Wake County Familiar Faces Health Collaborative

Wake County Familiar Faces Health Collaborative

The Wake County Familiar Faces Health Collaborative aims to improve the health and wellbeing of Wake County’s most vulnerable residents by meeting their individual needs and goals through a “whole person” approach where medical and social service providers across the care system share information and collaborate to provide integrated, holistic, and trauma-competent care.

The Problem

Our healthcare system is fragmented, confusing and full of gaps. For Familiar Faces – our most vulnerable community members – this can mean poor health, homelessness, food insecurity and more.

The Solution

An integrated, whole-person care system that brings together multiple providers to address all needs through a shared process and coordinated plan.

How we do it

Objective one: To use shared data to develop integrated, system-level community care plans for Familiar Faces. 

Objective two: To create a platform that can share data across multiple providers and organizations.

Usually, health information can only be shared with one organization, or sometimes across a few medical providers. Our data-sharing platform will allow both medical healthcare data and social services data to be shared with multiple organizations so providers can work together to create coordinated, successful community care plans. This can include:

  • Predictive modeling of accurate, local data to identify actual and potential high utilizers across the system.
  • Care coordination via collaborative care management with new/redesigned cross-organizational workflows.
  • Information sharing across the care system via an integrated data-sharing platform for service providers.
  • Program analytics with system-wide data sources to guide piloting, evaluation and iteration of program activities.

What it could mean

Treat and prevent chronic illness.
increase stability and self-sufficiency.
improve physical and mental health.
reduce unnecessary use of emergency and medical services.
Overall better qualify of life.

Our Partners

The collaborative partners have envisioned effective and equitable solutions to the challenges plaguing Familiar Faces and care providers in our community.

In November 2022, a team of IT specialists and human-centered design strategists from New South Technologies completed an analysis of the collaborative’s structure, goals and resources. Now armed with a strategic plan for moving ahead, we look forward to launching our pilot program in 2023.

WakeMed Health & HospitalsDuke Raleigh Hospital
UNC Rex HealthcareAlliance Health
SouthLightUNC WakeBrook
Wake STEP ClinicRHD North Carolina
Triangle Family ServicesOak City Cares
Raleigh/Wake PartnershipHealing Transitions
Recovery Communities of NCRaleigh Police Department
Wake EMSWake County Housing Department
Wake County Health & Human ServicesWake County Information Services
Wake County District AttorneyWake County Sheriff’s Office
Wake County Manager’s Office

Contact Us

Learn more about Wake County Familiar Faces