CA HIE Expands Data Sharing for Community Information Exchange

A California health information exchange (HIE) is expanding its data sharing capabilities to address social determinants of health (SDOH) through community information exchange (CIE).

In addition to being an HIE, the North Coast Health Improvement and Information Network (NCHIIN) network is an accountable community for health, noted Jessica Osborne-Stafanes, NCHIIN’s grants and program development director.

An accountable community for health is a growing network of organizations that works to connect people across community sectors through data exchange. Currently, the accountable community for health is focused on holistically addressing substance use disorder in Humboldt County.

“When you think of substance use disorder, you can think of the many segments of the community that would need to be involved in addressing that on the prevention to treatment spectrum,” Osborne-Stafanes said in an interview with EHRIntelligence.

Through the accountable community for health, NCHIIN saw the need for better systems to coordinate care for individuals with complex needs, including individuals who face SDOHs like substance use disorder, adverse childhood experiences, food insecurity, and behavioral health conditions.

However, while NCHIIN knew that there were likely other organizations and parties in the community working with those who face SDOH, there was no way to view that information in a uniform way, she noted.

“It takes a lot of staff, personnel resources, and time to search down who else is on the team that’s working with the clients that we’re working with, and it takes a lot of institutional knowledge to understand which of our clients qualify for which services,” Osborne-Stafanes explained.

Another initiative, the Humboldt Resiliency and Inclusion Through Support and Empowerment (RISE) project, highlighted the need for greater data exchange related to services for those dealing with SDOH. The initiative, which started about five years ago, is focused on supporting pregnant persons who are substance-affected.

“Humboldt County has a high rate of babies that are born substance-affected or mothers that deliver while they are substance affected,” Osborne Stafanes noted. “We initiated a project with our local Research and Policy Center and our Department of Public Health to try and understand why that was going on in Humboldt County and what might be done about it.”

In the first phase of the initiative, NCHIIN received robust community participation that led to producing a set of recommendations about what the network might do to address substance-affected mothers and babies in the county.

“In that second phase of the work, which just concluded in December of 2020, we were able to support local practices and hospital systems to put the 4P perinatal SUD risk screening tool into place,” Osborne Stafanes said. “We established a community-based perinatal care navigator that would support parents and link them to services and help coordinate care.”

The project also led to the development of the North Coast Resource Hub, which Osborne-Stafanes noted is similar in concept to CIE.

NCHIIN heard from many providers that they wanted to learn more about resources for substance-affected moms and babies.

“We developed a mobile-friendly website that is searchable with a starting set of community resources and services for helping parents that might be substance affected,” Osborne-Stafanes said.

She noted that as soon as the tool went live in the community, the network saw the potential to build out the solution to support additional populations.

“We put in more resources to support people affected by substance use disorder more broadly, not just necessarily pregnant or parenting persons,” she explained.

Then, NCHIIN partnered with the county to the north, Del Mar County, which had an opioid safety coalition and wanted to build out resources for their county. NCHIIN also partnered with the Southern Oregon counties adjacent to Del Mar.

These partnerships have built up the resource hub significantly, Osborne-Stafanes noted.

Ultimately, the hub will serve as the referral directory backbone for a community information exchange, which will support data SDOH data sharing.

Martin Love, NCHIIN CEO, noted that the network has been looking into CIE efforts since hearing about similar initiatives in San Diego about two years ago.

“Pretty early on, we thought that this is something that should happen in Humboldt County,” Love said. “We spent a fair portion of time looking at platforms and considering other ways we might go forward with that CIE concept.”

Love noted that the network recently partnered with health IT vendor QS Systems to utilize its platform for CIE due to its strong infrastructure geared towards HIEs.

NCHIIN has developed a robust community co-design process to shape thinking about what a CIE would ideally look like and function like in Humboldt County, Osborne-Stafanes explained.

“This summer, we did about a 10-week rapid cycle community co-design process focused on bringing 30 different individuals from various organizations in our community together to design the starting set of parameters for our CIE,” she noted. “Out of that work has been a variety of deliverables that will help shape the platform.”

“We’re delighted to work with QS Systems,” Osborne-Stafanes explained. “One of the things that we felt strongly about is that this isn’t a technology project — this is a community project. It comes down to how do we have the best care possible and the best system possible for our community, and that’s not really a bus that anyone can drive alone.”