Headline
This study offers a standardized approach for embedding community health workers (CHWs) into primary care, providing a valuable framework for health systems aiming to integrate this workforce.
Background
Health systems are seeking ways to expand CHW programs to enhance patient engagement in health care and address social needs. This study used standardized measures to monitor the success of a CHW program integrated into primary care practices across 17 sites in the New York City Health + Hospitals network. CHWs in this initiative were hired to reflect the diversity of the community, to integrate with the clinic teams, receive referrals from primary care providers for patients with at least two chronic medical conditions, and provide common CHW services, such as goal-setting, attending appointments with the patient, and home-visits, among other services.
Findings
Using patient demographics and other data from the health system’s electronic health record, 7,331 patients were enrolled into the CHW program over the two-year study period. CHW demographics related to sex, age, race, and insurance status were analyzed to ensure that they were reflective of patient communities.
CHWs engaged 80% percent of the enrolled patients by the end of the study period. In partnership with their CHW, patients identified an average of four goals to complete during the program, with the most common goals being to engage with primary or specialty care providers and address food insecurity and transportation needs. An average of three identified goals were achieved amongst patients that participated in the program during the study period.
Policy/Program Takeaways
Health systems interested in implementing a promising CHW program can adopt the standardized approach for implementing and monitoring CHW programs discussed in this study.