One of the biggest challenges of providing health and human services to any population is finding ways to efficiently connect individuals with the services they require. Over the last half century, many communities have attempted to solve this problem by creating helplines where individuals can call a directory of service providers in order to locate the ones that best fit their unique needs. In order to provide a nationally consistent way to access these resources, starting in the year 2000 the Federal Communications Commission (FCC) reserved the 211 dialing code to be used exclusively for community information and referral services.
There are now 211 community information services that cover at least part of all fifty states, as well as Washington DC and Puerto Rico. An estimated 93% of the US population is able to utilize a 211 program in order to access services that may include food and shelter, disaster relief, healthcare, behavioral health services, employment supports, and even volunteer and donation opportunities.
The strength of the traditional 211 information and referral services is their extensive directory of resources that can be accessed through a simple phone call. But they are also limited by the fact that 211 networks are designed to dispense information and not gather it. When there is little or no information being collected or shared, it creates a barrier to ensuring that all of an individual’s varied needs are being addressed. It also prevents any meaningful follow-up to ensure that proper care has been accessed. A lack of saved data may also lead to an awkward situation where a repeat caller is forced to share their basic information and history on each subsequent phone call.
What is a CIE?
In order to solve this data gathering limitation, some communities are turning to Community Information Exchanges (CIE). A CIE is an integrated network of health and human services providers that share a technology platform, resource database, and common language in order to facilitate data sharing, bi-directional referrals, and the creation of a longitudinal record for individual clients.
2-1-1 San Diego
The vanguard program that is being mirrored by other communities across the country is managed by 2-1-1 San Diego. This initiative was actually developed as two separate programs before merging to provide a larger and more comprehensive service. 2-1-1 San Diego was originally founded in 1997 in order to provide a directory of assistance programs to the over three million inhabitants of San Diego County, California, handling over 600,000 calls per year. In 2011, the City of San Diego’s EMS Medical Director developed the idea of creating an information exchange in order to better address the complex needs of the homeless population. This program was later expanded to include providers such as emergency services.
In 2016, the city CIE program merged with 2-1-1 San Diego in order to leverage the 211 program’s extensive network of existing provider partnerships. The next year, the program was transitioned to a new cloud-based platform which enables participating providers to create, share, and update longitudinal records for individual patients. This means that when someone calls into the 211 service to find resources or visits a CIE affiliated provider, the individual patient can choose to have a comprehensive and shareable service record created.
Currently, there are three tiers of partners within the 2-1-1 San Diego CIE network. Tier I is made up of referral partners that are listed in a searchable database but rely on 2-1-1 San Diego to facilitate the referral and follow-up process. Tier II providers are known as connected partners and have the ability to access basic information, as well as accept and direct referrals within the CIE network. But the ultimate goal is for all providers to eventually become Tier III partners, meaning that they will be able to access and update full client profiles, create and manage referrals, and participate in community care planning.
The success of the CIE network has created enough interest that 2-1-1 San Diego partnered with the Schultz Family Foundation in order to create a tool-kit that provides interested communities with the information and strategies they need to begin creating their own community information exchange. This overwhelming interested has been generated because CIE networks allow communities to promote person-centered care by enabling partners to integrate data, manage closed-loop referrals, and create longitudinal records. This, in turn, gives partners the ability to better match patients with the appropriate care and develop the best possible care plan for their individual needs and long-term success.