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Data Analytics to Support the Alignment of High Risk Adult Programs & Services

Award Number: R18HS027389
ORGANIZATION: AGENCY FOR HEALTH CARE RESEARCH AND QUALITY
OPDIV: AHRQ
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: KDA (KNOWLEDGE/DEVELOPMENT/APPLICATION)
PERIOD OF PERFORMANCE START DATE: 09/30/2019
PERIOD OF PERFORMANCE END DATE: 09/29/2023

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Data Analytics to Support the Alignment of High Risk Adult Programs & Services - High-risk individuals with substance use disorder (SUD), especially those who are justice-involved or homeless, have poor outcomes across a range of health indicators, including mortality. Better care requires multiple entities working in concert to share time-sensitive information, identify and prioritize the highest risk persons, and coordinate care across sectors. We propose to build and test a replicable, extensible and evaluable clinical support and analytics solution that meets the following specific aims: SA 1: Establish project scope and governance for data integration across sectors SA1.1 Convene stakeholders to design shared tools to improve outcomes SA1.2 Leverage existing governance structures to ensure extensibility and alignment with broad community/clinical data-sharing efforts SA 2: Create a shared language and systematic approach to risk assessment, care coordination and monitoring cross-sector use of services and costs SA2.1 Partner with stakeholders, including patients, to identify information needs SA2.2 Employ human-centered design principles and Lean methods for tool/dashboard design SA2.3 Elaborate requirements for EHR-supported workflows/dashboards SA2.4 Design and build EHR accessible tools for sharing data with capacity to integrate with a community-wide, social health information exchange SA 3: Deploy tools across sectors and assess impact on risk assessment, care coordination and performance monitoring workflows SA 3.1 Use formative evaluation to gauge adoption, reach and extensibility SA 3.2 Demonstrate the feasibility of summative evaluation to measure ROI SA 4: Provide a road map for sustaining and extending EHR tool implementation SA4.1 Partner with Colorado stakeholders to design next phase efforts SA4.2 Provide a tool kit of extensibility recommendations for state-wide interoperable cross-sector care coordination, leveraging data-sharing resources We will meet these aims and optimize data integration within a common EHR platform (i.e., Epic) through a Denver-based collaboration that includes an integrated delivery system, EHR-agnostic health information exchange, a unit that combines local public health functions with advanced informatics, and homeless services provider.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $0 )
2024	2021	DENVER HEALTH AND HOSPITAL AUTHORITY	777 BANNOCK ST	DENVER	CO	80204	DENVER	USA	Research on Healthcare Costs, Quality and Outcomes	000	3	2/9/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2022 ( Subtotal = $0 )
2022	2021	DENVER HEALTH AND HOSPITALS AUTHORITY	777 BANNOCK ST	DENVER	CO	80204	DENVER	USA	Research on Healthcare Costs, Quality and Outcomes	000	3	7/7/2022	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2021 ( Subtotal = $621,675 )
2021	2021	DENVER HEALTH AND HOSPITALS AUTHORITY	777 BANNOCK ST	DENVER	CO	80204	DENVER	USA	Research on Healthcare Costs, Quality and Outcomes	000	3	9/13/2021	NON-COMPETING CONTINUATION	$621,675
														Subtotal = $621,675

Issue Date FY: 2020 ( Subtotal = $645,665 )
2020	2020	DENVER HEALTH AND HOSPITALS AUTHORITY	777 BANNOCK ST	DENVER	CO	80204	DENVER	USA	Research on Healthcare Costs, Quality and Outcomes	001	2	9/3/2020	NON-COMPETING CONTINUATION	$645,665
2020	2019	DENVER HEALTH AND HOSPITALS AUTHORITY	777 BANNOCK ST	DENVER	CO	80204	DENVER	USA	Research on Healthcare Costs, Quality and Outcomes	000	1	12/19/2019	NEW	$0
														Subtotal = $645,665

Issue Date FY: 2019 ( Subtotal = $658,473 )
2019	2019	DENVER HEALTH AND HOSPITALS AUTHORITY	777 BANNOCK ST	DENVER	CO	80204	DENVER	USA	Research on Healthcare Costs, Quality and Outcomes	000	1	9/16/2019	NEW	$658,473
														Subtotal = $658,473

Grand Total All Awards = $1,925,813

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Data Analytics to Support the Alignment of High Risk Adult Programs & Services

Award Number: R18HS027389

ORGANIZATION: AGENCY FOR HEALTH CARE RESEARCH AND QUALITY

OPDIV: AHRQ

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: KDA (KNOWLEDGE/DEVELOPMENT/APPLICATION)

PERIOD OF PERFORMANCE START DATE: 09/30/2019

PERIOD OF PERFORMANCE END DATE: 09/29/2023

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