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Introduction. Use this page to quickly find all resources from the Clearinghouse database on HIT/Data.

Background. The use of electronic health records and other health information technology can help health centers improve access to care, quality of care and outcomes for patients. Use these resources to explore health IT issues such as Electronic Health Records (EHRs), Privacy and Security, and Telehealth.

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Results for: Topic Area = Health Information Technology (HIT)/Data

Displaying all 227 records.

Telehealth Office Hours: Cybersecurity Best Practices (2021). Resource Type: Archived Webinar. Description: This webinar tackles the issue of cybercrime and provides our top 15 Cybersecurity Best Practices that every organization should be doing to protect themselves and the communities they serve. More Details...

Strategic Investments in Telehealth and Digital Tools for Health Centers: Maintaining Your Competitive Advantage Beyond the Pandemic (2021). Resource Type: Publication. Description: This short guide describes FQHC telehealth utilization and barriers to adoption pre and during COVID19 pandemic. The document outlines reasons for maintaining or increasing adoption relative to improving health equity through technology access and move to value based care. A checklist is provided to guide technology investment and decision making. More Details...

Remote Access Checklist and User Agreement (2021). Resource Type: Publication. Description: This document is a sample remote access checklist and user agreement. More Details...

Telehealth Office Hours: Navigating the Current Telehealth Landscape (2021). Resource Type: Archived Webinar. Description: This office hour discusses new trends in telehealth optimization, funding & reimbursement. It reviews the current federal landscape as it relates to Telehealth in addition to highlighting recent trends in telehealth to include hybrid care models. More Details...

Community Health Centers Telehealth Promising Practices: Case Studies from the COVID-19 Pandemic (2021). Resource Type: Publication. Description: This collection of case studies highlights ten community health centers' promising practices and lessons learned in adoption or expansion of telehealth delivery in response to the covid-19 pandemic. More Details...

UDS Quick Guide for Federally Funded Health Centers: How to use UDS data to expand your understanding of SDOH (2021). Resource Type: Publication. Description: This UDS Guide will inform health center staff on how UDS offers rich and detailed insight to inform operations at health centers. More Details...

Building Clinical Informatics Session 4: Evaluating Usability and Human-Centered Design for Happy Users and Better Performance (2021). Resource Type: Archived Webinar. Description: Evaluating usability and implementing human-centered design principles can improve reimbursement, care team satisfaction, data quality, and reduce staff time spent on clinical tasks. This webinar describes how engaging vendor partners in user-centered improvements can improve the vendor-customer relationship and the care team experience. More Details...

Building Clinical Informatics Learning Community Session 3: Improving Data Exchange: COVID-19 as a Test Case for FQHC Interoperability (2021). Resource Type: Archived Webinar. Description: The most value-added approaches to interoperability should rely on enduring machine-to-machine connections with regular testing that bring data to the point of care. This webinar discusses how filling health data gaps with external data sources can change the effectiveness of care activities and close care gaps and work with FQHC partners to demonstrate the value these connections bring. More Details...

Building Clinical Informatics Learning Community Session 2: Data Validation: Building a Playbook for Data Quality (2021). Resource Type: Archived Webinar. Description: Extracting data from EHRs and health IT systems can be challenging; unfortunately, without a coordinated Data Quality Plan to clean and validate data, a large proportion of electronic health data do not reach a minimum level of quality for most use cases. A clear plan for data extraction, mapping, analytics, and validation can help immensely to create better data quality, particularly if applied consistently across use cases and iteratively over multiple data extracts. Here we present a few strategies and tools for evaluating data quality and hear from a partner who routinely engages in data quality practices with FQHCs. More Details...

Process for Tracking Utilization of COVID-19 Therapeutics (2021). Resource Type: Document. Description: This resource discusses who should report on the use of federally purchased therapeutics, rules governing reporting, and the process of reporting. More Details...

Past, Present, and Future: HCCNs and Health Centers Using Data to Drive Clinical Care Series: The Future State: Data Integrity (2021). Resource Type: Archived Webinar. Description: This is the third webinar in a three-part series -- Past, Present, and Future: HCCNs and Health Centers Using Data to Drive Clinical Care. During these webinars, hear how HCCNs and health centers are collecting and aggregating data on patient populations and leveraging data to support clinical quality improvement initiatives. More Details...

Billing, Coding, Documentation & Quality Series, Part II: Treating Substance/Opioid Use Disorders via Medication-Assisted Treatment (MAT) in Community Health (2021). Resource Type: Archived Webinar. Description: By providing CMS-covered Medication Assisted Treatment (MAT) services in the treatment of Substance/Opioid Use Disorders (SUD and OUD) your community health center’s clinical providers may be eligible for a more full range of loan repayment programs while providing desperately needed services to patients who need help with the medical and behavioral health issue related to this other public health emergency. More Details...

Past, Present, and Future: HCCNs and Health Centers Using Data to Drive Clinical Care: The Current State of HCCNs (2021). Resource Type: Archived Webinar. Description: This is the second webinar in a three part series -- Past, Present, and Future: HCCNs and Health Centers Using Data to Drive Clinical Care. During these webinars, hear how HCCNs and health centers are collecting and aggregating data on patient populations and leveraging data to support clinical quality improvement initiatives. Medical informaticists from leading organizations such as the Duke Institute for Health Innovation and the Johns Hopkins Bloomberg School of Public Health will present. Clinicians, quality improvement and data leads, Chief Executive Officers as well as Chief Information Officers will find this series useful to their every day work. More Details...

Past, Present, and Future: HCCNs and Health Centers Using Data to Drive Clinical Care: Looking Back: The Birth of the HCCNs – the Vision for Data (2021). Resource Type: Archived Webinar . Description: Join NACHC for a three part series -- Past, Present, and Future: HCCNs and Health Centers Using Data to Drive Clinical Care. During these webinars, hear how HCCNs and health centers are collecting and aggregating data on patient populations and leveraging data to support clinical quality improvement initiatives. Medical informaticists from leading organizations such as the Duke Institute for Health Innovation and the Johns Hopkins Bloomberg School of Public Health will present. Clinicians, quality improvement and data leads, Chief Executive Officers as well as Chief Information Officers will find this series useful to their every day work. More Details...

Coding & Documentation:: 2021 Evaluation & Management (E/M) Changes for Community Health Reporting Face-to-Face & Virtual E/M Visits (2021). Resource Type: Archived Webinar. Description: The first in a two-part series, this webinar addresses the updated 2021 E/M guideline for office and outpatient encounters. Topics include when to use the updated definition of Medical Decision Making for coding and billing, as well as CPT/HCPS-ll codes. More Details...

Strategies for Increasing HIV Screening Rates at Your Health Center (2020). Resource Type: Publication. Description: Health centers are always searching for innovative strategies to increase their HIV screening rates. This year, health centers have gotten creative by combining HIV testing with COVID-19 screening, while others are mailing at-home HIV testing kits to patients. Finding strategies to help increase HIV screening at your health center is a lesson in trial and error. We hope our latest blog will give you some ideas on improving your HIV screening rates! More Details...

Telehealth Resource Library: Curated telehealth resources for health centers (2020). Resource Type: Other. Description: HITEQ is actively compiling a telehealth resource library for health centers, which houses actionable telehealth resources in the areas of telehealth technology, patient use of telehealth, provider use of telehealth, tele-behavioral health, and operationalizing telehealth more generally. This curated set of resources aims to assist health centers in accessing those resources that directly address current telehealth needs and challenges. More Details...

Public Housing Primary Care (PHPC) COVID-19 Dashboard (2020). Resource Type: Publication. Description: This dashboard by NCHPH provides the latest COVID-19 statistics in Public Housing Primary Care (PHPC) Health Centers, including race and ethnicity data and additional resources. More Details...

Federal Activities and Approaches to Advance Social Determinants of Health Data Use and Interoperability in Support of Community Health Centers: HITEQ Highlights Webinar (2020). Resource Type: Archived Webinar. Description: View this HITEQ Center webinar, where the The Health and Human Services, Office of the National Coordinator for Health IT present on the current state of federal activities and standards based approaches for collecting, sharing, and using SDoH data with a focus on technical and policy considerations. The presentation describes available standards, tools, and initiatives for health center use and input. More Details...

Data Integration Best Practices for Health Centers & Homeless Services Publication: Health Center Focus Group Recommendations on Data Integration (2020). Resource Type: Publication. Description: Health centers use data and technology to improve health outcomes of patients, speed administrative processes, and collect patients’ health and housing histories. This report advances strategies for large and small health centers to match data with homeless service systems to identify and coordinate care for high utilizers of crisis care systems. More Details...

Ending the HIV Epidemic: The Health Center Role: HITEQ Highlights Webinar (2020). Resource Type: Archived Webinar. Description: This presentation will be led by Dr. Tim Long, and will focus on the four pillars of Ending the HIV Epidemic and primary care HIV prevention. This webinar will focus on the clinical aspects of Ending the HIV epidemic, and use of health IT and EHR to support clinical care. More Details...

Implementing Opt-Out HIV Screening in Your Health Center: Understanding Opt-Out HIV Testing (2020). Resource Type: Publication. Description: Getting tested for HIV is a powerful step towards taking control of one’s sexual health. Opt-out HIV testing, sometimes referred to as universal screening, is defined as conducting HIV testing after notifying patients that the test will be conducted and that they may decline or defer testing. According to the Centers for Disease Control and Prevention (CDC), opt-out testing is an evidence-based approach that has been shown to remove the stigma associated with HIV testing, foster earlier diagnosis and treatment, reduce transmission risk, and is cost-effective. More Details...

Addressing Intimate Partner Violence and Human Trafficking in the Health Center Setting: HITEQ Highlights Webinar (2020). Resource Type: Archived Webinar. Description: The coronavirus pandemic and consequent stay-at-home orders may increase danger for those at risk for or experiencing intimate partner violence and human trafficking (IPV/HT). Due to COVID-19, many health centers have shifted health encounters to virtual platforms, which offer unique opportunities to provide trauma-informed care and connect in new ways with those who may be experiencing abuse. Yet, telehealth and virtual visits also present health centers with new challenges related to privacy, safety and digital health equity. More Details...

Greenway Intergy: Understanding PA v12 and UDS 2020 reporting for Greenway Intergy Users (2020). Resource Type: n.a.. Description: This training is open to all health centers, PCAs, and HCCNs. The focus will be Practice Analytics v12 and UDS 2020 reporting for Greenway Intergy Users, so right on time for those preparing for CY2020 UDS reporting from Greenway. More Details...

Electronic Patient Engagement (EPE) Tool Inventory: Information from Health Centers and Vendors on Ten EPE Tools, Oct. 2020 (2020). Resource Type: Publication. Description: In the spring of 2020, HITEQ and several PCA and HCCN colleagues developed a survey to gather detailed information on health center experiences with a variety of EPE tools and included questions about product functions, strengths & weaknesses, cost, integration with EHRs, ease of implementation, and quality of vendor support. The results of that survey, as well as interviews and demonstrations are captured in this EPE Tool Inventory. Ten tools are profiled in the inventory, which can be downloaded in the Documents to Download section below. More Details...

Serving Rural Patients with Telehealth: Resources and Tips for Federally Qualified Health Centers: A HITEQ telehealth publication (2020). Resource Type: Publication. Description: With the challenges of provider shortages and lack of accessible facilities, telehealth presents an opportunity for health centers serving rural areas to expand health services, integrate primary care with subspecialty services, and improve care management.6 Telehealth provision in rural communities is particularly important and in-demand during the COVID-19 pandemic as many health centers have had to quickly transition to providing remote services. While telehealth has the potential to improve healthcare provision and access, many rural areas lack the reliable broadband connection and devices necessary for high-quality telehealth provision. More Details...

Ending the HIV Epidemic Collaborative: Other EHRs (2020). Resource Type: Learning Collaborative. Description: Peer to peer sharing. If you are a Primary Care HIV Prevention (PCHP) funded health center that struggles with clinical decision support, tracking HIV prevention and treatment outcomes, your peers can share innovative ideas and strategies to help you find solutions. Relationship building. This is a unique opportunity for PCHP health centers to get together to share ideas around HIV screening and prevention. The EHE Collaborative is an opportunity to build relationships with other PCHPs. Improved technical assistance and training. Your participation in this roundtable helps HITEQ tailor our training and technical assistance services to serve you better. More Details...

EnVision Centers, Jobs Plus and Health Centers Interactive Map (2020). Resource Type: Interactive Map. Description: NCHPH recently launched a new interactive map. This map shows the location of Health Centers, Envision Centers and Jobs Plus sites. EnVision Centers are centralized hubs that provide people living in public housing with resources and support needed to excel. Jobs Plus Sites. The place-based Jobs Plus Initiative program addresses poverty among public housing residents by incentivizing and enabling employment. Health Centers interested in partnering with near Envision Centers and Jobs Plus sites, visit this NCHPH resource and hover over the organization you want to partner with. Contact information will then be displayed in the information box. More Details...

Ending the HIV Epidemic Collaborative: Next Gen (2020). Resource Type: Learning Collaborative. Description: Peer to peer sharing. If you are a Primary Care HIV Prevention (PCHP) funded health center that struggles with clinical decision support, tracking HIV prevention and treatment outcomes, your peers can share innovative ideas and strategies to help you find solutions. Relationship building. This is a unique opportunity for PCHP health centers to get together to share ideas around HIV screening and prevention. The EHE Collaborative is an opportunity to build relationships with other PCHPs. Improved technical assistance and training. Your participation in this roundtable helps HITEQ tailor our training and technical assistance services to serve you better. More Details...

Ending the HIV Epidemic Collaborative: Greenway (2020). Resource Type: Learning Collaborative. Description: Peer to peer sharing. If you are a Primary Care HIV Prevention (PCHP) funded health center that struggles with clinical decision support, tracking HIV prevention and treatment outcomes, your peers can share innovative ideas and strategies to help you find solutions. Relationship building. This is a unique opportunity for PCHP health centers to get together to share ideas around HIV screening and prevention. The EHE Collaborative is an opportunity to build relationships with other PCHPs. Improved technical assistance and training. Your participation in this roundtable helps HITEQ tailor our training and technical assistance services to serve you better. More Details...

Ending the HIV Epidemic Collaborative: Next Gen: HITEQ Ending the HIV Epidemic Collaborative (2020). Resource Type: Learning Collaborative. Description: Peer to peer sharing. If you are a Primary Care HIV Prevention (PCHP) funded health center that struggles with clinical decision support, tracking HIV prevention and treatment outcomes, your peers can share innovative ideas and strategies to help you find solutions. Relationship building. This is a unique opportunity for PCHP health centers to get together to share ideas around HIV screening and prevention. The EHE Collaborative is an opportunity to build relationships with other PCHPs. Improved technical assistance and training. Your participation in this roundtable helps HITEQ tailor our training and technical assistance services to serve you better. More Details...

Building the Plane While Flying It: Health Care for the Homeless, Telehealth and COVID-19, Part II (2020). Resource Type: Archived Webinar. Description: This Coffee Chat is the second of our series highlighting representatives from three HCH health centers featured in the Council’s recent publication on telehealth. The conversation shared information on how to engage clients through telehealth to enhance the experience and how to develop low-literacy messaging. Presenters discussed how to engage clients with limited or no access to internet or broadband services and establishing “technology hubs” can address these challenges. More Details...

State-level HIV-related Infographics: Identifying opportunities for improvements in health centers (2020). Resource Type: Toolkit. Description: Health centers currently monitor HIV tests, HIV diagnoses, and Linkage to HIV care for patients newly diagnosed. According to the 2019 UDS data, more than 190,000 patients living with HIV receive medical care services at health care centers, including many sites co-funded by the Ryan White HIV/AIDS Program.r. More Details...

Nationwide HIV-related Care Interactive Infographicsics: Identifying opportunities for improvements in health centers (2020). Resource Type: Toolkit. Description: From January 1, 2019 through December 31, 2019, 2,259.758 medical patients (8.83%) of the United States' 25,589.752 total medical patients served at health centers received HIV tests. More Details...

Ending the HIV Epidemic Collaborative: Greenway (2020). Resource Type: Collaborative. Description: Peer to peer sharing. If you are a Primary Care HIV Prevention (PCHP) funded health center that struggles with clinical decision support, tracking HIV prevention and treatment outcomes, your peers can share innovative ideas and strategies to help you find solutions. Relationship building. This is a unique opportunity for PCHP health centers to get together to share ideas around HIV screening and prevention. The EHE Collaborative is an opportunity to build relationships with other PCHPs. Improved technical assistance and training. Your participation in this roundtable helps HITEQ tailor our training and technical assistance services to serve you better. More Details...

EHR Vendors Most Frequently Used by Health Centers: 2014 through 2019, according to information reported by health centers in the UDS. (2020). Resource Type: Publication. Description: Updated in 2020 with CY2019 data, these graphs and tables use health center reported UDS data from 2014 through 2019 to identify the EHRs most frequently used among health center programs, and shows the change between years. Download the PDFs below for all the information. 2014 and 2015 information was taken from the EHR Form in the UDS, and 2016, 2017, 2018, and 2019 information was retrieved from the Health IT Form in the UDS. Each of these forms can be seen in the UDS manual for the given year here. More Details...

Analysis of UDS Clinical Quality Measure Performance by Health Center Telehealth Use (2020). Resource Type: Publication. Description: The below analysis is based on Uniform Data System (UDS) reported by health centers (both 330 funded and Look Alikes). Performance on Clinical Quality Measures is derived from Tables 6B and 7 (with the exception of the Prenatal measure, which is not included). Telehealth Use is from Question 2 of the UDS’s Other Data Elements form, which asks Did your organization use telehealth in order to provide remote clinical care services [in referenc year]? Yes or No. More Details...

Ending the HIV Epidemic Collaborative: E-Clinical Works (2020). Resource Type: Collaborative. Description: Peer to peer sharing. If you are a Primary Care HIV Prevention (PCHP) funded health center that struggles with clinical decision support, tracking HIV prevention and treatment outcomes, your peers can share innovative ideas and strategies to help you find solutions. Relationship building. This is a unique opportunity for PCHP health centers to get together to share ideas around HIV screening and prevention. The EHE Collaborative is an opportunity to build relationships with other PCHPs. Improved technical assistance and training. Your participation in this roundtable helps HITEQ tailor our training and technical assistance services to serve you better. More Details...

Ending the HIV Epidemic Collaborative: E-Clinical Works (2020). Resource Type: Collaborative. Description: Peer to peer sharing. If you are a Primary Care HIV Prevention (PCHP) funded health center that struggles with clinical decision support, tracking HIV prevention and treatment outcomes, your peers can share innovative ideas and strategies to help you find solutions. Relationship building. This is a unique opportunity for PCHP health centers to get together to share ideas around HIV screening and prevention. The EHE Collaborative is an opportunity to build relationships with other PCHPs. Improved technical assistance and training. Your participation in this roundtable helps HITEQ tailor our training and technical assistance services to serve you better. More Details...

Brief Telehealth Needs Assessment (2020). Resource Type: Publication. Description: As it becomes ever more clear that the public health emergency will last longer than initially anticipated, health centers are likely adapting telehealth services to that reality. This includes moving to a more hybrid clinic model where some visits are in the clinic, but many are still best done via telehealth. This also means refining telehealth services that may have been very rapidly adopted in early 2020 to be more sustainable and integrated going forward. More Details...

Analysis of UDS Clinical Quality Measure Performance by Health Center Telehealth Use: Updated in Sept. 2020 with CY2019 UDS Data (2020). Resource Type: Publication. Description: A brief study of how health centers who report using telehealth compare to those who do not, using data reported on 2017 UDS. This analysis suggests that the average performance on each clinical quality measure is higher among those health centers who report using telehealth than those who do not use telehealth.  The below analysis is based on 2017 Uniform Data System USD reported by health centers both 330 funded and Look Alikes.  Performance on Clinical Quality Measures is derived from Tables 6B and 7 with the exception of the Prenatal and Birthweight measures. Telehealth Use is from Question 2 of the UDS’s Other Data Elements form, which asks Did your organization use telehealth in order to provide remote clinical care services [in 2017]? Yes or No.  Considerations 1. Names used for the quality measures shown here are colloquial, and do not reflect exact names used in the 2017 UDS Manual. 2. Measures are shown in alphabetical order, not in the same order as the UDS Manual. 3. The Diabetes measure is calculated as Controlled, as opposed to Uncontrolled, as is reported in the UDS. This was done for comparison purposes, so all measures are ‘better’ if higher. Observations Health centers that report using Telehealth, on average, report slightly higher performance on all clinical quality measures than those that report that they do not use telehealth. On average, across all measures, using telehealth is correlated with a 1.18% percentage point higher performance rate per clinical quality measure. A chart showing all measures side-by-side can be seen below. Download the full analysis document at the bottom of the page for details about each measure.   More Details...

HITEQ Highlights: Preparing for Value-Based Care through Sustainable Telehealth Workflows: HITEQ Highlights Webinar (2020). Resource Type: Archived Webinar. Description: Join the HITEQ Center, in collaboration with Certintell, for a webinar on Preparing for Value-Based Care through Sustainable Telehealth Workflows. The webinar will provide an overview of how health centers can use telehealth during the current public health emergency and ensure that they are ready for the shift to Value-Based Care. We will cover sustainable telehealth services that are often underutilized and example workflows that have worked for other health centers. More Details...

Preparing for CY2020 UDS HIV Reporting (2020). Resource Type: Publication. Description: Community health centers have an important role in ending the HIV epidemic. In alignment with that important role, several UDS measures related to HIV screening, treatment, and prevention have been added for CY2020 UDS reporting. Specifically, calendar Year 2020 UDS Reporting includes three new or modified HIV measures/ data elements. Download the slidedeck below for additional information on reporting these measures. More Details...

Leveraging the electronic health record (EHR) to link health center patients with MLP services (2020). Resource Type: Publication. Description: This issue brief provides concrete examples of how health centers in Iowa, Montana, and Texas are leveraging the EHR to complement their screening for the social determinants of health as well as to increase their capacity to deliver targeted MLP-related interventions. More Details...

FY2020 Primary Care HIV Prevention Reporting: Crosswalk of FY2020 PCHP reporting to CY2020 UDS Requirements, July 2020 (2020). Resource Type: Toolkit. Description: To support Primary Care HIV Prevention funded health centers, HITEQ has prepared a crosswalk that maps PCHP tri-annual reporting metrics to UDS measures and/ or fields. This assists health centers in leveraging UDS reporting functionality in their EHRs to inform completion of the tri-annual progress report to HRSA. The PCHP metrics listed in the first column crosswalk to specific data definitions in the CY2020 UDS, which are specified in the second column, and then further detail is provided in the third column. More Details...

Building the Plane While Flying It: Case Studies on COVID-19, Telehealth, and Health Care for the Homeless Centers (2020). Resource Type: Publication. Description: As is the case for most health centers, the COVID-19 pandemic forced Health Care for the Homeless health centers to rapidly adopt telehealth strategies to sustain client services remotely. But serving patients without homes necessitates additional innovation to reach clients in shelters, quarantine facilities, or even on the street, while attending to complex health and social needs. These case studies profile 17 HCH health centers and 2 consumers, offering a range of pragmatic, insightful perspectives on HCH telehealth in the COVID world. More Details...

Building the Plane While Flying It: Health Care for the Homeless, Telehealth, and COVID-19 (2020). Resource Type: Archived Webinar. Description: This archived webinar highlighted Health Care for the Homeless leaders who described their distinct experiences in adopting telehealth in light of the COVID-19 pandemic. The lessons learned promise to be helpful to other health centers that serve people without homes. More Details...

TelePrEP for Health Centers: Telehealth Resources and Innovations for HIV Pre-Exposure Prophylaxis (PrEP), June 2020 (2020). Resource Type: Publication. Description: Pre-exposure prophylaxis, or PrEP, has long been recognized as an effective treatment in the effort to end the HIV epidemic. Prescribing PrEP should be considered as part comprehensive prevention plan that includes a discussion about adherence to PrEP, condom use, other sexually transmitted infections (STIs), and other risk reduction methods. This HITEQ brief presents an overview of how health centers can utilize telehealth for PrEP access, or TelePrEP, for comprehensive care, and includes innovations and resources that health centers can utilize to extend these services to their patient populations. More Details...

HITEQ Highlights: Shared Care Planning Optimization Using the EHR (2020). Resource Type: Archived Webinar. Description: The HITEQ Center, in collaboration with the National Council for Behavioral Health, hosted a webinar on Shared Care Planning Optimization Using the EHR. The webinar provided an overview on the importance of shared care planning and how we can better optimize the electronic health record to make it the most successful and inclusive of the team. Components of shared care planning and different tools that will help with the creation and accessibility of shared care plans were discussed. More Details...

Cybersecurity Checklist for Health Center Staff Working Remotely (2020). Resource Type: Publication. Description: This PDF checklist, developed by HITEQ, provides a guide for health center staff to mitigate cybersecurity risks and threats during times of emergency and incident response that have them working remotely from the health center. More Details...

Creating a Plan to Address Provider Satisfaction with Health IT: Intervention Project Planning Template, June 2020 (2020). Resource Type: Template. Description: Provider satisfaction is of critical importance for health centers to promote safety and workforce stability. Organizations may be working to reduce burden or increase satisfaction of the provider workforce. This worksheet, created by HITEQ, assists organizations in operationalizing the information set forth in HITEQ’s Assessing Provider Satisfaction: Designing health IT interventions to improve satisfaction and reduce burden. Review that piece, and then download the project planning template to create a plan of your own. More Details...

HITEQ Highlights: Hear from your Peers: Using the EHR for Routine HIV Screening (2020). Resource Type: Archived Webinar. Description: The HITEQ Center, in collaboration with BC3 Technologies, LLC, hosted this webinar that explored key concepts and best practices in utilizing an electronic health record in routine HIV Screening. This webinar sought to motivate and educate the clinical team on how the electronic health record can be used as a tool in the workflow of a primary practice. Aspects of clinical decision support, reminders, and alerts were covered with an emphasis on best practices, challenges, solutions, and lessons learned. More Details...

PCA Enabling Services Virtual Summit Podcast Series (2020). Resource Type: Other. Description: The first-ever PCA Enabling Services Virtual Summit and podcast series is co-organized and hosted by the Health Center Association of Nebraska (HCAN) in partnership with Health Outreach Partners (HOP). The seven podcast episodes cover a variety of Enabling Services topics, with a focus towards Primary Care Associations. More Details...

The Health Center Program and Increasing Access to Comprehensive Care Through the Use of Telehealth: An Update During COVID-19 (2020). Resource Type: Archived Webinar. Description: This fact sheet discusses how health centers are expanding their use of telehealth during COVID-19. More Details...

Telehealth Office Hours: Focus on Sustainability (2020). Resource Type: Archived Webinar. Description: This webinar offers a broad overview of telehealth services, with a focus on sustainability. More Details...

Health Information Technology support for HIV Screening and Prevention Services: Environmental scan for Ending the HIV Epidemic (2020). Resource Type: Publication. Description: In the 2019-2020 contract year, as part of the Ending the HIV Epidemic initiative HITEQ conducted an environmental scan to determine the role of EHRs and health IT in health center capacity and ability to expand HIV screening and prevention. HITEQ reviewed existing data and existing literature, and conducted 15 interviews with health centers and health center partners. The results are structured as a SWOT analysis, outlining strengths and weaknesses internal to health center health IT systems as well as opportunities and threats, factors that are external to health centers. More Details...

Telehealth.HHS.gov website (2020). Resource Type: Other. Description: The Telehealth.HHS.gov website provides information about the latest federal efforts to support and promote telehealth services. It was built by the Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services (HHS). More Details...

Enabling Services Data Collection: Documenting Health Center Interventions In A Value-Based Payment Environment (2020). Resource Type: Archived Webinar. Description: In collaboration with Health Outreach Partners (HOP), AAPCHO promoted the importance of documenting social determinants of health (SDoH) interventions to demonstrate the value and scope of health center enabling services (ES). AAPCHO and HOP was joined by the Community Health Care Association of New York State (CHCANYS) to highlight how state, regional, and national partners can leverage SDoH and ES data for Value-Based Payment (VBP). More Details...

PrEP and Informatics (2020). Resource Type: Archived Webinar. Description: In this webinar experts from Fenway Health and HITEQ discuss using data, electronic health records, and informatics to make informed decisions regarding PrEP (pre-exposure prophylaxis) for HIV prevention. The webinar covers both clinical data usage and administrative staff support in using data and informatics for optimizing PrEP in health centers. More Details...

HITEQ Highlights: Health Center Defense Against the Dark Web: Strategies for Building Security Awareness, Education, and Compliance in 2020 (2020). Resource Type: Archived Webinar. Description: This HITEQ Center webinar explored key concepts and best practices that should be followed by Health Centers seeking to develop Defense in Depth and effectively implement hardened security programs at their sites. There are ever-increasing cybersecurity guidelines and protection measures that Health Centers must navigate and digest. This webinar sought to motivate and educate the health center workforce on critical privacy and security concepts and methods for defense. Aspects of Security Risk Assessment, security awareness training, and breach protection were covered with an emphasis on health center-wide information protection. More Details...

HITEQ Highlights: Electronic Patient Engagement in an Integrated Setting (2020). Resource Type: Archived Webinar. Description: Join the HITEQ Center, in collaboration with the National Council for Behavioral Health, for a webinar on Electronic Patient Engagement in an Integrated Setting and learn how health centers can use their EHR to engage patients in their own care and make communication easier between the patient and members of the care team. More Details...

HITEQ Highlights: HIV Prevention and Treatment for patients with SUD in an Integrated Behavioral Health Setting (2020). Resource Type: Archived Webinar. Description: Join the HITEQ Center, in collaboration with the National Council for Behavioral Health, for a webinar on understanding from a beginner perspective, how to integrate HIV prevention, screening into integrated behavioral health services, including how to identify patients at risk for HIV with a focus on SUD, facilitate screening, and prompting for re-screening at appropriate intervals. More Details...

Clinical Quality Measures for Eligible Professionals for 2020: A Crosswalk Comparison from The HITEQ Center (2020). Resource Type: Publication. Description: This spreadsheet provides a crosswalk of Clinical Quality Measures and their electronic specifications as defined in the 2020 update for Eligible Professionals (Clinicians). More Details...

Network Resource Guide for Health Center Controlled Networks (HCCNs) (2020). Resource Type: Publication. Description: For more information on the 49 HCCNs funded by HRSA, please visit the Network Resource Guide (NRG). https://networkresourceguide.org/. The NRG provides up-to-date information about HCCNs across the country that are working together to leverage health IT for health centers in ways to improve access to care, enhance quality of care, and achieve cost efficiencies. More Details...

Getting a New Workflow and Process Started during COVID-19 Pandemic: Moving to Telehealth during Coronavirus Public Health Emergency (2020). Resource Type: Publication. Description: Health centers are having to dramatically change approaches to patient care as the COVID-19 public health emergency keeps patients at home and ramps up the demands of telehealth and other remote care modalities. Many health centers are moving primary care, care for chronic conditions, behavioral health, and other important care that patients need to telehealth, but the changing landscape and quick turnaround is tricky for organizations to navigate successfully. This resource is a quick start guide for health centers making this change. More Details...

Bridging the Digital Divide: Using Technology to Improve Access to Health Care for Public Housing Residents (2020). Resource Type: Publication. Description: The purpose of this report is to outline the digital needs and challenges of public housing residents, the risks and benefits of using technology to improve patient care, and recommendations on how to prepare health centers and patients to optimize digital tools, improve access to care, and enhance efforts through partnerships to bridge the digital divide. More Details...

Triage & Tele-Health Support Plan for Isolation Units: Strategies for engaging clients for telehealth in COVID19 environment (2020). Resource Type: Publication. Description: This step-by-step support plan is applicable to Supportive Housing Providers, Managed Care Organizations (MCOs), Health Centers, and Case Management services across the country in the early stages for addressing infectious disease. The support plan includes Triage Interview Questions and Immediate Intervention Steps for front line staff. More Details...

The Roadmap to Becoming a Data-Driven Organization ll: Aligning your Data Strategy and Strategic Plan (2020). Resource Type: Archived Webinar. Description: This webinar will discuss how to develop an organizational strategy that focuses on data health centers need to achieve their short term and long term goals. Participants will learn how to utilize data to create a strategic plan by creating models that are used to predict, track and optimize health center outcomes. More Details...

Cyber Security Risks — COVID-19: Best Practices for Health Center Staff Working Remotely (2020). Resource Type: Publication. Description: The number of COVID-19 cases continue to increase throughout the United States, requiring more and more of our health systems to rely on employees working from home at times. While some of us are required to "shelter-in-place," unfortunately that shelter can create increased risks such as cyber security breaches. With good planning, policies, and employee and family education, health centers can minimize risk and support their employees while working remotely. This presentation will inform your Health Center remote workers on best practices for increasing cybersecurity at home. More Details...

Success Strategies for Coding and Documentation: Reporting Chronic Disease (2020). Resource Type: Archived Webinar. Description: NACHC offers a free virtual two-part training on accurate Coding and Documentation. This series is designed for clinical providers, utilization/quality review staff, and coders and billers. Participants will learn the essentials of clinical documentation, professional coding, and medical billing processes to minimize errors and denials. This webinar's topics include:Reporting Initiating Visits and Obtaining Patient Consent; Transitional Care Management• Chronic Care Management; Behavioral Health Integration (BHI); Preventive Medicine options in CPT & HCPCS-II; Virtual Communications Services More Details...

Success Strategies for Coding and Documentation: Quality Reporting and Care Management for CHC's (2020). Resource Type: Archived Webinar. Description: NACHC offers a free virtual two-part training on accurate Coding and Documentation. This series is designed for clinical providers, utilization/quality review staff, and coders and billers. Participants will learn the essentials of clinical documentation, professional coding, and medical billing processes to minimize errors and denials. This webinar's topics include: How to report “quality” versus billing; How to respond to the limitations of IT/EHR systems and interoperability standards; The team-based approach to success billing, coding and quality reporting that includes providers, managers, and coders; EDIS measures (combines CPT/HCPCS-II, and ICD-10-CM); Behavioral & Primary Care Integration intent via BHI and Psych CoCM SUD More Details...

Communications & Outreach Toolkit — COVID-19: Resources & Templates to help Health Centers Communicate information about services and programs during the Coronavirus Outbreak (2020). Resource Type: Toolkit. Description: Resources and templates Health Centers and PCAs can use to communicate information about services and programs to a variety of audiences, including the media, patients, prospective patients, community partners, during the Coronavirus outbreak. Resources include templates and documents like fact sheets, flyers, media relations templates, video animations, and more. More Details...

Using Non-Traditional Technology for Telehealth During COVID-19 Pandemic: Issue Brief for implementing commercial applications for telehealth consistent with March 2020 OCR Guidance (2020). Resource Type: Publication. Description: Health and Human Services’ Office of Civil Rights (OCR), the entity responsible for enforcing regulations under HIPAA, stated, effective immediately, it will exercise enforcement discretion and will not impose penalties for HIPAA violations against covered healthcare providers if patients are served on a good faith basis during the COVID-19 nationwide public health emergency. OCR has clarified that, during this public health emergency, these technologies can be used for any services, not only those specific to COVID-19. More Details...

Telehealth Policy during Coronavirus/COVID-19 Pandemic (2020). Resource Type: Publication. Description: The HITEQ Center is adding additional telehealth information, including policy and regulatory developments, relevant to coronavirus/ COVID-19 pandemic as it impacts health centers as it becomes available. More Details...

Telehealth Toolkit — COVID-19 (2020). Resource Type: Toolkit. Description: This toolkit outlines ways in which telehealth can be used in response to COVID-19. More Details...

Telehealth and COVID-19 (2020). Resource Type: Archived Webinar. Description: The National Consortium of Telehealth Resource Centers held a webinar exploring further uses and benefits of telehealth during the COVID-19 outbreak. More Details...

Telephone and Virtual Visits: Operational Considerations (2020). Resource Type: Publication. Description: Tips and scripts for health center organizations to use in conducting telehealth visits with patients. More Details...

Telehealth Workflows (2020). Resource Type: Other. Description: Suggested diagramed workflows for any organization managing patient caseloads via telemedicine. More Details...

HITEQ Highlights: Enhancing the EHR for Suicide Prevention (2020). Resource Type: Archived Webinar. Description: This webinar is the second in a series highlighting the intersection between health information technology and behavioral health services. The webinar explored key components to be built into an electronic health record in order to better address suicide prevention in health care. Decision support considerations, documentation and communication enhancements, as well as population health management strategies were discussed. More Details...

Remote Scribes, Transcription, Talk-to-Type, and Virtual Assistants: Tools for Decreasing Documentation Burden in the EHR; Developed October 2019 (2020). Resource Type: Publication. Description: Electronic Health Records (EHRs) have replaced obsolete paper medical charts and records, and their ability to exchange health information electronically have helped organizations provide higher quality and safer care for patients. However, despite their numerous advantages, EHRs can create an overload of documentation and clerical responsibilities for physicians, placing an increased demand on physicians’ time and compromise efficiency. Medical dictation, transcription, and scribing services have become an increasingly popular solution to address this hindrance. This resource introduces different transcription, scribing, and dictation services, and reasons why health centers should consider using them to reduce the burden of EHR documentation. More Details...

HITEQ Highlights: Using Health IT to Facilitate the Development and Administration of a PrEP Program (2020). Resource Type: Archived Webinar. Description: The HITEQ Center is launching a new webinar series for health centers to learn how their health center peers are using health IT to improve HIV prevention and care. For the first webinar, Using Health IT to Facilitate the Development and Administration of a PrEP Program, Robert Harris from the Community Health Center of Buffalo, Inc. described their whole system approach to develop an IT-supported PrEP program. Robert presented how they developed a viable and sustainable PrEP program maximizing the use of IT resources while minimizing the amount of staff resources needed to administer the program effectively. More Details...

HITEQ Highlights: Updates to the HITEQ UDS Clinical Analysis Dashboards (2020). Resource Type: Archived Webinar. Description: During this HITEQ Highlights webinar, learn about the updated HITEQ Center’s UDS dashboards, available on the HITEQ site for HCCNs, PCAs, and health centers, as well as a nationwide version available to all website visitors. These dashboards show UDS clinical quality measure reporting from calendar year 2018, historical data, and benchmark data from Healthy People 2020 goals. These updated dashboards include a number of new features, to allow users to compare outcomes across various groups to improve the understanding of how certain characteristics correlate with clinical quality outcomes. More Details...

HITEQ Highlights: Documentation Tips when using the Collaborative Care Model for the Treatment of Depression and Anxiety in Primary Care (2020). Resource Type: Archived Webinar. Description: Join the HITEQ Center, in collaboration with the National Council for Behavioral Health, for a webinar on Documentation Tips when using the Collaborative Care Model for the Treatment of Depression and Anxiety in Primary Care. The webinar provided a brief overview and benefits of the collaborative care model as well as information specific to each of the main staff roles. The role-specific nuances of documentation were highlighted, including considerations for tracking data such as clinical activities accomplished with each patient during the month. More Details...

Health Center Health IT/ EHR Assessment Tool: For PCAs and HCCNs to Assess Health IT across Multiple Health Centers; Updated in 2019 (2020). Resource Type: Publication. Description: HITEQ created this template to assist HCCNs, PCAs, or other organizations in conducting health IT assessments of multiple health centers. The questions within this instrument were adopted from proposed UDS health IT capabilities questions and the HITEQ Center's Meaningful Use readiness assessment survey. This instrument may include some questions that are more comprehensive than some organizations need, but a secondary goal is to ease future responses to UDS and other health IT-related surveys. More Details...

Assessing Provider Satisfaction: And how to design health IT interventions to improve satisfaction and reduce burden, January 2020 (2020). Resource Type: Publication. Description: This resource puts forth several options for assessing provider satisfaction or burden, with a focus on health IT. Each provider assessment also includes information about cost and access. In addition to surveying providers, there is other information that can be assessed for baseline when planning an intervention to decrease burden. These can be used for pre– and post-intervention monitoring and evaluation. Finally, related research findings, including the overall relationship between EHR and provider satisfaction, regulatory and documentation requirements, the impact of training, provider autonomy and role in EHR design, and in-basket management, are described. More Details...

HITEQ Highlights: Getting Started with a Social Media Strategy for HIV Prevention and Care (2020). Resource Type: Archived Webinar . Description: Join the HITEQ Center for a webinar on how to develop a social media strategy to improve your health center’s HIV prevention and care outreach. Using the POST (People, Objectives, Strategy, Technology) method, attendees learned how to use social media more efficiently to reach your target audiences. We also reviewed social media platforms including Facebook, Instagram, and Twitter, their uses and differences. Attendees received recommendations for social media management and graphic design tools at the end of the discussion. More Details...

Collecting Sexual Orientation and Gender Identity (SO/GI) Data In Electronic Health Records (2020). Resource Type: Archived Webinar. Description: Alex S. Keuroghlian, MD, MPH and Chris Grasso, MPH present the most up-to-date information and strategies for collecting sexual orientation and gender identity information. More Details...

Financial and Operational Benchmarking Trends and Techniques (2019). Resource Type: Archived webinar. Description: How do you assess your performance by looking at your financial metrics? Which metrics are important? How can you benchmark your performance to your peers? In this session, health centers will learn how to assess their health center’s financial and operational performance using benchmarking and comparative metrics from Capital Link’s audited financial database and data from the federal UDS reporting system and referencing Capital Link’s recently updated Federally Qualified Health Centers Financial and Operational Performance Analysis and Performance Benchmarking Toolkit. More Details...

EHR-Related Resources for 330 and RWHAP Dually Funded Health Centers: Resources curated from TargetHIV.org and other sites in October 2019 (2019). Resource Type: Publication. Description: Health centers funded by the Ryan White HIV/AIDS Program (RWHAP) must submit the Ryan White Services Report (RSR) annually and often maintain separate databases from their EHR to do so, which is less than ideal in many situations. This document summarizes resources related to integrating RWHAP data reporting requirements into EHRs, including specific vendors, as well as those related to improving HIV service delivery using technology. More Details...

Strategic Cybersecurity Breach Protection and Incident Response: Guidance and Resources for Health Centers (2019). Resource Type: Other. Description: This is Part 2 of HITEQ's Health Center Defense Against the Dark Web presentation series. This presentation provides general knowledge about breach mitigation and planning strategies for incident response. More Details...

Health Center Defense Against the Dark Web Presentation: Strategies for Building Security Awareness, Education and Compliance (2019). Resource Type: Other. Description: This cybersecurity presentation explores key concepts and best practices that should be followed by Health Centers seeking to develop Defense in Depth and effectively implement hardened security programs at their sites. Part 1 of this series will seek to motivate and educate the health center workforce on critical privacy and security concepts and methods for defense. Aspects of Security Risk Assessment, security awareness training, and breach protection will be covered with an emphasis on health center-wide information protection. More Details...

Improving Diabetes Outcomes: Curated Expert Guidance, Tools, and Resources, Updated September 2019 (2019). Resource Type: Toolkit. Description: As of CDC's 2017 National Diabetes Statistics Report, 30.3 million people, or 9.4% of the total U.S. population, have diabetes. Of these 30.3 million, only 23.1 million are diagnosed—while the other estimated 7.2 million are undiagnosed. This illustrates the need for targeted quality improvement and implementation of promising practices to address diabetes and needs of diabetic patients. This toolkit includes curated expert guidance, tools, and resources for enhancing care processes and outcomes for diabetes control, preventive care, and others targets for improvement. More Details...

Increasing Access to Healthy Food and Exercise in Public Housing Communities: Examples From Public Housing Primary Care Grantees (2019). Resource Type: Publication. Description: Public housing residents face the challenge of living in communities with poor access to healthy foods and safe places to exercise. Addressing access to healthy food and improving diet and exercise are critical components in improving the health of public housing residents. This report provides examples of Public Housing Primary Care Grantee strategies and programs that have increased access to healthy food, exercise and weight control models for public housing residents. More Details...

Ransomware Guidance Presentation for Health Centers: Updated with Ransomware Strategies from CISA (2019). Resource Type: Publication. Description: This ransomware guidance presentation for health centers, updated with ransomware strategies from CISA, provides information about ransomware, HIPPA implications, recent examples from the news, and suggested resources. More Details...

Center of Excellence for Protected Health Information: FOCUS: PHI is a SAMHSA-funded source for clear and accurate information about patient privacy and confidentiality (2019). Resource Type: Other. Description: Clear and accurate information about confidentiality is important to ensure that patient privacy is protected and that privacy laws are not erroneously interpreted to prevent disclosure of patient information. Individuals living with mental illness or substance use disorders may not seek care without guarantees of confidentiality and privacy protections. Clarifying privacy protections and promoting communication of patient records is critical for improving patients’ access to care and quality of treatment once in care. The Center for Excellence for Protected Health information is supported by SAMHSA and includes key resources around privacy and confidentiality. More Details...

Community Health Centers Meeting Rural Health Needs (2019). Resource Type: Publication. Description: This short fact sheet covers the barriers to care faced by rural communities and how Community Health Centers are helping to address those barriers: by focusing services on communities with the greatest difficulty accessing or affording care, innovating using telehealth technologies, and recruiting a wide range of health care providers to complement primary care, including dentists, pharmacists, and behavioral health professionals. Ultimately, health centers are achieving better improving outcomes for rural patients. More Details...

Building and Sustaining a Data Driven Culture: HITEQ Webinar (2019). Resource Type: Archived Webinar. Description: The HITEQ Center conducted a webinar on building and sustaining a data driven culture for Community Health Care Association of New York State. This webinar introduced concepts, tools and examples to help manage data as a strategic asset, align data strategy with organizational strategy, and explored ways to implement a data services function. More Details...

Panel Management in the Age of Value-Based Care: Health Center Case Studies Developed with Chiron Strategy Group, June 2019 (2019). Resource Type: Publication. Description: This downloadable HITEQ resource offers guidance on improving panel management activities, including real-life examples from two health centers of the challenges and successes in managing panels. More Details...

HITEQ Highlights: Developing Community Health Centers Along the Continuum of Pay for Performance (2019). Resource Type: Archived Webinar. Description: This HITEQ Highlights webinar described the continuum of value-based contracting, and suggested steps for health centers to move up the continuum. It also outlined basic elements of infrastructure to perform well in a value-based environment. Presenters from Yakima Valley Farm Workers Clinic presented their experience. More Details...

Health Center EHR Transition: Tips for everything from selection to contract negotiation to implementation (2019). Resource Type: Publication. Description: The HITEQ Center has a number of EHR transition tools that may be helpful for health centers that are considering a transition from one EHR to another. This resource brings together all these tools for easy access. More Details...

Compliance with 42 CFR Part 2: A Case Study with Community Medical Centers, Inc. (2019). Resource Type: Publication. Description: Health centers are actively expanding the substance use treatment services they offer in the community to address access to care for opioid use disorders, and more broadly to address better screening, referral and timely access to all substance use disorder (SUD) treatment. This case study is an example of how a health center is assessing operations to comply with 42 CFR Part 2, with a particular focus on changes to their health information technology (IT) systems. It includes a 42 CFR Part 2 Regulatory Checklist that health centers may find particularly helpful to review. More Details...

HITEQ Highlights: Addressing Childhood Obesity in Health Centers (2019). Resource Type: Archived Webinar. Description: This webinar focused on how to improve child weight screening, nutrition and physical activity counselling, and design appropriate and meaningful interventions according to health center peers. A number of tools that support this quality improvement around addressing child weight and potential for obesity were discussed, including Bright Futures guidance and data validation tools from HITEQ. More Details...

Telehealth Office Hours:: ADA issues in Telehealth (2019). Resource Type: Archived Webinar. Description: This presentation provides a high-level overview of accessibility considerations in telemedicine under Section 504 of the Rehabilitation Act and the Americans with Disabilities Act. We will discuss various types of services and modifications to help ensure that people with disabilities have equal access to telemedicine services. More Details...

HITEQ Highlights: Growing and Sustaining a Data Driven Culture (2019). Resource Type: Archived Webinar. Description: Building on the HITEQ Center’s previous webinars that introduced an Analytic Capability Assessment, building a roadmap for action and using data governance to maximize the value of data, the third webinar in this series explored how to grow and sustain these efforts. More Details...

HITEQ Highlights: Using Health Information Technology to Enhance Opioid Use Disorder Treatment (2019). Resource Type: Archived Webinar. Description: The Health Information Technology, Evaluation, and Quality Center (HITEQ) hosted this webinar on promising and innovative practices for the use of health information technologies (IT) to enhance opioid use disorder (OUD) treatment. The webinar also featured the experiences and practices of health centers which are currently using health IT to enhance OUD services. More Details...

Implementing a Pediatric Teledentistry Program: Promising Practice (2019). Resource Type: Publication. Description: Finger Lakes Community Health in New York established a successful teledentistry program. The teledentistry program focuses on providing pediatric dental care since. This promising practices will discuss lessons learned for this program. More Details...

EHR Vendors Most Frequently Used by Health Centers: 2014 through 2017, according to information reported in the UDS. (2019). Resource Type: Publication. Description: These graphs and tables use health center reported UDS data from 2014 through 2017 to identify the 10 EHRs most frequently used among health center programs, and shows the change between years. Updated in late 2018 with 2017 data, these graphs and tables use health center reported UDS data from 2014 through 2017 to identify the 10 EHRs most frequently used among health center programs, and shows the change between years. Download the PDFs below for all the information. 2014 and 2015 information was taken from the EHR Form in the UDS, and 2016 and 2017 information was retrieved from the Health IT Form in the UDS. 2018 information will be added when available. Each of these forms can be seen in the UDS manual for the given year here.  Efforts have been taken to normalize data for aggregation purposes such as to combine those that reported "Next Gen" and those that reported "NextGen"; otherwise, all information is used as reported by health centers without further verification.   More Details...

HITEQ Highlights: Managing Data as a Strategic Asset: Data Governance Fundamentals (2019). Resource Type: Archived Webinar. Description: In this webinar, the HITEQ Center presented the essentials of good data management processes and introduce the Center for Care Innovation’s Data Governance Handbook, offering ideas for action and tools to improve data quality, increase data literacy, and maximize access to data. More Details...

Health Center Data Validation Tool: Tool to Validate Adult BMI UDS Clinical Measure Reporting from EHR (2019). Resource Type: Publication. Description: This Excel-based tool is designed to support validation of EHR reporting for the Adult BMI clinical measure by comparing results from EHR to results from chart reviews or examination of underlying data. This assists in identifying specific data elements that are not being captured appropriately, either as a result of workflow or EHR report logic, and thereby effecting compliance rates. More Details...

Hepatitis B and the Opioid Epidemic: Opportunities to Increase Adult Vaccination: Webinar Resources (2019). Resource Type: Archived Webinar. Description: This webinar focuses on strategies to prevent and eliminate hepatitis B as a U.S. public health threat, particularly among special and vulnerable populations impacted by the opioid epidemic. To access the slides and recording, follow the link provided More Details...

Annual UDS Clinical Measure Data Dashboard: Excel Tool for Data Monitoring (2019). Resource Type: Publication. Description: This Excel file dashboard was shared by an existing health center and is used to depict performance on UDS measures over time. It was recently updated 2018 reporting requirements and clinical measures. More Details...

A Roadmap for Building a Data Driven Culture: HITEQ Highlights Webinar (2019). Resource Type: Archived Webinar. Description: In this webinar the HITEQ Center will introduce the Analytics Capability Assessment (ACA), a tool developed by the Center for Care Innovations that allows users to look critically at an organization’s analytics capability across three key domains: people, process, and technology. By determining their level of capability in each of these factors, organizations can develop an individualized roadmap to focus and prioritize capability-building efforts. The tool also helps to demystify some of the jargon that can often alienate non-technical staff. Methods, examples, and tips for deploying the ACA in health center organizations will also be shared. More Details...

ICD-10-CM Official Guidelines for Coding and Reporting: Part II of the Billing, Coding, and Documentation Webinar Series (2019). Resource Type: Archived Webinar. Description: Participants will demonstrate comprehension of documentation rules by performing a high-level analysis of the 2018 “ICD-10-CM Official Guidelines for Coding & Reporting,” which provides the most educational benefit related to diagnosis coding considering its increased importance when trying to tie together the seemingly competing worlds of quality medicine, optimal revenue, and health technology requirements. Sample action items and areas for additional research are given and optimal outcomes are discussed in order to apply the information to your clinical documentation, coding, and billing processes. More Details...

Health Center Security & Compliance System Implementation Guide: 1/1/2019 (2019). Resource Type: Publication. Description: This toolkit provides a framework for Health Centers to evaluate compliance and security concerns as they purchase, adopt, and implement technology solutions. There are ever-increasing cybersecurity guidelines and protection measures that Health Centers must navigate and digest. Newer and rurally located Health Centers can especially benefit from guidance and decision support that assists them in determining how to implement systems in a manner that meets compliance requirements and doesn’t expose information to undue security risk. Identifying and managing these types of risk can be especially important when procuring new Health IT e.g. EHRs, Medical Devices, Data Warehouses for the Health Center. This toolkit provides a framework for Health Centers to evaluate compliance and security concerns as they purchase, adopt, and implement technology solutions. Every time a Health Center adopts and implements newly procured technology, they could be exposing themselves to compliance gaps and security risks. Often these topics are addressed after the solution is implemented and are an after-thought. Unfortunately, the later in the adoption process that security is considered, the costlier it becomes to address as it may require redesign or reconfiguration of software, systems, and processes. Especially important for covered entities, like Health Centers, is for this process to meet the regulations outlined within HIPAA. Throughout this document, the related HIPAA requirements are highlighted within each section so as to better understand where this process sits within broader security risk assessment SRA practices. In the Appendix of this guide is an EHR/Health IT Systems checklist that can be used as an implementation interview guide when procuring new resources. This guide can help organizations identify security concerns and design the appropriate solution starting at the design and vendor-selection phase, thereby increasing the likelihood that security will be considered fully throughout the implementation process. Download the full toolkit below, which includes the following sections: System overview Information classification and inventory Business Associate Agreements and Contracts Risk Analysis Identity management Encryption Auditing and logging Contingency planning Workstation requirements Patching Security testing Vendor and developer access Physical security Network segmentation More Details...

Addressing Childhood Obesity in Health Centers: Promising Practices and Lessons Learned: January 2019 (2019). Resource Type: Publication. Description: The HITEQ Center interviewed ten health centers and health center partners to identify solutions and promising practices for addressing childhood obesity across the health center program. The focus included how health centers are meeting the Uniform Data System UDS measure and how they are taking further steps to identify and intervene with those at risk of obesity leveraging health information technology, electronic health records, and the data they have. Seven key areas are identified in the resulting issue brief. In the Fall of 2018, the HITEQ Center interviewed ten health centers and health center partners to identify solutions and promising practices for addressing childhood obesity across the health center program. The focus included how health centers are meeting the Uniform Data System UDS measure, Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents CMS155v6, and how they are taking further steps to identify and intervene with those at risk of obesity by leveraging health information technology, electronic health records, and resulting data. Seven key areas of improvement from interviews are identified in the resulting issue brief: Key 1. Embed Needed Data Capture in Workflow Key 2. Implement Successful Monitoring to Support Decision Making Key 3. Understand the Evidence Base Key 4. Identify Key Data and Metrics Key 5. Target Interventions Appropriately Key 6. Consider Alternative Appointment Types and Locations Key 7. Create Comprehensive, Accessible Interventions Download the issue brief below to see health center examples, related research, and health IT tools for each of these keys. More Details...

Using Health Information Technology to Facilitate SBIRT Service Delivery in Health Centers: HITEQ Highlights Webinar (2019). Resource Type: Archived Webinar. Description: The webinar discussed the use of health information technologies (IT) to facilitate the workflow of providing SBIRT services. Focus areas included: coding and billing for SBIRT services, using health IT to enhance SBIRT screening, communication, data capture and documentation, clinical decision support, and information sharing and reporting. The webinar presented examples and experiences of health centers currently using health IT to facilitate effective SBIRT service delivery. More Details...

HUD Policy Brief for Health Centers - Data Matching with Housing Community: Understanding the Role and Impact of Housing Policy for Health Centers (Data Matching) (2019). Resource Type: Publication. Description: Health centers and housing providers are serving the same clients, and HUD policies foster opportunities for partners to effectively share data target and improve Health Outcomes. This series translates federal housing policies to help health centers understand the impact and how to coordinate and adapt programming to create the most beneficial outcomes for clients. More Details...

Health Industry Cybersecurity Practices: Managing Threats and Protecting Patients (2019). Resource Type: Publication. Description: Cyber threats to healthcare entities put patient health, business continuity, and IT systems at risk. Under the auspices of the Cybersecurity Act of 2015 (CSA), Section 405(d), HHS convened the CSA 405(d) Task Group to enhance cybersecurity and align industry approaches by developing a common set of voluntary, consensus-based, and industry-led guidelines, practices, methodologies, procedures, and processes that healthcare organizations can use to enhance cybersecurity. More Details...

Using Social Determinants of Health Data & New Technology Tools to Connect with Appropriate Community Resources: We asked the questions, now what? Updated in December 2018 (2018). Resource Type: Publication. Description: The collection of data related to patients' non-medical needs through use of Social Determinant of Health SDoH assessment tools, can accelerate systemic population health improvement, as well as engage patients in addressing their social non-medical needs such as transportation, shelter, or intimate partner violence services through coordinated access to appropriate services. This case study discusses the process a health center may use to identify and stratify need, and profiles a number of new technologies, including Aunt Bertha, Now Pow, and 211 Community Information Exchange, for connecting patients to appropriate community resources.   Download full case study at the bottom of the page. The collection of data related to patients' non-medical needs such as transportation, housing, food security, safety, etc. through use of Social Determinant of Health SDoH assessment tools e.g., NACHC’s PRAPARE, AAFP’s The EveryONE Project, can accelerate systemic population health improvement, as well as engage individual patients in addressing those needs through coordinated access to appropriate services.  According to a 2017 American Academy of Family Physicians AAFP survey, 83% of respondents agreed that family physicians should identify and help with social determinants of health. Research from Kaiser Permanente suggests that, of those patients screened for social determinants of health, approximately two-thirds needed some services. PRAPARE pilot data from participating health centers identified housing, utilities, and food as the most frequently identified needs. Unfortunately, 80% of the family physicians surveyed by AAFP responded that they don’t have time to discuss social determinants of health with patients and more than half feel unable to provide their patients with solutions.  So, tools are needed to help providers meet these newly identified needs, with existing resources. A number of these tools are profiled in the resource available for free download below. Much like other screenings that are embedded in the regular workflow and used to assess the risk or severity of the patient’s condition, such as the PHQ-9, Social Determinants of Health assessment tools like PRAPARE are designed to operate similarly.  Identifying level of risk or need among patients screened for social determinants of health in order to strategize responses is generally done with ‘risk scoring’. Here are two examples: SDoH only: A health center could assign 1 point per social determinant of health identified. Multiple sources: A health center could assign points based on number of chronic conditions, medications, ED visits in the last 12 months, and SDoH, as discussed in this HITEQ population health presentation. Whatever approach is taken, it is important to look at the distribution of risk scores or need levels across the patient population to ensure reasonable proportions identified as high, moderate, and low. Note that Care Management, Competency A in the PCMH 2017 standards is concerned with this. In this resource download below!, we focus on what technology tools exist to address social non-medical needs identified through screening. For those patients with high need, the standard response is likely to be health center-based and intensive. For example, patients with high need may be provided with 1 intensive case management, social workers, and referral coordinators; 2 direct assistance with connecting to resources; 3 follow up with external providers; and 4 regular in-person follow-up visits. This is likely to take up the majority of available staff capacity. However, gathering social determinants of health information may also point to other needs among patients with more moderate needs or in a broader array of areas such as paying utilities or legal services. Given staff capacity and resource limitations, as well as patient preferences, those patients may require another way to be connected with appropriate community resources. It is important that any approaches used allow for tracking and follow-up, as well as provide information about community service capacity. The tools in the case study below including Aunt Bertha, Now Pow, and 211 Community Information Exchange support this process by facilitating connection with community resources and needed follow-up, partially answering the question We collected social determinant of health data, now what do we do? Download the resource below for full case studies and lessons learned from using Aunt Bertha, 211 Community Information Exchange, and other new tools for connecting patients with community resources! More Details...

Update on the HRSA UDS Sealant Measure - December 2018 (2018). Resource Type: Archived Webinar. Description: In 2015, HRSA introduced the first oral health clinical quality measure to the UDS, with the UDS Sealants Measure. This session will highlight the 2017 UDS data results for the dental sealants measure. Topics to be included: common challenges health centers have experienced in developing, modifying, and/or implementing clinical workflows and procedures to report on the measure. Best practices and work-arounds to address data collection and reporting challenges will be shared for those health centers that are not yet using the EDR vendor-developed solutions for reporting on the measure. More Details...

Data Driven Programming to Maximize Care for Residents of Public Housing: Presented for National Nurse Care Consortium (NNCC) for health centers serving public housing patients (2018). Resource Type: Publication. Description: This presentation walks public housing-focused health centers, such as those with public housing primary care grants, through available UDS reports and tools that can be used for informing services and planning. A number of specific examples are shown of how information from the UDS can be used for improvement. Other information provided serves as a reference for reporting of public housing on Table 4 of the UDS.  More Details...

Building Data Teams and Skills: Maximizing Data Literacy and Data Governance for a Data Driven Culture: A compendium of references and tools, created in October 2018 (2018). Resource Type: Publication. Description: This compendium of references and tools is intended to support Quality Improvement efforts and to build skills across health center staff, in particular those who may be tasked with leading data literacy and data governance activities or are new to the health center world.  More Details...

Managing Online Patient Engagement (2018). Resource Type: Publication. Description: An integral component of health center practice operations is patient engagement. Whether patient engagement is done over the phone, in person at the health center, via patient portals or online, health centers need to be prepared to provide a positive patient experience. However, managing patient expectations about online engagement can present challenges. More Details...

Creating and Managing Strong Passwords at Your Health Center: Guidance in relation to updated NIST security requirements and HIPAA (2018). Resource Type: Publication. Description: Is it acceptable/recommended for health centers to adopt the new password policy guidelines under NIST Special Publication 800-63B and will that still uphold the HIPAA security rule? This question had been posed to the HITEQ Center asking whether we had any guidance or recommendations on implementing the new NIST Guidelines regarding password security.  New Digital Identity Guidelines under NIST Special Publication 800-63-B presents new guidelines regarding password security that are much more user-friendly and consequently more likely to be observed by health center staff since constantly changing, complex password on multiple systems can be a source of frustration for the end user.  Question: Is it acceptable/recommended for health centers to adopt the new password policy guidelines under NIST Special Publication 800-63B and will that still uphold the HIPAA security rule? This question had been posed to the HITEQ Center asking whether we had any guidance or recommendations on implementing the new NIST Guidelines regarding password security.  New Digital Identity Guidelines under NIST Special Publication 800-63-B presents new guidelines regarding password security that are much more user-friendly and consequently more likely to be observed by health center staff since constantly changing, complex password on multiple systems can be a source of frustration for the end user.  After consulting with HITEQ cybersecurity experts and consultants who have helped publish cybersecurity guidelines, the recommendations outlined below were communicated. Answer: The short answer is Yes. HIPAA is not prescriptive and takes the general stance that authentication mechanisms should be “reasonable and appropriate” for the risk they present. Being able to say that you are implementing NIST Standards is a good way to show that you are implementing “reasonable and appropriate” controls. Some standards are relaxed in regards to password change and complexity, those items shouldn’t be taken in isolation. The additional controls in the 800-63 recommendations should also be put in place and can include: Having users check passwords against password lists from breaches e.g., https://haveibeenpwned.com/Passwords  Increasing the length requirements Getting rid of password reminder questions Increasing usability Further Guidance from NCCIC/US-CERT: NCCIC/US-CERT reminds users of the importance of creating and managing strong passwords. Passwords are often the only barrier between you and your personal information. There are several programs attackers can use to help guess or "crack" passwords. However, choosing strong passwords and keeping them confidential can make it more difficult for others to access your information. NCCIC/US-CERT recommends users take the following actions: Use multi-factor authentication when available. Use different passwords on different systems and accounts. Don't use passwords that are based on personal information that can be easily accessed or guessed. Use the longest password or passphrase permissible by each password system. Don't use words that can be found in any dictionary of any language. Refer to Tips on Choosing and Protecting Passwords and Supplementing Passwords for best practices and additional information. More Details...

Increasing Access To Care thorugh Tele-Dentistry: Promising Practice (2018). Resource Type: Publication. Description: Teledentistry is an emerging trend among health centers to expand access to dental care. This promising practice will discuss the story of Ravenswood Family Health Center in California and their use of the virtual dental home model. More Details...

Behavioral Health Integration Compendium: Curated Guidance and Resources from Experienced Organizations, developed with Chiron Strategy Group (2018). Resource Type: Publication. Description: Many health centers collaborate with external behavioral health providers or provide co-located or integrated behavioral health services within their health center. Some of the most significant challenges are determining which data to share, how to store it within the Electronic Health Record, and how to use it within primary care. This compendium of literature and resources offers some guidance related to behavioral health data integration, complete with key health center considerations for each. Many health centers collaborate with external behavioral health providers or provide co-located or integrated behavioral health services within their health center. Some of the most significant challenges are determining which data to share, how to store it within the Electronic Health Record, and how to use it within primary care. This compendium of literature and resources offers some guidance related to behavioral health data integration, complete with key health center considerations for each. Click on each heading below to access the original pieces being profiled. Integrating Behavioral and Primary Care — Technology and Collaboration This article focuses on the challenges of integrating data between primary care and behavioral health. It discusses a number of concerns, and approaches that have been taken, including the benefits of developing structured data within the EHR. Health Center Takeaway: Patient consent for sharing sensitive health information can be integrated into the EHR, which will allow for greater information sharing while complying with Federal privacy expectations. Can technology shape the future of behavioral health? This article includes a number of different ways that technology plays a part in integrated behavioral health, highlighting: Adoption of telehealth as a means to augment care; Inclusion of behavioral health data in Health Information Exchanges, citing the experience of Arizona; and An example of an application being developed with NIH support that hopes to provide collaborative care tools to patients. Health Center Takeaway: Health centers are encouraged to investigate whether insurers will reimburse for telehealth and what is required to do so, to see if developing a telehealth program might augment the availability of behavioral health services for your patients. HITEQ has a number of resources related to telehealth. Integrated Behavioral Health Partners Three Case Studies on Behavioral Health Data Sharing Three California case studies where organizations shared behavioral health data.  The website includes details regarding mental health data, substance use data, consent, methods of sharing, and challenges. Health Center Takeaway: Use these examples of different approaches to consent and level of information sharing to foster conversation among your leadership on how to create greater data integration. Center for Health Care Strategies Integrating Physical and Behavioral Health Care in Medicaid Toolkit Section IV: Information Exchange CHCS has developed a rich resource for behavioral health integration.  This section focuses on information exchange, and has a number of helpful resources identified. Health Center Takeaway: The last two resources are integrated care plan templates; if you have an external behavioral health partner, consider how you might share data between the two organizations in a standardized format. Patient-Centered Primary Care Institute Behavioral Health Integration: Obstacles & Successes Lessons learned from this interview: Change the mindset from the bringing together of two services to truly integrating whole health Shift from historic care delivery methods to a focus on achieving better health outcomes Building trust with primary care providers is essential Health Center Takeaway: Determining what patients need will help guide the type of integration services your health center develops, which can include different approaches for different sites. SAMHSA’s Quick Start Guide to Behavioral Health Integration for Safety-Net Primary Care Providers This guide helps any health center think about where it is in the process of integrating behavioral health, with a number of embedded links for additional information. Key areas of Administration, Workforce, and Clinical Practice. Health Center Takeaway: Use this guide to identify barriers to a fully-developed program, and find resources to help overcome them. Zufall Health Center Integrated Behavioral Health and Primary Care Change Package Zufall Health Center partnered with a local behavioral health system to create an Integrated Behavioral Health system, using grant funding to help support the pilot. This collection of lessons learned focuses on: Leadership Commitment Clinical Information Systems and Measurable Improvement Integrated Care Delivery Clinical Decision Support Patient/Family Engagement Health Center Takeaway: Leadership must assess organizational capacity to collaborate, and then collect baseline data on health outcomes, including preventative screenings, ED visits, hospitalizations as some of the early steps. Implementing measurement and management of key clinical outcomes are critical next steps. NCQA Mainstreaming Behavioral Health Care NCQA has developed a Distinction in Behavioral Health Integration, which allows recognition of Patient Centered Medical Homes who have integrated care teams in place using evidence-based protocols and ongoing quality measurement and improvement. Health Center Takeaway: Many health centers have achieved recognition as a Patient Centered Medical Home PCMH or are along the way.  Aligning behavioral health integration work to earn this Distinction can help provide a roadmap for implementation of integration activities, and externally create validation for potential funders. How Intermountain Healthcare's Mental Health Integration is Improving Care Intermountain Healthcare is a large health system, with 22 hospitals and 180 clinics. It has been developing Mental Health Integration services for a number of years, with three key components: Their mental health assessment tool activates a team consultation workflow to determine which patients are referred. They designed an operational system in which mental health specialists and nurse care managers are included in the primary care staff, through full-time co-location or frequent rotation.They evaluate the program regularly to monitor patient outcomes, team effectiveness and the culture of healthcare delivery from the perspective of the patient and the care provider. Health Center Takeaway: Integrating behavioral health takes time. Intermountain Healthcare has created an efficient process to develop programs and they plan for two years to implement and become revenue-neutral. Health centers would benefit from a long-term approach with a commitment of upfront internal or external funding.   Deeper Reading If you are looking for more in-depth reading on the topic, visit the following links for longer articles. Electronic Health Record Challenges, Workarounds, and Solutions Observed in Practices Integrating Behavioral Health and Primary Care This Journal of the American Board of Family Medicine article describes the electronic health record EHR-related experiences of practices striving to integrate behavioral health and primary care using tailored, evidenced-based strategies from 2012 to 2014; and the challenges, workarounds and initial health information technology HIT solutions that emerged during implementation. Behavioral Health Information Network of Arizona: 2014 HIMSS HIE Community Roundtable This HIMSS presentation describes the design and implementation of a Health Information Exchange in Arizona that integrates behavioral health data and is 42 CFR Part 2 compliant.  Useful for any health center leadership involved in such a project with their affiliated Health Information Exchange. More Details...

The Health Center CIO’s Guide to HIPAA Compliant Text Messaging: 2018 Updates on Methods for Successful Electronic Patient Engagement (2018). Resource Type: Publication. Description: This slide deck provides health centers with information and a presentation template overview of the HIPAA and electronic PHI risks related to texting and messaging that are important for health center leadership and IT managers to understand in making organizational decisions for these types of tools. This slide deck provides health centers with information and a presentation template overview of the HIPAA and electronic PHI risks related to texting and messaging that are important for health center leadership and IT managers to understand in making organizational decisions for these types of tools.   Key considerations covered within this slide deck: Important to understand new changes to enforcement of HIPAA as it relates to portable devices, texting, and emailing of PHI. HIPAA privacy and security rules need not act as an obstacle to texting, but compliance requires planning and diligence. All forms of communication involve some level of risk. Text messaging merely represents a different set of risks that, like other communication technologies, needs to be managed appropriately to ensure both privacy and security of the information exchanged. More Details...

Effective Social Media Management for Health Centers: Infographic Poster (2018). Resource Type: Publication. Description: Maintaining a good name in the digital era is becoming increasingly important as social media tools and platforms continue to expand the services they offer. As a health center, having a professional social media presence is becoming an influential channel in which to engage patient populations. Maintaining a good name in the digital era is becoming increasingly important as social media tools and platforms continue to expand the services they offer. As a health center, having a professional social media presence is becoming an influential channel in which to engage patient populations. These channels enable physicians and health groups to communicate and share information quickly while reaching millions of people. However, these same channels and other social media activities also create new challenges for the patient-physician relationship. In the current health care environment, health centers often don’t have the time or resources to effectively manage their own social media presence.  The HITEQ Center has gathered this brief list of tips and resources to help health centers get started with managing and maintaining a professional and engaging social media presence for their health center. Think Before You Post Above all else, make sure that you are complying with all privacy and security requirements before you post to social media. It is better to be slow in responding, rather than unknowingly violating HIPAA regulations. Have 2-3 people review a post before submitting. When dealing with patient information, be cognizant of the standards of patient privacy and confidentiality just as you would in any other context. There are boundaries to the patient-physician relationship that must be maintained—online and off. Never post identifiable patient information online and monitor your own internet presence to ensure that personal and professional information are kept separate. Also, be wary of inadvertently committing an act that constitutes medical malpractice. The National Association of Community Health Center’s NACHC guide to social media and medical malpractice relates two main areas of concern when it comes to social media, technology, and medical malpractice: 1 Committing an act that constitutes potential malpractice; and 2 the impact of social media use on a potential or pending malpractice proceeding. Know Your Audience Understanding your audience is key if you want to ensure patient and stakeholder engagement. The message you want to disseminate should resonate with your target audience. NACHC’s guide to Social Media for Health Centers relates that it is important to not stray too far from the types of topics that brought people to your site in the first place.  Try to understand how a user might receive your message if you want it to stick. Doing so can help you engage with past, current, and potential patients through meaningful and relevant content. This can encourage discussions and build credibility. Understanding your audience is also a great way to get to know your patients and stakeholders; it can help you learn about their experiences with the health center, identify their pain points, and uncover new ways to improve care. Engage Your Population Respond to all messages, including both praise and criticism. As Dr. John Halamka writes, “We don’t make excuses. We try to take it offline as soon as we can. We send a direct message to the reviewer.” Customer service shouldn’t stop when you go online. Developing an online relationship with patients and stakeholders is critical in upholding your health center’s values in customer service and relations. Enhancing online communication between the physician and patient is one way to maintain that relationship. This means responding to their comments and questions, especially if it’s a complaint, is a professional and timely manner. Immediately connect with the user to resolve the issue. Practice Quality Having a social media presence comes with the responsibility to report violating content. The AMA writes that if you “see content posted by colleagues that appears unprofessional… bring that content to the attention of the individual, so that he or she can remove it and/or take other appropriate actions.” Also, recognize that your own actions online and the content you post may negatively affect you or your health center’s reputation. Be aware of the consequences and how they can undermine your reputation and public trust. More Details...

Collecting Data On Asian Americans, Native Hawaiians, And Pacific Islanders For Community Health Center Needs Assessments: A Learning Series - Part 2: Data Resource Training: Using Community Commons to Map & Visualize the Needs of AA&NHPIs For Community Needs Assessments (2018). Resource Type: Archived Webinar. Description: This webinar introduces the Community Commons resource and how it can serve as a great tool to help health centers collect disaggregated data on Asian Americans, Native Hawaiians, and Pacific Islanders (AA&NHPIs). It provides a live demonstration of Community Commons’ mapping technology features and their Needs Assessment Toolkit. Speakers demonstrate how these tools can be used to inform a health center’s community health needs assessment and increase knowledge of available data resources. This will help to improve health center capacity to monitor and track the needs of medically underserved areas and populations. More Details...

Relevance of the Medicare Access and Chip Reauthorization Act (MACRA) to Health Information Exchange (HIE): An Issue Brief (2018). Resource Type: Publication. Description: This document provides an overview of Medicare Access and CHIP Reauthorization Act (MACRA), how HIE links to MACRA, and how health centers might be impacted. In this brief, we describe the relationship between new federal legislation regarding physician payment and the exchange of health information among organizations. For many years, Medicare has paid physicians on the basis of a resource-based relative value scale. This approach has led to increases in resource utilization and inappropriate care rather than rewarding physicians on the basis of quality of care and patient outcomes. It has resulted in steadily increasing physician fees, which the government attempted to control by implementing the Medicare sustainable growth rate (SGR). SGR slowed the increase and could even result in decreases in physician reimbursement. There has been a need to address these issues and to provide incentives which might lead to greater value to patients and fairer physician Medicare reimbursement. Download the brief below. More Details...

Enabling Services Data Collection Implementation Packet: Enabling Services Accountability Project (2017). Resource Type: Toolkit. Description: This toolkit includes tools and recommendations for how health centers can better capture data on enabling services (ES). This will help health centers provide a better understanding of the role of ES in health care access, utilization and outcomes for Asian Americans, Native Hawaiians, and Pacific Islanders (AA&NHPIs), and useful information to appropriately address these needs. More Details...

EHR Implementation Timeline for Health Centers: A Planning Tool for Health Centers Implementing New EHRs (2017). Resource Type: Publication. Description: To ensure successful and smooth implementation or migration of electronic health record (EHR) systems, it is critical for health center staff to carefully plan the process. This timeline document highlights key events and milestones that should take place in the months before, and immediately following, the EHR go-live date. To ensure successful and smooth implementation or migration of electronic health record (EHR) systems, it is critical for health center staff to carefully plan the process. This timeline document highlights key events and milestones that should take place in the months before, and immediately following, the EHR go-live date.   This provides a simplified timeline to aid health centers in planning EHR implementation or migration. Download the tool below.  More Details...

Collecting Data On Asian Americans, Native Hawaiians, And Pacific Islanders For Community Health Center Needs Assessments: A Learning Series - Part 1: Social Determinants of Health of Emerging Asian Americans, Native Hawaiians, and Pacific Islander (AA&NHPI) Populations by States (2017). Resource Type: Archived Webinar. Description: This webinar provides a data portrait of the fastest growing AA&NHPI populations by state with profiles of their social determinants of health characteristics. The five states are Arizona, Arkansas, Nevada, North Carolina, and North Dakota. The seven SDOH characteristics mentioned are educational attainment, foreign born, language spoken at home and ability to speak English, employment status, health insurance coverage, poverty level, and household characteristics. Collecting and having disaggregated data is important to better understand the unique barriers faced by AA&NHPIs since they represent more than 50 ethnic groups and over 100 languages. Health centers can use this data to develop more culturally and linguistically appropriate programs to better serve these communities. More Details...

Improving Diabetes Outcomes: Curated Expert Guidance, Tools, and Resources (2017). Resource Type: Publication. Description: According to 2016 UDS data, an estimated 14.3% of Federally Qualified Health Center patients nationwide have diabetes. Of these 2 million plus patients living with diabetes, approximately 32% have uncontrolled diabetes, with HbA1c equal to or above 9% or have had no test in the prior year. These statistics bring forth the need for improvement in the care of diabetes; several resources and research outcomes are profiled here with specific takeaways for health centers. As of CDC's 2017 National Diabetes Statistics Report, 30.3 million people, or 9.4% of the total U.S. population, have diabetes. Of these 30.3 million, only 23.1 million are diagnosed - while the other estimated 7.2 million are undiagnosed. Additionally, more than 1 in 3 adults or 84.1 million people in the U.S. have prediabetes. Among adults age 65 and older, nearly half have prediabetes. More Details...

Diabetes Improvement Toolkit (2017). Resource Type: Toolkit. Description: A website that hosts toolkits, guides, and other resources to support data collection, quality, and performance improvement with the use of Health IT tools More Details...

Staff Orientation to the use of Health Information Technology (HIT) to achieve the Triple Aim - Part I: Part 1 of 3: Effectively Using Data to Improve the Patient Experience (2017). Resource Type: Publication. Description: A custom, health-center focused eLearning module for onboarding and orienting clinical and administrative health center staff to the Triple Aim and their important role in collecting accurate and timely information to support informed decision-making.  The first aim – Patient Experience – is addressed in this module with a focus on the many staff a patient interacts with during a visit who impact the patient’s care.  ** Please note that viewing issues have been identified when using the Internet Explorer 11 browser. The series is best viewed in either Chrome, Firefox, or IE Edge browsers. The series is best viewed in either Chrome, Firefox, or IE Edge browsers. More Details...

Staff Orientation to the use of Health Information Technology (HIT) to achieve the Triple Aim - Part II: Part 2 of 3: Effectively Using Data to Impact Population Health (2017). Resource Type: Publication. Description: A custom, health-center focused eLearning module for onboarding and orienting clinical and administrative health center staff to the Triple Aim and their important role in collecting accurate and timely information to support informed decision-making.   The second aim – Population Health – is addressed in this module with a focus on the use of data to improve the health of a population or sub-group of patients.  ** Please note that viewing issues have been identified when using the Internet Explorer 11 browser. The series is best viewed in either Chrome, Firefox, or IE Edge browsers.The series is best viewed in either Chrome, Firefox, or IE Edge browsers. More Details...

Staff Orientation to the use of Health Information Technology (HIT) to achieve the Triple Aim - Part III: Part 3 of 3: Effectively Using Data to Increase Healthcare Value (2017). Resource Type: Publication. Description: A custom, health-center focused eLearning module for onboarding and orienting clinical and administrative health center staff to the Triple Aim and their important role in collecting accurate and timely information to support informed decision-making.  The third aim – Value – is addressed in this module with a focus on using data to achieve the best outcomes for patients while decreasing costs.  ** Please note that viewing issues have been identified when using the Internet Explorer 11 browser. The series is best viewed in either Chrome, Firefox, or IE Edge browsers.The series is best viewed in either Chrome, Firefox, or IE Edge browsers. More Details...

Quality Report Inventory: Organizing your quality team with a schedule and map of quality report distribution (2017). Resource Type: Publication. Description: This Report Inventory tool is a means to make public all available reports, the schedule for publishing to the organization, and their distribution.  A Report Inventory is a means to make public all available reports, the schedule for publishing to the organization, and their distribution. It provides a point of reference for all potential report requestors who are looking for data on any metric. The Report Inventory may also include reference to EHR alerts, mappings, and schedules and any supporting EHR or Population Health Management tools that are available to support improvement of each metric. Making this tool available on a shared drive or company intranet provides a point of reference for analysts to direct report requestors prior to acting on any new report request. The Report Inventory is organized by metric, including the denominator and numerator definitions, exclusions, and references to the metric steward which may be internal to the organization or external (e.g. UDS, NQF, etc.). The Report Inventory should be curated by your data analysts in collaboration with the responsible metric stewards within an organization. Download the Excel tool below to see a full example and additional instructions.  Also, see the companion Data Dictionary tool here. More Details...

EHR Optimization Series: Part Two of Three: Including slides, Workflow tool, and Provider Scorecard (2017). Resource Type: Publication. Description: The second of a three-part EHR Optimization series focused on establishing goals and expectations for optimizing EHR utilization and sharing proven strategy/tools for optimizing EHR utilization, including slides and related tools. The second of a three-part EHR Optimization series focused on establishing goals and expectations for optimizing EHR utilization and sharing proven strategy/tools for optimizing EHR utilization, including slides and related tools.  EHR Optimization Session 2 Slides From the second May 2017 Learning Session Provider Scorecard: Assessing accurate EHR documentation This resource provides a process and method that can be used to evaluate the degree to which an individual provider or care team member consistently documents required information in the appropriate place in the EHR. Blank and Sample completed, filled-in versions are available for download below. EHR Workflow Worksheet: EHR Optimization tool to map the workflow to enhance performance on a particular clinical measure This tool provides a structured way to review how data is captured and input in the EHR for a particular clinical measure across the clinical team including registration, pre-visit planning, nursing, and provider visit. The sample uses the BMI Percentile Children CMS 155 v5 as an example, and a blank version is also provided. Using the workflow tool will help answer questions on which components of the data are entered by whom, and facilitate soliciting feedback from staff on ways to improve efficient and accurate data capture. Blank and Sample completed, filled-in versions are available for download below. Visit the Guide for Improving Care Processes and Outcomes in Health Centers for additional tools and support for workflow assessment and improvement. Download each of these resources below, in the Documents to Download section. More Details...

EHR Optimization Series: Part Three of Three: Including slides, Data Dictionary, and Quality Report Inventory (2017). Resource Type: Publication. Description: The third of a three-part EHR Optimization series focused on establishing goals and expectations for optimizing EHR utilization and sharing proven strategy/tools for optimizing EHR utilization, including slides and related tools.  The third of a three-part EHR Optimization series focused on establishing goals and expectations for optimizing EHR utilization and sharing proven strategy/tools for optimizing EHR utilization, including slides and related tools.  EHR Optimization Session 1 Slides From May 2017 Learning Session; objectives include: Understand the role reporting has in EMR optimization Be able to list at least 3 considerations when developing reports to improve EMR utilization and meet the goals of the intended audience Identify at least 2 HITEQ resources for improving reporting effectiveness in facilitating decision-making Be able to discuss the interplay between reporting and data validation Slides are in the Documents to Download section; Recording is available below in the Links section.  ​Data Dictionary: Organizational tool to catalog your EHR and analytics platform data indicators A Data Dictionary provides a single point of reference for data mapping and interpretation for all of the indicators in your quality reports. Organization of the data definitions in this tool provides a reference for the team of the definitions which impact reports and alerts in the analytics application. That application may be the EHR or an analytics platform that is tied to the EHR. Anyone with questions about where data is being pulled from for any indicator can reference the Data Dictionary without analyst security privileges or expertise within the analytics tools. The Data Dictionary should be curated by analysts and made available on a shared drive or company intranet. Quality Report Inventory: Organizing your quality team with a schedule and map of quality report distribution A Report Inventory is a means to make public all available reports, the schedule for publishing to the organization, and their distribution. It provides a point of reference for all potential report requestors who are looking for data on any metric. The Report Inventory may also include reference to EHR alerts, mappings, and schedules and any supporting EHR or Population Health Management tools that are available to support improvement of each metric. Making this tool available on a shared drive or company intranet provides a point of reference for analysts to direct report requestors prior to acting on any new report request. The Report Inventory is organized by metric, including the denominator and numerator definitions, exclusions, and references to the metric steward which may be internal to the organization or external e.g. UDS, NQF, etc.. The Report Inventory should be curated by your data analysts in collaboration with the responsible metric stewards within an organization. Download each of these resources below, in the Documents to Download section. More Details...

EHR Optimization Series: Part One of Three: Including Performance Measure Crosswalk and Data Definition Worksheet (2017). Resource Type: Publication. Description: The first of a three-part EHR Optimization series focused on establishing goals and expectations for optimizing EHR utilization and sharing proven strategy/tools for optimizing EHR utilization, including slides and related tools.  The first of a three-part EHR Optimization series focused on establishing goals and expectations for optimizing EHR utilization and sharing proven strategy/tools for optimizing EHR utilization, including slides and related tools.  EHR Optimization Session 1 Slides From May 2017 Learning Session; agenda includes: Introductions EHR Optimization Defined Identifying “Waste” Data Life Cycle Strategies for EHR Optimization Closing/ Discussions/ Sharing eCQM Crosswalk for UDS, MIPS, PCMH, etc.: Quality Measure reference tool to understand relationship between eCQM, PCMH, Meaningful Use and UDS data measures The CMS eCQI Resource Center is the definitive eCQM resource. This tool provides a quick crosswalk to the eCQM measure definitions and guidance to which of the eCQM measures are reported for UDS 2019, MIPS, CPC+, and NCQA PCMH. *Updated in January of 2019* Performance Measure Data Definition Worksheet: Organizational tool to confirm eCQM measure specifications match EHR vendor logic ONC EHR Certification criteria means that vendors use eCQMs’ electronic Clinical Quality Measures’ specifications to define measures. Therefore, reported data for a measure should be consistent regardless of vendor. In practice, however, it is important to confirm the vendor’s logic is consistent with the health center’s definition and workflows. This tool supports alignment of the health center’s data definition with the vendor’s reporting logic. Download each of these resources below, in the Documents to Download section. Access part two and three of this series as well! More Details...

HITEQ Health App Decision Tree: A tool developed In collaboration with the Children's Health Fund to help choose appropriate Health Apps (2017). Resource Type: Publication. Description: There are thousands of consumer health applications health apps, which run on smartphones, watches, tablets, and other mobile devices. These Health Apps are available for download for general consumers, patients, and healthcare professionals. Currently, there is no governmental agency that provides certification or guidance on health apps, although there are several projects from organizations such as HL7, the FDA, ONC, and OCR that are working to provide guidance. User discrepancy in terms of the validity and safety of the health apps they choose to use are primarily based on ratings or recommendations. This guide seeks to provide a health app decision tree that can assist medical professionals and consumers in making wise choices when using health apps. There are thousands of consumer health applications health apps, which run on smartphones, watches, tablets, and other mobile devices. These health apps are available for download for general consumers, patients, and healthcare professionals. Currently, there is no governmental agency that provides certification or guidance on health apps, although there are several projects from organizations such as HL7, the FDA, ONC, and OCR that are working to provide guidance. User discrepancy in terms of the validity and safety of the health apps they choose to use are primarily based on ratings or recommendations. This guide seeks to provide a health app decision tree that can assist medical professionals and consumers in making wise choices when using health apps. The Children's Health Fund was made aware of a use case in which a health app that was targeted for use by adults was used for a child and consequently caused a detrimental health issue. Currently there are no certifying bodies for consumer-oriented health apps and consequently many doctors must navigate this domain themselves. This guide seeks to provide a health app decision tree that can assist medical professionals and consumers in making wise choices when using health apps. Download the decision tree below. More Details...

Measuring Population Health Management Return on Investment: A methodology to calculate ROI (Return on Investment) using a Matrix Tool (2017). Resource Type: Publication. Description: There is a great deal of interest among health centers, Primary Care Associations PCAs, and Health Center Controlled Networks HCCNs in the advantages associated with investing in Population Health Management electronic platforms. Measuring specific and quantifiable returns clarifies the benefits and supports consistent understanding among stakeholders of the value of PHM. There is a great deal of interest among health centers, Primary Care Associations PCAs, and Health Center Controlled Networks HCCNs in the advantages associated with investing in Population Health Management PHM electronic platforms.  Measuring specific and quantifiable returns clarifies the benefits and supports consistent understanding among stakeholders of the value of PHM. Available below, the PDF document titled Measuring Population Health Management Return on Investment outlines a conceptual process for measurement of ROI of a population health management system offered at the network level. What is presented here could also be used a starting point for developing an ROI analysis at the organizational level. The companion tool, an Excel file titled PHM ROI Matrix Tool, provides recommendations for measurement for different stages of PHM implementation and an ROI calculator. Download both of these resources below. These resources were created in partnership with Michigan Primary Care Association and Mark S. Rivera of Managed Care Consulting Inc./MCC Analytics, and HITEQ thanks both for their time, insight, and energy. More Details...

Data Dictionary Tool and Template: Organizational tool for your EHR and analytics platform data indicators (2017). Resource Type: Publication. Description: This Data Dictionary provides a single point of reference for data mapping and interpretation for all of the indicators in your quality reports. Organization of the data definitions in this tool provides a reference for the team of all such definitions that impact reports and alerts in the analytics application. This Data Dictionary provides a single point of reference for data mapping and interpretation for all of the indicators in your quality reports. Organization of the data definitions in this tool provides a reference for the team of all such definitions that impact reports and alerts in the analytics application. For example, it provides a format to document all items in a given report, and related EHR data. That application may be the EHR or an analytics platform that is tied to the EHR. Anyone with questions about where data is being pulled from for any indicator can reference the Data Dictionary without analyst security privileges or expertise within the analytics tools. The Data Dictionary should be curated by analysts and made available on a shared drive or company intranet. Download the Excel tool below to see a full example and additional instructions.  Also, see the companion Quality Report Inventory tool here. More Details...

Using Data to Manage Population Health Under Risk-Based Contracts: A background on what you need and how to use it (2017). Resource Type: Publication. Description: This resource will equip health center stakeholders with the understanding of what data-related capacity is needed to succeed under risk-based payment models.   This brief walks health centers through three key questions related to using data to succeed under risk-based contracts: 1 What data do I need and how do I get it?  2  How should I analyze the data? and 3 How should I use the data to manage quality and cost? Understanding the answers to these questions assists health centers in understanding the data-related capacities needed to participate successfully in risk-bearing payment models. Download the brief below! More Details...

ICD-10 Z-Codes for Social Determinants of Health: A quick reference guide for providers and health care leaders (2017). Resource Type: Publication. Description: This resource will equip health center stakeholders with the understanding of how standardized social determinants of health (SDoH) data can be used and which ICD10 z-codes are pertinent as a standardized SDoH data set. This resource describes ways standardized social determinant of health (SDoH) data can be used and provides a quick reference guide to which ICD-10 codes can help document standardized SDoH data.  Download here or below. More Details...

42 CFR Part 2 Final Rule and Health Center Compliance: A HITEQ Webinar in collaboration with the California Primary Care Association (CPCA) (2017). Resource Type: Publication. Description: This presentation explored the history and recent changes of 42 CFR Part 2, review common definitions, and how the changes may affect integrated medication-assisted treatment (MAT) and Screening, Brief Intervention, and Referral to Treatment (SBIRT) programs, and discussion on LifeLong Medical Care’s experience. More Details...

Security Risk Assessment: A HITEQ Privacy & Security Resource - New Templates Added May 2017 (2017). Resource Type: Template. Description: To successfully attest, providers must conduct a security risk assessment (SRA), implement updates as needed, and correctly identify security deficiencies. By conducting an SRA regularly, providers can identify and document potential threats and vulnerabilities related to data security, and develop a plan of action to mitigate them. More Details...

Business Intelligence Strategy in the Community Health Environment (2017). Resource Type: Publication. Description: This publication provides health centers and their primary care association, health controlled networks with guidance for business intelligence strategy. More Details...

The Value Proposition for Population Health Management for Health Centers: Calculating ROI on your PHM investment (2017). Resource Type: Publication. Description: Measuring return on investment ROI and the value of population health management is an emerging concern for health centers.  Calculating ROI on HIT investment is complex, and few health centers have experience in this endeavor.  The definition of value varies by type and size of provider, patient population, and other factors, and may be unique to an organization.  This white paper discusses principles and approaches to measure the value proposition for population health management for health centers.  Although few examples exist, we present the results of one health center’s measurement of the value of PHM. Measuring return on investment ROI and the value of population health management is an emerging concern for health centers.  Calculating ROI on HIT investment is complex, and few health centers have experience in this endeavor.  The definition of value varies by type and size of provider, patient population, and other factors, and may be unique to an organization.  This white paper discusses principles and approaches to measure the value proposition for population health management for health centers.  Although few examples exist, we present the results of one health center’s measurement of the value of PHM. Download the white paper below. More Details...

Results of Population Health Analytics/ Data Integration Survey: PCA/ HCCN Experiences Assessing and/ or Implementing Systems (2017). Resource Type: Publication. Description: HITEQ conducted an anonymous survey of population health analytic and data integration system needs and impressions among PCA/HCCNs in late 2016 and early 2017. The results of that survey, intended to help those looking to adopt similar systems, are laid out within. This includes ratings of key functionalities, discussion of most important features, and comments from those who have assessed and/ or implemented these tools. HITEQ conducted an anonymous survey of population health analytic and data integration system needs and impressions among Primary Care Associations and Health Center Controlled Networks in late 2016 and early 2017. The results of that survey, intended to help those looking to adopt similar systems, are laid out within. This includes ratings of key functionalities, discussion of most important features, and comments from those who have assessed and/ or implemented these tools. This piece reflects the aggregated responses of the 26 responding organizations that chose to participate through a call for responses to PCAs/ HCCNs. Responses are anonymous, are shared as they were provided with minimal editing, and reflect the views and experiences of the respondent(s) only. If you have experiences to add, please respond to the survey or email us! The survey results include: Number of respondents reviewing each system Ratings on selected functions Comments provided related to selected functions Data storage and management for each system Access to raw data downloads Features most important when assessing/ selecting a system Other priorities Reasons for making selection, vendor specific Reasons for making selection, general Three main lessons you’d like to pass on as a result of this experience General Comments Consider using this tool to help guide your thinking as to what questions you might ask vendors as well as what features you may want to see demonstrated if you are considering selecting a system of this type. The HITEQ Center does not endorse any systems or vendors, and has not validated any of the responses provided. More Details...

Demystifying Predictive Analytics: Factsheet on Predictive Analytics for Health Centers (2017). Resource Type: Publication. Description: Using predictive analytics in health care is an emerging field, especially for health centers. This tool will provide a brief explanation of the purpose of predictive analytics, the ingredients necessary to apply these methods, and ways that health centers are using this approach to improve results. The objective of this resource is to help health center leadership and staff understand how and when predictive analytics can help them, and to think about how predictive analytics might fit into their data-driven QI program. This one-page brief outlines the basics of this complex topic. We define predictive analytics and describe how health centers are adopting this innovation. Sources and uses of data for making predictions are discussed, and specific applications of predictive analytics are described.  Specific health center examples are offered to illustrate the potential of predictive analytics for health centers. More Details...

HITEQ-Social-Determinants-Data-Infographic-2017: Coding Social Determinants of Health (SDH) for Optimizing Value (2017). Resource Type: Other. Description: SDH coding is important for clinical management and outcomes reporting for payment reform and value based payment (particularly capitate payment), as well as other policy work. SDH coding begins with care providers, who often may need to understand how these data can be used to benefit not only the patient they are serving but also the broader population served by the organization. More Details...

Coding Social Determinants of Health (SDH) for Optimizing Value: An Infographic for Providers on the Benefits of Coding for SDH (2017). Resource Type: Publication. Description: The purpose of the infographic is to describe how SDH data would be used for a variety of goals that would have traction with the clinic staff audience who may likely need to modify workflows and behavior in order to collect such data.  The visual case could be used in presentations or hung on a provider break room wall. SDH coding is important for clinical management and outcomes reporting for payment reform and value based payment (particularly capitate payment), as well as other policy work. SDH coding begins with care providers, who often may need to understand how these data can be used to benefit not only the patient they are serving but also the broader population served by the organization. More Details...

Health IT Privacy & Security Skill Sets: The Importance of Information Security for all Health Center Staff (2017). Resource Type: Publication. Description: Since 2010, the healthcare industry has seen a remarkable increase in the use of technology in the administration and delivery in healthcare. This has led to a mass migration of data from paper charts and isolated systems to Electronic Medical Records EMRs and interconnected systems that transmit patient health and financial information across trusted and untrusted networks. While this has been a boon for the industry in its ability to provide timely information to those who need it the most, this transition has introduced a great deal of risk to the confidentiality and integrity of the information. Coupled with the fact that the information can be quickly monetized by criminals through insurance fraud and identity theft, the ecosystem is target-rich. Since 2010, the healthcare industry has seen a remarkable increase in the use of technology in the administration and delivery in healthcare. This has led to a mass migration of data from paper charts and isolated systems to Electronic Medical Records EMRs and interconnected systems that require ever-evolving privacy and security requirements to safely transmit patient health and financial information across trusted and untrusted networks. For an overview of the information contained herein access this recorded webinar and companion materials including a transcript and slides for reference.     Why Information Security Teamwork is Important for Health Centers Resource Context While the increase in the adoption of health IT across all service levels has been a boon for the healthcare industry in its ability to provide timely information to those who need it the most, this transition has introduced a great deal of risk to the confidentiality and integrity of the information. Coupled with the fact that the information can be quickly monetized by criminals through insurance fraud, extortion, and identity theft, the ecosystem is target-rich. Read More... What this means for health centers is that they are storing and transmitting high-value information in a dangerous environment which adds up to High Risk to the organization. The results of breaches include:  Reputational Breach Notification Laws require public notification of breaches Reduced ability to provide care Patients may withhold information if they cannot trust that it will be maintained confidentially Records that have been breached may contain incomplete or inaccurate information Financial Fines from the Office for Civil Rights Breach Notification costs; administrative and legal Remediation costs; technical remediation, staff retraining, Corrective Action Plans CAPs Legal action from affected patients and third party organizations Lost Business Loss of reputation may lead patients to seek care elsewhere Audience The strategies and tools in this Guide are targeted to all levels of health center staff, and health center partners that support Health IT Privacy & Security goals. Read More... Everyone who actively participates in the guidance and day to day operations of a health center have a responsibility to: Increase their awareness of primary healthcare security risk domains and the responsibilities of staff depending on their role within the health center to ensure better information security.   Improved their ability to recognize security risks within their own organization and better understand how to plan and mitigate for information security risks identified. Why Using this Guide is Important for Health Centers Community Health Centers need to continually refine their health IT security and privacy strategy. A lack in a clear strategic direction throughout all levels of health center services are being met with continually rising costs, across factors that include penalties, time expenditure, patient safety,trust and satisfaction, and the overall perception of quality held by related healthcare institutions. Health Centers need to invest in and devise a concrete roadmap and systems development and maintenance lifecycle that is transparent and supported by all levels of health center staff, including clinicial staff, front and back office staff, privacy and security staff, and the board of directors. Read More... Below are a few examples key stakeholders and their respective health IT privacy and security responsibilities All Clinical Staff: Even under emergency circumstances be diligent in handling and managing PHI Front and Back-Office Staff: Protect the confidentiality, integrity, and availability of electronic PHI at all times  Health Center Administration: Promote an organization-level committment to upholding best practices in health information privacy & security management.  Health Center Board of Directors: While a board is generally not involved in the day-to-day operations of cybersecurity, they do have a responsibility to ensure that proper structures are in place and that the organization is taking appropriate steps to identify and address cybersecurity risks How to Use this Guide Lorem ipsum dolor sit amet, consectetur adipiscing elit. Aenean varius sapien nisl, id convallis justo semper nec. Pellentesque massa urna, cursus vitae accumsan eu, feugiat vel ipsum. Maecenas commodo libero lacus, non congue leo condimentum ullamcorper. Morbi vehicula accumsan quam. Integer accumsan velit ac lacinia pulvinar. Cras at arcu quam. Quisque a sagittis tortor. Nulla ut urna quam. Sed sodales justo ut rutrum luctus. Sed a tellus sollicitudin, bibendum dolor at, condimentum urna. Cras venenatis eu lectus eget interdum. Read More... Nam a euismod dolor. Etiam in ornare magna. Praesent eu posuere enim, mollis sagittis lectus. Praesent pharetra sit amet arcu sed tincidunt. Class aptent taciti sociosqu ad litora torquent per conubia nostra, per inceptos himenaeos. Ut finibus, dui quis laoreet vestibulum, purus arcu vestibulum mi, nec rhoncus ex purus ac orci. Duis egestas ligula eros, in commodo turpis vehicula nec. Donec vulputate pharetra sapien, non vestibulum quam consequat non. Nulla elementum tempus risus, eget dapibus purus faucibus vel. Quisque vitae volutpat est. Suspendisse molestie at nulla vitae cursus. Donec efficitur leo sed scelerisque elementum. Phasellus lacinia ante in bibendum aliquam. Fusce tempor mi sed risus egestas viverra. Sed quis nisl luctus, tristique est sit amet, vestibulum diam. Vivamus in eros tincidunt neque rutrum volutpat. Duis vulputate turpis a lacus eleifend volutpat. Nunc vel interdum felis, ut sollicitudin massa. Ut ac aliquam lorem, nec ultrices enim. Nulla volutpat eros libero, non malesuada risus faucibus eu. Donec ultrices sodales accumsan. Duis gravida, mi non pretium porttitor, mauris est pellentesque eros, id vestibulum augue lectus non eros.   Health IT Privacy & Security Key Factors Compliance The HIPAA Privacy and Security Rules provides a set of standards for the Confidentiality, Integrity, and Availability of electronic Protected Health Information ePHI. Health Centers are required to demonstrate compliance with the HIPAA Privacy and Security Rules through the implementation of Administrative, Technical, and Physical safeguards. Read More... The HIPAA Security Rule is designed as a Risk Management Framework that consists of conducting regular Security Risk Analysis and implementing a Risk Management Process that implements reasonable and appropriate safeguards. The HITECH Act of 2009 builds on the HIPAA Privacy and Security Rules to include Breach Notification Requirements, increased patient access to their medical records, compliance of Business Associates, and stronger enforcement of compliance. The Meaningful Use MU program also enacted in the HITECH Act included requirements to conduct an annual Security Risk Assessment as a prerequisite for collecting incentive moneys. While MU did not add any requirements that were not already a part of the HIPAA Security Rule, it did provide the incentive for many organizations to conduct regular Security Risk Assessment where they previously had not.   Security While the HIPAA Security Rule does provide the foundation for information security, it is important for organizations to understand that being compliant does not necessarily equate to having good security. It is important for organizations to continuously evaluate their organization and their systems against industry standards and guidance to ensure appropriate security controls are in place. This can certainly be performed in conjunction with a HIPAA compliance program. Read More... It is important for Health Center IT leadership to understand the key differences between security and compliance. As illustrated in the graphic below, while there is a cross-over between compliance and security to the degree that compliance establishes some security baselines, it is important to know that security encompasses a broader domain of required practices and controls in order to be effective.   Approach The Security Risk Assessment approach outlined in the HIPAA Security Rule is designed to allow organizations to implement “reasonable and appropriate” safeguards. Said another way, the Rule does not prescribe what specific safeguards must be in place. This allows for flexibility based on the size of the organization, the technology in place, the number of medical records, and other organization-specific considerations. Read More... An example of this flexibility is can be seen when considering Disaster Recovery Planning. What is a reasonable disaster recovery plan for a large health system would be excessive for a small doctor’s office. An OCR auditor would certainly have different expectations of these two types of organizations. While the framework of the HIPAA Security Rule provides flexibility, the non-prescriptive nature of it can make it difficult to understand how to comply with its requirements and find concrete examples and expertise. Many organizations become concerned about identifying and documenting risks in their risk assessment as they worry it will be an indicator of non-compliance. Between the lack of understanding of the requirements and the fear of documenting risks, many assessments end up being an enumeration of security controls or simple checklists. Neither of these deliverables would meet the expectations of a Security Risk Assessment. When looking at what is a “reasonable and appropriate” safeguard, organizations can look at what other similar organizations are doing. If other similar organizations are encrypting their laptops, it would seem reasonable to expect your organization to do the same. Finally, one can look at industry standards and guidance for information on what security controls are not only reasonable and appropriate, but also effective. Remember, the goal is effective security, not just checking the checkboxes for compliance.   Health Information Security Basics An important place to start with protecting ePHI is with the basics. This is considered the “blocking and tackling” of information security, or those things that users, managers, and IT staff should be performing day-in and day-out to protect information. Step 1: Identify ePHI Many organizations only consider their EMR when considering the security of their ePHI. What one must consider is that EMRs do not reside in a bubble. ePHI is transmitted to and from EMR systems, communication with patients and other third parties often occurs outside the EMR, and data is generated and stored outside the EMR.   Read More... ePHI must be protected both at rest and in transit i.e. as it is being transmitted both internally and externally. Consider the following typical areas where ePHI is stored or transmitted: Practice Management System Email Text Messages Other messaging systems Fax transmission and storage of faxes Billing Systems Patient Portals Phone conversations and voicemail Photocopiers and network printers Medical Devices Image storage Reports Backup Storage If the people using ePHI on a day-to-day basis can learn to recognize when they are handling ePHI and where it is stored and/or transmitted, they can start to have the awareness of how it can be protected. Step 2: Protect ePHI When EMR and other product vendors market the fact that their system is “HIPAA-Compliant”, many take that as assurance that the system is secure and don’t give additional thought to protecting the information. Read More... Unfortunately, no matter how secure the system is, it is when the ePHI is used that the risk of a breach increases. Examples of potential openings for breach include: A user uses the same or slightly modified password between their personal email account and their EMR account. That password is compromised either because their email system has been compromised or a family member may know or find out the email password. Now that password can be used to access the EMR system by a third party. A staff member exports a report from the EMR and attaches it to an email for a colleague, referring provider, or billing company use. The message is sent using a public email system to another public email system. The risks involved include: While the message is being transmitted unencrypted over the Internet, it could be intercepted A typo in the email address could lead to the message being read by an unintended recipient Either person’s email system could be compromised and the information breached Information from an EMR system is exported to a USB drive in order to transfer to another computer. USB drive is lost or reused by another staff member and therefore information is breached. Step 3: System Protections Most operating systems these days are capable of protecting information, however the out-of-the-box configuration is generally focused more on usability than security, so enabling security protections is something that must be performed deliberately. Read More... Here are a few steps that can be taken to increase the security posture of modern workstations, laptops, and tablets: Password protection – Password protecting your system enables the user to prevent unauthorized access to information and/or tampering with the system. This also prevents others from connecting to a system over the network, so even if a workstation is located in a more secure area, it is important that all sessions be properly authenticated. Current standards for strong passwords include: At least 8 characters Mixture of uppercase/lowercase, numbers, and symbols Not based off a single dictionary word though phrases are good Do not use the same password for multiple systems Individual user accounts – If more than one person will be using a system, create an account for each person. This will allow you to determine who used a system and when as well as grant access to information to other users on an as-needed basis. Encryption – Many systems have built-in encryption capabilities; however, it may not be enabled by default. If a system with ePHI is lost or stolen and the data is encrypted, this will provide safe harbor from breach notification. <citation needed> Furthermore, the HIPAA Security Rule requires that organizations encrypt ePHI wherever “reasonable and appropriate”. Failure to do so would require an organization to provide evidence that it was not reasonable and appropriate or to provide evidence that equivalent alternate safeguards are in place. End-Point Protection – Traditionally, end-point protection consists of Anti-Virus software that detects malware based on signatures. While this is still an important protection, today’s attacks have become adept at evading detection by anti-virus signature-based detection. End-point protection adds additional protections including: Additional behavior-based heuristics for detecting malware Built-in antispyware protection More intelligent host-based firewall Intrusion Detection and Warning Application control and user management Data input/output controls such as locking down USB ports and other removable storage Step 4: Continuous Maintenance One of the toughest aspects of privacy and security management is the diligence required to maintain safety. Security is not a one-time task and requires ongoing maintenance, upgrades, training and changes to workflow. Read More... Below are a few examples of ongoing maintenance tasks that organization should be performing: Security Awareness Training – This is all about creating a culture motivated and dedicated to securing patient data. Workforce members require regular reminders regarding how to detect suspicious activity, handling of ePHI, and what to do in the event of a security incident. This is especially important as threats evolve and new threats appear. Patching – Many breaches occur because systems have security vulnerabilities that have fixes available, however the fix has not been applied. Be diligent about operating system updates and updating of third party software and components. Review Policies and Procedures – As technology and work processes change, policies and procedures should be reviewed and updated accordingly. HIPAA requires that organizations have a policy for review of policies. Standard practice is to perform this task annually or as changes occur. Health Information Security Basics While the HIPAA Security Rule does provide a framework for security risk management, it can be difficult to know what specific steps to take to implement “reasonable and appropriate” security controls. Ways of determining this may include looking at what other similar organizations are doing and adopting relevant industry standards. One such standard organization effort that security administrators may wish to consider is The Center for Internet Security’s CIS Top 20 Critical Security Controls CSC. This standard is internationally recognized and provides guidance that is flexible for organizations of all size and maturity. The guidance is specific and practical and can often be adopted without spending a lot of money. Per the Australia Signals Directorate ASD: “Incorporating the Top 4, the eight mitigation strategies with an 'essential' rating are so effective at mitigating targeted cyber intrusions and ransomware that ASD considers them to be the cyber security baseline for all organisations.” Critical Security Controls Read More... While ASD recommends the Top 4, CIS indicates “Controls CSC 1 through CSC 5 are essential to success and should be considered among the very first things to be done.” The top 5 controls include: CSC 1: Inventory of Authorized and Unauthorized Devices CSC 2: Inventory of Authorized and Unauthorized Software CSC 3: Secure Configurations for Hardware and Software CSC 4: Continuous Vulnerability Assessment and Remediation CSC 5: Controlled Use of Administrative Privileges These controls do map to requirements of the HIPAA Security Rule and can be used to assist organizations in finding specific technical measures that can help meet the requirements. A mapping of the Top 5 Controls provides an example: # Control Family HIPAA Security Controls 1 Critical Security Control #1: Inventory of Authorized and Unauthorized Devices 164.310c: Workstation Security - R 164.310d1: Device and Media Controls: Accountability - A 2 Critical Security Control #2: Inventory of Authorized and Unauthorized Software 164.310c: Workstation Security - R 3 Critical Security Control #3: Secure Configurations for Hardware and Software 164.310c: Workstation Security - R 4 Critical Security Control #4: Continuous Vulnerability Assessment and Remediation 164.308a8: Evaluation 164.308a6: Security Incident Procedures 5 Critical Security Control #5: Controlled Use of Administrative Privileges 164.310b: Workstation Use - R 164.310c: Workstation Security - R 164.312: Access Control: Unique User Identification - R 164.312b: Audit Controls 164.312d: Person or Entity Authentication   Acknowledgements Origins and Ongoing Refinement of this Guide: The content in this resource is drawn from and builds on widely used Information and Security standards, tools and protocols that have continually increased in terms of required measures, especially over the past couple decades in which the Internet and the ever-growing Internet of Things have evolved and expanded. The HITEQ Center plans to continue refining this Guide based on input from users like you, so please consider sharing your feedback through the comment form. Read More... This guide was developed in collaboration with Adam Kehler, CISSP, a Senior Consultant within the Healthcare Information Privacy and Security division of Online Business Systems. Adam specializes in assisting healthcare organizations in managing and meeting compliance requirements such as conducting security risk assessments, systems vulnerability assessments and regulations associated with HIPAA and Meaningful Use criteria. Adam is assisting the HITEQ project in building out resources and guidance to health centers on privacy and security best practices. More Details...

CHC Adoption Framework for Electronic Patient Engagement: Methods for deploying more personalized care to underserved populations (2017). Resource Type: Toolkit. Description: The introduction of electronic personal health records (PHR) systems, and the patient portals used to provide patients access to those records, into the fabric of the U.S. healthcare system provides a major opportunity to encourage positive health management practices, such as chronic disease management and increased care plan adherence, through greater engagement of the patient. More Details...

Using your EHR for Population Health Management: A Cross-reference Tool (2017). Resource Type: Publication. Description: Health centers are interested in managing population health but may not have the budget needed to purchase specialty suites. This tool will guide health centers in leveraging the “built in” functionality of certified EHRs to perform PHM functions by mapping the native PHM functionality available in the common certified EHRs used by health centers.  The aim is to help health centers to understand where to start in implementing PHM using what they already have available to them. This Excel spreadsheet has three tabs. Be sure to read Tab 1, “Approach” for guidance in interpreting the information provided by this tool. Tab 2 provides a crosswalk between native certified-EHR functionality and the elements of PHM. Tab 3 contains links to EHR certification specifications on HealthIT.gov for assistance in interpreting EHR certification standards.   Background Health centers are interested in implementing population health management (PHM), but often lack the resources to purchase specialized PHM software suites to implement in conjunction with their EHR. We assessed the functionality of certified EHRs to assist health centers in utilizing native EHR capabilities to perform PHM functions.   Methods There is no standardized consensus definition of population health management (PHM). We conducted a review of the literature to identify models and elements of PHM to develop a framework for assessing the degree to which native EHR capabilities perform the functions of PHM. We synthesized results of a recent scoping review of the literature (see references) and a comparison of PHM vendor functionality to arrive at a working definition of PHM and its essential elements. Our working definition of PHM maps to the triple aim: Population Health Management is the set of activities that simultaneously improve the health status and health outcomes of a population while improving quality and reducing per capita costs. We synthesized the literature to develop a framework for the essential elements of PHM: Identify patient subpopulations by user selected parameters and perform risk stratification Examine detailed characteristics of patient subpopulations in terms of health status and outcomes, and trigger targeted care Track clinical performance measures to assess the effect and improve interventions Integrate Data - Input and aggregate data within the EHR database Share data with external systems Create and send notifications to provider and patient Aggregate and analyze data within EHR data base We then mapped the functionality included in certified EHR systems against these essential elements of PHM, to create the EHR-PHM Crosswalk presented on the next tab.   Workbook Contents Tab 1 - Approach Tab 2 - Crosswalk  This tab lists required functionality inherent to all certified EHRs. Columns show how this functionality maps to the elements of PHM. Tab 3 - Certification Detail  This tab provides links to the Certification Companion Guide on HealthIT.gov for convenient access to the specifications behind each certification requirement.   Conclusions Native EHR functionality can be used to perform the elements of PHM. Certified EHRs, regardless of vendor, may be used to implement a comprehensive PHM program that performs all of the essential elements of PHM. In addition, certified EHR functionality and the EHR data base may be used to underpin the more advanced analytics functionality, and a more robust PHM user interface provided by specialized PHM suites and EHR add-ons offered by vendors. What you can't do with a certified EHR alone: Successful, robust PHM that manages risk associated with a population of patients necessitates integrating data on utilization and cost of care provided outside of the primary care provider's EHR. This requires some form of data import and/or integration such as provided by a data warehouse, HIE, all-payer database, or other infrastructure. This infrastructure typically includes multi-source integration of data within and external to the organization; in-depth, robust analytics capabilities; and a menu-driven, user-friendly interface. These functionalities are NOT inherently provided through standard EHR certification requirements, but may be available in some vendors’ offerings as add-ons or bundled functionality.   For More Assistance Using the native functionality of EHRs to conduct PHM may require the availability of and expertise in additional tools such as registries, excel, SQL or a reporting tool such as Crystal Reports. For consulting and assistance in applying these tools to customize your EHR for PHM, request HITEQ technical assistance here.   References Steenkamer Betty M., Drewes Hanneke W., Heijink Richard, Baan Caroline A., and Struijs Jeroen N.. Population Health Management. February 2017, 20(1): 74-85. doi:10.1089/pop.2015.0149. Public Health Informatics Institute. 2016. "Population Health Management Software: An Opportunity to Advance Primary Care and Public Health Integration." Decatur, GA: Public Health Informatics Institute. Jeroen N. Struijs, Hanneke W. Drewes, Richard Heijink, Caroline A. Baan, How to evaluate population management? Transforming the Care Continuum Alliance population health guide toward a broadly applicable analytical framework, Health Policy, Volume 119, Issue 4, April 2015, Pages 522-529, ISSN 0168-8510, http://dx.doi.org/10.1016/j.healthpol.2014.12.003.     More Details...

Why Collect Standardized Data on Social Determinants of Health?: A slide deck outlining the potential use of ICD10 coding for SDOH. (2017). Resource Type: Publication. Description: This resource will equip health center stakeholders with the motivation, knowledge, and ability needed to collect and use standardized social determinants of health data. This resource describes the importance of collecting Standardized SDOH Data in the context of value based payment.  The resource reviews commonly used codes in ICD-10 that can help document SDOH.  Finally, the slide deck describes useful tools for collecting these data and what’s on the horizon for health centers to strengthen their efforts to move “upstream” in addressing health disparities. Download this slide deck below. More Details...

Health Outcomes and Data Measures for Supportive Housing and Health Centers: A Quick (Data) Guide for Health and Housing Partnerships (2017). Resource Type: Publication. Description: Both health and housing providers are tracking data elements and outcomes for a similar vulnerable populations. This resource guide highlights the common data elements currently being tracked, and opportunities to learn from multi-sector partners More Details...

Business Intelligence Strategy in the Community Health Environment (2017). Resource Type: Publication. Description: No annotation provided by the authoring organization. More Details...

Breach Protection Overview Presentation for Health Centers: A HITEQ Privacy & Security Resource (2017). Resource Type: Publication. Description: Data breaches in healthcare are consistently high in terms of volume, frequency, impact, and cost. High-level breaches are increasingly occurring in a more targeted manner toward health centers. This presentation provides Health Center leadership and trainers with a template to use to build out their own organization-specific presentation on breach. Data breaches in healthcare are consistently high in terms of volume, frequency, impact, and cost. High-level breaches are increasingly occurring in a more targeted manner toward health centers. This presentation provides Health Center leadership and trainers with a template to use to build out their own organization-specific presentation on breach. This presentation template covers the following agenda: Quick Start Healthcare Privacy & Security Healthcare Privacy & Security Policies and Legislation Implications for Breach Management and Mitigation Strategies Questions and discussion More Details...

Prioritization Matrix: A framework for selecting QI activities or project (2017). Resource Type: Publication. Description: It is sometimes difficult to know what target metric to focus on when beginning a quality improvement project. A prioritization matrix is a management tool that uses a simple framework to compare multiple options side-by-side using standard criteria. This version includes four criteria and can be adapted for your purposes. What is it and how can it help me? It is sometimes difficult to know where to start when approaching several opportunities to improve care process that emerge from a quality improvement project. A prioritization matrix is a management tool that uses a simple framework to compare multiple options side-by-side using standard criteria.   Download one of the prioritization matrix tools below. One is for selecting a target for a QI Project (e.g., hypertension control, colorectal cancer screening, immunizations, etc.) The other is for selecting among potential improvements identified. These are word documents that you can further edit for your own purposes.   Prioritization Matrix for Selecting Target for QI Project Using the Guide to Improving Care Processes and Outcomes in Health Centers or beginning another QI project, a number of potential targets will be identified (e.g., hypertension control, diabetes control, colorectal cancer screening, no show rate, etc.) List those potential enhancements in the Opportunities to improve target performance column in this matrix. Rate each possible target according to the scale provided. You can also leave a column blank if you don’t find it relevant, just be sure to leave it blank for all options. When rating External requirement consider whether this target metric is related to required reporting, such as UDS, or even more that one reporting requirement? If yes, rate it a 3, otherwise, rate as a 2 for something that is desired or is tangentially related, or a 1 if it is not required for external reporting. When rating Cost consider how substantial the financial investment would be for addressing the target being considered? If the financial investment is relatively low, then rate it a 3. Rate a 2 if a moderate financial investment would be required, and rate a 1 if the activity would require a substantial financial investment, (i.e., the cost is high). When rating Difficulty, you may consider whether you currently have the staff, referral relationships, or other key components that are critical to addressing that target. For example, if you do not have an OB/GYN or someone appropriate to conduct pap tests on staff, and you don’t have an existing referral relationship with a provider who completes pap tests in your community, then targeting cervical cancer screening for improvement would be difficult. When rating Impact, consider how large of an impact addressing the target could have. For example, are there a large number of patients with the condition or in need of the screening? Is current performance particularly low such that a change could result in significant improvement? Once all potential enhancements are listed and ratings are in each column, add all columns together to identify the items that are likely to have the biggest greatest impact with the most efficiency. Those potential enhancements that have the highest score (=external requirement + cost + difficulty + impact) may be the best enhancements to try first.   Prioritization Matrix for Selecting Improvement to Test Using the Guide to Improving Care Processes and Outcomes in Health Centers or beginning another QI project, a number of potential targets will be identified (e.g., hypertension control, diabetes control, colorectal cancer screening, no show rate, etc.) List those potential enhancements in the Opportunities to improve target performance column in this matrix. Rate each possible target according to the scale provided. You can also leave a column blank if you don’t find it relevant, just be sure to leave it blank for all options. When rating External requirement consider whether this target metric is related to required reporting, such as UDS, or even more that one reporting requirement? If yes, rate it a 3, otherwise, rate as a 2 for something that is desired or is tangentially related, or a 1 if it is not required for external reporting. When rating Cost consider how substantial the financial investment would be for addressing the target being considered? If the financial investment is relatively low, then rate it a 3. Rate a 2 if a moderate financial investment would be required, and rate a 1 if the activity would require a substantial financial investment, (i.e., the cost is high). When rating Difficulty, you may consider whether you currently have the staff, referral relationships, or other key components that are critical to addressing that target. For example, if you do not have an OB/GYN or someone appropriate to conduct pap tests on staff, and you don’t have an existing referral relationship with a provider who completes pap tests in your community, then targeting cervical cancer screening for improvement would be difficult. When rating Impact, consider how large of an impact addressing the target could have. For example, are there a large number of patients with the condition or in need of the screening? Is current performance particularly low such that a change could result in significant improvement? Once all potential enhancements are listed and ratings are in each column, add all columns together to identify the items that are likely to have the biggest greatest impact with the most efficiency. Those potential enhancements that have the highest score (=external requirement + cost + difficulty + impact) may be the best enhancements to try first. More Details...

Health IT enabled Quality Improvement Project Charter: The first step in a QI project. (2017). Resource Type: Publication. Description:  A Project Charter serves as a reference of authority for the future of the project. Creating a Project Charter and getting sign off from all participants gives all involved the authority to begin the work outlined therein. The task of developing the Project Charter builds understanding, consensus, and clarity about purpose, expectations, roles and responsibilities, and communications. Why develop a Quality Improvement Project Charter? Formalizes authority to dedicate resources (such as staff time) to the QI project Defines the purpose and expectations for the QI project Identifies key stakeholders to engage in QI project Clarifies roles and responsibilities of the QI Lead and QI Team members Assures commitment and support for QI project from leadership and QI Team members Provides a sustainable framework for any QI Project A Project Charter serves as a reference of authority for the future of the project. Creating a Project Charter and getting sign off from all participants gives all involved the authority to begin the work outlined therein. The task of developing the Project Charter builds understanding, consensus, and clarity about purpose, expectations, roles and responsibilities, and communications. Download the Project Charter (Word document) below to use with your QI team. It is important that this be completed with your QI team and leadership. Also, be sure to be as specific as possible when completing your QI charter, as this will be your reference for all things related to your project.  For example, rather than say you will hold monthly meetings, be specific that meetings will be the third Wednesday of the month at 9am. Another example, for the communication plan, be specific as to exactly who needs to be communicated with at what frequency, and through what channels. More Details...

Emergency Department Care Coordination: Targeted Strategies to Improve Health Outcomes and Decrease Costs (2017). Resource Type: Publication. Description: This issue brief outlines strategies to achieve emergency department (ED) care coordination, summarize important legal and policy issues, and provides case studies of health centers that have implemented successful ED care coordination. More Details...

Examples of Technical Assistance Provided by Primary Care Associations and Health Center Controlled Networks: How HCCN’s and PCA’s can be helpful to Quality staff at a Health Center (2017). Resource Type: Publication. Description: Examples of Technical Assistance Provided by Primary Care Associations and Health Center Controlled Networks This document showcases Primary Care Associations (PCAs) and Health Center Controlled Networks (HCCNs) for five states, highlighting their work in Quality and Health IT.  These are examples of the types of assistance any health center may find from their own PCA and HCCN. HRSA provides funding to PCAs and HCCNs to provide state and regional resources to assist health centers. More Details...

Staffing Models, Program Elements, and Performance Expectations: A HITEQ Center Resource (2017). Resource Type: Publication. Description: The following document describes Quality and HIT staffing models for a low, middle, and high resourced health centers.  These models are intended to be both normative (e.g., How does my middle resource health center compare? Do I have all of these positions covered?) and aspirational (e.g., What benefits could we get if we move to the next level?).  The following document describes Quality and HIT staffing models for a low, middle, and high resourced health centers.  These models are intended to be both normative (e.g., How does my middle resource health center compare? Do I have all of these positions covered?) and aspirational (e.g., What benefits could we get if we move to the next level?).  Each model includes: Descriptions of staff Critical quality program elements at each stage How incentive payments could be allocated, and Performance expectations.  The model includes factors to consider when moving between stages and a staff position glossary to help define the different positions. As anyone who has worked in health centers knows, health centers are highly variable.  For this reason, this document is meant to help executives and quality staff think more deeply about their quality program.  It is not intended to be a literal guide. More Details...

Population Health Management, Social Determinants of Health and How These Fit: The relationship between population health management and social determinants of health (2016). Resource Type: Publication. Description: This is a 21-slide module presenting an introduction to the concept of and relationship between population health management and social determinants of health beginning with current definitions, a brief history of along with the evolution of the field. This is a 21-slide module presenting an introduction to the concept of and relationship between population health management and social determinants of health beginning with current definitions, a brief history of along with the evolution of the field. A comprehensive model for the relationship among the social determinants of health and outcomes of population health is also included. More Details...

Data for Population Health Management: Measuring Population Health & Emerging Directions in Population Health (2016). Resource Type: Publication. Description: This is an 18-slide module describes the role and importance of data to population health management. This is an 18-slide module describes the role and importance of data to population health management. This includes the various sources for data that inform population health management, an introduction to population health analytics; and recommended frameworks for collecting data and measuring impacts and outcomes of population health. The module concludes with a brief discussion of areas of future research and development in population health management. More Details...

Current Population Health Management in Health Centers: The Case for Implementing Population Health Management and Addressing the Social Determinants of Health (2016). Resource Type: Publication. Description: This is a 27-slide module on population health management in the Federally Qualified Health Centers (FQHCs). The module provides several examples of current initiatives that support PHM and SDM as well as the use of these concept in supporting health equity in navigating the Affordable Care Act (ACA). This is a 27-slide module on population health management in the Federally Qualified Health Centers (FQHCs). The module provides several examples of current initiatives that support population health management and social determinants of health as well as the use of these concept in supporting health equity in navigating the Affordable Care Act (ACA). The module also serves to specifically outline the rationale of PHM in areas of cost efficiency, quality improvement and patient care including value-based reimbursement and risk contracts, targeting care and resources to improve outcomes, and patient engagement and care management.   More Details...

A Roadmap for Implementing Population Health Management: The implementation of population health management and social determinants of health in healthcare centers (2016). Resource Type: Publication. Description: This is a 22-slide module on the implementation of population health management and social determinants of health in healthcare centers using the framework of the Institute for Healthcare Improvement (IHI) for health equity. This is a 22-slide module on the implementation of population health management and social determinants of health in healthcare centers using the framework of the Institute for Healthcare Improvement (IHI) for health equity. This outline provides a foundation that begins with electronic health records (EHR) and its progression to PHM. A step by step road map to implementation is outlined including adjusting organizational culture, conducting a vendor assessment, population stratification, work processes, patient registries, piloting and measuring implementation, and improvement. More Details...

Understanding EHRs, Analytics, Data Warehouses and HIE Repositories: A HITEQ Center-Developed White Paper (2016). Resource Type: Publication. Description: The goal of this paper is to clarify the roles of several health care data technologies that are often confusing to people, including Electronic Health Record (EHR) Databases, Analytic Systems and Data Warehouses, and Health Information Exchange (HIE) Data Repositories. Health Centers entering the realms of Data-driven Performance Measurement and Quality Improvement may find themselves mired in a bewildering assortment of tools, products and terminologies. There are multiple ways in which Health Centers use information, and for better or worse, multiple technologies designed to most efficiently meet their needs. One of the leading sources of confusion emanates from the oft-used term “data aggregation”. We aggregate data because we want to improve our insights into the data and thereby make better and more timely decisions. Data aggregation, put simply, is the assembly of electronic information from multiple sources for these purposes. More Details...

HRSA Telehealth Resource Center (TRC) Technical Assistance available to health centers!: 12/22 HITEQ/HRSA Webinar Transcription (2016). Resource Type: Publication. Description: A transcription of the December 22nd HITEQ/HRSA Telehealth Webinar. Please join HRSA’s Federal Office of Rural Health Policy (FORHP) and the Health Information Technology, Evaluation, and Quality (HITEQ) Center to learn about free telehealth and other health IT resources available to health centers. We will introduce participants to the regional Telehealth Resource Centers (TRCs) and how to access the resources and technical assistance provided by the TRCs.  Participants will also learn about the HITEQ Center and different health IT resources and services available. For more information on the TRCs, please visit: http://www.telehealthresourcecenter.org/. For more information on the HITEQ Center, please visit: http://www.hiteqcenter.org/. More Details...

Assessing the Value of Health Information Exchange (2016). Resource Type: Publication. Description: This issue brief provides an overview of the value of health information exchange, including determining ROI, categories of HIE benefits, and sources for additional information. Assessing the value of health information exchange (HIE) is important to health centers to support the case for using HIE and for increasing the use of HIE. HIE value can be financial value (cost savings, increased revenue) and clinical value (improved clinical processes and outcomes such as greater utilization of preventive care and fewer hospital readmissions). The value of HIE may not be the same across health centers, and some benefits may take longer to accrue than others. This document provides information to help health centers evaluate their return on the investment (ROI) in HIE — a measure of the efficiency of an investment. More Details...

HIE Evaluation Checklist: Scoring HIE offerings to assess suitability to your health center. (2016). Resource Type: Publication. Description: This HIE evaluation checklist is a scoring checklist that health centers can use to evaluate HIE offerings on a number of key components ; and was modified for the health center audience with permission from the HIMSS HIE Evaluation Checklist. HITEQ recommends this scoring checklist which health centers can use to evaluate HIE offerings on a number of key components. This has been adapted from an earlier checklist developed by the Healthcare Information and Management Systems Society (HIMSS), with permission. The checklist includes multiple criteria that may be more comprehensive than some providers need, but this scoring tool allows individual criteria to be included or omitted as appropriate during your review. The first tab ("HIE Evaluation Checklist") is a blank document. The second tab ("Checklist Example") shows how one provider might rate a particular HIE offering by including, excluding, and attaching its ratings to each criterion. Download the excel checklist below. More Details...

Health IT and QI Workforce Development: Onboarding for Success: 11/29 HITEQ Highlights Webinar Transcription (2016). Resource Type: Publication. Description: A transcription of the November 29th HITEQ Highlights webinar.  After a brief introduction to HITEQ and this Resource Set, this webinar will highlight two specific tools for onboarding new staff into your health center with a focus on speeding the onboarding of Health IT and QI staff. The webinar will delve into the two onboarding tools - the Calendar and the Sample of a Staff Member’s Dashboard for Required Tasks, showing how they are meant to be used and how you can customize them for your needs. More Details...

What MACRA Means for Health Centers: Payment reform and health center impact (2016). Resource Type: Publication. Description: This HITEQ brief outlines Medicare Access and CHIP Reauthorization Act (MACRA) MACRA, what it signals for payment reform, and when it impacts health centers. Medicare Access and CHIP Reauthorization Act (MACRA) establishes the Quality Payment Program through the Merit Based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs). Although most health centers are not affected by MACRA, they need to understand its components since MACRA reflects national trends to shift payment from volume- to value-based. This resource identifies several strategies health centers can take to respond to these shifting dynamics, even if MACRA requirements do not directly affect them for now. More Details...

Introduction to Value-Based Payment for Health Centers: What is Value-Based Payment and why are Health Centers Considering Payment Reform? (2016). Resource Type: Publication. Description: This HITEQ brief introduces value-based payment and role of health centers as payment models shift. The brief answers key questions about health centers’ engagement in value-based payment, including health-center specific Alternative Payment Methodology (APM), reasons to engage in payment reform, the shifts in primary care payment going forward, and the transition to value-based payment. Value-based payment is a systematic method of paying for care that rewards the cost-effective improvement of the health and well-being of a population.  Payment reform is changing current volume-based payment system to alternative payment models (APMs) that link payment to outcomes and align financial incentives with providing value. By engaging in value-based payment models, health centers can lay the foundation for financial sustainability, high quality care, and engaged staff. This resource outlines value based payment and payment reform specifically tailored to the health center environment. More Details...

Health Center Value Proposition Template: The Value of Health Centers in Assisting their Community to Meet the Triple Aim (2016). Resource Type: Publication. Description: This customizable document uses health center data to support them in demonstrating their value to potential partners and key stakeholders. The document provides evidence for how health centers align with the Triple Aim. Health centers can fill in and customize the value proposition template to demonstrate the value of their primary care services and care model in providing high quality, cost-effective care to those most in need.  The template is structured around the three tenants of the Triple Aim: 1. Improving population health through economic and job growth; addressing social determinants of health; and providing high quality care through a health home model, quality outcomes and implementation of health information technology. 2. Improving patient experience by providing care that is responsive to the needs and realities of the patient population, including patient portals, non-traditional hours and timely appointments. 3. Reducing the per capita cost of health care by engaging in payment reform efforts and providing high-quality care at a low cost. Download the template to create your value proposition below. More Details...

Sample of a Staff Members' Dashboard for Required Tasks: A 2016 HITEQ Resource (2016). Resource Type: Template. Description: This is an example of a staff member dashboard that is used to ensure effective delivery of assigned tasks.  This dashboard can be used in the onboarding and orientation process to ensure understanding of role expectations, and can be tailored for any direct-care staff member. More Details...

Introductory Letter for EHR/ Health IT Vendor: For use in Health Center RFP process (2016). Resource Type: Publication. Description: A template for the introductory letter to EHR vendors participating in the health center RFP process. Use the following letter template (available for download below) to clearly communicate the importance of addressing your status as a health center to the EHR vendors that have been chosen to participate on your EHR procurement process. This letter template references the Health Center Profile in the Addendum; that template can be found here. For further guidance, this resource can help to guide your organization through the process of EHR procurement using a comprehensive tool such as the EHR Planning and Procurement Toolkit from the Massachusetts eHealth Institute (MEHI). More Details...

Getting Started on the Quality Journey: Case Vignettes (2016). Resource Type: Publication. Description: Launching quality work at first can feel like a daunting task – even more so if you do not have the support of leadership in your organization.  Some individuals have successfully launched quality work by following the mantra: “What can I get done by next Tuesday?”  This mantra helps them sidestep inertia, extensive collaboration, and time consuming benchmarking research. Instead, by identifying small steps they can take to improve quality on their own, within the context of their existing job, they can start on the journey quickly. Furthermore, success in these small steps can help with Leadership Buy-In for the importance of Quality work. The vignettes in the attached document are not intended to be literal examples of such efforts, although they rely heavily on real-life experiences.  Nor are they intended to be instructions for specific projects the reader can pursue at their own health center. Rather, these are intended to be aspirational examples of quality work that can be launched by an individual with relatively little support and produce results “by next Tuesday” (or relatively quickly).  The vignettes are written to encompass both health centers with many resources and those with less, to provide a variety of perspectives.  We hope that they inspire associative thinking for the reader, helping to identify specific work that can be accomplished “by next Tuesday.” More Details...

Health Center's guide to the MEHI EHR Planning and Procurement Toolkit (2016). Resource Type: Publication. Description: An introduction to creating an EHR RFP using the MEHI EHR Planning and Procurement Toolkit. This resource shows the user how to use a comprehensive tool such as the EHR Planning and Procurement Toolkit from the Massachusetts eHealth Institute (MEHI) to guide your organization through the process of EHR procurement. The process documented in the EHR Planning and Procurement Toolkit offers a field-tested and proven methodology for a health center that is procuring an EHR. The Toolkit offers a process that will lead an organization through readiness and preparation, vendor solicitation, evaluation and selection, and vendor relationship management. Embedded within the Toolkit at critical steps along the way are the tools needed to execute an effective procurement process.  More Details...

Health Center EHR RFP Addendum (2016). Resource Type: Publication. Description: This is an addendum template to be added to an EHR Request For Proposal (RFP) to help health center further specify the EHR functionalities needed. You may also consider using the available template introductory letter for your RFP as well. For further guidance, this resource can help to guide your organization through the process of EHR procurement using a comprehensive tool such as the EHR Planning and Procurement Toolkit from the Massachusetts eHealth Institute (MEHI). This template is intended to be an addendum to the Request for Proposal (RFP) Template for Health Information Technology. This template can be used to add requirements specifically relating to the specialized requirements and operating environments of health centers. More Details...

Health IT-Enabled Quality Improvement: A Guide to Improvement: 10/4 HITEQ Highlights Webinar Transcription (2016). Resource Type: Publication. Description: A transcription of the October 4th HITEQ Highlights webinar. A transcription of the October 4th HITEQ Highlights webinar.  Improving care delivery is a business and mission imperative for health centers, and the HITEQ Center offers a growing collection of tools and services to support this journey. The foundation for these particular offerings is the "Guide for Improving Care Processes and Outcomes in FQHCs."  This web-based resource provides step-by-step guidance on understanding and improving workflows and information flows that drive performance on key targets such as hypertension control and colorectal cancer screening. Guide centerpieces include worksheets for documenting, analyzing, sharing and improving care processes for such targets. Strategies and tools in the Guide have been used successfully in various quality improvement (QI) initiatives, and a HITEQ Center focus is spreading this value more quickly and widely among health centers. This introductory training session introduces health centers and their partners to the Guide's proven approaches, worksheets and other health IT-enabled QI tool More Details...

Orientation Follow-up Survey (2016). Resource Type: Publication. Description: This follow up survey is given to the employee following the first 2-4 months of employment. This follow up survey is given to the employee following the first 2-4 months of employment. This information is used to inform the supervisor how helpful the orientation was and what, if any, information was missing. It can help improve the new employee orientation for future employees. More Details...

New Employee Orientation Evaluation Form (2016). Resource Type: Publication. Description: This is an evaluation form to give to a new employee immediately following the orientation program. This is an evaluation form to give to a new employee immediately following the orientation program. The feedback generated from its completion will help the supervisor learn what can be done to make the orientation more effective in the future for future employees as well as on what topics the new employee still may need clarification. More Details...

Benefits and Tools for Onboarding and Orientation of New Staff Members: Guidance and Methods for Health Centers (2016). Resource Type: Publication. Description: This document outlines the ways in which effective onboarding and orientation methods will result in shorter learning curves, improved job satisfaction, and improved retention.  This document outlines the ways in which effective onboarding and orientation methods will result in shorter learning curves, improved job satisfaction, and improved retention. It then provides explicit direction for how to organize an effective process, complete with checklists for supervisors to use to plan the process, and surveys for the employee to fill out immediately following the orientation and then again 2-4 months afterwards. More Details...

Encrypting Data at Rest on Servers: Implications for Health Centers (2016). Resource Type: Publication. Description: It is common practice today to encrypt data at rest, that is, data stored on servers. This is especially applicable to health centers who are less frequently actively transporting data across disparate networks. Like many smaller healthcare organizations, Health Centers are particularly vulnerable to potential attack and infiltration by data hackers for several reasons: they tend to have fewer technical support staff, resource limitations make it harder to assess, implement, and maintain safe data practices, and organizational inertia limits preventive action when no threat is perceived.  It is common practice today to encrypt data at rest, that is, data stored on servers. Like many smaller healthcare organizations, Federally Qualified Health Centers FQHC are particularly vulnerable to potential attack and infiltration by data hackers for several reasons: they tend to have fewer technical support staff, resource limitations make it harder to assess, implement, and maintain safe data practices, and organizational inertia limits preventive action when no threat is perceived. To build off an old adage, no one ever got fired for encrypting their data. But what protection does that really provide? Is just encrypting data enough? First, let’s distinguish between three methods for encrypting data at rest. Full-disk encryption. Most modern operating systems like Linux or Windows Server provide the capability to encrypt their disks in their entirety. This is accomplished with symmetric encryption whereby there is a key or passphrase that a computer operator has to enter when the disks are encrypted and when the system boots to allow access to the data. Typically, the password must be manually entered on the physical server console, though some virtualized and cloud-based environments offer remote passphrase entry and varying degrees of passphrase management and automation. With full-disk encryption, software installed on the server does not need to know or do anything special to operate normally: the operating system provides transparent access to the encrypted data as necessary with very little performance loss. But note that the initial encryption needs to be done on a new disk or set of disks as an existing disk will be wiped clean in the process. So it’s easiest to do this during an initial deployment or migration to a new server. File system encryption. Physical disks are typically divided into one or more file systems by the operating system.  As an alternative to full-disk encryption, file system encryption allows administrators to encrypt only selected file systems or even just selected folders within file systems. This makes it possible to configure a server than can boot without a passphrase; and then require a passphase only after the system is up and running and needs to access its encrypted file systems.  Similar to full-disk encryption, the encryption is transparently provided to applications by the operating system.  Unlike full-disk encryption, developers and administrators need to be careful not to store sensitive files on non-encrypted file systems. Database encryption.  Another way to encrypt data at rest is at the database level: The database software Oracle, SQL Server can provide application-level encryption. Like operating system level encryption, a key or passphrase is entered by an operator when the database starts up, after which all database operations access the encrypted data transparently hence the name: Both Oracle and Microsoft SQL Server call the feature “Transparent Data Encryption”. For servers that may store sensitive data in files outside the database, this provides less protection than encrypting the entire file system, but likely protects the most sensitive data on the system. What kind of protection does encrypting data at rest really provide? Here are a few salient points: Benefits of Encrypting Data at Rest First and foremost, encrypting data at rest protects the organization from the physical theft of the file system storage devices which is why end-user mobile devices from laptops to cell phones should always be encrypted. While this might sound unlikely, the physical disk devices are only as secure as the data center where they are located. While data center access control policy is usually quite strict, in practice it can be quite lax. Door entry can employ weak precautions like old push-button unlock devices, and the proliferation of easily-swappable modular disks for quick maintenance makes removing a disk quite easy. Encrypting data at rest can protect the organization from unauthorized access to data when computer hardware is sent for repair or discarded. Encrypting data at rest can help to satisfy information security or regulatory requirements such as the Payment Card Industry Data Security Standard PCI DSS or the Health Insurance Portability and Accountability Act HIPAA. In some deployments, the actual file system where data resides is somewhat disconnected from the server upon which applications are loaded either through the use of a storage area network SAN or cloud-based storage. This introduces the possibility that an intruder could break in to the storage subsystem but not the rest of the system. Encrypting the storage subsystem can protect against such attacks. Limitations of Encrypting Data at Rest Encryption of data at rest provides little protection against intrusions in which a hacker gains remote privileged access to a running server in which the passphrase has already been entered. Even more so, if the applications that access the encrypted files or databases web applications, query systems are not themselves secured, a hacker who penetrates one of these applications gains access to the data, whether it is encrypted or not. For database encryption, note that some database management systems only support data encryption in more advanced read more expensive versions of the software. When full-disk encryption is enabled on a physical non-virtualized server, remember that an operator – a human being – will need to type the passphrase into a console whenever the system starts up. For database-level encryption, the passphrase will need to be entered when the database starts up. While this intervention increases the level of protection, it is at the expense of convenience, as systems cannot reboot automatically without a passphrase or even without someone actually being in the server room which can be especially inconvenient if the system manager is not collocated with the hardware. File system encryption can mitigate some of these startup issues. And, of course, if that passphrase is ever lost your data will be encrypted forever. Special Considerations for Virtualized and Cloud-based Environments As mentioned, some virtualized and cloud-based environments offer remote passphrase entry and varying degrees of passphrase management and automation for full-disk encryption – but be aware that there is often a tradeoff between convenience and security with automated solutions. For example, if a cloud provider keeps your passphrase and automatically provides it to the operating system at boot time, the level of security offered by the full-disk encryption solution is largely dependent on how securely the cloud provider manages the passphrase. While encrypting data at rest can be a useful component in a data security toolbox, it must be implemented with a full understanding of the protection it does and does not provide. Organizations should consult with their vendors, data security staff, system staff, and application staff to determine an appropriate set of actions to secure institutional data. More Details...

How to Effective Manage Social Media within the Health Center Setting: A HITEQ infographic of key principles (2016). Resource Type: Publication. Description: This article written by Dr. John Halamka, CIO at Harvard Medical School and a Health IT adoption thought-leader, provides examples from the Beth Israel Deaconess Medical Center on best practices for healthcare providers in trying to manage social media efforts. This article written by Dr. John Halamka, CIO at Harvard Medical School and a Health IT adoption thought-leader, provides examples from the Beth Israel Deaconess Medical Center BIDMC on best practices for healthcare providers in trying to manage social media efforts. Topics covered include communication strategies, responding to positive and negative comments, and staff awareness. These topics, while garnered from Mr. Halamka's experience with being CIO for BIDMC  are discussed in a way that is relevant to all health care settings, including health centers. Included in this article are straightforward policies or concepts that are easily adopted into an organization's social media policies no matter what their size. Click on the link below to gain access to the related article... More Details...

Using the Systems Usability Scale to Assess Patient Portal Systems: English and Spanish Templates (2016). Resource Type: Publication. Description: When deploying personal health information systems such as patient portals Health Centers will often encounter challenges in effectively engaging their patient population. Understanding where these challenges are originating can at times be difficult to determine. One obvious area of evaluation is in determining whether the system being deployed is appropriately usable for the population. When deploying personal health information systems such as patient portals Health Centers will often encounter challenges in effectively engaging their patient population. Understanding where these challenges are originating can at times be difficult to determine. One obvious area of evaluation is in determining whether the system being deployed is appropriately usable for the population. Patient perception of the overall usability of the patient portal system can be evaluated through use of survey instruments such as the Systems Usability Scale (SUS). SUS is a well-established and validated usability scale that helps to determine the value, ease and interest of users of a particular system. Located in the Downloads section below are English and Spanish SUS survey instruments. Also located below is a link to further information on leveraging the SUS measures.  More Details...

Guide to Improving Care Processes and Outcomes in Health Centers: An approach to quality improvement (2016). Resource Type: Publication. Description: The quality improvement QI approach outlined in this Guide can be used to augment current QI approaches used in your health center, or can serve as a placeholder QI methodology when there isn’t already a robust QI process in place. It provides a framework and tools for documenting, analyzing, sharing and improving key workflows and information flows that drive performance on high-stakes care performance measures, and related improvement imperatives. This webpage provides strategies and tools that health centers and their partners can use to enhance care processes and outcomes targeted for improvement, such as hypertension and diabetes control, preventive care, and many others.   This webpage provides strategies and tools that health centers and their partners can use to enhance care processes and outcomes targeted for improvement, such as hypertension and diabetes control, preventive care, and many others. For authorship and acknowledgement for this Guide, see the bottom of this guide. The quality improvement QI approach outlined in this Guide can be used to augment current QI approaches used in your health center, or can serve as a placeholder QI methodology when there isn’t already a robust QI process in place. The approach provides a framework and tools for documenting, analyzing, sharing and improving key workflows and information flows that drive performance on high-stakes care performance measures, and related improvement imperatives.  The diagram to the left illustrates the data-driven, health IT-enabled continuous quality improvement approach that this Guide supports.  For an overview of the information contained herein access this recorded webinar and companion materials including transcript and slides for reference.     Background to Guide Guide Context and Approach This section includes guidance on leveraging Health IT to improve quality and clinical performance including data validation tools, Clinical Decision Support Quality Improvement worksheets, and change packages for recommended approaches related to various quality of care measures. Read More...   The diagram below illustrates the Guide’s focus on helping health centers adapt to the intensifying performance improvement imperatives they face pyramid tip. The Guide does this by providing strategies and tools to help analyze and improve critical workflows and information flows layers beneath the pyramid tip. For an introduction to the Guide that was presented as part of a webinar, see here the pertinent discussion is between these times/markers on the recording: 43:46-58:44     Audience The strategies and tools in this Guide are designed for quality, clinical and other health center staff, and health center partners that support quality improvement efforts. Read More... Everyone in a health center has a stake in successful quality improvement, and many different staff roles might be the first to encounter this Guide. For initial review, roles including QI/clinical/data/operations team members or leads are likely most appropriate. To drive substantial improvements, these tools and strategies should then be shared and used more widely with pertinent health center team members responsible for the organization’s clinical, operational and other activities key to successful QI. A QI team is typically the driving force behind the cross-stakeholder work outlined in this Guide. For more on building QI teams, see here.   Various organizations that support or depend on information from QI efforts within health centers can also become better QI partners by understanding and applying the strategies and tools in this Guide. These partners include:   Support organizations such as HCCNs, PCAs, payers and others   Organizations that supply health centers with technology that play a critical QI role, such as EHR and population health software vendors    Why Using this Guide is Important for Health Centers Quality improvement has traditionally been a core health center activity as health centers try to continually maximize value and efficiency. Dramatic healthcare payment reforms, increasingly tying payment to QI efforts and results, make effective QI a business imperative for all provider organizations. Wherever your organization is on the QI journey – from beginning through highly sophisticated – this Guide uses tools such as the CDS/QI Worksheets -- see under 'Document/ Analyze Flows; Identify Improvements' and strategies such as the CDS 5 Rights Framework that can enhance your QI efforts and results. Read More... Payment reforms seek to transform healthcare to achieve 3 key goals often referred to as the ‘Triple Aim’ or ‘Three-part Aim’:   Better care for individuals   Better health for populations   Lower cost   Key stakeholders assert that to achieve these goals, it’s important to also improve work life for clinicians and staff. Adding this dimension to the 3 goals above is referred to as the ‘Quadruple Aim.’ This shift to value-based payment is driven by both the public and private sector, and directly affects FQHC financial health. For example, the Merit-based Incentive Payment System is transforming Medicare by tying provider payments to performance on quality measures, clinical performance improvement activities, costs, and use of health IT. Medicaid and private payers are also driving transformation through increasing use of value and/or risk-based contracts that require successful QI.   Many health centers already use robust QI approaches such as those outlined in this quality improvement primer as part of UDS measure reporting and improvement efforts. Many likewise leverage powerful health IT capabilities such as population health management tools including disease/condition registries; EHR tools to enhance ordering, documentation and data review; and SMS texting with patients in this QI work. The drivers noted above, however, require increasingly sophisticated and effective approaches to health IT-enabled Quality Improvement health IT/QI. Other closely related terms include eCQI used by ONC and CMS and CDS-enabled QI CDS/QI, so those are terms referenced in some materials in this Guide as well.   The framework, strategies, and tools in this Guide can help your organization enhance its health IT/QI approach and results. In addition to the benefits this delivers in addressing payment drivers noted above, it can also improve staff satisfaction by streamlining care workflows, improve health center business strength by avoiding duplicated efforts and decreasing costs, and improve patient satisfaction by meeting their care needs more efficiently and effectively. How to Use this Guide The next main section of this resource, Health IT-Enabled QI Guide Details provides a step-by-step approach and tools for analyzing and enhancing care processes targeted for outcome improvement. The steps are outlined in the pathway under the first heading in that section, Approach to health IT-enabled QI. Read More... The Essential CDS/QI Worksheet is a core resource for analyzing and improving target-focused care. A preliminary workflow analysis and enhancement brainstorming exercise can be accomplished in as little as an hour by one or more health center staff reviewing the tutorial and using this worksheet. More comprehensive QI projects addressing all the steps in the pathway typically take up to a year or longer. In any case, the QI work should be a collaborative process involving all stakeholders within the health center, and ideally key partners as well such as the HCCN or PCA working with the health center, and their EHR and population health software vendors. Scanning these evidence-based strategies and tools will give health centers and their partners a sense for whether/how they can augment your current QI work. Users can then apply these approaches and resources with their team to the depth that would be most valuable and feasible given available time and resources. For a “quick win” exercise to identify potential high-yield, target-focused care process improvement opportunities, see this presentation Health IT Enabled QI: A Guide to Improvement. For additional ideas on introductory QI exercises, see the brief slide set, Five Minutes of Quality Improvement: Tackling Small QI Tasks. Contact the HITEQ Center for support on implementing the QI approach in this Guide.   Strategies and tools from this Guide in action:   CDS Learning Session ‘Quick Win’ Exercise: Sixteen community health centers in New Orleans conducted a valuable ‘Quick Win’ exercise using an earlier version of the Essential CDS/QI worksheet see here for further details about this exercise and results. In this activity, small teams from each health center e.g., a clinician and administrator were given a 20-minute overview of several key health IT/QI concepts and tools outlined in this Guide the broad CDS definition, CDS 5 Rights framework, and an earlier version of the CDS/QI Worksheet, each of which is explained later in this guide.   Immediately following, for just 20 minutes, each team independently used an enlarged version of the Essential CDS/QI Worksheet on a flip chart to document key workflows and information flows for their improvement target e.g., lipid or diabetes control. During this time, they also brainstormed refinements to one or more of the CDS 5 Rights “who, what, when, where, how” dimensions.   During the report-out following this brainstorming, health centers noted excitement about trying these enhancements to improve care processes and outcomes related to their target.   Using the Guide for Yearlong, Target Focused QI: Other QI projects have used the strategies and tools outlined in this Guide in yearlong, target focused QI efforts and have realized benefits for quality improvement and care processes, and increasingly in outcomes. In many cases these efforts involved collaboration with HCCNs and/or HIE/EHR/population management software vendors. These initiatives include:   A network of health centers in CA working on blood pressure control. The lead health center in this project, Petaluma Health Center, is a 2015 Million Hearts Hypertension Control Champion. View project report slides.   Improving blood pressure and diabetes in control in Trenton, NJ that included a health center among the participants. View project report slides .   Health centers in several states working on hypertension diagnosis and management several of which are achieving aggressive blood pressure improvement targets. Link to project overview.   Health IT-Enabled QI Guide Details Approach to Health IT-enabled QI The outline depicted in the figure below provides a step-by-step approach to analyzing and enhancing care processes targeted for outcome improvement. The sections below provide guidance and tools on addressing each of these steps. Read More...   Check/ Reinforce Foundations Successful health IT/QI efforts require a firm foundation of people, process, and technology elements. Read More... Cultivate a shared commitment within your team to improving care delivery and results, including fully leveraging health IT capabilities. Successful QI efforts deliver a ‘win-win-win’ for patients and their care teams, as well as broader organizational goals. This infographic and report examines characteristics of health centers that have achieved high clinical, financial and operational performance.     Ensure that key foundations for successful QI efforts are in place. For example, leadership and team support; stable well-utilized health IT systems such as EHR, population management software; bandwidth and capacity for the QI work; and shared understanding about QI goals and processes.  For some specific resources around ensuring key foundations, see here for Motivating Factors for Engaging in Health IT-enabled QI, and Engaging the Data Creators.  Also, see here for A Buyer’s Guide to Business Intelligence Tools.  Here is a tool to assess analytics capability in health centers, that also provides insights into the nuance of working with data and building a data-driven culture. A brief video introduction to using this tool is here.   Ensure access to and validate data that will underpin the QI efforts. For example, ensure that EHR and/or population management software can deliver needed data and reports, and produce the same values for targeted performance measures and related data as manual review/calculation. See here for questions to consider to help determine if you are fully utilizing your EHR capabilities for population management, and if additional tools are needed. This checklist can help with data validation and interpretation a webinar that includes an introduction to this checklist is here, and the pertinent discussion is between these times/markers on the recording: 8:15- 43:45. See here for a basic auditing tool Excel Template for data reports, and a case study on data validation.   Identify and address barriers to collaboration on effective process improvement such as stakeholder conflicts or conflicting goals among all concerned, including providers, care delivery and quality staff, partners e.g., health IT vendors, and patients.   Layer the approach and tools outlined below onto your general QI methodology, as well as any current target-focused QI activities. If no QI framework is in place, consider using the approach outlined in this Guide as a starting point, and build that out further through options such as those provided in the primer, Continuous Quality Improvement CQI Strategies to Optimize your Practice. Understand Health IT-enabled QI Everyone participating in the QI work should have a shared understanding of key definitions e.g., CDS, frameworks e.g., CDS 5 Rights, strategies e.g., the QI process outlined under the Implement and Evaluate Changes heading., tools e.g., Essential CDS/QI Worksheet, and key QI project success factors.   Read More... ‘Clinical Decision Support’ CDS is a key underpinning for the QI approach outlined in this Guide, but its meaning here might be different than what you have in mind especially if ‘alert’ figures prominently in your definition. In this Guide, CDS is defined as a process for improving health-related decisions and actions with pertinent knowledge and patient information to enhance health and care delivery. Under this definition, CDS is about supporting care decisions and actions, ideally in a manner that makes the appropriate decisions and actions the easy ones to execute. That is, facilitating workflow not interrupting it – as alerts often do. There are many different ways to provide this support e.g., CDS intervention types. See the CMS CDS tipsheet page for more details, including example CDS intervention types e.g., order sets, focused patient data summaries, documentation templates.   The CDS 5 Rights framework is a best practice QI approach recommended by CMS in the tipsheet above to support decisions and actions that drive performance targeted for improvement. It asserts that optimizing care processes and outcomes requires getting the right information to the right people in the right formats through the right channels at the right times see figure below. The tools and approaches outlined in this Guide help organizations implement this framework and enhance the contributions, experience and results for those involved in care delivery.   The Essential CDS/QI Worksheet see excerpt images below is a core health IT/ QI tool best used for initial efforts to map care processes and reveal potential enhancements. That is, to document and analyze target-focused information flows and workflows, and to brainstorm improvement opportunities see figure with excerpts from this worksheet below. The tutorial that follows provides guidance and examples on how the worksheet can be used. to streamline and enhance care processes. The Enhanced CDS/QI Worksheet,  pointed to below under the bullet titled 'For a deeper dive into health IT/ QI Foundations', is a more robust but more complicated tool for those already skilled in using the Essential CDS/QI Worksheet View the Tutorial on how to use the Essential CDS/QI Worksheet   See a completed Outpatient Essential CDS/QI Worksheet Example that uses this tool to illustrate the workflows and information flows that produced very high levels of blood pressure control in a small practice: Ellsworth Hypertension QI Case Study Note: this example used an earlier version of the Essential CDS/QI Worksheet that did not contain the ‘Foundational Activities’ section. This case study was originally developed for ONC and is also posted on here on healthit.gov. Attend to key QI project success factors:   Focus on People, Process, and Technology in that order, recognizing that engaging everyone involved is critical for success.     Focus on ‘the most important things’ when selecting improvement targets, opportunities to enhance care processes for the target, and activities to ensure successful implementation of those process changes.     QI activities involve a chain of stakeholders including health center QI leads, clinicians and staff, and ultimately patients. As the QI project unfolds and each of these groups is touched by the effort, seek to escalate engagement, insights, and momentum toward goals. For a deeper dive into health IT/QI foundations, consider these resources:   Tasks and Key Lessons from each chapter in “Improving Outcomes with Clinical Decision Support, and Implementer’s Guide, 2nd Edition.” These bulleted lists provide detailed guidance on successful CDS-enabled QI programs and interventions.   Enhanced CDS/QI Worksheet: Similar in concept to Essential version, but with additional space to document/review optimal care activities for the target, and the individual CDS 5 Rights dimensions for the current state. Consider using only after you are comfortable with the Essential CDS/QI Worksheet version Note: this example used an earlier version of the Enhanced CDS/QI Worksheet that did not contain the 'Foundational Activities' section.   View the Tutorial on how to use this Enhanced Worksheet [download the PDF and run locally for best results].   See a completed Outpatient Example: CHC Inc. hypertension QI case study   White papers and guides on HIT-CDS/QI:   Qualis Health: Integrating Clinical Decision Support Tools into Ambulatory Care Workflows for Improved Outcomes and Patient Safety   AHRQ: Using Health Information Technology to Support Quality Improvement in Primary Care   ONC: How-To Guides for Clinical Decision Support CDS Implementation Select Targets; Initiate QI Project   Successful QI efforts typically require significant time, energy and resources, so it is important to choose targets where the return will warrant the investment. This requires a clear and accurate understanding of baseline performance on the target.   Read More... Consider targets associated with business imperatives, such as UDS reporting especially for conditions where the health center is under-performing, and value-based payment initiatives from the private sector and CMS e.g., the Quality Payment Program which is radically overhauling Medicare payments to clinicians, and related value/risk-based payment models for Medicaid. Seek QI synergies with pertinent health center initiatives such as PCMH recognition and HRSA Health Center Quality Improvement Grant Awards.   Examine local performance gaps and improvement opportunities when reviewing payment drivers noted above and selecting targets. See the figure below from the HIMSS guidebook on improving outcomes for examples of local factors to consider in selecting targets for quality improvement intervention. Image Reference: Osheroff JA, Teich JM, Levick D, et. al. Improving Outcomes with Clinical Decision Support: An Implementer’s Guide, 2nd ed. Chicago: HIMSS. 2012.   Measure and understand your baseline performance on your targets. The CMS/ONC eCQI Resource Center has information about quality measure specifications for providers. The Checklist for Analyzing Performance Measure Data has detailed information about validating and interpreting these data. Document/Analyze Flows; Identify Improvements   A helpful QI adage is that “systems are perfectly designed to produce the results they deliver.” This truism highlights the importance of understanding current care processes that are driving sub-optimal performance on the targeted measure e.g., diabetes control, preventive care, use of expensive tests so they can be refined to deliver better results. The CDS/QI worksheet supports this analysis through a structured, broadly applicable framework for documenting, analyzing, sharing and improving target-focused care activities. Read More... Use the CDS/QI worksheet to help examine patient-specific and population management information flows and workflows, as well as foundational activities such as EHR configuration, policies, staff training, etc., that are producing sub-optimal performance on the target. For example, if the QI target is hypertension control, consider the current status of staff competency and training on measuring blood pressure appropriately foundational activities; registry use to identify and recall patients with poorly controlled blood pressure population management activities; and optimizing pre-visit huddles, order set use, and patient engagement/care plan adherence tools patient-specific supports.   Walk through the care process with special attention to the patient experience and document results in the Essential CDS/QI Worksheet.   Engage all care team members in the workflow/information flow and improvement analysis– including the patient, if possible.   If you are comfortable with the Essential CDS/QI Worksheet, consider using the Enhanced CDS/QI Worksheet instead of, or in addition to, the Essential Worksheet for a deeper dive into the ‘optimal state’ and the details of each CDS 5 Rights dimension.   Analyze this current state “what is?” to identify opportunities to improve target-focused information flow, workflow and results; i.e., to better address the CDS 5 Rights for the target. Document these potential enhancements in the CDS/QI Worksheet. Review the tutorial for the worksheet you are using i.e., essential vs. enhanced for guidance. For example, consider enhancements such as:   documentation templates, and related workflows for completing them, that make it easier to identify patient barriers to adherence with the care plan foundational activity;   text messages and/or personal calls to patients to decrease no-show rates patient-specific support, and   performance dashboards and related conversations to share target measure results with teams and clinicians as a springboard for brainstorming strategies to accelerate improvement population management activities.   Review evidence-based best care practices for the target “what should be”   Consider available best practice ‘change packages’ for the target:   For hypertension management, the CDC Hypertension Control Change Package presents change concepts, change ideas, and proven tools that outline ‘what should be’ best practices in categories that correspond to the categories on the CDS/QI Worksheets i.e., Foundation Activities, Population Management, and Patient-specific Supports and its subcomponents.   For detecting hypertension that may be ‘Hiding in Plain Sight’ in health centers and diagnosing hypertension so it can be managed appropriately to reduce heart attacks and strokes, see this similarly-structured “HIPS” change package.   For improving colorectal cancer screen rates as called for in the national "80% by 2018" campaign, see this similarly-structured change package   Examine other case examples and best practices for successful target-focused care strategies e.g., QI case studies published by ONC, and other resources:   Case examples on hypertension control:   Ellsworth Medical Clinic hypertension QI case study: narrative discussion and details presented in an earlier version of the Essential CDS/ QI Worksheet.   CHC, Inc.2 hypertension QI case study: narrative discussion and details presented in an earlier version of the Enhanced CDS/QI Worksheet. This study was originally developed for ONC and is also posted here on healthit.gov.   EHR Innovations for HTN Challenge results   Colorectal cancer screening recommendations for community health centers from the Oregon Primary Care Association and the National Colorectal Cancer Screening Roundtable    Case example on tobacco use screening and smoking cessation support at Miramont Family Medicine. This case study was originally developed for ONC and is also posted here on healthit.gov   Define potential workflow and information flow enhancements for the target “what could be here?” by combining ‘top down’ approaches i.e., starting from ‘what should be?’ best practices and ‘bottom up’ approaches i.e., improvement opportunities that emerge from the “what is?” analysis with stakeholders.   Prioritize identified enhancements to implement: Identify several enhancements that are most likely to deliver the greatest benefit in the shortest time with the least effort for initial implementation that is, use the “low hanging fruit” approach – see prioritization tools such as this Prioritization Matrix. Give special attention to changes that could yield strong benefits across multiple targets, or that appear especially promising for strengthening critical workflows and information flows e.g., related to patient engagement, registry use to identify and close care gaps, pre-visit planning, and efficiently executing evidence-based care plans. Implement & Evaluate Changes Implementing enhanced care processes requires that people e.g., health center clinicians, other staff, and patients do things differently. Formal change management approaches can help ensure that these changes are successful and that they produce desired results.   Read More... Use a QI methodology e.g., PDSA cycles to engage frontline staff and other key stakeholders in care processes and results to design, implement and evaluate the prioritized changes. Be sure to do this work with all the stakeholders and not to them i.e., seek and act on team members’ and patients’ input and feedback throughout the process. Be ready to modify patient care and quality improvement activities, CDS intervention details across any of the CDS 5 Rights dimensions, and other parameters if needed as improvement cycles unfold. Monitor implementation activities with structured tools that help you document and manage who’s doing what when, as well as the results. Sample monitoring tools:   Worksheets from Chapter 8: Putting Interventions into Action and Chapter 9: Measuring Results and Continuously Refining the Program in “Improving Outcomes with Clinical Decision Support: An Implementer’s Guide. Second Edition” provided with permission from HIMSS   IHI PDSA Worksheet: http://www.ihi.org/resources/Pages/Tools/PlanDoStudyActWorksheet.aspx   Validate and analyze performance measure data to make sure that the results are accurate, and that the team understands what they mean and what to do about them. This checklist can support this process. Harvest/Spread Results Ongoing attention to performance on key targets beyond ‘focused QI projects’ is generally warranted e.g. because performance may backslide for various reasons. In addition, there is a growing list of targets on which improvement is imperative. It is therefore important to ‘harvest’ learning, strategies and tools from each project that can be applied in an ongoing way to the target, and spread to other targets. The CDS/QI Worksheet’s structure can facilitate such cross fertilization amon