Hospital -Based Laboratories

Attachment A
Survey Questionnaire A
Hospitals

VERSION A (HOSPITALS)

2012 NATIONAL SURVEY ON HEALTH INFORMATION
EXCHANGE IN CLINICAL LABORATORIES

[LOGOS]

FRONT PAGE

Sponsors [ONC]/ [NORC]
1-800-XXX-XXXX

[INSERT INSTRUCTIONS HERE]

OMB No. (Insert OMB No.)
Statement of Burden
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 (Insert OMB No). The time
required to complete this information collection is estimated to average 20 minutes per response, including the time to review
instructions, search existing data sources, and gather the data needed, and complete and review the information collection. In you
have comments concerning the accuracy of this time estimate(s) or suggestions for improving this form, please write to:

(Insert Address here.)

VERSION A (HOSPITALS)

DEFINITIONS (Ordered Alphabetically)
Electronic Health
Record (EHR)

Electronically

Health Information
Exchange
Health Information
Organization
HL7
(Health Level 7)

LIMS
(Laboratory
Information
Management
System)
LIS
(Laboratory
Information
System)
LOINC test names
(Logical
Observation
Identifiers Names
and Codes)
Message standards

Ordering

practitioners
Personal Health
Record
(PHR)
Portal

An electronic record of health-related information on an individual that conforms
to nationally recognized interoperability standards and that can be created,
managed, and consulted by authorized clinicians and staff across more than one
health care organization.
Any computerized exchange typically transmitted over the internet or through a
network, using health information technologies such as Electronic Health Record
(EHRs) and direct access via a lab portal. Please do not include fax machines.
The electronic movement of health-related information among organizations
according to nationally recognized standards.
An organization that oversees and governs the exchange of health-related
information among organizations according to nationally recognized standards.
A messaging standard that can be used to send laboratory results from a
laboratory to an Electronic Health Record (EHR). Health Level Seven
International (HL7) is the global authority on standards for interoperability of
health information technology with members in over 55 countries.
A collection of computerized methods to acquire, analyze, store, and report
laboratory data.

A computerized clinical laboratory information system (LIS) is a software system
used in a clinical laboratory to computerize laboratory business processes such
as test processing, test scheduling, specimen and sample tracking, inventory
control, reporting, quality control and quality assurance management, and
statistical analysis and surveillance.
Terminology used to provide consistent naming of datasets that includes
standard codes for laboratory test names; for example, “Test name: Salmonella
Stool Culture LOINC Code: 20955-1”

A set of rules that allow information to be shared and processed in a uniform and
consistent manner. Messaging standards are particularly important because
they define how information is packaged and communicated from one party to
another. Such standards set the language, structure and data types required for
seamless integration from one system to another.
A physician or, when appropriate, a non-physician practitioner who orders
services for the patient.
An electronic record of health-related information on an individual that conforms
to nationally recognized interoperability standards and that can be drawn from
multiple sources while being managed, shared, and controlled by the individual.
Hosted and maintained by a provider or payer organization, without transferring
access and control and use of the information to the individual, are not
considered PHRs based on this definition.

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VERSION A (HOSPITALS)

SNOMED CT
organism codes
(Systematized
Nomenclature of
Medicine)
Structured format

Tests
Test results

A standard terminology that includes standard codes for organisms and other
results; for example, “Test name: Salmonella Enteridis, SNOMED CT
Code:7352500.”

Documentation of discrete data using controlled vocabulary, creating fixed fields
within a record or file, or another method that provides clear structure to
information (is not completely free text).
A clinical diagnostic laboratory service. Service and test are synonymous.
A laboratory test that is (1) ordered by a provider; (2) performed on received
specimens; and (3) finalized and results have been produced. The laboratory
has incorporated and calculated reference data to produce the results
referenced.

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VERSION A (HOSPITALS)

Section 1. General Information

We would like to begin by asking you a few background questions about you and your laboratory.

This survey is being sent to a random sample of clinical laboratories in hospitals. Some
hospitals have multiple entities (such as campuses) but are administered by a single
administrative unit while others are recognized as independent entities by accreditation groups
such as Medicare.
For purposes of this survey, we would like you to only respond for the location to which
this survey was mailed.
Q1.

Is your laboratory associated with a hospital that is a single administrative unit or
separate entities?
1
2

Separate entities
Single administrative unit (this one) (Go to Q2)

If separate entities:
Q1a.

Are the other locations in this state only or in more than one state?
1
This state only
2
More than one state

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VERSION A (HOSPITALS)

Q2.
Indicate the type of organization that is responsible for establishing policy for overall operation
of your hospital. Please select only one.
Government, nonfederal
1
State
2
County
3
City
4
City-County
5
Hospital district or authority
Nongovernment, not-for profit (NFP)
6
Church-operated
7
Other not-for-profit (including NFP Corporation)
Investor-owned, for-profit
8
Individual
9
Partnership
10
Corporation
Government, federal
11
Air force
12
Army
13
Navy
14
Public Health Service
15
Veteran’s Affairs
16
Federal other than 41-45 or 47-48
17
PHS Indian Service
18
Department of Justice
Q3.

What is your job title?
1
2
3
4
5
6
7

8
9

Laboratory Director
Laboratory Manager
Laboratory Information System Director
Medical Laboratory Technician or Clinical Laboratory Technician
Medical Technologist or Clinical Laboratory Scientist
Staff Pathologist
Chief Information Officer
Other (please specify)
Don’t know

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VERSION A (HOSPITALS)

Q4.

How many full time equivalents (FTEs) currently work only in the hospital laboratory?
This would not include administrative and information technology staff who are shared
with other parts of the hospital or hospital system.
1
2
3
4
5
6

Fewer than 15
15 to 30
31 to 45
46 to 60
61 or more (if selected, please provide number)
Don’t know

7

| | | |

Number of full time employees

Q5.

Which option below best describes the type of testing your laboratory performs?
1
Anatomic pathology testing (Go to Q7)
2
Clinical pathology testing
3
Both

Q6.

Does your laboratory perform any of the following types of clinical pathology testing?
Yes

Don’t
know

No

a. Routine chemistry

1

2

3

b. Clinical Microbiology (e.g., Virology, immunology)

1

2

3

c. Hematology

1

2

3

d. Genetics

1

2

3

e. Other, please specify

1

2

3

Section 2: Current Systems and Technical Architecture
We would like to ask you about your laboratory’s current practices on software-based information
management systems. In particular, we are interested in learning about your use of Laboratory
Information Systems (LIS) or Laboratory Information Management Systems (LIMS). To facilitate
completion of the following sections, we suggest working with your LIS manager.

Q7.

Does your laboratory currently use a Laboratory Information System (LIS/LIMS)?
1
2
3

Yes
No (Go to Q11)
Don’t Know (Go to Q11)

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VERSION A (HOSPITALS)

Q8.

Does your Laboratory Information System (LIS/LIMS) support multiple laboratories in the
hospital system or only your laboratory? By multiple laboratories we mean either a
laboratory with multiple physical sites or multiple laboratories located within a single
hospital.
1
2
3

Q9.

Multiple laboratories
Only one laboratory
Don’t Know

What type of Laboratory Information System(s) (LIS/LIMS) does your laboratory
currently use?
Please select all that apply.
1
2
3
4
5

Q10.

Commercial system managed by the laboratory
Commercial system managed by a third-party vendor
Local or internally developed (Go to Q11)
Other, please specify
Don’t know (Go to Q11)

(Go to Q11)

Which vendor(s) supplies your Laboratory Information System(s) (LIS/LIMS)?
Please select all that apply.

Cerner
2
CPSI
3
EPIC
4
Healthland
5
HMS
6
McKesson
7
Meditech
8
Middleware Vendor (e.g.,
Merge)
1

13

Orchard
SCC Soft
Siemens
Sunquest
Other, please specify

14

Don’t Know

9
10
11
12

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VERSION A (HOSPITALS)

Section 3. Methods Used to Send Test (Lab) Results and Volume of Exchange to
Ordering Practitioners

PLEASE REMEMBER TO ONLY RESPOND FOR THE LOCATION TO WHICH THIS
SURVEY WAS MAILED.
Q11.

We would like to ask you some questions about test results volume for the calendar
year 2012. If you cannot report for the calendar year, please identify the period of time
used to report the following test volumes and electronic exchange.
2012 calendar year
Other than calendar year. Please enter the periods this report will cover.

1
2

From
Day

Month

Year
2

Q12.

0

Month

To
Day

1

Year
2

0

1

Approximately, how many total test results did your laboratory send to ordering
practitioners during 2012? By test results we mean a laboratory test that is (1) ordered
by an authorized healthcare provider; (2) performed on received specimens; and (3)
finalized and results have been produced. For e.g., a Complete Blood Count (CBC), not
its component parts, should be counted as a single test result. Please consult your records
to answer this question. If records are not available, please provide your best estimate.

1

| | | | | | | | | |

Number of total test results

(Go to Q13)

From Records
Estimates
2

Don’t Know (Go to Q12a)

Q12a. Please select the range that includes the number of total test results.
1
2
3
4
5
6
7
8
9

0
1 to 9,999
10,000 to 19,999
20,000 to 29,999
30,000 to 39,999
40,000 to 49,999
50,000 to 59,999
60,000 to 69,999
70,000 to 79,999

10
11
12
13
14
15
16
17

80,000 to 89,999
90,000 to 99,999
100,000 to 249,999
250,000 to 999,999
1 million to 1.99 million
2.0 million to 2.99 million
3.0 million to 4.99 million
5.0+ million

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VERSION A (HOSPITALS)

Q13.

Did your laboratory send test results to ordering practitioners during
2012 using any of the following methods? Please answer a-d.
Yes

Don’t
know

No

a. Mail or Fax

1

2

3

b. Electronic non-discrete data (free-text format) including
email communications, scanned faxes or documents, text
files, and PDF files

1

2

3

c. Electronic discrete data (no free-text format) including
excel files, and LIS output reports

1

2

3

1

2

3

d. Electronic mixed format (free-text and non-free text
format), e.g., delivery of pathology or microbiology results
Q14.

How did your laboratory share test results electronically with ordering practitioners?
Please consider only results transmitted in 2012 for the following methods.
Yes

Don’t
know

No

a. Web portal provided by your laboratory

1

2

3

b. Web portal provided by a third party

1

2

3

c. Third party middleware vendor

1

2

3

d. Interface to Health Information Exchange (HIE)/
Health Information Organization (HIO)

1

2

3

e. Interface to Electronic Health Records (EHRs)

1

2

3

IF YES to Q14e, Go To Question 15. Otherwise, Go To Question 17.

Q15.

Is your laboratory currently capable of sending test results electronically in a structured
format (that is, using the HL7 messaging standard and a vocabulary standard such as
LOINC) to an ordering practitioner’s Electronic Health Record (EHR)?
1
2
3

Yes (Go to Q15a)
No (Go to Q17)
Don’t Know (Go to Q17)

Q15a. Does your capability of sending test results electronically in a structured
format extend to practitioners not part of your hospital or hospital system?
1
Yes
2
No

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VERSION A (HOSPITALS)

Q16.

Approximately, how many test results did your laboratory send electronically in a
structured format during 2012 to ordering practitioners using Electronic Health
Records (EHRs)? Please consult your records to answer this question. If records are not
available, please provide your best estimate.

| | | | | | | | | |

1

Number of test results

(Go to Q17)

From Records
Estimate
Don’t Know (Go to Q16a)

2

Q16a. Please select the range that includes the number of total test results.
1
2
3
4
5
6
7
8
9

0
1 to 9,999
10,000 to 19,999
20,000 to 29,999
30,000 to 39,999
40,000 to 49,999
50,000 to 59,999
60,000 to 69,999
70,000 to 79,999

10
11
12
13
14
15
16
17

80,000 to 89,999
90,000 to 99,999
100,000 to 249,999
250,000 to 999,999
1 million to 1.99 million
2.0 million to 2.99 million
3.0 million to 4.99 million
5.0+ million

Section 4: Lab Exchange Standards
In the following section, we will refer to “HL7.” HL7 (Health Level 7) is a messaging standard that can be
used to send laboratory results from a laboratory to an EHR. To facilitate completion of the following
sections, we suggest working with your IT staff or your LIS manager.

Q17.

Which of the following messaging standards are currently in use by your laboratory for
result reporting?
Please select all that apply.
1
2

3
4

5
6
7

HL7 2.3.1
HL7 2.5.1
Other HL7 version, please specify
Proprietary
Other, please specify
None
Don’t know

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VERSION A (HOSPITALS)

Q18.

Which vocabulary standard for laboratory result reporting is currently in use by your
laboratory?
Please select all that apply.
1
2
3
4

5
6
7

LOINC (Logical Observation Identifiers Names and Codes)
SNOMED CT (Systematized Nomenclature of Medicine)
Both of the above
Local Codes
Other, please specify
None
Don’t know

Section 5: Barriers to Exchange
We would like to learn about barriers to laboratory information exchange.
Q19.

Which one of the following issues concerning electronic delivery of laboratory test results
in a structured format is the primary challenge your laboratory is currently facing?
Please select one box.
1
2
3
4

5

6

7
8
9

EHR systems are unable to receive structured results
Insufficient information on exchange options available
Lack of harmonization of industry accepted standards
Inability of Laboratory Information System (LIS) to generate/receive electronic
messages/transactions in structured and standardized format
Subscription rates/fees for exchange service providers (including lab hub, third party
middleware vendor, and Health Information Exchange providers) are too high
Compliance with Clinical Lab Improvement Amendments (CLIA) regulations
Other, please specify
No challenges experienced in delivering structured laboratory results
Don’t know

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VERSION A (HOSPITALS)

Q20. Which one of the following issues concerning laboratory interfaces for electronic delivery
of test results in a structured format to ordering practitioners is the primary challenge
your laboratory is currently facing? Please select one box.
1
2
3
4
5

6
7

8

Q21.

The time required to build interfaces
The costs associated with building interfaces
Lack of harmonization of industry accepted standards
Lack of specific implementation guides
Lack of trained staff (human capital) needed to implement the interfaces
Other, please specify
No challenges experienced in developing laboratory interfaces for delivery of
laboratory results
Don’t know

Which of the following issues concerning adoption of LOINC codes for sending results
best describes the current situation in your laboratory? Please select all that apply.
1
2
3
4
5

6
7

8
9
10

Our laboratory information system (LIS) is not able to store LOINC codes
Our laboratory does not have LOINC codes/mapping for some of our tests
Our laboratory does not have LOINC codes/mapping for all our tests
Our laboratory has insufficient resources to maintain LOINC mappings over time
Our laboratory information system (LIS) is not able to send LOINC codes, as it
does not have an interface to send laboratory reports with LOINC codes
LOINC is not robust enough to support local code
EHRs do not have the ability to accept LOINC codes
Other, please specify
No issues experienced in using LOINC codes to send laboratory reports
Don’t know

Section 6: Implementation of Guidelines and Regulations
In the following question, we will refer to the “LRI guide.” The “LRI guide” is the implementation guide
developed by the Office of the National Coordinator’s (ONC) Standards and Interoperability Framework
laboratory results interface (LRI) initiative. It is an implementation guide for electronic submission of
Laboratory Results to Ambulatory EHRs. LRI is required for Meaningful Use Stage 2. For more
information about the S&I Framework initiatives, including the LRI initiative, visit
http://wiki.siframework.org/Lab+Results+Interface+(LRI)+Initiative

Q22.

Has your laboratory implemented the LRI guide for laboratory result content and format?
1
2
3

Yes
No
Don’t know

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VERSION A (HOSPITALS)

Q23.

Does your laboratory allow patients or their legal representatives direct access to their
laboratory results?
1
2
3
4

No (Go to END)
It is not legal in my state to send laboratory results directly to patients (Go to END)
Yes (Go to Q23a)
Don’t Know
Q23a. If YES, please indicate which of the following methods of delivery your
laboratory uses to deliver results directly to patients or patients’ legal
representatives.
Yes

Don’t
know

a. Mail & Fax

1

2

3

b. Web portal solution provided by laboratory

1

2

3

1

2

3

1

2

3

1

2

3

c. Transmission of results to a designated
Personal Health Record (PHR)
d. Through a community Health Information
Organization that provides
patient access to information
e. Through a physician’s EHR that provides
patients access

Q24.

No

Please enter your hospital’s Medicare Provider Number below.

1

|

|

|

|

|

Please check this box if more than one person helped complete this questionnaire.

End of Questionnaire
Thank you.
Please return the completed questionnaire in the enclosed postage paid envelope to:
NORC
Attn: National Clinical Laboratory Survey on Health Information Exchange
1 North State Street, 16th Floor
Chicago, IL 60602
If you prefer, you may:
fax your completed questionnaire to: 877-504-6296
or e-mail it to [email protected].
Please make sure to include the survey cover page in your fax or email.
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Proposed Contacts
Health IT Coordinator
Letter

Form Approved
OMB No. 0990Exp. Date XX/XX/20XX

[DATE]

To Whom It May Concern,

We are writing to make you aware of the upcoming National Survey on Health Information Exchange in
Clinical Laboratories, a survey of clinical laboratories to assess the electronic exchange of key laboratory
information across the United States. The Office of the National Coordinator for Health Information
Technology (ONC) is conducting this survey in collaboration with NORC at the University of Chicago.
This survey is supported by the College of American Pathologists (CAP) and the College of
Healthcare Information Management Executives (CHIME).
Crucial information on laboratory information exchange across the United States will be collected, including
the volume of laboratory information exchange, laboratory information exchange standards, current systems
and technical architecture, and barriers and facilitators of laboratory information exchange. The information
collected will provide crucial state and national data on the volume of laboratory information exchange
occurring electronically, reporting capacity, and other key measures of electronic exchange
This study will rely on data gathered from key informants such as, Laboratory Managers or Directors and
Laboratory Information System Specialists at the sampled laboratories. About 14,000 hospital and
independent laboratories have been selected to participate. Each lab has been selected from a listing of all
laboratories in the United States. The source of this listing is the Online Survey, Certification and Reporting
database maintained by the Centers for Medicare and Medicaid Services. Each lab was randomly selected
from this list of laboratories and from across the country; therefore, participation from each lab is crucial as no
lab can be replaced and is critical to the survey's success.
This study is composed of a survey questionnaire, which will be mailed along with a postage-paid envelope to
each selected lab. This survey should take about 20 minutes and should be completed by a lab director, the lab
manager, or another individual who is most knowledgeable in a laboratory’s information exchange capacities.
Laboratory Information Specialist or Information Technology staff may also help in completing some
questions.
ONC will use these findings to develop a comprehensive understanding of the baseline level of laboratory
information exchange. This information will inform program activities and policy efforts to promote
laboratory information exchange and provide more targeted assistance to states in developing their laboratory
information exchange strategies. Answers are confidential and will be used only in aggregate form in reports
issued by ONC. For more information about this Clinical Laboratories survey, please contact us toll free at
1-800-975-2754 or [email protected].
Sincerely,

Matthew Swain
ONC Program Analyst

Proposed Invitation
Contacts
Advance Letter

Form Approved
OMB No. 0990Exp. Date XX/XX/20XX

[DATE]
[FIRSTNAME] [LASTNAME]
[ADDR1]
[ADDR2]
[CITY], [STATE] [ZIP]
Dear [FIRSTNAME] [LASTNAME],

We are writing to request your participation in the upcoming National Survey on Health Information
Exchange in Clinical Laboratories, a survey of clinical laboratories to assess the electronic exchange
of key laboratory information across the United States. The Office of the National Coordinator for
Health Information Technology (ONC) is conducting this survey in collaboration with NORC at the
University of Chicago. This survey is supported by the College of American Pathologists (CAP) and
the College of Healthcare Information Management Executives (CHIME).
Your laboratory has been selected to complete a brief survey on its information exchange capacities and
activities. The information collected will provide crucial state and national data on the volume of laboratory
information exchange occurring electronically, reporting capacity, and other key measures of electronic
exchange. Also, we intend to do additional health care research by linking your responses to this survey to
available administrative medical information and other related records.
Within the next two weeks, you will receive a packet in the mail that contains the questionnaire. A business
reply envelope will be provided for return of the hardcopy questionnaire.
This survey should be completed by the lab director, the lab manager, or another individual who is
most knowledgeable about your laboratory’s information exchange capacities. Your Laboratory
Information Specialist or Information Technology staff may also help in completing some questions.
If you feel that you are not the best person to complete the survey, please have the individual(s) most familiar
with these areas complete the survey.
The survey will take approximately 20 minutes to complete. Your participation is voluntary and you may skip
any question. Your answers are confidential and will be used only in aggregate form in reports issued by
ONC. For more information about this survey, please feel free to contact our Lab Survey Help Line toll free
at 1-800-975-2754 or email at [email protected]. For questions about your rights as a study participant,
you may call Kathleen Parks, the NORC IRB Administrator, toll-free at 866-309-0542.
Your responses to the National Survey on Health Information Exchange in Clinical Laboratories are critical
to its success. We hope you decide to participate in this important effort.
Sincerely,

Matthew Swain
ONC Program Analyst

Proposed Invitation
Contacts
First Cover Letter

Form Approved
OMB No. 0990Exp. Date XX/XX/20XX

[DATE]
[FIRSTNAME] [LASTNAME]
[ADDR1]
[ADDR2]
[CITY], [STATE] [ZIP]
Dear [FIRSTNAME] [LASTNAME],

We are writing to request your participation in the National Survey on Health Information Exchange in
Clinical Laboratories, a survey of clinical laboratories to assess the electronic exchange of key laboratory
information across the United States. The Office of the National Coordinator for Health Information
Technology (ONC) is conducting this survey in collaboration with NORC at the University of Chicago. Your
laboratory has been selected to complete a brief survey on its information exchange capacities and activities.
The information collected will provide crucial state and national data on the volume of laboratory information
exchange occurring electronically, reporting capacity, and other key measures of electronic exchange. Also, we
intend to do additional health care research by linking your responses to this survey to available administrative
medical information and other related records. This survey is supported by the College of American
Pathologists (CAP) and the College of Healthcare Information Management Executives (CHIME).
This survey should be completed by the lab director, the lab manager, or another individual who is
most knowledgeable about your laboratory’s information exchange capacities. It is also likely that
your Laboratory Information Specialist or Information Technology staff may need to assist in
completing some questions. If you feel that you are not the best person to complete the survey, please
have the individual(s) most familiar with these areas complete the survey.
Please use the hardcopy questionnaire included in this mailing to complete the survey. A business reply
envelope is also provided for return of the hardcopy questionnaire (no additional postage required). The
survey will take approximately 20 minutes to complete. Your participation is voluntary and you may skip any
question. Your answers are confidential and will be used only in aggregate form in reports issued by ONC.
For more information about the purpose and importance of this survey or to receive help filling out the
survey form, please feel free to contact our Lab Survey Help Line toll free at 1-800-975-2754 or email at
[email protected]. For questions about your rights as a study participant, you may call Kathleen Parks, the
NORC IRB Administrator, toll-free at 866-309-0542.
Your responses to the National Survey on Health Information Exchange in Clinical Laboratories are critical
to its success. We will share a report with you summarizing the results upon completion. We hope you decide
to participate in this important effort.
Sincerely,

Matthew Swain
ONC Program Analyst

Proposed Invitation
Contacts
Reminder Cover Letter

Form Approved
OMB No. 0990Exp. Date XX/XX/20XX

[DATE]
[FIRSTNAME] [LASTNAME]
[ADDR1]
[ADDR2]
[CITY], [STATE] [ZIP]
Dear [FIRSTNAME] [LASTNAME],

We are writing to remind you to please participate in the National Survey on Health Information Exchange in
Clinical Laboratories, a survey of clinical laboratories to assess the electronic exchange of key laboratory
information across the United States. The Office of the National Coordinator for Health Information
Technology (ONC) is conducting this survey in collaboration with NORC at the University of Chicago. This
survey is supported by the College of American Pathologists (CAP) and the College of Healthcare
Information Management Executives (CHIME).
Your participation in the survey is critical in helping us better understand reporting capacity and the
volume of electronic laboratory information exchange occurring in the United States. If you recently
mailed your completed survey, please accept our sincere thanks and ignore this reminder. If you have not yet
participated, please know that your responses will contribute vital data on information exchange capacities.
Also, we intend to do additional health care research by linking your responses to this survey to available
administrative medical information and other related records.
This survey should be completed by the lab director, the lab manager, or another individual who is
most knowledgeable about your laboratory’s information exchange capacities. Your Laboratory
Information Specialist or Information Technology staff may also help in completing some questions.
If you feel that you are not the best person to complete the survey, please have the individual(s) most familiar
with these areas complete the survey.
Please use the hardcopy questionnaire included in this mailing to complete the survey. A business reply
envelope is also provided for return of the hardcopy questionnaire (no additional postage required). The
survey will take approximately 20 minutes to complete. Your participation is voluntary and you may skip any
question. Your answers are confidential and will be used only in aggregate form in reports issued by ONC.
For more information about the purpose and importance of this survey or to receive help filling out the
survey form, please feel free to contact our Lab Survey Help Line toll free at 1-800-975-2754 or email at
[email protected]. For questions about your rights as a study participant, you may call Kathleen Parks, the
NORC IRB Administrator, toll-free at 866-309-0542.
Your responses to the National Survey on Health Information Exchange in Clinical Laboratories are critical
to its success. We hope you decide to participate in this important effort.
Sincerely,

Matthew Swain
ONC Program Analyst

Proposed Invitation
Contacts
Reminder Postcard

Dear [FIRSTNAME] [LASTNAME],

Recently, we asked for your help with an important national survey. The National Survey on Health
Information Exchange in Clinical Laboratories is being conducted on behalf of the Office of the
National Coordinator for Health Information Technology (ONC) in collaboration with NORC, a nonprofit research organization affiliated with the University of Chicago. This survey is supported by the
College of American Pathologists (CAP) and the College of Healthcare Information Management
Executives (CHIME).
If you have already mailed back your survey, please accept our sincere thanks. If not, please do so as
soon as possible. To receive help filling out the survey form or if you have questions about the
purpose of the study, please feel free to contact our Lab Survey Help Line toll free at 1-800-975-2754
or email at [email protected].
Your participation is critical to the success of this study. We hope you will complete this important
survey.
Sincerely,

Matthew Swain
ONC Program Analyst

Proposed Invitation
Contacts
Final Reminder Cover
Letter

Form Approved
OMB No. 0990Exp. Date XX/XX/20XX

[DATE]
[FIRSTNAME] [LASTNAME]
[ADDR1]
[ADDR2]
[CITY], [STATE] [ZIP]
Dear [FIRSTNAME] [LASTNAME],

We are writing to remind you to please participate in the National Survey on Health Information Exchange in
Clinical Laboratories, a survey of clinical laboratories to assess the electronic exchange of key laboratory
information across the United States. The Office of the National Coordinator for Health Information
Technology (ONC) is conducting this survey in collaboration with NORC at the University of Chicago. This
survey is supported by the College of American Pathologists (CAP) and the College of Healthcare
Information Management Executives (CHIME).
Your participation in the survey is critical in helping us better understand reporting capacity and the
volume of electronic laboratory information exchange occurring in the United States. If you recently
mailed your completed survey, please accept our sincere thanks and ignore this reminder. If you have not yet
participated, please know that your responses will contribute vital data on information exchange capacities.
Also, we intend to do additional health care research by linking your responses to this survey to available
administrative medical information and other related records.
This survey should be completed by the lab director, the lab manager, or another individual who is
most knowledgeable about your laboratory’s information exchange capacities. Your Laboratory
Information Specialist or Information Technology staff may also help in completing some questions.
If you feel that you are not the best person to complete the survey, please have the individual(s) most familiar
with these areas complete the survey.
Please use the hardcopy questionnaire included in this mailing to complete the survey. A business reply
envelope is also provided for return of the hardcopy questionnaire (no additional postage required).The
survey will take approximately 20 minutes to complete. Your participation is voluntary and you may skip any
question. Your answers are confidential and will be used only in aggregate form in reports issued by ONC.
For more information about the purpose and importance of this survey or to receive help filling out the
survey form, please feel free to contact our Lab Survey Help Line toll free at 1-800-975-2754 or email at
[email protected]. For questions about your rights as a study participant, you may call Kathleen Parks, the
NORC IRB Administrator, toll-free at 866-309-0542.
Your responses to the National Survey on Health Information Exchange in Clinical Laboratories are critical
to its success. We hope you decide to participate in this important effort.
Sincerely,

Matthew Swain
ONC Program Analyst