2014 EHR Survey (Expanded)

The National Ambulatory Medical Care Survey (NAMCS) National Electronic Health Record Survey (NEHRS)

Att D_ 2014 EHR survey_Extension_FINAL formatted

2014 EHR Survey (Expanded)

OMB: 0920-1015

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0920-1015 can be found here:

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National Electronic Health Records Survey

Attachment D
OMB No

NOTICE - Public reporting burden of this collection of information is estimated to average 30 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, MS D-74, Atlanta, GA 30333, ATTN: PRA (0920-0234).
Assurance of Confidentiality - All information which would permit identification of an individual, a practice, or an establishment will be held confidential,
will be used only by NCHS staff, contractors, and agents only when required and with necessary controls, and will not be disclosed or released to other
persons without the consent of the individual or the establishment in accordance with section 308(d) of the Public Health Service Act (42 USC 242m)
and the Confidential Information Protection and Statistical Efficiency Act (PL-107-347).

National Electronic Health Records Survey 2014
The National Electronic Health Records Survey is affiliated with the National Ambulatory Medical Care Survey (NAMCS). The
purpose of the survey is to collect information about the adoption of electronic health records/electronic medical records
(EHRs/EMRs) in ambulatory care settings. Your participation is greatly appreciated. Your answers are completely confidential.
Participation in this survey is voluntary. If you have questions or comments about this survey, please call 866-966-1473.

1. We have your specialty as:

4. Do you see ambulatory patients in any of the
following settings? CHECK ALL THAT APPLY.

□
2□
1

Is that correct?

□1
□2

Yes
No

What is your specialty?

□

_______________________________________
This survey asks about ambulatory care, that is, care
for patients receiving health services without admission
to a hospital or other facility.

□
5□
4

2. Do you directly care for any ambulatory patients in
your work?

□1

Yes

Continue to Question 3

□2

Please stop here and
return the questionnaire
in the envelope provided.
Thank you for your time.

□3

I am no longer
in practice

}

□

The next question asks about a normal week.
We define a normal week as a week with a normal caseload,
with no holidays, vacations, or conferences.
3. Overall, at how many office locations (excluding
hospital emergency or hospital outpatient
departments) do you see ambulatory patients in a
normal week?

□

__________ locations

Private solo or group practice
Freestanding clinic/urgicenter (not
part of a hospital outpatient
department)
Community Health Center (e.g.,
Federally Qualified Health Center
(FQHC), federally funded clinics or
“look-alike” clinics)
Mental health center

If you see
patients in
any of
these
settings,
go to
question 5

Non-federal government clinic (e.g.,
state, county, city, maternal and child
health, etc.)
Family planning clinic (including
Planned Parenthood)
Health maintenance organization or
other prepaid practice (e.g., Kaiser
Permanente)
Faculty practice plan (An organized
group of physicians that treats
patients referred to an academic
medical center)

Hospital emergency or hospital
outpatient departments
None of the above

}

If you
select only
9 or 10,
go to Q41

For the remaining questions, please answer regarding the reporting location indicated in question 5
even if it is not the location where this survey was sent.
5.

At which of the settings (1-8) in question 4 do you see the most ambulatory patients?
WRITE THE NUMBER LOCATED NEXT TO THE BOX YOU CHECKED.

__________ (For the rest of the survey, we will refer to this as the “reporting location.”)
6.

What are the county, state, zip code, and telephone number of the reporting location?
Country
Zip Code

USA

County
Telephone

State
(

)

National Electronic Health Records Survey
12a In which year did you install your current
EHR/EMR system?
Year: ______________

7. How many physicians, including you, work at the
reporting location? ___________
7a

□1
□2
□3

How many physicians, including you, work at
this practice (including physicians at the
reporting location, and physicians at any other
locations of the practice)?

□4
□5
□6

1 physician
2-3 physicians
4-10 physicians

□1

11-50 physicians

□2

Single

More than 100 physicians

Multi

Yes

}

Unknown

Skip to Question 11

10a If yes, from those new patients, which of the
following types of payment do you accept?
Yes
1. Private insurance capitated
2. Private insurance non-capitated
3. Medicare
4. Medicaid/CHIP
5. Workers’ compensation
6. Self pay
7. No charge

□1
□1
□1
□1
□1
□1
□1

No Unknown

□2
□2
□2
□2
□2
□2
□2

□3
□3
□3
□3
□3
□3
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11. Does the reporting location submit any claims
electronically (electronic billing)?

□1

Yes

□2

□3

Unknown

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

□1
□2
□3
□4

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

}
}

Unknown

□6
□7
□8
□9

Allscripts
Amazing
Charts
athenahealth
Cerner

□11 NextGen
□12 Practice Fusion
□13 Sage/Vitera
□14 Other, specify

e-MDs
Epic
GE/Centricity
Greenway
Medical

□10 McKesson/

eClinicalWorks

__________________

□15 Unknown

12d 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.

Go to Question 10a

□3

Practice
Partner

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

□1
□2
□3

□1
□2
□3
□4
□5

9. How many mid-level providers (i.e., nurse
practitioners, physician assistants, and nurse
midwives) are associated with the reporting
location?
__________ mid-level providers

□2

Yes

12c What is the name of your current EHR/EMR
system? CHECK ONLY ONE BOX. IF OTHER IS
CHECKED, PLEASE SPECIFY THE NAME.

51-100 physicians

8. Is the reporting location a single- or multi-specialty
(group) practice?

□1

12b Does your current system meet meaningful use
criteria as defined by the Department of Health
and Human Services?

Go to Question 12a

□1

□2

Yes

□3

Unknown

12e Does your EHR have the capability to
electronically send health information to
another provider whose EHR system is
different from your system?

□1

□2

Yes

□3

Unknown

13. At the reporting location, are there plans for
installing a new EHR/EMR system within the next 18
months?

□1

□2

Yes

□3

Maybe

□4

Unknown

14. Medicare and Medicaid offer incentives to practices
that demonstrate “meaningful use of health IT.” At
the reporting location, are there plans to apply for
Stage 1 of these incentive payments?

□1 Yes, we already applied
□2 Yes, we intend to apply
□3 Uncertain if we will apply
□4 No, we will not apply

Go to Question 14a

}

Skip to Question 15

14a Are there plans to apply for Stage 2 incentive
payments?
Skip to Question 13

□1

Yes

□2

□3

Maybe

□4

Unknown
2

National Electronic Health Records Survey
15. 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.
15a Recording patient history and demographic
information?
15b Recording patient problem list?
15c Recording and charting vital signs?
15d Recording patient smoking status?
15e Recording clinical notes?
15f Recording patient’s medications and allergies?
15g Reconciling lists of patient medications to
identify the most accurate list?
15h Providing reminders for guideline-based
interventions or screening tests?
15i

Ordering prescriptions?
15i1 Are prescriptions sent electronically to the
pharmacy?
15i2 Are warnings of drug interactions or
contraindications provided?
15i3 Are drug formulary checks performed?

15j

Ordering lab tests?
15j1 Are orders sent electronically?

15k Viewing lab results?
15k1 Can the EHR/EMR automatically graph a
specific patient’s lab results over time?
15l

Ordering radiology tests?

15m Viewing imaging results?
15n Identifying educational resources for patients’
specific conditions?
15o Reporting clinical quality measures to federal or
state agencies (such as CMS or Medicaid)?
15p Identifying patients due for preventive or followup care in order to send patients reminders?
15q Generating lists of patients with particular health
conditions?
15r Electronic reporting to immunization registries?
15s Providing patients with clinical summaries for
each visit?
15t Exchanging secure messages with patients?
15u Providing patients the ability to view online,
download or transmit information from their
medical record?

Yes,
used
routinely

Yes,
but not
used
routinely

Yes,
but turned
off or not
used

Unknown

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Skip to 15j

Skip to 15j Skip to 15j

Skip to 15k Skip to 15k Skip to 15k

□3
□3

Skip to 15l

□4
□4

□5
□5

Skip to 15l Skip to 15l

The next questions are about sharing (either sending or receiving) patient health information.
3

National Electronic Health Records Survey
16. Do you refer any of your patients 16a Do you send the patient’s clinical
to providers outside of your
information to the other
providers?
office or group?

□1
□2

Yes  Go to Question 16a 
No  Skip to Question 17

17. Do you see any patients referred
to you by providers outside of
your office or group?

□1
□2
□3

16b Do you send it electronically
(not fax)?

Yes, routinely
Yes, but not routinely
No  Skip to Question 17

□1
□2
□3

Yes, routinely
Yes, but not routinely
No

17a Do you send a consultation report 17b Do you send it electronically
with clinical information to the
(not fax)?
other providers?
1 Yes, routinely
1 Yes  Go to Question 17a 
1 Yes, routinely
2 Yes, but not routinely
2 Yes, but not routinely
3 No
2 No  Skip to Question 18
3 No  Skip to Question 18

□
□

□
□
□

18. Do you take care of patients after 18a Do you receive a discharge
18b Do you receive it
they are discharged from an
summary with clinical information
electronically (not fax)?
from the hospital?
inpatient setting?
1 Yes, routinely
1 Yes  Go to Question 18a 
1 Yes, routinely
2 Yes, but not routinely
2 Yes, but not routinely
3 No  Skip to
2 No  Skip to Question 19
3 No  Skip to Question 19
Question 19

□
□

□
□
□

18c Can you automatically incorporate the received information into your
EHR system without manually entering the data?

□1

Yes

□2

□3

Not applicable, I do not have an EHR system

19. Do you share any patient health information (e.g., lab results, imaging reports, problem lists, medication lists)
electronically (not fax) with any other providers, including hospitals, ambulatory providers, or labs?

□1

□2

Yes  Go to Question 19a

No  Skip to Question 21

19a How do you electronically share patient health information? CHECK ALL THAT APPLY.

□1
□3

□2

EHR/EMR

Web portal (separate from EHR/EMR)

Other electronic method (not fax) ____________________

19b Is the patient health information that you share electronically sent directly from your EHR system to
another EHR system?

□1

Yes, routinely

□2

Yes, but not routinely

□3

□4

Unknown

19c With what types of providers do you electronically share patient health information?
CHECK ALL THAT APPLY.

□1
□2
□3
□4

19d To what extent do you agree or disagree with the
following statements about electronic
information exchange?
“Electronically exchanging clinical information
with other providers…”
a. …improves my practice’s quality of care.
b. …increases my practice’s efficiency.
c.

□5
□6
□7

Ambulatory providers inside your office/group
Ambulatory providers outside your office/group
Hospitals with which you are affiliated
Hospitals with which you are not affiliated

...increases my practice’s vendor costs.

d. …requires multiple systems or portals.
e. …increases my practice’s liability due to other
providers lacking adequate safeguards.
f. …decreases my ability to separate sensitive health
information from other data being exchanged.

Strongly
Agree

□
1□
1□
1□
1

Behavioral health providers
Long-term care providers
Home health providers

Somewhat Somewhat Strongly
Agree
Disagree Disagree

□
2□
2□
2□
2

□

1
1

□
3□
3□
3□
3

□

□
4□
4□
4□
4

□

Uncertain

□
5□
5□
5□
5

□

□
4

National Electronic Health Records Survey
20. Please indicate which types of health
data you share electronically (not fax)
with the health care providers listed to
the right. CHECK ALL THAT APPLY.

Hospitals with
which you are
affiliated

Ambulatory
providers inside
your office/group

Hospitals with
which you are
not affiliated

Ambulatory
providers outside
your office/group

□1
□1
□1
□1
□1

□2
□2
□2
□2
□2

□3
□3
□3
□3
□3

□4
□4
□4
□4
□4

Lab results

Imaging reports

Patient problem lists

Medication lists

Medication allergy lists

Do you share any of the above types of information using a “Summary Care Record”?
Summary Care Records are electronic files that contain the above health data in a standardized format.

□1 Yes

□2 No

□3 Unknown

21. Who owns the reporting location? CHECK ONE.

□1

□4

□3

□6
□7

Physician or physician
group
□2 Insurance company,
health plan, or HMO

Medical/academic health
center
□5 Other hospital

Community health center

Other health care corporation

22. Roughly, what percent of your patients
are insured by Medicaid?
_______________%
23. Do you treat patients insured by
Medicare?

Other

24. Over the past year at the reporting location, has
practice revenue…
Was this due, in
□1 Increased
part, to the EHR?
□1 Yes
□2 Decreased
□2 No
□3 Stayed about the same
□3 Uncertain
□4 N/A
□4 Uncertain (Go to 25)

}

□1

Yes

□2

□3

Unknown

25. Over the past year at the reporting location, have
practice office visits…
Was this due, in
□1 Increased
part, to the EHR?
□1 Yes
□2 Decreased
□2 No
□3 Stayed about the same
□3 Uncertain
□4 N/A
□4 Uncertain (Go to 26)

}

26. Does the reporting location receive additional compensation beyond routine visit fees for providing Patient
Centered Medical Home (PCMH) type services or for participating in a certified PCMH arrangement?

□1

Yes

□2

□3

Uncertain

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

□1

Yes

□2

□3

Uncertain

28. Does the reporting location participate in an Accountable Care Organization or similar arrangement where
you may share savings with insurers (including private insurance, Medicare, Medicaid, and other public
options)?

□1

Yes

□2

□3

Uncertain

29. Can patients seen at the reporting location do any of the following
online activities?
a. View test results online
b. Request referrals online
c. Request refills for prescriptions online
d. Request appointments online
e. Enter health information online (e.g., weight, symptoms)
f. Ask the provider questions online
g. Upload data from self-monitoring devices (e.g., blood glucose readings)

Yes

□
1□
1□
1□
1□
1□
1□
1

□
2□
2□
2□
2□
2□
2□
2

Uncertain

□
3□
3□
3□
3□
3□
3□
3

National Electronic Health Records Survey
30. Estimate the approximate number of years you have used any EHR system.

□1

□2

Never used an EHR system

□3

Under 1 year

_______________year(s)

If you USE an EHR system continue to Question 31.
If you DO NOT USE an EHR system skip ahead to Question 40.
31. EHR systems can support administrative and clinical needs. Does your practice use more than one EHR
system to meet its clinical needs?

□1 Yes, we use more than one EHR system
□2 No, we do not use more than one EHR system
32. To what extent do you agree or disagree that your current EHR system(s) meet(s) your practice’s clinical
needs?

□1
□2

□3
□4

Strongly Agree
Somewhat Agree

Somewhat Disagree
Strongly Disagree

33. Estimate the approximate number of EHR systems (i.e., not system updates) your practice has used over the
past 10 years.

□1
□2
□3

□4
□5

1 EHR system
2 EHR systems

6 or more EHR systems
Uncertain

3 to 5 EHR systems

34. Has your practice had to decide between buying necessary medical equiment and buying your EHR system?

□1

Yes

□2

35. Indicate the level of ease or difficulty for each of the
following tasks. If the EHR does not have the
function, mark Not Applicable.
How easy or difficult is it to use your EHR for…

□3

Uncertain

Very
Easy

a. Identifying patients due for preventive or follow-up
care?

b. 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)?

□

d. Exchanging secure messages with patients?

e. Providing patient summaries for each visit?

Providing patients the ability to view their medical
information?

g. Electronically (not fax) receiving clinical information
from other providers?

h. Electronically (not fax) receiving discharge
summaries from the hospital?

Electronically (not fax) sending patient health
information to another provider treating your patient?

Somewhat Somewhat
Easy
Difficult

□

Very
Not
Difficult Applicable

□

□
□
□
□
□
□
□
□
6

National Electronic Health Records Survey
36. Indicate the extent to which you agree or disagree with the
following statements about using your EHR system:

Strongly
Agree

□

a. Overall, my practice has optimized the use of its EHR system.

b. The time spent ordering medical services has increased.

My practice receives lab results faster.

d. The time spent reviewing patient information has increased.

e. My EHR produces clinical benefits for my practice.

Overall, my EHR saves me time.

Somewhat Somewhat
Agree
Disagree

g. The time spent documenting patient care has increased.

h. Overall, my practice functions more efficiently with an EHR
system.

My EHR disrupts the way I interact with my patients.

My EHR allows me to deliver better patient care.

Health information is less secure in my EHR system than a
paper-based system.

My EHR enhances patient data confidentiality.

m. My EHR produces financial benefits for my practice.

n. Use of my EHR results in incomplete billing for services.

o. Overall, the benefits of having an EHR outweigh its cost.

□

Strongly
Disagree

□

□
□
□
□
□
□
□
□
□
□
□
□
□
□

National Electronic Health Records Survey
Yes, within Yes, but not
37. This question is about the ways that an EHR system might
Not
within the Not at all
have affected your reporting location. Has your EHR system: the past 30
Applicable
days
past 30 days

□

a. Alerted you to a potential medication error?

b. Led to a potential medication error?

Alerted you to critical lab values?

d. Led to less effective communication during patient visits?

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

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

g. Helped you order fewer tests due to better availability of lab
results?

h. Helped you order more on-formulary drugs?

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

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

Helped you access a patient’s chart remotely (e.g., to work
from home)?

Helped you access a patient’s chart through your personal
device (e.g., smart phone, tablet)?

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

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

o. Enhanced overall patient care?

38. Overall, how satisfied or dissatisfied are you with
your EHR system?

□
2□
3□
4□
1

Very satisfied
Somewhat satisfied
Somewhat dissatisfied

□

□
□
□
□
□
□
□
□
□
□
□
□
□
□

39. Would you purchase this EHR again?

□
2□
3□
1

Yes
No
Uncertain

Very dissatisfied

40. What is a reliable E-mail address for the physician to whom this survey was mailed?
@
41. Who completed this survey?

□1

The physician to whom it was addressed

Thank you for your participation. Please return your survey in the
envelope provided. If you have misplaced the envelope, please send the
survey to: 2605 Meridian Parkway, Suite 200, Durham, NC 27713.

□2

Office staff

□3

Other

Boxes for Admin Use

File Type	application/pdf
File Title	Final 2012 EHR Survey
Author	Timothy Struttmann
File Modified	2014-04-02
File Created	2014-03-11