PCMH5C
On its own or in conjunction with an external organization, the practice systematically:
5.C.1 Demonstrates its process for identifying patients with a hospital admission and patients with an emergency department visit
5.C.2 Demonstrates its process for sharing clinical information with admitting hospitals and emergency departments
5.C.3 Demonstrates its process for consistently obtaining patient discharge summaries from the hospital and other facilities
5.C.4 Demonstrates its process for contacting patients/families for appropriate follow-up care within an appropriate period following a hospital admission or emergency department visit
5.C.5 Demonstrates its process for exchanging patient information with the hospital during a patient’s hospitalization
5.C.6 Collaborates with the patient/family to develop a written care plan for patients transitioning from pediatric care to adult care (NA for adult-only practices)
5.C.7 Demonstrates the ability for electronic exchange of key clinical information with facilities
5.C.8 Provides an electronic summary-of-care record to another care facility for more than 50 percent of transitions of care
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