## ACPOE Email Survey

### Vendors Contacted

+---------------------+-----------------------+-----------------------+
| > **Healthcare IT** | > **ePrescribing**    | > **Knowledgebase**   |
+---------------------+-----------------------+-----------------------+
| > GE Medical        | > Allscripts          | > MicroMedex          |
| > Systems           |                       |                       |
+---------------------+-----------------------+-----------------------+
| > Cerner            | > Amicore             | > Theradoc            |
+---------------------+-----------------------+-----------------------+
| > Eclipsys          | > ePhysician          | > First DataBank      |
+---------------------+-----------------------+-----------------------+
| > Epic              | > FireKey (NaviMedix) | > Clineanswers        |
+---------------------+-----------------------+-----------------------+
| > IDX               | > Heleos              | >                     |
+---------------------+-----------------------+-----------------------+
| > McKessonHBOC      | > iMedica             | >                     |
+---------------------+-----------------------+-----------------------+
| > Meditech          | > iScribe             | >                     |
+---------------------+-----------------------+-----------------------+
| > Siemens           | > Medemorphus         | >                     |
+---------------------+-----------------------+-----------------------+
| > 3M                | > MDeverywhere        | >                     |
+---------------------+-----------------------+-----------------------+
| > NextGen           | > MDPad               | >                     |
+---------------------+-----------------------+-----------------------+
| > Misys             | > PocketScript        | >                     |
+---------------------+-----------------------+-----------------------+
| > Per-se            | > Patient Keeper      | >                     |
+---------------------+-----------------------+-----------------------+
| > Physician Micro   | > Mercury MD          | >                     |
| > Systems           |                       |                       |
+---------------------+-----------------------+-----------------------+
| > iSoft (United     | > MedUnite            |                       |
| > Kingdom)          | >                     |                       |
|                     | > (pre ProxyMed)      |                       |
+---------------------+-----------------------+-----------------------+
| > MedTech (New      | > RxHub               | >                     |
| > Zealand)          |                       |                       |
+---------------------+-----------------------+-----------------------+
|                     | > SureScript          |                       |
+---------------------+-----------------------+-----------------------+
|                     | > NDCHealth           |                       |
+---------------------+-----------------------+-----------------------+
|                     | > ProxyMed            |                       |
+---------------------+-----------------------+-----------------------+

### *CPOE in Ambulatory Settings*

*Please type free text answers to the questions below.*

*Return the completed survey to Jan Walker (jwalker3@partners.org) or
fax to 781-416-8913. To include your responses in our project, we must
receive the survey by November 5, 2002.*

**Definition of Ambulatory Computerized Provider Order Entry (ACPOE)**

Ambulatory CPOE is an application that allows providers to write drug,
laboratory, radiology, referral, and procedure orders electronically in
ambulatory care settings. These systems also integrate some level of
decision-support functionality to assist providers in reducing error
rates and practice in an evidence-based fashion. Finally, these systems
may also allow providers to perform administrative functions such as
coding visits, providing codes for laboratory tests, and scheduling
future visits. Any one system may not have all these capabilities;
nevertheless, we are interested in your experiences with any of them.

"Ambulatory care settings" is a broad term referring to care outside
hospitals and other inpatient settings. For this survey, we define
ambulatory care settings as freestanding and hospital-based clinics
(both primary and specialty care), ambulatory surgery centers,
physician's offices, and home care settings.

**SECTION I -- Ambulatory CPOE products currently available**

1.  Does your organization currently have an ambulatory CPOE product for
    sale?

Yes No

**If YES, please answer questions 2 -- 10. If NO, please skip to SECTION
II.**

2.  Please indicate your product's name, current production version, and
    mode of delivery (software license, ASP).

>      

3.  What is the target market for your product: small, medium, large
    physician practices, community hospitals, health systems? Please
    specify outpatient setting size and type.

>      

4.  When was this product first implemented? How many installations of
    this product are currently up and running?

     

5.  Using the *ACPOE Features* list at the end of this survey, please
    indicate your product's current features and functions.

6.  Please describe your product's IT staffing, human resource, and
    training needs.

>      

7.  Please discuss your pricing model and any implementation cost data
    that you are willing to share. We will not quote specific prices
    without your permission.

> License model and cost: per server, per CPU, per MD, per user, other?
>      
>
> Maintenance fee structure and terms: % total contract price annually?
> Other?      
>
> Implementation fees: (typically 2x license costs?)      

8.  What benefits have providers and other stakeholders (payers,
    purchasers) realized from your product?

>      

a.  What are the financial impacts?      

b.  What are the clinical impacts?      

c.  What impact on user and patient satisfaction?      

d.  What impact on legal or compliance risk?      

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9.  How much value can providers and other stakeholders (payers,
    purchasers) expect immediately upon implementation of your ACPOE
    system? Over 6 months? Over one year?

>      

10. If you think some of your physician users have particular insight
    and data on the financial, clinical, or organizational benefits of
    your product, we would like to speak with them. Please provide
    contact information.

>      

***Thank you for completing this section. Please skip to SECTION IV.***

**SECTION II -- Ambulatory CPOE products in development**

11. Are you planning on developing an ACPOE product?

Yes No

**If Yes, please answer questions 12 - 18. If NO, please skip to SECTION
III.**

12. When will your product be available?

>      

13. Using the *ACPOE Features* list at the end of this survey, please
    indicate the features and functions the first version of your
    product will support.

14. What IT staffing, human resource and training resources will your
    product require?

>      

15. How will your product be delivered (software license, ASP)?

     

16. What market will this product be developed for: small, medium, large
    physician practices, community hospitals, health systems? Please
    specify outpatient setting size and type.

>      

17. What's the expected price range for this product? Please detail your
    intended pricing model. We will not quote specific prices without
    your permission.

> License model: per server, per CPU, per user (MD, RN, NP, ancillary
> staff)      
>
> License costs     
>
> Maintenance costs     
>
> Implementation costs     

18. What benefits do you anticipate providers and other stakeholders
    (payers, purchasers) realizing from your product?

>      

a.  What will be the financial impacts?      

b.  What will be the clinical impacts?      

c.  What will be the impact on user and patient satisfaction?      

d.  What will be the impact on legal or compliance risk?      

***Thank you for completing this section. Please skip to SECTION IV.***

**SECTION III -- No ambulatory CPOE products or plans**

19. Why are you not planning on developing an outpatient CPOE product?

>      

**SECTION IV -- General questions about CPOE in ambulatory settings**

1.  What are the main barriers to implementing ACPOE?

>      

2.  What are the best practices for implementing ACPOE?

>      

3.  What are the strategic advantages of ACPOE for different
    constituents: providers, payer, purchasers, and pharmaceutical
    outlets?

>      

4.  What additional sources -- studies, CPOE users, experts -- should we
    consult as we investigate the value of ambulatory CPOE?

>      

5.  Is there anything more your want to add about outpatient CPOE that
    we did not ask about?

>      

### Section V - ACPOE Features

Please select all features and functions that apply to your outpatient
CPOE system and, where indicated, provide free text comments.

1.  Patient data

> Demographics
>
> Height, weight, body-surface area (BSA)
>
> Diagnoses
>
> Problem list
>
> Laboratory data
>
> Cultures
>
> Imaging data
>
> Consultation reports
>
> Pharmacy
>
> Insurer
>
> Other (specify with free text)      
>
> Medication data: Current Past Over-the-counter Supplements
>
> Medication allergies: Medication name Reaction
>
> Drug sensitivities: Medication name Reaction

2.  Knowledge bases

> Drug references (e.g. USPDI, vol. 1)
>
> Patient education (e.g. USPDI, vol. 2)
>
> Formulary
>
> Medication cost
>
> Test costs
>
> Administrative code sets (e.g. ICD-9, CPT-4)
>
> Medical necessity
>
> Other (specify with free text)      

3.  Ordering

Medication: New Refills Indications

Laboratory: Hematology Chemistry Indications

> Culture (i.e. blood, urine) to be collected by laboratory
>
> Procedural specimens (e.g., spinal fluid, wound cultures) obtained at
> office
>
> Prewritten orders for patient-collected specimen at home
>
> Imaging
>
> Referral
>
> Structured ordering (templates, sets)
>
> Charge capture
>
> Other (specify with free text)      

4.  User interface

Presentation: Textual Graphical Spoken

Data entry: Keyboard/Mouse Touch-screen

> Handwriting (light pen, tablets) Voice recognition

5.  Decision support

> Static references (Merck manual, PDR, etc.)

Single medication: Formulary compliance Common side effects

> Route/dosing range verification Dosing calculation

## Drug interaction checking:

> What: Allergy Medications in current order OTC medications Medications
> in medication list
>
> Supplements Diagnosis Laboratory
>
> When: At ordering At refill Whenever patient data is updated
>
> Medication checks are by: Name Medication class
>
> Full chemical interaction (e.g. all sulfa drugs)
>
> Guidelines: Built-in Modifiable by practice Sharable with other
> practices/sites

Consequent orders

> Other (specify with free text)      

6.  Connectivity

+------------------+-------------------------------+-------+----------+
| **Connection     | **Direct connection**         | **F   | **Paper  |
| to**             |                               | ax-ba | -based** |
|                  |                               | sed** |          |
+------------------+-------------------------------+-------+----------+
| Insurer          | Eligibility verification      |       |          |
|                  |                               |       |          |
|                  | Pre-approval/authorization    |       |          |
|                  |                               |       |          |
|                  | Automated reporting           |       |          |
+------------------+-------------------------------+-------+----------+
| In-patient       | EMR                           |       |          |
| facility         |                               |       |          |
|                  | Scheduling                    |       |          |
|                  |                               |       |          |
|                  | Pre-admission orders          |       |          |
|                  |                               |       |          |
|                  | In-patient CPOE               |       |          |
+------------------+-------------------------------+-------+----------+
| Pharmacy         | New prescription              |       |          |
|                  |                               |       |          |
|                  | Refills                       |       |          |
|                  |                               |       |          |
|                  | Refill requests from pharmacy |       |          |
+------------------+-------------------------------+-------+----------+
| Laboratory       | Test ordering                 |       |          |
|                  |                               |       |          |
|                  | Test scheduling               |       |          |
|                  |                               |       |          |
|                  | Result reporting              |       |          |
+------------------+-------------------------------+-------+----------+
| Imaging          | Test ordering                 |       |          |
|                  |                               |       |          |
|                  | Test scheduling               |       |          |
|                  |                               |       |          |
|                  | Result reporting              |       |          |
+------------------+-------------------------------+-------+----------+
| Referrals        | Ordering referral             |       |          |
|                  |                               |       |          |
|                  | Scheduling referral           |       |          |
|                  |                               |       |          |
|                  | Result reporting              |       |          |
+------------------+-------------------------------+-------+----------+

***7.*** Hardware and software

> Database: Cache Microsoft SQL NCR Teradata
>
> Oracle Sybase
>
> Proprietary (specify with free text)      
>
> Server Operating system: AIX, HPUX, UNIX Linux
>
> Microsoft Windows Solaris
>
> Proprietary (specify with free text)      
>
> Client Platform**:** Personal computer Web browser client
>
> Palm OS PDA Pocket PCs
>
> Mobile phone client (WAP)

8.  Infrastructure requirements

> What additional software is required to support your outpatient order
> entry system?
>
> Electronic Medical Record (EMR)
>
> Clinical data repository
>
> Enterprise Master Patient Index
>
> Scheduling system
>
> Financial System
>
> Billing and coding system
>
> Other (specify with free text)      
>
> N/A
>
> Does your system include pre-developed interfaces or support for:
>
> Your own clinical systems
>
> Other vendors' clinical systems (specify with free text)      
>
> Systems integration standards (e.g. HL7) (specify with free text)
>      
>
> Other
>
> N/A
>
> What level of connectivity is required to support the following means
> of accessing your system?

  --------------- --------- ------ ------ -------- --------- ------------- -----
                  Dial-up   ISDN   DSL    Cable    More than Proprietary   N/A
                  Modem                   Modem or single T1 network       
                                          T1                 required      

  Off-site remote                                                          
  access from                                                              
  home                                                                     

  Intra-site                                                               
  access for                                                               
  multi-site                                                               
  installations                                                            

  ASP-style                                                                
  access                                                                   
  --------------- --------- ------ ------ -------- --------- ------------- -----

**Thank you very much for completing this survey. Please tell us where
to send a copy of our summary report:**

Name:      

Mailing address:      

Email: