Santa Cruz Health Information Organization will integrate SDOH data


Along with the creation of a A HIPAA-certified primary patient index, the Universal Identity Platform will enable SCHIO to integrate social determinants of health into patient records.

SCHIO participates in a community information exchange, Together We Care, a platform designed to compile data on SDOH and bridge the care coordination gap in Santa Cruz.

Information includes housing, homelessness, mental health and addictions issues, transportation and food insecurity, according to the announcement. Multiple vendors can communicate on the community information exchange, including case managers and social service providers.

With patient identity management platform, SCHIO can provide safe and more accurate data to community information exchange. Data can be shared with patients and health care organizations in the Santa Cruz area, and stronger patient records could help improve care.


Shared platforms can improve data integrity as well as the quality and efficiency of SEEs while Sharing data on the underlying social determinants of health, such as lack of transportation, between clinical and social services can help providers act to ensure access for the patients they come into contact with.

Some equity information exchanges can provide access to millions of patient records.

But to address the health of the population, analytics are needed to activate the data, experts say. Using advanced analytics, cohorts of people with common attributes can be identified, and healthcare organizations can then prioritize actions based on the urgency, severity, or cost of the challenges facing the groups. of patients, according to Sheila Talton, CEO of Gray Matter Analytics, in a recent Q&A with Healthcare IT News.

“Analysis of population data helps providers quickly determine which patients should be targeted for outreach and intervention. Perhaps the analysis identified several patients who recently missed their annual wellness visits Providers can then contact those patients to reschedule appointments or provide other meaningful interventions,” Talton said. Explain.

When Contra Costa Health System embarked on the holistic approach to personal care and integrating all data into its Epic EHR, there have been many successes. But one of the biggest successes was implementing an automated and scalable system to identify frequent users of multiple clinical and social systems, saving hours of case management administration.


“SCHIO is a special organization, and they have fostered an incredible relationship of trust within their community. They understand that this relationship of trust is built on accuracy and consistency, especially when it comes to patient data,” said Clay Ritchey, CEO of Verato.

Andrea Fox is the editor of Healthcare IT News.
Email: [email protected]

Healthcare IT News is a HIMSS publication.

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