ACCEL Initiatives
The Children’s Health Initiative expands health coverage to children under 300% of the Federal Poverty Level through outreach, enrollment campaigns, and procurement of insurance for children in the region. This initiative also implemented the utilization of Community Health Workers (CHWs) who assist children and their families to connect with and use appropriate health care, including securing a medical home.
The Provider Capacity Project is an ongoing effort to expand the network of providers willing to provide services to publicly insured patients, and meet additional service needs. This includes increasing the number of providers at the various rural and tribal clinics willing to see an established number of these patients, and fostering clinic redesign to enable improved internal processes and capacity in the community.
ACCEL develops and coordinates a nationally recognized model called Care Pathways, a set of standardized protocols for interagency shared case management that connects patients to health care services. Based on this outcome-based model developed in Ohio, a Care Pathway includes step-by-step actions for resolving problems and tracking outcomes across agencies. This model was seen as a tool that could enable ACCEL to organize the collaborative's activities and facilitate clarity in coordination and collaboration among participating institutions;
ACCEL has developed and implemented eight Care Pathways aimed at increasing access to care. Examples of our Care Pathways include: securing health insurance for newborns and young children, ensuring that insurance coverage is maintained over time, obtaining a medical home for newborns and children, and facilitating referrals between primary care practices and pediatric mental health services and specialty care services. The pathways were created alongside ACCEL strategies to expand supply and access to primary care providers (PCPs) for needy populations.
The Health Information Technology for Quality Care initiative focuses on the development and implementation of health information technology to improve patient access and quality of care across agencies. This initiative includes an interactive web-based application (iREACH) and telehealth efforts, as summarized below.
- With a grant from the Agency for Healthcare Research and Quality (AHRQ), ACCEL engaged in a rigorous process to research, plan and implement a centralized and shared web-based application (iREACH) to monitor and track ACCEL patients through a care pathway. The system, utilized by all ACCEL agencies, allows users at multiple locations to track, share, and update patient progress more efficiently.
The use of technology has allowed for real-time, efficient communication across agencies and standardized methods for patient-system navigation. Through an electronic tool, ACCEL has the ability to more efficiently extract data to guide its quality assurance (QA) efforts, evaluate the effectiveness of a care pathway, and identify barriers to success and communitywide trends.
- ACCEL is also helping to drive telehealth efforts within the County by coordinating the procurement and implementation of telemedicine units across agency sites. Through the use of telemedicine equipment, ACCEL seeks to improve access to care, promote patient engagement in their care, and build local provider capacity by coordinating Countywide continuing education opportunities.
Most recently, ACCEL was selected by the University of California, Davis and the California Telehealth Network to be one of 15 Model eHealth Community grant recipients. The grant seeks to support select communities across the state to become best-practice examples in the use and integration of technology to improve health and health care for its residents.
The Specialty Care Initiative: Access to specialty care services continues to be a major obstacle for publicly insured patients in the County. With funding from the California HealthCare Foundation, ACCEL successfully implemented two self-sustaining specialty care pathways in orthopedics and pain management. The pathways are available as a Countywide resource for ACCEL PCPs to refer their Medi-Cal and CMSP patients. The care pathways are made possible through the commitment and partnership of specialists from Marshall Orthopedics and the University of California, Davis Medical Center Pain Management.
ACCEL was also one of five care coordination sites across the county to participate in a National Institutes of Health (NIH) study. The project, Community Care Coordination Performance Measures (NIH-CCCPM) Project seeks to help address the lack of validated care coordination quality and performance measures, and the lack of comparative performance data, particularly for community-based care coordination organizations. All five sites use some version of the Care Pathways Model of Community Care Coordination developed by Drs. Mark and Sarah Redding. The project has defined common data elements across the five sites which can be used to identify aspects of care where performance may be sub-par; identify process changes likely to lead to improvement in outcomes, and to track changes over time. This study will contribute important knowledge that will improve the ability of ACCEL to measure, compare, and improve the quality of services that it delivers to El Dorado County patients by producing tested care coordination quality measures and comparative performance data for community-based care coordination.