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1. Do you presently have an Electronic Medical Record system?

Yes

No

1a. If yes, what is the name of the system and year of implementation?

1b. Would you recommend it to others?

Yes

No

2. Are you actively pursuing the purchase of an Electronic Medical Record system?

Yes

No

2a. If yes, what is your target date for a decision?

3. Do you see an Electronic Medical Record system in your future?

Yes

No

3a. If yes, when do you see this implementation occurring?

Not for 1-2 years

Not for 3-4 years

Not for 5+ years

4. What are the barriers to your decision to purchase a system?

5. How can the White Plains IPA/Hospital help you move toward a purchase?

6. Do you have any additional comments/questions?