NAMCS Computer Instrument
As in 2012, the 2013 NAMCS will be fielded as a fully computerized survey. The computerized survey instrument was tested throughout 2011 and made available to U.S. Census Bureau Field Representatives (our data collection agents) in November 2011 during a national training conference. Use of the computerized survey instrument is expected to simplify data collection, reduce errors and omissions, and improve data quality. In addition, it will also reduce respondent burden by tailoring the data collection to each sampled visit, skipping irrelevant questions automatically. Field Representatives (or interviewers, as they are also known) use laptops to enter information about physicians and non-physician clinicians during initial telephone screeners and induction interviews and also enter patient visit data for specified reporting periods.
NAMCS Sample SizeThe 2013 NAMCS sample includes approximately 11,000 physicians from office-based settings and more than 6,000 CHC providers (which may include both physicians and non-physician clinicians). As in 2012, NAMCS will continue sampling CHC providers at CHC service delivery sites, of which about 2,000 are included in the 2013 sample.
State-Based EstimatesThe nearly five-fold sample increase from 2011 to 2012 (more than 21,000 physicians and CHC providers) will enable NAMCS to produce state-based estimates for the 34 most populous states in the U.S. The 2013 NAMCS sample size will allow estimates to be made for the 22 most populous states. For the first time, researchers will be able to use 2012 and 2013 NAMCS data to compare medical care for selected states with other states, with any of the 9 Census Divisions within the 4 Census Regions: Northeast (New England, Mid-Atlantic), Midwest (East North Central, West North Central), South (South Atlantic, East South Central, West South Central), and West (Mountain, and Pacific), and with the Nation.
Lookback Module (2012-2013)The intent of the Lookback module is to improve the nation’s ability to monitor and evaluate the quality of clinical care to prevent diseases such as heart disease and stroke. Sampled visits which indicate patients with elevated risk for heart disease or stroke will have additional information collected from all prior visits to that sampled provider during the past 12 months. For example, the module records medications prescribed, changes in medications, family history, contraindications to certain medications, and various laboratory tests (i.e., total cholesterol, HDL, LDL, TGS, HbA1c, FBG, and serum creatinine). Combining data from the current visit as well as the prior visits will permit evaluation and monitoring of appropriateness of clinical management and the relationship to intermediate outcomes. Furthermore, information on the clinical management of such diseases could identify shortfalls in the quality of care and opportunities for improvement. The same lab values collected on the Lookback module are also collected on the regular Patient Record form for the current sampled visit.
Workflow Supplement (2011-2013)Added in 2011, the Physician Workflow Supplement is a longitudinal follow-up data collection initiative, also sponsored by ONC, to provide a better understanding of physician experiences with adoption and use of EHRs. The basesample for the survey comprises respondents to the 2011 EHR supplement. Respondents are being followed annually for a three-year period, beginning in 2011 and running through 2013. The main purpose of the survey is to obtain information on costs, benefits, and barriers related to the use of EHR systems at various stages of adoption.The Workflow Supplement data will help ONC and data users understand the experiences of adopters and measure progress towards Health Information Technology for Economic and Clinical Health Act (HITECH) program goals. Data will also help guide policymaking surrounding meaningful use criteria of EHR that have been established to help create a private and secure 21st century electronic health information system. Together with data from the EHR supplement, responses will help to develop criteria for successive stages of meaningful use. A report detailing the 2011 Physician Workflow Supplement is available as a NCHS Data Brief: Physician Adoption of Electronic Health record Systems: United States, 2011.
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