PHYSICIAN PRACTICE SOFTWARE TELPHONE SURVEY
DIALOG AND QUESTIONS--K.B. EDEN
>s1< Hello, my name is ______, and I am calling from Portland
State University on behalf of Providence Health System. We are
gathering information on computer software in physician offices.
When finished hit <1-9> or <g>
>ques< May I speak with your office manager (perhaps yourself) about the
computer software in your office?
[loc 14/1]
<1> Yes
<2> No computers in the office -- (Thank the respondent) [goto t17]
[cyan]This includes offices which outsource billing, scheduling
etc.
<3> Refused to participate (Thank the respondent) [goto t17]
<4> Duplicate Case (office manager already responded) [goto t17]
<5> Disconnected number or wrong number [goto t17]
<6> DQ - No new software in past 5 years or software too new [goto t17]
<7> NR - Never reached right person (at least 3 attempts) [goto t17]
<8> MAD - only reached answering machine or service [goto t17]
<9> Interview partially completed [goto t17]
===>
>d2< (REPEAT AS NEEDED FOR A NEW RESPONDENT: Hello my name is ______,
I am calling on behalf of Providence Health System. We are gathering
information on computer software in physician's offices.)
I would like to invite your practice to participate in a
statewide research project funded by Providence Health System and
a Portland State University doctoral fellowship. In return for your
participation, we will send you a summary of the results.
These results may help your practice and others learn more about
selecting computer software and understanding the impacts from these
software packages.
(AS NEEDED: The questions will take about 15 minutes of your time.)
(AS NEEDED: This project is not connected to any software vendor.)
(AS NEEDED: The lead researcher is Karen Eden, Providence Health
System, (PH: )
Has your practice acquired any computer software in the past five
years?
<1> Yes [goto inv]
<2> No
===>
>buy< By software I mean computer packages which allow you to send and
receive email, schedule patients, determine billing, etc. Does
your office have computers to perform any of these activities?
<1> Yes
<2> No (THANK the respondent). [goto t17]
===>
>inv< Are you involved in computer software decisions and/or
implementations for this practice?
<1> Yes
<2> No [goto nam1]
===>
>om< What is your name? [allow 25][goto cont]
===>
>nam1< What is the name of a staff member who is involved with
computer decisions and/or implementations? [allow 25]
===>
>spek< May I speak with [fill nam1]?
<1> new person [goto d3]
<2> respondent not available [goto recl]
===>
>d3< Introduction to primary respondent:
Hello, my name is ______, and I am calling from Portland
State University on behalf of Providence Health System. We are
gathering information on computer software in physician offices.
In return for your participation we will send you
a summary of our findings which may help your office and others
select computer software and understand the impacts of the software
on the practice.
(AS NEEDED: The questions will take about 15 minutes.)
I understand that you are involved in software selection and/or
implementation for this practice. Is this a convenient time for you
to answer a questions on your computer sofware?
<1> yes
<2> no [goto recl]
===>
>cont< START INTERVIEW
Your participation in this study is voluntary and will not affect any
other relationship with Providence Health System or Portland State
University. The names of all respondents and practices with be kept
confidential.
(Interviewer, press <1> to continue)
===>
>p1< First I have a few background questions. For each question I will
provide a list of categories for you to choose a response.
Which of these roles most closely describes your role with this
office? Would you say your principle role is as a . . . .
(READ categories until respondent selects one).
<1> Physician/physician's assistant/nurse practitioner
<2> Medical director
<3> Nurse/medical assistant
<4> Information system or computer manager
<5> Administrator/office manager, finance manager
<6> Purchasing agent
<7> Medical technologist
<8> Staff member/ billing clerk, scheduler, receptionist,
secretary
<9> Other, please describe . . . [specify]
===>
>p2< Which of these types of practices is yours? This practice is . . .
<1> Privately owned by one or more physicians
<2> Health system owned and operated
<3> Hospital department
<4> Other, please describe . . . [specify]
===>
>p3< Which of these categories most closely describes the size and type
of practice?
<1> Single primary care physician
<2> Single specialist
<3> 2-10 primary care physicians
<4> 2-10 specialists
<5> 2-10 specialists and primary care physicians
<6> More than 10 primary care physicians
<7> More than 10 specialists
<8> More than 10 primary care physicians and specialists
<9> Other, please describe . . . [specify]
===>
>prio< [allow 6]
>t1< [store <none> in prio]
>cat1< Computer Software
Let's discuss the computer software in your practice. Please tell
me if you or other staff members perform any of the following
activities on your computers.
Access and complete patient records using a computerized patient
record or "electronic medical record -- EMR"
<1> Yes
<2> No [goto cat2]
===>
>six1< Has this software been in your office at least six months?
<1> Yes
<2> No [goto cat2]
===>
>sel1< Were you involved in selecting any of this software?
<1> Yes
<2> No
===>
>t2< [if six1 eq <1> ]
[store <1> in prio]
[endif]
>imp1< Were you involved in implementing any of this software?
<1> Yes
<2> No
===>
>cat2< Do you or other staff members perform any of the following managed
care activities on your computer . . .
Track incoming and outgoing referrals,
Track patient enrollment records and PCPs,
Capitation accounting, e.g., account for fixed payments by
health plans, claims and pricing modules for referrals
Link with medical formularies (prescriptions)
Query database to create reports on the practice.
Statistical reporting on utilization and outcomes
<1> Yes
<2> No [goto cat3]
===>
>t5< [if prio ne <none> goto cat3]
>six2< Has this software been in your office at least six months?
<1> Yes
<2> No [goto cat3]
===>
>sel2< Were you involved in selecting any of this software?
<1> Yes
<2> No
===>
>t6< [if six2 eq <1> ]
[store <2> in prio]
[endif]
>imp2< Were you involved in implementing any of this software?
<1> Yes
<2> No
===>
>cat3< Do you or other staff members perform any of the following
communication activities on the computers in the practice?
Email or telemedicine to external colleagues (referring
physicians, hospital staff, patients, etc.,)
Remote link with other information systems, e.g., hospital
systems to check on admitted patients
Access the internet
Electronic data interchange (EDI) -- exchange diagnostic
information electronically (lab/x-ray results over
the wire)
Conduct online literature searches, e.g., Medline
Email with other colleagues in the practice via
a computer network
<1> Yes
<2> No [goto cat4]
===>
>t8< [if prio ne <none> goto cat4]
>six3< Has this software been in your office at least six months?
<1> Yes
<2> No [goto cat4]
===>
>sel3< Were you involved in selecting any of this software?
<1> Yes
<2> No
===>
>t9< [if six3 eq <1> ]
[store <3> in prio]
[endif]
>imp3< Were you involved in implementing any of this software?
<1> Yes
<2> No
===>
>cat4< Do you or other staff members perform any of the following
practice management activities on the computers in your
practice?
Billing
Collections
Appointment scheduling
Accounting
<1> Yes
<2> No
===>
>t11< [if prio ne <none> goto soft]
[if cat4 eq <2> goto thnk]
>six4< Has this software been in your office at least six months?
<1> Yes
<2> No [goto thnk]
===>
>sel4< Were you involved in selecting any of this software?
<1> Yes
<2> No
===>
>t12< [if six4 eq <1>]
[store <4> in prio]
[endif]
>imp4< Were you involved in implementing any of this software?
<1> Yes
<2> No
===>
>t13< [if imp4 eq <1> ]
[store <4> in prio]
[if prio eq <4> goto soft]
[endif]
>soft< [allow 25]
>t14< [if prio eq <1>]
[store <electronic medical record> in soft]
[endif]
[if prio eq <2>]
[store <managed care> in soft]
[endif]
[if prio eq <3>]
[store <communications> in soft]
[endif]
[if prio eq <4>]
[store <practice management> in soft]
[endif]
>snam< How do you refer to your [fill soft] software
in your office?
[allow 25]
===>
>dec< Who decided to implement the [fill snam] software in your practice?
<1> Staff members and/or partners within the practice.
<2> Another organization, e.g., hospital or health system.
===>
>p5a< Please answer the rest of the questions with your [fill snam]
software in mind. I am going to read a list of activities often
performed with the computers. Please answer "yes" if the stated
activity is performed using your [fill snam] software, otherwise
please respond with a "no".
Use various desktop applications: word processing, spreadsheets,
graphics, etc.
<1> Yes <2> No
===>
>p5b< Schedule patients and staff members.
<1> Yes <2> No
===>
>p5c< Generate fee slips or reimbursement charges.
<1> Yes, please list the billing system name, . . . [specify]
<2> No
===>
>p5d< Send and receive electronic mail (email) to colleagues [u]within[n]
the practice.
<1> Yes <2> No
===>
>p5e< Send and receive electronic mail (email) to colleagues [u]external[n]
to the practice, referring physicians, hospital staff, etc.
<1> Yes <2> No
===>
>p5f< Access and complete patient records in the practice (computerized
medical records).
<1> Yes <2> No
===>
>p5g< Electronic Data Interchange (EDI) -- exchange diagnostic
information electronically, e.g., lab reports, x-ray results.
<1> Yes <2> No
===>
>p5h< Query patient information to report delivery of health care
services, e.g., to report immunization rates, quality indicators.
<1> Yes <2> No
===>
>p5i< Follow guidelines and protocols.
<1> Yes <2> No
===>
>p5j< Access on-line medical literature, e.g., Medline, professional
journals.
<1> Yes <2> No
===>
>p5k< Access the internet (World Wide Web).
<1> Yes <2> No
===>
>p5l< Track patient enrollment periods and primary care physician.
<1> Yes <2> No
===>
>p5m< Track incoming and outgoing referrals.
<1> Yes <2> No
===>
>p5n< Conduct statistical analysis of patient utilization and outcomes.
<1> Yes <2> No
===>
>p5o< Perform captitation accounting (accounts for fixed payments by
by the health plan payers and/or determines prices for
referrals).
<1> Yes <2> No
===>
>p5p< Link with other information systems, e.g., hospital systems to
check on admitted patients, medical formularies.
<1> Yes <2> No
===>
>p5q< Are there other activities?
<1> yes, please describe . . . [specify]
<2> no
===>
>p6< Which of these categories best represents the cost
to purchase your [fill snam] software? Would that be . . . .
<1> Less than $10,000
<2> $10,000-50,000
<3> $50,000-100,000
<4> $100,000-200,000
<5> More than $200,000
<6> The software was given to the practice by another organization,
e.g., hospital, health system.
===>
>p7< Which of these cost categories best represents the annual maintenance
and licensing fees?
<1> $0
<2> Up to $5,000
<3> $5-10,000
<4> $10-20,000
<5> More than $20,000
<6> The software was given to the practice by another organization,
e.g., hospital, health system.
===>
>p8< Was this your first installation of software for the practice?
<1> Yes <2> No
===>
>p9< What is the level of customization of your [fill snam] software?
It is a . . .
<1> Commercial package, basically "off-the-shelf"
<2> Commercial package with specially written software for your
practice
<3> Completely custom built computer system for your practice
===>
>p10< How often do you personally use this software?
<1> Never
<2> Less than once per week
<3> A few times per week
<4> Daily
===>
>p11< How many staff members use this software on a daily basis?
<1> Only one, yourself
<2> 2-5 other staff members
<3> more than 5 staff members
===>
>p12< How long has the [fill snam] software been in your practice?
<1> Less than one year
<2> More than one year
===>
>t15< [if dec eq <2>]
[store <none> in unam]
[goto p16]
[if p11 eq <1>]
[store <none> in unam]
[goto p13a]
[endif]
>unam< What is the name of someone who uses the [fill snam] software daily?
[allow 15]
(IF NEEDED: We would like to ask this person a small subset
of these questions -- the interview will likely take 5 minutes.)
===>
>p13a< Now I would like to ask you some questions about your selection
method and implementation process. Please respond with the
[fill snam] software in mind.
Who were the champions or decision makers in the selection and
customization processes? Customization refers providing input
to the software vendor for writing software specific to the
practice.
I am going to read a list of potential categories of participants.
For each category, please tell me if at least one person was
a champion in the selection and customization processes. Please
select a response from the following: selection, customization,
both selection and customization, and not involved.
One or more of the clinical staff: (READ as needed: a physician,
physician's assistant, nurse practitioner, nurse, medical
technicians and assistants)
<1> Selection
<2> Customization
<3> Both selection and customization
<4> Not involved
===>
>p13b< One or more of the administrative staff: (READ as needed:
office manager, finance manager, medical director)
<1> Selection
<2> Customization
<3> Both selection and customization
<4> Not involved
===>
>p13c< Computer specialist [u]within[n] practice
<1> Selection
<2> Customization
<3> Both selection and customization
<4> Not involved
===>
>p13d< Computer consultant from [u]outside[n] the practice
<1> Selection
<2> Customization
<3> Both selection and customization
<4> Not involved
===>
>p13e< One or more office staff members: (READ as needed:
billing clerk, scheduler, secretary, receptionist, etc.)
<1> Selection
<2> Customization
<3> Both selection and customization
<4> Not involved
===>
>p13f< One or more of the following: health system, insurance, or
patient representative
<1> Selection
<2> Customization
<3> Both selection and customization
<4> Not involved
===>
>p13g< Were there other people involved?
<1> Yes, please describe who and how they were involved
. . . [specify]
<2> No
===>
>p14a< What steps were performed in selecting your [fill snam ] software? I
will read a list of possible steps. Please respond with "yes" or
"no" for your practice.
Formed a selection committee to direct the selection and to
oversee implementation.
<1> Yes <2> No
===>
>p14b< Reviewed your long term business plan, e.g., five year plan of the
practice, before making the selection.
<1> Yes <2> No
===>
>p14c< Prepared a list of software requirements -- a "needs assessment".
<1> Yes <2> No
===>
>p14d< Determined selection criteria and used them in evaluating the
software options.
<1> Yes <2> No
===>
>p14e< Conducted interviews with other colleagues who have made similar
selections.
<1> Yes <2> No
===>
>p14f< Requested information from vendors, e.g., RFP -- Request For Proposal,
RFI--Request For Information.
<1> Yes <2> No
===>
>p14g< Participated in a demonstration where you viewed and/or used the
software before purchasing.
<1> Yes <2> No
===>
>p14h< Made a site visit to a current installation of the software.
<1> Yes <2> No
===>
>p14i< Compared the software options with the best in the field.
<1> Yes <2> No
===>
>p14j< Used a formal decision analysis to compare different software
packages and the risks associated with each.
(AS NEEDED: For example did you consider the financial and
performance risks associated with each software package?)
<1> Yes <2> No
===>
>p14k< Made cost comparisons of the software packages.
<1> Yes <2> No
===>
>p14l< Did you use any other steps?
<1> Yes, please describe . . . [specify]
<2> No
===>
>p15a< Why did you choose this software? I will read a list of
statements. Please rate each statement on an importance
scale ranging from "no importance", "very low importance",
to "very high importance".
(READ all responses on the first few questions until the responder
begins to volunteer importance levels.)
The computer software appeared easy to use. Would you say this
had . . .
<1> No importance
<2> Very low importance
<3> Low importance
<4> Medium importance
<5> High importance
<6> Very high importance
===>
>p15b< The software appeared to improve one or more of the business
processes in the practice, e.g., the reimbursement process, patient
records. Would you say this had . . .
<1> No importance
<2> Very low importance
<3> Low importance
<4> Medium importance
<5> High importance
<6> Very high importance
===>
>p15c< There were strong testimonies from other users.
<1> No importance
<2> Very low importance
<3> Low importance
<4> Medium importance
<5> High importance
<6> Very high importance
===>
>p15d< The vendor had many installed sites and was responsive
to our practice needs during the selection process.
<1> No importance
<2> Very low importance
<3> Low importance
<4> Medium importance
<5> High importance
<6> Very high importance
===>
>p15e< This software was already in use by other sites
(other providers, hospitals) closely affiliated with this
practice.
<1> No importance
<2> Very low importance
<3> Low importance
<4> Medium importance
<5> High importance
<6> Very high importance
===>
>p15f< This software would help the practice perform processes
needed to reach our long term business strategy, e.g, report
preventive measures, needed in winning managed care contracts.
<1> No importance
<2> Very low importance
<3> Low importance
<4> Medium importance
<5> High importance
<6> Very high importance
===>
>p15g< This software provided the most value for the cost.
<1> No importance
<2> Very low importance
<3> Low importance
<4> Medium importance
<5> High importance
<6> Very high importance
===>
>p15h< This software was compatible with existing systems
in the practice.
<1> No importance
<2> Very low importance
<3> Low importance
<4> Medium importance
<5> High importance
<6> Very high importance
===>
>p15i< Were there other influencing factors?
<1> Yes, please describe and rate, [specify]
<2> No
===>
>p16< During the implementation of the [fill snam] software, were the staff
given a reduced workload to allow time to learn the
computer software?
<1> Yes <2> No
===>
>p17a< Finally, we seek to learn about the impact the [fill snam]
software has had on your practice. I will read to you several
statements. For each statement, please give me a rating of agreement
ranging from "strongly [cyan]disagree[n]" to "strongly agree". If
the stated impact is not pertinent to your practice, please respond
with "not applicable".
The computer software has created a more accurate and timely
billing process. Would you . . .
<1> Strongly [cyan]disagree[n]
<2> Slightly [cyan]disagree[n]
<3> Neither agree or disagree
<4> Slightly agree
<5> Strongly agree
<6> Not applicable
===>
>p17b< The software has improved the scheduling of patients for
routine, preventive and urgent appointments. Would you . . .
<1> Strongly [cyan]disagree[n]
<2> Slightly [cyan]disagree[n]
<3> Neither agree or disagree
<4> Slightly agree
<5> Strongly agree
<6> Not applicable
===>
>p17c< The practitioners have reduced the amount of time and effort
needed to complete patient records.
<1> Strongly [cyan]disagree[n]
<2> Slightly [cyan]disagree[n]
<3> Neither agree or disagree
<4> Slightly agree
<5> Strongly agree
<6> Not applicable
===>
>p17d< The practitioners have an improved ability to access accurate patient
information from multiple sites.
<1> Strongly [cyan]disagree[n]
<2> Slightly [cyan]disagree[n]
<3> Neither agree or disagree
<4> Slightly agree
<5> Strongly agree
<6> Not applicable
===>
>p17e< The software has improved the accuracy of practice
documentation, helpful in reducing malpractice costs.
<1> Strongly [cyan]disagree[n]
<2> Slightly [cyan]disagree[n]
<3> Neither agree or disagree
<4> Slightly agree
<5> Strongly agree
<6> Not applicable
===>
>p17f< The software has improved the referral process . . . in