Patient Reports About Health IT (Text Version)
On September 20, 2011, Keith McInnes made this presentation at the 2011 Annual Conference. Select to access the PowerPoint® presentation (480 KB). Plugin Software Help.
Slide 1
Patient Reports about Health Information Technology (Health IT)
Developing & Field Testing Survey Questions for Outpatient Settings
Keith McInnes
Boston University School of Public Health &
VA Bedford Medical Center
Slide 2
Outline
- Background.
- Item Development.
- Illustrative Items.
- Field Testing.
- Methods.
- Sample descriptive statistics.
Slide 3
Background
- Growing use of health IT.
- Electronic health records.
- Providers using computers during patient visit.
- Eprescribing.
- Patient portals/personal health records.
- Unknown how it affects patient experience of care.
- Interest in developing supplemental items for CAHPS® surveys.
Slide 4
Consumer Assessment of Healthcare Providers and Systems (CAHPS®)
- Standardized surveys to:
- Assess patient-centered care.
- Compare and report on performance.
- Improve quality of care.
- Patient is the best source of information.
- Supplemental items vs. "core" items.
- Clinician & Group Survey.
Slide 5
Development Process
- AHRQ stakeholder meeting 2006.
- Literature review.
- Focus groups.
- Develop item inventory.
- Expert interviews (CIOs, health IT experts, Personal Health Record (PHR) managers).
- Cognitive interviews.
- Identification of field test sites.
Slide 6
Survey Content
Access to Care:
- Core: In the last 12 months when you made an appointment for a check-up or routine care with this doctor, how often did you get an appointment as soon as you thought you needed?
- Health IT: In the last 12 months, when you used E-mail or a Web site to get an appointment at this doctor's office, how often did you get an appointment as soon as you thought you needed?
Response Options: Never, Sometimes, Usually, Always.
Slide 7
Survey Content (cont.)
Getting Information:
- Core: In the last 12 months, when you phoned this doctor's office during regular office hours, how often did you get an answer to your medical question the same day?
- Health IT: In the last 12 months, when you E-mailed this doctor's office, how often did you get an answer to your medical question as soon as you needed?
Slide 8
Survey Content (cont.)
Prescription Medicines:
- Health IT: In the last 12 months, did you ever use E-mail or a Web site to ask this doctor's office to refill or renew one of your prescriptions?
Slide 9
Survey Content (cont.)
Patient use of Web site or portal:
- Health IT: In the last 12 months, how often were these lab or other test results presented in a way that was easy to understand? (lab results).
- Health IT: In the last 12 months, how often was the list of prescription medicines up to date? (Eprescribing).
- Health IT: In the last 12 months, how often were the visit notes easy to understand? (After visit summary).
Slide 10
Survey Content (cont.)
Provider use of computer:
- Health IT: During your visits in the last 12 months, did this doctor ever use a computer or handheld device to show you information?
- Health IT: During your visits in the last 12 months, did this doctor's use of a computer or handheld device make it harder or easier for you to talk with him or her?
Slide 11
Survey Content (cont.)
Doctor Communication:
- Core: In the last 12 months, how often did this doctor explain things in a way that was easy to understand?
Staff:
- Core: In the last 12 months, how often did clerks and receptionists at this doctor's office treat you with courtesy and respect?
Shared Decisionmaking:
- Core (supplemental): In the last 12 months, did this doctor talk with you about the pros and cons of each choice for your treatment or your health?
Slide 12
Field Testing
- Beth Israel Deaconess Medical Center, Boston.
- Group Health Cooperative, Washington State.
- Kaiser Permanente Southern California.
Slide 13
Field Testing—Overview
Beth Israel (BIDMC) | Group Health (GHC) | Kaiser Permanente (KPSC) | |
---|---|---|---|
Site Description | 1 Medical Center | 9 outpatient clinics | 2 Medical Centers |
Number of MDs selected | 19 | 20 | 30 |
Patients per physician | 125 | 125 | 120 |
Mode | Internet | Internet, then Mail | |
Completes (response) | 1,115 ( 48%) | 1,631 (65% ) | 1,896 ( 53%) |
Slide 14
Age and Gender
BIDMC (%) | GHC (%) | KPSC (%) | |
---|---|---|---|
Age | |||
18-34 yrs | 9 | 8 | 7 |
35-44 yrs | 14 | 9 | 9 |
45-54 yrs | 24 | 16 | 18 |
55-64 yrs | 30 | 31 | 29 |
65-74 yrs | 17 | 23 | 23 |
75 or older | 6 | 14 | 14 |
Female | 57 | 62 | 57 |
Slide 15
Education
BIDMC (%) | GHC (%) | KPSC (%) | |
---|---|---|---|
Less than HS | 1 | 2 | 1 |
HS graduates | 4 | 9 | 11 |
Some college | 16 | 26 | 37 |
4-yr college graduate | 27 | 22 | 22 |
More than 4-yr college | 53 | 41 | 30 |
Slide 16
Race / Ethnicity
BIDMC (%) | GHC (%) | KPSC (%) | |
---|---|---|---|
Hispanic | 1 | 2 | 8 |
Non-Hispanic | |||
White | 92 | 85 | 82 |
Black | 2 | 3 | 3 |
Asian | 4 | 7 | 6 |
Othera | 1 | 3 | 1 |
a American Indian, Alaska Native, Native Hawaiian, or Other Pacific Islander
Slide 17
Health Status—Self-Rating
BIDMC (%) | GHC (%) | KPSC (%) | |
---|---|---|---|
Poor | 2 | 2 | 2 |
Fair | 9 | 9 | 13 |
Good | 31 | 36 | 34 |
Very Good | 40 | 38 | 36 |
Excellent | 19 | 15 | 15 |
Slide 18
Acknowledgements
- AHRQ.
- BIDMC, GHC, KPSC.
- Julie A. Brown.
- Paul D. Cleary.
- Carol Cosenza.
- Lin Ding.
- Patricia Gallagher.
- John Halamka.
- Ron Hays.
- Mimi Hugh.
- Michael Kanter.
- James Ralston.
- Carl Serrato.