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CIE Summit 2020 Scholarship Request
This form is to capture your interest in receiving a scholarship from the Data Across Sectors for Health National Program Office for the Community Information Exchange Summit 2020, hosted by San Diego 211.
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Email
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Your email
Your Name
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Your answer
Position or title
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Your answer
Organization
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Your answer
Are you funded or supported by any of these All In National Partners or other national initiatives?
DASH: Data Across Sectors for Health
PHNCI: Public Health National Center for Innovations
BUILD Health Challenge
NJHI: New Jersey Health Initiatives
Nemours Integrated Learning Lab
Colorado Health Foundation
Other:
Do you have a profile in the All In online community?
Yes
No
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What 1-3 things are you most hoping to learn or get out of the CIE Summit?
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Your answer
Other comments you'd like to share about the intent for your participation and desired goals, or what sessions you are most interested in.
Your answer
The following is a list of 22 sectors that may be involved in collaborations for local community health. Which one best describes that of your organization (if applicable)?
Public health
Clinical health care and delivery system
Mental/behavioral health care
Health care payment
Social/human services
Faith-based
Food and nutrition
Housing/homelessness
Education/schools
Academia/research
Criminal justice/corrections (e.g. prisons, jails)
Legal and the court system
Public safety/law enforcement
Transportation
Parks and recreation
Banking/finance/business
Philanthropy
Planning, economic or community development
Information management infrastructure (e.g. technology company, HIE)
Other local/state/tribal government not mentioned above
Other community-based/nonprofit not mentioned above
Community member (not representing an organization)
Other:
Clear selection
How would you describe the stage of development of multi-sector data sharing in your community?
Planning phase: Data are not yet being shared across sectors, but we are actively engaged in planning.
System building phase: We are in the process of designing and developing the platforms, databases, templates, and/or software for data sharing.
Launching phase: We are in the beta testing or pilot implementation phase of sharing data.
Scaling phase: We are bringing data sharing work to scale as envisioned during planning.
Innovating phase: Data sharing is fully operational as envisioned; the system is being refined and expanded to include new data sources and provide new services such as advanced analytics and reporting functionalities, etc.
Don't know
Not applicable
Other:
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If awarded scolarship to attend the CIE Summit, I agree to complete a short survey assessing the impact of this experience on our community's multi-sector collaboration and data sharing work. DASH will send a link the week after the event.
Yes
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