Community Care Coordination (CCC)
- Nikhil Balasubramanyam (Deactivated)
- Nicolle Tamparong (Deactivated)
Welcome to the Community Care Coordination (CCC) component of the Unified Care Continuum Platform (UCCP)!
The CCC is a comprehensive health management tool that was designed for use by case managers, care coordinators, behavioral health, medical providers, as well as leaders across the Care Continuum (program directors, CMOs, policymakers, and more). This manual explains the purpose and function of the many features within the CCC.
The CCC has several unique features, which aim to facilitate values-based, patient-centered care:
The platform guides providers through a charting process that begins with getting to know the patient’s values (who or what is important to the patient), in effect shifting care planning from a problem-centered model to a patient-centered model.
Referral features allow providers to refer patients from one agency to another and communicate about patients they have in common. This increases collaboration and decreases duplication in services across the care continuum.
Assessments within the platform measure patient and provider engagement, as well as a variety of advanced data points regarding social determinants of health and barriers to care.
Interoperability with the Unified Care Continuum Platform’s other components, the Community Resource eXchange (CRX) and Community Data eXchange (CDX).
The CRX streamlines real-time resource referral between community agencies.
The CDX feeds social service and acute medical service utilization data into the CCC health record, and supports real-time alerts when patients visit the Emergency Department.