Skip to content
Practice Survey - EHR
By completing this survey, it will make your practice eligible to apply for funding through a funding opportunity that will be available this month.
Please provide data for the time frame of January 1, 2023-June 30, 2023.
1.
Name of practice
2.
Name of person completing this survey
3.
Position/Title of person completing this survey
4.
Email of person completing this survey
5.
Please indicate practice ownership (Select all that apply):
Hospital or health system owned practice (non-rural health clinic)
Independent, private practice (non-rural health clinic)
Provider-based rural health clinic
Independent rural health clinic
Federally Qualified Health Center
Free medical clinic
Other (please specify)
6.
Please indicate how many FTE providers are in your practice:
7.
Please indicate the percentage of patients by demographic characteristic:
Hispanic
Non-Hispanic
Black
White
Other
Female
Male
Primary Language English
Primary Language Spanish
I cannot provide this type of information on my patient population.
8.
Please estimate the number of patients that are covered by:
Medicare (Traditional Only)
Commercial Insurance
Medicaid (Plain Only)
Uninsured/Self-Pay
Other
Do not know
9.
What is your average daily visit count?
10.
Please select all patient demographic characteristics that are required to be collected by your practice:
Date of birth
Ethnicity
Race
Gender
Primary language
Language proficiency
Disability
Sexual orientation
Gender identity
11.
Please indicate if you use the following data categories when collecting ethnicity data:
Categories: Hispanic or Latino; Not Hispanic or Latino
Yes
No, we do not collect ethnicity data from our patients
Do not know
No, we collect ethnicity data, but use the following categories:
12.
Please indicate if you use the following data categories when collecting race data.
Categories: Black or African American; White; Asian; American Indian or Alaska Native; Native Hawaiian, or Other Pacific Islander
Yes
No, we do not collect race data from our patients
Do not know
No, we collect race data but use the following categories:
13.
Do you classify patients as multi-racial?
Yes
No
Do not know
14.
Does your practice have a standardized written process for collecting patient demographic data?
Yes
No
Do not know
15.
Indicate
when
the patient's race and ethnicity data is collected (Select all that apply.)
By registration staff, during initial patient registration for new patients at initial patient visit only
By registration staff, during patient registration at each patient visit
By nursing staff, during patient intake prior to initial patient visit
By nursing staff, during patient intake at each visit
By patient, during pre-registration either in person or online
Do not know
16.
How
is the patient's race and ethnicity data collected? (Select all that apply.)
Patient verbally self-reports their race and ethnicity and the data is recorded by the office staff
Patient self-reports their race and ethnicity through paper forms
Patient self-reports their race and ethnicity through online forms
Office staff observes patient race and ethnicity and records their observations
Data collection process varies as there is no standard process for collecting patient race and ethnicity
Do not know
17.
How is the patient's race and ethnicity data recorded? (Select all that apply.)
Patient self-reported data is recorded through completion of an online form
Patient self-reported data is abstracted from paper form and inputted into practice management system/electronic health record
Office staff directly inputs data into practice management system/electronic health record during the registration process
Do not know
18.
Does your practice monitor clinical performance measures? (Select all that apply.)
Yes, we review clinical performance measures generated from our EHR on a monthly basis
Yes we review clinical performance measures generated from our EHR on a quarterly or semi-annual basis
Yes, we review clinical performance measures generated from our EHR on an annual basis
Yes, we review clinical performance measures in reports provided by a managed care organization or other payer
Yes, we review clinical performance measures in reports provided by our ACO or health system
No, we do not monitor clinical performance measures (If selected, skip questions 19-22)
Do not know
19.
Select the type of clinical performance measurements that you collect and review. (Select all that apply.)
Chronic disease (i.e., blood pressure control)
Preventive (i.e., breast cancer screening)
Behavioral health (i.e., depression screening)
Care coordination (i.ee., referral loop closure)
Safety (i.e., fall risk)
Cost of care (i.e., hospital readmissions)
20.
Do you currently stratify clinical performance measures by patient demographic data? Select the answer that best reflects current practice.
Yes, we stratify all clinical performance measures by patient demographic data
Yes, we stratify selected clinical performance measures by patient demographic data
No, we do not stratify clinical performance measures by patient demographic data but, we have the capability to run these reports
No, we do not stratify clinical performance measures by patient demographic data because we do not currently have the capability to run these reports (If selected, skip Question 21).
21.
If you stratify clinical performance measures by patient demographic data, please select which patient demographic category is used to stratify.
Race
Ethnicity
Gender
Language proficiency
Language preference
Disability
Sexual orientation
Gender identity
Other (please specify)
22.
If you do NOT stratify clinical performance measures by patient demographic data, please select any barriers you have for generating these reports.
EHR has limited reporting capabilities and cannot generate these types of reports.
EHR can generate these types of reports, but they are difficult to produce.
EHR can generate these types of reports, but they require an additional module.
Additional data analysis is needed and practice does not have required expertise.
Health system IT/Clinical informatics does not provide these types of reports.
Patient demographic data stratification reports are not prioritized in our performance monitoring strategy.
Patient demographic data stratification reports are not required to fulfill the requirements of our value-based payer contracts.
23.
Describe your practice capabilities related to performance improvement.
We have a dedicated person who is charged with performance improvement activities.
We have a provider/staff person who has a portion of their time dedicated to performance improvement activities.
Performance improvement is a shared responsibility among several staff providers/members.
We do not have any specific person who is charged with performance improvement.
24.
Describe your practice capabilities related to health informatics/EHR optimization and reporting.
We have a dedicated person who is charged with health information/EHR optimization and reporting, and they have formalized training in this area.
We have a dedicated person who is charged with health information/EHR optimization and reporting, and they have on-the-job training and experience in this area, but no formalized training.
We have a superuser(s) that assists with health informatics/EHR optimization and reporting.
We receive support from an external consultant.
We do not have any specific support for health informatics/EHR optimization and reporting.
25.
Thank you for completing this survey. The SC Office of Rural Health is offering opportunities for practices to receive funding to classify patient data. Would your practice be interested in learning more about this opportunity? If so, please click
here
to learn more.
Yes
No
