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Ordering Clinician Survey

Welcome to the Ordering Clinician Survey.

Thank you for participating in this important survey that will help us determine the feasibility of one approach to improving compliance with documentation requirements and reducing the burden associated with ordering DME. For more information on this effort, being developed by the Health Level Seven (HL7) Da Vinci work group, please click here or go to:

This survey should take approximately 10 minutes to complete. Please be reassured that all survey findings will be provided only in aggregate fashion, and no individual responses will be presented. The Da Vinci work group will use these survey results to assess the current state of functionality required for electronic data exchange of documentation requirements. Please click ‘Next’ to begin.

[ provide a link to additional information if needed ]

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  1. Do you use an electronic health record (EHR) system? If response is:

No- “Thank you for participating”

Yes- “Please select which EHR you use:” ( Note these are the top EHR vendors in ambulatory and hospital reporting per ONC data)

EHR Vendor

Allscripts Professional EHR

Allscripts TouchWorks EHR

Amazing Charts


Centricity EMR


ChartLogic EHR

Compulink Business Systems




e-MDs Solution Series



FairWarning Technologies


Iatric Systems

Integrated Practice Solutions







Midas+ Solutions

Modernizing Medicine

NextGen Healthcare

Orion Health

Practice Fusion

SCC Soft Computer


Sunquest Information Systems

The Staywell Company, LLC


Other: Free text

  1. Version: Free text
  2. Do you prescribe medications electronically? y/n If response is:

Yes- go to 4

No- go to 6

  1. Do you use electronic prior authorization for medications? If response is:

Yes- go to 6

No- go to 5

  1. Why not? Select all that apply
  • EHR doesn’t support it
  • Workflow is inefficient
  • Payer doesn’t support it
  • I don’t know what this is
  • Other: Free text
  1. Do you use medical necessity checking software when ordering labs or other services?

Yes- go to 7

No- go to 9

  1. For which payers do you use the software? Select all that apply
  • Medicare
  • Medicaid
  • Commercials Payers
  1. Is the software integrated into your EHR?
  2. Do you order any durable medical equipment (DME)? Yes/No
  3. Do you order home oxygen or continuous positive airway pressure (CPAP)? Yes/No
  4. Please select all types of insurance you participate with: Select all that apply
  • Medicare
  • Medicare Advantage
  • Medicaid
  • Medicaid Managed Care
  • Children’s Health Insurance Program (CHIP)
  • Commercial
  • Staff Model HMO
  • None
  • Other: Free text
  1. From the following list, please select DME items that you routinely order: Select all that apply
  • Stationary Oxygen systems
  • Portable Oxygen systems
  • Oxygen concentrators
  • Continuous Positive Airway Pressure (CPAP) Device
  • BiPAP Auto
  • BiPAP Plus
  • BiPAP S/T
  • BiPAP autoSV Advanced
  • Nasal cannulas
  • Non-rebreather masks
  • Ventilators
  • Masks
  • Oxygen Conserving Device
  • High Flow Oxygen Therapy
  • Other home oxygen/CPAP item: Free text
  1. How do you order DME? Select all that apply
  • In EHR
  • Using online website
  • By phone
  • By fax
  • By secure email
  • Other: Free text

If EHR is not selected go to 14, otherwise skip to 15

  1. Why don’t you use your EHR to order DME?
  • EHR does not support ordering DME
  • EHR workflow is inefficient
  • My suppliers have their own forms to complete
  • My suppliers cannot receive an electronic order
  • Other: Free text
  1. What percentage of your DME orders are placed by using: Enter the percentage of orders for each method. Enter 0 if you do not use that method.
  • EHR
  • DME ordering software integrated into or interfaced with your EHR
  • An online DME ordering website (separate from / outside of your EHR)
  • Phone
  • Fax
  • Secure email
  • Other: Free text
  1. What resources do you use to determine payer documentation requirements? Select all that apply
  • Web search
  • Payer web site
  • DME ordering website
  • Supplier template
  • Printed guidance
  • None
  • Other: Free text
  1. Who generally completes the documentation for the order, if required?
  • Ordering clinician
  • Nursing staff
  • Front office staff
  • No one, we give the patient a paper order
  • Other: Free text
  1. How do you submit documentation to a DME supplier? Select all that apply
  • Mail
  • Fax
  • Electronically
  • Secure email
  • Other: Free text
  1. How do you submit documentation to a payer? Select all that apply
  • Mail
  • Fax
  • Secure email
  • Electronically through EHR
  • Electronically through a third party product (e.g. Fast Attach)
  • Other
  1. Would you be interested in having your EHR display documentation requirements, on demand, at the point of ordering DME? If response is:

No- go to 21

Yes- go to 22

  1. Why not ?” Free text
  2. Would you be interested in having your EHR prompt you for documentation that is missing in the clinical record and required to support medical necessity for ordered DME?

No- go to 23

Yes- go to 24

  1. Why not? Free text
  2. Would you be interested in submitting prior authorization requests through your EHR or integrated practice management system?

No- go to 25

Yes- go to 26

  1. Why not? Free text
  2. Does your EHR allow you to : Select all that apply
  • Associate patient diagnoses with the order
  • Enter a start date different than order date
  • Enter length of need
  • Enter Peak Flow Rate
  • Enter O2 flow rate in LPM
  • Enter O2 %
  • Enter Average Flow Rate
  • Enter Frequency of use
  • Enter Target O2 Sat
  • Enter Frequency of O2 Sat monitoring:
  • Enter Maximum length of need for a single trip (e.g. without recharge) in time
  • Select DME item with associated HCPCS codes
  • Enter Means of delivery (e.g. Nasal cannula, Non-rebreather, Ventilator, Mask, Pap Bleed in, Oxygen Conserving Device, High Flow Oxygen Therapy, Other)
  • Order accessories
  1. Do you use third party clinical decision support with your EHR?

Yes- go to 28

No- go to 29

  1. What do you use?
  2. Do you use third-party apps with your EHR?

Yes- go to 30

No- go to 31

  1. What do you use?
  2. What barriers or problems concern you about using your EHR to order DME? Free text
  3. What is your role in the practice?
  • Physician
  • Nurse Practitioner
  • Physician Assistant
  • Nurse
  • Front office staff
  • Back office staff
  • Other Free text

After completing this question display “Thank you for participating”