In recent years, health centers have become increasingly interested in and charged with not only addressing the health concerns of their patients, but centering and responding to patient’s social needs. According to Healthy People 2030, social needs, also known as the social determinants of health, are the conditions in the environments where people live, learn, work, and play that affect a wide range of health, functioning, and quality-of-life outcomes and risks. Social needs encompass the quality of and access to resources such as housing, transportation, safety, employment, food, and more. Identifying and addressing unmet social needs as part of the clinical encounter provides the opportunity to deliver higher-quality, whole-person care, advance population health, and reduce healthcare costs.

Implementing a social need screening effectively is an iterative process. Many health centers find that their approach evolves as new concerns or considerations arise. The examples in this resource, gleaned from interviews with health centers, illustrate that unique context and needs drive what works.

Although health centers have more options than ever to use electronic tools to engage patients in care, selecting those that most effectively further the goal of providing high-quality and efficient patient care is challenging. In this explainer, we consider three types of tools that health centers may invest in: Remote Patient Monitoring, Electronic Patient Engagement, and mHealth Personal Apps. By understanding what they are and how they are implemented, their advantages and disadvantages, and how they align with value-based care and the clinical workflow, health centers can choose the suite of tools that best serve their patient needs.

This Excel-based scoring rubric is intended to be used by health centers to assess electronic patient engagement tools (like automated outreach SMS platforms) to determine which tool is most likely to meet the health center's needs.

Lack of Internet and broadband access prevents some patients from using telehealth and other technology that can support their own health care and getting accurate health care information. In one 2020 study, 42 million Americans lacked adequate access to broadband (high speed internet). As of 2019, about one in five people did not have smartphones, and among low income people nearly one third do not have a smartphone. Rates of computer ownership are not much better. Those patients who do have access to the technology may or may not have the capacity and willingness to use it, depending on past experiences. Some patients aren't comfortable with technology, while others don't trust it or believe that virtual care is sub-par, despite growing evidence of its benefits. This culminates in a clear digital divide that can hinder the ability for patients to fully engage in their care or take advantage of things like remote
patient monitoring, telehealth, mHealth, or patient portal.
This resource provides an overview and some tips for assessing a patient's ability to engage with technology for virtual care, and and interventions that can be used to bridge gaps that are uncovered.

Last fall, the HITEQ Center published an inventory describing many software tools that facilitate electronic patient engagement (EPE). The inventory detailed feedback from health center users of the EPE tools as well as information from the vendor about features and integration. As the health center workload has expanded to accommodate COVID-19 vaccination, the opportunity of EPE tools to address the needs of both health center and patients in this moment became apparent. HITEQ contacted the vendors included in the original inventory to gather supplemental information on how their products can be leveraged to support COVID-19 vaccine communication and distribution. Four EPE vendors responded, and those responses are outlined herein.

In the spring of 2020, HITEQ and several PCA and HCCN colleagues developed a survey to gather detailed information on health center experiences with a variety of EPE tools and included questions about product functions, strengths & weaknesses, cost, integration with EHRs, ease of implementation, and quality of vendor support. The results of that survey, as well as interviews and demonstrations are captured in this EPE Tool Inventory.

Electronic patient engagement technologies are having a significant impact on diabetes-related health outcomes and can help to increase patient to provider diabetes care plan involvement and communication. This HITEQ webinar explored use cases and strategies for effective adoption and evaluation of electronic patient engagement diabetes interventions within the health center setting.

The introduction of electronic personal health records (PHR) systems, and the patient portals used to provide patients access to those records, into the fabric of the U.S. healthcare system provides a major opportunity to encourage positive health management practices, such as chronic disease management and increased care plan adherence, through greater engagement of the patient.  Unfortunately, there is still a broad gap between the effective use of PHR technologies where advanced health information services are perhaps most needed, especially within the underserved communities supported by community health centers. This guide provides health centers with an adoption framework that can be used to assess the goals and methods for deploying electronic patient engagement services.

As Health Centers increase the amount of electronic communications sent out to their patients they need to continually assess the literacy level of the content that they are sending out across patient portals, text messages, and social networks. This guide provided by the Office of Disease Prevention and Health Promotion helps staff "develop intuitive health websites and digital tools that can be easily accessed and understood by all users — including the millions of Americans who struggle to find, process, and use online health information."

The Patient Engagement Playbook provides Health Centers with strategies for improving patient enrollment, activation and communication, care giver engagement and integration of patient-generated health data. For Health Centers attesting to Meaningful Use stages the Playbook also provides guidance and clarification around meeting patient engagement related objectives.

Health Center clients represent a broad range of cultures, many of whom do not speak English, or at the least have a limited vocabularly and find it difficult to read or write in English. Unfortunately, many of the current patient portals supported by some of the primary electronic health record (EHR) systems used by Health Centers do not provide a broad range of available languages. Provided in this resource is a listing of the current status of patient portals and the degree to which they provide multi-lingual support.

This Chilmark Research report discusses challenges to current patient portal systems which may help health center leadership better understand why or why not they are encountering issues when trying to effectively engage their clients with patient portal systems.

This video may also provide insights to various technologies that health centers may consider adopting to further achieve patient activation and engagement goals.

This guide provides examples and overviews of patient portal considerations for minors as it relates to Meaningful Use, HIPAA. state consent laws and associated policies. The articles and presentations included for download and linked to from related websites include use cases and examples from multiple states and national level guidelines.

This article provides an overview of a patient portal implementation conducted by Patients First within east central Missouri counties. The NextMD patient portal was rolled out in August 2010 and serves three core functions:  1) Providing patients with an electronic clinical summary, 2) Providing timely access to lab results, and 3) Providing secure messaging with clinical and office staff.

This report published by the California Health Care Foundation provides preliminary findings of patient portal impact as it relates to safety-net organizations.

This YouTube video provided by the U.S. Department of Health and Human Services offers a white board style overview of how electronic health record systems directly support a patient's health. It includes topics of health data standards, health information exchange, health apps and new technologies, and patient rights to their health information.

The Office of the National Coordinator (ONC) has recently published several patient portal stories from patients who found success in being able to better understand their and their families conditions, care plans and health services received. These patient portal stories are meant to help both providers and patients understand how patient portals can increase a patient's engagement with their care and increase communication between healthcare staff and patients and between patients and their family members.

Healthcare continues to be the sector most targeted globally by ransomware and related malware attacks and leads in the average total cost of data breach across industries. The FY 2021 American Rescue Plan Funding provides an excellent opportunity for Health Centers to make strategic investments in cybersecurity infrastructure and services. This HITEQ Highlight, presented by Adam Kehler of Online Business Systems provides an overview of assets that can increase Health Center cybersecurity. Topics covered include cybersecurity infrastructure and services that can increase defense-in-depth for health IT, including EHRs, telehealth tools and services, mobile medical devices, patient portals, and related health information software applications.

Note: You can view our American Rescue Plan: Budget Your Cybersecurity Investments guidance document in the Documents to Download section below. An accessible version of the handout is is also available in the Documents to Download section.