Table 1.

Elements of Physician Practice Connections–Readiness Survey, by Domain

Chronic Care Model DomainElements of the Physician Practice Connections–Readiness Survey
Health care organizationIndividual provider feedback
Performance measurement
Formal quality improvement activities
Delivery system redesignAdvanced access visits
Primary care teams
Scheduling system for physician continuity
Non-MD educator*
Nurse manager*
Previsit planning*
After-visit follow-up*
Missed appointments follow-up*
Clinical information systemsDisease registry*
Problem lists
Medication lists
Process flow sheets*
Checklists of tests or interventions*
Patient assessment questionnaire*
Clinical test tracking
Referral tracking
Decision SupportClinical guidelines*
Clinical guidelines preventive services
Clinician reminders for chronic illness care*
Clinician reminders for preventive services
Clinician reminders for risk assessments
Clinician reminders for counseling
Abnormal radiology and lab test alerts
Abnormal test protocols
Self-management supportPatient reminders for chronic illness care*
Patient reminders for preventive services
Self-management programs for risk factors
Individualized patient education about chronic illness*
Self-management programs for chronic illness*
Self-management plans/materials for chronic illness*
Electronic information/communication with patients
Systematic risk factor screening
  • ↵* Asked separately for diabetes, cardiovascular disease, depression, and asthma.