We developed structured but open ended data gathering tools for the site visit to (1) allow for targeted, systematic collection of relevant information and (2) capture the overall richness of respondent experiences. Telephone discussions and in-person interviews with respondents were conducted using discussion guides and a tabular form was emailed to IS staff at respondent health centers to facilitate collection of standard information relating to infrastructure and technical capacity.
Discussion guides. Preliminary versions of the discussion guides used for the site visit followed from a generic site visit protocol developed earlier in the study and reviewed, modified and approved by ASPE and HRSA. As noted above, informal pre-site visit conversations with respondents allowed us to incorporate information gathered during those conversations into tailored discussion guides for each interview. For each scheduled interview, the NORC team prepared materials that outlined our preliminary knowledge of the respondent and highlighted outstanding questions to address during the interview. Respondents who had experience with OCHIN were asked about the impetus behind OCHIN, the characteristics of the participating health centers versus the non-participating centers, the stakeholders’ experiences with OCHIN and Epic, and the potential for replicating a system like OCHIN in other regions of the country. Examples of discussion guides and preparation materials used in the site visit are included as Appendix A.
Gathering data on health center IS.To gather information about the health centers’ IS infrastructure; we designed a short table with fields relevant to various aspects of a health center’s network, data and technology. This table was distributed to the various health center respondents prior to the site visit. Several of the sites returned very helpful information, including diagrams of their local or wide area networks (LANs or WANs), examples of written policy statements, a classification of support issues compiled by the center’s help desk, examples of paper-based records, and information about applications used to manage clinical and practice management data. The table used to gather these data is provided as Appendix B.