2 Patient Portal Survey for Workers

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NIH)

NIH Clinical Center Patient Portal Survey for Workers.v001.08182021 (2)

Health Information Technology Patient Satisfaction Survey (CC)

OMB: 0925-0648

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Shape1

NIH Clinical Center Patient Portal Survey for Workers

Please respond to these prompts as they apply to your experience with the FollowMyHealth® Patient Portal in use at the National Institutes of Health Clinical Center. This survey is anonymous.


NIH Clinical Center Privacy Policy - https://www.cc.nih.gov/disclaimers.html


OMB # 0925-0648, Expiration Date: 06/30/2024


Public reporting burden for this collection of information is estimated to average 5 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. 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: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0648). Do not return the completed form to this address.

1.How long have you used the NIH Clinical Center Patient Portal?

Shape2 1 year or less

Shape3 2 years

Shape4 3 years

Shape5 4 years or more

2.How many times have you used the NIH Clinical Patient Portal?

Shape6 0

Shape7 1 to 5

Shape8 6 to 10

Shape9 11 to 40

Shape10 41 or more

3.Please indicate your level of agreement with the following statement. The process to create your FollowMyHealth® Patient Portal account was easy.

Shape11 Strongly Disagree

Shape12 Disagree

Shape13 Neutral

Shape14 Agree

Shape15 Strongly Agree

4.Does the NIH Clinical Center put your lab results in the Patient Portal for you to see?

Shape16 Yes

Shape17 No

Shape18 Don't know

5.In the last 12 months, did you look for your lab results in the NIH Clinical Center Patient Portal?

Shape19 Yes

Shape20 No

6.In the last 12 months, how often was it easy to find these lab results in the NIH Clinical Center Patient Portal?

Shape21 Never

Shape22 Sometimes

Shape23 Usually

Shape24 Always

7.In the last 12 months, how often were these lab results made available in the NIH Clinical Center Patient Portal as soon as you needed them?

Shape25 Never

Shape26 Sometimes

Shape27 Usually

Shape28 Always

8.In the last 12 months, how often were these lab results presented in a way that was easy to understand?

Shape29 Never

Shape30 Sometimes

Shape31 Usually

Shape32 Always

9.Does the NIH Clinical Center make your vaccination record available in the Patient Portal for you to see?

Shape33 Yes

Shape34 No

Shape35 Don't know

10.In the last 12 months, did you look for your vaccination record in the NIH Clinical Center Patient Portal?

Shape36 Yes

Shape37 No

11.In the last 12 months, how often was it easy to find your vaccination record in the NIH Clinical Center Patient Portal?

Shape38 Never

Shape39 Sometimes

Shape40 Usually

Shape41 Always

12.In the last 12 months, was your vaccination record presented in a way that was easy to understand?

Shape42 Yes

Shape43 No

13.Does the NIH Clinical Center Patient Portal Service Center provide support via phone?

Shape44 Yes

Shape45 No

Shape46 Don't know

14.In the last 12 months, did you call the NIH Clinical Center Patient Portal Service Center?

Shape47 Yes

Shape48 No

15.In the last 12 months, please rate your experience with calling the NIH Clinical Center Patient Portal Service Center.

Shape49

Shape50

Shape51

Shape52

Shape53

Shape54

Shape55

Shape56

Shape57

Shape58

Shape59

Unsatisfactory

Satisfactory

16.What information do you feel is missing from the NIH Clinical Center Patient Portal? (If none, you may skip this question.)

Shape60

17.What functionality do you feel is missing from the NIH Clinical Center Patient Portal? (If none, you may skip this question.)

Shape61

18.Do you use the FollowMyHealth® Patient Portal for other healthcare facilities you visit?

Shape62 Yes

Shape63 No

19.Do you enter information from other medical providers into the FollowMyHealth® Patient Portal?

Shape64 Yes

Shape65 No

20.What is your age?

Shape66 18 to 24

Shape67 25 to 34

Shape68 35 to 44

Shape69 45 to 54

Shape70 55 to 64

Shape71 65 to 74

Shape72 75 or older

21.Sex:

Shape73 Male

Shape74 Female

Shape75 Unknown

22.What is the highest grade or level of school that you have completed?

Shape76 8th grade or less

Shape77 Some high school, but not graduate

Shape78 High school graduate or GED

Shape79 Some college or 2-year degree

Shape80 4-year college graduate

Shape81 More than 4-year college degree

23.Are you of Hispanic or Latino origin or descent?

Shape82 Yes, Hispanic or Latino

Shape83 No, not Hispanic or Latino

24.What is your race?

Shape84 American Indian or Alaska Native

Shape85 Asian

Shape86 Black or African American

Shape87 Native Hawaiian or Other Pacific Islander

Shape88 White

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