10a HCCN Progress Report

The Health Center Program Application Forms

HCCN Progress Report - clean

OMB: 0915-0285

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OMB Number: 0915-0285; Expiration Date XX/XX/20XX

Health Center Controlled Networks (HCCN) PROGRESS REPORT TABLE

HCCN NAME:


Number of Participating Health Centers (Baseline)

Number of Participating Health Centers (Current)

APPLICATION TRACKING NUMBER:


GRANT NUMBER:




PARTICIPATING HEALTH CENTER

Participating Health Center Name


Grant/Look alike Number


PATIENT DETAILS

Total Patients (UDS Definition)


Number of Sites (Baseline)


Number of Sites (Current)


ENHANCE THE PATIENT AND PROVIDER EXPERIENCE

  1. What percentage of patients at this PHC accessed their patient portal within the last 12 months?


  1. What patient portal features are currently available to patients?

[ ] medical history [ ] lab/test results [ ] shared care plans [ ] education/self-management tools [ ] appointment scheduling [ ] appointment reminders [ ] medication refill [ ] remote monitoring devices [ ] other (explain)

  1. What percentage of patients have used a digital tool (e.g., electronic messages sent through the patient portal to providers, remote monitoring) between visits to communicate health information with the PHC in the last 12 months?


  1. What percentage of providers reported increased satisfaction post implementation of at least one health IT-facilitated intervention?


  1. What health IT-facilitated intervention has this PHC used within the last 12 months to improve provider satisfaction?

[ ] improved CDS [ ] EHR template customization/optimization [ ] telehealth [ ] eConsults [ ] mobile health [ ] dashboards [ ] other reporting tools (please explain)

ADVANCE INTEROPERABILITY

  1. In the last 12 months, did this PHC complete a security risk analysis?

[_] Yes [_] No [_] Previously completed within project period

  1. In the last 12 months, did this PHC implement a breach mitigation and response plan based upon the completion of a security risk analysis?

[_] Yes [_] No [_] Previously completed within project period

  1. In the last 12 months, did this PHC experience a data breach or ransomware event?

[_] Yes [_] No

  1. In the last 12 months, did this PHC transmit a summary of care record to at least 3 external health care providers and/or health systems using certified EHR technology through platforms that align with HL7 or national standards specified in the ONC Interoperability Standards Advisory?

[_] Yes [_] No

  1. If you answered yes to Question 4 above, please provide details about the platform you are using to transmit a summary of care record.


  1. In the last 12 months, did this PHC integrate data into structured EHR fields (i.e., not free text or attachments) from at least 3 external clinical and/or non-clinical sources?

[_] Yes [_] No

USE DATA TO ENHANCE VALUE

  1. What other health IT tools and solutions did this PHC use in the last 12 months to analyze data in support of value-based care activities?

[ ] Business Intelligence Software [ ] Data Analytics [ ] Predictive Analytics [ ] SMART Apps [ ] Patient-Centered Tools [ ] other (please explain)

  1. In the last 12 months, did this PHC use a dashboard and/or standard reports to present useful data to inform value-based care activities (e.g., improve clinical quality, achieve efficiencies, reduce costs)?

[_] Yes [_] No

  1. In the last 12 months, did this PHC use health IT to collect or share social risk factor data with care teams and use this data to inform care plan development on at least 50 percent of patients identified as having a risk factor?

[_] Yes [_] No

  1. Describe progress to date on the applicant choice objective




THE HEALTH CENTER CONTROLLED NETWORK WILL COMPLETE THIS SECTION AT THE END OF THE 3-YEAR PROJECT PERIOD FOR THE ONE-TIME FINAL REPORT

  1. CUSTOMER SATISFACTION



  1. CHALLENGES AND BARRIERS



  1. LESSONS LEARNED



  1. CONTINGENCY PLANNING



  1. PROMISING PRACTICES



  1. KEY CONTACT



Public Burden Statement: 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 project is 0915-0285. Public reporting burden for this collection of information is estimated to average 1 hour 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 14N-39, Rockville, Maryland, 20857.


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleHCCN Progress Report Final
AuthorNivedita Nagare
File Modified0000-00-00
File Created2023-08-29

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