Att J - EHR item modifications

Att J NAMCS-1 EHR items and list of modifications.pdf

National Ambulatory Medical Care Survey

Att J - EHR item modifications

OMB: 0920-0234

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Attachment J: NAMCS-1 EHR items modifications
EHR Questions on the 2012 NAMCS

14. Does your practice submit any claims electronically (electronic billing)?

□1
□2
□3

Yes
No
Unknown

15. Do you or your staff verify an individual patient’s insurance eligibility electronically?

□1
□2
□3

Yes

Go to Question 15a

No
Unknown

Skip to Question 16

11162

15a. How do you or your staff electronically verify an individual patient’s insurance eligibility? Is it
through an EHR/EMR system, a stand-alone practice management system, or some other
electronic system?

□1
□2
□3
□4

Stand-alone practice management system
EHR/EMR system
Another electronic system
Unknown

15b. When you electronically verify a patient’s insurance eligibility, do you usually get results
back before the patient leaves the office?

□1
□2
□3

Yes
No
Unknown

16. Does your practice use an electronic health record (EHR) or electronic medical record (EMR)
system? Do not include billing record systems.

□1
□2
□3
□4

Yes, all electronic
Yes, part paper and
part electronic
No
Unknown

}

Go to Question 16a.

Skip to Question 17.

16a. In which year did you install your EHR/EMR
system?
Year:

___________

16b. What is the name of your current EHR/EMR system? CHECK ONLY ONE BOX. IF OTHER
IS CHECKED, PLEASE SPECIFY THE NAME.

Attachment J: NAMCS-1 EHR items modifications

□1 Allscripts □2 Cerner
□3 eClinicalWorks
□4 Epic
□5 GE/Centricity □6 Greenway Medical
□7 McKesson/ □8 NextGen □9 Sage
Practice Partner

□10 Other_________________

□11 Unknown

17. At your practice, are there plans for installing a new EHR/EMR system within the next 18
months?

□1Yes

□2 No

□3 Maybe

□4 Unknown

18. Medicare and Medicaid offer incentives to practices that demonstrate “meaningful use of
health IT”. At your practice, are there plans to apply for these incentive payments?

□1 Yes, we already applied
When did you first apply?

□1

2011

□2

2012

□3

Unknown

□2 Yes, we intend to apply
When do you intend to first apply?

□1

2012

□2

2013 or later

□3

Unknown

□3 Uncertain if we will apply
□4 No, we will not apply
19. Please indicate whether your practice has each of the computerized capabilities listed below
and how often these capabilities are used. CHECK NO MORE THAN ONE BOX PER ROW.
Yes,
used routinely

19a. Recording patient history and
demographic information?
19a1. If yes, does this include a patient
problem list?
19b. Recording and charting vital signs?
19c. Recording patient smoking status?
19d. Recording clinical notes?
19d1. If yes, do the notes include a list of the
patient’s medications and allergies?
19e. Ordering prescriptions?
19e1. If yes, are prescriptions sent
electronically to the pharmacy?

□

□
1□
1□
1□
1

Yes,
Yes,
but not
but turned off
used routinely or not used
2

□

□
2□
2□
2□
2

□

□
3□
3□
3□
3

□

4
Skip to 19b

□
4□
4□
4□
4

Skip to 19e

□
4□
4

Skip to 19f

□

4
Skip to 19e2

Unknown

□

5
Skip to 19b

□
5□
5□
5□
5

Skip to 19e

□
5□
5

Skip to 19f

□

5
Skip to 19e2

Attachment J: NAMCS-1 EHR items modifications

Yes,
used routinely

19e1a. When orders for prescriptions are
submitted electronically, are they submitted
by the prescribing practitioner, or by
someone else? CHECK ALL THAT APPLY.

□1
□2
□3

Unknown

□

Prescribing practitioner
Someone else

Unknown
19e2. If yes, are warnings of drug interactions
or contraindications provided?
19f. Providing reminders for guideline-based
interventions or screening tests?
19g. Providing standard order sets related to a
particular condition or procedure?
19h. Ordering lab tests?
19h1. If yes, are orders sent electronically?
19h1a. When orders for lab tests are
submitted electronically, are they submitted
by the prescribing practitioner, or by
someone else? CHECK ALL THAT APPLY.

□1
□2
□3

Yes,
Yes,
but not
but turned off
used routinely or not used

□
1□
1

□

□
4□
Skip to 19i

□

4
Skip to 19i

□

□
5□
5

Skip to 19i

□

5
Skip to 19i

□

Prescribing practitioner
Someone else
Unknown

19i. Viewing lab results?
19i1. If yes, can the EHR/EMR automatically
graph a specific patient’s lab results over time?
19j. Viewing imaging results?
19k. Viewing data on quality of care measures?
19l. Reporting clinical quality measures to
federal or state agencies (such as CMS or
Medicaid)?
19m. Generating lists of patients with particular
health conditions?
19n. Electronic reporting to immunization
registries?
19n1. If yes, reported in standards specified by
Meaningful Use criteria?
19o. Providing patients with clinical summaries
for each visit?
19p. Exchanging secure messages with
patients?

□
1□
1

□
2□
2

□
3□
3

□

4
Skip to 19j
4

□

□
4□
4

□

5
Skip to 19j
5

□

□
5□
5

□

□
4□
Skip to 19o

□

□
5□
5

Skip to 19o

Attachment J: NAMCS-1 EHR items modifications

Yes,
used routinely

19q. Providing patients with an electronic copy
of their health information?

Yes,
Yes,
but not
but turned off
used routinely or not used

□

Unknown

□

20. Do you share any patient health information electronically (not fax) with other providers,
including hospitals, ambulatory providers, or labs?

□1
□2

Yes  Go to Question 20a
No  Skip to Question 21

20a. How do you electronically share patient health information? CHECK ALL THAT APPLY.

□1
□2
□3

EHR/EMR
Web portal (separate from EHR/EMR)
Other electronic method: ________________

21. Please indicate which types of health data you share
electronically (not fax) with the health care providers
listed to the right. CHECK ALL THAT APPLY.

Hospitals
with which
you are
affiliated

Ambulatory
providers
inside your
office/ group

□
1□
1□
1□
1□

21a. Lab results

□
2□
2□
2□
2□

21b. Imaging reports
21c. Patient problem lists
21d. Medication lists
21e. Medication allergy lists

Hospitals
with which
you are
not affiliated

□
3□
3□
3□
3□

Ambulatory
providers
outside your
office/ group

□
4□
4□
4□
4□

21f. Do you share any of the above types of information using a “Summary Care Record”? [A Summary Care Record is an
electronic file that contains the above health data in a standardized format.]
1

□

Yes

□

Unknown

22. When you refer your patient to a provider outside of your office or
group:

Yes,
routinely

Yes, but
not
routinely

Does not
apply

22a. Do you receive a report back from the other provider with results of the
consultation?

1□

2□

3□

4□

22b. Do you receive it electronically (not fax)?

1□

2□

3□

4□

23. When you see a patient referred to you by a provider outside of your office or group:
23a. Do you receive notification of both the patient’s history and reason for
consultation?

1□

2□

3□

4□

23b. Do you receive them electronically (not fax)?

1□

2□

3□

4□

24a. Do you receive all of the information you need to continue managing the
patient?

1□

2□

3□

4□

24b. Is the information timely, available when needed?

1□

2□

3□

4□

24c. Do you receive it electronically (not fax)?

1□

2□

3□

4□

24. When your patient is discharged from an inpatient setting:

Attachment J: NAMCS-1 EHR items modifications
Changes between the 2011 NAMCS-1 EHR items and the 2012 NAMCS-1EHR
items
Questions deleted
During your last normal week of practice, about how many encounters of the following type did
you make with patients?
1. Nursing home visits

__________

2. Other home visits

__________

3. Hospital visits

__________

4. Telephone consults

__________

5. Internet/e-mail consults

__________

Please indicate whether the reporting location has each of the computerized capabilities listed
below and how often these capabilities are used. CHECK NO MORE THAN ONE BOX PER ROW.
If yes to viewing lab results, are results incorporated into EMR/EHR?
Public health reporting
If yes to public health reporting, are notifiable diseases sent electronically?

At the reporting location, what percent of your current patients have Medicaid/CHIP?
_________%

Do you or your staff verify an individual patient’s insurance eligibility electronically, with results
returned immediately? CHECK ONE.

□1
□2
□3
□4
□5

Yes, with a stand-alone practice management system
Yes, with an EMR/EHR system
Yes, using another electronic system
No
Unknown

At the reporting location, if orders for prescriptions or lab tests are submitted electronically, who
submits them? CHECK ALL THAT APPLY.

□1
□2
□3
□4

Prescribing practitioner
Other
Prescriptions and lab test orders not submitted electronically
Unknown

Attachment J:NAMCS-1 EHR items modifications
Questions modified (questions in 2011 survey are in red)
What is the name of your current EMR/EHR system? CHECK ONLY ONE BOX. IF OTHER IS
CHECKED,
PLEASE SPECIFY THE NAME.

□1 Allscripts
□4 eClinicalWorks □7 GE/Centricity
□10 NextGen
□2 Cerner
□5 Epic
□8 Greenway Medical □11 Sage
□3 CHARTCARE □6 eMDs
□9 MED3000
□12 SOAPware

□13 Practice Fusion
□14 Other________
□15 Unknown

What is the name of your current EHR/EMR system? CHECK ONLY ONE BOX. IF OTHER IS
CHECKED, PLEASE SPECIFY THE NAME.

□1 Allscripts
□4 Epic
□7 McKesson/

□2 Cerner
□3 eClinicalWorks
□5 GE/Centricity □6 Greenway Medical
□8 NextGen
□9 Sage

Practice Partner

□10 Other_________________

□11 Unknown

************************************************************************************************************
Beginning in 2011, Medicare and Medicaid will offer incentives to practices that demonstrate
“meaningful use of Health IT”. At the reporting location, are there plans to apply for Medicare
or Medicaid incentive payments for meaningful use of Health IT?

□1
□2
□3

Yes, we intend to
apply
Uncertain whether
we will apply
No, we will not
apply

Go to Question 22a.

}

Skip to Question 23.

In which year do you expect to apply for the meaningful use payments?

□1
□2
□3
□4

2011
2012
After 2012
Unknown

Medicare and Medicaid offer incentives to practices that demonstrate “meaningful use of health
IT”. At the reporting location, are there plans to apply for these incentive payments?

□1 Yes, we already applied
When did you first apply?

□1

2011

□2

□2 Yes, we intend to apply

2012 □3 Unknown

Attachment J: NAMCS-1 EHR items modifications
When do you intend to first apply?

□1

2012

□2

2013 or later

□3

Unknown

□3 Uncertain if we will apply
□4 No, we will not apply
************************************************************************************************************
Please indicate whether the reporting location has each of the computerized capabilities listed
below.
CHECK NO MORE THAN ONE BOX PER ROW. Does the reporting location have a computerized
system for:
The “yes” response category did not have frequency associated with it.
Please indicate whether the reporting location has each of the computerized capabilities listed
below and how often these capabilities are used. CHECK NO MORE THAN ONE BOX PER ROW.
The response categories were modified to have “yes, used routinely” and “yes, but not used
routinely”.

***********************************************************************************************************
Do you exchange patient clinical summaries electronically with any other providers?
Go to
□1 Yes, send summaries only
Question
□2 Yes, receive summaries only
21a.
□3 Yes, send and receive
summaries
Skip to Question 22.
□4 No

□5

Unknown

}
}

How do you electronically send or receive patient clinical summaries? CHECK ALL THAT APPLY.

□1
□2
□3
□4
□5

Through EMR/EHR vendor
Through hospital-based system
Through Health Information Organization or state exchange
Through secure email attachment
Other/Unknown

Do you share any patient health information electronically (not fax) with other providers, including
hospitals, ambulatory providers, or labs?

□1
□2

Yes  Go to Question 19a
No  Skip to Question 21

19a. How do you electronically share patient health information? CHECK ALL THAT APPLY.

□1
□2
□3

EHR/EMR
Web portal (separate from EHR/EMR)
Other electronic method: ___________________

Attachment J: NAMCS-1 EHR items modifications
************************************************************************************************************
This change only applies to the mail survey.
At the reporting location, what percent of your patient care revenue comes from the following?
1. Medicare
%
1. Medicaid/CHIP
%
2. Private insurance

3. Patient payments
4. Other

(including charity, research, CHAMPUS,
VA, etc.)

TOTAL

%
100%

Roughly, what percent of your patient care revenue at the reporting location comes from the
following?
1. Medicare
2. Medicaid/CHIP

%
%

3. Private insurance

4. All other sources

Roughly, the total should sum to:

100 %

Questions added
Please indicate whether the reporting location has each of the computerized capabilities listed
below and how often these capabilities are used. CHECK NO MORE THAN ONE BOX PER ROW.
Recording and charting vital signs?
Recording patient smoking status?
Reporting clinical quality measures to federal or state agencies (such as CMS or Medicaid)?
Generating lists of patients with particular health conditions?
If yes to viewing lab results, can the EMR/EHR automatically graph a specific patient’s lab results
over time?
If yes to electronic reporting to immunization registries, reported in standards specified by
Meaningful Use criteria?
Providing patients with an electronic copy of their health information?

Attachment J: NAMCS-1 EHR items modifications
21. Please indicate which types of health data you share
electronically (not fax) with the health care providers
listed to the right. CHECK ALL THAT APPLY.

Hospitals
with which
you are
affiliated

Ambulatory
providers
inside your
office/ group

□
1□
1□
1□
1□

21a. Lab results

□
2□
2□
2□
2□

21b. Imaging reports
21c. Patient problem lists
21d. Medication lists
21e. Medication allergy lists

Hospitals
with which
you are
not affiliated

Ambulatory
providers
outside your
office/ group

□
3□
3□
3□
3□

□
4□
4□
4□
4□

□

Yes

□

Unknown

22. When you refer your patient to a provider outside of your office or
group:

Yes,
routinely

Yes, but
not
routinely

Does not
apply

22a. Do you receive a report back from the other provider with results of the
consultation?

1□

2□

3□

4□

22b. Do you receive it electronically (not fax)?

1□

2□

3□

4□

23. When you see a patient referred to you by a provider outside of your office or group:
23a. Do you receive notification of both the patient’s history and reason for
consultation?

1□

2□

3□

4□

23b. Do you receive them electronically (not fax)?

1□

2□

3□

4□

24a. Do you receive all of the information you need to continue managing the
patient?

1□

2□

3□

4□

24b. Is the information timely, available when needed?

1□

2□

3□

4□

24c. Do you receive it electronically (not fax)?

1□

2□

3□

4□

24. When your patient is discharged from an inpatient setting:

This below while changedthe National EHR Survey 2012 does NOT apply to the in-personand the
only applies to the mail survey.
At the reporting location, what percent of your patient care revenue comes from the following?
1. Medicare
%
5. Medicaid/CHIP
%
6. Private insurance

7. Patient payments
8. Other

(including charity, research, CHAMPUS,
VA, etc.)

TOTAL

%
100%

File Type	application/pdf
Author	CDC User
File Modified	2011-10-03
File Created	2011-09-26