What is an intrapreneurial opportunity within the Community Health Center and it's impact with respect to both the level of effort and resources needed and the potential benefits to the organization. ? Intrapreneurial opportunities are a very different pa

RUNNING HEAD: PEST Analysis Reaves 1

Briana Reaves

Dr. Ducharme

MBA 515

Southern New Hampshire University

The Community Health Center

The Community Health Center (CHC) is a non-profit organization located in Middletown, CT. CHC offers comprehensive primary care services primarily to the uninsured, underinsured, and key populations within the community. CHC has been a very successful non-profit organization over the past 40 years, but the success of the company could not be accomplished without analyzing the political, economic, social, and technical factors. These external factors play a major role within the healthcare industry. CHC is able to take advantage of opportunities and identify threats. There are many different challenges that CHC faces when analyzing each of these factors, but overall CHC overcomes them in order to be successful.

Political

Most of the patients of Community Health Center have health insurance through Obamacare which is also known as the Patient Protection and Affordable Care Act (ACA). On March 23, 2010, President Barrack Obama signed this law, so Americans could have access to affordable, quality health insurance, and to reduce the growth in U.S. healthcare spending (Obamacare, 2016). According to the Obamacare website, the health insurance offers many different types of benefits to patient. These benefits include:

· Stopping the insurance company from letting a person go because they’re sick or make a mistake on the application

· Stopping insurance companies from imposing unjustified rate hikes

· Expanding Medicaid insurance to millions in states that decided to expand the program

· Stopping insurance companies from imposing unjustified rate hikes

· Letting young adults stay on their parents insurance until they turn 26

· Stopping insurance companies from denying coverage and charging more based off of a person’s health status

· Requiring all insurers to cover people with pre-existing conditions

These benefits help to ensure that patients receive the quality of care that they deserve. However, in most states doctors can choose not to participate in networks offered in the marketplaces also known as exchanges (Leonard, 2015). As a result, many patients are seen by providers that are outside of their healthcare network. When this is done, patients usually have to pay an unusually high amount of money out of pocket. Due to CHC accepting most healthcare insurances, this helps individual avoid out-of pocket expenses.

Economic

The Community Health Center is a non-profit organization, so it is primarily funded by the government. CHC receives different grants for specialty programs. For example, there is a suboxone program at CHC which is a treatment program for patients that are dependent on pain prescriptions, heroin, and opiates. This program is funded by HRSA and SAMHSA. In order to receive these grants, the program director has to write out a grant and then submit it to a federal agency for review. Once the written grant is reviewed, the federal agency can approve it and provide the Community Health Center with a significant amount of money with certain guidelines of what can be spent with it. For example, the suboxone program received grant money to provide transportation for the program. So CHC purchased a van with the grant money that is used specifically for patients within the program. Along with the suboxone program, CHC has seven center for key population programs which includes; HIV/AIDS, HEP C, sexually transmitted disease prevention, LGB care, transgender health, substance use disorders, and primary care for the homeless (CHC, 2019).

All of the center for key population programs are funded by grants from the government. As mentioned previously, the HRSA and SAMHSA grants are the main grants that fund the specialty programs. For the suboxone program, the grants allow for the program to have care coordinators, provider training, and the distribution of suboxone vouchers. Care coordinators help to monitor how the program is going and the patients. Providers of the program have to attend monthly trainings in order to get updated about different ways suboxone is affecting patients and how they can make it better. During the trainings, providers are not able to see patients for their appointments, so the grants that are received help to pay for the provider trainings along with making sure CHC can afford for providers to not see patients. The program also distributes suboxone vouchers to patient, so they do not have to pay for their medication to be treated. The suboxone program is just one example of CHC’s key population program. Overall, the programs are run similar, but this could not be possible without the grants CHC receives.

Another type of grant the Community Health Center receives is the triple A grant. The triple A grant is for patients of CHC that do not have commercial insurance and are 60 and older. This grant also covers recommended dental procedures that the patients cannot afford with their insurance. In order to qualify for this grant, patients only need to complete an application form and then have a dental appointment, so the dentist can determine what kind of dental procedure is recommended. The grant is renewed every October, so patients are able to receive free dental treatments annually.

Social

The Community Health Center provides care and employs many different people of various backgrounds and ethnicities. Culture competence is a key factor for CHC in making sure that patient’s needs are met. Cultural competence is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or those professions to work effectively in cross-cultural situations (Cultural Competence, 2004). CHC employees work together to accommodate each patient. For example, CHC provides care to many Muslim women. Most Muslim women that are patients of CHC request to see female providers. According to Respecting Muslim Patients’ Needs, for observant Muslim women, covering up the body is important when they are in the company of non-mahram males, those not related by blood or marriage (Rabin, 2010). CHC employees always honor these types of requests because they are aware and respect the cultural values of patients. According to the Curricula Enhancement Module website, cultural competence consists of five essential elements such as:

· Valuing diversity

· Having the capacity for cultural self-assessment

· Being conscious of the dynamics inherent when cultures interact

· Having institutionalized culture knowledge

· Having developed adaptations to service delivery reflecting an understanding of cultural diversity

CHC honors all of these elements within cultural competence. The example above proves that these elements reflect the attitudes, structures, policies, and services of the organization.

CHC not only adheres well to culture competency, but it also honors socio-economic backgrounds. The organization does not discriminate against patients that have different social and economic positions based on income, education, and occupation. No patient is turned away from receiving services from CHC no matter what their socio-economic status may be. For example, as stated previously, CHC provides care to transgender patients. Many of the transgender patients prefer to be called by a different name, but sometimes their name hasn’t been legally changed. So out of respect, CHC has implemented a section in the patient’s chart for a preferred name to be entered. Employees are advised to use the preferred name when speaking to them.

Since CHC is a very diverse organization, there are many patient that speak different languages. In order to communicate effectively with patient that speak different languages, CHC hires front line staff and providers that speak more than one language. For example, CHC has a large Spanish and polish speaking population. So many of the front line staff and providers speak both languages. With being hired, some of the positions require employees to be bilingual. If an employee is not able to communicate with an employee because they do not speak the same language, they can use CHC’s language line. CHC’s language line has over 12 different languages. The employees have to call the language line to speak to an interpreter that is able to translate. Utilizing the language ensures effective communication, so patients can receive the healthcare they deserve.

Technical

Technology continues to advance every day. Utilizing technical resources are one if the many reasons why the Community Health Center continues to remain successful. Everything is mostly done electronically within the organization. Every employee receives a computer and scanner when they are hired. Patients files are all updated electronically with no paper files. In order to ensure that this is done efficiently, CHC invests in different health systems. For example, there are three main healthcare systems that CHC uses. The systems include eclinicalWorks (eCW), NOVO, and Centricity. Each of these systems have a key role for the patients and the company.

The eclinicalWorks system also known as eCW contains charts of every patient. The charts consist of patients’ health information such as diagnoses, medications, doctors’ clinical notes, patient documents, referrals, appointments, etc. One of the main uses of this system, is so every employee can communicate with the providers about a patient’s care. It can be considered to be a messaging system because this is how most messages are relayed regarding patients. For example, if a patient calls and requests a refill of their medication, the employee that answers that phone call will then send a message through eCW to the patient’s primary care physician to notify them that the patient needs a refill. ecW also connects patients to their patient portal. Patients are able to access their health information on their phones and computers. With the patient portal, patients can see their lab results and write messages to their doctors.

The NOVO system is used to schedule appointments for patients. Most of the appointments that are scheduled are through this particular system. Although, appointments can be scheduled through Centricity as well. The NOVO scheduling allows employees to schedule appointments that patients are due for. Providers are advised to make appointment recalls in this system, so an employee knows when the patient is due for the appointment and was it’s for. For example, if a baby is due for their 2 month vaccines, an appointment will show saying that the baby is due for his/her vaccines and to schedule the appointment as a physical. The NOVO system also allows employees to see when a patient was last seen and all of their past appointment dates.

The Centricity system displays a patients demographics and allows it to be updated if there are any changes. It also keeps track of a patient’s insurance and financial notes. The system will show if a patients insurance is active, inactive, or if they have a balance that needs to be paid. Along with this information, the system also contains each site and each provider within those sites schedules. Employees are able to check patients in for their appointments and cancel the appointments if they are missed. Providers are also able to see what patients are on their schedules and the reason why.

Overall, all of these systems help to provide great care for the patients. Most of the time, one system cannot be used without the other. If one system is down, it can be difficult to help a patient because certain information in one of the systems is not able to be reviewed. For example, information that is entered into Centricity automatically updates in to the eclinicalWorks system as well.

Along with these healthcare systems, technical systems are to be primarily used by providers and not employees. These systems include Project Echo and PainNet. Project Echo consists of econsults which helps eliminate patients having to travel to see specialty providers elsewhere. For example, if a patient is experiencing stomach pain and their primary care physician has an idea of what it could be, but is not 100% sure, they can send an econsult to a gastroenterologist. Econsults are electronic consults that providers use instead of sending a patient to see a specialist. Within the econsults, the primary care physician send their clinical notes regarding the patients stomach pain, bloodwork results, and any diagnostic images. The specialty provider then reviews it and discusses with the primary care physician what they think the plan of care should be for the patient.

PainNet is an online learning community that helps provide essential tools and resources to help providers tackle issues of pain and prescriptions for opioid management (Gianelli, 2016). This system coincides with the suboxone program. PainNet is a tool that many providers use to access pain care content. PainNet is available to Project Echo participants as well, so they can share they information they find when caring for a patient with other providers (Gianelli, 2016).

CHC also has kiosks at each site that allows patients to check in for the appointments electronically. So instead of employees manually having to check them in, patient are able to use a touchscreen and put in their information to check in.

Overall, CHC has many external factors that can determine what opportunities the company should take and threats that exist. This type of analysis can also help the company embrace change. By analyzing the political, social, economic, and technical factors within the company, goals can be made. This analysis shows that CHC does a great job with analyzing these factors and embracing change.  

References Gianelli, L. (2016). Tools and Strategies for Treating Chronic Pain, Reducing Opioid Use Now Available Free to Health Care Providers. Middletown, CT: CHC. Rabin, R. C. (2010). Repecting Muslim Patients' Needs . The New York Times. Center, C. H. (2016, July). Our History. Retrieved from Community Health Center: http://www.chc1.com/About-Us/Our-History Leonard, K. (2015). Doctors, Hospitals, Say 'No' to Obamacare Plans. U.S. News. Retrieved from http://www.usnews.com/news/articles/2015/11/04/doctors-hospitals-wont-accept-obamacare-marketplace-plans Definitions of Cultural Competence . (2004, November). Retrieved from Curricula Enhancement Module Series: http://nccc.georgetown.edu/curricula/culturalcompetence.htm