Site: Anchorage, Matanuska-Susitna Borough, Alaska
Key organization: Southcentral Foundation (SCF)
The Use of Data and Community Health Aides Program (CHAP) is part of a 2-pronged approach diabetes management program utilized by the Southcentral Foundation (SCF). SCF is an Alaska-Native owned, non-profit health care organization that concentrates on providing health care services to Alaska Natives and American Indian people living in 55 rural villages in the Anchorage Service Unit located in Southcentral Alaska. SCF uses “the Using Data approach” to create a diabetes registry and action list that help identify elements that contribute to patient care, risk factors, co-morbidity conditions, test results and more. The CHAP approach focuses on the use of high-school graduates that have unique training and responsibilities to provide diabetes care to patients in hard-to-access areas of Alaskan communities. The aides receive training to provide remote care to patients such as diabetes management, they also live and work in the remote areas where they provide their services. The aides also connect patients with specialty services with the use of telehealth and help coordinate health educator visits to remote sites. In addition to serving as aides that bridge the gap between patients and diabetes health care services, they also encourage people to use an app called My Alaska Wellness app that facilitates the communication between health care providers and patients, and where they can access their own medical records and keep track of their diabetes management.
This promising practice can be adapted in health center programs by following the steps provided below:
1. Update clinical data from the Electronic Health Records (EHR) system into a database.
2. Create action lists in the EHR, to get a snapshot of a patient’s overall health and actions.
3. Review data on a regular basis to keep track of patients that need follow ups.
4. Have at least one on-site staff member in remote clinics that are trained to assess and refer patients.
5. Encourage patients to use technology such as apps and patient portals to improve communication with practitioners and have access to resources.
6. Bring health educators to remote sites on a regular basis.
For more information on this promising practice, go to CHWs of the Future – Virtual Visits and Technology (Session #4)