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ONE UTAH HEALTH COLLABORATIVE INNOVATION SUBMISSION
Do you have an innovative solution that you’d like help accelerating? Complete the below form and we’ll follow up on how the Collaborative may be able to help.
18
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1
Name
First Name
Last Name
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2
Email
example@example.com
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3
Phone Number
Please enter a valid phone number.
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4
Organization
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5
Organization Website
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6
Provide a concise title for your innovation (50 letter count limit):
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7
Provide a general description of the innovation:
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8
Describe the patient or population demographic that it primarily benefits (E.g., diagnosis/condition, background, geography) and how it benefits them (E.g., affordability, improved health outcomes, increased equity, patient convenience).
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9
How can or does the innovation reduce total healthcare dollars spent in Utah (e.g., amounts paid in insurance premiums, out-of-pocket expenses, and reimbursements for products or services)?
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10
Is the innovation financially self-sustaining? If not, is there a business plan for it to be?
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11
How long has the innovation been active (E.g., pre-launch or months/years in operation) and how many individuals have been affected to date?
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12
If the innovation is active, is it currently being applied in Utah?
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13
Is there any quantifiable evidence of the innovation’s benefit regarding cost reduction, improved outcomes, or greater equity?
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14
Please describe ways the Collaborative might support the innovation? Primary areas include public promotion, connections, advice, and independent cost-benefit analysis.
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15
(Optional) Please upload any relevant documents or additional resources:
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16
How did you hear about the Collaborative?
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17
Terms and Conditions
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This field is required.
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18
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