10-10144 Voice of the Veteran (VOV) Satisfaction Survey Office of

OMB Number 2900-0770

Estimated Burden: 7 mins

EXP Date: XX/XX/2014

Extended Hours Program Evaluation

User Survey

OMB 2900-0770

Estimated burden: 7 minutes

Expiration Date xx/xx/xxxx

The Paperwork Reduction Act of 1995: This information is collected in accordance with section 3507 of the Paperwork Reduction Act of 1995. Accordingly, we may not conduct or sponsor and you are not required to respond to, a collection of information unless it displays a valid OMB number. We anticipate that the time expended by all individuals who complete this survey will average seven (7) minutes. This includes the time it will take to follow instructions, gather the necessary facts and respond to questions asked. Customer satisfaction is used to gauge customer perceptions of VA services as well as customer expectations and desires. The results of this telephone/mail survey will lead to improvements in the quality of service delivery by helping to achieve services. Participation in this survey is voluntary and failure to respond will have no impact on benefits to which you may be entitled.

VA Form 10-10144

Veterans Health Adminsitration

J.D. Power and Associates

OSI Conjoint Survey – Primary Care

Section Name	Section Title	Level	Order Group	Order
Introduction	Introduction	1
Choice Tasks	Access to VHA Primary Care	1
Follow-up Questions	Misc Diagnostics	1
Demographics	Demographics	1

INTRODUCTION

Welcome. J.D. Power and Associates has been asked by the Department of Veterans Affairs to conduct a study to better understandVeterans’ attitudes and opinions about Veterans’ access to Primary Care at VA facilities. This study is not

regarding any care you may have received, or any care you might receive in the future, but your preferences, as a

Veteran, with regards to Primary Care.

Your responses will be completely anonomyous and will not affect any benefits or services you may be receiving from

the VA.

This survey will take approximately 10-12 minutes to complete. We thank you in advance for your participation.

Click here for our privacy and cookie notice.

­­­

S1 Are you currently a Veteran?

1 Yes

0 No [TERMINATE]

99 Don’t know [TERMINATE]

S2. Do you currently receive health care from the Department of Veterans Affairs?

1. Yes—my primary care provider is through the VA

2. Yes—but my primary care provider is not through the VA

0 No

­­­

S3. Do you currently receive health care from a provider other than the Department of Veterans Affairs?

1. Yes

0 No

[PROG: IF S2 = 0 and S3 = 0 then TERMINATE; ELSE IF S2 = 1 OR 2 THEN FILL VA HEALTHCARE QUOTA; IF S2 = 0 AND S3 = 1 THEN FILL NON-VA HEALTHCARE QUOTA]

­­­

S4. Are you currently being treated for a chronic condition with the Department of Veterans Affairs or another provider (e.g., diabetes, hypertension)?

1. Yes

0 No

CHOICE TASKS

Thank you for your responses so far. We’d now like you to go through an exercise that will better help us understand your opinions about how you prefer to access VA healthcare for primary care.

In the following exercise, you will presented choices with different features that fall into 5 different categories as specified below. Your task is to select the choice you would prefer the most regarding how you would access VA healthcare. When making your selection, you can assume everything is the same except the differences shown for each choice. You will be asked to make selection for a total of 20 screens. Each screen may look very similar. However the choices are different so please be careful in making your selection.

Focus only on primary care which includes physicals/preventative care, illness or injury, follow-up visits or information with your primary care provider (not any type of Speciality Care).

Time Availability: The times you can access healthcare

Weekday 8AM-4:30PM Only

Weekday Extended Hours (7AM to 7PM)

Weekday Extended Hours (7AM to 7PM) and Weekend (8AM-4:30PM)

Timeliness: How long it takes to get an appointment from the time you first request to be seen?

Same day

Within 3 days

Within a week

Within a month

[PROG NOTE: THIS FACTOR IS ONLY SHOWN WITH FACE TO FACE AND TELEHELP MODALITY BELOW]

Travel Time: The amount of transit time from your home to healthcare provider’s facility

Less than 45 minutes

45 to 90 minutes

More than 90 minutes

Modality: How you interact with the care provider?

Face to face (VA Hospital or Outpatient Clinic)

Phone (not 24-Hour Hotline)

Secure Messaging (Myhealthyvet.gov website)

VA Telehelp (CVT)—going to a VA facility, but interacting with your physician by video conference

24-Hour Hotline (Phone)

Caregiver: The person providing the healthcare

Your VA Primary Physician

Registered Nurse/Physician Assistant

Clinical Pharmacist

Any one from your PACT

A physician who is not your primary physician

Note: PACT is your Patient Aligned Care Team and it includes your primary care physician, registered nurse, health technician, clerk and pharmacist

[PROG NOTE: SHOW 20 SCREENS (EXAMPLE BELOW), RANDOMLY MANIPULATING THE FEATURE SET WITHIN THE THREE CHOICES FOR EACH SCREEN]

FOLLOW-UP

­­­

F1. Which of the following methods would you prefer most to be reminded about an appointment you have with the VA?[PROG: SINGLE RESPONSE, FORCED]

1. Letter in the mail

2. Postcard in the mail

3. Text/SMS message

4. Phone call

5. Secure Messaging (Myhealthevet.gov website)

0 No preference

­­­

F2. If the VA had to cancel an appointment, which of the following methods would you prefer most to be notified?[PROG: SINGLE RESPONSE, FORCED]

1. Letter in the mail

2. Postcard in the mail

3. Text/SMS message

4. Phone call

5. Secure Messaging (Myhealthevet.gov website)

0 No preference

F3. Would you participate in a group appointment if one was offered? Group appointments are typically check-ups for veterans with the same condition. Private interaction with your primary care provider can be part of the appointment as well as group education and interaction.

1. Yes

0. No

2 Maybe

F4. While not currently offered by the VA, would you be willing to use an unsecured communication method (e.g. Skype, Facetime) to interact with your primary care provider or PACT Team member?

0. Yes

0 No

2 Maybe

DEMOGRAPHICS

These last few questions are for classification purposes only.

D1. In what year were you born?

Year of birth [PROG: DROPDOWN, FORCED, RANGE = 1914- 1996]

9998 Prefer not to answer [PROG: EXCLUSIVE]

D2. Are you…? [PROG: SINGLE RESPONSE, FORCED]

0. Male

0 Female

98 Prefer not to answer

D3. What was the last year of school you completed? [PROG: SINGLE RESPONSE, FORCED]

1 8th grade or less

2 Some high school

3 High school graduate

5 Some college

6 4-year college degree

9 More than 4 year degree

98 Prefer not to answer

D4. Is the area in which you live a/an…?

[PROG: SINGLE RESPONSE, FORCED]

1 Rural area

2 Suburban area

3 Urban area

99 Don't know

D5 Which of the following best describes your health status? [PROG: SINGLE RESPONSE, FORCED]

1. Excellent

2. Very Good

3. Good

4. Fair

5. Poor

98 Prefer not to answer

EXIT. That concludes our survey. J.D. Power thanks you for participating.

© 2014 J.D. Power and Associates, McGraw-Hill Financial. All Rights Reserved. Page 7