In this season of gratitude, NACHC wants to say THANK YOU to the nearly 1,500 Community Health Centers around the country for providing whole-person care to your communities, regardless of patients’ ability to pay. Health centers reach beyond the exam room every day to prevent illness and address the social and economic drivers that affect patient health and well-being. As our President and CEO Kyu Rhee, MD, MPP explains in this video, health centers are innovators and problem-solvers who do whatever it takes to meet whole health needs.
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Community Health Centers around the country are consistently testing Artificial Intelligence (AI) and tech tools for creative outreach. At the National Association of Community Health Center’s (NACHC’s) CHI and EXPO in August, we learned how San Ysidro Health successfully uses new AI and tech for patient engagement, care plan compliance, and Medicaid re-enrollment.
AI Increasing Patient Engagement at the San Ysidro Call Center
Vice President of Population Health at San Ysidro Health, Sonia Tucker, told us how her multi-disciplinary team researched different AI tools to support its call-in center as it struggled with higher call volumes and fewer agents. Sonia explained:
“In 2021 patient engagement was dropping, abandonment rates were rising, and patients were frustrated. We needed to do something about it.”
San Ysidro chose Kore.ai to deliver HealthAssist – an automated approach to call-center conversations for health providers. With the right training data from Uniform Data System (UDS), their Electronic Health Records, and language learning sources in English and Spanish, the San Ysidro team felt Kore.ai could help them reduce operational costs and improve call-center response rates, patient scheduling, and appointment reminders. They also used recorded call center data to identify themes and create a “rules engine” to train Kore.ai. The abandonment rate and number of unassigned patients have dropped substantially, and now they’re exploring how AI can help increase patient compliance. While there are “kinks” in these AI systems, overall, they’ve been happy with the ways AI supports their call center operations.
Since these practices are still new, Sonia left us with a few “AI pro tips”: “When training your AI, think carefully about your prompts– consider the AI like a young Intern you’re training.” She also said, “Hallucinations are a real problem. It’s critical to monitor AI communications and make immediate corrections, constantly.”
AI Tapped to Inspire Care Compliance
San Ysidro is also testing AI tools like ChatGPT for bi-directional text messages with patients. That tool is used for appointment reminders, follow-up conversations, redetermination campaign messages in all languages, surveys, and even one-on-one texting with the nursing team. San Ysidro staff are training the AI to create personalized messages for different service needs – using Azara to gather Social Drivers of Health – overlayed with zip code heat mapping to identify the location of patients they’d like to reach.
Ana Melgoza, Vice President of External Affairs at San Ysidro shared that, “tech is helping us provide information in different languages based on a better understanding of the reality of patients’ lives as we try to meet them where they are and help them with patient compliance”.
Take, for example, their “El Zapaton” program. This program was developed with incentives (shoe giveaways, food baskets, books, personal protective equipment, socks) based on analyzing patient data. The program’s aim is to improve quality measures for things like vaccine uptake, follow-up care, and medication adherence.
Hootsuite is a social media management tool, also powered by AI, that enables San Ysidro to post messages and short-form videos on multiple social media sites in multiple languages in support of the campaign and patient outreach. They can also reach patients directly through text messaging, call reminders, QR code promotions, digital media in waiting rooms, and provider support.
Traditional low-tech, in-person activities then clinched the deal with patients and helped San Ysidro develop trust and relationships. Atypical partnerships help as well. For example, many patients work late so Uber Eats became a partner; or they have pets, so local pet stores donated dog food or leashes. Favorite activities have included a “walk with doctors” event, cooking classes at the local university, and affinity groups.
Additional AI tools to help with Patient Outreach
Technology and AI tools that use generative learning are now ubiquitous, and health centers are researching different ways to use these tools. For clinical support, AI tools are advertised for ambient scribing, predicting no-show patterns, improving data quality research, helping with chronic care management and follow-up reminders, and even augmenting decisions for medical diagnoses.
For communications and outreach, this list of AI Tools for Communicators shares just a few of the many messaging, design, and outreach resources available.
Board members also want to understand “big data” and desire training to understand how AI could be useful for their health center.
What tools are you using?
While NACHC does not endorse any of the AI and Tech tools listed in this article, we are trying to understand how and why they’re being used by health centers. Please share what you’ve learned!
Send your stories to: cmo@nachc.com
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NACHC recognizes that as AI resources expand, data stewardship, data privacy, and thoughtful data governance policies will be more essential than ever, and we’re working to support health centers. Health Information Technology – NACHC
FOR IMMEDIATE RELEASE CONTACT: Amy Simmons Farber 202 309-0338
Bethesda, MD. – The Continuing Resolution (CR) Congress just passed to prevent a government shutdown includes an extension of mandatory Community Health Center Funding, the National Health Service Corps, and the Teaching Health Center Graduate Medical Education program through January 19, 2024.
NACHC appreciates that Congress included health centers and workforce programs in the short-term funding bill at current funding levels. This is another indicator that lawmakers on both sides of the aisle value health centers’ role as the largest primary care network in the nation, serving 31.5 million Americans, regardless of patients’ insurance status or ability to pay.
“While we join our members in breathing a sigh of relief that Congress did not allow Community Health Center funding to expire on November 17, the repeated short-term funding extensions are disrupting the work of health centers to care for 1 in 11 Americans,” said NACHC President and CEO Kyu Rhee, MD, MPP. “We hope that this short-term agreement gives Congress time to reach a bipartisan agreement on long-term funding for health centers, including a much-needed increase in essential primary care funding, which saves lives and reduces overall health care spending.”
The short-term funding creates uncertainty for health centers, which already operate on thin margins and are facing a triple threat of fiscal pressures: workforce shortages, Medicaid redeterminations, and losses from drug manufacturer restrictions on the 340B program. Health centers are experiencing a surge in demand for their services and rising costs, yet federal funding, which accounts for a large portion of their budgets, is not keeping pace.
“The funding uncertainty is causing unnecessary stress for our member health centers that need predictability to retain and recruit providers and staff, plan and deliver services, and sustain operations,” said Dr. Rhee. “By law and mission, health centers serve communities with unequal access to health care. Congress can support that mission by passing long-term stable funding, which improves the health of our nation and delivers significant economic impact for communities that need it the most.”
Earlier this month, Dr. Rhee wrote to congressional leadership urging them to include funding for Community Health Centers, the National Health Service Corps, and the Teaching Health Center Graduate Medical Education program in the eventual CR. View Dr. Rhee’s letter.
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NACHC is the leading innovative change agent collaborating with affiliates and partners to advance Community Health Centers as the foundation of an equitable health care system free from disparities, and built on accessible, patient-governed, high-quality, integrated primary care.
Merrill Warschoff Press is NACHC’s Senior Vice President for Development and Innovation.
At NACHC’s inaugural InnovationEx event in Las Vegas, NACHC CEO Dr. Kyu Rhee presented a new framework for thinking about innovation at community health centers. The 5 X’s of Health Center Innovation capture the key steps health centers need to leverage to innovate:
eXplore. Explore the opportunities, challenges and potential solutions affecting health centers and the people they serve. This will likely include really looking at the specific problem you think you want to solve, researching what others have done in similar situations and learning more about the conditions and contributing factors at play.
eXperiment. Experiment and test solutions – and even fail, gather patient, staff and partner input. Experimentation includes creation of a solutions(s), and engaging with the people and organizations most impacted – especially patients and staff.
eXcel. Excel by refining and improving the solution. After testing one or more solutions and gathering input and feedback, during the Excel stage, you should focus on making your chosen solution the best it can be.
eXpand. Expand, scale and catalyze innovations, learn from both successes and failures and assure sustainability. Here, you can bring your innovation to additional sites or services and build sustainability for the future.
eXchange. Exchange insights and learnings and scale solutions to advance impact. The exchange phase is most impactful when you start sharing your innovation externally and broadly so others can learn from it (and from any success or failures) and adopt it for their own opportunities and challenges.
NACHC’s Center for Community Health Innovation (CCHI) is here to help health centers, PCA’s and HCCN’s not only implement the 5 X’s, but especially to serve as a host or convener for the Exchange of innovations among the health center ecosystem.
Other resources:
- The CCHI Innovictionary is an innovation dictionary that defines innovation tools and concepts with a health center lens and provide curated resources.
How do the 5 X’s resonate with your health center innovation experience? Have a tweak or a suggestion? Want to be the first to hear about new innovation opportunities? Please write to us at innovation@nachc.org.
This post is part of NACHC’s Innovation Blog Series. This series is hosted by our Center for Community Health Innovation.
Today, NACHC President and CEO Kyu Rhee, MD, sent a letter to congressional leadership urging them to include a short-term extension of funding for the Community Health Center, the National Health Service Corps, and the Teaching Health Center Graduate Medical Education programs in the next Continuing Resolution (CR).
Government Funding Will Expire on November 17th
A short-term extension would prevent any disruption to these essential programs’ funding and give Congress more time to agree on a path forward for a long-term solution that provides increased funding and greater stability to the three programs.
Currently, government funding is scheduled to expire on November 17th and it’s highly unlikely the House and Senate will be able to finish the appropriations process before then. In this situation, Congress usually passes a Continuing Resolution (CR) to prevent a shutdown and allow more time for negotiations to continue. NACHC is very appreciative that Congress included a short-term extension for health centers and primary care workforce programs in September’s CR, but now Congress must act again to prevent any disruption to these essential programs’ funding after the November 17th deadline.
In his letter to leadership today, Dr. Rhee wrote:
“On behalf of the 1,487 health centers across the country, I write to ask that Congress include a short-term extension of the Community Health Center Fund, the National Health Service Corps, and the Teaching Health Center Graduate Medical Education program in any upcoming Continuing Resolution. A short-term extension of these essential programs will provide health centers additional stability as they meet their communities’ primary care needs. It will also give Congress more time to build consensus around a long-term extension at the highest possible funding level for all three programs.”
The letter continues, “Health centers are proud of the nearly sixty years of bipartisan support for their mission of providing care to underserved communities, and we look forward to working with you to secure long-term, stable, and increased funding for Community Health Centers and their workforce as soon as possible.”
Get Updates on Federal Funding
Subscribe to NACHC’s Washington Update for updates on federal funding and opportunities to speak up for health centers. Visit NACHC’s Federal Funding resources page.
Community Health Centers offer a hugely important service for Veterans and their unique behavioral, medical, and social service needs. On a national level, health centers serve nearly 400,000 patients who identify as Veterans, a rate that is steadily increasing.
In honor of Veterans Day, we interviewed Rodney Hummer, RN, BSN, who is both a Veteran and the Vice President of Strategy for the Missouri Primary Care Association. Rodney has a long history with Community Health Centers as a patient, Board Member, Clinic Manager, Director of Development and most recently as Interim CEO. He received the “Hometown Hero Award,” and the “Citizenship Award” as testament to his unwavering commitment to helping others.
NACHC: Tell us about your military career. How has it potentially influenced you to join the Health Center Movement?
Hummer: I went into the Air National Guard right out of high school and was trained as a combat medic. Soon thereafter volunteered for the Gulf War covering multiple medical roles throughout the tour. Upon return home, obtained my RN BSN, then commissioned as an officer. An FQHC (Federally Qualified Health Center) CEO, who was also prior military, sold me on the mission of the FQHC, and I joined his board of directors. From there I transitioned to a full-time employee running rural clinics for that FQHC. I was promoted to Director of Development, then ultimately CEO. From the FQHC I moved to working for the Missouri Primary Care Association where I currently provide training and technical assistance to our FQHCs all over the state.
“All of my training in the military has prepared me to support the health center movement.“
Rodney Hummer
All of my training in the military has prepared me to support the health center movement. State of the art training in medicine, working with other likeminded professionals focused on the same mission, evaluating and adjusting the strategic plan due to the changing environment, continual focus on performance improvement and outcomes, taking healthcare to the patient (such as with MASH units and mobile units), stackable development of staff through training/mentoring and an unwavering focus on achieving objectives and caring for our people. The mission and focus are the same, both in the military and in our FQHCs.
NACHC: Why should Community Health Centers, PCAs and other stakeholders still care for Veterans and their difficulties given there is a US Department of Veterans’ Affairs?
Hummer: Most people erroneously believe that if you served in the US Military, you would receive free healthcare for the rest of your life. When in fact, only about ½ of all Veterans qualify for care through the VA. As many Veterans fulfill their 4-year/6-year commitment, then move on to a civilian career, (unless they served in combat, retired with 20 years, or have a service-related disability), they don’t qualify for Veterans Administration (VA) care. Because of this, many Veterans obtain healthcare through our FQHCs either with their private insurance/Medicaid/Medicare or our sliding fee (uninsured) program.
“[I]t’s mission essential for health centers to accurately screen for veteran status.“
Rodney Hummer
That’s why its mission essential for health centers to accurately screen for Veteran status with “Have you ever served in the US Military or Armed Forces?” This includes Air Force, Army Coast Guard, Marines, Navy, National Guard or Reserves. Versus simply asking “Are you a Veteran?” Many FQHCs are caring for way more veterans, with unique needs, but are unaware because of the screening question. As the VA changes qualifying criteria, such as with the recent PACT ACT, FQHCs can assist the Veterans in sourcing the care they qualify for.
NACHC: What’s most rewarding about your work in helping Veterans?
Hummer: Helping Veterans who have fallen through the cracks who “no longer have a unit or base” and have been unable to find the help/assistance/purpose they desperately need.
NACHC: What’s most challenging? Do you have advice for others who might face similar challenges when helping Veterans?
Hummer: Any veterans don’t want to talk about their military service, yet need help, and may qualify for VA benefits. The biggest challenge is connecting with Veterans on a personal level and gaining their trust. After you have established this, you can help them access the care they need and qualify for.
NACHC: What’s one “small step” a reader of this blog can take that will make a difference or help improve Veterans health care?
Hummer: “Be the one”, this a mantra of the American Legion. You may think that your actions are insignificant, or that you are not qualified to make a difference. But for a Veteran who is down on their luck, struggling with life or addiction, your simple act of reaching out to help them…. may save their life.
NACHC: How has NACHC been a resource in supporting Veterans issues?
Hummer: NACHC has been wonderful to serve as a resource for Veteran outreach. Learning about best practices, emerging VA policy issues, and connecting with other health centers in this space has been invaluable to myself and many others.
LEARN MORE ABOUT HOW HEALTH CENTERS ASSIST VETERANS
NACHC Resources: NACHC creates resources to assist health centers serving veterans. Browse resources.
NACHC’s Veterans Interest Group (VIG) is an informal networking and information group intended to share promising practices, policy updates, and operational information regarding increased access to care and services for the Veteran populations served in community health centers. If you would like to receive Veterans-related updates via email from NACHC, please send your contact info to trainings@nachc.org. Previous updates and web recordings can be found at the bottom of this page: https://dev.nachc.org/resource/supporting-our-nations-veterans/