2022 SVS PSO National Quality Long-Term Follow Up (LTFU) Survey

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* 1. First Name

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* 2. Last Name

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* 3. Email

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* 4. Job Title

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* 5. VQI Region

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* 6. Total Number of Centers that you Abstract for (0-25)

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* 7. Do you use a third-party abstraction company?

No

Yes

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* 8. If you use a third-party abstraction company, do they abstract:

Procedure Data Only

LTFU Data Only

Both

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* 9. Total number of FTE's that your site(s) support specifically for LTFU abstraction which includes employees and third party (best estimate)

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* 10. Does your center(s) have trouble collecting LTFU due to the following? (Select all that apply).

Lack of dedicated staff for LTFU data collection

Staff reassigned due to COVID

Follow up occurs at an office outside of your facility

Follow up occurs outside of LTFU window (9-21 months)

Lack of scheduling resources

Lack of access to medical records – internal or external

Other (please specify)

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* 11. Have patients expressed concerns regarding LTFU due to the following? (Select all that apply)

COVID-19

Financial concerns (Co-pays, Out-of-pocket costs, etc.)

Long distance/travel

No concerns

Patient Refusal

Other (please specify)

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* 12. Do you review LTFU rates with your physicians and/or administrators?

Yes

No

Other (please specify)