Patient Reports about Health IT

1. Patient Reports about Health IT Developing & Field Testing Survey Questions for Outpatient Settings Keith McInnes Boston University School of Public Health & VA Bedford Medical Center

2. Outline • Background • Item Development • Illustrative Items • Field Testing • Methods • Sample descriptive statistics

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

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

5. Development Process • AHRQ stakeholder meeting 2006 • Literature review • Focus groups • Develop item inventory • Expert interviews (CIOs, health IT experts, PHR managers) • Cognitive interviews • Identification of field test sites

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 website 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

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?

8. Survey Content (cont.) Prescription Medicines • Health IT: In the last 12 months, did you ever use email or a website to ask this doctor’s office to refill or renew one of your prescriptions?

9. Survey Content (cont.) Patient use of website 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)

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?

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 Decision Making • 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?

12. Field Testing • Beth Israel Deaconess Medical Center, Boston • Group Health Cooperative, Washington State • Kaiser Permanente Southern California

13. Field Testing - Overview

14. Age and Gender

15. Education

16. Race / Ethnicity a American Indian, Alaska Native, Native Hawaiian, or Other Pacific Islander

17. Health Status – Self-Rating

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