OMB Number: 0915-0285; Expiration Date XX/XX/20XX |
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Health Center Controlled Networks (HCCN) PROGRESS REPORT TABLE |
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HCCN NAME:
Number of Participating Health Centers (Baseline) Number of Participating Health Centers (Current) |
APPLICATION TRACKING NUMBER:
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GRANT NUMBER:
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PARTICIPATING HEALTH CENTER |
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Participating Health Center Name |
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Grant/Look alike Number |
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PATIENT DETAILS |
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Total Patients (UDS Definition) |
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Number of Sites (Baseline) |
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Number of Sites (Current) |
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ENHANCE THE PATIENT AND PROVIDER EXPERIENCE |
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[ ] medical history [ ] lab/test results [ ] shared care plans [ ] education/self-management tools[ ] appointment reminders [ ] appointment scheduling [ ] medication refill [remote monitoring devices] [ ] other (explain) |
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[ ] improved CDS [ ] EHR template customization/optimization [ ] telehealth [ ] eConsults [ ] mobile health [ ] dashboards [ ] other reporting tools (please explain) |
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ADVANCE INTEROPERABILITY |
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[_] Yes [_] No Previously completed within project period[_] |
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[_] Yes [_] No Previously completed within project period[_] |
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[_] Yes [_] No |
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[_] Yes [_] No |
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[_] Yes [_] No |
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USE DATA TO ENHANCE VALUE |
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[ ] Busines Intelligence Software s [ ] Data Analytics [ ] Predictive Analytics [ ] SMART Apps [ ] Patient-Centered Tools [ ] other (please explain) |
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[_] Yes [_] No |
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[_] Yes [_] No |
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THE HEALTH CENTER CONTROLLED NETWORK WILL COMPLETE THIS SECTION AT THE END OF THE 3-YEAR PROJECT PERIOD FOR THE ONE-TIME FINAL REPORT |
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Public Burden Statement: Health centers (section 330 grant funded and Federally Qualified Health Center look-alikes) deliver comprehensive, high quality, cost-effective primary health care to patients regardless of their ability to pay. . [email protected] HYPERLINK "https://sharepoint.hrsa.gov/sites/bphc/oppd/ED1/OMB%20Forms%20Approval%202020/[email protected]" 42 U.S.C. 254b HYPERLINK "http://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section254b&num=0&edition=prelim" |
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | HCCN Progress Report Final |
Author | Nivedita Nagare |
File Modified | 0000-00-00 |
File Created | 2021-01-13 |