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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. Outline. Background Item Development Illustrative Items Field Testing Methods

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Patient reports about health it

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


Outline
Outline

  • Background

  • Item Development

  • Illustrative Items

  • Field Testing

    • Methods

    • Sample descriptive statistics


Background
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


Consumer assessment of healthcare providers and systems cahps
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


Development process
Development Process (CAHPS®)

  • 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


Survey content
Survey Content (CAHPS®)

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


Survey content cont
Survey Content (cont.) (CAHPS®)

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?


Survey content cont1
Survey Content (cont.) (CAHPS®)

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?


Survey content cont2
Survey Content (cont.) (CAHPS®)

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)


Survey content cont3
Survey Content (cont.) (CAHPS®)

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?


Survey content cont4
Survey Content (cont.) (CAHPS®)

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?


Field testing
Field Testing (CAHPS®)

  • Beth Israel Deaconess Medical Center, Boston

  • Group Health Cooperative, Washington State

  • Kaiser Permanente Southern California



Age and gender
Age and Gender (CAHPS®)


Education
Education (CAHPS®)


Race ethnicity
Race / Ethnicity (CAHPS®)

a American Indian, Alaska Native, Native Hawaiian, or Other Pacific Islander



Acknowledgements
Acknowledgements (CAHPS®)

  • 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


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