2017 Telemedicine Section Survey

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1. Please enter your full name. (Required.)

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2. Do you provide or expect to provide telehealth services in the next 3 years? (Required.)

Yes

Unsure

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3. Do you provide or expect to provide "direct to patient" emergency telehealth services? (Required.)

Yes

Unsure

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4. Please select the appropriate level of experience with the following services:

	No Experience	Have Past Experience	Have Expertise	Currently Practice
Prehospital Care	Prehospital Care No Experience	Prehospital Care Have Past Experience	Prehospital Care Have Expertise	Prehospital Care Currently Practice
Emergency Medicine	Emergency Medicine No Experience	Emergency Medicine Have Past Experience	Emergency Medicine Have Expertise	Emergency Medicine Currently Practice
Urgent Care	Urgent Care No Experience	Urgent Care Have Past Experience	Urgent Care Have Expertise	Urgent Care Currently Practice
Chronic Condition Management	Chronic Condition Management No Experience	Chronic Condition Management Have Past Experience	Chronic Condition Management Have Expertise	Chronic Condition Management Currently Practice
Skilled Nursing Facility/LTAC/IRF	Skilled Nursing Facility/LTAC/IRF No Experience	Skilled Nursing Facility/LTAC/IRF Have Past Experience	Skilled Nursing Facility/LTAC/IRF Have Expertise	Skilled Nursing Facility/LTAC/IRF Currently Practice
Behavioral Health/Telepsychiatry	Behavioral Health/Telepsychiatry No Experience	Behavioral Health/Telepsychiatry Have Past Experience	Behavioral Health/Telepsychiatry Have Expertise	Behavioral Health/Telepsychiatry Currently Practice
Telestroke/Teleneurology	Telestroke/Teleneurology No Experience	Telestroke/Teleneurology Have Past Experience	Telestroke/Teleneurology Have Expertise	Telestroke/Teleneurology Currently Practice
Provider-to-provider	Provider-to-provider No Experience	Provider-to-provider Have Past Experience	Provider-to-provider Have Expertise	Provider-to-provider Currently Practice
Orthopedics	Orthopedics No Experience	Orthopedics Have Past Experience	Orthopedics Have Expertise	Orthopedics Currently Practice
ENT	ENT No Experience	ENT Have Past Experience	ENT Have Expertise	ENT Currently Practice
Dermatology	Dermatology No Experience	Dermatology Have Past Experience	Dermatology Have Expertise	Dermatology Currently Practice
Wound Care	Wound Care No Experience	Wound Care Have Past Experience	Wound Care Have Expertise	Wound Care Currently Practice
Ophthamology	Ophthamology No Experience	Ophthamology Have Past Experience	Ophthamology Have Expertise	Ophthamology Currently Practice
Pediatrics	Pediatrics No Experience	Pediatrics Have Past Experience	Pediatrics Have Expertise	Pediatrics Currently Practice
Trauma	Trauma No Experience	Trauma Have Past Experience	Trauma Have Expertise	Trauma Currently Practice
Education	Education No Experience	Education Have Past Experience	Education Have Expertise	Education Currently Practice
Satisfaction	Satisfaction No Experience	Satisfaction Have Past Experience	Satisfaction Have Expertise	Satisfaction Currently Practice
Technology/Informatics	Technology/Informatics No Experience	Technology/Informatics Have Past Experience	Technology/Informatics Have Expertise	Technology/Informatics Currently Practice
Access	Access No Experience	Access Have Past Experience	Access Have Expertise	Access Currently Practice
Mobile Health	Mobile Health No Experience	Mobile Health Have Past Experience	Mobile Health Have Expertise	Mobile Health Currently Practice

Other (please specify or add comments)

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5. Of the issues listed below, please rank the most pertinent issues to your practice? (Note: 1 is highest priority, 10 is lowest)

Reimbursement

Lack of Hospital Support

Operational Challenges

Time

Multistate Licensing

Space

Equipment

Nursing

Productivity

Metrics

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6. Please list any other pertinent issues to your practice that were not listed above, if applicable.

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7. How well do you feel each of the following are prepared/educated about telemedicine?

	1 (least prepared)	2	3	4	5 (most prepared)
Medical Students	Medical Students 1 (least prepared)	Medical Students 2	Medical Students 3	Medical Students 4	Medical Students 5 (most prepared)
Residents	Residents 1 (least prepared)	Residents 2	Residents 3	Residents 4	Residents 5 (most prepared)
Nurses	Nurses 1 (least prepared)	Nurses 2	Nurses 3	Nurses 4	Nurses 5 (most prepared)
Nurse Practitioners	Nurse Practitioners 1 (least prepared)	Nurse Practitioners 2	Nurse Practitioners 3	Nurse Practitioners 4	Nurse Practitioners 5 (most prepared)
Physician Assistants	Physician Assistants 1 (least prepared)	Physician Assistants 2	Physician Assistants 3	Physician Assistants 4	Physician Assistants 5 (most prepared)
Attending Physicians	Attending Physicians 1 (least prepared)	Attending Physicians 2	Attending Physicians 3	Attending Physicians 4	Attending Physicians 5 (most prepared)
Hospital Administrators	Hospital Administrators 1 (least prepared)	Hospital Administrators 2	Hospital Administrators 3	Hospital Administrators 4	Hospital Administrators 5 (most prepared)

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8. How important do you feel it is for each of the following to have education and training in telemedicine?

	1 (least important)	2	3	4	5 (most important)
Medical Students	Medical Students 1 (least important)	Medical Students 2	Medical Students 3	Medical Students 4	Medical Students 5 (most important)
Residents	Residents 1 (least important)	Residents 2	Residents 3	Residents 4	Residents 5 (most important)
Nurses	Nurses 1 (least important)	Nurses 2	Nurses 3	Nurses 4	Nurses 5 (most important)
Nurse Practitioners	Nurse Practitioners 1 (least important)	Nurse Practitioners 2	Nurse Practitioners 3	Nurse Practitioners 4	Nurse Practitioners 5 (most important)
Physician Assistants	Physician Assistants 1 (least important)	Physician Assistants 2	Physician Assistants 3	Physician Assistants 4	Physician Assistants 5 (most important)
Attending Physicians	Attending Physicians 1 (least important)	Attending Physicians 2	Attending Physicians 3	Attending Physicians 4	Attending Physicians 5 (most important)
Hospital Administrators	Hospital Administrators 1 (least important)	Hospital Administrators 2	Hospital Administrators 3	Hospital Administrators 4	Hospital Administrators 5 (most important)

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9. How would you prefer to learn about Telemedicine? (Note: 1 is most preferable, 4 is least)

Scientific Assembly

ACEP Newsletter

Annals of Emergency Medicine Priority Topic

Webinars / Joint Webinars with other sections (ie: Rural EM)

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10. Are there other ways you wish to learn about Telemedicine?

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11. What factors do you think are important regarding ACEP’s strategic planning for telehealth reimbursement? (please specify)

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12. If you would like to opt out of having your answers included in the searchable database, please check the box.

I would like to opt out

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* 1. Please enter your full name. (Required.)

Question Title

* 2. Do you provide or expect to provide telehealth services in the next 3 years? (Required.)

Question Title

* 3. Do you provide or expect to provide "direct to patient" emergency telehealth services? (Required.)

Question Title

* 4. Please select the appropriate level of experience with the following services:

Question Title

* 5. Of the issues listed below, please rank the most pertinent issues to your practice? (Note: 1 is highest priority, 10 is lowest)

Question Title

* 6. Please list any other pertinent issues to your practice that were not listed above, if applicable.

Question Title

* 7. How well do you feel each of the following are prepared/educated about telemedicine?

Question Title

* 8. How important do you feel it is for each of the following to have education and training in telemedicine?

Question Title

* 9. How would you prefer to learn about Telemedicine? (Note: 1 is most preferable, 4 is least)

Question Title

* 10. Are there other ways you wish to learn about Telemedicine?

Question Title

* 11. What factors do you think are important regarding ACEP’s strategic planning for telehealth reimbursement? (please specify)

Question Title

* 12. If you would like to opt out of having your answers included in the searchable database, please check the box.

1. Please enter your full name. (Required.)

2. Do you provide or expect to provide telehealth services in the next 3 years? (Required.)

3. Do you provide or expect to provide "direct to patient" emergency telehealth services? (Required.)

4. Please select the appropriate level of experience with the following services:

5. Of the issues listed below, please rank the most pertinent issues to your practice? (Note: 1 is highest priority, 10 is lowest)

6. Please list any other pertinent issues to your practice that were not listed above, if applicable.

7. How well do you feel each of the following are prepared/educated about telemedicine?

8. How important do you feel it is for each of the following to have education and training in telemedicine?

9. How would you prefer to learn about Telemedicine? (Note: 1 is most preferable, 4 is least)

10. Are there other ways you wish to learn about Telemedicine?

11. What factors do you think are important regarding ACEP’s strategic planning for telehealth reimbursement? (please specify)

12. If you would like to opt out of having your answers included in the searchable database, please check the box.