Implementation of NCCARE360, a Digital Statewide Closed-Loop Referral Platform to Improve Health and Social Care Coordination: Evidence from the North Carolina COVID-19 Support Services Program

Q2 Medicine
Connor Drake, Eugenia R McPeek Hinz, B. Granger, Isa Granados, Abigail Rader, Ariana Pitcher, Shemecka Mcneil, William K. Bleser, Carolyn Avery, Janet Prvu Bettger, Elena Tenenbaum, Megan Shepherd-Banigan, Eleanor Wertman, Lisa McNerney, Marissa Mortiboy, John Purakal, Dev Sangvai, Susan E Spratt
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引用次数: 1

Abstract

Efforts to improve population health by being responsive to patients’ social and economic conditions will benefit from care models and technologies that assess and address unmet social needs. In 2019, NCCARE360 launched in North Carolina as the first state­wide digital care coordination network to “close the loop” on referrals between community-based organizations (CBOs), health service providers, and social service agencies. The platform creates a shared network for sending and receiving electronic referrals and track client outcomes. As a case study, we compare NCCARE360 resolution rates for community resource referrals originating from a large integrated health system primarily in Durham County from September 1, 2020, through February 28, 2021. In the first year, COVID-19 Support Ser­vices Program (COVID-SSP) funding was available to reimburse associated CBOs for providing food assistance and case management services. We compared this with the same period the following year after funds had been exhausted. We present frontline implementation experiences and highlight opportunities, challenges, and recommendations for NCCARE360 implementation. Multi-level considerations for individual end users, organizations adopting the platform, and policymakers are presented. Addi­tionally, we find that when COVID-SSP funding was available, more referrals were placed (3,220 cases) and referrals were more likely to be resolved (88% resolution rate) when compared to the same time frame when funds were no longer available (860 cases; 30% resolution rate). These results underscore the importance of reimbursement mechanisms and funding. The examination of referral rates is observational and may not generalize to other contexts. The shift to value-based care is an opportunity to embrace structural solutions to health and social care fragmentation. There is also an opportunity to realize the potential of NCCARE360 and efforts like it to contain costs and improve health outcomes and equity.
实施 NCCARE360,这是一个全州范围内的数字闭环转介平台,旨在改善医疗和社会护理协调:来自北卡罗来纳州 COVID-19 支持服务计划的证据
通过响应患者的社会和经济状况来改善人口健康的努力将受益于能够评估和解决未满足的社会需求的护理模式和技术。2019 年,NCCARE360 在北卡罗来纳州启动,这是首个全州范围的数字护理协调网络,旨在 "闭环 "社区组织 (CBO)、医疗服务提供者和社会服务机构之间的转介。该平台创建了一个共享网络,用于发送和接收电子转介,并跟踪客户结果。作为一项案例研究,我们比较了 2020 年 9 月 1 日至 2021 年 2 月 28 日期间 NCCARE360 对主要来自达勒姆县大型综合医疗系统的社区资源转介的解决率。在第一年,COVID-19 支持服务计划 (COVID-SSP) 的资金可用于补偿相关社区组织提供的食品援助和个案管理服务。我们将其与资金用尽后的第二年同期进行了比较。我们介绍了一线实施经验,并强调了 NCCARE360 实施过程中的机遇、挑战和建议。我们还介绍了个人最终用户、采用该平台的机构和政策制定者的多层次考虑因素。此外,我们还发现,在 COVID-SSP 资金到位时,与资金不再到位时(860 个案例;30% 的解决率)相比,转介数量更多(3220 个案例),转介更有可能得到解决(88% 的解决率)。这些结果凸显了报销机制和资金的重要性。对转诊率的检查是观察性的,可能无法推广到其他情况。向以价值为基础的医疗保健转变是一个机会,可借以从结构上解决医疗保健和社会护理分散的问题。同时,这也是实现 NCCARE360 以及类似项目在控制成本、改善医疗效果和公平性方面的潜力的机会。
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来源期刊
North Carolina Medical Journal
North Carolina Medical Journal Medicine-Medicine (all)
CiteScore
1.40
自引率
0.00%
发文量
121
期刊介绍: NCMJ, the North Carolina Medical Journal, is meant to be read by everyone with an interest in improving the health of North Carolinians. We seek to make the Journal a sounding board for new ideas, new approaches, and new policies that will deliver high quality health care, support healthy choices, and maintain a healthy environment in our state.
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