Survey to Evaluate the Use of HITRC Tool, Care Transition Summary Toolkit, by REC

Westat Care Transition Summary Toolkit Evaluation Survey DRAFT

Form Approved

OMB No. 0955-0003

Exp. Date XX/XX/20XX

1. As part of your role at your Regional Extension Center (REC), do you work with Eligible Professionals to help them reach the Meaningful Use objectives for electronic health records (or supervise REC staff who do)?

• Yes (GO TO QUESTION 2)

• No (SKIP TO THANK YOU #1)

2. The Health Information Technology Research Center (HITRC) portal and the National Learning Consortium on the HealthIT.gov web site offer tools to assist you in helping Eligible Professionals satisfy the Meaningful Use requirements. Have you looked at any of those tools?

• Yes (SKIP TO QUESTION 4)

• No (GO TO QUESTION 3)

3. Which of the following are reasons why you have not looked at the tools available online? (check all that apply)

• I was not aware there were tools available online

• I have no need for the tools

• No Eligible Professionals have asked for any tools

• Eligible Professionals are unlikely to spend enough time with any tool

• The time that I have available to help Eligible Professionals is too limited

• I have not had time to examine the tools available online

• The tools are difficult to find and download

• Other – please specify

(SKIP TO THANK YOU #2)

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0955-0003. The time required to complete this information collection is estimated to average 10 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Health & Human Services, OS/OCIO/PRA, 200 Independence Ave., S.W., Suite 336-E, Washington D.C. 20201, Attention: PRA Reports Clearance Officer

4. Have you ever offered any of the tools available online to any Eligible Professionals?

• Yes (SKIP TO QUESTION 6)

• No (GO TO QUESTION 5)

5. Which of the following are reasons why you have not offered any of the tools available online to any Eligible Professionals? (check all that apply)

• I can best help Eligible Professionals without the tools available online

• No Eligible Professionals have asked for any tools

• Eligible Professionals are unlikely to spend enough time with any tool

• In my experience, tools such as these are rarely helpful

• The time that I have available to help Eligible Professionals is too limited

• I intend to offer the tools available online to Eligible Professionals later

• I am still considering whether to offer these tools

• Other – please specify

(GO TO QUESTION 6)

6. Have you ever looked at the Care Transition Summary Toolkit for helping Eligible Professionals with using EHRs to create patient summaries for transitions of care? Open the PDF document for the tool at this HITRC Web page

• Yes (IF Q4=YES THEN GO TO QUESTION 7;

IF Q4=NO THEN SKIP TO QUESTION 13)

• No (SKIP TO THANK YOU #2)

7. Have you ever offered the Care Transition Summary Toolkit to any Eligible Professionals?

• Yes (SKIP TO QUESTION 9)

• No (GO TO QUESTION 8)

8. Which of the following are reasons why you have not offered the Care Transition Summary Toolkit to any Eligible Professionals? (check all that apply)

• No Eligible Professionals asked for any help to reach Meaningful Use for Transitions of Care Summaries

• This tool would not help Eligible Professionals reach the Meaningful Use criteria for Transitions of Care Summaries

• Other please specify

(SKIP TO QUESTION 9)

9. Have you used the Care Transition Summary Toolkit in any of these ways? (check all that apply)

• I have shared the Care Transition Summary Toolkit with a colleague

• I have discussed the Care Transition Summary Toolkit with a Community of Practice or other group

• Other, please specify

(IF Q7=YES THEN GO TO QUESTION 10)

(IF Q7=NO THEN SKIP TO QUESTION 13)

10. When you offered the Care Transition Summary Toolkit to Eligible Professionals, did any Eligible Professionals ever try to use the tool?

• Yes (SKIP TO QUESTION 12)

• No (GO TO QUESTION 11)

11. Why did the Eligible Professionals not try to use the Care Transition Summary Toolkit? (check all that apply)

• Eligible Professionals did not like the toolkit when they saw it

• Eligible Professionals preferred to reach the Meaningful Use requirements for Transitions of Care Summaries without any tool

• The Eligible Professionals decided not to try to reach the Meaningful Use requirements for Transitions of Care Summaries

• Eligible Professionals prefer that REC personnel use the tools for them

• Other please specify

(SKIP TO QUESTION 13)

12. When you offered the Care Transition Summary Toolkit to Eligible Professionals, did the Eligible Professionals usually go on to meet the Meaningful Use care coordination objectives?

• Yes

• No

• I don’t know

(GO TO QUESTION 13)

13. Please share what you think of the Care Transition Summary Toolkit by answering the remaining questions. Open the PDF document for the tool at this HITRC Web page

Overall, how would you rate the Care Transition Summary Toolkit?

Very good, Good, Fair, Poor

14. How difficult would Eligible Professionals find this tool to use?

Very difficult, Somewhat difficult, Not very difficult, Not at all difficult

15. How likely are Eligible Professionals to use this tool?

Very likely, Somewhat likely, Not very likely, Not at all likely

16. How would you describe the tool in terms of its visual appeal?

Very appealing, Somewhat appealing, Not very appealing, Not at all appealing

17. To what extent does the tool offer information beyond what Eligible Professionals are likely to already know?

Very much, Somewhat, A little, Not at all

18. To what extent does the tool offer information beyond what REC staff members are likely to already know?

Very much, Somewhat, A little, Not at all

19. How likely is it that you will offer this tool to Eligible Professionals in the future?

Very likely, Somewhat likely, Not very likely, Not at all likely

20. Please provide any additional feedback that you may have regarding the Care Transition Summary Toolkit. For example, what did you like or dislike about it? Or, how might it be improved? <text box>

(GO TO THANK YOU #2)

THANK YOU #1. This questionnaire is for REC staff who work with Eligible Professionals. Thank you for your time.

THANK YOU #2. Thank you for taking the time to complete this survey. Your responses will help us improve the development of this and other tools in the future. If you have any questions, concerns, or additional feedback about the survey please write to [email protected]