Potential Measures for Clinical-Community Relationships

A-18. Measure 15: Patient engagement with CHERL

Appendix Table A-18. CCRM Atlas Measure 15: Patient engagement with CHERL

Domain: Referral process Element/
relationship:
Clinic/clinician-patient
Instrument: N/A
Purpose: This measure calculates the proportion of eligible patients who received referrals to a CHERL by a clinician if the patient was identified by the clinician as needing improvement in one or more of the four unhealthy behaviors.
Format/data source: Electronic health/medical record. A computerized support system was developed to collect patient data; track patient calls, dates of service, and clinician feedback; and guide the counseling. Patient-specific health behavior and demographic information was entered by the CHERL based on self-report by the patients.
Measure type: Process Date: 2006
Preventive service/ USPSTF: Alcohol Misuse Counseling; Healthy Diet Counseling; Obesity Screening and Counseling – Adults; Tobacco Use Counseling and Interventions – Non-Pregnant
Clinical practice: Primary Care – Family Practice; Primary Care – Internal Medicine
Denominator: Number of eligible patients (those identified by the clinician as needing improvement in one or more unhealthy behaviors): Patients eligible for improvement were those who had smoked one puff or more in past 7 days; had drunk two alcoholic drinks per one occasion most days in the past month; did not eat a low-fat diet or at least five total fruits and/or vegetables per day; and/or did not participate in moderate exercise at least 5 days per week, or vigorously at least 3 days per week.
Numerator: This was a count of the number of patients who had at least one “visit” with a CHERL (visits were by phone).
Development & testing: The Reach, Efficacy/Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) model provided the framework for the analysis of study results.
Past or validated application: Adult patients at 15 practices selected for convenience in three Michigan communities were eligible for CHERL referral if a patient was identified by the clinician as needing improvement in one or more of the four unhealthy behaviors.
Citation(s): Holtrop, J.S., Dosh, S.A., Torres, T., Thum, Y.M. The community health educator referral liaison (CHERL): A primary care practice role for promoting healthy behaviors. American Journal of Preventive Medicine (2008) 35:S365-S372.
Notes: N/A
Page last reviewed October 2013
Internet Citation: A-18. Measure 15: Patient engagement with CHERL. October 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/prevention-chronic-care/resources/ccrm-atlas-suppl/ccrm-apptaba-18.html