Behavioral Health Integrator

Health centers are interested in using social determinants data to manage and improve the health of their patient population and community, and are at different places on the population health management (PHM) and social determinants of health (SDH) adoption curve. The Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences (PRAPARE) is a national effort to help health centers and other providers collect the data needed to better understand and act on their patients’ social determinants of health. In this webinar, the Colorado Community Managed Care Network (CCMCN), a Health Center Controlled Network (HCCN) highlighted a Tableau data dashboard that they have developed to help their health centers make decisions on population health management. They discussed the rationale for developing the tool, challenges and facilitators to integration, and how their health centers benefit from data sharing across Tableau.

There is a great deal of interest among health centers, Primary Care Associations (PCAs), and Health Center Controlled Networks (HCCNs) in the advantages associated with investing in Population Health Management electronic platforms. Measuring specific and quantifiable returns clarifies the benefits and supports consistent understanding among stakeholders of the value of PHM.

Health Catalyst published the inaugural version of the Healthcare Analytics Adoption Model in 2012, a proposed framework to measure the adoption and meaningful use of data warehouses and analytics in healthcare in ways similar to the well-known HIMSS Analytics EMRAM model. A second version of the Health Analytics Adoption Model was released in 2013.

This can be a helpful framework for understanding what is infrastructure and processes are needed to use data successfully to manage the health of your population and engage in alternative payment arrangements that continue to gain traction. 

This is a 4-module PowerPoint presentation is intended as a “backgrounder” for health center staff to introduce the field of population health management. It provides an overview of population health concepts and discusses the role of the social determinants and population health management within the general population. All four modules can be completed by staff to gain a working knowledge of these concepts, implementation directions, creating a cogent and current case for the utility of PHM and SDH, an introduction to data sources and analytics, as well as next steps in the field.

This is a 21-slide module presenting an introduction to the concept of and relationship between population health management and social determinants of health beginning with current definitions, a brief history of along with the evolution of the field.