Public & Community Health Organizations

Overcome Data Fragmentation & Operational Silos

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Overview of Public & Community Health Management

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CommunityHealth+ is a large public health and social services organization in the United States.

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Specializes in serving underserved populations through Medicaid, Medicare, and community health delivery systems.

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Offers 300+ programs in primary care, maternal health, chronic disease, behavioral health, and housing.

Crisis

An intricate network of smaller entities, each operating with distinct administrative frameworks and clinical workflows

Meet Maria

Caught in Crisis: A Patient's Struggle in a Fragmented System

I've been waiting weeks for my mental health referral to be processed.

Every time I visit a new clinic, I have to repeat my medical history.

I can't access my medication because one department doesn't talk to the other.

Maria Rodriguez

32 Years Old

Family
Mother of two young children
Health Condition
Type 2 Diabetes Postpartum Depression
Housing Stability
At risk due to untreated health conditions

Uncover her challenged journey

Maria, a 32-year-old mother of two young children suffering from diabetes and postpartum depression. She visits a CommunityHealth+ primary care clinic and is referred to their behavioral health program for counseling.

However, due to disparate referrals and disconnected systems, Maria’s information doesn’t reach the behavioral health department for weeks. By the time they call her, she has missed critical weeks of care and is now facing severe anxiety, worsening diabetes, and financial distress.

Meanwhile, her case manager in the housing assistance program has no idea Maria is struggling. They don’t realize she has missed work due to her untreated health conditions, putting her housing at risk.

Organizations like CommunityHealth+ was designed to help people like Maria, but its fragmented system was failing her.

Challenges

Navigating complex healthcare systems, managing chronic illness, balancing family and work responsibilities

Needs

Timely access to healthcare services, coordinated care, financial and housing stability

Are you ready to break free from the challenges of a fragmented system?

Unlock solutions for seamless care and improved outcomes.

Learn how blueBriX can help!
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Why Large Public Health Organizations Struggle with Care Coordination

CommunityHealth+ isn't alone. Public health and community health organizations face massive challenges in managing their programs.

Arrow Fragmented Programs & Data Silos

Over 300 programs operate in isolation, preventing a holistic view of patient care.

Arrow Complex Multi-Source Billing & Grant Management

Medicaid, Medicare, government grants, and private payers require different billing models.

Arrow Duplicate & Disconnected Patient Records

Patients receive services across multiple departments, but their data isn't unified.

Arrow Inefficient Public Health Reporting

Compliance with state, federal, and grant-based requirements is tedious and prone to errors.

Arrow Delayed or Lost Referrals

Manual, paper-based processes mean that high-risk patients experience care delays.

Arrow Lack of Real-Time Data & Population Health Insights

Leadership teams struggle to make data-driven decisions for community-wide interventions.

How blueBriX Fixed the Breakdown in Care

Created a Single, Unified Patient Record Across All Programs
  • No more duplicate records! A universal patient identity system connected Maria’s primary care, behavioral health, and social services data.
  • Doctors, case managers, and outreach workers could instantly access her complete medical and social history.
Compliance-Ready Public Health Reporting & Data Dashboards
  • Automated state, federal, and grant-based compliance reporting for HRSA, Medicaid, Medicare, and UDS.
  • Real-time dashboards tracked program impact, patient engagement, and population health trends.
Automated & Instant Referrals Between Departments
  • Instead of waiting weeks for referrals to be processed manually, blueBriX enabled real-time referral notifications.
  •  Patients like Maria’s behavioral health referral was automatically routed within minutes, ensuring she got an appointment within days, not weeks.
Enabled Mobile & Community-Based Service Integration
  • Field workers, community outreach teams, and home-based care providers could access and update records from any location.
  • Integrated telehealth, mobile clinics, and remote patient monitoring tools.
Simplified Multi-Source Billing & Grant Management
  • Ensured financial transparency across Medicaid, Medicare, private insurers, and grant funding sources.
  • Allowed leadership to track funding utilization, prevent revenue leakage, and optimize reimbursements.
A Coordinated Treatment Plan Engine
  • Standardized evidence-based treatment plans for chronic disease, mental health, and social services.
  • Allowed programs to customize care plans based on their specific intervention models.
Breakdown Line
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Do you want to experience the seamless care?

Seamlessly Connecting Patients, Providers, and Wellness for Better Outcomes

Learn how blueBriX can help!

The Implementation Journey: From Chaos to Coordination

blueBriX implemented a phased rollout to ensure minimal disruption and maximum impact.

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Data Migration & Unification

Consolidated scattered patient records from multiple EHRs, legacy systems, and paper-based files.

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Customization for Public & Community Health Needs

Tailored workflows for behavioral health, maternal health, substance abuse, and social services.

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Staff Training & Change Management

Provided role-based training for clinicians, case managers, finance teams, and IT staff.

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Pilot Launch & Optimization

Tested with select programs first (e.g., chronic disease & behavioral health) before expanding across all 300+ programs.

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Full Deployment & Continuous Improvement

Ongoing support, monitoring, and optimization to adapt to emerging public health needs.

Implementation steps

The Impact: A Fully Integrated, Data-Driven Public Health System

Care Coordination Success
Advanced Public Health Insights
Massive Efficiency Gains
A Cultural Shift to Proactive, Collaborative Care
Improved Financial & Grant Management

Care Coordination Success

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Patients like Maria received timely mental health treatment, proper diabetes management, and social support—all connected through blueBriX.

Advanced Public Health Insights

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Real-time dashboards tracked disease prevalence, intervention effectiveness, and funding utilization.

Massive Efficiency Gains

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Automated workflows reduced referral processing time by 80%. Case managers spent less time on paperwork, more time helping patients.

A Cultural Shift to Proactive, Collaborative Care

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Teams across medical, behavioral health, and social services departments worked together seamlessly.

Improved Financial & Grant Management

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Increased Medicaid reimbursements by 20% through accurate billing and claims management. Optimized grant reporting, ensuring full compliance with funding agencies.

The Future of Public & Community Health is Unified & Data-Driven

With blueBriX, CommunityHealth+ transformed into a connected, efficient, and data-driven public health organization.

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Seamless patient care across multiple programs

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Automated compliance reporting for grant-funded healthcare

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Smarter financial planning & optimized billing

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Real-time data insights to improve population health

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Are you struggling with fragmented programs, disconnected patient records, and operational inefficiencies?

Let's Talk

Discover how blueBriX can help you transform public and community health management.

Learn how blueBriX can help!

Reach out, let’s talk

Enhancing patient outcomes with personalized, value-based care solutions.