Changes to 2016 NEHRS

Attachment B – Changes to 2016 NEHRS
Questions deleted
14. In which year did you install your current EHR system?
Year: ______________

17. What is the name of your current EHR system? CHECK ONLY ONE BOX. IF OTHER IS CHECKED,
PLEASE SPECIFY THE NAME.

□1
□2
□3
□4
□5

Allscripts
Community
Computer
Service, Inc.
athenahealth
Cerner

□6
□7
□8
□9

□11
□12

e-MDs
Epic
GE/Centricity
Eyefinity/
Officemate

□10 NextGen

□13

Sage/Vitera/
Greenway
Other, specify

_________________

□14

eClinical Works

Practice Fusion

Unknown

18. Has your practice made an assessment of the potential risks and vulnerabilities of your electronic
health information within the last 12 months? This assessment would help identify privacy- or
security-related issues that may need to be corrected.

□1

□2

Yes

□3

No

Unknown

20. Medicare and Medicaid offer incentives to practices that demonstrate “meaningful use of health IT.”
Have you ever applied for Meaningful Use Incentive Program payments?

□1
□2
□3
□4

Yes, at the reporting location
Yes, not at the reporting location
No
Unknown

21. Do you plan to apply for Meaningful Use Incentive Program payments in the future?

□1

Yes

□2

No

□3

Unknown

25. Does the reporting location participate in a Pay-for-Performance arrangement, where you can receive
financial bonuses based on your performance?

□1

Yes

□2

No

□3

Unknown

1

39. How do you search patient health information from outside sources? CHECK ALL THAT APPLY.

□1

EHR

□2

Web portal

□3

Other____________________

22. Indicate whether the reporting location has each of the
computerized capabilities listed below and how often these
capabilities are used. CHECK NO MORE THAN ONE BOX PER
ROW.

Yes,
Used
Routinely

Yes,
But Not
Used
Routinely

No

Unknown

c.

Recording and charting vital signs?

□1

□2

□3

□4

d.

Recording patient smoking status?

□1

□2

□3

□4

j1. Are orders sent electronically?

□1

□2

□3

□4

k1. Can the EHR automatically graph a specific patient’s lab results over
time?

□1

□2

□3

□4

o.

Reporting clinical quality measures to federal or state agencies (such as
CMS or Medicaid)?

□1

□2

□3

□4

r.

Electronic reporting to immunization registries?

□1

□2

□3

□4

2

Questions modified (questions in 2015 survey are in red; 2016 are in black)
22. At the reporting location, are you currently accepting new patients?

□1

□2

Yes

□3

No

Unknown

11. At the reporting location, are you currently accepting new patients?

□1
□2
□3

Yes
No (Skip to 13)
Don’t know (Skip to 13)

13. Does the reporting location use an electronic health record (EHR) system? Do not include billing
record systems.

□1
□2
□3
□4

Yes, all electronic
Yes, part paper and part
electronic
No
Unknown

}
}

Go to Question 14

Skip to Question 19

20. Does the reporting location use an EHR system?

□1
□2
□3

Yes
No

(Skip to 22)

Don’t know (Skip to 22)

15. Does your current EHR system meet meaningful use criteria as defined by the Department of Health
and Human Services?

□1

□2

Yes

□3

No

Unknown

21. Does your EHR system meet meaningful use criteria (certified EHR) as defined by the Department of
Health and Human Services?

□1

Yes

□2

No

□3

Don’t know

3

16. Does your EHR have the capability to electronically send health information to another provider
whose EHR system is different from your system? Do not include eFaxing.

□1

□2

Yes

•

No

□3

Unknown

Items below amends 2015 Q16 above to assess the sending to or receiving of patient health
information from another provider whose EHR system is different from the reporting location.

28. Do you electronically send patient health information to another provider whose EHR system is different

from your own?

□1 Yes
□2 No
□3 Don’t know
29. Do you electronically receive patient health information from another provider whose EHR system is

different from your own?

□1 Yes
□2 No
□3 Don’t know

4

22. Indicate whether the reporting location has each of the
computerized capabilities listed below and how often these
capabilities are used. CHECK NO MORE THAN ONE BOX PER
ROW.

Yes,
Used
Routinely

Yes,
But Not
Used
Routinely

No

Unknown

a.

Recording patient history and demographic information?

□1

□2

□3

□4

b.

Recording patient problem lists?

□1

□2

□3

□4

e.

Recording clinical notes?

□1

□2

□3

□4

f.

Recording patients’ medications and allergies?

□1

□2

□3

□4

g.

Reconciling lists of patient medications to identify the most accurate list?

□1

□2

□3

□4

h.

Providing reminders for guideline-based interventions or screening tests?

i.

Ordering prescriptions?

□1
□1

□2
□2

□3
□3

□4
□4

Skip to j

Skip to j

Are prescriptions sent electronically to the pharmacy?

□1

□2

□3

□4

□2
□2

□3
□3

□4
□4

j.

Ordering lab tests?

□1
□1

k.

Viewing lab results?

□1

l.

Ordering radiology tests?

□1

m. Viewing imaging results?

Are warnings of drug interactions or contraindications provided?

Skip to k

□2

Skip to k

□3

□4

Skip to l

Skip to l

□2

□3

□4

□1

□2

□3

□4

n.

Identifying educational resources for patients’ specific conditions?

□1

□2

□3

□4

p.

Identifying patients due for preventive or follow-up care in order to send
patients reminders?

□1

□2

□3

□4

q.

Generating lists of patients with particular health conditions?

□1

□2

□3

□4

s.

Providing patients with clinical summaries for each visit?

□1

□2

□3

□4

t.

Exchanging secure messages with patients?

□1

□2

□3

□4

Amended 2016 computerized capabilities items below - use the 2015 original questions above: the
computerized capabilities questions were grouped into categories: 1) basic computerized capabilities; 2) safety;
3) patient engagement; and 4) population management. The response categories were refined into “Yes”, “No”
or “Don’t Know”.


Item below amends 2015 Q22 above to assess whether the reporting location uses each of the
computerized capabilities listed.
5

23. Indicate whether the reporting location uses each of the computerized capabilities
listed below. CHECK NO MORE THAN ONE BOX PER ROW.
Does the reporting location use a computerized system to:

BASIC
COMPUTERIZED
CAPABILITIES

Yes

No

Don’t
know

Record patient history & demographic information?

□

□

□

Record patient problem list?

□

□

□

Record patients’ allergies and medications?

□

□

□

Record clinical notes?

□

□

□

View lab results?

□

□

□

View imaging reports?

□

□

□

□
□
□

□
□
□

□
□
□

Order lab tests?

□

□

□

Order radiology tests?

□

□

□

Provide reminders for guideline-based interventions or screening tests?

□

□

□

Reconcile lists of patient medications to identify the most accurate list?

□

□

□

Provide patients with clinical summaries for each visit?

□

□

□

Exchange secure messages with patients?

□

□

□

Identifying patients due for preventive or follow-up care?

□

□

□

Providing data to generate lists of patients with particular health
conditions?

□

□

□

Providing data to create reports on clinical care measures for patients with
specific chronic conditions (e.g., HbA1c for diabetics)?

□

□

□

Order prescriptions?
Are prescriptions sent electronically to the pharmacy?
Are warnings of drug interactions or contraindications provided?

SAFETY

PATIENT
ENGAGEMENT

POPULATION
MANAGEMENT

6

23. Has your reporting location been recognized as a Patient Centered Medical Home (PCMH) by a state, a
commercial health plan, or a national organization, such as the National Committee for Quality
Assurance (NCQA), the Joint Commission, URAC, or the Accreditation Association for Ambulatory
Health Care (AAAHC)?

□1

□2

Yes

□3

No

Unknown

17. Has your reporting location been recognized as a Patient Centered Medical Home (PCMH) by a state, a
commercial health plan, or a national organization, such as the National Committee for Quality
Assurance (NCQA), the Joint Commission, URAC, or the Accreditation Association for Ambulatory
Health Care (AAAHC)?

□1

□2

Yes

□3

No

Don’t know

24. Does the reporting location participate in an Accountable Care Organization (ACO) arrangement with
Medicare or private insurers? An ACO is an entity typically composed of primary care physicians,
specialists, and hospitals, and held financially accountable for the cost and quality of care delivered to a
defined group of patients.

□1

□2

Yes

□3

No

Unknown

18. Does the reporting location participate in an Accountable Care Organization (ACO) arrangement with
Medicare or private insurers? An ACO is an entity typically composed of primary care physicians,
specialists, and hospitals, and held financially accountable for the cost and quality of care delivered to a
defined group of patients.

□1

□2

Yes

□3

No

Don’t know

27. Roughly, what percent of your patients are insured by Medicaid?
_______________%

13. What percent of your patients are insured by Medicaid?
_______________%

28. Do you treat patients insured by Medicare?

□1

□2

Yes

□3

No

Unknown

14. Do you treat patients insured by Medicare?

□1

Yes

□2

No

□3

Don’t know

7

2015 NEHRS HIE items on referring patients and HIE.

29. Do you send patient health information to other providers and
public health agencies outside your medical organization using
the following methods of data transmission?
Paper-based method (e.g., mail, fax)
eFax
EHR (not eFax)
Web Portal (separate from EHR)

30. Do you receive patient health information from other providers
and public health agencies outside your medical organization
using the following methods of data transmission?
Paper-based method (e.g., mail, fax)
eFax
EHR (not eFax)
Web Portal (separate from EHR)



Yes

No

Uncertain

□1
□1
□1
□1

□2
□2
□2
□2

□3
□3
□3
□3

Yes

No

Uncertain

□1
□1
□1
□1

□2
□2
□2
□2

□3
□3
□3
□3

Item below amends 2015 Qs-29 and 30 above to assess how patient health data is shared with other
providers. Patient health information sharing was refined into two separate questions without listing
each type of data transmission in 2016: send and receive through paper-based methods; send or
receive patient health information electronically.

26. Do you ONLY send and receive patient health information through paper-based methods including
fax, eFax, or mail?

□1 Yes (Skip to
□2 No
□3 Don’t know

32)

27. Do you send or receive patient health information electronically? Electronically does not include
scanned or pdf documents from fax, eFax, or mail.

□1 Yes
□2 No (Skip to 32)
□3 Don’t know (Skip

to 32)

8

31. Do you refer patients to the following types of providers? If yes, how often do you send patient health
information electronically through either your EHR or web portal? Do NOT include eFax, fax, or other paperbased methods.
No

Yes

Often

Sometimes

Rarely

Never

Ambulatory care providers
outside your organization

□1

□2

□1

□2

□3

□4

Ambulatory care providers
within your organization

□1

□2

□1

□2

□3

□4

Hospitals unaffiliated with your
organization

□1

□2

□1

□2

□3

□4

Hospitals affiliated with your
organization

□1

□2

□1

□2

□3

□4

Behavioral Health providers

□1

□2

□1

□2

□3

□4

Long-term care providers

□1

□2

□1

□2

□3

□4



Item below amends 2015 Q31 above to assess how patient health data is sent to referrals.

24. Do you refer patients to the following

providers? If so, how do you send
patient health information to them?
Electronic does not include fax, eFax, or
mail.

No

Yes,
Yes,
Yes,
we
send
patient
we send patient
we send patient
health information health information health information
via paper-based
electronically
both electronically
methods
(EHR, webportal or
and via paper
online registries) (Fax, eFax, or mail)
based methods

Yes,
we do not
send patient
health
information
to the
provider

Ambulatory care providers outside your
organization

□

□

□

□

□

Ambulatory care providers within your
organization

□

□

□

□

□

Hospitals unaffiliated with your organization

□

□

□

□

□

Hospitals affiliated with your organization

□

□

□

□

□

Behavioral Health providers

□

□

□

□

□

Long-term care providers

□

□

□

□

□

9

32. Do you see patients that have received care from the following types of providers? If yes, how often do you
receive patient health information electronically through either your EHR or web portal? Do NOT include
eFax, fax, or other paper-based methods.
No

Yes

Often

Sometimes

Rarely

Never

Ambulatory care providers
outside your organization

□1

□2

□1

□2

□3

□4

Ambulatory care providers
within your organization

□1

□2

□1

□2

□3

□4

Hospitals unaffiliated with your
organization

□1

□2

□1

□2

□3

□4

Hospitals affiliated with your
organization

□1

□2

□1

□2

□3

□4

Behavioral Health providers

□1

□2

□1

□2

□3

□4

Long-term care providers

□1

□2

□1

□2

□3

□4



Item below amends 2015 Q32 above to assess how patient health data is received from patients at the
reporting location.

25. Do you see patients from the following

providers? If so, how do you receive
patient health information from them?
Electronic does not include fax, eFax, or
mail.

No

Yes,
Yes,
Yes,
Yes,
we do not
we receive patient we receive patient
we receive patient
receive
health information health information health information
patient
via paper-based
electronically
both electronically
health
methods
(EHR, webportal or
and via paper based information
online registries) (Fax, eFax, or mail)
methods
from the
provider

Ambulatory care providers outside your
organization

□

□

□

□

□

Ambulatory care providers within your
organization

□

□

□

□

□

Hospitals unaffiliated with your organization

□

□

□

□

□

Hospitals affiliated with your organization

□

□

□

□

□

Behavioral Health providers

□

□

□

□

□

Long-term care providers

□

□

□

□

□
10

35. When treating patients seen by other providers outside your medical organization, how often do you
or your staff have clinical information from those outside encounters electronically available at the
point of care? Electronically available does not include scanned or PDF documents.

□1
□5

Often
Uncertain

□2

Sometimes

□6

□3

Rarely

□4

Never

I do not see patients outside my medical organization

34. When treating patients seen by other providers outside your medical organization, how often do you
or your staff have clinical information from those outside encounters electronically available at the
point of care? Electronically available does not include scanned or PDF documents.

□1
□5

Often
Don’t Know

□2

Sometimes

□6

□3

Rarely

□4

Never

I do not see patients outside my medical organization

36. Do you have the capability to electronically search for your patient’s health information from sources
outside of your medical organization (e.g. remote access to other facility, health information
exchange organization)?

□1

Yes

□2

No (Skip to 40)

□3

Uncertain (Skip to 40)

35. Do you electronically search for your patient’s health information from sources outside of your
medical organization (e.g. remote access to other facility, health information exchange organization)?

□1

Yes (Go to 36)

□2

No (Skip to 41)

□3

Don’t Know (Skip to 41)

11

37. What type of patient health information do you routinely search for from sources outside your
medical organization? CHECK ALL THAT APPLY.

□1

Lab results

□2

Patient problem lists

□3

Imaging reports

□4

Medication lists

□5

Medication allergy lists

□6

Discharge summaries

□7 Other___________________

37. Do you routinely search for the following patient
health information from sources outside your
medical organization?
Yes

No

Lab results

□

□

Patient problem lists

□

□

Imaging reports

□

□

Medication lists

□

□

Medication allergy list

□

□

Discharge summaries

□

□

Vaccination history

□

□

Advance directives

□

□

Care plans

□

□

12

38. How often do you electronically search for health information from sources outside of your medical
organization when seeing a new patient or an existing patient who has received services from other
providers?

□1

Always

□2

Often

□3

Sometimes

□4

Rarely

□5

Never (Skip to 40)

36. How often do you electronically search for health information from sources outside of your medical
organization when seeing a new patient or an existing patient who has received services from other
providers?

□1

Always

□2

Often

□3

Sometimes

□4

Rarely

□5

Never

13

Questions added
Content below in red was approved and asked on the 2015 NEHRS (Q33), and black is new content
proposed on the 2016 NEHRS.
30. For providers outside of your medical
organization, do you electronically send and
receive, send only, or receive only the following
types of patient health information?
Medication lists
Patient problem lists
Medication allergy lists
Imaging reports
Laboratory results
Public health registry data (e.g., immunizations, cancer)
Clinical registries

Do not Send
Both Send
Send
Receive
or Receive
and Receive Electronically Electronicall
Electronicall
Electronically
Only
y Only
y

□1
□1
□1
□1
□1
□1
□1

□2
□2
□2
□2
□2
□2
□2

□1

□2

Hospital discharge summaries
Emergency Department notifications
Summary of care records for transitions of care or referrals
Patient-generated data (e.g. data from self-monitoring

devices or mobile health applications)

□3
□3
□3
□3
□3
□3
□3
□3
□3
□3

□4
□4
□4
□4
□4
□4
□4
□4
□4
□4

□3

□4

Content below in red was approved and asked on the 2015 NEHRS (Q34), and black is new content
proposed on the 2016 NEHRS.
30. When electronically receiving information from
other providers, do you integrate the following
types of patient health information into your EHR
without special effort like manual entry or
scanning?

Yes

No

Don’t know

Not
Applicable

Medication lists

□1

□2

□3

□4

Patient problem lists

□1

□2

□3

□4

Medication allergy lists

□1

□2

□3

□4

Imaging reports

□1

□2

□3

□4

Laboratory results

□1

□2

□3

□4

Public health registry data (e.g., immunizations, cancer)

□1

□2

□3

□4

Referrals (e.g., referral requests or reports)

□1

□2

□3

□4

Hospital discharge summaries

□1

□2

□3

□4

Emergency Department notifications

□1

□2

□3

□4
14

Summary of care records for transitions of care or referrals
Patient-generated data (e.g. data from self-monitoring

devices or mobile health applications)

□1

□2

□3

□4

□1

□2

□3

□4

Content below in red was approved and asked on the 2015 NEHRS (Q22 u, v, w), and black is new content
proposed on the 2016 NEHRS.

32. Can patients seen at the reporting location do the following
online activities? Can patients…
View their medical record online?
Download health information from their electronic medical record to their
personal files?
Transmit health information from their electronic medical record to a
designated third party of their choice (e.g. another provider)?
Request corrections to their electronic medical record?
Enter their health information online (e.g., weight, symptoms)?
Upload their data from self-monitoring devices (e.g., blood glucose readings)?

Yes

□
1□
1

□
1□
1□
1□
1

No

Don’t Know

□
2□

□
3□

2

3

□
2□
2□
2□

□
3□
3□
3□

2

3

15

Content below in red was approved and asked on the 2015 NEHRS (Q40), and black is new content
proposed on the 2016 NEHRS.

41. To what extent do you agree or disagree with the
following statements.

Strongly
Agree

Somewhat Somewhat
Agree
Disagree

Strongly
Disagree

Not
Applicable

Electronic information exchange with providers outside
my organization gives me access to the patient health
information I need.

□1

□2

□3

□4

□5

Electronically sending clinical information to providers
outside my organization is easy to do using my EHR.

□1

□2

□3

□4

□5

Electronically receiving clinical information from other

□1

□2

□3

□4

□5

Electronic information exchange with providers outside
my organization improves my ability to coordinate care for
my patients.

□1

□2

□3

□4

□5

Electronic information exchange with other providers
reduces duplicate test ordering.

□1

□2

□3

□4

□5

Electronic information exchange with providers outside
my organization is cumbersome to do with our EHR.

□1

□2

□3

□4

□5

Electronic information exchange with providers outside
my organization prevents medication errors.

□1

□2

□3

□4

□5

Electronic information exchange with providers outside
my organization is difficult because providers in my
referral network do not have the capability to exchange
data electronically.

□1

□2

□3

□4

□5

Electronic information exchange with providers outside
my organization provides me with clinical information that
I can trust.

□1

□2

□3

□4

□5

Electronic information exchange with providers outside
my organization increases my practice’s vendor costs.

□1

□2

□3

□4

□5

providers is easy to do using my EHR

16

NEW CONTENT: Below was not asked prior NEHRS questionnaire. These questions are important to
the goal of ONC.

15. Is this medical organization affiliated with an Independent Practice Association (IPA) or Physician
Hospital Organization (PHO)?

□1

Yes

□2

No

□3

Don’t know

19. Estimate the approximate number of years you have used any electronic health record (EHR) system?
Do not include billing record systems.

□ Never used an EHR system
□ Under 1 year
□ ________year(s)

33. Within the last 30 days has your EHR system…

Yes

No

□

2

□

2

□

2

□

2

□

2

□

2

□

2

□

2

□

2

□

2

□

2

□

2

Alerted you to a potential medication error?

1

Led to a potential medication error?

1

Inadvertently led you to select the wrong medication or lab order from a list?

1

Led to less effective communication during patient visits?

1

Made it difficult for you to find clinical content needed for medical decision
making?

1

Sent you too many alerts, causing you to overlook something important?

1

Alerted you to critical lab values?

1

Reminded you to provide preventive care (e.g., vaccine, cancer screening)?

1

Reminded you to provide care that meets clinical guidelines for patients with
chronic conditions?

1

Facilitated direct communication with a patient (e.g., email or secure
messaging)?

1

Facilitated direct communication with other providers who are part of your
patient care team?

1

Enhanced overall patient care?

1

Not
Applicable

□

3

□

□

3

□

3

□

3

□

3

□

3

□

3

□

3

□

3

□

3

□

3

□

3

□
□
□
□
□
□
□
□
□
□
□

17

38. How often do you use electronically received patient health information from outside of your medical
organization to manage your patient population?

□1

Often

□2

Sometimes

□3

Rarely

□4

Never

□5

Don’t know

39. Do you prescribe controlled substances?

□1

Yes

□2

No (Skip to 41)

□3

Don’t Know (Skip to 41)

40. Are prescriptions for controlled substances sent electronically to the pharmacy?

□1

Yes

□2

No

□3

Don’t Know

18