Table 4.

Results of the Thematic and Domain Analysis on Audiologist Perception When Reporting Hearing Assessment Results to State Early Hearing Detection and Intervention (EHDI) Programs

Domains and Themes	Frequency of comment
Domain I Barrier: Inherent to the system design domain	n = 58
Theme 1 — Reporting system access issue Sample comments: Sign in process cumbersome; Must sign in twice; Takes state IT too long to reset expired password	11
Theme 2 — System reliability/stability Sample comments: Data were not saved properly; Fax not going through or fax not receiving	7
Theme 3 — Locating the right patient in the reporting system Sample comments: Poor search function so finding the right child is difficult; Child’s name often changes after hospital discharge and reporting system requires exact name and date of birth match and I don’t have the birth name	10
Theme 4 — Non-user-friendly design Sample comments: Navigation tab very complicated; Reporting form or reporting page too complicated; Neonatal intensive care and well-baby child records are located in two separate systems	30
Domain II Barrier: Related to work demands on a clinician and the healthcare environment domain	n = 36
Theme 5 — Work demands Sample comments: Too busy; No time to report because no time was set aside for paperwork; Short staffed; No financial incentive-reporting reduces time to generate income	31
Theme 6 — Assumptions about the need to report related to the care environment Sample comments: Assume other audiologists have reported because patient has visited another clinic; Patients were seen by different audiologists so likely others have reported	5
Domain III Barrier: Related to incomplete knowledge on the reporting requirement and a lack of helpful tool domain	n = 32
Theme 7 — Incomplete knowledge on the requirement and the process Sample comments: Did not know I need to report normal hearing result; Unaware that a reporting requirement exists; Don’t know when or how to report	27
Theme 8 — Lack helpful tool Sample comments: No access to EHDI data system to determine which patients require reporting; Law requires me to report only infants who failed; No access to database to find out which infant has failed	5
Domain IV Barrier: Inherent to the reporting process domain	n = 13
Theme 9 — Access to a workable process Sample comments: No computer/internet access because no internet coverage; Clinic computer not compatible with the reporting portal.	6
Theme 10 —Duplicate effort/task Sample comments: Must enter data in patient’s chart and also for the EHDI program; Have to enter data in 3 separate databases–confusing and increase workload.	7