Section 5.5 Maintain

EHR and HIE Satisfaction SurveysWhen implementing electronic health records (EHR), health information exchange (HIE), or other health information technology (HIT), local public health (LPH) departments will want to get feedback from all users and stakeholders, and be aware of concerns, expressed or implied. Conduct formal satisfaction surveys about your EHR and HIE use within one to three months of go-live. Include key attributes of EHR and HIE use in subsequent staff and client satisfaction surveys (e.g., at least every six months during active HIT implementation and annually thereafter).

Time needed: 8 hoursSuggested other tools: NA

Staff EHR and HIE Satisfaction SurveysDuring implementation of any major change, attention must be made to communicating with users. Most organizations hold both formal and informal meetings with end users daily following go-live, weekly for a few weeks thereafter, and then monthly. Some organizations also provide feedback notes to new users and may host a special help desk hotline for staff for at least a few weeks after go-live.

How to Use 1. Anecdotal evidence is not scientific but may be the best way to spot problems early, reinforce

HIT goals, and recognize staff members for their efforts. Ensure that all of the organization’s leaders are available in person or via phone, chat, email, or other means during and after implementation. Implementation of hardware and software does not guarantee adoption by users. HIT is not effective if it is not used, or not used as intended. Recorded anecdotes can be

both positive and negative. For example, a nurse calling in with a suggestion could mean positive interest, or could reflect the desire to return to old ways. An increase in verbal orders by physicians could signal concerns about a portal you have installed. These occurrences are

opportunities to thank the staff members for their efforts, record their process-related concerns, and reveal red flags for further exploration.

2. A good way to ensure that you actively seek information and document all anecdotes about the new HIT is to add to your communication plan (see 2.2 Communication Plan), such as in the following example.

Communication Plan with HIT Anecdotal Assessment ExamplesWho What When Findings Analysis Date for

F/UResolved

Administrator -Check in with every new user-Check in with selected clients

-First 3 days of go live-First 3 days of go live and weekly for 1 month

Users -Speak with every user expected to use HIT

-During first week of go live-Monthly for 3 months

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Who What When Findings Analysis Date for F/U

Resolved

HIT Project Manager

-Check in with every new user-On call

-First 5 days of go live-First 5 days 24x7-thereafter as designated

IT Staff -On call -First 5 days after go-live continuously-thereafter as designated

Copyright © 2014, Margret\A Consulting, LLC. Used with permission of author

3. A formal HIT User Satisfaction Survey is also important. Review the sample survey below, which enables an organization to compare results against the first eight items its baseline beliefs survey (see 1.8 EHR and HIE Beliefs Assessment).

a. Review the questions on general usability and needs and modify them according to the specific application being implemented, if needed.

b. Distribute, tally responses, and compare with baseline results. Use the results to target additional training and communications.

HIT User Satisfaction SurveyThe purpose of this survey is to obtain feedback on our EHR system and how well it is meeting your needs. Results will be compared with the initial readiness assessment data as a benchmark and used to identify areas in need of improvement. We will periodically resurvey users until the system has stabilized and everyone is comfortable using it.

Instructions

Please complete this survey and return to: ____________________ by: ______________Concerning our recent EHR and HIE implementation, check the column that most closely describes how you feel about each of the following statements:

StronglyAgree

Agree Neutral Disagree StronglyDisagree

1. EHR and HIE has increased overall efficiency.2. Computerized alerts and reminders are annoying.3. Our clients/families are OK with our use of EHR.4. EHR and HIE improves my personal productivity.5. EHR and HIE is difficult to learn how to use.6. Use of EHR in front of clients is depersonalizing.7. EHR is not as accurate or complete as paper records8. EHR and HIE improves quality and client safety.

Please rate the following concerning the EHR and HIE:Worse than Expected

Poor Acceptable Good Better than Expected

a. Trainingb. Response timec. Dependabilityd. Technical supporte. Ease of usePlease identify below any additional assistance you would

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like and provide any other comments Yes No Describe Needsa. Computer navigationb. Template changesc. Changes to decision support rulesd. Adjusting workflowe. Other:

Copyright © 2014, Margret\A Consulting, LLC. Used with permission of author

Client EHR and HIE Satisfaction Surveys

How to Use:1. Use the following survey to learn how your clients are responding to your use of EHR and

HIE. (Modify the survey to reflect the specific technology you have adopted, such as EHR at the point of care, HIE—involving obtaining their consent, personal health record [PHR], telehealth, home monitoring devices, or other.)

2. You may choose to have these printed as a postcard for nurses to distribute during a visit or sent via a letter to the client after a visit with the request for them to be returned in a postage-paid envelope you supply. Include appropriate instructions in the survey form.

3. If you already use a client satisfaction survey, consider whether you want to add some questions similar to those on this form or if you want to conduct a separate survey in addition to your normal survey. A regular satisfaction survey may not be conducted in close proximity to the EHR or HIE implementation. However, if you do use such a survey and it is timely enough, you might want to compare results on other aspects of the visit against those from pre-EHR. If you find a significant drop in all aspects of the survey that cannot otherwise be accounted for, it may reflect the impact of the EHR.

As part of our continuous quality improvement efforts, we recently adopted new computer systems to help our nurses and others carry out their duties to provide the best possible health care services for you. We would like to know what you think!

If you need help completing the form or have questions, please don’t hesitate to call us at: SUPPLY NUMBER1. My provider explained his or her use of the computerized systemto me. □ Yes □ No □ Not sure2. My provider asked me for my permission to obtain information to support my care from my other providers.

□ Yes □ No □ Not sure

3. I believe that using the computer system will help my provider improve my care.

□ Yes □ No □ Not sure

4. I believe my personal health information that is stored in the electronic system is safe and private.

□ Yes □ No □ Not sure

5. I would like information about how I can use a computer to help keep track of medications, remind me about my appointments, or learn more about my health conditions.*

□ Yes □ No □ Not sure

6. I have questions or concerns about the computer system.* □ Yes □ No □ Not sure7. I would like to thank ___________________________________ (fill in name of person) for helping me understand the computer.* If you would like to be contacted directly, please give us your name and contact information:

Name: _____________________________________________________________________□ Day time phone #:__________________ □ Evening phone #: ___________________

Copyright © 2014, Margret\A Consulting, LLC. Used with permission of author

4. If you feel a survey form may not be appropriate for your clients, consider having nurses document any concerns expressed by clients. If no concerns are mentioned, have nurses ask

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clients a few specific questions about use of the computer and document responses so they can be evaluated in light of changes that may need to be made in usage, education, workflow, etc. These may be suitable questions that are also consistent with the above surveys:

a. Do you have any questions about our new EHR?

b. Did I explain well enough to you how we use the EHR (or HIE if applicable)?

c. Would you be interested in learning more about our EHR?

d. (If the facility has a portal or is using Direct email) Would you be interested in exchanging information with me using our secure portal/email?

Copyright © 2014 Stratis Health. Updated 03-10-14

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