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Leverage the PRAPARE Tool to Act on Social Determinants of Health

Posted by Nicole Miller on Oct 27, 2020 6:00:00 AM

Presently in a pandemic, community health centers are reimagining and adjusting how they assess and address patient Social Determinants of Health.  The Protocol for Responding to and Assessing Patient’s Assets, Risks and Experiences (PRAPARE) is a national effort to help health centers collect the data needed to better understand and act on patient’s social determinants of health.   Here we will discuss and demonstrate how to use the PRAPARE tool in NextGen to align with national initiatives proposed under Meaningful Use, Clinical Coding ICD-10, and Health Centers’ Uniform Data System (UDS) 

Why is it Important to Collect Data on Social Determinants of Health? 

Under the value-based pay environment, providers are held accountable for costs and outcomes. Collecting data on Social Determinants of Health is important to define and document the increased complexity of patients.  It is difficult to improve health & wellbeing and deliver value, unless we address community barriers. When providers address these community barriers, it enables them to demonstrate the value they bring to patients, communities, and payers while advocating for change at community and national levels. 

What Does the PRAPARE Tool Measure?  

  • Race and Ethnicity 
  • Veteran Status 
  • Farmworker Status 
  • Housing Status 
  • Education 
  • Employment 
  • Language Preference 
  • Domestic Violence 
  • Insurance Status 
  • Neighborhoods  
  • And More 


NextGen PRAPARE Implementation, Flowsheet and Configuration 

NextGen PRAPARE Implementation 


To help facilitate standardized PRAPARE data capture, the National Association of Community Health Centers, (NACHC) worked with Electronic Health Record (EHR) vendors and Health Center Controlled Networks to create PRAPARE EHR templates that are freely available to users. For NextGen users, NexGen originally created a template known as the Social Determinants of Health that included Financial, Education, Stress, Depression, Physical Activity, Alcohol Use, Social Connection and Isolation, Exposure to Violence.  This was a template that was used prior to the NextGen 5.9.2020.1 upgrade.  

Social Determinants of Health NextGen

Currently, if you have upgraded to the NextGen Version 5.9 UD3 or higher the PRAPARE template is now standard within NextGen and can be accessed by signing an End User License Agreement. This new tool includes sections 

  • Personal Information 
  • Personal Characteristics 
  • Family and Home 
  • Money and Resources 
  • Social and Emotional Health 
  • Optional Additional Questions  
  • Interpretation 
  • PRAPARE Flowsheet 

Protocol for Responding to and Assessing Patient Assets, Risks, and Experiences (PRAPARE)

PRAPARE Flowsheet
The PRAPARE Flowsheet is a new template and a new addition to the PRAPARE template itself.  It enables you to view history on questions that have been answered from the patient's overtime.  This demonstrates a progression overtime of your patient’s responses to each question.





PRAPARE Flowsheet

How to Configure the PRAPARE Template in NextGen? 

The configuration can be done in the practice configuration template. The section that is listed is under PRAPARE with two options: PRAPARE and Social Determinants of Health.  It is recommended to select one or the other.  In addition, there is the PRAPARE scoring ID where you can determine if the score has a minimum or maximum to determine what interpretation should be listed. The image below is the out of box recommendations. 
Section: PRAPARE 
*Make note to remove the check mark in the Social Determinants of Health box.  


PRAPARE Scoring Configuration  

PRAPARE 2 Config 2

To learn how to use the PRAPARE Template in NextGen, we prepared a demo to understand and act on patient social determinants of health.  


OSIS PRAPARE Configuration Demo


PRAPARE Implementation and Action Toolkit

Topics: EHR, Community Health Center, FQHC, NextGen Optimization, PRAPARE