Attach B_EHR_IMPL

Health Center Controlled Networks (HCCN)

Grantee Contact
Grantee of Record
Organization Name
Contact Name
Contact Title
Address
Phone Number
Fax Number
Email Address
Web Site
Multi Site Grant?
Grantee Contact Information Form Comments:
Is Grantee Contact Information Form Complete?

Page: 1/18

Network

Health Center Controlled Networks (HCCN)

Type of Grant and Updates (Part A: Section 1)
Type of Grant
HIT Planning Grant
EHR Implementation Grant

X

HIT Innovation Grant
Quality Improvement Grant

Jobs

Number

How many new jobs, expressed as "full-time equivalents" (FTE), are
expected to be created as a result of the grant? A job created is a new
position created and filled or an existing unfilled position that is filled
as a result of the Recovery Act funding. Please provide a brief listing
by title.
How many jobs, expressed as "full-time equivalents" (FTE), are
expected to be retained as a result of the grant? A job retained is an
existing position that would not have been continued to be filled were
it not for Recovery Act funding. Please provide a brief listing by title.

Page: 2/18

Brief Listing by Title

Health Center Controlled Networks (HCCN)

Electronic Health Records (EHR), Innovations
Project Phase
Planning
Testing
Infrastructure Building
Implementation
Description:

Projected Number of Weeks (Time Before Next Phase):

Engaged in Health Information Exchange?
No

Type of Grant and Updates Form Comments:

Is Type of Grant and Updates Form Complete:
In Progress

Page: 3/18

Health Center Controlled Networks (HCCN)

Part A: Updates (Section 2)
2. Status Of Implementation of Project Participants
Health Center
Name or Other
Organization
Name

# Sites
in
Project
Scope

# Sites UDS # (if
in
330
Project grantee)
Scope
Implem
ented

U.S. Zip
State Code
or
Territ
ory

#
Patients
in
Project
Scope

#
Patients
Impacted
to Date

#
Medical
Provider
FTEs in
Project
Scope

#
Date MOA/
Medical Contract
Provider Signed
FTEs
Impacted
to Date

3. Provide a brief status of barriers encountered to date
4. Provide a brief description of key lessons learned to date
5. Provide an assessment of technical assistance needs
Readiness
Environmental Scan
Readiness Evaluation
Needs Analysis
Board/Leadership/Staff Buy-in
Identifying critical data elements
Other
Contracting
RFP-Assistance
Evaluating Proposals
Vendor Selection
Contract Negotiations
Other
Evaluating
EHR
Clinical Outcomes/Processes
Other
Sustainability
EHR
Page: 4/18

Go Live
Date of
New EHR
or
Innovations
System

Go Live
Date of
Expanded
EHR or
Innovations
System (if
applicable)

Comments
(changes
to
participant
s)

Health Center Controlled Networks (HCCN)

Other HIT Systems
Open Source
HIE
Other
Reporting
Population Health Reports
Health Disparities Reports
HRSA Reports
Clinical Measures Reports
Other
Implementation
Implementation of System
Work Flow Analysis
Testing
Disaster Recovery
Interfaces
Templates
Telecommunication
Other
Advanced/Other
Quality Improvement
Corporate Governance/Structure
Privacy & Security
Legal/Regulatory Stark
Other
Describe Selected Items by Specific Area Selected
6. Describe the status of the Network Governance of this Project.
Network Committee

Last Date of Meeting

7. Network Customer Service to Members
Page: 5/18

List of Issues

Health Center Controlled Networks (HCCN)

Part A: Updates (Section 2) Form Comments

Part A: Updates (Section 2) Form Complete?

Page: 6/18

Health Center Controlled Networks (HCCN)

Part B: Accomplishments
1. Planning Grant
Not Applicable

2. EHR Implementation and Innovations
Measuring the Impact of HIT on Health Outcomes
HRSA is interested in measuring the impact of EHR/HIT in terms of outcomes that support the
aims of these grant programs. HRSA requires performance outcome measures, two of which HRSA defines to
include diabetes control and child immunization. Use this section to report on these two measures using data
from the project participants in the network.
If different from UDS, state the source used for calculating the data under "other"" and provide an update to any
change or any other needed clarification in the "comments" section. In the baseline column, state the percentage
and provide the actual numerator and denominator used to calculate it. There is one baseline; it is not recalculated each year. The measures are inclusive for HIT and non-HIT patients alike.
Ideally, these measures should be calculated at the Network level; however, it is understood that calculations at
the Network level are not always possible. Select the appropriate level:
Network Level

Health Center Level

Page: 7/18

Health Center Controlled Networks (HCCN)

Required Measure 1 and 2
Required Measures

Baseline
Numerator

Current Progress

Denominator

%

Numerator

Denominator

%

Method of calculating consisten
with Uniform Data System (UDS)

Measure 1:
Child Immunization

”

Measure 2:
Diabetes
control

>7% and
<9%
•

Indicate which aims from the list below are the most fitting to your measures listed below. Add rows if necessary to
capture additional measures.
Required Measure 3 and up
Required Measures

Baseline
Numerator

Current Progress

Denominator

%

Numerator

Denominator

%

Comments

AIM(s)

3. Any other accomplishments of the project thus far
Please describe such as:
Accomplishment

Comment

Increasing the availability and transparency of information related to
the health care needs of the patient and support physician decision
making.
Supporting the rapid response to address both natural and manmade disasters, including those due to bioterrorist acts.
Promoting continuity of care across settings when patients move
from outpatient to urgent, emergency, and inpatient care, and when
patients move between geographic areas either voluntarily or
involuntarily as in the case of a disaster.
Creating interoperability with other safety net providers such as
health departments and other HRSA grantees.
Enhancing the capability of safety net providers to enter into
collaborative strategies that leverage initiatives and resources
(including knowledge, experience, and funding) already present in
their communities.

Page: 8/18

Health Center Controlled Networks (HCCN)

Promoting the creation of a sustainable business model for
deploying HIT in safety net networks.
Promoting a more effective marketplace, greater competition and
systems analysis, enhanced quality, and improved outcomes in
health centers.
Enhancing various reporting needs and requirements. Examples of
reporting needs may include: Joint Commission accreditation;
Quality improvement and/or quality assurance initiatives; reportable
diseases; various state reporting requirements.
Utilizes HIT to assist with elements and/or activities related to health
reform efforts such as expanding access, reducing disparities, etc.
Part B: Accomplishments Form Comments:
Is Part B: Accomplishments Form Complete:

Page: 9/18

Health Center Controlled Networks (HCCN)

Part C: Software
Complete the table below to provide an update of the IT infrastructure developed by or planned to be developed
by the Network for HIT.
Type of Software

Vendor

Software, Version, Release (OR note if
feature is included in EHR or PMS)

Practice Management
System
Electronic Health Record
Computerized Physician
Order Entry
Registry
Electronic Prescribing
Other (identify)
Third Party Report Writer
(if applicable)
Dental Electronic Health
Record (if applicable)
Do you have Eligibility Screening as a part of Practice Management System?
Do you have Clinical Decision Support as a part of Electronic Health Record?

Part C: Software Form Comments:
Is Part C: Software Form Complete:

Page: 10/18

Date CCHIT
Certified (EHR)

Health Center Controlled Networks (HCCN)

Part D: Contingency Planning and Business Recovery Process in the Event of
a Business Interruption at the Network Level
Include information on the development of back up systems in the event that an incident could occur by chance
or unforeseen circumstances related to the Network, such as a disaster, to ensure the continuity of HIT
implementation and continuity of care (24/7).

Part D: Contingency Planning Form Comments:
Is Part D: Contingency Planning Form Complete:

Part E: Evaluation (Section 1)

Page: 11/18

Health Center Controlled Networks (HCCN)

Table E-1: Initial One-Time Costs
Please indicate the extent to which you are tracking the following variables related to initial one-time costs of
health IT implementation for your organization.

Statements

Tracking this cost
Tracking this
Do not have an
Loose estimate
Do not have the
rigorously but not
cost rigorously
estimate, but
of this cost but
means to track
completely
with a very
plan to estimate
and estimate
comprehensively and not tracking
accurate
this cost in the
rigorously
this cost
have a reasonably
estimate
future
3
5
accurate estimate
1
4
2

Workflow Redesign
Training
Historical Chart
Abstraction
Decreased
Productivity
during
Hardware
Purchases
Software
Purchases
Building
Interface
Modules
Comments:

Page: 12/18

Health Center Controlled Networks (HCCN)

Table E-2: Ongoing Costs
Please indicate the extent to which you are tracking the following variables related to ongoing costs of health IT
implementation for your organization.

Statements

Tracking this cost
Tracking this
Do not have an
Loose estimate
Do not have the
rigorously but not
cost rigorously
estimate, but
of this cost but
means to track
completely
with a very
plan to estimate
and estimate
comprehensively and not tracking
accurate
this cost in the
rigorously
this cost
have a reasonably
estimate
future
3
5
accurate estimate
1
4
2

Software
Licences
Technical
Support Staff
System/Network
Administration
Ongoing Data
Entry
Comments:
Table E-3: Financial Benefits
Please indicate the extent to which you are tracking the following variables related to financial benefits of health
IT implementation for your organization.

Statements

Tracking this cost
Tracking this
Do not have an
rigorously but not
Loose estimate
Do not have the
cost rigorously
estimate, but
completely
of this cost but
means to track
with a very
plan to estimate
comprehensively and not tracking
and estimate
accurate
this cost in the
have a reasonably
rigorously
this cost
estimate
future
accurate estimate
3
5
1
4
2

Less expensive
medications
Improved lab
utilization
Improved
utilization of
radiology tests
Improved drug
utilization
Better capture of
charges

Page: 13/18

Health Center Controlled Networks (HCCN)

Decreased billing
errors
Reduced ADEs
Reduced chart
pulls
Elimination of
dictation,
reduced
transcription
Increased
revenue from
preventive care
services
Automatic
documentation of
diagnostic codes
Decreased costs
to medical
audits, enhanced
reporting
capabilities
Comments:

Page: 14/18

Health Center Controlled Networks (HCCN)

Part E: Evaluation (Section 1) Form Comments:
Is Part E: Evaluation (Section 1) Form Complete:

Page: 15/18

Health Center Controlled Networks (HCCN)

Part E: Evaluation (Section 2)
Table E-4: Other Costs and Benefits
Do you have any other costs and benefits?

No

Comments:
Table E-5: Other Resources and Strategies to Leverage Funds
Report dollar amounts secured from within the project period timeframe of this grant only.
Was your network able to leverage funds or other resources from outside sources to assist in your efforts around
HIT and Quality? If "yes" then please describe which strategies have been successful, and the result of
resources leveraged.

Strategy

Description

Received for local funding

Received for state funding

Received for federal funding

Received for private grant funds

Demonstrated a sound return on
investment
Developed products, tools, and
services that can be sold to
generate program income
Generated income by providing
technical assistance and other
services to outside organizations
Generated income through user
fees
Implemented cost sharing

Page: 16/18

Dollars
Leveraged

Purpose Of
Dollars
Leveraged

Health Center Controlled Networks (HCCN)

Strategy

Description

Increased efficiency of services

Negotiated with state government
and Medicaid agencies to cover
services
Reinvested cost savings resulting
from greater efficiencies
Reduced cost of services

Solicited funds from taxing
authorities
Solicited in-kind contributions from
network members
Solicited monetary contributions
from network members
Other

Comments:

Page: 17/18

Dollars
Leveraged

Purpose Of
Dollars
Leveraged

Health Center Controlled Networks (HCCN)

Part E: Evaluation (Section 2) Form Comments:
Is Part E: Evaluation (Section 2) Form Complete:

Page: 18/18