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