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Resource Overview

Population Health Management requires aggregating patient data from a number of sources, and conducting analytics and modeling to derive actionable insights that translate to increased patient engagement and improved outcomes.  Resources in this section describe data sources that are available to health centers, how to access and integrate them, and ways to enrich them with patient-provided data through health risk assessments and patient engagement technologies.

Getting and Using PHM and SDH Data

Data Dictionary Tool and Template

Data Dictionary Tool and Template

Organizational tool for your EHR and analytics platform data indicators

This Data Dictionary provides a single point of reference for data mapping and interpretation for all of the indicators in your quality reports. Organization of the data definitions in this tool provides a reference for the team of all such definitions that impact reports and alerts in the analytics application. For example, it provides a format to document all items in a given report, and related EHR data. That application may be the EHR or an analytics platform that is tied to the EHR. Anyone with questions about where data is being pulled from for any indicator can reference the Data Dictionary without analyst security privileges or expertise within the analytics tools. The Data Dictionary should be curated by analysts and made available on a shared drive or company intranet.

Download the Excel tool below to see a full example and additional instructions. 

Also, see the companion Quality Report Inventory tool here.

Documents to download

Previous Article Using Data to Manage Population Health Under Risk-Based Contracts
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Intended AudienceEHR, IT, and QI Staff; Clinical Quality Team members looking for ways to communicate data to their team and other stakeholders

Acknowledgements

This resource collection was cultivated and developed by the HITEQ team with valuable contributions from the National Association of Community Health centers (NACHC) as well as HITEQ's Advisory Committee and many health centers who have graciously shared their experiences with HITEQ.

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HITEQ works to provide top quality resources, but know your needs can be specific. If you are just not finding the right resource or have a highly explicit need then please use the Request a Resource button below so that we can try to better understand your requirements.

If on the other hand you know of a great resource already or have one that you have developed then please get in touch with us by clicking on the Share a Resource button below. We are always on the hunt for tools that can better server Health Centers.

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The Quadruple Aim
Quadruple Aim

A Conceptual Framework

Improving the U.S. health care system requires four aims: improving the experience of care, improving the health of populations, reducing per capita costs and improving care team well-being. HITEQ Center resources seek to provide content and direction aligned with the goals of the Quadruple Aim

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