- Overview
- Adult Immunizations
- Alcohol and Substance Use (SBIRT)
- Asthma
- Appropriate Use of Antibiotics for ARI
- Childhood Obesity
- Colorectal Cancer Screening
- Cardiovascular Disease (CVD) and Stroke Prevention
- Depression
- Diabetes in Adult Patients
- Gestational Diabetes
- Hepatitis B and C
- Immunizations
- Motivational Interviewing
- Obesity
- Pediatric Immunizations
- Preconception & Interconception Care
- Prevention
- Tobacco Cessation and Secondhand Smoke Exposure
Community - Resources and Policies
Mobilize community resources to meet needs of patients
- Encourage patients to participate in effective community programs
- Form partnerships with community organizations to support and develop interventions that fill gaps in needed services
- Advocate for policies to improve patient care
By looking outside of itself, the health care system can enhance care for its patients and avoid duplicating effort. Community programs can support or expand a health system's care for chronically ill patients, but systems often don't make the most of such resources. A health system might form a partnership with a local senior center that provides exercise classes as an option for elderly patients. State departments of health and other agencies often have a wealth of helpful material available for the asking - wallet cards with tips for controlling diabetes, for example. National patient organizations such as the American Diabetes Association can help by promoting self-help strategies.
Elements of the CCM
Click on the links below for more resources.
- Community Resources and Policies
- Health Systems Organization of Healthcare
- Self-Management Support
- Delivery System Design
- Decision Support
- Clinical Information Systems
- Informed, Activated Patient
- Prepared, Proactive Practice Team
Local and state health policies, insurance benefits, civil rights laws for persons with disabilities, and other health-related regulations also play a critical role in chronic illness care. Advocacy by medical organizations on behalf of their patients can make a difference.
Community Linking Resources
Forms
Additional Information
For questions and additional information, please contact Allyson Gottsman at (720) 297-1681.
