Community Health Worker Encounter Implementation Guide (PSS-2567)

Community Health Workers (CHWs) play a critical role in providing community-based health services. The American Public Health Association (APHA) defines a Community Health Worker as: “a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. This trusting relationship enables the worker to serve as a liaison/link/intermediary between health/social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery.”

Because most CHW activity happens outside of the clinical environment, however, most data that CHWs collect and manage cannot be shared or aligned with clinical data through FHIR standards or otherwise. This impacts CHW data quality, access, and use with clinical providers, community-based organizations, and patients/participants alike. 

The development of this IG centers around the core “CHW Encounter” with a patient/participant. The USCDI standard can be adopted for demographic data, with new elements of the CHW Encounter defined by this IG. This includes the Encounter date, type, location, duration, and provider. Associated datasets around the CHW Provider and CHW Services will also be defined based on Medicare’s Community Health Integration Services. This IG will also include updates to the patient/participant’s health status and align with social need screening and referral standards/IGs — including [the Gravity Project|https://thegravityproject.net/], the [SDOH Clinical Care IG|https://build.fhir.org/ig/HL7/fhir-sdoh-clinicalcare/], and the [Human Services Directory IG|https://build.fhir.org/ig/HL7/FHIR-IG-Human-Services-Directory/]. 

Data elements are being defined in collaboration with the [National Council on CHW Core Consensus Standards|https://www.c3council.org/] and the St. Louis-based [Integrated Health Network|https://stlouisihn.org/], which is transitioning to a Salesforce-based data system for local CHWs and has agreed to implement the emerging IG to facilitate data sharing with clinical providers and community-based organizations. Use cases will include referrals from clinics to CHWs, from CHWs to healthcare settings, and between CHWs and community-based organizations providing aligned health related social needs services.