Category | Topics |
---|---|
⭐️ Affinity GroupsSee what each of the Affinity Group teams have been working on, as they continue to meet at least quarterly.
|
6
|
⭐️ PHLN ActivitiesDiscussions about program-related items, including convenings, site visits, webinars, and more!
|
18
|
Resource LibraryFind all resources from the Forum compiled in one place here!
|
11
|
Behavioral Health IntegrationInformation and tools about integrating behavioral health into primary care, covering different models, roles, screening tools, and use of registries to identify and manage patients; monitoring outcomes.
|
5
|
Care Management for Complex PatientsIdentifying high-risk patients; defining interventions for patients based risk levels; building community partnerships, and managing hospital transitions.
|
6
|
Data Governance & AnalyticsData governance, stewardship, and analytic tools. Data visualization and data transparency.
|
4
|
Learning OrganizationsUnderstanding adaptive and technical challenges; leading and managing change; communicating around large change initiatives; clarifying leadership roles and how leaders work together to provide integrated care.
|
1
|
Planned Care and In-ReachGauging patients’ needs and delivering timely services and support before and during the visit, with an emphasis on leveraging technology, data tools for clinical decision making, and patient engagement strategies.
|
8
|
Proactive OutreachUsing data and the care team to outreach to patients with care gaps or assigned members that have yet to establish care; examples of outreach strategies including outreach reports.
|
8
|
Social NeedsScreening and prioritizing non-medical needs, as well as building internal systems, referral processes, and effective partnerships with community organizations to respond to identified needs.
|
12
|
Team-Based Care 2.0Care team roles and functions; standing orders; protocols and tools to optimize individual team roles; use of alternative visits; reducing variation and promoting standardization of care teams across sites.
|
13
|
11
|