ICD/CRT Appropriate Use Criteria Survey

Question Title

* 1. In which of the following ways have you used the ICD/CRT Appropriate Use Criteria App?
(Select all that apply)

As a tool to support my own clinical decision making

To facilitate a discussion with a patient during a visit

To consult the likelihood of CMS coverage of a treatment option for a patient

To facilitate the documentation process (i.e. have a record of the appropriateness rating of a treatment for a given patient)

To facilitate treatment discussions across specialties

To guide or teach others at my practice/institution

As an informational reference

As a patient, to review my risk and treatment options

Other (please specify)

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* 2. What other tools have you used to help make decisions about ICD and CRT therapy for your patients?

2013 ACC/HRS ICD/CRT Appropriate Use Criteria document

2012 ACC/AHA Device-Based Therapy Guideline document

ACC ICD Clinical Data Registry reports

Other (please specify)

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* 3. Which information or function within the app is most useful to you? (Select all that apply.)

Appropriate use score (I.e., Appropriate, May Be Appropriate, Rarely Appropriate)

CMS Advice (i.e., Coverage can be expected/Coverage cannot be expected)

Ability to email results

Please explain:

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* 4. Overall, how useful is the ICD/CRT AUC App to you?

Very Useful

Useful

Somewhat useful

Not very useful

Not at all useful

Please explain:

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* 5. Would you recommend the ICD/CRT AUC App to a colleague?

Yes

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* 6. What best describes your clinical designation?

General Cardiologist

Electrophysiologist

Cardiac Surgeon

Primary Care Physician

Physician Assistant

Nurse Practitioner

Registered Nurse

Pharmacist

Medical Trainee or Student

Patient

Other (please specify)

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* 7. Which best describes your current practice environment?

Private Practice

Hospital

Anticoagulation Clinic

Other (please specify)

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* 8. Do you practice mostly within the US or internationally?

I practice in the US.

I practice internationally.

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* 9. Which best describe how often you use other clinical decision support apps?

Daily

Weekly

Monthly

Yearly

Never

Please specify some of the apps you use:

Question Title

* 1. In which of the following ways have you used the ICD/CRT Appropriate Use Criteria App? (Select all that apply)

Question Title

* 2. What other tools have you used to help make decisions about ICD and CRT therapy for your patients?

Question Title

* 3. Which information or function within the app is most useful to you? (Select all that apply.)

Question Title

* 4. Overall, how useful is the ICD/CRT AUC App to you?

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* 5. Would you recommend the ICD/CRT AUC App to a colleague?

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* 6. What best describes your clinical designation?

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* 7. Which best describes your current practice environment?

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* 8. Do you practice mostly within the US or internationally?

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* 9. Which best describe how often you use other clinical decision support apps?

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* 10. What suggestions do you have for improving the ICD/CRT Appropriate Use Criteria App?

* 1. In which of the following ways have you used the ICD/CRT Appropriate Use Criteria App?
(Select all that apply)