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Survey Templates Surveys HealthCareSurvey

HealthCareSurvey

Sample Survey

Dear valuable participant:


You are invited to participate in this survey on Web Based Electronic Patient Records.
It will take approximately 10 minutes to complete the questionnaire.
The survey is aimed at Health Care Professionals / Nurses / Administrators and Patients.
I am greatly interested in having your valuable opinions.
Your answers will be greatly confidential and will be used to study the potential of
a Web Based Electronic Patient Record in Palestine.
In case you have any questions about the survey you can call me at my email [email protected]


Thank you very much for your time and support.



Michael AbuZuluf

University of Liverpool MSc IT student






To start with the survey please click the Continue button.




Name:
email:
Are You?
2.Gender?
3.What is your level of education?
4.How many years of experience in your profession do you have?
5.How do you estimate your English language Proficiency?
6.Do you own a computer at home?
7.Do you use the Internet?
8.Do you use email software?
9.Do you use Microsoft office software such as Word or Excel?
10.How do you estimate your typing skills?
11.How do you estimate your computer background and computer skills?
12.Have you ever used a computerized medical system?
13.If you have have ever used a computerized medical system before, how would you rate your satisfaction with it?
14.In your career, was it easy to send medical records between medical centers?
15.Do you think having a standard way of documenting and communicating medical records will benefit Health Care?
16.Do you think the Web (Internet) will be very beneficial in setting a standard for documenting and communicating Health Records?
17.Will you agree to work with a standard in Health Care and a standard way to document medical record?
18.These questions are about things that will influence you to use and accept a web-based computerized medical system. Please click the button against each question to show whether you agree or disagree with the statement on the left.
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
The new system must be easy to learn and use
It should eliminate Paper Work
It should reduce medical care paper records
It must save time documenting medical care files
It should allow easier access to patients' data, X-Rays and Lab Results
It must save physician's time
It should help in decision making
It must secure patients' sensitive data from intruders or un-authorized persons
It should have an easy and fast access to the Internet
It should have an option of using Arabic Language where appropriate
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
It must be supported from top management or the Ministry of Health
It should be a web based system
The new system must be unified across all medical centres and hospitals in Palestine
How important are these factors in encouraging you to accept a web-based computerized medical system? Please place them in order by typing 1 against the most important factor, 2 against the next most important and so on down to 5 for the least important factor.
The new system has enough support from top management or the Ministry of Health.
The system is unified across all medical centres and hospitals in Palestine.
The system must secure patients' sensitive data from intruders or un-authorized persons.
The system must save physician's valuable time.
The system must be easy to learn and use.
20.These questions are about the things that may make you unwilling to use and accept a web-based computerized medical system. Please click the button against each question to show whether you agree or disagree with the statement on the left.
Will Strongly Refuse the system
Will Refuse the system
Neutral
Will Accept the system
Will Strongly Accept the system
I do not have a good computer background
The new system needs lots of computer skills
English is difficult for me
I am slow in typing
The system needs lots of typing
The system needs lots of time to learn
The system contains lots of cumbersome and strange screens
I am suspicious about the security of my patients' sensitive data
The system is slow and takes lots of time to access and retrieve data
The Internet connection is not fast enough in Palestine
Will Strongly Refuse the system
Will Refuse the system
Neutral
Will Accept the system
Will Strongly Accept the system
The system is a Web-Based one
We do not have up-to-date and fast computers
The new system is buggy
I will spend lots of time looking at the screen and typing on the keyboard
The system is not Arabic Based
There is no support from Top Management or the Ministry of Health
Every Medical Center or Hospital uses its own computer system
How important are these factors in persuading you to reject a web-based computerized medical system? Please place them in order by typing 1 against the most important factor, 2 against the next most important and so on down to 5 for the least important factor.
I am slow in typing and the system needs lots of typing
I am suspicious about the security of my patients' sensitive data
The system takes lots of time to access and retrieve data
There is no support from Top Management or the Ministry of Health
The Internet Connection is not fast enough in Palestine
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