This paper discusses Community Vital Signs, which include data on housing, environmental exposure, neighborhood race and ethnicity data, neighborhood socio-economic makeup, and other data, and how these data may be useful to population health management.

This resource will equip health center stakeholders with the motivation, knowledge, and ability needed to collect and use standardized social determinants of health data.

Empanelment is the basis for population health management and the key to continuity of care. Accepting responsibility for a finite number of patients, instead of the universe of patients seeking care in the practice, allows the provider and care team to focus more directly on the needs of each patient. Inside, find guidance for establishing and maintaining patient panels.

Does your agency’s UDS report accurately reflect the work you do for depression screening and other behavioral health integration activities? Join this webinar to learn strategies and steps your team can use to make the most of the EHR to support improved health outcomes for your patients. Gain insight from a health technology expert and practical tips from an agency who learned to make their EHR a true part of the team to improve UDS depression measures through inputting and analyzing depression screening data from the EHR.

HealthNet’s successful use of Health IT to move metrics is highlighted in case studies focused on the value of leveraging IT to standardize care and improve patient outcomes. With the assistance of electronic health records and a variety of IT interventions, HealthNet has reduced low birth weights, improved care outcomes for pediatric patients, and significantly increased patient satisfaction.