No Wrong Door: Improving Care Coordination on the White Earth Reservation

Copyright

2016

The White Earth Reservation Tribal Council is expanding implementation of WECARE (White Earth Coordination, Assessment, Resource and Education), a care coordination database system that provides an efficient and effective way to link families on or near the reservation to the services they need. The project is using RiteTrack software to improve care coordination, enabling connections between primary care, home health, education, early childhood programs, and human services in an accountable care-like organization. Clients complete a universal intake assessment indicating their interest in a wide range of community services, creating an electronic alert referral for appropriate programs to address the social determinants of health.