1. U.S. Department of Health and Human Services
Health Resources and Services Administration
HRSA Health Information Technology
and Quality Webinar
“Tips for Generating and Utilizing Quality Data
Reports Using Health IT”
Date: 7/22/2011
US Department of Health and Human Services
Health Resources and Services Administration

2. Office of Health Information Technology and
Quality
Additional HRSA Health IT and Quality Toolboxes and
Resources including past webinars can be found at:
http://www.hrsa.gov/healthit
http://www.hrsa.gov/quality
Additional questions can sent to the following e-mail address:
HealthIT@hrsa.gov
• US Department of Health and Human Services
• Health Resources and Services Administration

3. Upcoming HRSA Health IT and Quality
Announcements
• New Items to the HRSA Health IT Site:
• CMS Frequently Asked Questions Document on Meaningful Use for CAHs
• HRSA Health IT Adoption Toolbox for HIV/AIDS Providers
• Next HRSA HIT and Quality webinar, "Privacy and Security – What Questions Should
You Ask Your Vendor“ Friday August 19th 2pm EST
• Last month’s webinar “Tips for the Safety Net Community on Using Health IT within a
Patient Centered Medical Home” Now available online
• HRSA “Call for Papers: Evidence for Informing the Next Generation of Quality
Improvement Initiatives: Models, Methods, Measures and Outcomes” for Journal
of Health Care for the Poor and Underserved.
Due September 1st. Questions? Please contact OHITQPapers@hrsa.gov

4. Introduction
Presenters:
• Margaret Flinter-Community Health Center Inc.
• Dr. Kwame Kitson-Institute for Family Health
• Bob Demarco-Springfield Medical Care
Systems Inc.

5. Using Data to Drive Quality
Daren Anderson, MD - VP/Chief Quality Officer
Nwando Olayiwola, MD, MPH - Chief Medical Officer
Margaret Flinter, APRN, PhD - Senior VP/Clinical Director
Community Health Center, Inc.
July 22, 2011
1

6. Community Health Center, Inc.
Our Vision: Since 1972, Community Health Center, Inc. has been building a
world-class primary health care system committed to caring for underserved and
uninsured populations and focused on improving health outcomes, as well as
building healthy communities.
CHC Inc. Profile:
• Founding Year - 1972
• No. of health centers – 12
• No. of Service Locations - 173
• SBHC locations – 23
• Organization Size - 450
Innovations
• Integrated primary care disciplines
• eConsults with specialists Three Foundational Pillars
• Fully integrated EHR
• Patient portal and HIE Clinical Excellence
• Automated clinical dashboards Research & Development
• Nation’s first Nurse Practitioner Training the Next Generation
residency training program

7. CHC Inc. Patient Profile
• Patients who consider CHC their health care home: 130,000
• Health care visits: 350,000 per year
CHC Patient Demographics
90.80%
100%
75%
64.8% 65% Patient Care Model
42%
50%
22% • PCMH (NCQA Level 3)
25% 6%
0% • Advanced access scheduling
• Clinical dashboard & drive improvement
• Expanded hours
Care Delivery
• Clinical integration of all services
Medical Care & Ancillary Services • Formal research program
Dental Care
• Electronic health records
Mental Health Care
• Residency training for nurse practitioners
Prenatal
• W.Y.A. (Wherever You Are) Health Care for the
Top Chronic Diseases homeless
Cardiovascular Disease • Mobile dentistry services to 150 schools
Diabetes • Outreach and eligibility screening/enrollment
Asthma

8. Performance Feedback –
Competing Interests
Organizations Providers
Productivity & Efficiency Quality and Performance
Population Health Individual patient outcomes
Systems improvement Professional Growth
10/05/10 4

9. Middle Ground?
• Providers are inherently interested in and concerned
about the quality of care they deliver
• Self-reflection is a powerful driver
• Framing of QI feedback – non-competing interests
• Utilize multiple vehicles to communicate performance
10/05/10 5

10. Provider-Centered QI Cycle
• Encourage provider
participation in measure
Defining
selection and definition
• Provide frequent,
individual and systems
Enhancing Monitoring reporting
• Provide actionable data
to front line teams
• Link performance and
Reporting
quality
10/05/10 6

11. Multilevel Performance
Assessment
Performance Appraisals Peer Reviews
Data Driven
Provider
Feedback
Dashboard and
Professional Education
Sharepoint
10/05/10 7

12. Using Data to drive QI
• Key Points for discussion:
– Make data easily accessible to teams
– Use a structured QI approach
– QI projects need a strong focus on
measurement
– Collect data to evaluate each PDSA
– Provide actionable data to front line teams
– Use data to drive performance and sustain
gains
10/05/10 8

13. Key Points
• Key Points for discussion:
– Make data easily accessible to teams
– Use a structured QI approach
– QI projects need a strong focus on
measurement
– Collect data to evaluate each PDSA
– Provide actionable data to front line teams
– Use data to drive performance and sustain
gains
10/05/10 9

14. CHC Quality Improvement
on SharePoint
10/05/10 10

15. 10/05/10 11

16. 10/05/10 12

17. 10/05/10 13

18. 10/05/10 14

19. Key Points
• Key Points for discussion:
– Make data easily accessible to teams
– Use a structured QI approach
– QI projects need a strong focus on
measurement
– Collect data to evaluate each PDSA
– Provide actionable data to front line teams
– Use data to drive performance and sustain
gains
10/05/10 15

20. Based on “Clinical Microsystems”, Nelson et al
10/05/10 16

21. Key Points
• Key Points for discussion:
– Make data easily accessible to teams
– Use a structured QI approach
– QI projects need a strong focus on
measurement
– Collect data to evaluate each PDSA
– Provide actionable data to front line teams
– Use data to drive performance and sustain
gains
10/05/10 17

22. Embed Measurement
into each PDSA
• How will we know that a change is an improvement?
• Use Survey Monkey, EHR data, chart reviews, hand
counts, to measure PDSA outcomes
• Data collection does not need to be complicated.
Simplicity is key
10/05/10 18

23. Based on “Clinical Microsystems”, Nelson et al
8/19/10 19

24. 10/05/10 20

25. • Key Points for discussion:
– Make data easily accessible to teams
– Use a structured QI approach
– QI projects need a strong focus on
measurement
– Collect data to evaluate each PDSA
– Provide actionable data to front line teams
– Use data to drive performance and sustain
gains
10/05/10 21

26. Example:
Planned Care Huddles
• Purpose:
– ensure all patients are offered routine prevention/screening
– improve efficiency
– share routine tasks amongst the team
– promote team cohesion
– improve the health of our patients and our community

27. Basic Process
• Pre-huddle
– MA reviews CDSS for scheduled visits next day
– MA notes things that are due on a paper copy of the schedule
– RN reviews patient schedule for vaccine needs/SM needs/other
disease management needs
• Huddle
– booked into schedule each day
– MA convenes huddle 5 minutes before start of patient schedule
– Brief review by team of what is due, discussion of plan for
complex cases.

28. Missed Opportunities: Agency-wide
595 595
600
500
424
400 A1C testing in patients with diabetes
(6months)
303 Breast cancer screening
290
300
Colorectal cancer screening by colonoscopy
219
200 Depression Screening
148 146
115
100
39 32 24
0
Week of April 25th Week of May 2nd Week of May 9th

29. Missed Opportunities: Site that started huddling
40
36
35
Sum of A1C
30 testing in patients
with diabetes (6
months)
25 Sum of Breast
24
cancer screening
22
21
20
17 17 Sum of Colorectal
15 cancer screening
by colonoscopy
10 10 Sum of
9 Depression
7 Screening
6
5
4 4
3 3
2
0 0
4/25 5/2 5/9 5/16
Middletown

30. Missed Opportunities: Site that didn’t start huddling
200
180 179
160 Sum of A1C testing
in patients with
140 142 diabetes (6
138 136 months)
Sum of Breast
120
cancer screening
100
Sum of Colorectal
80 80 cancer screening
by colonoscopy
65 65 65
60
Sum of Depression
40 Screening
35 32 32
20 24
11 11
6 4
0
4/25 5/2 5/9 5/16
Meriden

32. 10/05/10 28

33. 10/05/10 29

34. • Key Points for discussion:
– Make data easily accessible to teams
– Use a structured QI approach
– QI projects need a strong focus on
measurement
– Collect data to evaluate each PDSA
– Provide actionable data to front line teams
– Use data to drive performance and sustain
gains
10/05/10 30

35. Improving HTN Care Using Technology
Developing an HTN Dashboard
– Combine registry reporting from EHR with
real-time pt data from the practice
management system
– Present timely, actionable data to each care
team
– Not just a performance “report card”
8/19/10 31

36. Hypertension Performance Indicators
32

37. Locate your panel on Share point

38. Click to sort by Average BP or Next Appt

40. Summary of Key Points
• Performance feedback critical for provider professional
growth and clinical objectives
• Framing of QI feedback for providers must reflect
balance between quality and efficiency, not competition
• SharePoint is an effective tool for providing easily
accessible data to front line teams
• Use multiple sources of data to evaluate QI projects
• Present actionable data
• Data drives performance
10/05/10 36

41. Comments or Questions?
Please Contact:
Daren Anderson
VP/ Chief Quality Officer
Daren@chc1.com
860.347.6971 ext.3740
_________________________
Margaret Flinter
Senior VP and Clinical Director
Margaret@chc1.com
860.347.6971 ext. 3622
_________________________
Nwando Olayiwola
Chief Medical Officer
Nwando@chc1.com
860-347-6971 ext. 3728
37

42. Medical Home
Coordinated Care Management
Start date: 05 05 11
Springfield Medical Care Systems
Springfield, Vermont

43. Springfield Medical Care System
Brief Chronological Organizational History
Springfield Hospital was formed in 1914
• Moved to our current location in1923; expansions 1955,1964
• Critical Access Hospital designation received in 2005
– 9 primary care practices, 1 OB/GYN practice, 5 specialty practices
– FQHC approval received in 2009
• Unique model, perhaps the only one in the United States where a
community health center and critical access hospital work
together under one umbrella governing Board of Directors.

44. Our Service Area
• We serve 12 communities in Vermont and New Hampshire
• Service area population is approximately 35,000

45. Long standing relationship
Primary Care – Springfield Hospital
Long history of close working relationship between
primary care practices and hospital presenting unique
opportunities to assess our environment, identify
realizable goals, collaborate and implement change
towards establishing a Medical Home for the community
we serve.

46. An opportunity recognized
Establish a care coordination system between our
Community Health Center and Hospital.
Initial Focus: Emergency Department Utilization

47. Emergency Department
Emergency Department Volume
18,000 1 7 ,3 3 5
1 6 ,8 2 6 1 6 ,8 7 6 1 7 ,0 2 5
1 6 ,1 3 5
16,000 1 5 ,6 2 4
1 4 ,3 9 8
14,000
1 3 ,0 1 6
1 2 ,7 4 2 1 2 ,5 6 8 1 2 ,6 4 1
1 2 ,1 9 9
12,000
1 0 ,6 4 3
10,000
8,000
6,000
4,000
2,000
0
FY 1998 FY 1999 FY 2000 FY 2001 FY 2002 FY 2003 FY 2004 FY 2005 FY 2006 FY 2007 FY 2008 FY 2009 FY 2010

48. Key Daily Indicator Report 05 01 11 - 06 11 11 05 01 11 - 07 09 11 Definitions
Summary Average / Total Average / Total Definitions define "Indicator" and identifies number as average or total
Community Health Center - Monday through Friday
Indicator No./% No./% Indicator Definition
New patients 143 218 Total new patients added daily Indicator of system growth
CHC Utilization 88% 90% Average percentage of clinician's blocked hours filled Indicator of clinical activity and capacity
Walk ins/same day 1833 3133 Total number of walk in patients accepted Indicator of clinical activity and capacity
No shows 444 781 Total number of patients did not show for appointment Indicator of clinical activity
Springfield Hospital
Indicator No./% No./% Indicator Definition
Emergency Department, Inpatient Activity - Sunday through Saturday; OR Utilization - Monday through Thursday; Endo - Monday through Friday
Emergency Department visits 46 47 Average number of ED patients daily Indicator of ED activity level
Admissions 193 338 Total number of inpatient admissions daily Indicator of clinical activity level
Discharges 208 354 Total number of inpatient discharges daily Indicator of clinical activity level
* (Actual) OR Utilization (Room 1) 85.6% 72.6% Percentage of OR capacity utilized Indicator of clinical activity level
* (Actual) OR Utilization (Room 2) 78.3% 60.6% Percentage of OR capacity utilized Indicator of clinical activity level
* (Actual) Endoscopy Utilization 66.6% 65.7% Percentage of Endoscopy capacity utilized Indicator of clinical activity level
Transfers 27 40 Total number of ED transfers for no capacity Indicator of restricted capacity
Midnight Hospital census 18.5 19.0 Average number of inpatients at midnight, end of prior day Indicator of final daily census
Observation patients 1.0 0.9 Average number of observation patients at midnight Indicator of clinical activity level
9a.m. Activity Report - Daily planning meeting "snapshot" - Monday through Friday
Core Measures (met/not met) Met 100% Met 100% Clinical hospital quality measures (met or unmet) Quality of care indicator
9 a.m. Hospital census 18.7 19.3 Average number of inpatient and observations patients Indicator of daily census
9 a.m. Windham Center census 9.1 9.0 Average number of patients Indicator of daily census
Labor 0.4 0.3 Average number of labor patients (not in census) Indicator of clinical activity level
One to one patient care 0.4 0.5 Average number of patients with special needs Indicator of clinical activity level
Same Day Surgery admissions 0.9 0.8 Average confirmed ED and Same day surgery admits Indicator of ED activity level
Confirmed ED admissions 0.3 0.4 Average number of available total staffed beds Prime capacity indicator
Total inpatient capacity 21.7 20.4 Average number of available total staffed beds Prime capacity indicator
* Note: (Actual) OR/Endo Utilization collection data start date June 6

49. Emergency Department
General categories of visits
• Emergent care
• Acute care chronic disease management:
– heart failure, diabetes, asthma, pain management, pneumonia, mental
health
• Unable to get an appointment with PCP
• Practice closed to new patients
• Patient has no designated PCP
• Patients with financial needs,10% of ED patients are insured
• Frequent Flier
• Drug Seekers
• Transient

50. An Opportunity for a Medical Home
Capture and redirect from ED to CHC
• Emergent
• Acute care chronic disease management:
– heart failure, diabetes, asthma, pain management, pneumonia, mental health
• Unable to get a timely appointment with primary care physician
• Practice closed to new patients
• Patient has no designated PCP
• Patients with financial needs,10% of ED patients are insured
• Frequent flier
• Drug seekers
• Transients

51. Capture audience
• We have assessed that 2000 to 3500 Emergency
Department ED patients annually through a coordinated
systems based effort might be redirected to our
Community Health Center and provided a Medical Home
– This respresents12 to 20% of our current ED volume

52. Impact of ED volume reduction
Assumptions
Emergency Department Community Health Center
– Improved access to – Increased utilization
Emergency Services for – Increased Medical Home
those that need it population base
– Shorter ED wait times – Increased opportunities for
– Increase in clinical value preventive care
time – Appropriate management
– Reduction of potential of chronic disease
medical errors – Less costly delivery of care
– Lower staff burn out

53. Medical Home
Coordinated Care Management
Hospital Care Managers CHC Care Managers
Building a system to coordinate communications and
follow up between our established hospital Case
Management system and our newly formed CHC Care
Management Team

54. Indicators for CHC care coordination & CHC referral
• ED patients without identified CHC primary care provider
• ED patients requiring post ED procedure follow up care
• ED “frequent fliers”
• Patients with a chronic diseases: CHF, Diabetes,
Obesity, Pediatric Asthma
• Patients seen in the ED within 3 days of a CHC visit
• Patients requiring financial assistance, 10% of ED patients are uninsured.

55. Key measurable improvement indicators
• Volume of new CHC patients
• Volume of walk in/same day CHC patients
• CHC Utilization
• Volume of ED visits, i.e. volume reduction
– Volume of ED patients assigned a PCP
– Volume of frequent fliers
– Volume of chronic disease referrals
– Volume of patients provided financial assistance
• In addition this team will be coordinating inpatient hospital
discharges and hospital readmissions

56. Initial Goals
• Increase CHC Utilization by 7%
– Improve access
– Increase walk-in/same day
– Increase Community education
• Decrease ED volume by 15%
– Assign PCP
– Chronic Disease referral, increase management
– Financial Assistance
– Decrease frequent fliers

57. Very early progress indicators
At this point, a bit of the Hawthorne effect, perhaps
• CHC Walk in Same Day Access - 17% increase over 2010
• ED patients assigned a CHC PCP – 14 patients per week are being
identified as needing a PCP
• ED Volume is demonstrating downward trend towards 2007-8 levels
– Economy, other factors vs early care coordination efforts

58. Summary
• Our overall goal is provide excellent preventative primary care
• Data will guide us to determine the sources of patients who will
benefit and measure progress
• A Care Management system that joins our CHC and hospital has
been implemented and is in the beginning stages of evolution
• Early data results points towards potential wins
• Next steps will move to include our local community care centers as
part of our care management network

59. THE IMPACT OF HEALTH
INFORMATION TECHNOLOGY
ON QUALITY IMPROVEMENT
THE INSTITUTE FOR FAMILY
HEALTH
Kwame A. Kitson, MD
VP of Quality Improvement
Institute for Family Health
19 West 21st street
New York, NY 10003
kkitson@ institute2000.org
212-633-0815
www. institute2000.org HRSA Webinar
July 22, 2011

60. LEARNING OBJECTIVES
 NOW THAT YOUR ORGANIZATION HAS ACCESS TO DATA,
HOW DO YOU TRANSLATE THAT INTO MEANINGFUL USE ?
 HOW CAN THE USE OF DATA AND REPORTING IMPACT
PATIENT SAFETY ?
 HOW CAN THE USE OF DATA AND REPORTING IMPROVE
QUALITY MEASURES PERFORMANCE ?

61. MEANINGFUL USE OF HIT DATA
 “MORE DATA = MORE PROBLEMS”

62. MEANINGFUL USE OF HIT DATA
 A mountainful of data yet a finite amount of
resources to handle it.

63. MEANINGFUL USE OF HIT DATA
 “Beware lest you lose the substance by
grasping at the shadow .” Aesop
 Solution- Target measures and target resources in the most efficient
ways possible.

64. MEANINGFUL USE OF HIT DATA
 Electronic Patient Outreach Team Created

65. PATIENT SAFETY
 DRUG RECALLS

66. THE IFH RESPONSE
TO THE VIOXX RECALL
FDA SENDS AN ALERT BY EMAIL
INTERNAL VIOXX REPORT GENERATED
664 PATIENTS IDENTIFIED VIA REPORTING
WITHIN 35 MINUTES OF RECEIVING FDA EMAIL
ALL BUT SIX PATIENTS CONTACTED
BY TELEPHONE OR MAIL WITHIN 10 DAYS

67. PATIENT SAFETY
DRUG INTERACTIONS
AND CONTRAINDICATIONS
 INTERNAL EHR VENDOR LINKED DRUG- DRUG INTERACTION
WARNINGS
 CUSTOM REPORTING
ASTHMA PATIENTS ON BETA BLOCKERS
PREGNANT PATIENTS ON CLASS D OR X MEDICATIONS
BEERS CLASSIFIED MEDICATIONS IN THE ELDERLY

68. PATIENT SAFETY
IDENTIFYING AND PREVENTING
INAPPROPRIATE MEDICATION PRESCRIBING
 CUSTOM REPORTING
NARCOTIC ANALGESICS
METFORMIN IN PATIENTS WITH RENAL DISEASE

69. PATIENT SAFETY
IDENTIFYING AND PREVENTING INAPPROPRIATE
CODING
 CUSTOM REPORTING
PROBLEM LIST AUDIT REPORTS IDENTIFIED MISCODING OF
PATIENTS (HIV, DIABETES).
THIS LED TO ENHANCEMENTS IN DECISION SUPPORT WHICH
PREVENTED FURTHER REOCCURENCES.

70. PERFORMANCE IMPROVEMENT IN QUALITY
MEASURES
MACROSOLUTIONS
(i.e. DECISION SUPPORT,
GLOBAL WORKFLOW
CHANGES)
ACCESS TO DATA
ALLOWS FOR
GREATER ABILITY
TO PINPOINT PROBLEMS
MICROSOLUTIONS
(i.e. INDIVIDUAL
PROVIDER ATTENTION)

71. PERFORMANCE IMPROVEMENT IN
QUALITY MEASURES
CQI INTERVENTIONS ARE APPLIED WITH
CONTINUED REASSESSMENT
 DECISION SUPPORT ALERTS ACCOMPANIED BY
WORKFLOW CHANGES.
 IFH – AGGRESSIVE IMPLEMENTATION OF BEST PRACTICE
ALERTS 9 MONTHS AFTER GO-LIVE

72. IFH BEST PRACTICE ALERTS
PRIMARILY BASED ON HEDIS CRITERIA
• PneumoVax
• Seasonal FluVax
• Breast Cancer Screening
• Cervical Cancer Screening
• Lead Screening
• HGBA1C Testing & Control

73. IFH BEST PRACTICE ALERTS
• Ophthalmology consults for diabetics.
• Peak Flow measurements for all asthmatics
• Nephrology consults for patients with greater
than 1.8 serum creatinine.
• LDL Screening
• Annual RPR Screening in HIV

74. Number of Vaccinations Given
Ja
n
10
20
30
40
50
60
0
M -02
ar
M -02
ay
-
Ju 02
Se l-02
p
N -02
ov
Ja -0 2
n
M -03
ar
M -03
ay
-
Ju 03
Se l-03
p
N -03
ov
Ja -0 3
n
M -04
ar
M -04
ay
-
Ju 04
Se l-04
p
N -04
ov
Ja -0 4
n
Electronic Reminders Begin
M -05
ar
M -05
ay
-
Ju 05
Se 5l-0
p
N -05
ov
Ja -0 5
n
M -06
ar
M -06
ay
-
Ju 06
Se l-06
p
N -06
ov
Ja -0 6
n
M -07
ar
M -07
ay
-
Monthly Pneumonia Vaccinations Among 65+
Ju 07
PNEUMOVAX
Se l-07
p
N -07
ov
Increase Preventive Services
Ja -0 7
n
M -08
ar
M -08
ay
Electronic Health Record Reminders
-
Ju 08
Se l-08
p
N -08
ov
Ja -0 8
n
M -09
ar
-0
9
5%
-5%
15%
25%
35%
45%
55%
65%
75%
85%
95%
Percent Vaccinated (Since Jan 2002)

75. COLORECTAL CANCER SCREENING
Colorectal Screening IFH Sites 2005 to 2008
100%
BPA FOR COLORECTAL
SCREENING INITIATED
90%
JAN 2008
80%
70%
EAST 13TH ST. FAMILY HLTH CTR
60%
MT. HOPE FAMILY HEALTH CENTER
PARKCHESTER FAMILY HLTH CTR
50% PHILLIPS FAMILY PRACTICE
SIDNEY HILLMAN FAMILY HLTH CTR
40% URBAN HORIZONS FAMILY HLTH CTR
WALTON FAMILY HEALTH CTR
30%
20%
All sites listed
10% were fully on
0% the EHR as of
Jan 2003
05
05
05
06
06
06
06
06
06
07
07
07
07
07
07
08
08
08
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
1/
1/
1/
8/
0/
0/
1/
1/
1/
8/
0/
0/
1/
1/
1/
9/
0/
0/
/3
/3
/3
/2
/3
/3
/3
/3
/3
/2
/3
/3
/3
/3
/3
/2
/3
/3
08
10
12
02
04
06
08
10
12
02
04
06
08
10
12
02
04
06

76. 05
/3
1/2
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
00 100%
07 5
/3
1/
20
09 05
/3
0/
20
11 05
/3
0/
20
01 05
/3
1/
20
03 06
/3
1/
20
05 06
/3
1/
20
07 06
/3
1/
NURSING
SHORTAGE
20
PERSONNEL
09 06
/3
0/
20
11 06
/3
0/
20
01 06
/3
1/
20
03 07
/3
1/
20
05 07
/3
1/
20
07 07
/3
1/
20
09 07
/3
NURSING
RESOLVED
SHORTAGE
0/
20
11 07
/3
0/
20
01 07
/3
PARKCHESTER DEPRESSION SCREENING RATE
1/
20
03 08
/3
1/
20
08
TO BPA ADHERENCE
STEPPED UP VIGILANCE
PARKCHESTER

77. THE INSTITUTE
FOR URBAN
FAMILY HEALTH
ROUTINE HIV SCREENING AT IFH NYC SITES
100%
NYSDOH POLICY DECISION
90% CHANGE SUPPORT
80% FEBRUARY 2010 INITIATED
70%
60%
50%
40%
30%
20%
10%
0%
09/30/2007
12/31/2007
03/31/2008
06/30/2008
09/30/2008
12/31/2008
03/31/2009
06/30/2009
09/30/2009
12/31/2009
03/31/2010
06/30/2010
09/30/2010
12/31/2010

78. THE INSTITUTE
FOR URBAN
FAMILY HEALTH
TCNY REPORT: KNOW YOUR HIV STATUS
100% DECISION SUPPORT INITIATED
NYSDOH POLICY
90% CHANGE 2/2010
80%
70% AMSTERDAM AVENUE
EAST 13TH ST. FAMILY HLTH CTR
60% HOMELESS CENTERS
MT. HOPE FAMILY HEALTH CENTER
50%
PARKCHESTER FAMILY HLTH CTR
40% PHILLIPS FAMILY PRACTICE
SIDNEY HILLMAN FAMILY HLTH CTR
30% URBAN HORIZONS FAMILY HLTH CTR
20% WALTON FAMILY HEALTH CENTER
10%
0%

79. THE INSTITUTE
NYCDOH EQUITS SMOKING
FOR URBAN
FAMILY HEALTH
CESSATION REPORT
100%
90%
80%
70%
60% 58%
52%
50% 48% ALL NYC SITES
IFH CLINICAL SITES
40% 33%
28% 30%
30%
20%
10%
0%
BASELINE QUARTER 1, 2011 QUARTER 2, 2011

80.  The greatest danger for most of us is not that our
aim is too high and we miss it, but that it is too low
and we reach it.
Michelangelo

81. Office of Health Information Technology and
Quality
Additional HRSA Health IT and Quality Toolboxes and
Resources including past webinars can be found at:
http://www.hrsa.gov/healthit
http://www.hrsa.gov/quality
Additional questions can sent to the following e-mail address:
HealthIT@hrsa.gov
• US Department of Health and Human Services
• Health Resources and Services Administration