New York State Department of Health Telehealth Provider Survey

Telehealth Provider Survey

The New York State Department of Health (The Department) is conducting a survey of all health care providers to gain knowledge of your experience using telehealth during the COVID-19 Public Health Emergency (PHE) and your plans to continue to use telehealth. The Department will use the results of this 5-minute survey to inform telehealth policy development.

Please limit to one survey response per individual clinician, but the Department encourages multiple clinicians to respond from the same organization, especially if they have different perspectives.

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* 1. Health Care Facility or Organization Type (Select primary type of facility from dropdown)

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* 2. Which region/county of New York State is your facility or organization Located

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* 3. What is the Zip Code for your Facility/Organization?

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* 4. What is the geographic location of your health care facility/organization?

Urban

Suburban

Rural

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* 5. Provider Type (Select from dropdown)

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* 6. Are you an enrolled Medicaid Provider?

Yes

Other (please specify)

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* 7. Over the past year, what was the average number of patients seen monthly at your health care facility/organization?

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* 8. Over the past year, what percentage of your patient visits are telehealth visits?

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* 9. of the visits you complete, how often is a health service delivered via telehealth ?

	Never	Rarely	Sometimes	Often	N/A
I (the provider) am on site at my facility during the visit	I (the provider) am on site at my facility during the visit Never	I (the provider) am on site at my facility during the visit Rarely	I (the provider) am on site at my facility during the visit Sometimes	I (the provider) am on site at my facility during the visit Often	I (the provider) am on site at my facility during the visit N/A
My patient is on site at my facility during the visit	My patient is on site at my facility during the visit Never	My patient is on site at my facility during the visit Rarely	My patient is on site at my facility during the visit Sometimes	My patient is on site at my facility during the visit Often	My patient is on site at my facility during the visit N/A
Neither myself (the provider) nor my patient is on site at the facility during the visit	Neither myself (the provider) nor my patient is on site at the facility during the visit Never	Neither myself (the provider) nor my patient is on site at the facility during the visit Rarely	Neither myself (the provider) nor my patient is on site at the facility during the visit Sometimes	Neither myself (the provider) nor my patient is on site at the facility during the visit Often	Neither myself (the provider) nor my patient is on site at the facility during the visit N/A
I ( the provider) remotely monitor my patient who is off site (BP monitor, blood glucose meter, weight scale, pulse oximeter, etc.)	I ( the provider) remotely monitor my patient who is off site (BP monitor, blood glucose meter, weight scale, pulse oximeter, etc.) Never	I ( the provider) remotely monitor my patient who is off site (BP monitor, blood glucose meter, weight scale, pulse oximeter, etc.) Rarely	I ( the provider) remotely monitor my patient who is off site (BP monitor, blood glucose meter, weight scale, pulse oximeter, etc.) Sometimes	I ( the provider) remotely monitor my patient who is off site (BP monitor, blood glucose meter, weight scale, pulse oximeter, etc.) Often	I ( the provider) remotely monitor my patient who is off site (BP monitor, blood glucose meter, weight scale, pulse oximeter, etc.) N/A

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* 10. Are you a provider who can prescribe medications?

Yes