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SOCIAL DETERMINANTSOF HEALTH SURVEY INTHE EHRPRAPAREPROTOCOL FOR RESPONDING TO AND ASSESSINGPATIENT ASSETS, RISKS, AND EXPERIENCES

HISTORYPROJECT OVERVIEW/RATIONALEIn September 2013, the National Association of Community HealthCenters (NACHC), the Association of Asian Pacific Community HealthOrganizations (AAPCHO), the Oregon Primary Care Association (OPCA),and the Institute for Alternative Futures (IAF) launched a project fundedby the Kresge Foundation, Kaiser Community Benefit, and Blue Shield ofCalifornia Foundation to create, implement, and promote a standardizedpatient risk assessment protocol that goes beyond medical acuity toidentify risk related to the “social determinants of health” (SDH). Thegoal of this project is to develop and pilot a consensus-driven nationalstandardized patient risk assessment protocol in partnership with healthcenters and their networks that not only helps health centers betterunderstand and manage their patient populations, but also supportsdevelopment of a more appropriate payment methodology that sustainsSDH-related interventions.

HISTORY 1 year grant to develop and implement a SDoHsurvey that can be used Nationally. HIT/Care Coordination Implementation phase 3 months data gathering Alohacare patients Incorporate into the HRA Face to face or over the phone Test week 7/27 – 7/31

Project Implementation Team

SDoH Survey (PRAPARE) The WCCHC revised survey is comprised of original surveyquestions, input from the PRAPARE meeting in Oregon andWCCHC Care Coordinators. Survey is split in several sections Demographics (auto-filled from check in)Personal CharacteristicsFamily & Home/HousingHealthcareMoney & ResourcesMedical ConditionsSocial & Emotional Health The patient will complete the EMR template survey using aWCCHC tablet or desktop computer in patient mode. The order of questions on paper survey may be slightlydifferent from the EMR template survey.

SDoH Survey (PRAPARE)

SDoH Survey (PRAPARE)

SDoH Survey (PRAPARE)

SDoH Survey (PRAPARE)

SDoH Survey (PRAPARE)

SDoH Survey (PRAPARE)

SDoH Survey (PRAPARE)

SDoH Survey (PRAPARE)

SDoH Survey (PRAPARE)

SDoH Survey incorporated into HRA HRA on paper SDoH survey has a template

Updates in EPM Complete the paper HRA Transfer SDoH info to SDoH template 3 areas where you’ll have to update info in EPMVeteran Status

Updates in EPMMigrant Worker Status

Updates in EPMIncome data

The patient will complete the EMR template survey using a WCCHC tablet or desktop computer in patient mode. The order of questions on paper survey may be slightly different from the EMR template survey. SDoH Survey (PRAPARE) SDoH Survey (PRAPARE) SDoH Survey (PRAPARE)