HIT systems incorporate the five Yes Title V 0 None specific health policy priorities 1 Weak (IF YES) How effective are those State Medicaid of the Centers for Medicare and policies and procedures? CHIP 2 Moderate Medicaid Services: improving 1 Not effective Health Plan/Insurer 3 Strong quality, safety, and efficiency; 2 Somewhat effective Provider (please specify) improving patient access to 3 Very effective Family/Consumer care; improving care Other (please specify) coordination; improving public health; and ensuring privacy and OPTIONAL: security protections for personal Why? health insurance. No for score, above ) (Select “0” Not applicable to my organization Enter Score: Enter Score: To promote care coordination Yes Title V 0 None across providers and systems (IF YES) How effective are those State Medicaid 1 Weak serving children, electronic policies and procedures? CHIP 2 Moderate health information should be 1 Not effective Health Plan/Insurer 3 Strong accessible, retrievable, and 2 Somewhat effective Provider (please specify) available, and use a documented 3 Very effective Family/Consumer process for exchanging health Other (please specify) information across care settings that includes an agreement OPTIONAL: about exchanging information, Why? the types of information to be No for score, above) (Select “0” exchanged, time frames for Not applicable to my organization exchanging information, and how the health plan facilitates referrals. Enter Score: Enter Score:
HIT systems incorporate the five specific health policy priorities of the Centers for Medicare and Medicaid Services: improving quality, safety, and efficiency; improving patient access to care; improving care coordination; improving public health; and ensuring privacy and security protections for personal health insurance. Yes (IF YES) How effective are those policies and procedures? 1 Not effective 2 Somewhat effective 3 Very effective No (Select “0” for score, above ) Not applicable to my organization Enter Score: Title V State Medicaid CHIP Health Plan/Insurer Provider (please specify) Family/Consumer Other (please specify) 0 None 1 Weak 2 Moderate 3 Strong OPTIONAL: Why? Enter Score: To promote care coordination across providers and systems serving children, electronic health information should be accessible, retrievable, and available, and use a documented process for exchanging health information across care settings that includes an agreement about exchanging information, the types of information to be exchanged, time frames for exchanging information, and how the health plan facilitates referrals. Yes (IF YES) How effective are those policies and procedures? 1 Not effective 2 Somewhat effective 3 Very effective No (Select “0” for score, above) Not applicable to my organization Enter Score: Title V State Medicaid CHIP Health Plan/Insurer Provider (please specify) Family/Consumer Other (please specify) 0 None 1 Weak 2 Moderate 3 Strong OPTIONAL: Why? Enter Score:
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