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Hi David! Yes, see transcript below:
Trish Dyer:Trish Dyer, Oneida TN from Mountain People’s Health Council
Donna Reeves:Donna and Sandra – Central Counties Health Centers, Springfield, IL
Nancy:Nancy Ceja from La Clinica in Oakland, CA
Kathy Hopkins:Hi — This is Kathy and Rebecca from the Family Health Centers in Brooklyn, New York
Israel Reyes:Hi Israel Reyes from Charter Oak Health Center Hartford, CT
Angie Rohn and Delaney Sieving:Angie And Delaney for Virginia, il
Lia Sebring:Lia Sebring from Portland, Oregon – Oregon Health and Science University
Sharayah Foster:Sharayah Foster – Alaska Primary Care Association
Tara Ferguson-Gould:Tara FErguson-Gould from Alaska Primary Care Association
Monica Razo:Monica Razo Community Health Network in Alvin, TX
Jocelyn Sampson:Hi! This is Jocelyn Sampson from Triad Adult and Pediatric Medcine in Greensboro, NC
Terri Kennedy, Community Care KS:Terri Kennedy from Community Care Network of Kansas. We are the KS PCA!
Jaclyn Noble:Jaclyn Noble: Triad Adult and Pediatric Medicine, Greensboro, NC
Nellie Roehl:Nellie Roehl- Alaska Primary Care Association
David Huntley:David Huntley: Neighborhood Health, Nashville TNJoe Lee (AAPCHO):Out of curiosity, who is currently using or planning to use the PRAPARE tool? And what kind of cross-training opportunities happen at your org?
Susan Leonard:I am still really confused as to why I would need to use PRAPARE – our member health centers state they are already capturing SDOH data in their EHR.
Amanda Perez 5:My clinic is currently using Prapare, we have not started cross training yet.
Angie Rohn and Delaney Sieving:I like Susan Leonard’s question. I have the same question
Ely Romero:Our facility uses PRAPARE(Patient Advocate) is entering and asking questions to patient.
Donna Reeves:We plan to utilize PRAPARE in the very near future.. Our outreach staff will be spearheading the implementation.
Joe Lee (AAPCHO):Thanks for your comment, Susan. We’re certainly curious to hear how else health centers are collecting SDoH data, whether that’s via PRAPARE or not.
Albert Ayson:Susan and Angie – We’re discussing PRAPARE as a lived example in this session since it has been widely recognized by health centers and PCAs naionwide. In the end, we encourage all health centers to collect standardized data on SDoH. I hope that helps
Joe Lee (AAPCHO):Ely, Donna – Thanks for sharing what you’re currently doing/planning to do.Angie Rohn and Delaney Sieving:Is there an added benefit using the PRAPARE instead of the SDoH?
Michelle Jester 2:Hi Angie and Delaney! PRAPARE is a standardized social determinants of health assessment tool. It is patient-centered, in multiple EHR systems, and tested by multiple health centers in lots of different states. It is now the most dominant social determinant screening tool used by health centers and is increasingly being used by hospitals, health systems, and health plans. It’s being recognized as a really useful, usable, and actionable tool. It’s mapped to standardized codes (ICD-10 Z codes, LOINC, SNOMED codes) to help with additional standardization.
Michelle Jester 2:I hope that helps answer your question!
Angie Rohn and Delaney Sieving:Thank you Michelle it does help
Michelle Jester 2:What’s most important is health centers having standardized data on the social determinants of health so that they can better understand their patients and demonstrate health center value. We think PRAPARE is the most patient-centered and flexible approach out there, but we are a little biased
Kathy Hopkins:Can you provide some examples of how you quantify response data – for example, if food insecurity is identified as a need, are you going as far as collecting data on the value of food stamps received by that patient?
Michelle Jester 2:AAPCHO has a great set of enabling service codes to help capture what is being provided to address the need identified as wella as the “intensity” of that service in terms of time a staff person is taking to address that need. They are now working to update that list of codes with more SDH interventions and partnerships. We plan to add those codes into PRAPARE as a big “PRAPARE 2.0 release” . This will really help build the evidence base as to what it takes to care for complex populations and demonstrate the value of those services and interventions
Ginny Potrepka:We have a demographic sheet that is filled out prior to visit that captures most of the data in PRAPARE tool. I have a few questions about how to assist patient eompleting some of the questions, ie #17 about stress. Can patients really differntiate between “somewhat,” and “a little bit”?
Susan Leonard:Is there a charge for PRAPARE?
Satoya:Does Athena have PRAPARE by chance?
Michelle Jester 2:PRAPARE is free to use! All of our resources (including the EHR templates) are free and available at our website at http://www.nachc.org/prapare
Michelle Jester 2:I am currently working Athena to develop a PRAPARE template. They have a beta version that they will test with clients very soon. I suspect a template will be available by spring or early summer
Michelle Jester 2:We currently have PRAPARE EHR templates for eClinicalWorks, Epic, Cerner, GE Centricity, NextGen. I am currently working with Athena and Health Choice Network and ARCare are developing templates for Greenway Intergy and SuccessEHS, respectively
Michelle Jester 2:If you are on an EHR where a PRAPARE template doesn’t currently exist, please let me know! we’d be happy to work with you and the vendor to get a PRAPARE template built in that system.
Amanda Perez 5:How often should a Patient do the Prapare forms?
Michelle Jester 2:Ginny, that’s a great question! We had PRAPARE reviewed by a health literacy expert for a 4th – 5th grade reading level. We also conducted cognitive testing with patientss before piloting PRAPARE. , and we conducted some evalutions with patients and staff after the pilot. Patients areported that they understood the questions. though I can see your point where “little bit stressed” and “somewhat stressed” seem similar. I believe our health literacy expert recommended that language so that it was most easily understood on a Likert scale but I can go back and look at the history to find out more!
Michelle Jester 2:Amanda, we have a PRAPARE Data Documentation guide that provides recommended frequencies for each question. Some questions just need to be asked once, others are recommended at once a year (e.g, education, etc.), but others we recommend be asked at every visit because they could change quickly and have a huge impact on the patient’s health or health management. These are questions like housing stability, material security, stress, etc. We know that may be difficult to do at every visit, so at a minimum, we recommend that PRAPARE be administered annually. Most of the EHR tempaltes allow for the input of dates so that you know when PRAPARE was last administered. Some also have “reminders” or “triggers” to alert staff which PRAPARE questions the patient is due for
Ginny Potrepka:Thanks Michelle, I guess I share some of the concerns Kathy shared above, do we have action plans for the data we are collecting. Do we do something different with a Somewhat stressed that a llittle bit. Do we assess food stamp status if they have food access needs.
Michelle Jester 2:Ginny: great point! I should have mentioned this at the beginning but we view PRAPARE as a conversation starter. We hope that PRAPARE is not administered as a static screening tool but a way to help capture standardized data through conversation with patients. So, hopefully there is more contextual information,. We have a PRAPARE risk score methodology as well to help determine (in a rudimentary way as it’s not currently weighted) which patients might be most at risk. In that scoring methodology, “somewhat stressed” receives a higher score than “a little bit stressed” so that would help guide action. We hope that by having this data, it can better help your organization figure out where to best devote your l efforts. Hopefully the income quesation also helps assess food stamp eligibility as well so that you can easily act on the data you are collecting.
Michelle Jester 2:But having this information is helpful for even more upstream work. For example, let’s say you discover that a lot of your patients are experiencing food insecurity but they actually aren’t eligible for food stamps. This data can help inform policy to potentially change the eligibility requirements for food stamps. But, it’s a lot harder to do that advocacy work without having standardized data.
Satoya:Is the goal to have 500 additional questioners?
Albert Ayson: Satoya – That is correct, 500 additional questionnaires
Albert Ayson: for 2019
Satoya: to be asked to patients?
Satoya: surveyed***
Albert Ayson: Satoya – correct to patients. You can connect with La Clinica offline for more infoHi all! Two items:
1. Here is the URL link to the Adobe Connect recording from our Week 3 session: http://nhchc.adobeconnect.com/pto152jidm1m/
2. Attached is the “SDoH Academy LC #2 – Session 3 Slide Deck – FINAL”Recruitment & Retention Plan Template
https://chcworkforce.org/acu-health-center-provider-retention-and-recruitment-plan-templateFinancial Impact Calculator
https://chcworkforce.org/star%C2%B2-center-financial-assessment-toolBurnout Self-Assessment
https://chcworkforce.org/star%C2%B2-center-burnout-assessment-toolUpcoming LC on Workforce Metrics
https://chcworkforce.org/star%C2%B2-center-data-metrics-learning-collaborativeTwo items:
1. Share your feedback in our Final LC Evaluation: https://www.surveymonkey.com/r/6QKVLR5
2. Take the ACU Workforce Self-Assessment: https://chcworkforce.org/acu-self-assessment-tool
For Week 4 and to close out our workforce learning collaborative, please respond to the prompt below by: Tuesday, March 5th at 11:59 pm ET.
“Lack of time resources can often feel like the biggest obstacle in developing the managers and the culture at your organization. How could you incorporate discussion about these issues into your existing meetings and trainings for managers and staff?”
Please note: the discussion board will be open for 4 more weeks! In order to receive a Certificate of Completion, we’ll be looking that you answer all 4 weeks worth of reflection questions. This is a great opportunity to share your thoughts and share updates or best practices with your peers.
Hi Ely! Thanks for your candid response. I’m curious to know how call center agents, like yourself, can be incorporated into SDoH work. When I think call center agents, I automatically think of patient advocate or patient representative because your role has the potential to connect patients or new patients with the right person, service, or resource. Perhaps being aware of SDoH initiatives at your health center or organization is enough to make sure you’re communicating potential services that someone is curious about. Any thoughts?
Hi all! Below are helpful resources related to our week 3 topic on training health center workforce for SDoH:
PRAPARE – Social Determinants of Health (AAPCHO x NACHC x OPCA)
http://www.nachc.org/research-and-data/prapare/Enabling Services Data Collection Training (AAPCHO x HOP x NHCHC)
http://www.enablingservices.aapcho.orgCultural Humility Training (AAPCHO)
E-mail training@aapcho.orgEmpathic Inquiry Training (Oregon PCA)
https://www.orpca.org/initiatives/empathic-inquiryHealth Coaching (UCSF Center for Excellence in Primary Care)
https://cepc.ucsf.edu/health-coaching> OPTION A: Take a snapshot of your current workflow and make note of what changes your organization can you make that are feasible to advance your SDoH and ES initiatives? If no workflow exists, refer to sample workflows in the PRAPARE Toolkit: http://www.nachc.org/research-and-data/prapare/toolkit/chapter-5-develop-workflow-models-april-2018/. Choose a workflow of your choice, then modify it to fit your organization’s needs and be sure to cite any sources. Feel free to post your workflow ideas, screenshots, or files here for others to see and comment on!
> OPTION B: Pull a job description of a patient navigator, community health worker, care coordinator. See how you can modify that job description to advance your SDoH and enabling service initiatives? If no job description exists, sketch out an ideal position with a title and some responsibilities and duties of this position.
For Week 3, please select 1 of 3 questions below and reply with your response by: Tuesday, February 26th at 11:59 pm ET. (Please note: if you’re feeling like an overachiever, feel free to answer more than one question):
1) What is your organization currently doing, planning to do, or needing, to train staff on Social Determinants of Health (SDoH) data?
(Examples include educating staff on the importance of the social determinants, how it aligns with Patient-Centered Medical Home efforts, how to collect those determinants using the specific EHR system, and how to connect patients to available resources to meet the needs identified.)2) Let’s assume that you’ve successfully implemented standardized data collection systems for SDoH and Enabling Services interventions. What challenges do you perceive in using that data to achieve value-based payment reform, and who are the best staff persons (operations, policy, etc.) in your organization to advocate for that kind of change?
3) What is your city, county, or state currently doing, planning to do, or needing, to implement value-based payment reform?
(Examples include policy advocacy for enhanced reimbursement and participation in SDoH-related pilot initiatives.)
Hi all! Here’s the recording to accompany the slides from Week 2: http://nhchc.adobeconnect.com/p2pkbpyqk2vz/