1.
How would you best describe the Electronic Health Record (EHR) or Electronic Medical Record (EMR) solution you use in your practice:
I use an EHR/EMR and Practice Management System offered by the same vendor
I use a third-party EHR/EMR that is integrated with my Practice Management System
I use a stand-alone third-party EHR/EMR that is NOT integrated with my Practice Management System
I do not have an EHR/EMR Solution
2.
Please provide us with the name of the EHR/EMR product you use:
3.
Is the EHR/EMR system you currently use CCHIT or ARRA-certified as of 2010?
Yes
No
Unsure
4.
Will your practice benefit from the reimbursements offered by Medicare and Medicaid for meeting the “meaningful use” criteria associated with electronic health record systems?
Yes
No
Unsure
5.
Which of the following best describes your need for an EHR system that is CCHIT or ARRA certified?
Must have now
Nice to have now, but necessary in 5 years
Do not need a CCHIT or ARRA -certified system now, but will in 5 years
Do not need a CCHIT or ARRA -certified system now or in the future
6.
Which of the following best describes your plans for EHR/EMR for the next 5 years?
I plan to use my current EHR/EMR solution that is CCHIT or ARRA -certified
I plan to use my current EHR/EMR that is NOT CCHIT or ARRA -certified
I plan to purchase a new EHR/EMR solution that is CCHIT or ARRA -certified within the next 5 years
I plan to purchase a new EHR/EMR solution that is NOT CCHIT or ARRA -certified within the next 5 years
I don’t plan to implement EHR/EMR in my practice
7.
How would you prefer to purchase a solution for managing EHR/EMR?
As an add-on from my Practice Management System Vendor
From a third-party vendor that is integrated with my Practice Management System
From a third-party vendor that functions independently of my Practice Management System
I wouldn’t purchase a solution for managing Electronic Health Records (EHR)
8.
Please provide us with the name of the PM Software system that you use:
9.
How much do you think an EHR/EMR solution costs a practice on average per month (costs do not include PM costs or other third-party software costs)?
Less than $250 per month
$250 - $500 per month
$501 - $750 per month
$751 - $1000 per month
Over $1000 per month
10.
How much do you agree or disagree with the following statement: “The process of providing eye care is unique from general medical care or other care provided in other specialties”
Completely Agree
Somewhat Agree
Neither Agree nor Disagree
Somewhat Disagree
Completely Disagree
11.
How important is it for the EHR/EMR to be customized for your specialty within eye care?
Very important
Somewhat important
Neutral
Somewhat unimportant
Not important
12.
Contact Information
First Name
Last Name
Company Name
Street Address
Apt/Suite/Office
City
State
Postal Code
Email Address
Phone Number
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