Form #1 Form #1 Semi-Structured Interview Guide

A

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

ttachment C: Semi-Structured Interview Guide

A Multisite Field Study Applying Novel Methods to Better Understand the Relationship between Health IT and Ambulatory Care Workflow Redesign

Semi-Structured Interview Protocol (draft)

Purpose: To solicit healthcare workers’ beliefs of, attitudes toward, and perceptions about how health IT implementation may alter their clinical workflow.

Instructions

1. Avoid asking for information that would uniquely identify the interviewee.

2. A question may be skipped if the interviewee has adequately addressed it in an earlier part of the conversation.

3. A probing question may be skipped if the interviewee has adequately addressed it in an earlier part of the conversation.

Public reporting burden for this collection of information is estimated to average XX 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.

Section 1: Introduction

Purpose: To introduce the study.

Suggested time: 3 minutes

1. Introduce yourself and if applicable, briefly refer to your experience observing the interviewee.

2. Introducing the study.

Thanks for your support (continuing support) in this study. As you may know, our objective is to understand how use of health information technology, or health IT, may impact your work and workflow. What we learn here will help us generate knowledge about how health IT can be used to improve healthcare in the United States.

This interview will take approximately 30–45 minutes. Your participation and your responses will be treated confidentially and all of our findings will be reported anonymously. To the extent possible, individuals and organizations will be assured of the confidentiality of their replies under Sections 944(c) and 308(d) of the Public Health Service Act[42 U.S.C. 299c-3(c) and 42 U.S.C. 242m(d)]. We will greatly appreciate a recording of this interview for analysis purposes.

3. Hand out the Consent Form.

Section 2: Descriptive/Background Questions

Purpose: Warm up questions to gather general facts about the interviewee and the work environment.

Suggested time: 5 minutes

1. I’d like to start with some questions about your position here and your general work setting.

2. What’s your role in the clinic? (Q1)

Note: While we may have some of this data collected already, the goal of this question is to warm the interviewee up and to learn additional information that we may not know about.

Probing questions

1. What is your job title?

2. How does your general work schedule look like on an average day?

3. What are your main job responsibilities?

4. Approximately, on an average day, how much time do you spend on each of your main job responsibilities?

3. How long have you been working as a __________ in this clinic? (Q2)

Probing questions

1. What was your work experience prior to joining this clinic?

2. Are you also working (practicing) elsewhere other than this clinic?

Section 3: health IT Implementation and Workflow

Purpose: Questions to gather specific information about health IT’s impact on workflow.

Suggested time: 20–30 minutes

1. Your clinic recently implemented [name of the system]. Has use of this system changed your work? If so, in what ways? (Q3)

No probing questions. Let the interviewee speak.

Note: It is fine if part of the interviewee’s response may not be related to the particular system or systems named. This applies to all questions in this protocol.

2. Has the implementation of [name of the system] changed your workflow? If so, in what ways? (Q4)

Note: Do not define workflow for the interviewee while asking this question. Let the interviewee first speak based on her or his own interpretation, then use the probing questions below.

Probing questions

1. Has use of the system changed the amount of work you do?

• Has it introduced additional workflow processes?

• Has it eliminated some old workflow processes?

2. How has it changed the amount of time you spend doing your work?

3. How has it changed the amount of time you allocate to different work tasks?

4. How has it changed the order in which you do your work?

3. Has [name of the system] ever got in the way of your work? (Q5)

Probing questions

1. Please describe the most recent incidence when that happened, if any.

2. Please describe the worse case you have run into, if any.

3. Do you think you are interrupted more often after starting using the system? (Interviewer: Please provide an example of the relevant interruptions observed in the field.)

4. Has the implementation of [name of the system] changed the way you interact with co-workers in your clinic in accomplishing your work? If so, in what ways? (Q6)

Probing questions

1. Has it changed the number of co-workers you interact with in the clinic in accomplishing your work?

2. Has it changed the type of co-workers you interact with in the clinic in accomplishing your work?

5. Has the implementation of [name of the system] changed the way you interact with people outside your clinic in accomplishing your work? If so, in what ways? (Q7)

Probing questions

1. Has it changed the number of people you interact with outside the clinic in accomplishing your work?

2. Has it changed the type of people you interact with outside the clinic in accomplishing your work?

6. If applicable: Has the implementation of [name of the system] changed the way you interact with patients? If so, in what ways? (Q8)

No probing questions. Let the interviewee speak.

7. Overall, do you think the implementation of [name of the system] has improved your workflow? (Q9)

Probing questions

1. If so, in what ways?

2. If worse, in what ways?

3. If worse, how could things have been done differently to avoid the problems encountered?

Section 4: Additional Questions

Purpose: Questions to gather additional feedback.

Suggested time: 5–10 minutes

1. When you run into a problem using [name of the system], who do you go to for help? (Q10)

No probing questions. If possible, ask the interviewee to provide specific names.

2. Overall, what do you think about the implementation process of [name of the system]? (Q11)

Probing questions

1. Did you participate in planning, purchasing, customizing, and implementing the system?

2. Was the training you received adequate?

3. How would your rate the quality of the technical support?

3. Overall, how do you like the IT systems used in your clinic, that is, any kind of computer software programs you use in your everyday work? (Q12)

No probing questions. Let the interviewee speak.

4. If applicable: Overall, how do compare your current workflow, after starting to use these IT systems, to your workflow in the past? (Q13)

No probing questions. Let the interviewee speak.

Section 5: Wrap-Up

Purpose: To collect additional information that the interviewee may want to provide.

Suggested time: 5 minutes

1. Is there anything else that you’d like to share with us regarding how the implementation of [name of the system] has affected your workflow? (Q14)

No probing questions. Let the interviewee speak.

2. Anything else you’d like to tell us? (Q15)

No probing questions. Let the interviewee speak.

3. Thank you very much for taking the time to participate in the study. We appreciate it much your time and your help.