Community Health Programs

The Boston Health Equity Program

Whittier’s Boston Health Equity Program (BHEP) is a new model of primary care delivery that combines care coordination, community outreach and education, and wellness support. BHEP explicitly seeks to eliminate health disparities and their associated costs. It stratifies all patients according to their conditions so that appropriate services can be provided by the multidisciplinary team of health care professionals.

BHEP is data-driven and results are aggregated on a monthly dashboard that is then shared with providers. BHEP uses outcome measures related to the community, adult patients, youth patients, and the health system.

BHEP launched in 2012 and is continuously being refined to address the needs of the diverse populations served. Specific innovations (planned and existing) within this system include:

  1. Innovative and culturally appropriate community outreach to increase access to care and early detection of illness with hard-to-reach populations;
  2. Primary care that includes visit redesign and a system of off-site Virtual Clinics connected digitally to Whittier providers and that integrates medical care, mental health care and social supports;
  3. Medication management to maximize safety for those with multiple complex health issues and to support optimal recovery;
  4. Wellness programming that is fully integrated with primary care, tailored to individual needs and buttressed by ongoing support to ensure patient compliance and self-management;
  5. Targeted community-based care for cancer patients that fully integrates specialized medical care with wellness, psychosocial support and primary care;
  6. Education and assistance in properly utilizing primary care and the Whittier urgent care center to avoid hospital re-admissions and reduce emergency room use;
  7. Infrastructure improvements to technology systems to gain efficiency, effectiveness and provide data for continuous quality improvement, including a Patient Portal, an enhanced Cancer Registry and online transmission and review of Virtual Clinic data; and
  8. Implementation of a Wellness and Fitness Center to provide an integrative medicine model of care for the whole person.