Wisconsin Health Information Technology Extension Center (WHITEC)

About

Careers

Subsidized services available for
qualifying primary care providers

Wisconsin Health Information Technology Extension Center

Application to Participate

The Wisconsin Health Information Technology Extension Center (WHITEC) provides education, outreach, and technical assistance to Wisconsin health care providers in selecting, implementing, and using health information technology (HIT) to improve the quality and value of health care.

If you wish to apply to work with WHITEC on HIT adoption and meaningful use, please review and complete the following online application, or download a PDF of the application.

For questions or additional information, please contact:

Heidi Clarke
WHITEC Administrative Assistant
hclarke@whitec.org or (608) 729-2708

Note: Vendor inquires should be directed to Chris Becker at cbecker@metastar.com or (608) 395-9820.

Practice Name

Practice Address

City

State

Zip Code

Practice Phone Number

Name of Authorized Representative

Title

Email Address

Are you affiliated with a hospital(s)? Yes No

If yes, please list:

Do you have multiple clinic sites? Yes No

If yes, how many?

Are you a Federally Qualified Health Center? Yes No

Are you a Critical Access Hospital? Yes No

Are you a Rural Hospital with less than 50 beds? Yes No

Number of primary care* physicians in the practice:

Number of primary care* mid-level providers (PA, NP) in the practice:

*Primary care is defined as Family Practice, Internal Medicine, OB/GYN, and Pediatrics

Number of other specialty physicians in the practice:

Number of specialty mid-level providers (PA, NP) in the practice:

Please list the specialties the practice would represent:

Current Status:

Are you currently using an electronic practice management (scheduling and/or billing) system? Yes No

If yes, list product name and date of implementation:

Are you currently using an Electronic Health Record (EHR)? Yes No

If yes, list product name, version and date of implementation:

Have you purchased an EHR, but have yet to implement? Yes No

If yes, list product name and anticipated date of implementation:

If no, when do you plan to purchase an EHR? implement an EHR?

How did you hear about WHITEC?

Mailing Conference Website Other