Table 2.

Revised survey items for environmental factors based on round 2 feedback.

RESPONSE OPTIONS (unless otherwise indicated) Strongly Agree, Agree, Neutral, Disagree, Strongly Disagree, Don’t Know/Unsure
ENVIRONMENTAL FACTORS
Reimbursement
1	Reimbursement levels from our most common payers are sufficient to support remote patient monitoring.
2	Reimbursement levels from our most common payers are sufficient to support audio-only calls with patients.
3	Reimbursement levels from our most common payers are sufficient to support emails with patients.
4	Reimbursement levels from our most common payers are sufficient to support telehealth for substance-use services.
5	Reimbursement levels from our most common payers are sufficient to support telehealth for mental health services.
6	Within my practice environment, for telehealth services that are billable, reimbursement for them is equal to comparable in-person services.
7	Uncertainty about future reimbursement for telehealth services hinders my practice’s ability to integrate telehealth and in-person services.
8	Uncertainty about whether telehealth services will be reimbursed for a particular patient hinders my practice’s ability to integrate telehealth and in-person services.
9	Variability in reimbursement for telehealth services across payers hinders my practice’s ability to integrate telehealth and in-person services.
Leadership Priorities
1	Leaders in our health system commit sufficient resources to telehealth.
2	Leaders in our health system commit sufficient resources to integration of telehealth with in-person services.
3	Leaders in our health system commit sufficient resources to addressing health disparities.
4	Leaders in our health system commit sufficient resources to delivering health care services that are responsive to individual patient preferences.
5	People in leadership positions within my practice environment commit sufficient resources to telehealth.
6	People in leadership positions within my practice environment commit sufficient resources to effective integration of telehealth with in-person services.
7	People in leadership positions within my practice environment commit sufficient resources to addressing health disparities.
8	People in leadership positions within my practice environment commit sufficient resources to delivering health care services that are responsive to individual patient preferences.
Quality Improvement Efforts
1	We have a performance indicator to measure the time between a patient making an appointment and completing the visit.
2	We have a performance indicator to measure the time patients spend waiting past the appointment time.
3	We have performance indicators to measure adherence to evidence-based/consensus-based clinical practices.
4	We have performance indicators to measure patient safety.
5	We have performance indicators to measure patient health outcomes.
6	We have performance indicators to measure patient satisfaction with telehealth visits.
7	We have performance indicators to measure provider satisfaction with telehealth visits.
8	We have performance indicators to measure health disparities.
9	We have performance indicators to measure the number of patients seen during a specific time period.
10	In our clinic, quality improvement (QI) methods are used to improve telehealth services in the following areas (Check all that apply): Timeliness of care Adherence to evidence-based or consensus-based clinical practices Patient safety Patient health outcomes Patient satisfaction Health disparities Clinical team workflow efficiency Provider satisfaction Other _______ None of the Above
Supportive Staffing for a Hybrid Model
1	In our clinic, providers have the option to work outside of the clinic when completing telehealth visits.
2	In our clinic, support staff develop plans in collaboration with providers to support care delivery in a hybrid model.
3	In our clinic, support staff have protocols for supporting providers working in a hybrid model.
4	In our clinic, support staff prepare the computer, camera, and other needed technology for a telehealth visit prior to the provider logging in for the visit.
5	In our clinic, support staff are able to troubleshoot problems with the computer, camera, and other needed technology for a telehealth visit prior to the provider logging in for the visit.
6	For in-person visits in our clinic, support staff update the medication list with a patient at the beginning of the visit.
7	When the provider is located in our clinic, support staff update the medication list with a patient at the beginning of a telehealth visit.
8	When the provider is located outside of our clinic, support staff update the medication list with a patient at the beginning of a telehealth visit.
9	For in-person visits in our clinic, support staff schedule follow-up visits with patients at the end of the visit.
10	When the provider is located in our clinic, support staff schedule follow-up visits with the patient at the end of a telehealth visit.
11	When the provider is located outside of our clinic, support staff schedule follow-up visits with a patient
12	Overall, in our clinic, support staff effectively support the work of providers who see patients in a hybrid model.
Space, Technology, and Training
1	When at the clinic, providers have access to physical space that meets their needs to conduct telehealth visits.
2	In our clinic, the telehealth platform can be accessed through the electronic health record.
3	In our clinic, the electronic health record and telehealth platform work well together.
4	In our clinic, the electronic health record supports in-person visits and telehealth visits equally well.
5	In our clinic, providers receive adequate training on communicating with patients during telehealth visits.
6	In our clinic, providers receive adequate training on the technology used to conduct telehealth visits.