Article Figures & Data
Tables
Clinic Location Affiliation MCa No. Specialty Nonwhite Race, % Non-English Language, % Medicaidb/ Medicare, % Interviews CHW clinics A Urban Health system 37 Internal medicine 15 11 7/45 5: CC, CHW, MC, Sup (2) B Small city Health system 21 Pediatric 17 9 27/0.1 7: BH, CC, CHW, MC (2), PL, Sup C Rural Health system 10 Family medicine NA 1 17/45 5: CC, CHW, CM, MA, MC D Urban Health system 23 Internal medicine 65 17 55/23 5: CC, CHW, CM, MC (2) E Urban Health system 9 Family medicine 54 36 44/12 5: CHW (2), CM, MC, PL Non-CHW clinics F Urban Health system 11 Family medicine 68 34 59/16 8: BH, CC (3), CM (2), MC, PL G Urban Health system 19 Family medicine 89 8 80/5 6: CC, CM, MC, Ph, PL, Sup H Urban FQHC 9 Family medicine 39 58 41/12 5: CC (2), CM, PL, Sup I Urban FQHC 15 Primary carec 80 43 58/8 5: CC, CM, MA, PL, Sup BH = behavioral health worker; CC = care coordinator; CHW = community health worker; CM = clinic manager; FQHC = federally qualified health center; MA = medical assistant or interpreter; MC = medical clinician; NA = data not available; Ph = clinical pharmacist; PL = physician leader or champion, or medical director; Sup = supervisor of care coordinators, CHWs, or nursing; SW = social worker.
↵a MC = includes physicians, nurse practitioners, and physician assistants.
↵b Medicaid = includes other government and medical assistance funds.
↵c Primary care = family medicine, internal medicine, and pediatrics.
Common roles Outreach, health education, community resource linkage, health coaching, social support, system navigation, facilitation of communication between patient and clinician Unique, clinic-specific roles Care coordination, home-based support, community health promotion, language-specific care coordination, cultural liaison, acting as “eyes and ears” in the community for clinic team PCMH=patient-centered medical home.
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The Article in Brief
Integrating Community Health Workers Into Medical Homes
Elizabeth A. Rogers , and colleagues
Background There is evidence for the value of community health workers (non-clinical workers from the communities they serve) in helping patients manage chronic diseases, yet they are often not considered an essential part of the health care team. This qualitative study set out to define the roles of community health workers (CHWs) on medical home care teams and identify facilitators and barriers to utilizing a community health worker model.
What This Study Found Community health worker models are facilitated by leaders/champions with knowledge of CHWs, a practice culture of innovation, prioritization of patients' non-medical needs, and sustainable reimbursement strategies. Their roles include outreach, health education and coaching, community resource linkage, system navigation, and facilitating communication between patient and clinician.
Implications
- The authors contend that work remains to raise awareness of community health workers, in spite of growing evidence of their effectiveness.
