Form #2 Form #2 Staff Interview Guide

Attachment D: Staff Interview Guide 6

A

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

ttachment D: Staff Interview Guide

Using Health Information Technology in Practice Redesign: Impact of Health Information Technology on Workflow

Staff Interview Guide

Public reporting burden for this collection of information is estimated to average 60 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. 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.

Thank you for participating in the study today. The goal of the study is to learn about your work related to care coordination, including the computer-based tools you interact with to do that work. There are two parts to the study. The first is an interview where we will ask you questions to learn about your work related to care coordination, including the computer-based tools you interact with to do that work. After you complete the interview, we will ask you to fill out a short survey about you use technology in your work. First we need to review the consent documents.

[Give subject copy of consent form and review elements of consent].

Please read the form carefully. If you still would like to participate in the interview, please sign the consent form. If you agree to have the interview recorded, please initial the line next to the first statement. If you do not agree to have the interview recorded, please initial the line next to the second statement. Do you have any questions before we move on?

[After respondent agrees to participate and signs consent form]

Thank you again for agreeing to participate in the study today. As I mentioned before, the goal of the study is to help us learn about your work related to care coordination, including the computer-based tools you interact with to do that work.

• If subject has agreed to audio recording:

I have set up the tape recorder here in front of us. Please speak clearly during the interview so that the tape will record your voice accurately. I may ask you to repeat a response to make sure that it is recorded.

• If subject has not agreed to audio recording and a note taker is not available:

I will take notes during our conversation today. I may ask you to slow down or pause for a moment so that I can record what you say accurately.

• If subject has not agreed to audio recording and a note taker is available:

My colleague [NAME] will take notes during our conversation today. He/she may ask you to slow down or pause for a moment so that he/she can record what you say accurately.

During the interview, please use only your first name if you refer to yourself. This will help us keep your responses private. Your individual answers will not be reported to your fellow care team members or the clinic management. If we do share information from the interview, we will only report it at the aggregate level, so that it is not obvious who said what.

The interview will take about one hour to complete. If you need to take a break during the interview to use the restroom or get a drink, please let me know and we will pause the interview.

If any of my questions aren’t clear or you don’t understand a word that I use, please let me know and I will rephrase the question for you.

Please remember that you are not required to answer any specific question. You may also leave the interview at any time.

At the end of the interview, we will ask you to fill out a short survey about how you use technology in your work. Once you have completed the interview and the survey, you will receive a gift of $25 for your participation.

Do you have any questions before we start the interview?

1. Clinic Name: ­[Record Clinic Name]:

2. Demographic Information

We are going to start by asking you some general questions about yourself. For some of these questions, I will read off choices for you to choose from.

1. What is your age?

• 25 or under

• 26-35

• 36-45

• 46-55

• 56-65

• 65 or older

2. What is your gender?

3. Are you Hispanic or Latino/Latina? No/Yes

4. For this question, I will read off several choices. What is your race? Please select one or more.

• American Indian or Alaska Native

• Asian

• Native Hawaiian or other Pacific Islander

• Black or African American

• White

5. Please describe your educational background, what degrees you have and where you trained, and any additional types of training you have.

6. What is your current role at the clinic?

7. How many years have you been doing this job?

8. Can you give a brief overview of your prior experience?

3. Technology Experience in General

We will now move to some questions about your experience with technology in health care settings.

1. What electronic health record (EHR) programs/systems have you used in the past or are you presently using?

2. How long have you used these systems? Or for systems used in the past, how long did you use them?

3. How would you describe your level of proficiency with these systems/programs?

4. How quickly or easily do you learn new computer programs/systems?

4. Work Routines

Now we are going to turn to the topic of work routines. The next few questions will ask about your work routines and how you care for patients with diabetes.

All Clinics:

1. Can you describe your daily work routine?

2. Please describe your routine interactions with patients.

3. Can you walk us through some daily activities involving the coordination of care for patients with diabetes?

Early-MHT Clinics:

1. How have your routines related to care coordination for diabetes patients changed since before the MHT implementation?

2. Has the implementation of the MHT system changed your work experience? If so, how?

5. Interaction with Computer Technology/Work Context

Pre-MHT:

1. How much time in a typical day do you spend using health IT? During work? Before or after work hours?

2. How does technology affect the pace of your daily work routines?

3. Does technology “consume” or “save” time in your daily schedule? How does it “consume” or “save” you time?

4. What is your comfort level with using the computer systems and/or programs that you use on a daily basis?

5. What processes do you use to coordinate the care of patients that involve using technology?

Early and Mature MHT Clinics:

1. Has the amount of time that you spend using technology during your work day changed since the implementation of MHT? In what ways?

2. What processes do you use to coordinate the care of patients using technology?

3. What is your comfort level with the MHT system?

4. How do you feel about care coordination after the MHT implementation?

6. Strategies for Dealing with Unanticipated Workflow or Health IT Challenges

Now I am going to ask you some questions about how you deal with challenges associated with caring for patients, either because of current workflows or due to technology.

Pre-MHT Clinics:

1. How do you accomplish coordination of patient care right now for patients with diabetes?

2. What challenges do you face in performing care coordination activities for each patient?

3. When problems arise with coordination of care, how you deal with them?

4. How do you improvise to deal with technology or organizational issues that impact coordination of care?

Early and Mature MHT Clinics:

1. How do you accomplish coordination of patient care right now for patients with diabetes (if appropriate: since implementing the MHT system)?

2. What challenges do you face in performing care coordination activities for each patient?

3. When problems arise with coordination of care, how do you deal with them?

4. What are your impressions of the coordination of patient care after the MHT implementation?

5. What challenges do you face in your work routines after the MHT implementation?

6. What issues have you experienced in using the MHT system?

7. What strategies do you use to deal with these issues?

7. Conclusion

That concludes our interview. Thank you very much for your participation today! I will now give you the survey to complete. If you have any questions about the survey, please feel free to ask me. Thank you again for your time and participation.