CHAN stakeholders attributed the network’s success, in part, to a statewide cultural mindset that favors the sharing of information, resources, and assistance among public health entities trying to build themselves up. This section outlines the public health safety net environment in New Hampshire and discusses a selection of other initiatives going on in the State and their relationship with CHAN.
The OCPH. The Office of Community and Public Health in the N.H. Department of Health and Human Services (DHHS) provides leadership and a core public health capacity for New Hampshire. The Office is organized into five major program divisions, comprised of the Divisions of Family and Community Health, Chronic Disease Prevention, Laboratory Sciences and Environmental Health, Epidemiology and Vital Statistics, and Health Services Planning and Review. The OCPH collects information on pre-natal care, family planning, diabetes, and cancer screening performance measures from consolidated health centers in New Hampshire, including the member centers of CHAN, and provides funding and support to safety net providers. Respondents indicated that the Office works closely with CHAN on issues related to reportable conditions, chronic disease management and public health education among low income populations. CHAN has been the administrative contractor for the NH Diabetes Prevention and Control Program since 1999. Similar developments are underway in NH for Asthma, also through CDC funding support. Although there is no automated electronic reporting between Logician and the OCPH, this functionality has been discussed.
Bi-State PCA. Through a Memorandum of Agreement (MOA), the first of its kind nationally, CHAN also collaborates closely with the Bi-State Primary Care Association, a private, not-for-profit organization with a membership of forty entities in Vermont and New Hampshire that provide and support community-based primary care services. These member organizations include community health centers, rural health clinics, private and hospital-supported primary care practices, health care for the homeless programs, clinics for the uninsured and social service agencies. To assure sensible division of goals and services between the PCA and CHAN, there is overlap between the board of directors of the two organizations and regular communication among leadership regarding new and ongoing initiatives.
Southern NH AHEC. A separate MOA is with the Southern NH Area Health Education Center, a non-profit program dedicated to the development of health professions. CHAN collaborates with the AHEC on the identification of staff development needs and the provision of a range of continuing education services for the health center staff. Training topics range from clinical competencies to cultural and leadership skills. Specifically for CHAN, the AHEC provides education credits for the EMR training curriculum.
New Hampshire Logician User Group. An informal group of health centers have been collaborating on the deployment of EMR since 1997. The agencies work together primarily on the development of end-user tools, which are shared between the organizations, thereby capitalizing on limited resources and technical talent with experience in Logician. CHAN has been an active collaborator of this group; giving and receiving tools and developing the collective intellectual capital. The User Group sponsors an annual regional workshop, named “AutumnLogic”, that showcases the work in New Hampshire and provides opportunity for potential EMR users to interface with EMR pioneers and observe new vendor developments.
The New Hampshire Community Technology Partnership. The N.H. Community Technology Partnership is a collaborative of six regional partnerships, representing more than 50 health and social service agencies in New Hampshire. The partnership’s goal is to implement a statewide, online service that provides clients access to health and human services programs and allows service providers to coordinate delivery of services online. Funded primarily through a BPHC HCAP grant, the coalition is working on developing an electronic “tool box” of program eligibility screening and care coordination tracking software with a central data base for all clients. Currently, the eligibility screening and care coordination modules are online and the central database prototypes are being delivered. Overall, the project seeks to (1) provide a network that connects participating agencies to a wide range of health care providers and human services agencies; (2) streamline intake processes across services and systems by providing a single point of entry; and (3) host a centralized database that maintains client-level information for program eligibility, care history and demographics.
Of the CHAN members, only Health First Family Care (HFFC) is currently involved in the Technology Partnership, although all are eligible. Our HFFC respondent explained that the current tracking software allows secure, confidential, centralized sharing of key data on safety net clients online. In Health First Family Care’s region, network agencies have agreed to create a joint disease management and treatment program that is managed electronically through the Partnership’s IS tools. Although CHAN has not been formally involved to date in the eligibility screening and care tracking initiative, CHAN respondents indicated that they are looking forward to a demonstration of the system scheduled for September 2004 and may play an active role in the project.
Medication Bridge Program. The New Hampshire Medication Bridge Program, a private-public partnership that helps eligible uninsured and underinsured patients obtain prescription medications from pharmaceutical companies’ Patient Assistance Programs, is the fourth prominent state health initiative. Participating sites include hospitals, community health centers, physician offices, senior housing, and non-profit organizations. All five CHAN members participate in the program, which has provided over 200,000 prescriptions for over 14,000 individuals throughout the state since January 2001.