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Date

Agenda

Notes

Action Items

3/6/24

  • Met previously with Katja’s team on Oral Health last week

  • Closed Loop Transportation Project

    • Meeting regularly with KPHC

      • Solidifying measures to track (diagnoses code, evaluation measures)

      • Received preliminary report, will be discussing later today

      • Working on readiness assessment

      • Webinar coming up in a month - came up with PDSA slide deck to populate

    • Have created Project Guideline Infographic, sent to KPHC team for preliminary data capture

    • Have heard from others interested in this work as well for future opportunities and testing

      • Hawaii PCA

    • Hoping to continue work after July 31

2/20/24 - Email Update

1/21 project updates in lieu of meeting:

  • Closed Loop Transportation Project

    • AAPCHO met with KPHC and discussed the progress of the closed loop tracking system and worked together to incorporate measures.

    • AAPCHO created a guideline document for KPHC with project outline, measures, and diagnoses codes

    • KPHC met with their IT team on 2/15 to implement measures

    • Will meet with them today

    • AAPCHO working on readiness assessment

  • Oral Health Project Update

    • Continuing reviewing the literature from the environmental scan, and adding onto existing resources with updated national guidelines and newer articles from various journals

    • Incorporated new oral health data including numbers, percentages, and data visualization into Webinar PPT slides

    • Incorporated new oral health recent publications and findings section into Webinar PPT slides

2/7/24

  • CareQuest Oral Health

    • Environmental scan underway, have collected 20+ entries

      • Will be updating the presentation deck shortly

      • Survey

        • Testing in SurveyMonkey - second review in process

      • What are the disaggregated categories that HCs are collecting?

        • Asking HCs to submit reg forms, will do cross tabulation of what they are collecting, what are the most prominent categories they are using

    • Any planning needed for educational activities?

      • Aiming for May

      • Will begin NACHC internal process

      • CHI abstract submission open, due March 1

    • Blogs

      • Who will be writing the blogs?

      • Need to be in the queue for NACHC ones, also can link to one of AAPCHO’s posts

  • SDOH Closed Loop Pilot

    • Working with KPHC to incorporate measures - discussing what measures they will be tracking (just transitioned to Athena)

      • Added question for patients “have you been able to access the resources you need to address your social needs” to track closed loop referral

      • Testing with MAs and getting their feedback

      • Beginning implementation at multiple sites

      • Meeting with them later today

    • AAPCHO may need assistance with data, ONC later on; dissemination of survey

1/10/24

Closed Loop Transportation Project Update in lieu of meeting: Activity 1 and 2

Activity 1 Update 1/10/24: AAPCHO met with KPHC and discussed the progress of the closed loop tracking system. KPHC reviewed the newly developed EHR form with their MAs and made some refinements based on their feedback. KPHC will next plan to test with providers for feedback. AAPCHO also sent the drafted subcontract to KPHC for feedback.

Activity 2 Update 1/10/24: KPHC and AAPCHO reviewed the SDOH Closed Loop workflow and discussed the evaluation tracking measures. AAPCHO sent these tracking measures to KPHC to discuss with their IT staff to include in reporting.

1/10/24

Oral Health Project Update in lieu of meeting: Activities 1a and 1b

Activity 1a Update 1/10/24: Currently reviewing literature from the Environmental Scan for relevance.

Activity 1b Update 1/10/24: Addressed IRB application reviewer suggestions and IRB application was approved.

1/3/24

Closed Loop Transportation Project Update in lieu of meeting: Activity 1

Activity 1 Update 1/3/24: AAPCHO has been meeting regularly with the project site at Kalihi-Palama Health Center (KPHC). We have discussed and developed a project description, scope of work, and work plan and have also discussed the design of the case study report with proposed project strategies and evaluation measures. In our meetings, we have been focusing on learning about their closed loop protocol and workflow, especially since they are transitioning to AthenaOne. Also, now that the contract with NACHC has been issued to AAPCHO, we are also developing the subcontract for KPHC.

1/3/24

Oral Health Project Update in lieu of meeting:

Activity 1a and 1b

Activity 1a Update 1/3/24: Completed Environmental Scan methodology and began literature reviews with over 50 entries but need to review studies for relevance

Activity 1b Update 1/3/24: Developed survey to include questions about data disaggregation collection practices at health centers serving AA, NH/PI Communities. Submitted survey for approval with AAPCHO Community IRB.

11/15/23

  1. AAPCHO status with discussions health center site

  2. Link to Confluence (Jonathan and Sarah)

  3. Atlanta meeting

  4. Next steps

add text

CareQuest Project: Activity 1b. Assessment of key informant current oral health population data resources used at health centers serving AA, NH/PI communities.

1/30/24

11/1/23

Discussion Points:   AAPCHO and CareQuest

  • Introductions

    • AAPCHO

    • NACHC  (name, roles, and responsibilities)

  • Review of scope of work

  • Open Discussion

  • Next Steps

  • Oral Health

    • SOW Review

      • 1c - data will be collected directly from HRSA/UDS+?

        • Will request de-identified data after it is available; we shouldn’t rely on UDS+ data

        • Potential to influence ONC categories

  • Opportunity to publish

  • PHIT to create Confluence (populate with files from other work)

10/18/23

  • Welcome and Introductions  (3 minutes)

  • Adult Immunization Overview (5 minutes)  5 years in the making…

  • Data Overview (5 minutes)  the what the where the mess

  • Publications Plan

  • Next

  • Transportation - originally planning to exploring linkages to diabetes

    • Also adult immunization? Other comorbidities?

    • Working with one health plan, would have adult immunization rates but would not have transportation measure (Aloha Care)

    • How do we get referral incorporated into system?

  • Consistency of data over the years? Partners, data elements, etc. - NACHC team would need to dig in further

  • Who are the teams involved, will partners be leading?

  • Publishing models and looking at initial evaluation results

  • Liked the idea - Best practices for payment, roadmap

    • Collaborate with partners to make sure we have stakeholder perspective

  • Idea - If we standardize measure and workflow, this is what can happen in 3, 6 months

    • Who have we asked?

  • AAPCHO did paper on PRAPARE on screening rates

  • “Closing the loop” - we asked HCs what vaccines they keep on site and which they refer, asked if they closed the loop

    • Of the patients referred out, how many were also asked about transportation issues, were they addressed, and if so, what was the immunization outcome?

    • A lot of patients can be lost to follow up, want to make sure that loop is closed - what percent of patients actually went by the recommendation, didn’t? A lot of different scenarios

    • We have tools on self-inventory and referral

  • Narrow it to prototype we can scale after - by disease, age group?

    • Focus by payer?

  • NACHC will send publication list to Rosy once

  • Jen will update data and share dashboards

10/11/23

Discussion Points:

  • Welcome and Introductions

  • Overview of CareQuest     Katja  (See attached) 

  • Overview of current Status of Transportation Measure   (Julia)

  • Discussion on next steps:

    • Define roles and responsibilities moving forward  AAPCHO-NACHC.

      • Carequest

      • Transportation

    • Meeting dates and times

    • Next steps

  • Focus on publishing

  • CareQuest

  • Universal screen to test for transportation

    • Element optionally requested by UDS

  • Contract would go through 6/30/24

    • One contract for 2 SOWs

    • Conference - could do CHI 2024, open to other options

      • Travel should be included but separate for auditing purposes

  • SDOH Closed Loop Pilot Proposal

    • Products

      • Compiled recommendations from health centers and stakeholders on design of closed loop referral system for Transportation or other SDOH

      • Data collection implementation resources including workflow diagram(s), data template, data reporting/tracking templates, and screenshots

      • Developed and tested Implementation Readiness Assessment Tool

      • Narrative Report that describes key findings, promising practices, and lessons learned as well as recommendations for next steps

    • Closed loop protocol - work with transportation providers and providees to ensure patient received transportation recommended by HC or other social service provider and be able to state what the outcome for the patient was

      • Hopefully will be able to work with vendors to collaboratively test as well

    • Some groundwork has been done, Informatics will check in with Julia

    • What measure(s) would be most meaningful to track implementation, impact?

      • Could add additional data elements to EMR

  • Roles

    • NACHC will handle environmental scan, Informatics side

    • AAPCHO handle research side

  • Meetings

    • 2 pm EST on Wednesdays works for AAPCHO, most of NACHC team - bimonthly

  • Katja/Kathy will begin working on SOW and executing contract

  • NACHC will take care of environmental scan

  • Figure out meeting cadence, Rosy will send times

  • Determine main NACHC point of contact for Transportation

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