The PCHI CHW Visit
Table of Contents
Overview
The CHW Visit is the core activity that anchors all PCHI-required workflows inside Pear Suite. It is required at enrollment and every 30 days, and it is the single point where risks are identified, Recommendations are created, and all downstream PCHI logic is triggered. Every major PCHI workflow, including Pathways, Supervisor Reviews, Episodes of Care, Billing, and the Quarterly Benchmark Report, can all be triggered from risks identified within the CHW Visit.
It consists of five structured flows that screen for risks across all PCHI-defined need areas. The findings collected here determine which pathways could be opened to address the member’s needs and will guide CHWs to open them in compliance with PCHI standards.
The Five Screening Flows
Each CHW Visit contains five flows covering PCHI-required risk domains. These flows gather the member’s current circumstances, any identified risks, and contextual details needed to determine whether a risk exists and whether a Pathway should be opened.
These flows ensure consistent data collection across organizations and ensure that PCHI’s required risk logic fires automatically.
How Risks Generate Recommendations
When the CHW identifies a risk during any of the five flows, the Visit automatically generates a Recommendation. Recommendations appear after each flow is submitted and populate on the left-hand column of the Activities page. They serve as the CHW’s decision point for opening Pathways based on risks identified during the Visit.
Each Recommendation presents PCHI-dictated Pathways associated with that specific risk. CHWs must decide whether to open the suggested Pathway or dismiss the Recommendation. The Recommendations list should be cleared after each Visit to keep the workflow clean and accurate.
Opening Pathways From the CHW Visit Findings
Based on the risks surfaced across the Visit flows, CHWs select Pathways directly from the Recommendations list. This ensures each opened Pathway is tied to a validated PCHI risk.
CHWs may manually open additional Pathways if more needs surface during the conversation, but Recommendations remain the core driver of PCHI-aligned openings.
How the CHW Visit Drives All Downstream PCHI Steps
A complete and accurate CHW Visit supports:
- Correct Recommendations.
- Properly opened Pathways.
- Accurate Supervisor Review Requests that are tied to the care pathway from which they are fired, allowing supervisors to review all activities and notes associated with that pathway when completing their review.
- Valid closure logic feeding Episodes of Care.
- Billing for completed pathways.
- Accurate Quarterly Benchmark Report data.
The CHW Visit provides the strongest foundation for reliable PCHI reporting and workflow performance. Additional Pathways can be opened outside of a Visit when needed, but the CHW Visit remains the most consistent and complete method for capturing risks that drive the full PCHI model.