Awardee interviews for the evaluation of the Advance Interoperable Health Information Technology to Support Health Information Exchange program

AWARDEE NAME: TITLE OF PROGRAM (EXAMPLE) Form Approved

OMB No. 0955-0003

Exp. Date 12/31/2017

Program outputs

Program outcomes

Program impacts

Program components

Program inputs

Awardee: Name of awardee

Primary partner: Other organization(s) that assisted with program development or implementation.

Type of organization: What type of organization is the awardee?

Implementing sites: How many sites implemented the program? For example, how many schools or how many social service organizations?

Intervention setting: What type(s) of site(s) was the awardee working with? For example, hospitals, elementary schools, or mental health centers?

EHRs at implementing sites: Information on whether or not the implementing sites used EHRs at the start or during the intervention.

Geographic coverage area: In what county or state was the program implemented?

Target population: What category(s) of non-EP(s) was the awardee trying to include in its program? For example, behavioral health providers, school nurses, or counselors at centers that provider services to homeless clients.

Projected participants at start of intervention: Within each of the target population(s), how many individuals was the awardee expecting to enroll (Target)? For example, 32 school nurses or 150 behavioral health providers). How many individuals were actually enrolled (Actual)?

High quality care:

• If the program outcomes are achieved, what will be the broader impacts on the quality of health care? For example, improved care coordination.

• What is the expected impact if the program outputs are realized? For example, reduced test duplication and improved disease management.

• Intervention: Brief summary of program’s main goal and employed approach.

• Activities:

• What activities did the awardee and partners undertake to implement the program? For example, deploy patient consent tools, establish pathways to share documents among mental and physical health providers, train school nurses how to use Direct Secure Messaging. While these activities should be clearly described, please ensure the information provided can be understood by a lay person.

Motivation: What is the underlying issue that this program sought to address?

• What is the direct effect of the non-EPs adopting, receiving, and using electronic information exchange tools? For example, school nurses integrated HIE information into school records and used information as part of their workflow. Patients used information from their patient portal to understand their health and make informed health care decisions.

Healthier people:

• If the program outcomes are achieved, what are the broader impacts on healthier people? For example, improved asthma control for children.

Lower costs:

• If the program outcomes are obtained, what are the broader impacts on health costs? For example, reduced costs associated with unnecessary tests.

Identification: How did the awardee identify/select the non-EPs to include in their program? For example how was a school district chosen for the project or how were the schools/school nurses within the school district selected?

Enrollment: Was there a process used to enroll non-EPs into the program? For example, did behavioral health providers need to sign up to participate in the program?

Notes: Outputs, outcomes, and impacts may not have been achieved during the specified grant period.

EPs are providers who are eligible for Centers for Medicare and Medicaid Services EHR Incentive Programs. Non-EPs are providers who were not eligible.

Sustainability, scalability, and replicability

Sustainability: What did the awardee do to support continued sustainability of the program that was implemented through the cooperative agreement?

Scalability: What did the awardee do to expand the intervention within the organization(s) that participated in the intervention?

Replicability: What did the awardee do to aid other organizations in implementing a similar intervention?

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