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Resource Overview

Population Health Management (PHM) is an evolving concept encompassing a suite of emerging technologies to aggregate, analyze and use data to improve clinical and financial outcomes.  PHM tools enable health centers to identify, monitor and target care to patients within a population. Resources in this section provide a conceptual foundation to help health center staff deepen their understanding of PHM and how the social determinants of health can be used to improve outcomes.

PHM and SDH Concepts and Overview Resources

Health Center Case Examples in Coding and Documenting Social Risks: Introduction

Privacy and Data Sharing Considerations | HITEQ Learning Collaborative

HITEQ Center 0 1366

Are you capturing information like immigration or refugee status, intimate partner violence, human trafficking, risk of acquiring HIV through sexual contact or substance use disorder, or other information that brings up questions about how to document or code while respecting the patient’s privacy?

This health center learning collaborative series will present health center case examples that explore the privacy and data sharing considerations of EHR documentation of sensitive patient information, such as social history and social risk, and encourage participants to discuss the implications for health centers and their patients. 

Health Center Case Examples in Coding and Documenting Social Risks

Immigration Case Example | Privacy and Data Sharing Considerations | HITEQ Learning Collaborative

HITEQ Center 0 1060

Are you capturing information like immigration or refugee status, intimate partner violence, human trafficking, risk of acquiring HIV through sexual contact or substance use disorder, or other information that brings up questions about how to document or code while respecting the patient’s privacy?

This health center learning collaborative series will present health center case examples that explore the privacy and data sharing considerations of EHR documentation of sensitive patient information, such as social history and social risk, and encourage participants to discuss the implications for health centers and their patients. 

Health Center Case Examples in Coding and Documenting Social Risks

Privacy and Data Sharing Considerations | HITEQ Learning Collaborative

HITEQ Center 0 1046

Are you capturing information like immigration or refugee status, intimate partner violence, human trafficking, risk of acquiring HIV through sexual contact or substance use disorder, or other information that brings up questions about how to document or code while respecting the patient’s privacy?

This health center learning collaborative series will present health center case examples that explore the privacy and data sharing considerations of EHR documentation of sensitive patient information, such as social history and social risk, and encourage participants to discuss the implications for health centers and their patients. 

Health Center Case Examples in Coding and Documenting Social Risks

Intimate Partner Violence Case Example | Privacy and Data Sharing Considerations | HITEQ Learning Collaborative

HITEQ Center 0 1050

Are you capturing information like immigration or refugee status, intimate partner violence, human trafficking, risk of acquiring HIV through sexual contact or substance use disorder, or other information that brings up questions about how to document or code while respecting the patient’s privacy?

This health center learning collaborative series will present health center case examples that explore the privacy and data sharing considerations of EHR documentation of sensitive patient information, such as social history and social risk, and encourage participants to discuss the implications for health centers and their patients. 

Health Center Case Examples in Coding and Documenting Social Risks

Roundup of Final Privacy and Data Sharing Considerations and Takeaways | HITEQ Learning Collaborative

HITEQ Center 0 1016

Are you capturing information like immigration or refugee status, intimate partner violence, human trafficking, risk of acquiring HIV through sexual contact or substance use disorder, or other information that brings up questions about how to document or code while respecting the patient’s privacy?

This health center learning collaborative series will present health center case examples that explore the privacy and data sharing considerations of EHR documentation of sensitive patient information, such as social history and social risk, and encourage participants to discuss the implications for health centers and their patients. 

SDOH Data Dashboards Module 4: SDOH Dashboard Design - Advanced

HITEQ SDOH Data Dashboards Series

Molly Rafferty 0 2288

The Social Determinants of Health Data Dashboards training is a four-module series. Modules range from about 8 minutes to 12 minutes in length. Module four provides advanced-level information on using social determinants of health data and dashboards for facilitating and tracking social needs referrals, conducting predictive analysis with social determinants of health and health outcomes data, and using social determinants of health data to improve reimbursement for addressing social needs.

SDOH Data Dashboards Module 3: SDOH Dashboard Design - Intermediate

HITEQ SDOH Data Dashboards Series

Molly Rafferty 0 2270

The Social Determinants of Health Data Dashboards training is a four module series. Modules range from about 8 minutes to 12 minutes in length. Module three provides intermediate level information on collecting social determinants of health data and using data visualization for effective dashboards with stratification of data.

SDOH Data Dashboards Module 1: Introduction to SDOH Dashboard Design

HITEQ SDOH Data Dashboards Series

Molly Rafferty 0 2768

The Social Determinants of Health Data Dashboards training is a four module series. Modules range from about 8 minutes to 12 minutes in length. Module one provides an introduction to the role of screening and collecting data on social determinants of health, identifying social determinants of health measures and using data effectively, and assessing organizational data dashboard capability. Subsequent modules provide beginner, intermediate and advanced level considerations and examples for social determinants of health data dashboards. 

Making a Good First Impression: Digital Patient Intake Solutions

How Health Centers can Use Digital Intake Tools to Support Social Determinants of Health Data Collection

Molly Rafferty 0 3137

Now more than ever, health centers know that addressing social determinants of health is key to ensuring patients from underserved and disadvantaged groups receive quality, informed, and comprehensive care. This resource explores how health centers can effectively and safely collect critical patient information, including sensitive information like social need screening, through digital patient intake solutions that rely on paper-free, data-smart registration and EHR integration. Health centers can walk through why adding these solutions to their clinics can engage rather than alienate patients, and how to implement these technologies to screen for social risk and improve the patient experience.

The resource is available in the Documents to Download section below.

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Acknowledgements

This resource collection was cultivated and developed by the HITEQ team with valuable contributions from the National Association of Community Health centers (NACHC) as well as HITEQ's Advisory Committee and many health centers who have graciously shared their experiences with HITEQ.

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The Quadruple Aim
Quadruple Aim

A Conceptual Framework

Improving the U.S. health care system requires four aims: improving the experience of care, improving the health of populations, reducing per capita costs and improving care team well-being. HITEQ Center resources seek to provide content and direction aligned with the goals of the Quadruple Aim

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