Att N - 2012 Physician Workflow Supplement - EHR Adopter

National Ambulatory Medical Care Survey

Att N Workflow_Adopters

Physician Workflow Survey (line 8)

OMB: 0920-0234

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0920-0234 can be found here:

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Attachment N: 2012 Physician Workflow Supplement (EHR adopters)
National Ambulatory Medical Care Survey v1.1

OMB No. 0920-0234: Approval expires 03/31/2013

NOTICE - Public reporting burden of this collection of information is estimated to average 30 minutes per response, including the time for reviewing instructions,
searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. 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: CDC/ATSDR Information Collection
Review Office; 1600 Clifton Road, MS D-74, Atlanta, GA 30333, ATTN: PRA (0920-0234).
Assurance of Confidentiality - All information which would permit identification of an individual, a practice, or an establishment will be held confidential, will be used
for statistical purposes only by NCHS staff, contractors, and agents only when required and with necessary controls, and will not be disclosed or released to other
persons without the consent of the individual or the establishment in accordance with section 308(d) of the Public Health Service Act (42 USC 242m) and the
Confidential Information Protection and Statistical Efficiency Act (PL-107-347).

Physician Workflow Supplement Year 2012
The purpose of the Physician Workflow study is to collect information about the experiences office-based physicians are having with
and without electronic health records (EHR). Your participation is greatly appreciated and voluntary. Your answers are completely
confidential. If you have questions or comments about this survey, please call 866-966-1473.

This survey asks about ambulatory care, that is, care for patients
receiving health services without admission to a hospital or other facility
1. Do you directly care for any ambulatory patients in your
work?

□1
□2
□3

Yes

Continue to Question 2.

Please stop here and
return the questionnaire in
the envelope provided.
Thank you for your time.

I am no longer
in practice

}

2. Overall, at how many office locations do you see
ambulatory patients in a normal week?

4. At which of the settings in question 2 do you see
the most ambulatory patients? WRITE THE
NUMBER NEXT TO THE BOX YOU
CHECKED. __________
For the remaining questions, please answer regarding the
reporting location indicated in question 3 even if it is not
the location where this survey was sent.
5. What are the county, state, zip code and telephone
number of the reporting location?
Country

USA

County

____________ locations

State

3. Do you see ambulatory patients in any of the
following settings? CHECK ALL THAT APPLY.

□1
□2
□3
□4
□5
□6
□7
□8
□9

Zip Code
Telephone

(

)

Private solo or group practice
Freestanding clinic/urgicenter (not part of a
hospital outpatient department)
Community Health Center (e.g., Federally
Qualified Health Center (FQHC), federally funded
clinics or “look alike” clinics)

6. Is the reporting location a solo practice, or are you
associated with other physicians in a partnership, in
a group practice or in some other way?

Mental health center

□1
□2

Non-federal government clinic (e.g., state,
county, city, maternal and child health, etc .)

6a. How many?

Family planning clinic (including Planned

Solo  Skip to Question 8
Associated with other physicians

__________ physicians

Parenthood)

Health maintenance organization or other
prepaid practice (e.g., Kaiser Permanente)

7. Approximately how many of the following types of
staff do you have?

Faculty practice plan

_____ Number of midlevel providers (NP, PA)

None of the above

_____ Number of clinical staff (RN, MA)
_____ Number of administrative/ non-clinical staff

If you answered none of the above in question 3,
skip to question XX).
If you checked any of the boxes 1-8 in question 3,
continue to question 4.

8. Is the reporting location a single- or multi-specialty
(group) practice?

□1

Single

□2

Multi

National Ambulatory Medical Care Survey v1.1

OMB No. 0920-0234: Approval expires 03/31/2013

9. Who owns the reporting location? CHECK ONE.

□1
□2
□3
□4
□5
□6
□7

13. 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?

Physician or physician group
Insurance company, health plan, or HMO
Community health center

□1 Yes, we already applied
□2 Yes, we intend to apply
□3 No, we will not apply

Medical/academic health center
Other hospital
Other health care corporation
Other

Please indicate the reason for not applying
CHECK ALL THAT APPLY:
 Do not meet eligibility criteria
 No plans to purchase an EHR
 Lack of resources to apply
 Process to apply is difficult
 Unfamiliar with incentive program
 Plan to retire soon, so not interested
 Uncertain whether will actually receive
incentives
 Not ready to implement electronic
prescribing
 Other, please
describe:_________________

10. At the reporting location, do you participate in a
certified Patient-centered medical home arrangement?

□1
□2
□3
□4

Yes, we participate
No, but we plan to participate
No and we don’t plan to participate
Uncertain

11. At the reporting location, do you participate in a Pay
for performance arrangement in which you can receive
financial bonuses based on your performance

□1
□2
□3
□4

Yes, we participate
No, but we plan to participate
No and we don’t plan to participate

□4 Uncertain if we will apply

Uncertain

12. At the reporting location, do you participate in an
Accountable care arrangement by which you have
shared saving with Medicare or private insurers?

□1
□2
□3
□4

14. Overall, how satisfied are you with practicing
medicine?

□1
□2
□3
□4

Yes, we participate
No, but we plan to participate
No and we don’t plan to participate
Uncertain

15 Indicate whether you agree or disagree with the
following statements.

Very satisfied
Somewhat satisfied
Somewhat dissatisfied
Very dissatisfied

Strongly
Agree

□
1□

It is possible to provide high quality care to all my patients.

I spend enough time with my patients during their office visits.
16. Please indicate whether your patients in your practice can:
View test results online:
Request referrals online:

□Yes
1□Yes

Request refills for prescriptions online:
Request appointments online:

□No
2□No
1□Yes
2

□Yes

□No

Somewhat
Agree

□
2□
2

Somewhat
Disagree

□
3□
3

Strongly
Disagree

□
4□
4

National Ambulatory Medical Care Survey v1.1

17. Please tell us about your patient
medical records system for the
following tasks, include whether the
process is computerized, how easy or
difficult it is, and whether this is a
routine task for the clinic.

OMB No. 0920-0234: Approval expires 03/31/2013

Is this process How easy or difficult is this to do with Does your
computerized? your current medical record system? practice do
this
routinely?

Yes

Very Somewhat
Easy
easy

Somewh
Very
at
Difficult
difficult

Yes

Population management
Generate a list of patients by diagnosis
Generate a list of patients by lab result

□
1□
1

Generate a list of patients by vital signs (e.g., blood
pressure)

Generate a list of patients due or overdue for tests or
preventive care

Track patients who have missed appointments

Send patients reminders for preventive or follow up
care

Quality improvement
Generate reports on the quality of care delivered to
patients with specific chronic conditions (i.e. H1AC
control for diabetic patients)

□

Generate reports on quality of care by patient
demographic characteristics (e.g., race, ethnicity)

Submit clinical care measures to payers (e.g., blood
pressure control, HA1C, smoking status)

Patient communication/access to health data
Provide patients with a clinical summary for each visit
Exchange secure messages with patients
Provide patients with a copy of their health
information
Provide a record of patient advanced directives

□
2□
2

□
1□
1□
1□
1

□
1□
1

□

□
2□
2□
2□
2

□
2□
2

□

□
1□
1□
1□
1

□
3□
3

□

□
2□
2□
2□
2

□
4□
4

□

□
3□
3□
3□
3

□
1□
1

□

□
4□
4□
4□
4

□
2□
2

□

□
1□
1□
1□
1

□
□
□
□
□
□
□

□
2□
2□
2□
2

Coordination of Care

□

Track referral completion

Obtain information needed to continue managing a
patient post-hospital discharge

Share patient clinical information with other providers
treating your patient

□

□
□

National Ambulatory Medical Care Survey v1.1
18. 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 patient history and demographic information?
. If yes, does this include a patient problem list?
Recording and charting vital signs?
Recording patient smoking status?
Recording clinical notes?
If yes, do the notes include a list of the patient’s
medications and allergies?
Ordering prescriptions?
. If yes, are prescriptions sent electronically to the
pharmacy?
If yes, are warnings of drug interactions or
contraindications provided?
Providing reminders for guideline-based interventions or
screening tests?
. Providing standard order sets related to a particular
condition or procedure?
Ordering lab tests?
. If yes, are orders sent electronically?
Viewing lab results?
Viewing imaging results?
. Electronic reporting to immunization registries?
If yes, reported in standards specified by Meaningful Use
criteria?

OMB No. 0920-0234: Approval expires 03/31/2013
Yes,
used
routinely

□
1□
1□
1□
1□
1□
1□
1□
1

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

□
2□
2□
2□
2□
2□
2□
2□
2

□

1
1
1
1

□
1□
1□
1□
1

□

□
3□
3□
3□
3□
3□
3□
3□
3

□

□
2□
2□
2□
2

□

Unknown

4□
Skip to 18b

5□
Skip to 18b

□
4□
4□
4

4□
Skip to 18e

□

4□
Skip to 18f

□

5□
Skip to 18f

□

□
3□
3□
3□

□

5□
Skip to 18e

□

□
5□
5□
5

□
4□
Skip to 18i

□
4□
4□
4□
4

Skip to 18o

□

□
□
□

□
5□
5

Skip to 18i

□
5□
5□
5□
5

Skip to 18o

□

An EHR is a computerized patient medical file integrated to contain patient demographic and clinical data such as prescription records, lab
and imaging results, and clinical summaries. EHRs may also include functions for computerized order entry and clinical decision support.
An EHR IS NOT a billing or practice management system. An EHR is NOT obtaining medical information from another provider, physician
office, or hospital BY faxing, photocopying, or printing the medical information from an external website, and then including the
18.

Which of the following best describes your practice’s current EHR adoption status?

□ We are actively using an EHR system that was installed more than 12 months ago (GO TO 19)
2□ We are actively using an EHR system that was installed within the past 12 months (GO TO 19)
3□ We are not actively using an EHR system but have one installed (Skip to 33)
4□ We do not have an EHR system (Skip to 33)
1

National Ambulatory Medical Care Survey v1.1
19. Please indicate whether you agree or disagree with the
following statements about using your EHR system.
Overall, my practice has functioned more efficiently with an EHR
system.
The amount of time spent to plan, review, order, and document care
has increased.

OMB No. 0920-0234: Approval expires 03/31/2013
Strongly
Agree

□
1□
1□
1□
1□
1□
1□
1□
1□
1□
1□
1□
1□
1□
1□
1□
1

The amount of time spent responding to pharmacy calls increased.
Sending prescriptions electronically saves me time.
The number of weekly office visits increased.
My practice receives lab results faster.
My practice saves on costs associated with managing and storing
paper records.
Billing for services is less complete.
My EHR produces financial benefits for my practice.
My EHR produces clinical benefits for my practice.
My EHR allows me to deliver better patient care.
My EHR makes records more readily available at the point of care.
My EHR disrupts the way I interact with my patients.
My EHR is an asset when recruiting physicians to join the practice.
My EHR enhances patient data confidentiality.
My EHR reduces transcription costs
20. This question is about the ways that an EHR system might
affect your clinic. Has your EHR system:
Alerted you to a potential medication error?
Led to a potential medication error?
Alerted you to critical lab values?
Reminded you to provide preventive care (e.g., vaccine, cancer
screening)?
Reminded you to provide care that meets clinical guidelines for
patients with chronic conditions?
Helped you identify needed lab tests (such as HbA1c or LDL)?
Helped you order fewer tests due to better availability of lab
results?
Helped you order more on-formulary drugs (as opposed to offformulary drugs)?
Facilitated direct communication with a patient (e.g., email or
secure messaging)?
Helped you access a patient’s chart remotely (e.g., to work from
home)?
Enhanced overall patient care?

Yes,
within 30
days

□
1□
1□
1□
1□
1□
1□
1□
1□
1□
1□
1

Somewhat
Agree

□
2□
2□
2□
2□
2□
2□
2□
2□
2□
2□
2□
2□
2□
2□
2□

□
3□
3□
3□
3□
3□
3□
3□
3□
3□
3□
3□
3□
3□
3□
3□

Yes, but not
within 30
days

□
2□
2□
2□
2□
2□
2□
2□
2□
2□
2□
2

Strongly
Disagree

Somewhat
Disagree

□
4□
4□
4□
4□
4□
4□
4□
4□
4□
4□
4□
4□
4□
4□
4□

Not at
all

□
3□
3□
3□
3□
3□
3□
3□
3□
3□
3□
3

Not
Applicable

□
4□
4□
4□
4□
4□
4□
4□
4□
4□
4□
4

National Ambulatory Medical Care Survey v1.1

OMB No. 0920-0234: Approval expires 03/31/2013

21. To what extent have you experienced the following as a barrier to
using your clinic’s EHR system?
Annual cost of maintaining an EHR system

Adequacy of training for you and your staff
Adequacy of EHR technical support
Access to high speed Internet (e.g., broadband, cable)
Reliability of the system (e.g., EHR down or unavailable when needed)
Templates that are customized to my discipline and clinic
Resistance of your practice to change work habits

Year (YYYY): _ _/_ _/_ _/_ _

□2 Unknown

23. What is the name of your current EHR/EMR system?
CHECK ONLY ONE BOX.

□1 Allscripts □2 Cerner □3 eClinicalWorks □4 Epic
□5 GE/Centricity □6 Greenway Medical □7 McKesson/
□8 NextGen □9 Sage
Practice Partner
□10 Other: specify:______________
□11 Unknown
24. Does your current system meet meaningful use
criteria as defined by the Centers for Medicare &
Medicaid Services (CMS)?
1□ Yes (Skip to24a.)
2□ No (Go to 25)
3□ Uncertain (Go to 25)
24a. Are there plans to upgrade your system to
meet meaningful use criteria?
1□ Yes, already upgraded
2□ Yes, plan to upgrade
3□ No
4□ Uncertain

26. Would you purchase this EHR again?

□ Yes
2□ No
3□ Uncertain
1

27.Over the last year, has using an EHR system affected
your productivity?
1□ Yes, productivity increased

Minor
Barrier

□
2□
2□
2□
2□
2□
2□
2□
2

Not a
Barrier

□
3□
3□
3□
3□
3□
3□
3□
3

□ Yes, productivity decreased
3□ No. Productivity stayed the same
4□ Uncertain
2

28. How many hours, on average, did you spend in
ongoing training over the past year to use your
practice’s EHR?
□1 Did not receive training
□2 1 to 8 hours
□3 9 to 40 hours
□4 41 to 80 hours
□5 Over 80 hours
29. Did you experience changes in clinical staff (e.g., RN,
MA) as a result of integrating EHRs in your clinic?

□ Yes

(Check all that apply)

□ Increased clinical staff
□ Decreased clinical staff
□ Shift in responsibilities among existing clinical staff
□ None of the above apply

□ No clinical staff changes
3□ Uncertain
2

30. Did you experience changes to administrative/
nonclinical staff as a result of integrating EHRs in your
clinic?

□ Yes

25.
Overall, how satisfied or dissatisfied are you with
your EHR system?
1□ Very satisfied
2□ Somewhat satisfied
3□ Somewhat dissatisfied
4□ Very dissatisfied

□
1□
1□
1□
1□
1□
1□
1□
1

Loss of productivity using an EHR system

22. In which year did you install your EHR system?

Major
Barrier

(Check all that apply)

□ Increased administrative staff
□ Decreased administrative staff
□ Shift in responsibilities among existing staff
□ None of the above apply

□ No staff or practice changes
3□ Uncertain
2

National Ambulatory Medical Care Survey v1.1
31. Did your practice receive assistance with EHR selection,

implementation or use from another organization?

□ Yes

[GO TO 31a]

□ No

[SKIP to 32]

OMB No. 0920-0234: Approval expires 03/31/2013

33. Your answers in this survey will be linked to deidentified claims data through your publically
accessible NPI number. If unacceptable, indicate below.

31a. How satisfied or dissatisfied were you with the
□ Unacceptable
help you received from the following groups in
selecting,implementing or using your EHR system? 34. What is a reliable E-mail address for the physician to
Very
Somewhat
Somewhat
Very
whom this survey was mailed?
N/A
Satisfied

EHR vendor
Regional
extension
center
Consulting
Company
Other,
Please
specify name

□
1□
1□
1

□

Satisfied

□
2□
2□
2

□

Dissatisfied

□
3□
3□
3

□

Dissatisfied

□
4□
4□
4

□

□
5□
5□
5

___________________@__________________
35. Who completed this survey?

□
2□
3□
1

The physician to whom it was addressed
Office staff
Other

□

__________

32. At the reporting location, are there plans for installing
a new EHR/EMR system within the next 12 months?

□1Yes

□2 No

□3 Maybe

□4 Unknown

Thank you for your participation. Please return your survey in the envelope provided.
If you have misplaced this envelope, please send this survey to the following address:
2605 Meridian Parkway, Suite 200, Durham, NC 27713

Boxes for Admin Use

File Type	application/pdf
Author	Jamoom, Eric (CDC/OSELS/NCHS)
File Modified	2011-10-03
File Created	2011-09-28