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The Quadruple Aim
Quadruple Aim

A Conceptual Framework

Improving the U.S. health care system requires four aims: improving the experience of care, improving the health of populations, reducing per capita costs and improving care team well-being. HITEQ Center resources seek to provide content and direction aligned with the goals of the Quadruple Aim

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Resource Overview

  • Rationale
  • Challenges
  • Approach

Mobile health (mHealth) tools have the potential to play a pivotal role in fostering a sense of greater patient engagement within underserved populations. By facilitating patient use of mHealth applications in collaboration with electronic health record (EHR) and personal health record (PHR) systems there is an opportunity to empower individuals to take a more active role toward managing their health conditions.

The proliferation of consumer mobile health applications and devices is creating new opprotunities for engaging patients in their care and leaves little doubt as to the impact that these tools will have on the way that people manage their health, health information, and health communications with their care providers, family and friends. This shift to increased self-management of health by consumers will change a patient’s relationship with their doctor and the way healthcare is practiced.
The current laws and standards in place to ensure patient’s privacy and health information security will need further review to determine whether mobile health technologies create unique situations that are not yet addressed. This poses many challenges for health centers as to how best to support patient use of these tools and ways in which to incorporate them into their own clincial support systems.

Mobile health characterizes a shift in the point of care for the patient. The point of care has classically been located at the hospital or clinic. Mobile health is beginning to shift this model so that the point of care is more frequently a matter of where the person happens to be located at that time, consequently providing opportunities for more timely care. It is also important to note that these tools help to increase the accessibility of Healthcare to populations where direct access to Healthcare professionals is limited and so health management is more frequently left in the hands of the consumer.

The tools provide in this resource cover a range of different mobile health tools, strategies, and guidelines for consideration as Health Centers seek to leverage these technologies to better engage and activate their patients.

Mobile Health Resources

Sample Information Blocking policies, procedures, and templates

Tools for Health Centers to Comply with Rules Prohibiting Information Blocking

Steps in using sample information blocking policies, procedures, and templates from HITEQ:

(available for download at the bottom of this page)

 

  1. Conduct Initial Information Blocking Risk Assessment (Appendix A) as part of the organizational record, and update annually thereafter.
  2. For any organizational practices that appear on the list of suspected practices for Information Blocking (Appendix A, Section VI)
    1. Record the exact practice and current workflow, and assess whether any of the 21st Century Cures Act ONC exceptions apply using Appendix D: Information Blocking Exceptions and other references. 
    2. For any practices that are reviewed where no exceptions apply, cannot be modified, and is/are necessary, document that the organization does not intend for the practice to result in information blocking.
  3. Develop/review policy/ procedure for reviewing/fulfilling requests for information.
    1. Ensure that process is non-discriminatory and expedient.
    2. Ensure that electronic and physical information requests are consistent in terms of consent, privacy, and legal requirements.
  4. Develop a process for documenting exceptions to requests
    1. Ensure that process aligns with the eight possible exceptions, noting that five allow for not fulfilling the request while the other three refer to procedures for fulfilling requests.
    2. Use other HITEQ information blocking process resources, including Appendix D: information blocking exceptions
  5. Implement documentation for exceptions on a case-by-case basis
  6. Develop a process for responding to requests, either where information will be shared and access maintained or where the request will not be fulfilled, and the reason needs to be communicated. 
  7. Review and adopt information blocking complaint procedures (Appendix E)
    1. Use Appendix G as a template for investigation workflow.
    2. Use Appendix H to document the investigation.
  8. Document complaints, incidents, and related responses and/ or actions
    1. Use Appendix F - Incidence Response Log to document this.

Download all of these documents below.

Disclaimer: Information blocking forms become part of the record and can be reviewed by OIG during an investigation. The HITEQ Center and related entities are not liable for any direct or indirect consequences resulting from information given herein and advises legal counsel review of these and all forms prior to use.

The HITEQ Center project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of awards totaling $779,625 with 0% financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.

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Acknowledgements

This resource collection was cultivated and developed by the HITEQ team with valuable suggestions and contributions from HITEQ Project collaborators.

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