Healthcare Provider Views on Telemedicine

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* 1. What is your profession?

Physician

Nurse Practitioner

Physician’s Assistant

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* 2. What area or specialty do you work in? (select all that apply)

Primary Care

Nutrition

Pediatrics

Mental health

Dermatology

Sexual health

Other (please specify)

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* 3. What percent of your practice is telemedicine?

1-25%

26-50%

51-75%

> 75%

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* 4. From which payer sources are your telemedicine services reimbursed and by approximately what %? (please enter whole numbers and omit the %; total must add up to 100)

Commercial health plans

Employer plans

Patient self-pay

Medicare/Medicaid

Healthcare Provider Views on Telemedicine

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* 1. What is your profession?

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* 2. What area or specialty do you work in? (select all that apply)

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* 3. What percent of your practice is telemedicine?

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* 4. From which payer sources are your telemedicine services reimbursed and by approximately what %? (please enter whole numbers and omit the %; total must add up to 100)

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* 5. Please rank the following drivers in order of importance to the adoption of telemedicine:

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* 6. Please rank the following challenges/barriers in order of importance to the adoption of telemedicine:

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* 7. Please rank the following digital health technologies in order of importance to the adoption or impact of telemedicine:

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* 8. Please rank the following in order of telemedicine’s potential to impact healthcare delivery from high to low:

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* 9. Please rank the following patient populations in order of who you think can benefit the most from telemedicine:

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* 10. Please share what you believe is critical for the adoption of telemedicine going forward?

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* 11. OPTIONAL: Enter your email address if you would like to see the results of this survey