Interview Guide

Attachment 3

Interview Guide for Key Project Staff and Stakeholders

Form Approved

OMB No. 0920-XXXX

Exp. Date:

Evaluation of the SAMHSA PDMP Electronic Health Record (EHR) Integration and Interoperability Expansion (PEHRIIE) Program

Interview Guide for Key Project Staff and Stakeholders

Public reporting burden of this collection of information is estimated to average 45 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 NE, MS D-74, Atlanta, Georgia, 30333; ATTN: PRA (0920-XXXX).

Interviewer’s Legend

	Description of Item	Action Required
Plain text	Mandatory text	State/read out loud
Bolded text	Organizational headers	Nothing/Do not read
(Italicized text)	Place holder for tailoring interview	Replace with appropriate identifying information based on response or respondent
[Probe]	Probe for elaboration, specifying, and additional items	Optional; ask only if information not clear or not yet captured (use as checklist)
[Paraphrase]	Paraphrased question	Rephrase if original question unclear to respondent
[Clarifying Information]	Examples of the type of information desired	Provide clarifying information or examples if unclear to respondent

For each state, the following specific program names will be substituted in place of “the PDMP”:

State Name	PDMP Name
Florida	E-FORCSE
Illinois	The PMP or The PIL
Indiana	INSPECT
Kansas	K-TRACS
Maine	The PMP
Ohio	OARRS
Texas	PAT
Washington	The PDMP
West Virginia	The CSMP or RxDataCheck

Before we begin this interview, I’d like to go over the purpose of today’s interview, and review the relevant informed consent and privacy information pertaining to today’s interview.

Evaluation Project Overview

The Centers for Disease Control and Prevention (CDC) and subject matter experts at Brandeis University are conducting an evaluation of the SAMHSA cooperative agreement program aimed at improving real-time access to PDMP data and strengthening existing PDMPs. Through this program, (insert name of state) has implemented changes to (insert name of PDMP designed to establish integrated access to the PDMP via Electronic Health Records (EHRs) and/or other health information technology (HIT) systems and to expand the availability of PDMP data across state lines. This evaluation will identify cross-cutting barriers to and facilitators of successful implementation of these two primary program goals and will also examine the impact of these systemic changes on PDMP use and prescription drug overdose related outcomes.

The purpose of today’s interview is for us to understand the processes involved with the implementation of your project, some of the challenges that you encountered, the successes you’ve achieved, and any lessons that you’ve learned.

Do you have any questions for us about the planned evaluation or the purpose of today’s interview?

Consent to Proceed with the Interview

This interview will last approximately forty five minutes. Your participation is voluntary, and you do not have to answer any question that you don’t feel comfortable answering. There are no right or wrong answers to any of these questions. Your responses will not influence either the status of your current funding or any future funding decisions. Do you agree to proceed with this interview?

We would like to take extensive notes during our interview. We will keep these notes in a secure location and any identifying information that we collect will not be disclosed unless compelled by law. For our site visit report, we will combine responses across our interviews, and will not attribute comments or observations to any specific individual or interview sessions. Do we have your permission to take notes during today’s interview?

Finally, we would like to record this interview to ensure that we capture everything you say accurately. We will keep the recording in a secure environment. Recordings will not be transcribed but will instead be used to review and clarify our notes and to ensure the information we capture today is accurate and complete. Do we have your permission to record today`s interview?

Do you have any additional questions for us before we start the interview?

1. Background and Project Context

First, we would like to learn about your organizational affiliation and your involvement with the expansion of the PDMP, as well as some of the factors that led to your involvement in this project.

1. What is your role at (insert organization/agency)?

1. How long have you been there?

2. [Probe] How long have you been in this particular role?

2. What aspects of this project are you or your (insert organization/agency) responsible for?

1. [Paraphrase] What is your role in this grant project?

2. [Probe] Were you involved with the development of the proposal for this grant?

   1. [Probe] In what capacity were you involved?

3. How much of your time is dedicated to this grant project?

4. Who do you interact with regarding this grant project?

   1. [Probe] Who do you interact within your organization/agency?

   2. [Probe] Who do you interact with outside of your organization/agency?

3. What other PDMP projects relating to interstate interoperability and/or health information technology integration have you or your (insert organization/agency) been involved with?

1. [Paraphrase] For example, were you or your organization involved in any of the MITRE pilot projects or other related pilot projects?

2. [Probe] What was your role in these projects?

3. [Probe] What was accomplished through these projects?

4. [Probe] What work or resulting products was sustained from these projects?

5. How did your involvement with these projects contribute to your work on the current interoperability project?

4. What other projects relating to the PDMP are you or your (insert organization/agency) currently working on outside of this grant?

1. [Paraphrase] Are you working on any other projects relating to the PDMP outside of this SAMSHA grant?

2. [Probe] How do these projects contribute or relate to this SAMSHA grant project?

5. What factors lead to the development of this PDMP grant project?

1. [Note for interviewers – If the answer to A2b indicates the respondent was not involved in the development of this grant project, please frame these questions to ask about what drove *their participation in* in the grant project.]

2. [Paraphrase] What drove the need to expand PDMP interoperability? And what drove the need to expand integration with EHR and other HIT?

3. [Probe] Was it driven by increased awareness of the problem posed by controlled substance misuse and diversion?

4. [Probe] Was it driven by a lack of PDMP use?

5. [Probe] Was it driven by concerns about the quality of the PDMP data?

   1. [Clarifying Information] For example, were there concerns about the timeliness or the amount of data that was available?

6. [Probe] Was it driven by the needs or desires of the provider community?

7. [Probe] Was it driven by legislative interest or mandate?

8. [Probe] Was it driven by previous activities?

2. Activities and Challenges

Now, we would like to ask you about your specific grant activities in more detail, including the resources required, and to discuss some of the challenges you’ve encountered during this project.

1. What grant activities have you or your (insert organization/agency) carried out so far for this grant project?

1. Is this consistent with what you expected to have completed at this stage?

2. What resources were needed to implement the activities of this grant that have been completed thus far?

1. [Probe] Was there a budget for your portion of this project?

   1. [Probe] Was your grant budget sufficient?

2. [Probe] What staff was needed?

   1. [Probe] What additional staff at your organization or outside your organization was needed?

   2. [Probe] What were their roles in this project?

   3. [Probe] How much time did they contribute?

3. [Probe] What pre-existing system infrastructure was needed?

4. [Probe] What additional space was needed?

5. [Probe] What additional equipment was needed?

6. [Probe] What additional programming time was need?

7. Is this consistent with your expectation of what resources would be needed for implementation?

   1. [Probe] What unexpected resources were necessary for implementation?

3. What challenges have you encountered in your work on this grant project?

1. [Paraphrase] What challenges did you face when establishing interoperability with other states? What challenges did you face when establishing integration with EHR and other HIT systems?

2. [Ask after each challenge] How did you overcome these challenges?

3. [Probe] What administrative challenges did you encounter?

4. [Probe] What technological problems did you encounter?

5. [Probe] What legal barriers did you encounter?

   1. [Probe] What privacy issues did you encounter?

   2. [Probe] What challenges in executing data sharing agreements or Memoranda of Understanding (MOU) did you encounter?

   3. [Probe] What other policy or legislative challenges did you encounter?

6. [Probe] What communication challenges did you encounter?

7. [Probe] What challenges did you encounter with partners and stakeholders?

8. Are these consistent with your expectations of the potential challenges you anticipated encountering?

   1. [Probe] Which of these particular challenges were unanticipated or unexpected?

4. What other challenges did the PDMP grant project as a whole encounter that we haven’t yet talked about?

3. Successes and Outcomes

Next, we want to learn more about the successes you’ve accomplished, and outcomes achieved through this grant project.

1. What are some successes that have been achieved through this grant project for your organization?

1. [Probe] What technical improvements have been made to either your system or others?

2. [Probe] What policy or legislative changes resulted?

3. [Probe] What clinical, patient safety or public health changes resulted?

4. [Probe] What state PDMPs did you establish interoperability with as a result of this grant?

5. [Probe] What HIT, PDS and/or EHR systems did you establish integration with as a result of this grant?

6. [Probe] Has there been an increase in visibility of the PDMP either within or outside the state?

7. [Probe] Has there been an increase in communication between the PDMP staff and other government or health organizations?

2. What partnerships or collaborations resulted from or were strengthened as a result of this grant project?

1. [Probe] within your state?

2. [Probe] outside of your state?

3. [Probe] Have any partnerships developed as a result of this project that you did not expect?

4. How did these partnerships or collaborations contribute to the progress and success of this grant project?

   1. [Clarifying information] For example, commitments between the organizations such as signed business or legal contracts, data sharing agreements, or MOU.

3. How has your organization’s involvement in this grant affected other work or relationships with other organizations?

1. [Probe] Has there been an increase in visibility of your organization?

4. How are you tracking the successes achieved and challenges encountered during this project?

1. [Paraphrase] How do you or your organization measure or collect information on the successes of the project?

2. [Probe] Do you have regular project meetings?

3. [Probe] Are you conducting an evaluation?

4. [Probe] How do you define success?

   1. [Probe] Is success an increase in the number of registered users?

   2. [Probe] Is success a decrease in diversion?

   3. [Probe] Is success a decrease in misuse?

   4. [Probe] Is success new policies passed?

5. What do you feel are the most valuable activities or improvements made through this grant project?

1. [Probe] Upgrade to ASAP 4.2?

2. [Probe] Adoption of NIEM standards?

3. [Probe] Improvements to real time data access?

4. [Probe] Improvements to reporting standards?

5. [Probe] Improvements to user interface?

6. What do you feel are the least valuable activities or improvements?

6. What do you feel are the most valuable features of the PDMP?

1. [Probe] unsolicited reports?

2. [Probe] red flags?

3. What do you feel are the least valuable features of the PDMP?

4. Future and Lessons Learned

Finally, we would like to know about your future steps and lessons learned on this project.

1. What parts or products of your work on this project will be sustained after the SAMSHA grant concludes?

1. How might your work be sustained?

2. What is needed to sustain your work?

3. What factors affect the sustainability of your work?

4. [Probe] What parts or products of your work might not be sustained?

   1. [Probe] What are reasons these products might not be sustained?

2. What resources are needed to sustain your work relating to this project? What resources do you or your (insert organization/agency) require on an ongoing basis related to this project?

1. [Probe] What funds are needed?

2. [Probe] What staff is needed?

   1. [Probe] What additional staff at your organization or outside your organization is needed?

   2. [Probe] What are their roles in sustaining your work?

   3. [Probe] How much time do they need to contribute?

3. [Probe] What pre-existing system infrastructure is needed?

4. [Probe] What space is needed?

5. [Probe] What equipment is needed?

6. [Probe] What programming time is needed?

7. Is this consistent with your expectation of what resources would be needed for sustainability?

   1. [Probe] What unexpected resources are necessary for sustainability?

3. What are the next steps that you or your (insert organization/agency) will be working on?

1. [Probe] What are the goals of these next steps?

   1. [Probe] What needs to happen before you can accomplish these goals?

2. What is the highest priority for you?

3. What challenges do you expect to encounter during this next phase of work?

4. What could help you overcome these challenges?

   1. [Probe] What resources might you need?

5. How might you leverage resources and successes from this grant for the next steps?

   1. [Probe] What partnerships or collaborations will be pursued as part of these next steps?

4. We will be compiling what we learn today to form recommendations for other states trying to establish interoperability and integration. What advice do you have for other states trying to do the same?

1. What do you wish you had known from the beginning?

2. What would you redo or restart if you had the chance?

5. Do you have any additional comments on items that we have discussed or not covered during the interview?

Thank you so much for taking the time to talk to us today!