75% Practice identifies 2 items 50% Practice identifies 1 X 25% No scoring option 0% Practice identifies 0 items Examples/Notes: ( ) ( ) are usually reports available for all counties in NC – ( ) ( ) ( ) 3 Points Element 2F: Use of System for Population Management The practice uses electronic information to generate lists of patients and take action to remind patients or clinicians proactively of services needed, as follows: What is our current status? Process Tools/ Resources needed Due Date What needs to happen? Owner Patients needing pre-visit Flowsheets, templates or screen EMR/RMD Flowsheet & CarePlan screen planning (obtaining tests prior to Yes No visit, etc.) Patients needing clinician review Flowsheets, templates or screen shots EMR/RMD Flowsheet & CarePlan screen or action Yes No Patients on a particular Flowsheets, templates or screen shots medication Yes No Patients needing reminders for Flowsheets, templates or screen shots EMR/RMD Flowsheet & CarePlan screen preventive care Yes No Patients needing reminders for Flowsheets, templates or screen shots RMD Patient handout specific tests Yes No Patients needing reminders for Flowsheets, templates or screen shots Screen shot of reminder email to patients/ follow-up visits such as for a chronic Yes No copy of letters to patients condition Patients who might benefit from Flowsheets, templates or screen shots care management support. Yes No
75% Practice identifies 2 items 50% Practice identifies 1 X 25% No scoring option 0% Practice identifies 0 items Examples/Notes: ( ) ( ) – are usually reports available for all counties in NC ( ) ( ) ( ) Element 2F: Use of System for Population Management 3 Points The practice uses electronic information to generate lists of patients and take action to remind patients or clinicians proactively of services needed, as follows: What is our current status? What needs to happen? Tools/ Resources needed Process Owner Due Date Patients needing pre-visit planning (obtaining tests prior to visit, etc.) Flowsheets, templates or screen Yes No EMR/RMD Flowsheet & CarePlan screen Patients needing clinician review or action Flowsheets, templates or screen shots Yes No EMR/RMD Flowsheet & CarePlan screen Patients on a particular medication Flowsheets, templates or screen shots Yes No Patients needing reminders for preventive care Flowsheets, templates or screen shots Yes No EMR/RMD Flowsheet & CarePlan screen Patients needing reminders for specific tests Flowsheets, templates or screen shots Yes No RMD Patient handout Patients needing reminders for follow-up visits such as for a chronic condition Flowsheets, templates or screen shots Yes No Screen shot of reminder email to patients/ copy of letters to patients Patients who might benefit from care management support. Flowsheets, templates or screen shots Yes No
ccnc_2008_ppc_pcmh_workbook.docx