Meaningful Use in 2015 Survey

Please submit answers to the following questions for up to 10 facilities. There is also one option per question for those who supply IT services to affiliated physicians. Please answer for the majority of EPs you support.

	Stage 1	Stage 2
Facility 1	Facility 1 Stage 1	Facility 1 Stage 2
Facility 2	Facility 2 Stage 1	Facility 2 Stage 2
Facility 3	Facility 3 Stage 1	Facility 3 Stage 2
Facility 4	Facility 4 Stage 1	Facility 4 Stage 2
Facility 5	Facility 5 Stage 1	Facility 5 Stage 2
Facility 6	Facility 6 Stage 1	Facility 6 Stage 2
Facility 7	Facility 7 Stage 1	Facility 7 Stage 2
Facility 8	Facility 8 Stage 1	Facility 8 Stage 2
Facility 9	Facility 9 Stage 1	Facility 9 Stage 2
Facility 10	Facility 10 Stage 1	Facility 10 Stage 2
Physicians	Physicians Stage 1	Physicians Stage 2

Stage 1

Stage 2

Facility 1

Facility 1 Stage 1

Facility 1 Stage 2

Facility 2

Facility 2 Stage 1

Facility 2 Stage 2

Facility 3

Facility 3 Stage 1

Facility 3 Stage 2

Facility 4

Facility 4 Stage 1

Facility 4 Stage 2

Facility 5

Facility 5 Stage 1

Facility 5 Stage 2

Facility 6

Facility 6 Stage 1

Facility 6 Stage 2

Facility 7

Facility 7 Stage 1

Facility 7 Stage 2

Facility 8

Facility 8 Stage 1

Facility 8 Stage 2

Facility 9

Facility 9 Stage 1

Facility 9 Stage 2

Facility 10

Facility 10 Stage 1

Facility 10 Stage 2

Physicians

Physicians Stage 1

Physicians Stage 2

	1 = We will not make it	2 = Not confident	3 = Unsure	4 = fairly confident	5 = very confident
Facility 1	Facility 1 1 = We will not make it	Facility 1 2 = Not confident	Facility 1 3 = Unsure	Facility 1 4 = fairly confident	Facility 1 5 = very confident
Facility 2	Facility 2 1 = We will not make it	Facility 2 2 = Not confident	Facility 2 3 = Unsure	Facility 2 4 = fairly confident	Facility 2 5 = very confident
Facility 3	Facility 3 1 = We will not make it	Facility 3 2 = Not confident	Facility 3 3 = Unsure	Facility 3 4 = fairly confident	Facility 3 5 = very confident
Facility 4	Facility 4 1 = We will not make it	Facility 4 2 = Not confident	Facility 4 3 = Unsure	Facility 4 4 = fairly confident	Facility 4 5 = very confident
Facility 5	Facility 5 1 = We will not make it	Facility 5 2 = Not confident	Facility 5 3 = Unsure	Facility 5 4 = fairly confident	Facility 5 5 = very confident
Facility 6	Facility 6 1 = We will not make it	Facility 6 2 = Not confident	Facility 6 3 = Unsure	Facility 6 4 = fairly confident	Facility 6 5 = very confident
Facility 7	Facility 7 1 = We will not make it	Facility 7 2 = Not confident	Facility 7 3 = Unsure	Facility 7 4 = fairly confident	Facility 7 5 = very confident
Facility 8	Facility 8 1 = We will not make it	Facility 8 2 = Not confident	Facility 8 3 = Unsure	Facility 8 4 = fairly confident	Facility 8 5 = very confident
Facility 9	Facility 9 1 = We will not make it	Facility 9 2 = Not confident	Facility 9 3 = Unsure	Facility 9 4 = fairly confident	Facility 9 5 = very confident
Facility 10	Facility 10 1 = We will not make it	Facility 10 2 = Not confident	Facility 10 3 = Unsure	Facility 10 4 = fairly confident	Facility 10 5 = very confident
Physicians	Physicians 1 = We will not make it	Physicians 2 = Not confident	Physicians 3 = Unsure	Physicians 4 = fairly confident	Physicians 5 = very confident

1 = We will not make it

2 = Not confident

3 = Unsure

4 = fairly confident

5 = very confident

Facility 1

Facility 1 1 = We will not make it

Facility 1 2 = Not confident

Facility 1 3 = Unsure

Facility 1 4 = fairly confident

Facility 1 5 = very confident

Facility 2

Facility 2 1 = We will not make it

Facility 2 2 = Not confident

Facility 2 3 = Unsure

Facility 2 4 = fairly confident

Facility 2 5 = very confident

Facility 3

Facility 3 1 = We will not make it

Facility 3 2 = Not confident

Facility 3 3 = Unsure

Facility 3 4 = fairly confident

Facility 3 5 = very confident

Facility 4

Facility 4 1 = We will not make it

Facility 4 2 = Not confident

Facility 4 3 = Unsure

Facility 4 4 = fairly confident

Facility 4 5 = very confident

Facility 5

Facility 5 1 = We will not make it

Facility 5 2 = Not confident

Facility 5 3 = Unsure

Facility 5 4 = fairly confident

Facility 5 5 = very confident

Facility 6

Facility 6 1 = We will not make it

Facility 6 2 = Not confident

Facility 6 3 = Unsure

Facility 6 4 = fairly confident

Facility 6 5 = very confident

Facility 7

Facility 7 1 = We will not make it

Facility 7 2 = Not confident

Facility 7 3 = Unsure

Facility 7 4 = fairly confident

Facility 7 5 = very confident

Facility 8

Facility 8 1 = We will not make it

Facility 8 2 = Not confident

Facility 8 3 = Unsure

Facility 8 4 = fairly confident

Facility 8 5 = very confident

Facility 9

Facility 9 1 = We will not make it

Facility 9 2 = Not confident

Facility 9 3 = Unsure

Facility 9 4 = fairly confident

Facility 9 5 = very confident

Facility 10

Facility 10 1 = We will not make it

Facility 10 2 = Not confident

Facility 10 3 = Unsure

Facility 10 4 = fairly confident

Facility 10 5 = very confident

Physicians

Physicians 1 = We will not make it

Physicians 2 = Not confident

Physicians 3 = Unsure

Physicians 4 = fairly confident

Physicians 5 = very confident

	Yes	No	I don't know
Facility 1	Facility 1 Yes	Facility 1 No	Facility 1 I don't know
Facility 2	Facility 2 Yes	Facility 2 No	Facility 2 I don't know
Facility 3	Facility 3 Yes	Facility 3 No	Facility 3 I don't know
Facility 4	Facility 4 Yes	Facility 4 No	Facility 4 I don't know
Facility 5	Facility 5 Yes	Facility 5 No	Facility 5 I don't know
Facility 6	Facility 6 Yes	Facility 6 No	Facility 6 I don't know
Facility 7	Facility 7 Yes	Facility 7 No	Facility 7 I don't know
Facility 8	Facility 8 Yes	Facility 8 No	Facility 8 I don't know
Facility 9	Facility 9 Yes	Facility 9 No	Facility 9 I don't know
Facility 10	Facility 10 Yes	Facility 10 No	Facility 10 I don't know
Physicians	Physicians Yes	Physicians No	Physicians I don't know

Yes

I don't know

Facility 1

Facility 1 Yes

Facility 1 No

Facility 1 I don't know

Facility 2

Facility 2 Yes

Facility 2 No

Facility 2 I don't know

Facility 3

Facility 3 Yes

Facility 3 No

Facility 3 I don't know

Facility 4

Facility 4 Yes

Facility 4 No

Facility 4 I don't know

Facility 5

Facility 5 Yes

Facility 5 No

Facility 5 I don't know

Facility 6

Facility 6 Yes

Facility 6 No

Facility 6 I don't know

Facility 7

Facility 7 Yes

Facility 7 No

Facility 7 I don't know

Facility 8

Facility 8 Yes

Facility 8 No

Facility 8 I don't know

Facility 9

Facility 9 Yes

Facility 9 No

Facility 9 I don't know

Facility 10

Facility 10 Yes

Facility 10 No

Facility 10 I don't know

Physicians

Physicians Yes

Physicians No

Physicians I don't know

Meaningful Use in 2015

Snapshot Survey

Question Title

* 1. What Stage of MU are you scheduled to meet in program year 2015?

Question Title

* 2. How confident are you that your facilities will be able to meet your required Stage in program year 2015?

Question Title

* 3. Would a shortened reporting period in 2015 (similar to the quarter EHR reporting period policy of 2014) improve your confidence?