Confronting the challenges of a global pandemic and the need for innovative virtual models of care, NACHC is delivering solutions.
One of NACHC’s Quality Center’s newest and most exciting initiatives, Leading Change: Transforming At-Home Care, mobilized a national cohort of health centers to develop new, efficient models of virtual care for high-risk patients.
NACHC’s pilot took forward-thinking steps to enable health centers to manage chronic conditions and ongoing care from the safety and comfort of their patient’s homes, while empowering patients to be more self-reliant and proactive in preventing health problems. The central feature of this pilot was the set of self-care tools, including a blood pressure monitor, home A1c tests, home colorectal cancer screening test, scale, and thermometer which were provided to patients and coupled with educational instruction and consistent care team support.
Initial results from the pilot are promising. One participant, East Bay Community Action Program, told us the experience will inform patient care from now on:
“We are confident that this program and the education and tools given to the patients will lead to positive trends through the end of the year. Telehealth and remote patient monitoring are here to stay, and I think participating in this program led us to some great insights on how to sustain and improve these services for our patients.”
East Bay Community Action Program
Building on the network created through the “Elevate” learning forum
NACHC could rapidly launch this program given the infrastructure, processes, and people that were in place through its Elevate national learning forum, and the dedicated health centers, primary care associations (PCAs), and health center-controlled networks (HCCNs) that readily mobilize for transformative initiatives. NACHC released a national call for health center applicants in July 2020 and selected twenty (20) health centers in sixteen (16) states from a national pool of capable candidates. The health centers selected to participate in this ten-month pilot project (September 2020 – June 2021) represented a range of rural, urban, large, and small organizations.
“Leading Change” sought to test interventions and document results
The Leading Change: Transforming At-Home Care pilot project:
- Tested the impact of providing patients with self-care tools (called a ‘Patient Care Kit’), offered in connection with care team support, monitoring, and follow-up in a virtual care setting
- Developed health center and patient care workflows and protocols for patient care and monitoring in the virtual setting
- Documented implementation experiences and best practices in the deployment and use of Patient Care Kits in the virtual care setting for the benefit of health centers nationally
The project was built on the foundation of NACHC’s Value Transformation Framework (VTF), and the system-change tools offered through Elevate’s Learning Forum.
Participants offered NACHC enthusiastic feedback
Health centers that participated were excited about the pilot and its potential. Though this was just a small test, all participating health centers felt that this was a window into the future. Here is some of the feedback we’ve received:
- “Patients were excited to see the changes in our telemedicine visits and impressed with developments for the clinic’s staff.” (Native American Health Center)
- “We had several patients who were hesitant or didn’t know how to do video visits and ultimately they became self-sufficient and gained confidence in the technology and self-measurement tools.” (OneWorld CHC)
- “We had several patients who really turned their health around. They also enjoyed the check-ins by staff.” (Accordia Health)
- “This pilot got the Wright Center to invest in more remote patient monitoring, and we now see a shift to incorporate this model and use of technology as a way to streamline communication and access for patients.” (The Wright Center for Community Health)
- “Patients felt heard and supported, especially through the COVID-19 crisis.” (Zufall Health)
To learn more, check out NACHC’s Quality Center Initiatives.