| FINAL MONTHLY PROGRESS REPORT – Optimizing Virtual Care (OVC) | ||||
| Grant Recipient Information (Please Complete) | ||||
| Grant Recipient Organization Name | OVC Grant Number | BCHMIS ID | Reporting Month | |
| Introduction This document is a suggested biannual progress report template for Optimizing Virtual Care (OVC) grant recipients to report project activities. We encourage you to use the Grant Recipient MPR to report information related to overall program implementation and the following OVC project objectives: A. Increase Access to Care and Information B. Improve Clinical Quality and Health Outcomes, C. Enhance Patient Care Coordination D. Promote Health Equity Some questions included this document may not be relevant for all grant program’s activities. Grant recipients may choose to share additional information above and beyond the data requested in the Additional Data tab. The Grant Recipient biannual progress report includes the following sections: |
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| I. Information and Instructions | ||||
| Read Me - Guidance for completing the Grant Recipient biannual progress report | ||||
| Definitions - Definitions for variables | ||||
| Share Additional Information - Grant recipients may use this tab to submit any additional information, comments, or data findings not requested in other areas of the template | ||||
| IV: Quarterly Updates | ||||
| This document provides a suggested biannual progress report template to support OVC grant recipient health centers reporting data biannually to assess the OVC program. Please find key definitions, 12-item Measures Set Summary, 13 table templates, and additional guidance included in this workbook, as outlined below: | ||||
| Reporting Period: Quarterly | Q1: 3/1/2022 to 5/31/2022, and Q2: 6/1/2022 to 8/31/2022 |
Q3: 9/1/2022 to 11/30/2022 Q4: 12/1/2022 to 2/28/2023 |
Q5: 3/1/2023 to 5/31/2023, and Q6: 6/1/2023 to 8/31/2023 |
Q7: 9/1/2023 to 11/30/2023 Q8: 12/1/2023 to 2/28/2024 |
| Submission Deadline: Bi-annually, one month after reporting period ends | Q1and Q2 due on: 10/5/2022 | Q3 and Q4 due on: 4/5/2023 | Q5 and Q6 due on: 10/5/2023 | Q7 and Q9 due on: 4/5/2024 |
| Quarterly Access Tables (1-6) - Increasing Access to Care and Information | ||||
| Table 1: Patient Visits by Service Category | ||||
| Table 2: Patient Utilization of All Virtual Care Modalities by Service Category | ||||
| Table 3: Patient Utilization of All Virtual Care Modalities by Race and Ethnicity | ||||
| Table 4: Patient Utilization of All Virtual Care Modalities by Special and Other Populations | ||||
| Table 5: Patient Utilization of All Virtual Care Modalities by Medical Insurance Type | ||||
| Table 6: Patient Utilization of All Virtual Care Modalities by Age | ||||
| Quarterly Quality Tables (7-11) - Improving Qualty of Care and Outcomes | ||||
| Table 7: Percent of Patients with Health Screenings and Outcomes by Virtual Care Type | ||||
| Table 8: Percent of Patients with Health Screenings and Outcomes by Patient's Race and Ethnicity | ||||
| Table 9: Percent of Patients with Health Screenings and Outcomes by Patient's Primary Medical Insurance | ||||
| Table 10: Patient Overall Rating of Most Recent Visit and Report of Virtual Video Visit Training, by Visit Type | ||||
| Table 11: Patients Who Reported Receiving Instructions for Synchronous Video Virtual Care Visit | ||||
| Quarterly Care Coordination Tables (12-16) - Enhancing Care Coordination | ||||
| Table 12: Virtual Care Claims Submitted Versus Reimbursed by Virtual Care Types | ||||
| Table 13: Virtual Care Claims Submitted Versus Reimbursed by Patience Primary Medical Insurance Type | ||||
| Table 14: Medial Appointment Wait Time by Service Category | ||||
| Table 15: Medial Appointment Wait Time by Visit Type | ||||
| Table 16: Virtual Care Strategic Assessment Composit Score | ||||
| Virtual Care Strategic Deployment Self-Assessment Model Instrument | ||||
| Public Burden Statement: Data collection for the Optimizing Virtual Care (OVC) Grant program will provide HRSA with information to guide future program and policy decisions regarding virtual care. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this information collection is 0906 -XXXX and it is valid until XX/XX/202X. This information collection is required for HRSA-funded health centers to obtain or retain OVC grant funding. Public reporting burden for this collection of information is estimated to average 2 hours per response, including the time for reviewing instructions, searching existing data sources, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to HRSA Reports Clearance Officer, 5600 Fishers Lane, Room 14N136B, Rockville, Maryland, 20857 or [email protected]. | ||||
| Key Term | Definition |
| Appointment Wait Time | This is the time (in hours or days) patients must wait before they can see a health care provider for an appointment. |
| Ethnicity | Self-reported patient ethnicity (Hispanic or Latina/o or Not Hispanic/Latina/o) |
| Face-to-Face (In-Person) Health Visit | Documented, in-person, face-to-face contact between a patient and a provider who exercises objective judgment in the provision of services to the patient. To be included as a visit, services rendered must be documented in the patient’s record |
| Limited English Proficient (LEP) | Describes individuals who do not speak English as their primary language and who have a limited ability to read, speak, write, or understand English. |
| Medical Insurance | Patient's primary medical insurance (Medicare, Medicaid/Childrens Health Insurance Program (CHIP)/other public insurance, private insurace) |
| Patient | Patient: A person who has at least one countable visit in one or more categories of services |
| Race | Self-reported patient race (Asian, Native Hawaiian, Black, African American, White, More than one race) |
| Service Category | Includes medical care, dental, mental health, substance use disorder, vision, other professional, enabling |
| Special Populations | Migratory and seasonal agricultural workers, homeless populations, residents of public housing, patients from school-based health centers, veterans, populations with limited English proficiency, |
| Telehealth | The use of electronic information and telecommunications technologies to support and promote long-distance clinical health care, patient and professional health-related education, public health, and health administration. |
| Telemedicine | Telemedicine is a subset of telehealth services referring to remote clinical services. |
| UDS Service Categories | Medical, dental, mental health, substance use disorder, vision, other professional, and enabling services. |
| Virtual Care Type: Asynchronous Store and Forward | Asynchronous Store and forward: Electronic transmission of medical information for remote evaluation, such as x-rays, sonograms, other digital images, documents, and pre-recorded audio and/or videos that are not real-time interactions. |
| Virtual Care Type: Mobile Health (mHealth) | Patient technologies, like smartphone and tablet apps, that enable patients to capture personal health data independent of an interaction with a clinician. |
| Virtual Care Type: Other Asynchronous Technologies | Email, fax, internet/online questionnaires, prescribing, or other transmissions. |
| Virtual Care Type: Remote Monitoring | Patient technologies, like smartphone and tablet apps, that enable patients to capture personal health data independent of an interaction with a clinician. |
| Virtual Care Type: Synchronous Audio-Only | Use of a telephone or audio-only technology to conduct a “live” or real-time interactive visit between a patient and provider. |
| Virtual Care Type: Synchronous Video | Use of a two-way video technology or other HIPAA compliant video connection to conduct a “live” or real-time interactive visit between a patient and provider |
| Virtual Care Types | 1. Synchronous Live Audio Only 2. Synchronous Live Video 3. Asynchronous Store and Forward 4. Remote monitoring 5. Mobile health(mHealth) 6. Other Asynchronous technologies |
| Virtual visit | Virtual (telemedicine/telehealth) contact between a patient and a licensed or credentialed provider who exercises his/her independent, professional judgment in the provision of services to the patient. Virtual visits must be provided using interactive, synchronous audio and/or video telecommunication systems that permit real-time communication between the provider and a patient • Virtual visits should use telemedicine- specific CPT or HCPCS codes with: • GT – Via interactive audio and video telecommunications systems • .95 – Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system |
| Visit | A documented contact between a patient and a licensed or credentialed provider who exercises his/her independent, professional judgment in the provision of services to the patient. Virtual visits are allowable for each of the service categories. This is the only change to the definition of a visit. All other criteria remain the same) |
| [Grant recipients may use this tab to submit any additional information, comments, or data findings not requested in other areas of the template] |
| Priority | Domain/ Objective | Measure Name | Measure Description | Measure Type | Numerator | Denominator | Stratified by | Table Template | UDS Measure | NQF # | CMS ECQM ID | Measure Steward | Measurement Period | Reporting Frequency | Data Submission Periods/Due Dates | Specification Updates Needed | Burden | Other Notes | |
| Access to Care and Information | Patient Utilization of Face-to-Face (In-person) Visits | Percentage (number) of patients with a face-to-face (in-person) visit for each service category (medical, dental, mental health, substance use disorder, vision, other professional, enabling) | Structural | Number of patients with at least one face-to-face (in-person) visit | Total number of patients with a countable visit during the measurement period or in the 12 months prior to the measurement period. | Service Category | Table 1 | Yes | N/A | N/A | Calendar Quarter | Biannually | TBD | N/A | |||||
| Access to Care and Information | Patient Utilization of Virtual Visits | Percentage (number) of patients with a virtual visit for each service category (medical, dental, mental health, substance use disorder, vision, other professional, enabling) | Structural | Number of patients with at least one synchronous/ live audio-only visit, and Number of patients with a synchronous/live video visit) | Total number of patients with a countable visit during the measurement period or in the 12 months prior to the measurement period. | Service Category | Table 1 | Yes | N/A | N/A | Calendar Quarter | Biannually | TBD | N/A | |||||
| Access to Care and Information | Patient Utilization of Virtual Visits | Percentage (number) of patients with both a face-to-face (in-person) and a virtual visit, for each service category (medical, dental, mental health, substance use disorder, vision, other professional, enabling) | Structural | Number of patients with at least one synchronous/ live audio-only visit, and Number of patients with a synchronous/live video visit) | Total number of patients with a countable visit during the measurement period or in the 12 months prior to the measurement period. | Service Category | Table 1 | Yes | N/A | N/A | Calendar Quarter | Biannually | TBD | N/A | |||||
| All Health Centers | Access to Care and Information | Patient Utilization of all Virtual Care Modalities or Types | Percentage (Number) of patients who had a virtual care encounter during the measurement period for six virtual care types: a. Synchronous/Live audio-only b. Synchronous/live video, c. Asynchronous Store and forward, d. Remote monitoring,e. Mobile health(mHealth) f. Other Asynchronous technologies |
Structural | Number of patients with a virtual care encounter (by virtual care type) | Total number of patients with a countable visit during the measurement period or in the 12 months prior to the measurement period. | Service Category Race and Ethnicity Special Populations Medical Insurance |
Tables 2, 3, 4, 5, 6 | No | N/A | N/A | Calendar Quarter | Biannually | TBD | N/A | ||||
| Patient Care Coordination | Service Reimbursement | Percentage of virtual care claims submitted vs. reimbursed | Structural | Number of virtual care claims reimbursed | Number of virtual care claims submitted during the measurement period | Virtual Care Type Medical Insurance |
Table 12.,13 | No | N/A | N/A | Calendar Quarter | Biannual | TBD | N/A | |||||
| Patient Care Coordination | Mean Appointment Wait Time | Mean time (in days) measured from the day of engagement with a scheduler (scheduling an appointment) to the day on which the appointment is scheduled (appointment date) | Process | Summed total of time (in days) measured from the day of engagement with a scheduler (scheduling an appointment) to the day on which the appointment is scheduled (appointment date), for all scheduled face-to-face (In Person) or telehealth visits scheduled during the reporting period. | Total number of scheduled face-to-face (In-Person) or telehealth visits | Service Category Visit Type |
Table 14,15 | No | N/A | N/A | Calendar Quarter | Biannual | TBD | N/A | Wait Time Standards for Primary Care Visits In the Indian Health Service Direct Care Facilities | 2019 (ihs.gov); Woodcock, Elizabeth, Sarah Kier, and Vivian Zhao. "Patient access metrics in the ambulatory enterprise." Management in Healthcare 2.2 (2017): 153-164. | ||||
| Patient Care Coordination | Virtual Care Strategic Assessment - Self Score | Health centers self-assessed virtual care strategic maturity level based on leadership and governance, technology platforms, virtual care operations, and health equity categories | Structural | Self Score | Maximum possible score (99) | N/A | Table 16 | No | N/A | N/A | Calendar Quarter | Biannual | TBD | N/A | Meyers, JF. (2021) Virtual Care Strategic and Tactical Deployment Maturity Self-Assessment Model. Oakland, CA: The California Health Care Safety Net Institute | ||||
| Choose At Least 3 of 9 Preventive Care and Screening/Health Outcome Measures to Report | Quality of Care and Outcomes | Preventive Care and Screening: Breast Cancer Screening | Percentage of women 51–73 years of age who had a mammogram to screen for breast cancer. Process |
Process | Women with one or more mammograms during the 27 months prior to the end of the measurement period. | Women 51 through 73 years of age with a medical visit during the measurement period. | Virtual Care Type Medical Insurance Race and Ethnicity |
Tables 7, 8, 9 | Yes | 2372 | CMS125v10 | NCQA | Calendar Quarterly | Biannual | TBD | No | |||
| Quality of Care and Outcomes | Preventive Care and Screening: Cervical Cancer Screening | Percentage of women 23–64 years of age who were screened for cervical cancer. | Process | The number of women with one or more screenings for cervical cancer. (Appropriate screenings are defined per UDS specifications) | Women 23 through 63 years of age with a medical visit during the measurement period. | Virtual Care Type Medical Insurance Race and Ethnicity |
Tables 7, 8, 9 | Yes | 0032 | CMS124v10 | NCQA | Calendar Quarterly | Biannual | TBD | No | ||||
| Quality of Care and Outcomes | Preventive Care and Screening: Childhood Immunization Status | Percentage of children 2 years of age who had four diphtheria, tetanus and acellular pertussis (DTaP); three polio (IPV), one measles, mumps and rubella (MMR); three or four H influenza type B (Hib); three hepatitis B (Hep B); one chicken pox (VZV); four pneumococcal conjugate (PCV); one hepatitis A (Hep A); two or three rotavirus (RV); and two influenza (flu) vaccines by their second birthday. | Process | Children who have evidence showing they received recommended vaccines, had documented history of the illness, had a seropositive test result, or had an allergic reaction to the vaccine by their second birthday | Children who turn 2 years of age during the measurement period and who had a medical visit during the measurement period. | Virtual Care Type Medical Insurance Race and Ethnicity |
Tables 7,8,9 | Yes | N/A | CMS117v10 | NCQA | Calendar Quarterly | |||||||
| Quality of Care and Outcomes | Preventive Care and Screening: Colorectal Cancer Screening | Percentage of patients 50 through 74 years of age who had appropriate screening for colorectal cancer. | Process | Patients with one or more screenings for colorectal cancer. (Appropriate screenings are defined per UDS specifications) | Patients 50 through 74 years of age with a medical visit during the measurement period. | Virtual Care Type Medical Insurance Race and Ethnicity |
Tables 7, 8, 9 | Yes | 0034 | CMS130v10 | NCQA | Calendar Quarterly | Biannual | TBD | No | ||||
| Quality of Care and Outcomes | Preventive Care and Screening: HIV Screening | Percentage of patients 15 through 65 years of age who were tested for HIV when within age range. | Process | Patients with documentation of an HIV test performed on or after their 15th birthday and before their 66th birthday. | Patients aged 15 through 65 years of age at the start of the measurement period and with at least one outpatient medical visit during the measurement period. | Virtual Care Type Medical Insurance Race and Ethnicity |
Tables 7, 8, 9 | Yes | N/A | CMS349v4 | CDC | Calendar Quarterly | Biannual | TBD | No | ||||
| Quality of Care and Outcomes | Preventive Care and Screening: Screening for Depression and Follow-Up Plan | Percentage of patients aged 12 years and older screened for depression on the date of the visit or 14 days prior to the visit using an age-appropriate standardized depression screening tool and, if screening was positive, had a follow-up plan documented on the date of the visit. | Process | Patients who: •were screened for depression on the date of the visit or up to 14 days prior to the date of the visit using an age-appropriate standardized tool AND, •if screened positive for depression, had a follow-up plan documented on the date of the visit. |
Patients aged 12 years and older with at least one medical visit during the measurement period. | Virtual Care Type Medical Insurance Race and Ethnicity |
Tables 7, 8, 9 | Yes | 0418e | CMS2v11 | NCQA | Calendar Quarterly | Biannual | TBD | No | ||||
| Quality of Care and Outcomes | Preventive Care and Screening: Diabetes Eye Exam | Percentage of patients 18-75 years of age with diabetes and an active diagnosis of retinopathy in any part of the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or diabetics with no diagnosis of retinopathy in any part of the measurement period who had a retinal or dilated eye exam by an eye care professional during the measurement period or in the 12 months prior to the measurement period | Process | Patients with an eye screening for diabetic retinal disease. This includes one of the following: •Diabetes with a diagnosis of retinopathy in any part of the measurement period and a retinal or dilated eye exam by an eye care professional in the measurement period •Diabetes with no diagnosis of retinopathy in any part of the measurement period and a retinal or dilated eye exam by an eye care professional in the measurement period or the 12 months prior to the measurement period |
Patients 18-75 years of age with diabetes with a medical visit during the measurement period. | Virtual Care Type Medical Insurance Race and Ethnicity |
Tables 7, 8, 9 | No | N/A | CMS131v10 | NCQA | Calendar Quarterly | Biannual | TBD | No; Currently a MIPs CQM. Specifications are publicly available. HRSA may want to provide a courtesy notification to NCQA of use. | This measure was suggested by multiple grant recipients and was selected in lieu of UDS measure Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan. CMS has deemed the BMI measure as not telehealth appropriate. See reference:https://ecqi.healthit.gov/sites/default/files/2022-EP-EC-Telehealth-Guidance.pdf. | |||
| Quality of Care and Outcomes | Health Outcome: Hemoglobin A1c (HbA1c) Poor Control(<9.0) | Percentage of patients 18–75 years of age with diabetes who had hemoglobin A1c (HbA1c) greater than 9.0 percent during the measurement period | Outcome: Intermediate | Patients whose most recent HbA1c level performed during the measurement period was greater than 9.0 percent or patients who had no HbA1c test conducted during the measurement period. | Patients 18 through 74 years of age with diabetes with a medical visit during the measurement period. | Virtual Care Type Medical Insurance Race and Ethnicity |
Tables 7, 8, 9 | Yes | 0059 | CMS122v10 | NCQA | Calendar Quarterly | Biannual | TBD | No | ||||
| Quality of Care and Outcomes | Health Outcome: Controlling High Blood Pressure | Percentage of patients aged 12 years and older with major depression or dysthymia who reached remission 12 months (+/- 60 days) after an index event | Outcome: PRO-PM | Patients whose most recent blood pressure is adequately controlled (systolic blood pressure less than 140 mmHg and diastolic blood pressure less than 90 mmHg) during the measurement period | Patients 18 through 84 years of age who had a diagnosis of essential hypertension overlapping the measurement period or the year prior to the measurement period with a medical visit during the measurement period | Virtual Care Type Medical Insurance Race and Ethnicity |
Tables 7, 8, 9 | Yes | 0710e | CMS165v10 | Minnesota Community Measurement | Calendar Quarterly | Biannual | TBD | No | ||||
| Quality of Care and Outcomes | Health Outcome: Depression Remission at Twelve Months | Percentage of patients 18–85 years of age who had a diagnosis of hypertension overlapping the measurement period or the year prior and whose most recent blood pressure (BP) was adequately controlled (less than 140/90 mmHg) during the measurement period. | Outcome | Patients who achieved remission at 12 months as demonstrated by the most recent 12 month (+/- 60 days) PHQ-9 or PHQ-9M score of less than 5 |
Patients aged 12 years and older with a diagnosis of major depression or dysthymia and an initial PHQ-9 or PHQ-9 modified for teens (PHQ-9M) score greater than 9 during the index event between November 1, 2019 through October 31, 2020 and at least one medical visit during the measurement period | Virtual Care Type Medical Insurance Race and Ethnicity |
Tables 7, 8, 9 | Yes | 0018 | CMS159v10 | NCQA | Calendar Quarterly | Biannual | TBD | No | ||||
| OPTIONAL: For Health centers implementing the CAHPS Clinical and Group Visit Adult 4.0 (beta) Survey | Quality of Care and Outcomes: Patient Experience of Care | Patient Overall Rating of Most Recent face-to-face (in-person) or synchronous virtual care (phone or video) visit | Mean overall rating of the most recent visit for all adults patients responding to item 21 of the CAPHS Clinical and Group Survey and Instructions Adult 4.0 (beta) (On a scale of 0 to 10, with 0 being the worst and 10 being the best) | Patient Experience of Care | Sum of the overall rating of for all adult patients who responded to item 21 of the CAHPS Clinician & Group Survey Adult Visit Survey 4.0 (beta) | Sum of the maximum possible rating (10) for all adult patients who responded to item 21 of the CAPHS Clinical and Group Survey and Instructions Adult 4.0 (beta) | Visit Type | Table 10 | No | N/A | CAHPS Clinician & Group Visit Adult Survey 4.0 (beta) | Calendar Quarterly | Biannual | TBD | N/A | CAHPS Clinician & Group Adult Visit Survey 4.0 (beta) (ahrq.gov); https://www.ahrq.gov/sites/default/files/wysiwyg/cahps/surveys-guidance/cg/overview-questionnaires-cg40-3350.pdf | |||
| Quality of Care and Outcomes: Patient Experience of Care | Patient Virtual Video Visit Training | Percentage of patients who reported receiving instructions to use video prior to a synchronous, video virtual care visit | Patient Experience of Care | Adults who responded (1-Yes) to item 7: "Did this provider's office give you all the instructions you needed to use video for this visit?" | Adults who responded 1-Yes to item #6 ( Did you need instructions from this provider’s office about how to use video for this visit?) of the CAPHS Clinical and Group Survey and Instructions Adult 4.0 (beta) | N/A | Table 11 | No | N/A | CAHPS Clinician & Group Visit Adult Survey 4.0 (beta) | Calendar Quarterly | Biannual | TBD | N/A |
| Table 1: Patient Visits by Service Category | |||||||
| Service Category | Total number of patients with a countable visit during the measurement period | Patients with face-to-face (in-person) visits | Patients with Synchronous Live Audio only virtual visits |
Patients with Synchronous Live Video virtual visits |
Patients with both face-to-face and virtual care visits | ||
| a. Medical | |||||||
| b. Dental | |||||||
| c. Mental Health | |||||||
| d. Substance Use Disorder | |||||||
| e. Vision | |||||||
| f. Other professional | |||||||
| g. Enabling | |||||||
| h. Total Patients | |||||||
| Table 1 Comments: | |||||||
| Table 2: Patient Utilization of All Virtual Care Modalities by Service Category | |||||||
| Service Category | Total number of patients with a countable visit during the measurement period or in the 36 months prior to the measurement period. | 4a. Synchronous/Live Audio Only Virtual |
4b. Synchronous/Live Video Virtual Visits |
4c. Asynchronous Store and Forward | 4d. Remote Monitoring | 4e. Mobile Health (mHealth) | 4f. Other Asynchronous Technologies |
| a. Medical | |||||||
| b. Dental | |||||||
| c. Mental Health | |||||||
| d. Substance Use Disorder | |||||||
| e. Vision | |||||||
| f. Other professional | |||||||
| g. Enabling | |||||||
| h. Total Patients | |||||||
| Table 2 Comments: | |||||||
| Table 3: Patient Utilization of All Virtual Care Modalities by Race and Ethnicity | |||||||
| Race and Ethnicity | Total number of patients with a countable visit during the measurement period or in the 36 months prior to the measurement period | 4a. Synchronous/Live Audio Only Virtual |
4b. Synchronous/Live Video Virtual Visits |
4c. Asynchronous Store and Forward | 4d. Remote Monitoring | 4e. Mobile Health (mHealth) | 4f. Other Asynchronous Technologies |
| Hispanic or Latino/a | |||||||
| a. Asian | |||||||
| b. Native Hawaiian | |||||||
| c. Other Pacific Islander | |||||||
| d. Black/African American | |||||||
| e. American Indian/Alaskan Native | |||||||
| f. White | |||||||
| g. More than one race | |||||||
| h. Unreported/Refused to report race | |||||||
| Not Hispanic or Latino/a | |||||||
| a. Asian | |||||||
| b. Native Hawaiian | |||||||
| c. Other Pacific Islander | |||||||
| d. Black/African American | |||||||
| e. American Indian/Alaskan Native | |||||||
| f. White | |||||||
| g. More than one race | |||||||
| h. Unreported/Refused to report race | |||||||
| Total Patients | |||||||
| Table 3 Comments: | |||||||
| Table 4: Patient Utilization of All Virtual Care Modalities by Special and Other Populations | |||||||
| Special and Other Population | Total number of patients with a countable visit during the measurement period or in the 36 months prior to the measurement period | Synchronous/Live Audio Only Virtual |
Synchronous/Live Video Virtual Visits |
Asynchronous Store and Forward | Remote Monitoring | Mobile Health (mHealth) | Other Asynchronous Technologies |
| a. Migratory and seasonal agricultural workers | |||||||
| b. Homeless population | |||||||
| c. Residents of public housing | |||||||
| d. English Language proficiency | |||||||
| e. Patients from school-based health centers | |||||||
| f. Veterans | |||||||
| g. Limited English Proficient populations | |||||||
| h. Total Patients | |||||||
| Table 4 Comments: | |||||||
| Table 5: Patient Utilization of All Virtual Care Modalities by Medical Insurance Type | |||||||
| Insurance type | Total number of patients with a countable visit during the measurement period or in the 36 months prior to the measurement period | Synchronous/Live Audio Only Virtual |
Synchronous/Live Video Virtual Visits |
Asynchronous Store and Forward | Remote Monitoring | Mobile Health (mHealth) | Other Asynchronous Technologies |
| a. None/Uninsured | |||||||
| b. Medicaid/CHIP/Other Public | |||||||
| c. Medicare | |||||||
| d. Private | |||||||
| e. Total Patients | |||||||
| Table 5 Comments: | |||||||
| Table 6: Patient Utilization of All Virtual Care Modalities by Age | |||||||
| Insurance type | Total number of patients with a countable visit during the measurement period or in the 36 months prior to the measurement period | Synchronous/Live Audio Only Virtual |
Synchronous/Live Video Virtual Visits |
Asynchronous Store and Forward | Remote Monitoring | Mobile Health (mHealth) | Other Asynchronous Technologies |
| a. Ages 3 through 17 years | |||||||
| b. Ages 18 through 24 years | |||||||
| d. Ages 25 through 39 years | |||||||
| e. Ages 40 through 54 years | |||||||
| f. Ages 55 through 64 years | |||||||
| g. Ages older than 65 years | |||||||
| h. Total Patients | |||||||
| Table 6 Comments | |||||||
| Table 7: Percent of patients with Health Screenings and Outcomes by Virtual Care Type | ||||||||||||||
| (Select at Least 4 of 9 Screenng and Outcome Measures to Report) | ||||||||||||||
| Medical Insurance | None of these or Technology not offered | Breast Care Screening | Cervical Care Screening | Childhood Immunization Status | Colorectal Cancer Screening | Depression Screening and Follow-Up Plan | Diabetes Eye Exam | HIV Screening | Diabetes Control (Hemoglobin A1C) | High Blood Pressure Control | Depression Remission, 12 months | Other (Write In) | Other (Write In) | Other (Write In) |
| a. Synchronous/Live Audio Only Virtual |
||||||||||||||
| b. Synchronous/Live Video Virtual Visits |
||||||||||||||
| c. Asynchronous Store and Forward | ||||||||||||||
| d. Remote Monitoring | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | ||||
| e. Mobile Health (mHealth) | ||||||||||||||
| f. Other Asynchronous Technologies | ||||||||||||||
| Total (Any Virtual Care) | ||||||||||||||
| Table 7 Comments: | ||||||||||||||
| Table 8: Percent of Patients with Health Screenings and Outcomes by Patient's Race and Ethnicity | ||||||||||||||
| (Select at Least 4 of 9 Screenng and Outcome Measures to Report) | ||||||||||||||
| By Race and Ethnicity | None of these | Breast Care Screening | Cervical Care Screening | Childhood Immunization Status | Colorectal Cancer Screening | Depression Screening and Follow-Up Plan | Diabetes Eye Exam | HIV Screening | Diabetes Control (Hemoglobin A1C) | High Blood Pressure Control | Depression Remission, 12 months | Other (Write In) | Other (Write In) | Other (Write In) |
| Hispanic or Latino/Latina | ||||||||||||||
| a. Asian | ||||||||||||||
| b. Native Hawaiian | ||||||||||||||
| c. Other Pacific Islander | ||||||||||||||
| d. Black/African American | ||||||||||||||
| e. American Indian/Alaskan Native | ||||||||||||||
| f. White | ||||||||||||||
| g. More than one race | ||||||||||||||
| i. Total patients | ||||||||||||||
| Not Hispanic or Latino/Latina | ||||||||||||||
| a. Asian | ||||||||||||||
| b. Native Hawaiian | ||||||||||||||
| c. Other Pacific Islander | ||||||||||||||
| d. Black/African American | ||||||||||||||
| e. American Indian/Alaskan Native | ||||||||||||||
| f. White | ||||||||||||||
| g. More than one race | ||||||||||||||
| i. Total patients | ||||||||||||||
| Table 8 Comments: | ||||||||||||||
| Table 9: Percent of Patients with Health Screenings and Outcomes by Patient's Primary Medical Insurance | ||||||||||||||
| (Select at Least 4 of 9 Screenng and Outcome Measures to Report) | ||||||||||||||
| Medical Insurance | None of these | Breast Care Screening | Cervical Care Screening | Childhood Immunization Status | Colorectal Cancer Screening | Depression Screening and Follow-Up Plan | Diabetes Eye Exam | HIV Screening | Diabetes Control (Hemoglobin A1C) | High Blood Pressure Control | Depression Remission, 12 months | Other (Write In) | Other (Write In) | Other (Write In) |
| a. None/Uninsured | ||||||||||||||
| b. Medicaid/CHIP/Other Public | ||||||||||||||
| c. Medicare | ||||||||||||||
| d. Private | ||||||||||||||
| e. Total Patients | ||||||||||||||
| Table 9 Comments: | ||||||||||||||
| Table 10: Patient Overall Rating of Most Recent Visit and Report of Virtual Video Visit Training, by Visit Type | ||||||||||||||
| (OPTIONAL to Report: For Health centers that implement the CAHPS Clinical and Group Visit Adult 4.0 (beta) Survey) | ||||||||||||||
| Service Category | All Patients who responded to item 21 of the CAPHS Clinical and Group Survey and Instructions Adult 4.0 (beta) | Patients with face-to-face (in-person) visits | Patients with Synchronous Live Audio only virtual visits |
Patients with Synchronous Live Video virtual visits |
Note: If your health center did not adminster the CAHP survey, but collected similar virtual care patient satisfaction data using a comparable survey, you may describe the alternative survey in the "comments" section below the table and submit your findings related to patient satisfaction in the "Additional Data" sheet. | |||||||||
| a. Mean patient rating of most recent visit (Range 0 to 10) | ||||||||||||||
| Table 10 Comments: | ||||||||||||||
| Table 11: Patients Who Reported Receiving Instructions for Synchronous Video Virtual Care Visit | ||||||||||||||
| (OPTIONAL to Report: For Health centers that implement the CAHPS Clinical and Group Visit Adult 4.0 (beta) Survey) | ||||||||||||||
| a. Patient reported last visit was synchronous, video virtual care visit | Note: If your health center did not adminster the CAHP survey, but collected similar virtual care patient satisfaction data using a comparable survey, you may describe the alternative survey in the "comments" section below the table and submit your findings related to patient satisfaction in the "Additional Data" sheet. | |||||||||||||
| b. Patient reported receiving instructions before last synchronous, video virtual care visit | ||||||||||||||
| Table 11 Comments: | ||||||||||||||
| For Other Surveys | ||||||||||||||
| Survey Name: | ||||||||||||||
| Institution: | ||||||||||||||
| Survey Question | ||||||||||||||
| Question Response Options | ||||||||||||||
| (insert table?) | ||||||||||||||
| Table 12: Virtual Care Claims Submitted Versus Reimbursed by Virtual Care Types | |||
| Number of virtual care claims submitted during the measurement period | Total Claims Reimbursed | ||
| a. Face-to-face (In-person) Visits | |||
| b. Synchronous Live Audio Only | |||
| c. Synchronous Live Video | |||
| d. Asynchronous Store and Forward | |||
| e. Remote Monitoring | |||
| f. Mobile Health (mHealth) | |||
| g. Other Asynchronous technology: (Write In) ____________________ | |||
| Comments | |||
| Table 13: Virtual Care Claims Submitted Versus Reimbursed by Patience Primary Medical Insurance Type | |||
| Number of virtual care claims submitted during the measurement period | Total Claims Reimbursed | ||
| a. None/Uninsured | |||
| b. Medicaid/CHIP/Other Public | |||
| c. Medicare | |||
| d. Private | |||
| e. Total Patients | |||
| Comments | |||
| Table 14: Median Appointment Wait Time by Service Category | |||
| Service Category | Median appointment wait time (in days) | ||
| a. Medical | |||
| b. Dental | |||
| c. Mental Health | |||
| d. Substance Use Disorder | |||
| e. Vision | |||
| f. Other professional | |||
| g. Enabling | |||
| h. Total Patients | |||
| Table 15: Median Appointment Wait Time by Visit Type | |||
| Visit Type | Median appointment wait time (in days) | ||
| a. Face-to-face (In-person) Visits | |||
| b. Synchronous Live Audio Only | |||
| c. Synchronous Live Video | |||
| Comments | |||
| Table 16: Virtual Care Strategic Assessment Composite Score (See instructions on the VCSD Self Assessment Model Tool tab) | |||
| Dimension | Self-Assessment Score (Range 1 to 9) | What topics would you like to learn more about or get additional support on? (Write in) | |
| a. Leadership Platforms | a.1. Leadership | ||
| a.2. Governance | |||
| b. Virtual Platforms | b.1. Core Telecommunications Platform | ||
| b.2. Virtual Care Devices | |||
| b.3. Technology Support | |||
| b.4. Cybersecurity Support | |||
| c. Virtual Care Operations | c.1. Operational and Clinical Standards | ||
| c.2. Provider/Staff Engagement | |||
| c.3. Patient and Family Engagement | |||
| d. Health Equity | d.1. Awareness | ||
| d.2. Action | |||
| Comments |
| Virtual Care Strategic Deployment Self-Assessment Model Instrument | ||||||
| Citation: Meyers, JF. (2021) Virtual Care Strategic and Tactical Deployment Maturity Self-Assessment Model. Oakland, CA: The California Health Care Safety Net Institute | ||||||
| The Virtual Care Strategic and Tactical Deployment Maturity Self-Assessment Model presented in this document was authored by Jim Meyers, DrPH under funding from the California Health Care Safety Net Institute. | ||||||
| Instructions: 1. Read the descriptions for each maturity level (columns) for each of the 11 categories (rows) found in the 4 operational dimensions. Using the self-scoring key - in yellow - put your maturity level self-score in column G. Example: Start by reading the "Leadership" category in the Dimension "Leadership and Governance". The description column will help you to understand the maturity assessment question. Each of the next three columns will describe ever-increasing degrees of maturity and they each have a range of scores you can choose. If you feel the "foundational" response best matches your current situation, choose a score between 4 and 6 that best represents your self-assessment. Put that score into the column G in place of the words "Fill in Number". 2. If you feel any category row should receive immediate attention, please put a short description of the attention needed in the last column (H). |
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| Capability Levels: | Foundational (Enterprise-wide Strategic Response) |
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| Self-Score: | Score: 4 to 6 | |||||
| Dimension | Category | Description | Self-Score | What topics would you like to learn more about or get additional support on? | ||
| Leadership and Governance | Leadership | To what degree have organizational leaders committed to immediate and long-term adoption of virtual care operations? | • Leaders support a more permanent virtual care deployment plan that integrates telehealth into standard care operations. • Board and enterprise leaders allocate sufficient resources and staff to meet the demands of the new virtual care environment. |
Fill In Number | ||
| Governance | To what degree has the organization committed to a permanent organization-wide virtual care governance/strategic oversight structure? | • A virtual care governance structure is established organization-wide. • Virtual care structure, process and outcome metrics are defined, tracked, and acted upon. • Virtual care governing bodies include all levels of staff (e.g., senior leaders, front-line workers) from across departments (e.g., quality improvement, IT, ambulatory care). |
Fill In Number | |||
| Technology Platforms | Core Telecommunications Platform | How successful has the organization been in establishing a core telecommunications platform to support virtual care needs for data exchange (speed, bandwidth, interoperability), processing capability and data storage capacity? | • Bandwidth and connection speeds improve as capacity is built or contracted. • Interoperability continues to be a large barrier between legacy systems, new contractor-based systems, and HIE platforms. • Resources are allocated for legacy system upgrade planning and initial deployment to meet the needs of virtual care operations. • Cybersecurity risks decrease as a more permanent platform solution set is put in place. |
Fill In Number | ||
| Virtual Care Devices | How successfully has the organization met the hardware and software support needs of providers, staff and patients for the desired synchronous and asynchronous virtual care operations? | • The organization plans for and begins purchasing common hardware and software solutions across the enterprise in support of their virtual care operational needs. • Hardware and software consistency leads to greater acceptance of virtual care operations. • Virtual care hardware and software quality and options are standardized for the home-based workforce. |
Fill In Number | |||
| Technology Support | How successfully has the organization met the technical support needs of providers, staff and patients for the desired synchronous and asynchronous virtual care operations? | • Technology support functions are reorganized to more permanently meet the needs of the new virtual care environment; • Leaders and technical support staff specifically trained in virtual care technologies are hired. • Resources are researched, purchased, and allocated that specifically support home-based staff needs (e.g.; dual screens, special cameras, etc.). • Technical support staff may join pre-telehealth visit workflows to help staff and patients prepare for proper virtual care connection. • Just-in-time short-term contract support is used where appropriate to remain nimble as the virtual care operational environment unfolds. |
Fill In Number | |||
| Cybersecurity Support | To what degree has the organization built cybersecurity infrastructure protections, user protocols, and training necessary to counter existing and emerging cybersecurity threats? | • Cybersecurity harm reduction efforts cover broad infrastructure threats and are not typically targeted to unique virtual care risks; focus mainly on extending protection for HIPAA compliance into the various virtual care settings; rely on in-house expertise; and rely on external data exchanges and brokers of data to provide their own cybersecurity protections. • Awareness of HIPAA, privacy, and cyber-security threats specific to virtual care operations relies on in-house expertise; risk reduction measures are often reactive, are slow to be put in place and are only moderately successful at increasing protection from unique virtual care cybersecurity risks. |
Fill In Number | |||
| Virtual Care Operations | Operational and Clinical Standards | To what degree has virtual care functioned with the same or better care and operational quality standards as in-person care? | • Virtual care quality standards aim for equal or better care quality compared to in-person care. • Virtual care workflows link to all necessary integrated team-based care team and admin processes (e.g. registration, intake, remote patient monitoring, vital signs collection, etc.). • Quality improvement oversight and structure, process, and outcome measures integrate virtual care operations; • Protocols are formalized to appropriately triage patients to in-person or virtual care options and to take into account patient preference. • Telecommuting protocols for staff and providers are standardized to create consistent well-being, connectivity quality, and care quality. • The patient portal becomes a viable and user-friendly pathway for patient-facing pre-visit and post-visit administration functions including eligibility screening, pre-visit surveys, check-in, linking to virtual care visit, post-visit follow-up, and completion of all billing processes. • Permanent, safe and appropriate diagnostic, care and counseling options leverage virtual care advantages in select specialty areas (e.g. specialty care, physical therapy, behavioral health, etc). • Care teams prioritize moving communication, counseling, and remote monitoring of chronic conditions to virtual care when and where it can produce better patient outcomes. |
Fill In Number | ||
| Provider/Staff Engagement | How proficient are providers and staff in using virtual care tools in terms of access (hardware, software, connectivity, setting, language), training, usability, and coordination across teams? | • Virtual care operations provide a seamless patient visit flow that is perceived by both provider/staff and patients as equal or better than previous in-person only processes (e.g., advanced team-based workflows provide more "in-person"-like handoffs and communications between interpreters, front desk, care team members, navigators and eligibility/billing functions). • Providers and staff are engaged in quality improvement assessment and improvement cycles for continuous improvement of their virtual care operations and the integration of those operations into both hybrid and in-person care settings. |
Fill In Number | |||
| Patient and Family Engagement | How proficient/engaged are patients, families, and caregivers in virtual care in terms of access (hardware, software, connectivity, setting, language), digital health literacy, and use? | • Patients are aware of the options for accessing virtual care and are getting more comfortable with care delivered through virtual care processes. • Patients are regularly screened for digital access and virtual care interface skills. • Regular feedback processes (including virtual feedback) measure patient satisfaction with virtual care. • Advanced team-based workflows provide more "in-person"-like handoffs and communications between medical assistants, nurses, and physicians. • Basic vital signs collection processes are coordinated where reliable through manual patient self-assessment. • Policies and procedures are put in place to help caregivers and family members link into virtual care processes as easily as the patient can. |
Fill In Number | |||
| Health Equity | Awareness | How successful has the organization been in creating awareness of varying levels of access to and uptake of virtual care in their patient population and the impact of virtual care on inequities in access, care, experience, and outcomes? | • Virtual care governance and organizational resource allocation processes prioritize the collection of information on health equity in virtual care operations. • The organization proactively screens patients on access to and skills (e.g., digital health literacy) necessary to use virtual care. • Virtual care access, use, and health equity outcomes measures are collected and categorized by vulnerable population, broken down by demographics, and that information is disseminated across the organization (e.g., via dashboard or regular reporting). |
Fill In Number | ||
| Action | To what degree are virtual care processes intentionally designed to create equitable access to care and reduce health disparities in the population served? | • The organization prioritizes and allocates resources to existing projects that have the potential to decrease health inequities caused by virtual care processes. • Evidence-based processes are in place to reduce health inequities in the use of virtual care such as: virtual interpreter services; non-English device instructions and prompts; programs to connect to caregivers/family who help bridge communication divides; and, prioritization of organizational actions that increase patient trust and more equitable use of virtual care. |
Fill In Number | |||
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |