Form CMS-10719 MACBIS Software Application Electronic Surveys for Users

MACBIS Software Application Electronic Surveys for Users (Survey Instrument)

PRA Disclosure Statement According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0938-1185 (CMS-10719). The time required to complete this information collection is estimated to average 5 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: CMS, 7500 Security Boulevard, Attn: PRA Reports Clearance Officer, Mail Stop C4-26-05, Baltimore, Maryland 21244-1850.

Question Title

* 1. Do you think <this CMS MACBIS software application> is useful for <CMS / State / Drug Manufacturer> interaction?

I would not use this product

I would not use this product.

I would use this regularly.

I believe this is valuable for someone else on our T-MSIS team.

I believe this is valuable for Medicaid directors and other executives.

It is helpful to see our state's data from CMS' perspective.

I would like to see more personalized information about our state

Other (please specify)

Question Title

* 2. What part of this new “feature” do you feel is most useful and why?

Note: this question will display in close placement to the new feature(s)

Question Title

* 3. What part of <this CMS MACBIS software application> do you feel is most useful and why?

Question Title

* 4. If you could build any feature you wanted on <this CMS MACBIS software application>, what would you want?

Question Title

* 5. Overall, how usable is <this CMS MACBIS software application>?

Very easy

Easy

Neither easy nor difficult

Difficult

Very difficult

If participating in User Acceptance Testing

Question Title

* 1. Did you feel that you had complete documentation to do the testing? (Select all that apply)

I would have preferred to have received the information earlier.

The document provided was helpful for testing.

The document provided was too complicated.

I would have preferred more guidance about expectations. 

The kickoff webinar was helpful in setting expectations. 

The kickoff webinar was too time-consuming.

Timelines were made clear.

Timelines were unclear.

Other Comments

Question Title

* 2. Was there enough communication during UAT? (Select all that apply)

I would have preferred a daily touch point.

I would have preferred no kickoff meeting.

CMS did not respond to my comments in a timely manner.

CMS was responsive.

I feel that my feedback was heard.

My questions were answered.

Other Comments

Question Title

* 3. Do you think this new feature is useful?

Note: this question will display in close placement to the new feature(s)

I would not use this product.

I would use this regularly.

I believe this is valuable for someone else on our team.

I believe this is valuable for Medicaid directors and other executives.

It is helpful to see our data from CMS' perspective.

I would like to see more personalized information.

Other Comments

Question Title

* 4. Thank you very much for participating in the <MACBIS software> UAT. Based on this experience... (Select all that apply)

I enjoyed having a preview of the product and being able to give feedback.

I would not want to participate in the future.

It was too time consuming.

I am interested in testing upcoming new features.

Other Comments

The following screenshots are to present look and feel of the electronic survey. Actual verbiage is documented in questions above.