1.Welcome Page Page 1
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2.Practice Characteristics Please describe the facility where you primarily work 1. Which of the following best describes the facility where you primarily work? Hospital based academic practice Free standing academic practice Hospital based private practice Free standing private practice None of the above/i do not know 2. How many full time equivalent radiation oncologists work at your practice (round up to nearest whole number, no decimals)? (i.e. Count half time practitioners as 0.5) Number of attending radiation oncologists 3. Approximately what percent of your practice's revenue come from the Medicaid or Medicare program? Please skip this question if you do not know or prefer not to answer. Percent revenue 4. On average, how many patients are on treatment each day at your facility? Average Number on Treatment 3.Current Electronic Health Record System Characteristics Please describe your current use of electronic health record systems in your primary practice. Please note that "record and verify" (R & V) systems refer only to treatment delivery. Electronic health record (EHR) systems refer to systems that manage patient medical records, documentation, physician order entry, etc. Please do NOT include treatment planning/contouring as a EHR system. Page 3
1. What is your current record and verify (R & V) system? Elekta (Mosaiq or Impac) Varian (Aria) Siemens (Lantis) 2. Does your practice use an electronic health record (EHR) system? Yes No Comments 4.Current Electronic Health Record Systems Please describe the current electronic health record system that is in use at the facility where you primarily work. Page 4
1. Which of the following electronic medical record system(s) does your practice use? Please check all that apply. Please check Mosaiq/Impac or Aria ONLY if they are also being used to manage patient medical records and NOT solely for record and verify purposes. Aria Mosaiq/Impac Allscripts Amkai E-Clinical Works E-MDs EPIC Cerner GE Centricity NextGen Page 5
2. Please describe the functionality of your current electronic health record system. Include capabilities of all systems in use at your facility. Use following as a guidelines: ---------------------------------------------------------- Basic: Record documents, allergies, medications Moderate: Computerized physican order entry, electronic prescriptions, drug and allergy checks, ability to generate reports Advanced: Clinical-decision support tools, patient reminder systems, automatically generates reports, searchable database management tools Basic Moderate Advanced 3. How satisfied are the users (doctors, nurses, administrative staff, IT staff, etc.) with your current electronic health records system? Very dissatisfied Dissatisfied Content Satisfied Very Satisfied N/A Satisfaction Level Comments 4. How long has your facility had an electronic health record system (in years)? Years 5.Attitude toward electronic health record systems Page 6
1. Do you believe that use of electronic health record systems improves quality or safety of treatments? Yes No 6. 1. In what ways do you think use of electronic health record systems will improve quality or safety of treatments? Reduce mistreatments Reduced medication errors Reduce wait time Improve documentation Assist quality improvement measures Improve workflow 7.Challenges to Electronic Health Record Implementation Please describe the challenges with electronic health records systems in the facility where you primarily work. Page 7
1. What challenges has your department encountered in implementing (or attempting to implement) electronic health record usage? Please check all that apply. High cost Uncertain return on investment Unexpected difficulties in implementation Lack of physician buy-in Lack of institutional resources Lack of support services Difficulty finding a systems that meets our needs 8.Meaningful Use Adoption Describe knowledge and adoption of Meaningful Use as described by the Centers for Medicare and Medicaid Services "Meaningful Use" criteria 1. Who in your department has primary responsibility for implementation and upgrades of electronic health record systems? Clinical director IT director Both Clinical and IT directors Page 8
2. How familiar are you with the CMS Meaningful Use Criteria for electronic health record usage? I did not know that this program existed I am slightly familiar with these criteria I am somewhat familiar with these criteria I am familiar with these criteria I am very familiar with these criteria 9.Plans for Adoption of Meaningful Use Ready System Describe plans for implementation of meaningful use ready electronic health record systems at the facility where you primarily work 1. Do you currently have plans to adopt an electronic health record (EHR) system that meets meaningful use criteria? My EHR system currently satisfies meaningful use criteria We plan to implement a compliant EHR system by Oct 1, 2011 We plan to implement a compliant EHR system in the next 24 months, but after Oct 1, 2011 We have no plans to implement a compliant EHR system 10.Why plans to implement EHR Describe rationale for implementation of CMS Meaningful Use compliant electronic health record system at the facility where you primarily work Page 9
1. Why do you plan to implement a CMS Meaningful Use compliant EHR? Please select all that apply. Collect CMS incentives Avoid CMS penalties It will improve patient care It will improve workflow It will save money It will enhance billing We need to upgrade our information systems for other reasons 11.No plans to implement EHR reason Describe reason why decision was made to not implement a CMS Meaningful Use compliant system at this time at the facility where you primarily work Page 10
1. Why do you NOT plan to implement a meaningful use compliant electronic medical record system? No systems are currently available Available systems are are not compatible with my current system I believe it will reduce workflow It is too expensive I did not know about meaningful use criteria 12.Communication with Other Facilities Describe the extent of communication with other facilities or professional groups about electronic record systems 1. To what extent do you currently communicate with personnel from other facilities or professional groups regarding electronic medical record systems? Not at all Few times per year Few times per month Few times per week Daily Other 13.Barriers to Adoption Page 11
Please identify barriers to adoption of CMS Meaningful Use criteria at the facility where you primarily work 1. How important are each of these barriers to adoption of CMS Meaningful Use of electronic health records (EHR) in the facility where you primarily work? Not important Mildly Somewhat Moderately important important Important Very Important Lack of knowledge of meaningful use program specifics No commerical EHR compliant systems Cost of implementation Guidelines do not apply to my practice Difficulty with integration with the hospital system Delays in the hospital wide electronic medical record system implementation No national guidelines for radiation oncology standards Not enough human resources to devote to implementation Adoption will negatively affect my workflow 2. How much would the following measures help you to implement CMS Meaningful Use compliant electronic health record (EHR) systems? Not helpful Mildly helpful Somewhat Moderately helpful helpful Very helpful Radiation Oncology specific information on criteria ASTRO guidelines for implementation ASTRO education sessions Contact information for Regional Extension Centers (REC's) established to assist with meaningful use implementation 14.Demographics Please describe your role in the facility where you primarily work Page 12
1. What is your role in the department? Chairman Clinical Director Clinician IT director IT staff 2. How many years have you worked (as a staff member not including training) in radiation oncology? Years 15.End Thank you page 1. Thank you for your time! Please direct any questions to: xinglei.shen@jeffersonhospital.org Feedback is appreciated: Page 13