Form #4 Form #4 Patient Interview Guide

Attachment F: Patient Interview Guide 6

A

Form Approved
OMB No. 0935-XXXX
Exp. Date XX/XX/20XX

ttachment F: Patient Interview Guide

Using Health Information Technology in Practice Redesign: Impact of Health Information Technology on Workflow

Patient Interview Guide

Public reporting burden for this collection of information is estimated to average 60 minutes per response, the estimated time required to complete the survey. 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: AHRQ Reports Clearance Officer Attention: PRA, Paperwork Reduction Project (0935-XXXX) AHRQ, 540 Gaither Road, Room # 5036, Rockville, MD 20850.

Thank you for participating in the study today. The goal of the study is to learn more about how your health care providers work with computers and with each other. There are two parts to the study. The first is an interview where we will ask you questions about yourself, your health history, and your care experience here at the clinic. The second part includes filling out two short surveys. After you complete the interview, we will ask you to fill out two short surveys about your diabetes and your health. First we need to review the consent documents.

[Give subject copy of consent form and review elements of consent].

Please read the form carefully. If you still would like to participate in the interview, please sign the consent form. If you agree to have the interview recorded, please initial the line next to the first statement. If you do not agree to have the interview recorded, please initial the line next to the second statement. Do you have any questions before we move on?

[After respondent agrees to participate and signs consent form]

Thank you again for agreeing to participate in the study today. As I mentioned before, the goal of the study is to help us understand how your health care providers work with computers and with each other.

• If subject has agreed to audio recording:

I have set up the tape recorder here in front of us. Please speak clearly during the interview so that the tape will record your voice accurately. I may ask you to repeat a response to make sure that it is recorded.

• If subject has not agreed to audio recording and a note taker is not available:

I will take notes during our conversation today. I may ask you to slow down or pause for a moment so that I can record what you say accurately.

• If subject has not agreed to audio recording and a note taker is available:

My colleague [NAME] will take notes during our conversation today. He/she may ask you to slow down or pause for a moment so that he/she can record what you say accurately.

During the interview, please use only your first name if you refer to yourself. This will help us keep your responses private. Your answers will not be individually reported to your care team members here at the clinic. If we do share information from the interview with clinic staff, we will only report it at the aggregate level, so that it is not obvious who said what.

The interview will take about one hour to complete. If you need to take a break during the interview to use the restroom or get a drink, please let me know and we will pause the interview.

If any of my questions aren’t clear or you don’t understand a word that I use, please let me know and I will rephrase the question for you.

Please remember that you are not required to answer any specific question. You may also leave the interview at any time.

At the end of the interview, we will ask you to fill out two short surveys about your diabetes and your health. Once you have completed the interview and the surveys, you will receive a gift of $25 as a thank you for your participation.

Do you have any questions before we start the interview?

1. Clinic this patient uses: ­[Record Clinic Name]

2. Demographic information:

We are going to start by asking you some general questions about yourself. For some of these questions, I will read off choices for you to choose from.

1. What is your age?

• 25 or under

• 26-35

• 36-45

• 46-55

• 56-65

• 65 or older

2. What is your gender?

3. Are you Hispanic or Latino/Latina? No/Yes

4. For this question, I will read off several choices. What is your race? Please select one or more.

• American Indian or Alaska Native

• Asian

• Native Hawaiian or other Pacific Islander

• Black or African American

• White

5. Please describe your education.

6. Please briefly describe your work experience (past, current)

For the next three questions, I will read off choices after I ask the question.

7. What is your household income?

• Under $10,000

• $10,001 – $24,999

• $25,000 – $39,999

• $40,000 - $49,999

• $50,000 - $74,999

• $75,000 - $99,999

• Over $100,000

8. What is your marital status?

• Single

• Married

• Divorced

• Separated

• Widowed

• Partnered

9. What type of health insurance do you have?

• Private insurance (e.g., provided through your employer or school)

• Medicare (provided to citizens over the age of 65 or with certain medical conditions)

• Medicaid (provided to low income individuals, most often women and children)

• Military insurance (e.g., Tricare)

• Uninsured

• Other

• Not sure

3. Health History

We are now going to ask you some questions about your health history and your care experience, such as how often you come to the clinic, who you talk to while you are here, and how you and your doctors work together to manage your health and your care.

1. Please describe the diagnoses received from a doctor and the approximate dates of diagnosis.

2. How would you describe your health?

Probe for specific information (e.g., ask whether their glucose levels have been high or low).

4. General Care Experience

1. How often do you come to this clinic for your diabetes?

2. Who do you talk to or see about your diabetes?

3. Please discuss your experience with this clinic: things that go well, and things that don’t go well.

Probe for issues that are relevant to care coordination for their diabetes, and any observations or experiences concerning the role of health IT.

5. Patient Workflow

Now I am going to ask you some questions about the tasks you do to manage your health.

1. Describe what you do at home (and other places outside the clinic) to take care of your diabetes.

2. Please describe the typical process for visiting the clinic, including activities before and after the actual visit.

Use paper artifacts if necessary.

3. Describe phone calls or visits you usually have in between appointments, such as blood work, at the clinic.

4. Do any of the staff from this clinic talk to staff in other clinics (e.g., your endocrinologist) about you and your health conditions (e.g., to make appointments for you, or to get or give information)? If so, please describe.
   
   
   

6. Problems Related to Your Diabetes Care

Now I am going to ask you some questions about challenges that you may have encountered in receiving care for your diabetes.

1. What are some of the problems or challenges you’ve encountered in receiving health care for diabetes?

2. Describe any problems or challenges you’ve had with the clinic, getting information or sharing information about your care for diabetes.
   
   
   

7. Strategies for Managing Diabetes-Related Information

In this section, I will ask you about how you manage information related to diabetes.

1. Regarding your diabetes, what information do you need to manage?

(Offer examples if necessary: your list of medicines and when you take them; your blood sugars; your routines such as exercising, eating, and glucose testing; your future office visits, future lab visits, and medication refills or renewals; reminders for any/all of these things)

2. How do you manage the information related to your diabetes?

Include each area outlined in previous question.

3. How do you let your doctor or your doctor’s staff know how you are doing at each appointment?

4. How do you let your doctor or your doctor’s staff know how you are doing in between appointments?
   
   
   

8. Overall Assessment

This is the last question in the interview.

1. Please give us your impression of the way the clinic coordinates your diabetes care.

Ask about general and clinic-specific programs (e.g., follow-up calls and patient portal).

9. Conclusion

Thank you very much for your participation today! I will now give you the two surveys to complete. If you have any questions about the surveys, please feel free to ask me. Thank you again for your time and participation.