BSI QIA -Healthcare Information Exchange (HIE) Subset - May Status

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* 1. Facility Name and/or CCN

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* 2. Provide the names of 2 hospitals which you would like to gain access to their Electronic Medical Record - SKIP this question if you provided this information previously

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* 3. What is the name of the hospital you will be/are working with this month?

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* 4. I have identified the point of contact (POC) who can grant permission to gain access to the EMR for this hospital.

Yes

No

Other

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* 5. Verbal or written contact has been made with the POC

Yes

No

Other

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* 6. A request for access has been made and/or a meeting has been set up to discuss the project further. (Check all that apply)

No

Yes

A request for access has been made

A meeting has been set up with the hospital/health system to discuss the project further

Barriers to making a request or setting up a meeting

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* 7. Response to Request for EMR Access

Hospital has given permission to access EMR

Hospital has denied access EMR - Provided details in comment field

Decision to grant access is pending

Reasons EMR Access was Denied

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* 8. Facility is actively engaged with hospital IT department to join EMR

Yes

No - identify any barriers in comment box

N/A - Access has been denied

Barriers

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* 9. Facility has gained EMR access and is able to view at LEAST blood culture results

Yes - please provide date in comment box

No

N/A Access has been denied

Barriers/comments OR Date of Access