Practice Outreach and Communication. The Project Manager shall contact all primary care (internal medicine, family practice, pediatric, and naturopath) and substance abuse practices within the HSA in order to encourage their participation in the program and area learning health system activities. In collaboration with the Blueprint QI Facilitators, the Contractor will help willing practices engage in the processes for achieving National Committee for Quality Assurance (NCQA) Patient-Centered Medical Home (PCMH) recognition, integrating CHT staff into practice workflows, and joining the appropriate CC forums within the HSA. The Project Manager will monitor the status of each primary care practice throughout these activities and report any issues encountered to the State’s Blueprint Assistant Director as they arise. Additional supports funded and provided by the State and available to the practices include QI facilitation for assistance with NCQA-PCMH scoring activities and continuous quality improvement, data quality initiative project leaders, and Vermont Information Technology Leaders (VITL) staff for establishing practice electronic health record (EHR) interface connectivity to the Vermont Health Information Exchange (VHIE) and associated data repositories designated by the State. The Project Manager shall facilitate collaboration between the practices and area Blueprint QI Facilitators and ACO provider networks to promote quality improvement, including participation in the CC forum(s) and associated quality improvement projects, learning collaboratives, training events, and other mechanisms to ensure innovation between practices. In collaboration with the QI facilitators, the Project Manager will also support primary care practices in implementing quality improvement initiatives through activities including: Providing access to relevant data reports and interpretation of these reports, such as Blueprint practice and HSA profiles, ACO reports, Emergency Department (ED) use, inpatient admissions, data on trends in hospital readmission rates, population outreach reports, access to lists of patients for each practice, ACO reports, and other relevant patient data Coordinating and reporting on progress of quality improvement projects between practices, specialists, hospitals, and community organizations based on core clinical measures, data reports, and priorities identified by the CC leadership team and stakeholders, ACOs, and State healthcare reform initiatives Integration of CHT staff i...
