Form CMS-10590 QualityNetPortal_UserSurvey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (CMS-10415)

CMS-10590.QualityNet_User_Survey_101615

QualityNet.org and QualityNet Secure Portal Customer Satisfaction and Task Prioritization Survey for Phase 1 of the QualityNet Portal (QNP) redesign project (CMS- 10590)

OMB: 0938-1185

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Introductory Email:



Subject Line: Request for your feedback on QualityNet.org and QualityNet Secure Portal

The Centers for Medicare and Medicaid (CMS) is improving the user experience of QualityNet.org and the QualityNet Secure Portal and invites you participate in a survey that will help us in this process. Your opinion and experience are important in defining future improvement efforts.

Your survey responses are anonymous, and will help CMS evaluate and improve QualityNet.org and the QualityNet Secure Portal. The survey should take approximately 10 minutes to complete. Please only complete the survey once, and provide your feedback by [INSERT DATE].

Thank you!

QualityNet User Survey – DRAFT



Thank you for your participation in the QualityNet.org and QualityNet Secure Portal survey!

The Centers for Medicare and Medicaid (CMS) is improving the user experience of QualityNet.org and the QualityNet Secure Portal. Your opinion and experience matter to us.

Your responses are anonymous, and will help CMS evaluate and improve QualityNet.org and the QualityNet Secure Portal. The survey should take approximately 10 minutes to complete.

Thank you!



  1. What type of facility do you represent? (radio buttons, multiple answers)

    1. Inpatient Hospital

    2. Outpatient Hospital

    3. Ambulatory Surgical Center

    4. Physician’s Office

    5. PPS-Exempt Cancer Hospital

    6. ESRD Facility

    7. Inpatient Psychiatric Facility

    8. Quality Improvement Organization

    9. Other __________________________



  1. What is your quality program affiliation? (radio buttons, multiple answers)

    1. Inpatient Hospital Quality Reporting Programs (IHQR)

    2. Outpatient Hospital Quality Reporting Programs (OHQR)

    3. Physician Quality Reporting Program (PQRS)

    4. Ambulatory Surgical Center Quality Reporting Program (ASC)

    5. PPS-Exempt Cancer Hospital Quality Reporting Program

    6. ESRD Quality Incentive Program (QIP)

    7. Inpatient Psychiatric Facility Quality Reporting Program (IPFQR)

    8. Quality Improvement Organization (QIO)

    9. Other ____________________________

[PAGE BREAK]



QualityNet.org

  1. How frequently do you visit QualityNet.org? (radio buttons, one answer)

    1. Daily

    2. Weekly

    3. Monthly

    4. Quarterly

    5. Annually

    6. I don’t visit QualityNet.org


  1. Please look at the following list and choose the top 5 reasons that you visit QualityNet.org.
    Give a score of 1 to the MOST IMPORTANT to you, 2 to the next most important, then 3, 4, and 5. Please give ONLY one score of 1, one 2, one 3, one 4, and one 5. Leave the rest blank.
    Please trust your first instincts and spend no more than a couple of minutes on this question.

    Rank



    Program overview


    Benchmarks of care


    Specification manuals


    Measure(s) information


    Program requirements and eligibility


    Program reporting timelines


    Program news (alerts, notifications, known issues)


    E-mail notifications


    Training and events (videos, user guides, recorded webinars)


    HelpDesk contact information


    QualityNet Secure Portal registration information


    Log in link to the QualityNet Secure Portal


    Data collection and CART


    Program forms (reconsideration, etc.)


    Question & Answer tools


    Program support contact information


    QIO contact information


    Other __________________________

  2. Please select the appropriate answer below based on your experience(s) with QualityNet.org.


Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

Not Applicable

QualityNet.org is fast and easy-to-use.







I can quickly and easily find the information I need on QualityNet.org.







QualityNet.org is organized in a way that makes sense to me.







I am able to find the most up-to-date information about my quality reporting program on QualityNet.org.







QualityNet.org meets my expectations.









Additional comments on QualityNet.org: (open text field, 1,000 character limit)

[PAGE BREAK]

QualityNet Secure Portal

  1. How frequently do you log in and access QualityNet Secure Portal? (radio buttons, one answer)

    1. Daily

    2. Weekly

    3. Monthly

    4. Quarterly

    5. Annually

    6. I don’t use QualityNet Secure Portal


  1. Do you have an active QualityNet Secure Portal log in? (radio buttons, one answer)

    1. Yes

    2. No

    3. I’m not sure



  1. Please look at the following list and choose the top 5 reasons that you use the QualityNet Secure Portal.
    Give a score of 1 to the MOST IMPORTANT to you, 2 to the next most important, then 3, 4, and 5. Please give ONLY one score of 1, one 2, one 3, one 4, and one 5. Leave the rest blank.
    Please trust your first instincts and spend no more than a couple of minutes on this question.

Rank

Reason


Secure file transfer to CMS


Secure email (send, receive)


Vendor authorization


Report authorization


Collab tool


CCSQ data dictionary


Measure selection intention


Denominator declaration


Notice of participation


Population and sampling


Manage measures


Manage multifactor credential


Edits contacts or campuses


Data submission


Reports (run, search)


Update account password


Update my account


News and announcements


Other _________________________







  1. Please select the appropriate answer below based on your experience(s) with QualityNet Secure Portal


Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

Not Applicable

Logging into QualityNet Secure Portal is clear and easy.







I find it difficult to navigate through QualityNet Secure Portal.







Navigation links and labels are clear and concise in QualityNet Secure Portal.







I can easily switch back and forth between QualityNet.org and QualityNet Secure Portal.







QualityNet Secure Portal meets my expectations.









Additional comments on QualityNet Secure Portal: (open text field, 1,000 character limit)



[PAGE BREAK]

  1. If you could choose one thing to improve about QualityNet.org or the QualityNet Secure Portal, what would it be? (open text field, 1,000 character limit)

[PAGE BREAK]




More Information (Optional)

  1. What is your gender? (radio buttons, one possible answer, optional)

  1. Male

  2. Female


  1. How old are you? (radio buttons, one possible answer, optional)

  1. 25 or younger

  2. 26-35

  3. 36-45

  4. 46-55

  5. 56-65

  6. 66 or older


  1. Which of these accessibility features do you use?

  1. Screen reader

  2. Enlarged text

  3. High-contrast display

  4. I don’t use any accessibility features

  5. Other _____________





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