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Population Health: Data-Driven Quality Improvement

Population health management hinges on accurate and timely data collection. The Health Center Controlled Network (HCCN) collaborates extensively with the Massachusetts Department of Public Health (MDPH) on various initiatives focused on collecting and leveraging clinical data to enhance population health outcomes. Our most recent MDPH projects are described below:

MDPHnet

MDPHnet is a graphical user interface through which MDPH can query de-identified electronic health record information data from targeted regions of Massachusetts to analyze the health characteristics of specific populations. Many of our Data Reporting and Visualization System community health centers contribute to MDPHnet data.

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HIE

The Health Information Exchange (HIE) is a secure platform that enables health care providers to access and securely share patient medical information electronically. This facilitates more informed decision-making, leading to improved patient care.

The HCCN offers a low-cost Event Notification Service contract with Bamboo Health to notify health centers when their patients arrive at emergency rooms or are admitted to hospitals across the country. This interoperability is supported by the Mass HIway, the state’s mechanism for health data exchange.

Quality Improvement

Data collection is essential for assessing population needs and developing effective improvement strategies. The HCCN recognizes the importance of rigorous data gathering to inform targeted quality improvement initiatives, particularly when considering the social factors that impact our patients’ health.

UDS and UDS Trends Analysis Reporting

The HCCN assists Federally Qualified Health Centers with their annual UDS reporting by providing annual training and technical assistance on UDS and UDS Trends Analysis Reporting.

HRSN

Health-related social needs (HRSN) are conditions that can affect health, well-being, and quality of life, such as housing and food insecurities, employment, and transportation. The HCCN works with centers to encourage and support the standardized collection of HRSN data, enabling more comprehensive and effective patient care.