My HealtheVet Pilot Survey
Veteran Questionnaire
2007
Introduction:
As a participant in the My HealtheVet Pilot Program, you have had an opportunity to use the My HealtheVet Pilot website at www.health-evet.va.gov to view health education information, request and view copies of some portions of your VA medical record, and use the self-entry features to record and track health information such as weight, blood pressure and blood sugar. Your willingness to participate in this Pilot Program is greatly appreciated and we hope that you have found the My HealtheVet Pilot to be a valuable experience.
Your feedback about the My HealtheVet Pilot is important to us and will help us to continue to develop the My HealtheVet Program so that it best meets your needs. Please take a few minutes to participate in this online survey and share your comments about the Pilot and your experience in using it.
We appreciate your time in responding to this important survey. We will use the information you provide to evaluate the use of My HealtheVet so that we can provide the best services possible to veterans.
Instructions:
This survey is estimated to take about 10-20 minutes of your time. Your response to each question is voluntary. Your answers are protected under the Privacy Act and section 5701 if Title 38 U.S. Code. The survey has been approved by the Office of Management and Budget (OMB # XXXX) and meets the requirements of the Paperwork Reduction Act. You may send comments about this questionnaire to XXXX. If you need help in completing the survey questions, please call XXXX.
Most of the survey questions will ask you to choose one of several options; however a few of the questions will ask you to write your answer. Please use specific examples whenever possible. There are no right or wrong answers. We want to know what you think about the My HealtheVet Pilot website and whether you think its use helps make your health care better. At the end of the survey we’ll ask you a few questions about your background that will help us to interpret the results of this survey. Your response to these questions is optional.
After answering all of the survey questions, press the submit button at the end to complete your survey. Thank you for your help in evaluating the My HealtheVet Pilot Program.
Questions:
How did you first hear about the My HealtheVet Pilot project?
From my doctor
From another veteran
From a friend or co-worker
From a VA Staff member
From a flyer, brochure, or newsletter
From my Veteran Service Organization
Other
If other, please explain:
_____________________________________________
Where did you sign up for the My HealtheVet Pilot?
Albany, NY
Bath, NY
Bay Pines, FL
Buffalo, NY
Canandaigua, NY
Portland, OR
Syracuse, NY
Tampa, FL
Washington, DC
How long have you been using the My HealtheVet Pilot website?
Less than 1 month
More than 1 month but less than 6 months
More than 6 months but less than 12 months
More than 1 year but less than 2 years
More than 2 years but less than 4 years
More than 4 years
On average, how often have you used the My HealtheVet Pilot website in the last 90 days?
Daily
Weekly
Monthly
Less than once a month
Have not used in the last 90 days
Have never used
If you received training prior to using the My HealtheVet Pilot website, please indicate the type of training you received:
(Please check all that apply)
Group instruction with from VA staff
Individual instruction from VA staff
Non-VA staff showed me how to use it (ex. student, volunteer, another veteran)
Self-instruction using provided materials
No training
If you received training prior to using the My HealtheVet Pilot website, did it help you in using the website?
Very helpful
Somewhat helpful
Not helpful
No training
Why did you decide to participate in the My HealtheVet Pilot?
(Please check all that apply)
Access health education materials
Track my self-entered health information (blood pressure, weight, etc.)
Track my personal information (emergency contacts, etc.)
Access information from my VA medical record (test results, doctor’s notes, etc.)
Improve my understanding of my medical treatment
Provide other people with access to my medical information (doctors, family members, etc.)
Access someone else’s personal health record as a delegate or grantee
My doctor suggested it
Other
If other, please explain:
_____________________________________________
Most often, where do you access the My HealtheVet Pilot website?
My home computer
Other computer (work, public library, family member, etc.)
Public computer at a VA Medical Center
Most often, what type of Internet connection do you use to access the My HealtheVet Pilot website?
Dial-up access
Broad band access
Not sure
Please rate your general level of skill in using the Internet:
Beginner/Novice
Intermediate
Advanced
Which of the following My HealtheVet Pilot website features have you used?
(please check all that apply)
Health Education Library
VA Administrative Info (appointments, wellness reminders, co-payments, etc.)
My VA Patient Record (admissions, prescriptions, progress notes, labs, etc.)
VA Update Requests (requested updated VA Medical Record data)
Self-entered Information (personal info, medications, allergies, etc.)
Self-entered Data (logs such as blood pressure, blood sugar, cholesterol, etc.)
Someone else’s personal health journal (as a grantee or delegate)
(please check all that apply)
Looked up information on a disease, condition, or treatment
Discussed information obtained from the website with my health care provider
Shared my self-entered data with my health care provider
Granted access to my Personal Health Journal to my VA health care provider
Granted access to my Personal Health Journal to a non-VA health care provider
Granted access to my Personal Health Journal to a spouse, family member, or advocate
Other
If other, please explain:
_____________________________________________
13. Choose your top five most useful My HealtheVet Pilot website services from the list provided below. Please enter the number 1- 5 in the box, with 1 being most useful, 2 being second most useful, etc.
Entering my own health information
Viewing portions of my official medical record (ex. lab results)
Prescription History
Co-payments
Appointments
Health Education Library
Providing delegate/grantee access
Wellness Reminders
Linking to other VA sites
Other service
If other, please explain:
_____________________________________________
How easy is it for you to understand the information in the Health Education Library?
Very Easy
Easy
Difficult
Very Difficult
When you update or read your personal medical record, how easy is it for you to understand your medical information?
Very Easy
Easy
Difficult
Very Difficult
For the following questions, please select the answer that most closely matches your opinion.
I find the My HealtheVet Pilot website easy to navigate and locate information relevant to my healthcare.
Strongly Agree
Agree
Not Sure
Disagree
Strongly Disagree
On average, I find the information and services provided by the My HealtheVet Pilot website to be useful.
Strongly Agree
Agree
Not Sure
Disagree
Strongly Disagree
The My HealtheVet wellness reminders have helped me to take action.
Strongly Agree
Agree
Not Sure
Disagree
Strongly Disagree
Not applicable
Using the My HealtheVet Pilot website has improved communication between my health care provider and me.
Strongly Agree
Agree
Not Sure
Disagree
Strongly Disagree
Using the My HealtheVet Pilot website helps me stick to my treatment plan.
Strongly Agree
Agree
Not Sure
Disagree
Strongly Disagree
The My HealtheVet Pilot website adequately protects the privacy of my personal health data.
Strongly Agree
Agree
Not Sure
Disagree
Strongly Disagree
I find that the My HealtheVet Pilot website helps improve my healthcare.
Strongly Agree
Agree
Not Sure
Disagree
Strongly Disagree
I would recommend the use of My HealtheVet to other veterans.
Strongly Agree
Agree
Not Sure
Disagree
Strongly Disagree
All veterans and VA staff are eligible to use the National My HealtheVet website (www.myhealth.va.gov). Are you currently registered at the National My HealtheVet website?
Yes
No
Not Sure
Please share your thoughts on the My HealtheVet Pilot experience and how it has affected your health care:
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
Please provide any additional comments you have about the My HealtheVet Pilot. If you wish to elaborate on any of the survey responses you provided you may also do so here.
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
In the following section we’ll ask you a few questions about your background that will help us to interpret the results of this survey. Your response to these questions is optional. (If you choose to not answer please move to the end of survey and press the submit button to complete your survey.)
27. Please select the category that includes your age:
<20 years 20-24 25-29 30-34 35-39
|
40-44 45-49 50-54 55-59 60-64
|
65-69 70-74 75-79 80-84 85-89 90+ years |
28. What is your gender?
Male
Female
29. Which of the following best describes the highest level of education you have completed?
Did not complete high school
High school graduate
Some college or vocational school
Current college or graduate student
College graduate
Some postgraduate school
Graduate or professional degree
30. Do you have any impairment that would affect your ability to use the website?
Visual
Hearing
Mobility
Dexterity
None
Would you be willing to participate in a focus group to offer additional information about your experiences with the My HealtheVet Pilot Program? If so please send us an email indicating your interest to MHVPilotEvaluation@va.gov . Please provide your name, email address, telephone number and mailing address so that we may contact you. This information will be kept confidential.
Thank you for your help in evaluating the My HealtheVet Pilot Program.
The VA My HealtheVet Program Office
| File Type | application/msword |
| File Title | My HealtheVet Pilot Survey |
| Author | Kim M. Nazi |
| File Modified | 2007-08-06 |
| File Created | 2007-08-06 |