Provider Technology Adoption Survey

Health plans are required to submit provider technology adoption information to the Center for Health Information and Analysis (CHIA) as part of the All-Payer Claims Database initiative (114.5 CMR 21.00 in accordance with M.G.L. c. 118G).1 CHIA is the Massachusetts state agency created to support transparency and increase quality and efficiency in the health care delivery system.

In an effort to assist health plans to collect provider technology adoption information and to avoid duplicate data requests, HealthCare Administrative Solutions (HCAS) developed this website to collect provider information to comply with the state requirement and to assess provider technology use in the state. Providers are asked to complete the survey below. The information provided will be submitted to the Center for Health Information and Analysis and to the health plans you designate at the end of the survey.

For additional information regarding this survey, click on the following link(s):

Provider Survey

Please answer the following questions:
(*denotes required fields)

Provider Contact Information

  *First Name:  
  *Last Name:  
   Practice/Group/Facility Name  
  *Address Line 1:  
   Address Line 2:
  *Zip Code:  
  *Phone Number:  
   Email Address:  
  *Provider Individual NPI:  
           Group Name:         Provider Group NPI:    ( If applicable )
           Group Name:         Provider Group NPI:    ( If applicable )
  *Provider License Number:  


Survey Questions

Do you use:
A.   *An Electronic Health Records (EHR) system?    

*If yes, please select the name of your vendor. 2    

*If your current EHR vendor is not listed above, please enter the name here.  

*Do you have the capacity to perform eVisits or web visits?  

B.   An Electronic Prescribing system?  

If yes, what type of system do you use?

       Please enter the name of your vendor/product.  

C.   A Practice Management System (PMS)?  

If yes, please enter the name of your PMS vendor/product.

D.   Do you participate in any information exchanges?  

If yes, or are planning to participate in an exchange, please answer the following:

What types of data do you exchange (or are you planning to exchange)? Check all that apply.


Which entities do you (or are you planning to) exchange clinical data? Check all that apply.  


Do you use a patient portal for:

a.   Administrative functions (e.g. schedule appointments, refill prescriptions, access lab results)?

b.   Patient Health Record (PHR) functions (e.g. patients can maintain demographic information, review medication utilization, view office visit summaries)?


Authorization and Release
I hereby authorize HealthCare Administrative Solutions (HCAS) to release the self-reported information included above to the Center for Health Information and Analysis and:

 To the following health plans: Blue Cross Blue Shield of Massachusetts, Boston Medical Center HealthNet Plan, Fallon Community Health Plan, Harvard Pilgrim Health Care, Health New England, Neighborhood Health Plan, Network Health, Tufts Health Plan, and additional health plans that agree to collaborate on this project at a later date.


To only the health plans I indicate below:

Temporary Field for testing phase
Enter Sample Date Reported Below
This date will emulate when the record was entered to allow for different report months
*If Left Blank, a date of October 25,2011 will be saved
 (e.g; 2011-10-25)

HCAS provides access to the survey on this website for the convenience of HCAS member plans and their participating providers. HCAS makes no guarantee regarding the survey and disclaims any responsibility for its accuracy, completeness or compliance with Division and other requirements. Individuals submitting survey data are responsible for the accuracy of their submissions and compliance with their vendor and payer contracts. HCAS reserves the right to use survey data to develop a summary report of findings that may be used for external distribution.
  1. Center for Health Information and Analysis, The All-Payer Claims Database Provider File Submission Guide, December 1, 2010.
  2. The EMR vendor list included on this website has been re-produced from the following source: Massachusetts eHealth Institute,, December 15, 2011.


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