EHR Needs Assessment Survey

Thank you for taking time to complete this survey. The goals of the survey are to gain a better understanding of the usage of health information technology in Connecticut physician’s offices. The survey also seeks to highlight facilitators and barriers to technology use in the practice setting. Any questions you may have about this survey should be directed to: Anne Elwell at Qualidigm: (860)632-6322.


2. Please fill in the following information about your clinical office(s):















Technology Use








8. If you are not currently using an EHR, please indicate any other forms of technology you are using:











Barriers to Electronic Health Record Adoption

10. Please rate your concern about the following barriers to adoption of EHR on a scale of 1 to 5. Choose the appropriate response for each item below:

1 - Not at all concerned;
2 - Slightly concerned;
3 - Somewhat concerned;
4 - Moderately concerned;
5 - Extremely concerned;
Don’t know.

Financial



Organizational




Legal or Regulatory




State of Technology