CQM Partner Site-level Interview Guide

Form Approved

OMB No. 0920-xxxx

Exp. Date XX/XX/20XX

4c. CQM Partner Site-Level Interview Guide

Note: Public reporting burden of this collection of information is estimated to average 1 hour 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 Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-20HP)

Date of Interview:
Interviewer:
Organization Name
Organization Type
State
Organization City		Zip Code
Strategies Implemented (select all that apply):	☐ B1 ☐ B2
Interviewee Name:		Position/Title

Introduction

Thank you for taking the time to participate in this interview. My name is [Insert name] and I am with the Deloitte evaluation team. Our team is working with the CDC Division for Heart Disease and Stroke Prevention. We understand your organization has been receiving support from the [insert state] health department to support the promotion of clinical quality measurement activities, specifically for the prevention, diagnosis, and management of cardiovascular disease. This support is provided to you under a CDC-funded project. CDC has hired Deloitte Consulting to evaluate this project to better understand how clinical quality measurement supports client care, as it relates to the prevention and management of high blood pressure and high blood cholesterol. We also want to understand what type of support the health department is providing to your organization and what you’ve found to be most valuable support to promote clinical quality measurement.

The information collected from this interview will be analyzed together with information gained from interviews with others within your organization as well as from other healthcare organizations. We also will be conducting interviews with the state health department. Together, these interviews will provide valuable insights on different approaches for promoting use of electronic health records and health information technology for clinical quality measurement and improved client management, and help us understand which approaches seem to work well in specific contexts.

The interview will take no longer than 1 hour. Your participation in this interview is completely voluntary. You may choose to skip questions or stop the interview at any time and it will not in any way impact the funding or technical assistance you receive from the health department or CDC. All information will be kept secure and any personally-identifiable information will be removed when results are aggregated for analysis.

If at any time during the interview you are not clear about what we’re asking, be sure to let me know. We appreciate your candid response.

With your permission, we would like to record this interview for transcription purposes.

Do we have your permission to record?

☐ Yes

☐ No

Do you have any questions or concerns before we start the interview?

I. Background

I’d like to start with some questions to understand [name of organization] and your role within the organization.

1. Can you tell me about your organization and the populations that it serves, specifically for cardiovascular related diseases?

Probe:

• What is the socioeconomic landscape of the clients that you serve?

• What are the different populations?

2. What is your role at your health organization?

Probe:

• How long have you been in this role?

• How long have you been working with this organization?

• Can you tell me about your role in relation to developing, modifying, enhancing, or otherwise supporting EHRs and/or CQM-related efforts within your organization?

• How any years have you been working on EHRs/HIT-related work within your organization?

II. EHR Landscape

We’d like to learn about your organization’s EHR system and state-level policies that may impact the adoption and use of EHRs.

3. What is the EHR system that your organization currently uses? What are the data sources for your EHR system?

4. I’d like to learn more about your state’s policies around EHRs and HIT. Could you tell me about the kinds of policies/regulations that are in place to govern the use of EHRs/HIT?

5. To what extent do these policies and/or regulations impact your work?

6. Are there any current issues that are being discussed at your organization in regards to EHRs/HIT?

Probe: Can you share some examples with me?

III. Health Department Support

The following questions are going to ask you about how the health department is working with your organization to support activities related to promoting or enhancing use of EHRs for client management.

7. In what ways has the health department supported your organization with developing or enhancing your EHRs to support diagnosis and management of clients with high blood pressure or high blood cholesterol?

Probe:

• What types of health department interventions or activities were most helpful to your organization to develop or strengthen EHRs/HIT?

• What do you think should be the health department’s role in supporting the use of EHRs?

8. What are some of the challenges that you face with regards to integrating/aligning EHRs and HIT within provider workflows?

Probe: How can the health department best help address these challenges?

9. What factors within your organization have facilitated the use of EHRs/HIT for the diagnosis and management of clients with high blood pressure or high blood cholesterol?

Probe: How can the health department best encourage/support these facilitators?

10. How would you describe your organization’s EHR capability, specifically with respect to its ability to support diagnosis and management of clients with high blood pressure? What about for high blood cholesterol?

Probe:

• Does your EHR have clinical decision support tools built in to support providers in diagnosing and managing clients with high blood pressure or high blood cholesterol?

• Does the EHR serve as clinical data repository only? Does it have operational computerized provider entry forms? Is it linked to clinical decision support tools?

11. How does your EHRs support the following:

• Identification of clients with high blood pressure? High blood cholesterol?

• Management of clients with high blood pressure? High blood cholesterol?

  • For example, does the HIT provide prompts for SMBP? Does it trigger alerts for other members of the care team (i.e. TBC)?

• Referral of clients with high blood pressure to evidence-based lifestyle programs? What about for high blood cholesterol?

12. How would you say your organization’s EHR/HIT capability has changed in the last 1-3 years since you started working with the health department?

IV. Use of EHRs/HIT and Clinical Quality Measures

The following questions are going to ask you your organization’s activities related to enhancing reporting on and use of clinical quality measures.

13. Can you tell me about your organization’s process for collecting, reporting, and using clinical quality measures specific to high blood pressure and high blood cholesterol?

Probe:

• Which high blood pressure/high blood cholesterol-related quality measures does your organization track and report?

• How are these measures tracked and reported?

• Who is responsible for compiling these reports?

• Does your organization use dashboards? Please describe these dashboards – what information do they comprise? Who uses the dashboards?

14. What are some of the challenges that you face with regards to tracking and reporting on HBP/HBC clinical quality measures?

Probe: How can the health department best help address these challenges?

15. What factors within your organization have facilitated the tracking and reporting on HBP/HBC clinical quality measures?

Probe: How can the health department best encourage/support these facilitators?

16. Does your organization use EHRs/HIT to assess health disparities, specifically for high blood pressure or high blood cholesterol?

Probe - If yes

• Please describe how you conduct this assessment.

• What types of disparities do you track? (i.e. disease burden, clinical care, health outcomes)?

• What processes/structures are in place to support this type of assessment (e.g. who is assigned to monitor disparities)

Probe - If no

• Are there any barriers that make it difficult to conduct this type of disparities assessment? Please describe.

17. Does your organization have a formal clinical quality improvement process for the care and management of clients with high blood pressure or high blood cholesterol? What about to address health disparities? Please tell me about this process.

Probe:

• Does your organization have a dedicated QI team? How big is this team, who is it comprised of?

• Does your organization have regular data review meetings? Where is the data pulled from?

• What other structures/process support QI efforts?

• What’s the level of organizational leadership for QI efforts?

• Are there organizational level incentives for QI?

18. Can you give me an example of a quality improvement process related to high blood pressure or high blood cholesterol that was recently implemented?

Probe:

• Has your organization implemented a QI process to address health disparities related to high blood pressure or high blood cholesterol? Please tell me about this process.

• Have there been any other efforts put in place to address any health disparities that have been identified?

19. In what ways has your health department supported your organization with developing or enhancing clinical quality measurement processes?

Probe:

• What types of health department interventions or activities were most helpful to your organization to develop or strengthen CQM processes?

• What was the role of the health department in supporting assessments of health disparities?

• What was the role of the health department in supporting QI efforts for improving diagnosis, care, or management of clients with HBP/HBC?

• What was the role of the health department in supporting QI or other efforts to address any identified disparities in the diagnosis, care, or health outcomes for people with HBP/HBC across different population groups?

• What do you think should be the health department’s role in these processes?

20. Do you have other partners, or additional funding sources outside of the health department supporting clinical quality measurement efforts within your organization?

Probe: Is there any other support you need to further strengthen CQM within your organization?

V. Effectiveness of EHRs/CQMs

The following questions are going to ask you about the effectiveness of the CQM activities/interventions:

21. In your opinion, how has the use of EHRs/HIT affected the identification of clients with high blood pressure within your organization? How about identification of clients with high blood cholesterol?

22. How has the use of EHRs/HIT affected the management of clients with high blood pressure or high blood cholesterol?

Probe:

• How has the use of EHRs/HIT affected the referral of clients to evidence-based lifestyle

23. How has the reporting and tracking of clinical quality measures affected population level gaps in clinical care for clients with high blood pressure or high blood cholesterol?

Probe:

• Have you observed any specific changes in the identification of clients with HBP/HBC across different population groups?

• Have you observed any specific changes in the management/referral of clients with HBP/HBC across different population groups?

24. To your knowledge, have there been any unintended outcomes from the activities/interventions?

Probe: If so, what were they?

VI. Close

Those were all the questions I had for you. Is there anything else you’d like to add that we haven’t had a chance to discuss?

Thank you so much for your time. This concludes our interview. If you have any additional questions, please feel free to contact Gizelle Gopez, [email protected].

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