The information found in this Community Health Worker Annual Report describes program performance between January 2020 and June 2021. The report is meant to be a resource for the Dartmouth—Hitchcock Health system and partners.
The Community Health Worker Program began in August 2016 by working with patients with a history of high Emergency Department (ED) utilization. After a successful pilot program with two Community Health Workers (a 50% decrease in average ED visits), D-H added CHW services for primary care patients beginning July 2017. Availability of CHW services for D-H employees also began in July 2017.
To identify patients with health related social needs, a SDoH screening tool was piloted from September 2017 to December 2017, initially tested with Medicaid patients receiving primary care with D-H Heater Road providers. It has been used at primary care practices located at Heater Road since January 2018 to identify patients with actionable social determinants of health issues which are then addressed by a CHW. Since this time, screening practices have expanded to all primary care locations at Dartmouth-Hitchcock Health, with current efforts focused on expanding screening beyond the Medicaid population to include adult patients, regardless of insurance type. The D-H Community Health Worker workforce has expanded in order to meet the needs of our patients as they are identified by the screener and providers.
The Community Health Worker Program began in August 2016 by working with patients with a history of high Emergency Department (ED) utilization. After a successful pilot program with two Community Health Workers (a 50% decrease in average ED visits), D-H added CHW services for primary care patients beginning July 2017. Availability of CHW services for D-H employees also began in July 2017.
To identify patients with health related social needs, a SDoH screening tool was piloted from September 2017 to December 2017, initially tested with Medicaid patients receiving primary care with D-H Heater Road providers. It has been used at primary care practices located at Heater Road since January 2018 to identify patients with actionable social determinants of health issues which are then addressed by a CHW. Since this time, screening practices have expanded to all primary care locations at Dartmouth-Hitchcock Health, with current efforts focused on expanding screening beyond the Medicaid population to include adult patients, regardless of insurance type. The D-H Community Health Worker workforce has expanded in order to meet the needs of our patients as they are identified by the screener and providers.
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