The circumstances of a person's life affect their health much more than the medical care they receive. But the systems that support people's health, social, and economic needs are usually disconnected.
That's where social health information exchange (S-HIE) comes in. The Metro Denver Partnership for Health (MDPH) is working to raise up an interoperable S-HIE ecosystem that harnesses technological tools and community relationships to provide whole-person and whole-family care.
What is an interoperable Social Health Information Exchange (S-HIE) ecosystem?
An interoperable S-HIE ecosystem is an effort to build a community of care around individuals and families. A S-HIE ecosystem creates connections and strengthens coordination among health, human, and community-based service providers to offer more holistic, customized care for people in need.
Why is a S-HIE ecosystem important?
Nonmedical social factors such as food, housing, utilities, transportation, and safety significantly influence the health of Coloradans. Unmet social needs limit people from being active in their communities, diminish their overall well-being, and increase the likelihood that a person will develop a chronic disease and not be able to manage their care.
These unmet needs are often disproportionately experienced by Black, Latino, and indigenous populations, and are exacerbated during a crisis, like the COVID-19 pandemic, when people experiencing disparities face even greater barriers to protecting their health.
While many care providers are implementing S-HIE systems (for example, Aunt Bertha, Unite Us, and NowPow) to help address unmet social needs, these systems are not yet connected through an interoperable ecosystem. The goal of creating an interoperable ecosystem for S-HIE is to provide more holistic, customized support by connecting health care systems, human service agencies, and community-based service organizations to coordinate the care being provided to individuals and families in the community, regardless of what systems those organizations use internally.
An effective S-HIE ecosystem harnesses relationships and technologies to reduce disparities and improve health outcomes by:
- Emphasizing people over processes;
- Finding the fit for whole-person and whole-family care; and
- Building a stronger safety net.
You come to a point when you’re “tired of being tired.” I used every resource I could possibly find… When you have the right support, it’s not hard to get better.
— Katie, community member
There was no clear process, it was disjointed, not comprehensive. I went into the hospital, transitional housing, and finally permanent housing. I had some amazing care coordinators, but it was far more complicated and stressful than it needed to be.
— Joseph, community member
At A Glance: MDPH Social Health Information Exchange Efforts
The Colorado Health Institute works with the Metro Denver Partnership for Health (MDPH) as a convener, facilitator, and strategic advisor. For the Social Health Information Exchange initiative, CHI’s activities include:
- Convening the MDPH S-HIE partners for cross-sector coordination and collaboration.
- Designing and implementing ongoing collaboration infrastructure and governance structure. This includes creating a decision-making framework and securing signed Memoranda of Understanding or other agreements as needed.
- Developing and implementing a S-HIE Interoperability Plan to coordinate regional technical interoperability projects, in coordination with the Office of eHealth Innovation (OeHI) Care Coordination Information Governance Task Force. This includes securing letters of commitment from cross-sector partners.
- Determining the financial vision, structure and strategic priorities for sustainability and implementing that plan.
- Developing a plan for sustained community engagement to ensure community-driven priorities.
Finding the right services at the right time can pose challenges for anyone, but these challenges are exacerbated for those who also face discrimination based on race and ethnicity, gender, sexual orientation, ability, language, or other characteristics. Interoperable S-HIE will promote equity by transforming the currently siloed systems, ridden with access barriers, to make them more effective, accessible, and responsive to the needs of every community member.
The MDPH S-HIE Steering Committee is a cross-sector collaboration including:
Public Health Agencies
- Jefferson County Public Health
- Public Health Institute at Denver Health
- Tri-County Health Department
- Centura Health
- Children’s Hospital Colorado
- Denver Health
- Kaiser Permanente Colorado
- National Jewish Health
- SCL Health
Regional Accountable Entities
- Colorado Access
- Colorado Community Health Alliance (CCHA)
Human Service Agencies
- Boulder County Department of Housing and Human Services
- Denver Human Services
- Aurora Health Alliance
- Colorado Coalition for the Homeless
- Denver Regional Council of Governments (DRCOG)
- Douglas County Human Services
- Family Resource Center Association
- Health First Colorado Community Member
- Jefferson Center
- Jefferson County Health Alliance
- Mental Health Center of Denver (MHCD)
- Mile High Health Alliance
- Mile High United Way
- One Colorado
Health Information Exchange Organizations
- Colorado Community Managed Care Network (CCMCN)
- Contexture (CORHIO)
Are you interested in advancing our work to align technology and connect community resources to help the people they serve? There are many ways to help:
- Provide funding to support convening, facilitation, and strategic planning efforts
- Add your unique perspective to the conversation by serving on a workgroup related to community engagement, sustainability, or implementation
- Attend our annual open assembly to meet our partners and other interested stakeholders (date will be announced in early 2022)
Ironically enough, we find that even building in screening at the health systems-level … is a barrier because we ask the same questions over and over. There’s a fatigue from patients about getting the questions asked again and again, and a stigma around answering them in the first place. Even asking the question, we know is a challenge, and broadly we find that our healthcare partners don’t like to ask any questions that they don’t have a solution for.
— Rachael, partner
S-HIE Value Proposition
Advancing a Coordinated Ecosystem for a Social Health Information Exchange (S-HIE) in Colorado (white paper)
OeHI Care Coordination Page
MDPH S-HIE Focus Group Summary
Colorado Health Information Governance Guidebook
Implementation Guidance for Screening for Social Determinants of Health in an Electronic Health Record