Appendix 4-C. DI Evaluation Form
North Central Region Exercise
Drug Identification Line Instructions
In addition to the quarantine calls you will be receiving over the next 2
days, the Interactive Response (IR) system has other possible uses in a public
health emergency. As a volunteer, we request your assistance in testing
one of these additional capabilities.
You have been requested to test the Drug Identification (DI) Line. In
the event of a biologically based public health emergency, it may be necessary
to distribute antibiotics to the entire Denver Metro region within 48 to 72
hours. Not all Point of Dispensing (POD) locations will be dispensing
drugs that have the same appearance. It is also possible for an individual
to forget which pills they received or become confused which pills are theirs. An
automated inbound call system allows a caller to access this information using
pill imprints, color, shape and size.
Using the automated system, please identify the pill pictured below by following
the instructions and prompts provided by the IR. Please fill out the
evaluation after you complete the call. Thank you for your assistance
in testing this communication tool.
Volunteer Name: _____________________________________________________
- Please call XXX-XXX-XXXX.
- Using the photo above, follow the prompts to identify this pill.
- Based on the information provided by the IR, what is this pill?
_____________________________________________________
Please fill out the evaluation questions on the second page, and thank you
for your assistance in testing the Drug Identification Line.
Dear Quarantine Exercise Volunteer:
Please answer the following questions regarding your experience using the
Drug Identification Line.
Questionnaire responses will use a scale of 1 to 5:
1 = Strongly Disagree
2 = Disagree
3 = Undecided
4 = Agree
5 = Strongly Agree
Please tell us how much you agree or disagree with the following statements:
Question |
Strongly Disagree |
Disagree |
Undecided |
Agree |
Strongly Agree |
1. The directions given
by the IR were easy to follow. |
1 |
2 |
3 |
4 |
5 |
2. The voice on the IR message
was easy to understand. |
1 |
2 |
3 |
4 |
5 |
3. The recorded voice on the IR went
at a proper speed. |
1 |
2 |
3 |
4 |
5 |
4. The recorded voice on the IR was
at a proper volume. |
1 |
2 |
3 |
4 |
5 |
5. I trust that the automated
system correctly identified my pill. |
1 |
2 |
3 |
4 |
5 |
6. I am satisfied with
my experience using the IR. |
1 |
2 |
3 |
4 |
5 |
7. If a public health emergency
actually occurred and I needed antibiotics, I would trust receiving health
department information via an automated system like the IR. |
1 |
2 |
3 |
4 |
5 |
8. Based on my experience
with the IR, I would prefer to receive information from an automated system
vs speaking to a live person. |
1 |
2 |
3 |
4 |
5 |
Comments (Please use the back of this sheet for additional room if necessary)
______________________________________________________________________________________
______________________________________________________________________________________
Thank you again for your assistance in evaluating this communication tool. Your
assistance will allow us to provide important information to a large portion
of the region's population in a public health emergency. We believe
these tools have the greatest potential to reduce patient surge demands on
the traditional health care delivery system facilities and allow public health
agencies to focus on epidemiology and control measures.
If you have questions about this tool or the testing process, please contact <Insert
Test Coordinator Name> at the <Insert their Agency Name>: <Insert
Their Phone#> or <Insert Their E-mail Address>
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