Executive sponsor
Sets the outcome, removes blockers, and makes the final launch decision.
FQHC implementation guide
Start with one accountable operating model.
Kept Count is configured around your team, policy, EHR, and billing authority. Implementation moves through visible gates before a bounded first cohort goes live.
The launch principle
Configure. Prove. Approve. Then activate.
No EHR replacement projectNo PHI during public evaluationNo automatic claims submissionNo launch without owner sign-off
The implementation sequence
Five phases with a concrete output at every step.
- 01
Align the operating model
Choose the first patient cohort, programs in scope, practice-led versus IHA-supported staffing, and the outcomes the launch must prove.
Output
Scope brief and named owners
- 02
Configure the guardrails
Map consent, clinical supervision, exceptions, documentation, patient communication, QA, security, and billing review to practice policy.
Output
Approved workflow and control map
- 03
Validate with synthetic data
Run the end-to-end journey—from panel review through the billing-support packet—without real patient information.
Output
Acceptance evidence and open-issue log
- 04
Clear the production gates
Complete contracting, BAAs, covered-environment controls, role provisioning, training, escalation coverage, and sign-off.
Output
Documented go-live decision
- 05
Launch a bounded first cohort
Activate the agreed cohort, monitor exceptions and quality, review evidence with leadership, and expand only after the practice accepts the results.
Output
Measured operating review
Ownership
The right people are in the room before configuration begins.
One person may hold more than one role in a smaller organization. What matters is that each decision has a named owner and backup.
Clinical lead
Approves care protocols, supervision, escalation boundaries, and clinical acceptance.
Operations lead
Owns staffing, daily workflow, training, service levels, and issue resolution.
Compliance / privacy / security
Reviews consent, access, data flow, incident response, and production gates.
Billing / RCM lead
Confirms coding, evidence standards, held-line review, and final claims authority.
IHA implementation lead
Coordinates configuration, training, acceptance evidence, and launch support.
Decisions for the first working session
Six questions turn interest into a launchable plan.
You do not need every answer before the first conversation. These are the decisions the implementation process will make explicit.
- First cohort
- Which patients and locations create a bounded, representative starting point?
- Program scope
- Which care-management programs are in scope, and which are explicitly out?
- Staffing model
- Will your staff operate the workflow, will IHA add navigator capacity, or will responsibilities be shared?
- Clinical escalation
- Who receives each category of exception, through which channel, and on what response expectation?
- Documentation standard
- What must be present before work is considered complete or review-ready?
- Claims release
- Who reviews evidence, resolves held lines, chooses final codes, and authorizes submission?
What “ready” means before real-data use.
Readiness is evidence, not a date on a calendar. The practice accepts the workflow after the people, controls, and environment perform as agreed.
- A representative patient journey completes from identification through review-ready evidence
- Consent, assignment, escalation, QA, and held-line behavior match approved practice policy
- Every role can perform its work and cannot access work outside its authority
- Clinical and operational owners can find unresolved exceptions and their assigned owners
- Billing can trace the support and review history behind each proposed line
- The practice documents approval—or records exactly what must change before approval
Map one real-world FQHC scenario together.
Bring your panel range, current programs, staffing approach, EHR, and biggest implementation concern. Do not include patient information.