Form 2

QHIN Application

Part III – Exchange of Required Information and Ability to Perform Functions of a QHIN

The questions in this Part correspond to Part 4, Sections I.2 and I.3 of the QHIN Onboarding & Designation SOP.

Part I – Basic Applicant Information

Question 1

Part II – Organizational Requirements

Question 2 Question 3

Part III – Exchange of Required Information and Ability to Perform Functions of a QHIN

Question 4
Question 5
Question 6
Question 7
Question 8
Question 9
Question 10
Question 11
Question 12
Question 13

Question 13.

Please describe any gaps between your current technical infrastructure and the requirements of the QTF and explain how you will address these gaps in your project plan (Part VI of this application) so that your Designated Network will be able to fully comply with the applicable provisions of the QTF prior to beginning the conformance testing required in Part 4, Section III of the QHIN Onboarding & Designation SOP.

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Form 2

QHIN Application

Part I – Basic Applicant Information

Part II – Organizational Requirements

Part III – Exchange of Required Information and Ability to Perform Functions of a QHIN

Part IV – Organizational Infrastructure and Legal Authority

Part V – QHIN Privacy and Security Requirements

Part VI – Project Plan

Part VII - Background References

Part VIII - Attestation

Question 13.

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