1. Please indicate which of the following subjects should be included in a description of Consumer Health Informatics(CHI) activities. (Check the box next to all that apply)
Consumer Health Information - provision of patient education through technology
Patient access to their own electronic medical records
Consumer Health commerce - advertising for consumer goods
Patient Decision Support/Tailoring of information for self-help/disease management
Patient-to-Patient communication for social support
Quality Assessment of CHI
Security/Confidentiality
Patient-health care provider communication and relationships
Other(s) (specify)

2. Please rate how important each of the following areas of expertise are to development, implementation, and evaluation of Consumer Health Informatics interventions.

◈ Rate each on a scale from: 1=Very unimportant, 2=Unimportant, 3= Neutral, 4=Important, 5=Very important
a. Computer science	1   2   3   4   5
b. Health sciences (Medicine, Nursing, Dentistry, Public Health, etc)	1   2   3   4   5
c. Library sciences	1   2   3   4   5
d. Health Education sciences	1   2   3   4   5
e. Medical Illustration	1   2   3   4   5
f. Evaluation sciences (quality assessment, outcomes assessment, etc)	1   2   3   4   5
g. Other(s) (specify)

3. Please indicate the single most important issue to be incorporated into future Consumer Health Informatics research. (Click in the circle of the most correct answer)
CHI Epidemiology/Needs Assessment  (understanding how individuals use, and want to use CHI)
CHI program design/ implementation
CHI Quality Assessment/Quality Assurance - (evaluating, creating industry standards, etc)
Consumer Health Satisfaction ? (understanding the perceived value of CHI interventions)
Outcomes research for CHI - (the impact of CHI on health outcomes, service utilization, etc)
Other(s) (specify)

4. Are there any ongoing informatics activities (i.e., program development, research, education) at your institution that focus of Consumer Health Informatics? (Click the circle next to your answer)
Yes   No
  If yes, describe

5. What is the most important benefit to further development, implementation, and evaluation of Consumer Health Informatics interventions?
  

6. What is the greatest barrier to further development, implementation, and evaluation of Consumer Health Informatics interventions?
  

7. Would you recommend that Consumer Health Informatics be considered a separate discipline within Health Informatics? (Click the circle next to your answer)
No, (explain - other suggestions?)
Yes, Somewhat agree
Yes, agree
Yes, Strongly agree
Comment

8. Please indicate the informatics working groups that you participate in.
American Medical Informatics Association
European Federation of Medical Informatics
International Medical Informatics Association
Pan Asian Medical Informatics Association
Other (please specify)

9. Please indicate your primary institutional affiliation.
Academic
Industry
Government
Other (specify)

10. Please indicate Country or region where you work or reside.
  a.   
  b.   
  c.   

11. Indicate your discipline by education/training.  (e.g. Medicine, Nursing, Public Health, etc)
  

12. Explain how CHI may specifically apply in your field or discipline. (e.g. aspects of health, scope, or areas of CHI of particular importance in your discipline)