Form #3 Form #3 Telephone Follow-up Interview

B

Form Approved
OMB No. 0935-XXXX
Exp. Date XX/XX/20XX

lue Text: notes for Interviewer

‘‘Overcoming Barriers to Expanded Health Information Exchange (HIE) Participation in Indiana’’

AHRQ, through its contractor, the Regenstrief Institute at Indiana University, proposes to assess the barriers to participation in health information exchange (HIE) in Indiana. The Regenstrief Institute will use its experience to date working with a variety of organizations to establish specific barriers to engagement in HIE cited by stakeholders, define the barriers and evaluate them.

The Regenstrief Institute will develop and implement a questionnaire and survey process to identify barriers that may exist throughout the State of Indiana to participation in the Indiana Network of Patient Care (INPC). The INPC is a local health information infrastructure that includes information from five major hospital systems (fifteen separate hospitals), the county and State public health departments, and Indiana Medicaid and RxHub. The INPC began operation seven years ago and is one of the first examples of a local health information infrastructure. This research will elicit and aggregate feedback from large and small physician groups, as well as hospitals, throughout the State of Indiana.

The goal is to identify the gaps in understanding, barriers and disconnects that may exist with providers’ adoption of, and membership in, the INPC. The relationship between the stakeholders involved in the Indiana HIE is governed by a contract between the participants. The Regenstrief Institute, acting on behalf of the participants, created and operates the exchange, including serving as the custodian of the data. The Regenstrief Institute will survey three key stakeholder groups in the State of Indiana: small hospitals, small physician practices (less than 5 providers) and large physician practices (greater than 20 providers) to identify barriers for each of these groups to participate in a HIE in general, and specifically the INPC. It is difficult to predict the barriers that will be identified, but based on their experience to date, anecdotal evidence suggests that the cost of interfaces and the management attention needed to participate will be the two major barriers. The findings will be used to create approaches to engage specific entities to participate in their statewide HIE.

This project is being conducted pursuant to AHRQ’s statutory mandates to conduct and support research, evaluations and initiatives to advance information systems for health care improvement and to promote innovations in evidence-based health care practices and technologies by conducting and supporting research on the development, diffusion, and use of health care technology.

Phone Interview Guide

• When discussing HIE, it will be used as a noun for an organization (i.e., IHIE)

• Review the reason for the survey. Grant to determine barriers to implementation and how to overcome them.

• Reassure interviewee that this survey is not a marketing ploy and they will not receive a call from anyone.

• If a physician, ask for hospital affiliation.

• Review the results of the Web-Based Survey responses regarding the participation types and vendors.

1. If unfamiliar with HIE, review the email/information sent and answer any questions

2. Hit the high points and anything that stands out.

• If your organization were to authorize participation in a health information exchange who would be involved?

CIO	Director of Technology	Practice Manager	Administrative Team
CFO	IT Manager	Board of Directors	Other:
CMO	IT Team	Physicians

1. Has this always been the case (not the people, but the title – who’s involved)?

• Yes

• No

• Decision making?

CIO	Director of Technology	Practice Manager	Administrative Team
CFO	IT Manager	Board of Directors	Other:
CMO	IT Team	Physicians

• Selection process?

CIO	Director of Technology	Practice Manager	Administrative Team
CFO	IT Manager	Board of Directors	Other:
CMO	IT Team	Physicians

• Implementation process?

CIO	Director of Technology	Practice Manager	Administrative Team
CFO	IT Manager	Board of Directors	Other:
CMO	IT Team	Physicians

• Financial Approval?

CIO	Director of Technology	Practice Manager	Administrative Team
CFO	IT Manager	Board of Directors	Other:
CMO	IT Team	Physicians

• Legal Contracting?

CIO	Director of Technology	Practice Manager	Administrative Team
CFO	IT Manager	Board of Directors	Other:
CMO	IT Team	Physicians

Comments:

HIE Participants

• Were you directly or indirectly involved in the decision to participate in the health information exchange that your organization currently participates in?

• Yes (how?)

• No (why not?)

Comments:

• How long has your organization been participating in a health information exchange?

Type of HIE	Vendor/Role (participant/user, contributor/member, both)	Years	Months

Ask about any upcoming plans and timelines for additional participation.

• Would you recommend to peers in similar organizations that they participate in a health information exchange? If so, what type of services?

• Yes

• No

Comments:

1. Do you have an avenue to speak with your peers (advisory group, etc.)? If so, what?

2. Would the exchange better fit a smaller or larger organization?

• Smaller Organization

• Larger Organization

Comments:

• Would you make modifications to the healthcare information exchange that you participate in?

(if there were no financial limitations, current participating services)

• Yes

• No

Comments: (If yes, what modifications would you make? If no, why not?):

• Would you like other types of services to be offered from a health information exchange?

(if there were no financial limitations, services with no access)

• Yes

• No

Comments:

• If you had the opportunity, would you recommend to your organization to participate in a health information exchange again and why?

• Yes

• No

Why?

Comments:

1. Was the selection and implementation process smooth?

• Yes

• No

Comments:

2. Do you feel your vendor worked well with your organization?

• Yes

• No

Comments:

3. Do the services meet your needs, and those of your organization?

• Yes

• No

Comments:

HIE Non-Participants

• Do you think there could be benefits or value to participating in a health information exchange for your organization? (do not pry or “promote”)

• Yes

• No

Comments:

• If yes, what benefits do you think there could be from a healthcare information exchange for your organization?

Access to Pt. Records	Reduced Delays	Increased Quality of Care	Other:
Access to Lab Results	Reduced Costs	Increased Efficiency
Streamline Processes	Reduce Admin Time	Reduce Malpractice

• For your staff and their daily job activities?

Access to Pt. Records	Reduced Delays	Increased Quality of Care	Other:
Access to Lab Results	Reduced Costs	Increased Efficiency
Streamline Processes	Reduce Admin Time	Reduce Malpractice

• Would you recommend that your organization participate in a health information exchange?

• Yes

• No

Why/Why Not?

Comments:

If they previously made such a recommendation and been rejected, find out why.

• What are some of the barriers that you feel would (or have) prohibit(ed) your organization from participating in a health information exchange? (provide a list?)

Investment Costs	Personal Time	Staff Not Accepting
Bandwidth Capacity	Privacy/HIPAA Concerns	Physicians Not Accepting
Leadership Turnover	IT Support	Implementation Knowledge
No ROI	Not Strategically Important	Other:
Awareness of Availability	Not Practical with Practice	Other:

Get list and then prioritize the top 3.

Public reporting burden for this collection of information is estimated to average 15 minutes per response, the estimated time required to complete the survey. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Form Approved: OMB Number 0935-XXXX Exp. Date xx/xx/20xx. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: AHRQ Reports Clearance Officer Attention: PRA, Paperwork Reduction Project (0935-XXXX) AHRQ, 540 Gaither Road, Room # 5036, Rockville, MD 20850.