Interoperable Social Health Information Exchange Ecosystem

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.

The Metro Denver Partnership for Health is one of many groups in Colorado working to advance an interoperable social health information exchange ecosystem. To learn more about CHI’s work with the Office of eHealth Innovation and other groups, please visit the OeHI Care Coordination Projects webpage.

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

Mission

We collaborate and align technology, connecting community resources and the people they serve.

Vision

Individual social and health needs are met to promote equity and improved health outcomes in our communities.

Values

Trustworthy, Respectful, Equitable, and Inclusive

Guiding Principles

Connective, Scalable, Person-centric/Holistic, and Secure

CHI’s Work

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.

Health Equity

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.

Who’s involved?

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

Health Systems

Centura Health
Children’s Hospital Colorado
Denver Health
HealthONE
Kaiser Permanente Colorado
National Jewish Health
SCL Health
UCHealth

Regional Accountable Entities

Colorado Access
Colorado Community Health Alliance (CCHA)

Human Service Agencies

Boulder County Department of Housing and Human Services
Denver Human Services

Community-Based Organizations

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)

Join Us

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 April 19-20, 2022. Learn more.

To learn more, share your ideas, or get involved, contact Kirsti Klaverkamp at klaverkampk@coloradohealthinstitute.org.

Resources

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.