Community Health in the Spotlight: Brevard Health Alliance

Federally qualified health centers (FQHCs) perform a critical function in the U.S. healthcare ecosystem by providing care to medically underserved communities and offering a affordable care for the uninsured or underinsured. One subset of FQHCs are community health centers that offer a range of outpatient services from primary care, dental care, chronic disease management, behavioral health services, and more. According to the National Association of Community Health Centers (NACHC), in 2021 more than 1,400 community health centers in the U.S. served 30 million patients or one in 11 people across the county.

These community health centers are a driving force behind the integrated healthcare transformation and depend on health information technology (health IT) to effectively coordinate care since they involve many care team members. To get insight into what’s happening with community health centers, we spoke with Shaun Garcia, MD, MS, Chief Quality Officer of Brevard Health Alliance, an FQHC serving Brevard County Florida that partners with Audacious Inquiry, A PointClickCare company, to use the Encounter Notification Service® (ENS®) for care coordination. Dr. Garcia shared how his career taught him the need for value-based care, described current community health initiatives at Brevard, and explained the role of health IT in these programs.

Community Health Centers Moving the Needle on Integrated Healthcare

Community health centers have a network of providers that support patient health needs across the continuum of care. Dr. Garcia shared that Brevard Health Alliance practices team-based care in which a patient’s care team may include a primary care physician, a dentist, a behavioral health provider, a licensed clinical social worker (LCSW), a pharmacist, and a patient panel coordinator. The care team works together to address the entire spectrum of healthcare needs and to ensure that social determinants of health (SDOH)—like language barriers, lack of transportation, cost of care, or access to insurance—don’t interfere with a patient’s ability to receive high-quality treatment.

Dr. Garcia described Brevard specifically saying, “Because we’re a community health center, we see everyone regardless of their ability to pay. We have about a 53% Medicaid population, 24% uninsured/no health insurance, then about 5% of patients do cash pay. For patients who don’t have funds to pay, so we have a sliding scale for them. Then the rest of our patients have commercial, and a variety of health plans. We don’t turn anyone away.”

Dr. Garcia came to Brevard Health Alliance with formal training in public health and medicine, as well as business administration. Having started his career in public health, he always had an eye on making an impact at the organizational level, even as he became a primary care provider. Moving away from practicing medicine, Dr. Garcia began working in administration at a community health system in California that was an integrated system, which owned the health plan, the network, and the third-party administrator.

He explained, “Once I saw that, with my experience, I instantly knew what value-based care was, and all those years of work just made perfect sense to me. And in my opinion, in primary care, there’s nothing like the double bottom line: helping patients out while still being able to have a thriving business.”


Bringing Care Directly to the Most Vulnerable Populations

Brevard Health Alliance is located on the eastern coast of Central Florida, about an hour east of Orlando in Brevard County. Dr. Garcia shared that they care for about 64,000 patients, or roughly one in 10 people in the county, each year. In addition to the patients who visit their center for care, they also go into the community to offer care to those who may not be able to come to them or need extra outreach.

One Brevard Health Alliance community health initiative involves mobile medical units that serve patients anywhere in the county at any location, eliminating the need to find transportation to access healthcare. Another Brevard Health program will see health services expand to a clinic located inside of a new mixed-income housing development as another way to bring care directly to patients. As Garcia described, “That’s the cutting edge of being there for the patients where they are. This is something that is important to us because we know that the more upstream we go, the better off patients are going to be.”

Two other programs in development include working with prisons throughout Brevard County to offer healthcare to inmates and addressing the opioid crisis by working with community partners to help those struggling with opioid use.

They also partner with an elementary school in Cocoa to address access barriers to healthcare for its students and their families. Future plans could include a school-based health center site within the elementary school. Eventually, the plan is to be available to students throughout Brevard County and also support their mental health needs. Dr. Garcia was particularly excited about this, sharing, “I saw how effective it was for community health centers to have a therapist in place at the schools and that it could make a big difference for those high school students.”


Community Health and the Role of Health IT

Providing care to patients all over Brevard County with many providers and coordinators involved requires care coordination solutions that are effective to ensure access to updated health records no matter where care is being offered. Brevard Health Alliance first started working with Audacious Inquiry in 2018 to leverage the Encounter Notification Service® (ENS®) for real-time alerts when patients are hospitalized, transferred, or discharged from a hospital. Within the first few months of implementing ENS, Brevard Health Alliance saw a 4.6% decrease in uncontrolled diabetic patients, an 8.7% decrease in readmission rates for Medicaid patients, and a 5.9% decrease in readmission rates for Medicare patients.

Dr. Garcia began working at Brevard Health Alliance two years ago and sees solutions like ENS as essential to care coordination and addressing gaps in care. In his own words, “Without using technology to fill those holes, you’re hoping the patient can figure it out. But when you care coordinate for a patient, it gives them that extra bandwidth in their day to feel like, ‘Someone’s taking care of me, and I don’t have to try to figure out what to do.’”

An example Dr. Garcia offered about ways Brevard Health is leveraging health IT is with risk stratification and patient panel tracking. They pull data from the health information exchange (HIE) to risk stratify patients based on information like number of emergency department (ED) visits in the past six months, for example. They can then create patient panels and assign coordinators to provide proactive outreach. For ED-sensitive patients, they can do something as simple as send a magnet for their fridge that breaks down when something is an emergency versus when they should call Brevard Health Alliance. To take it a step further, the coordinator can receive an alert when a patient in their panel has been admitted to the ED to start care coordination right away.

Another use case for the future involves setting up alerts when patients with opioid use disorders are discharged from the hospital. Dr. Garcia envisions setting up admission, discharge, transfer (ADT) alerts for patients in Brevard County struggling with opioid use who are discharged from a hospital and need help accessing behavioral health care as a next step. A care coordinator could receive a notification when a patient is leaving the hospital to provide support for next steps in their treatment plan.


Advice for Community Health Centers to Address Challenges with Technology Adoption

Leveraging technology in a community health setting is key to supporting better outcomes for patients. However, Dr. Garcia knows firsthand that while health IT is crucial, it can also come with its own set of challenges. In his time at Brevard Health Alliance, he shared that working through the HIE and using the ENS alerts are the first steps they’ve taken towards real-time data feeds.

Looking at the work with the schools and prisons in Brevard County, he explained that the technology and data exchange component is a work in progress. He shared, “It’s still a challenge. The good thing is at least we have our electronic health record (EHR) positioned in the schools, but the health records from the jails—we haven’t gotten there yet.”

As far as wins in health IT for Brevard Health Alliance, Dr. Garcia was particularly excited about a new component of their EHR that helps remove a step from their process of accessing data from the HIE. He explained, “Anytime you can minimize the number of clicks or entries into a portal, that’s huge. Now I’m just inside my one unit and I get a notification that someone just showed up at the hospital. That’s going to be big win for us.”

When it comes to implementing new technology at a healthcare facility, he advised, “You have to know that the transition is going to be hard. You have to have a transition plan, and it has to involve everybody because it is mixed into clinical operations. They need to know this is going to be happening and you need to include them in the process.”

To learn more about partnering with Audacious Inquiry, A PointClickCare Company, for health IT solutions, contact us today. For details about how real-time alerts can support better transitions in care, download our care coordination guide.


About Shaun Garcia, MD, MS

Shaun Garcia Brevard Headshot Blog Shaun E. Garcia, MD, MS is the Chief Quality Officer at Brevard Health Alliance. Dr. Garcia has 15 years of international healthcare experience with expertise in multidisciplinary ambulatory settings and a focus on strategically weaving operations, clinical, and data together for improved outcomes and quality.



About the Author

DIana Bauza About The AuthorDiana Bauza is a content writer based in Philadelphia. She writes about products and services in the health and technology industries, with the goal of empowering consumers with quality information to help them make decisions that best serve their needs.