Monday, November 6, 2017

Community Health Centers: Centers of Innovation and Best Practices in a Changing Healthcare Landscape

Leslie Chatelain, MPH, Research Associate

Acronyms:
PCH – Partnership for Community Health
CHC – Community Health Center
ICH – Institute for Community Health

The landscape of healthcare in the U.S. has rapidly changed in the last several years. These changes have compelled community health centers (CHCs) to innovate to keep up. One mechanism enabling CHCs to implement innovative projects is grant programs. Some of these grants are funded by foundations which, in 2014 alone, gave away $60 billion (http://data.foundationcenter.org, most current data).  An example of this is the Partnership for Community Health Excellence and Innovation Grant Program (PCH), which has awarded over $17 million to CHCs in Massachusetts since 2014.  This money has helped grantees to develop and implement innovative projects to transform their operations and patient communications. The PCH grant program contracted with ICH to lead the foundation and grantee-level evaluations.  By using a participatory, utilization focused approach to this evaluation (http://instituteforcommunityhealth.blogspot.com/2017/10/the-foundation-to-effective-reporting.html), grantee CHCs have been able to collect meaningful data on the successes and challenges they have encountered while implementing their projects.  To magnify the impact of the foundation’s grant-making activities, ICH helps to strategically disseminate lessons learned so others can replicate and expand upon the grant-supported work.  One way this is done is by convening best practices forums or learning collaboratives.    

A learning collaborative or best practices forum offers an opportunity to grantees to pool and share knowledge with other CHCs who may benefit from such an exchange. PCH held such a forum most recently in September 2017 with 3 panels consisting of some of the current grantees. The panel topics included: addressing social determinants of health through adding new roles to the care team, improving care through telehealth technology, and taking a population health approach to chronic opioid dependence.
Insights from the forum’s panel on telehealth technology include the following:
·         With their small profit margins, community health centers generally cannot implement the kinds of projects presented at the forum without additional resources committed to innovation. Consequently, the investment provided by the funders was critical.
·         For technological projects, there is a need to assess the technology that is currently in place to determine what software or program would fit best with the existing infrastructure.
·         For all of the potential benefits that telehealth projects can have, it is essential that the right staff is in place to manage and harness the potential of the technology.

·         Telehealth projects have advanced thinking about what is possible to achieve with technology. Patient access to specialists is difficult across all health centers in the state and telehealth projects may be able to address that.
o   Example:  One project utilizing telehealth technology to triage dermatological conditions has determined that 75% of referrals to dermatology specialists are unnecessary.  Cutting down on unnecessary referrals frees up the services of dermatologists for patients who really need them.
At the conclusion of the discussion, one forum attendee reported that they “couldn’t wait to head back to their community health center and implement some of the ideas discussed at the forum.” Other attendees spoke similarly. This open sharing of knowledge, best practices, and lessons learned will serve to inform future innovative projects at community health centers and help to improve quality of care, increase patient/staff satisfaction, and reduce costs/increase operational efficiency at CHCs.
If interested, please see the following video to view the presentations and discussions from the forum

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