with a primary care provider (doctor, nurse practitioner or physician assistant)		Checkbox, one-up vertical	Multi	Y	Skip Logic	VA Notes_info Would Like2
			Visit notes from a clinic visit with a specialist (medical or surgical specialty)
			Visit notes from a mental health professional
			Notes from a hospital visit or stay (emergency room visit or discharge summary
			Laboratory test results (blood, urine or other lab test)
			Radiology test results (X-ray, MRI, ultrasound or other imaging test)
			Problem list (conditions or diagnoses)
			Other (please explain)	DA
			I don’t know						VA Notes OE_Would Like2
CAS0028951	DA2	Other- most interested in visit notes			Text area, no char limit		N
CAS0028967		We would like to ask you about how you think viewing your visit notes (VA Notes) might help you with your health and your health care. Think about how notes help you now, or, if you have not yet viewed your notes, how visit notes might help you in the future.17. Visit notes (VA Notes) will help me understand my health and medical conditions better.	Disagree		Radio button, one-up vertical	single	Y		VA Notes Future Help
			Somewhat disagree
			Somewhat agree
			Agree
			I don’t know
CAS0028968		Visit notes will help me remember the plan for my care better.	Disagree		Radio button, one-up vertical	single	Y		VA Notes Remember plan for care
			Somewhat disagree
			Somewhat agree
			Agree
			I don’t know
CAS0028969		Visit notes will help me take better care of myself.	Disagree		Radio button, one-up vertical	single	Y		VA Notes Better Care of Self
			Somewhat disagree
			Somewhat agree
			Agree
			I don’t know
CAS0029016		Visit notes will help me do a better job taking my medications as prescribed.	Disagree		Radio button, one-up vertical	Single	y		VA Note Better care of Meds
			Somewhat disagree
			Somewhat agree
			Agree
			I don’t know
			I don’t take any medications
CAS0029017		Visit notes will make me feel more in control of my health care.	Disagree		Radio button, one-up vertical	Single	Y		VA Notes More in control
			Somewhat disagree
			Somewhat agree
			Agree
			I don’t know
CAS0029018		Visit notes will make me worry more.	Disagree		Radio button, one-up vertical	Single	Y		VA notes Worry
			Somewhat disagree
			Somewhat agree
			Agree
			I don’t know
CAS0028970		Visit notes will help me be better prepared for clinic visits.	Disagree		Radio button, one-up vertical	Single	Y		VA Notes Prepared
			Somewhat disagree
			Somewhat agree
			Agree
			I don’t know
CAS0028971		Visit notes will be more confusing than helpful.	Disagree		Radio button, one-up vertical	Single	Y		VA Notes Confusing
			Somewhat disagree
			Somewhat agree
			Agree
			I don’t know
CAS0028972		I think viewing visit notes will change how I feel about my provider or health care team	Disagree		Radio button, one-up vertical	Single	Y		VA Notes Change View
			Somewhat disagree
			Somewhat agree
			Agree
			I don’t know
CAS0028973		In the past, have you ever requested a copy of your medical records from a VA facility?	Yes		Radio button, one-up vertical	Single	Y		Medical Records Request
			No
CAS0028974		I would like to be able to add comments to my VA Notes.	Disagree		Radio button, one-up vertical	single	Y		VA Notes add comments
			Somewhat disagree
			Somewhat agree
			Agree
			Don’t know
CAS0028975		Do you think that you will use the Blue Button to access your visit notes in the future?	I will NOT use it in the future		Radio button, one-up vertical	Single	Y		VA Notes Blue Button use Future
			I might use it in the future.
			I will definitely use it in the future
CAS0029036		Do you ‘follow’ your local VA medical center on Facebook?	Yes		Radio button, one-up vertical	Single	Y		Facebook
			No, I don’t use Facebook
			No, I do use Facebook but have not ‘followed’ my VA medical center page
RJB00029		My use of the My HealtheVet personal health record has improved my ability to manage my health.	Strongly agree		Drop down, select one	Single	Y		MHV improve Health
			Agree
			Not sure
			Disagree
			Strongly disagree
			Not applicable
CAS0029037		The My HealtheVet website provides articles on topics of interest to Veterans. What topics are you most interested in for upcoming articles?			Open-ended		N		OE_Articles
CAS0029038		Have you discussed your My HealtheVet Personal Health Record with any of the following people? Please check all that apply:	My VA health care provider		Checkbox, one-up vertical	Multi	N		Discussed Health Care
			My non-VA healthcare provider(s)
			My family, friends, or caregiver(s)
			Veterans I know
			Other (please specify)	A
			I have not discussed My HealtheVet Personal Health Record with others
CAS0029039	A	I have discussed my My HealtheVet Personal Health Record with:			Text field, <100 char		N		OE_Discussed medical records
ALM0173		What is the main improvement that you would suggest for the My HealtheVet web site?			Open-ended	Single	N		One Improvement
CAS0029040		What additional services would you like to see on My HealtheVet? (Please select all that apply)	Schedule or change my VA appointments		Checkbox, one-up vertical	Multi	N		Additional Services
			Track the status of my prescription refill delivery
			View/pay my VA bills/copayments
			View a list of my VA health care providers and their contact information
			Use a mobile app for My HealtheVet
			Join an online forum to discuss health issues with other Veterans
			Advance check-in for my VA clinic visits
			Authorize sharing information I have stored in My HealtheVet with other people (e.g., family, caregiver)
			Authorize sharing information that I have stored in My HealtheVet with my VA health care team
			Authorize sharing information that I have stored in My HealtheVet with my Non-VA health care provider
			Check to determine if my different medications are safe when taken together
			More online educational programs
			Receive a monthly email newsletter
			Receive notification of new content/features on the site
			Other (please specify):	A
CAS0029041	A	Other - Services			Text area, no char limit	Single	N		OE_Other Services
CAS0029042		Are you aware that there is a My HealtheVet Coordinator at each VA Medical Center to assist with questions, concerns, and outreach for My HealtheVet?	Yes		Radio button, one-up vertical	Single	Y		MHV Coordinator Awareness
			No
CAS0029043		Have you contacted the My HealtheVet Help Desk in the past 3 months?	Yes	A,B	Radio button, one-up vertical	Single	Yes	Skip Logic	Help Desk
			No
			Do not recall
CAS0029044	A	How was that experience?	Excellent		Radio button, one-up vertical	single	y	skip logic	Help Desk Rating
			Very Good
			Good
			Fair
			Poor
CAS0029045	B	Was your question, issue, or concern resolved?	Yes		Radio button, one-up vertical	single	y	skip logic	Help Desk Resolution
			No
			Partially
			Not Sure
AED06379		Have you completed this survey within the past 3 months?	Yes		Radio button, one-up vertical				Survey
			No			Single	N
			Don't recall