Att O - 2012 Physician Workflow Supplelment - EHR Nonado

National Ambulatory Medical Care Survey

Att O Workflow_Nonadopters

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⚠️ Notice: This form may be outdated.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 O: 2012 Physician Workflow Supplement (EHR nonadopters)
National Ambulatory Medical Care Survey

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

____________ locations

County
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)

□1
□2

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

continue to question 4.

__________ physicians

7. Approximately how many of the following types of
staff do you have?
_____ Number of midlevel providers (NP, PA)

None of the above

If you checked any of the boxes 1-8 in question 3,

Associated with other physicians

6a. How many?

Faculty practice plan

If you answered none of the above in question 3,
skip to question 34).

)

Solo  Skip to Question 7

Parenthood)

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

(

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

Family planning clinic (including Planned

USA

_____ Number of clinical staff (RN, MA)
_____ Number of administrative/ non-clinical staff
8. Is the reporting location a single- or multi-specialty
(group) practice?

□1

Single

□2

Multi

National Ambulatory Medical Care Survey
9. Who owns the reporting location? CHECK ONE.

□1
□2
□3
□4
□5
□6
□7

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

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

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?

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

□1
□2
□3
□4

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:_________________

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

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

□4 Uncertain if we will apply

Uncertain

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

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

15. Please indicate whether you agree or disagree
with the following statements.

□1
□2
□3
□4

Very satisfied
Somewhat satisfied
Somewhat dissatisfied
Very dissatisfied

Strongly
Agree

Somewhat
Agree

□

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

I spend enough time with my patients during their office visits.

Somewhat
Disagree

□

Strongly
Disagree

□

National Ambulatory Medical Care Survey

16. 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
computerized? your current medical record system?

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

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
17 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?

Yes

□
1□
1□

□
2□
2□

□

□
1□

□
2□

□

□
1□
1□
1□

□

□
1□
1□

□
2□
2□
□

□
2□

□

□
3□

□

□
1□
1□
1□

□
3□
3□

□

Yes,
used
routinely

□
1□
1

□

□
1□
1□
1

□

□
2□
2□
2□

Very Somewhat Somewh Very
Easy
easy
at difficult Difficult

□

□
2□
2□
2□

□

□
2□
2□

□

□
3□
3□
3

□
4□
4

Yes

□
1□
1□
□

□
1□

□

□
4□
4

□
□

□
1□
1□
1□

□

□
2□
2□
2□

4
Skip to 18b

□
2□
2

□

□
4□
4□
4□

□
2□
2□
2

□

Yes,
Yes,
Un
but not
but turned off kno
used routinely or not used wn

□

□
3□
3□
3□

□
4□
4□
4

Does your
practice do
this
routinely?

□

□
□

Unknown

□

5
Skip to 18b

□
5□
5

National Ambulatory Medical Care Survey
17 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.

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

. 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?

□
1□
1

□
2□
2

□

1
1
1
1
1
1

□
1□
1

□

18. To what extent do you view the following as a barrier to adopting an
EHR system?
Reaching consensus within the practice to select an EHR
Finding an EHR system that meets your practice’s needs
Effort needed to select an EHR system
Cost of purchasing an EHR system
Ability to secure financing for an EHR system
Annual cost of maintaining an EHR system
Loss of productivity during the transition to 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)

□
4□
□
4□

□

□
3□

□

□
□

□
5□
5

Skip to 18i

□
5□
5

Skip to 18j

□
4□

□
5□

Skip to 18o

□

□
1□
1□
1□
1□
1□
1□
1□
1□
1□
1□
1□
1□

□

□
4□

□

Major
Barrier

□

Skip to 18i

Skip to 18f

□
4□

□

□
5□
5

Skip to 18f
4

Skip to 18e

□

□
5□
5

Skip to 18e

□

□
2□

Unknown

□

Lack of demonstrated value of EHR

□

. Electronic reporting to immunization registries?

Resistance of your practice to change work habits

□

□
3□

□

Viewing imaging results?

If yes, reported in standards specified by Meaningful Use
criteria?

Yes,
Yes,
Un
but not
but turned off kno
used routinely or not used wn

Skip to 18o

□

Minor
Barrier

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

Not a
Barrier

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

National Ambulatory Medical Care Survey

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

Very
Likely

19. How likely do you think an EHR system would be able to:

Somewhat
Likely

□
1□
1□
1□
1□
1□
1□
1□
1□
1□

Alert you to potential medication errors?

□
2□
2□
2□
2□
2□
2□
2□
2□
2□

Lead you to potential medication errors?
Remind you to provide care that meets clinical guidelines for
patients with chronic conditions?
Help you order fewer tests due to better availability of lab results?
Facilitate direct communication with a patient (e.g., email or
secure messaging)
Enhance overall patient care?
Reminded you to provide preventive care (e.g., vaccine, cancer
screening)?
Helped you identify needed lab tests (such as HbA1c or LDL)?
Helped you order more on-formulary drugs (as opposed to offformulary drugs)?
Helped you access a patient’s chart remotely (e.g., to work from
home)?

20. How much of an influence did or would each of the following have on
your decision to adopt an EHR system?
Government incentive payments for EHR use

Major
Influence to
Adopt

□
1□
1□
1□
1□
1□
1□
1□
1

Proposed financial penalties for not using an EHR
Availability of government-certified products
Assistance with selecting an EHR system
Technical assistance with EHR implementation in my practice
EHR systems being used by trusted colleagues
Capability of exchanging information electronically within my referral network
Requirement to use an EHR for maintenance of board certification

Not at all
Likely

□
3□
3□
3□
3□
3□
3□
3□
3□
3□
3

Minor
Influence to
Adopt

□
2□
2□
2□
2□
2□
2□
2□
2

Not
Applicable

□
4□
4□
4□
4□
4□
4□
4□
4□
4□
4

Not an
Influence

□
3□
3□
3□
3□
3□
3□
3□
3

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
information in a paper-based record.
21.

Which of the following best describes your practice’s current EHR adoption status?
1□ We do not have an EHR system (Skip to 33)
2□ We are not actively using an EHR system but have one installed. (Skip to 33)
3□ We are actively using an EHR system that was installed more than 12 months ago (GO TO 21).
4□ We are actively using an EHR system that was installed within the past 12 months (GO TO 21)

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

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. Which of the following best represents your EHR
system?

□

Stand alone (Client server) – A self-contained
system, where data and application functionality are
delivered onsite.
1

□

Web-based design (Cloud system or Application
Service Provider (ASP)) – Service provider hosts the EHR
system and stores data. Practice accesses the system and
data through the Internet.
2

National Ambulatory Medical Care Survey
25. Does your current system meet meaningful use
criteria as defined by the Centers for Medicare &
Medicaid Services (CMS)?
1□ Yes (Go to 23a.)
2□ No (Skip to 24)
3□ Uncertain (Skip to 24)
25a.
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. Overall, how satisfied or dissatisfied are you with your
EHR system?
1□ Very satisfied
2□ Somewhat satisfied
3□ Somewhat dissatisfied
4□ Very dissatisfied

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

31. Did you experience changes to administrative/
non-clinical staff as a result of integrating EHRs in
your clinic?

□ Yes

(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

32. Did your practice receive assistance with EHR selection,

implementation or use from another organization?

□ Yes

Very
Satisfied

27. Would you purchase this EHR again?

□ Yes
2□ No
3□ Uncertain
1

28.Over the last year, has using an EHR system affected
your productivity?
1□ Yes, productivity increased
2□ Yes, productivity decreased
3□ No. Productivity stayed the same

□ Uncertain

29. 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
30. Did you experience changes in clinical staff (e.g., RN,
MA) as a result of integrating EHRs in your clinic?

□ Yes

□ No clinical staff changes
3□ Uncertain

□ No

[SKIP to 33]

Somewhat
Satisfied

□
1□
1□

EHR vendor

Regional
extension
center
Consulting
Company
Other:
Please
specify
name

□
2□
2□

□
3□
3□

□

Somewhat
Dissatisfied
3

□

Very
Dissatisfied

□
4□
4□
4

□

N/A

□
5□
5□
5

□

__________

33. 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

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

□

(Check all that apply)

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

[GO TO 32a]

32a. How satisfied or dissatisfied were you with the
help you received from the following groups in
selecting, implementing or using your EHR
system?

Unacceptable

35. What is a reliable E-mail address for the physician to
whom this survey was mailed?

__________________@__________________

36. Who completed this survey?

□
2□
3□
1

The physician to whom it was addressed
Office staff
Other

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	2011-10-03