Community Networks are a cross between a Health Information Exchange (HIE) and a social media website. They are simply a way to describe a highly connected group of practices, agencies and their clients. Sharing information through the PTI Data Center, the goal of Community Networks is universal screening and 100% reach. Coordinate care between agencies by sharing screenings, flags, referrals, notes, dispositions and performance metrics. Perform data mining across agencies based on data sharing agreements.
Screening Sites In Community Networks
Screening sites include clinics, child care centers, schools and health fairs, but also include portals and personal apps. Portal screening sites can be a clinic’s patient portal or PTI Public using a PTI Portal website service, or an external portal like ASQ Online or an HIE. If a screening site is not able to manage screening results, the profile needs to be connected to a Care Coordination site to fill this role.
Care Coordination Sites To Manage Results
Care Coordination sites include public health, child find, programs like HMG, clinics and services. Results that are out-of-range are flagged for follow up. The flag is typically managed by the screening site but can be shared with another site, health care and child care for example. When indicated, flags can be used to generate a referral with a source and a destination. Notes, status and outcomes attached to flags and referrals keeps the responsible parties informed.
Data Mining Sites To See The Big Picture
Umbrella organizations like county and state public health or programs like HMG or Project Launch can view summary information across their connected agencies with the proper data sharing permissions. Usage statistics measure reach. Results statistics do basic surveillance measuring prevalence. Outcomes and time between, and at different agencies, measures performance. Feedback of this information keeps everyone on course.
Connection Through The PTI Data Center
All data in the PTI Data Center is de-identified which makes it easy to share information with the right connection permissions. Where required a Business Associates Agreement (BAA) can be used. The Meeting Milestones Initiative (MMI) in Grand County, Colorado where the Community Network concept was first developed, uses a Community BAA to simplify the permissions process. Connections make everything work together.
Everyone Simply Manages Their Clients
The primary advantage of a Community Network is that everyone goes about their normal business. Using connections, it does not matter who does the screenings and owns the data. Connected agencies can do the care coordination and umbrella agencies can get the information they need without any extra work. No grand initiative has to be implemented, simply start using apps and get connected.