Application for Participation

Join us in this TB Elimination Alliance Learning Collaborative to explore quality improvement strategies for standardized data collection through electronic health record (EHR) template development. EHR plays a critical role in optimizing the latent TB infection care cascade, and the Learning Collaborative will highlight clinical experts in this area.

Dates
Session 1: Thursday, February 3
Session 2: Thursday, February 10
Session 3: Thursday, February 17
Session 4: Thursday, February 24

Time: 10:30am-12:00pm HT / 12:30-2:00pm PT/ 3:30-5:00pm ET

Intended Participants:
Health centers, health center look-alikes, and other community health organizations interested and/or invested in TB/LTBI screening, testing, and treatment. Health centers and health center look-alikes will be prioritized for selection. An honorarium will be made available for Community Health Center providers and staff participating.

Application Deadline:
Friday, January 21 by 5pm local time
 
Please contact tea@aapcho.org if you have questions or need additional information.

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* 1. Contact Information

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* 2. Which of the following best describes your organization type?

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* 3. Which EHR system does your health center/organization use?

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* 4. What is your area(s) of expertise and role in your health center/organization?

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* 5. What are your interests, challenges, needs, and/or expectations of this Learning Collaborative?

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* 6. Do you have a dedicated EHR Department or Staff in your organization?

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* 7. If you answered yes to Question 5, is that person you?

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* 8. What specific questions would you like to ask our clinical experts?

Please consider where you and your organization are at now BEFORE participating in this learning collaborative by responding to the questions below.

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* 9. Where would you say your organization currently is in EHR template development for LTBI screening, testing, and treatment BEFORE participating in this learning collaborative?

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* 10. In a few sentences, please explain why you chose the response above.

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* 11. What resources would help your organization with EHR template development for LTBI screening, testing, and treatment?

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* 12. Would you be interested if we offered CME credit?

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* 13. How did you learn about this learning collaborative opportunity? Select one or more.

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* 14. By submitting this application, you agree to attend all four (4) sessions and to secure documentation of commitment from your supervisor or health center leadership upon acceptance into this learning collaborative. Documentation is due before the first session (February 3) to tea@aapcho.org.

Please check the box to be eligible for this application.

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