Semi-structured Telephone Protocol for EHRs Subject Matt

Attachment J:

Semi Structured Telephone Protocol for EHRs Subject Matter Expert Interviews

Form Approved OMB No. 0920-0943

Exp. Date xx/xx/xxxx

Notice – CDC estimates the average public reporting burden for this collection of information as 60 minutes per response, including the time for reviewing instructions, searching existing data/information sources, gathering and maintaining the data/information 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 (0920-0943).

Assurance of Confidentiality – We take your privacy very seriously. All information that relates to or describes identifiable characteristics of individuals, a practice, or an establishment will be used only for statistical purposes. NCHS staff, contractors, and agents will not disclose or release responses in identifiable form without the consent of the individual or establishment in accordance with section 308(d) of the Public Health Service Act (42 U.S.C. 242m(d)) and the Confidential Information Protection and Statistical Efficiency Act of 2018 (CIPSEA Pub. L. No. 115-435, 132 Stat. 5529 § 302). In accordance with CIPSEA, every NCHS employee, contractor, and agent has taken an oath and is subject to a jail term of up to five years, a fine of up to $250,000, or both if he or she willfully discloses ANY identifiable information about you. In addition to the above cited laws, NCHS complies with the Federal Cybersecurity Enhancement Act of 2015 (6 U.S.C. §§ 151 and 151 note) which protects Federal information systems from cybersecurity risks by screening their networks.

Introduction and verification of subject matter expert’s name, agency, and position.

Explain why calling

• We are asking for information about the use EHRs system in ADSCs and RCCs as well as the availability of EHRs data for these places.

• The phone call takes on average 60 minutes to complete.

Share confidentiality, informed consent, and voluntary participation information

• All information which would permit identification of an individual, a practice, or an establishment will be held confidential, and will be used for statistical purposes only by NCHS staff and agents and will not be disclosed or released to other persons without your consent. If you have any questions about your rights as a participant in this study, call NCHS’ Confidentiality Officer at (888) 642-1459.

• Participation is voluntary, but will assist greatly in helping further our nation’s understanding of residential care communities

• Refusal to participate will involve no penalty.

• Subject may discontinue participation at any time without penalty.

Begin interview:

1. Interviews

Interviews questions have been developed for the two primary groups: 1) Electronic Health Record (EHR) Vendors, and 2) Provider/Trade Associations representing Residential Care Communities (RCCs).

Vendors are included due to market share of population of interest. Provider/Trade Associations are included due to the representation of RCC providers and prior support for an EHR adoption survey in RCCs.

Vendor Interviews:

One interview will be conducted with each EHR vendor interviewee group (up to two participants per vendor organization not to exceed 9 total individuals interviewed). Vendors will be selected and interviewed based on their market share of RCC providers. We plan to interview Point Click Care and Matrix Care based on their significant market share. Two other EHR vendors will be selected from the vendor list in the 2022 NPALS instrument based on frequency of survey responses from 2018.

Vendor Interview Questions:

• Tell us about the customers you serve and more specifically the RCC providers that you serve?

  • Describe the RCC organization structure and size for your clients.

  • What percentage of market share do you serve in your estimation?

• Provide an overview of your current Electronic Health Records System (EHR) platform?

  • Please provide a demonstration of your system.

  • Are data available on a consistent basis across geographic areas and provider types?

  • Describe the data and frequency of collection.

• Do RCCs collect and use a unique set of EHR functions and data through your platform?

  • If so, describe the functions that are unique to RCCs.

  • Are their unique elements to RCC EHRs compared to other provider settings you serve?

  • Does your system data dictionary and database structure align with the NPALS domains?

  • How can data be extracted from your EHR system by RCC to support NPALS?

    • Could this be done by different EHR user types?

    • Are the data aggregated or do they have identifiable information that can link the data to respondents?

  • Do you report RCC data to available research or public health trusted digital ecosystems for the exchange of healthcare data?

    • Optional Question for interview with PointClickCare (PCC): Discuss the findings from interview team’s mapping of PCC’s data dictionary to their repository posted to Datavant/COVID-19 digital ecosystem.

    • Optional Question for MatrixCare and other EHR vendors interviewed: Would you consider reporting your RCC data to a trusted digital ecosystem such as Datavant?
      
      

Provider/Trade Association Interview:

Our interview will be conducted as a group with amongst Provider/Trade Associations inclusive of Argentum, LeadingAge NY, LeadingAge, Center of Excellence for Assisted Living and National Center for Assisted Living with one participant from each association not to exceed 9.

Provider/Trade Association Interview Questions:

• What is your impression of RCC EHR adoption over time? [we will display previous NPALS EHR adoption data and stratification through 2018]

  • Does this reflect today’s environment?

  • If no, please describe why or what is changing.

  • On past surveys, some RCC’s reported an off the shelf business application (e.g., Excel) as their EHR. Is there a general awareness and understanding of what an EHR system is and how it functions in RCCs?

    • How would your members define an EHR?

  • What features would they expect their EHR system to include?

• Do state regulations and/or reporting requirements impact EHR adoption and use?

  • If so, describe how.

• Describe how RCCs use EHR systems to support their clinical and business needs.

  • Do you notice a difference in EHR use based on different variables such as number of beds, ownership type, urban/rural, population served, etc.?

• Do RCC’s use other types of health IT systems and applications to support their unique needs?

  • If yes, please describe.

• Do RCC’s routinely collect data in their EHR system that align with the NPALS such as administrative data, problem/diagnoses, medication and allergies, functional status, and others.

  • How would you describe the ability of RCC’s to share this data in an interoperable manner?

• Would providers find it helpful to have their EHR data be used in the completion of the NPALS?

  • Would they prefer to abstract and report the data from the EHR?

    • If so, do they typically have a workforce that can support this process?

  • Would they prefer their vendor support abstraction and reporting?

  • Would they prefer another trusted third party be used to abstract their data?

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