Video-Based DOT Survey
The purpose of this survey is to assess your level of experience and interest in using video-based directly observed therapy (VDOT), perceived or experienced benefits and concerns, and ways in which VDOT can be used to treat other infectious diseases and health conditions. We are interested in learning about both synchronous (real-time) and asynchronous (store-and-forward) uses of VDOT. Whether or not you have ever used or witnessed VDOT in practice, your opinions are valuable and your response to this survey will be greatly appreciated. This survey is anonymous and your responses will not be linked back to you in any way.
Please email your completed survey to
or complete survey online at
https://www.surveymonkey.com/r/videoDOT
by May 5th, 2015.
1. Please check the category that best describes your professional role? (Select only one answer.)
o Clinician (physician, nurse, respiratory therapist)
o Administrator/manager
o Outreach worker
o Researcher
o Educator
o Other (please specify) ______
2. Please check the category that best describes the type of organization that you work for? (Select only one answer.)
o Public health agency
o Medical clinic or hospital
o Academic institution
o Federal or state payer of health coverage (e.g., Medi-Cal)
o Private health insurance company
o Other (please specify) ______
3. How familiar are you with VDOT? (Check only one answer.)
o Never heard of it before today (skip to question 6)
o Heard of it, but never observed it in use (skip to question 6)
o Observed it in use, but never used it myself (skip to question 6)
o Used VDOT in practice (go to question 4)
4. What type of VDOT have you used? (Check only one answer.)
o Asynchronous (recorded)
o Synchronous (live videoconference)
o Both asynchronous and synchronous
5. How long have you used VDOT? (Check only one answer.)
o Less than 3 months
o Between 3 and 6 months
o More than 6 months
Questions 6 and 7 are related to ASYNCHRONOUS (recorded) VDOT ONLY.
6. Based on your experience or perceptions, please indicate your level of concern about asynchronous VDOT regarding each item below by placing an “X” in one column for each row.
No Concern / Minimal Concern / Moderate Concern / Major Concern / Not Surea. HIPAA compliance/security
b. Reimbursement
c. Staff acceptance
d. Patient’s ability to perform VDOT
e. Patient’s concerns about confidentiality
f. Medication adherence
g. Managing side effects
h. Connectivity problems
i. Equipment problems
j. Workload increases
k. Staff layoffs
l. Training staff
m. Training patients
n. Start-up costs
o. Legal issues
p. Lack of data on the efficacy of VDOT
q. Other (please specify)
7. Based on your experience or perceptions, please indicate the level of benefit from asynchronous VDOT for each item below by placing an “X” in one column for each row.
No Benefit / Minimal Benefit / Moderate Benefit / Major Benefit / Not Surea. Cost effectiveness
b. Patient satisfaction
c. Staff satisfaction
d. Staff safety
e. Improved medication adherence
f. Managing side effects
g. Other (please specify)
Questions 8 and 9 are related to SYNCHRONOUS (live) VDOT ONLY.
8. Based on your experience or perceptions, please indicate your level of concern about synchronous VDOT regarding each item below by placing an “X” in one column for each row.
No Concern / Minimal Concern / Moderate Concern / Major Concern / Not Surea. HIPAA compliance/security
b. Reimbursement
c. Staff acceptance
d. Patient’s ability to perform VDOT
e. Patient’s concerns about confidentiality
f. Medication adherence
g. Managing side effects
h. Connectivity problems
i. Equipment problems
j. Workload increases
k. Staff layoffs
l. Training staff
m. Training patients
n. Start-up costs
o. Legal issues
p. Lack of data on the efficacy of VDOT
q. Other (please specify)
9. Based on your experience or perceptions, please indicate the level of benefit from synchronous VDOT for each item below by placing an “X” in one column for each row.
No Benefit / Minimal Benefit / Moderate Benefit / Major Benefit / Not Surea. Cost effectiveness
b. Patient satisfaction
c. Staff satisfaction
d. Staff safety
e. Improved medication adherence
f. Managing side effects
g. Other (please specify)
Level of Interest in VDOT and Other Applications
10. Please rate your interest level in implementing or expanding a VDOT program.
o No interest (skip to question 12)
o Minimal interest
o Moderate interest
o High interest
11. If interested in starting or expanding a VDOT program, which type is of most interest to you?
o Asynchronous
o Synchronous
o Both asynchronous and synchronous
o Not sure
12. In addition to TB, what other infectious diseases or health issues do you think VDOT could be used for to improve disease management? (Select all that apply.)
o HIV patients on antiretroviral therapy / o Hepatitis Bo Ebola / o Hepatitis C
o Substance abuse / o Mental health problems
Other (please specify) ______
13. Recognizing that VDOT may not be a viable option for all TB patients, what proportion of patients in your county would need to be monitored via VDOT to justify implementing a VDOT program in your county? ______percent
14. Any additional comments regarding VDOT? ______
______
______
Thank you for your participation!!
This study was funded by the California HealthCare Foundation.
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