Appendix E: Other Data Elements Instructions continuing medical education, in addition to clinical services.) Health centers are becoming increasingly diverse and comprehensive in the care and services Yes provided. These questions capture the changing 2a1. Who did you use telehealth to landscape of healthcare centers to include communicate with? (Select all that apply) expanded services and delivery systems. Patients at remote locations from Questions your organization (e.g., home Report on these data elements as part of your telehealth, satellite locations) UDS submission. Topics include Specialists outside your organization treatment (MAT), telehealth, and (e.g., specialists at referral centers) outreach and enrollment assistance. Respond to each question based on your health center status 2a2. What telehealth technologies did you as of December 31. use? (Select all that apply) Real-time telehealth (e.g., Medication-Assisted Treatment (MAT) for conference) Opioid Use Disorder Store-and-forward telehealth (e.g., How many physicians, certified nurse secure email with photos or videos of practitioners and physician assistants, patient examinations) or with whom the health center has contracts, have obtained a Drug Addiction Remote patient monitoring Treatment Act of 2000 (DATA) waiver to Mobile Health (mHealth) treat opioid use disorder with medications specifically approved by the 2a3. What primary telehealth services were U.S. Food and Drug Administration (FDA) used at your organization? (Select all that for that indication? apply) How many patients received Primary care treatment for opioid use disorder Oral health from a physician, certified nurse Behavioral health: Mental health practitioner, or physician assistant, with a DATA waiver working on behalf of the Behavioral health: Substance use health center? disorder Did your organization use telehealth in order Dermatology to provide remote clinical care services? Chronic conditions (The term includes “telehealth” Disaster management services, but encompasses a “telemedicine” broader scope of remote healthcare services. Consumer and professional health Telemedicine is specific to remote clinical education services whereas telehealth may include (Please specify: remote non-clinical services, such as provider ________________) training, administrative meetings, and
Appendix E: Other Data Elements Instructions Health centers are becoming increasingly diverse and comprehensive in the care and services provided. These questions capture the changing landscape of healthcare centers to include expanded services and delivery systems. Questions Report on these data elements as part of your UDS submission. Topics include treatment (MAT), telehealth, and outreach and enrollment assistance. Respond to each question based on your health center status as of December 31. Medication-Assisted Treatment (MAT) for Opioid Use Disorder How many physicians, certified nurse practitioners and physician assistants, or with whom the health center has contracts, have obtained a Drug Addiction Treatment Act of 2000 (DATA) waiver to treat opioid use disorder with medications specifically approved by the U.S. Food and Drug Administration (FDA) for that indication? How many patients received treatment for opioid use disorder from a physician, certified nurse practitioner, or physician assistant, with a DATA waiver working on behalf of the health center? Did your organization use telehealth in order to provide remote clinical care services? (The term “telehealth” includes “telemedicine” services, but encompasses a broader scope of remote healthcare services. Telemedicine is specific to remote clinical services whereas telehealth may include remote non-clinical services, such as provider training, administrative meetings, and continuing medical education, in addition to clinical services.) Yes 2a1. Who did you use telehealth to communicate with? (Select all that apply) Patients at remote locations from your organization (e.g., home telehealth, satellite locations) Specialists outside your organization (e.g., specialists at referral centers) 2a2. What telehealth technologies did you use? (Select all that apply) Real-time telehealth (e.g., conference) Store-and-forward telehealth (e.g., secure email with photos or videos of patient examinations) Remote patient monitoring Mobile Health (mHealth) 2a3. What primary telehealth services were used at your organization? (Select all that apply) Primary care Oral health Behavioral health: Mental health Behavioral health: Substance use disorder Dermatology Chronic conditions Disaster management Consumer and professional health education (Please specify: ________________)
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