Relevant and Pertinent Short
Survey Results
Summary
February 19, 2016
Robert Dieterle
Holly Miller, MD
Russel Leftwich, MD
Summary of Participation
Organization
American Academy of Family Physicians
American Hospital Association
American Medical Association
Other
Total
Total
103
34
ToC1
62
28
433
43
613
163
23
275
Note 1: ToC – declared they have received ToC Documents
Note: there are no significant differences in in answers between the full set of
respondents and the 275 that have experience receiving ToC documents
Demographics
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Practice location distribution matches US population distribution
General Practice and all relevant specialties represented
All practice types (IDN/Hospital/Unaffiliated) represented
Response by practice size represents solo to >20 provider practices
All payer types well represented
EHR and ToC Experience
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>80% have used EHRs for over 3 years
> 60% have or plan to send ToC documents
47% have received ToC documents
hospital discharge and consults are the most common
documents
 About 50% review the documents
 30% incorporate discrete clinical data personally
General Issues
 Over 50% declare too much information
 45% declare needed information is missing
 Majority believe organization and lack of a clear
summary are a problem
 >30% did not receive them in a timely fashion
Hospital Discharge
 80% want same information as traditional discharge summary
 30-40% prefer or are neutral on receiving all hospitalization data
 One in three declare they receive some or all information from a
hospitalization at least 50% of the time
 >45% declare that important information is missing over 50% of
the time
Ambulatory
 >80% want all information from the current ambulatory visit
 >80% want new or changed information from all ambulatory
visits
 50% declare they receive all information from the current
ambulatory visit at least 50% of the time
 30% declare that important information is missing over 50% of
the time
Value of Specific Information
 Hospital Discharge and CCD
 Over 50% consider information in 18 of the 26 sections
(including optional sections) valuable
 Of the 26 sections listed only 4 are consider valuable by
less than 40% of the respondents
 Ambulatory (consult/progress note/CCD)
 Over 50% consider information in 20 of the 28 sections
(including optional sections) valuable
 Of the 28 sections listed only 5 are consider valuable by
less than 40% of the respondents
Scope Preferred for Specific
Information
 Hospital Discharge and CCD
 65% want all procedures (from all hospitalizations)
 50% want last available functional status, plan of
treatment, review of systems and vital signs
 Hospital studies / results are equally distributed
between last, first and last and all
 Ambulatory (consult/progress note/CCD)
 50-90% want functional status, plan of treatment,
problems, procedures, review of systems and vital signs
from the current visit only (not from prior visits)
Medications
 Hospitalization
 90% declare active and prescribed meds at discharge necessary (60%
declare they are always received)
 > 80% declare admission and administered medications necessary or
useful (<25% declare they are always received)
 Ambulatory Visit
 >80% declare new and discontinued medications are necessary (50%
declare they always receive new meds and only 30% declare they receive
discontinued meds)
 > 70% declare current meds at time of visit are necessary (<45% declare
they are always received)
Alternative Approaches
 40% want to receive less information
 60% want to receive more information if they have
better display and incorporation capability
 50% of all respondents want
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User defined summaries
Table of contents with links
Drag and drop for incorporation of discrete data
Automated incorporation
Detection of duplicate data
Comments and Follow-up
Count
Percentage
Contact information
142
23 %
Willing to participate
278
46 %
129
46 %
86
14 %
Providing contact information
Provided exit comments
Note: this from all respondents
Summary
1.
2.
3.
4.
5.
50% of surveyed provider receive ToC documents
Hospital – want same information as paper discharge document
Ambulatory – want all information from current visit
Ambulatory – want changed information from prior visits
At least 30 % of providers want information from all sections of the
C-CDA documents, 50% from 70% of the sections
6. 50% that want less information, in general from prior visits or
repeated data (e.g. Vital signs)
7. 60% want better tools to review and incorporate
8. 50% declare important information is missing in ToC