S-HIEs And Why They’re Important to Care Coordination


Over the last two decades the healthcare industry has made an enormous shift in the way medical records are stored and accessed. Beginning in 2009, government incentives drove healthcare providers to fully adopt electronic health records (EHR). With medical records stored electronically, greater sharing of records and collaboration among providers became possible. The health information exchange (HIE) emerged as a way to facilitate the exchange of health data across healthcare systems, government entities, and providers across multiple geographies, specialties, and care settings.

Now that EHR and HIE technology is commonplace, a new technology is emerging that extends upon both these innovations: the social health information exchange (S-HIE). A national survey of physicians found that 85 % of physicians believe that unmet social needs directly lead to worse health care for Americans and that social needs are as important to address as medical needs[i]. This recognition of the impact the social determinants of health have on patients’ health outcomes has spurred the need for providers to have access to a patient’s social history along with the medical history. And out of that need the S-HIE was born.

The S-HIE connects community-based providers that meet client needs for the social determinants of health—such as housing, food security, safety, transportation, and employment — with providers of medical care, mental health, and behavioral health services. Medical providers can use this information to customize care plans to fit a patient’s unique circumstances. Providers can even prescribe care at a participating community provider, such as physicians prescribing food available from a local food pharmacy.

Community-based providers benefit from the two-way nature of the S-HIE. As patients are assessed in a medical or behavioral health setting they may be diagnosed with social needs in addition to medical needs. These social needs can be communicated through the S-HIE to the community-based providers who can provide these services to the patient.

As population healthcare models proliferate, the S-HIE becomes increasingly important. Information available through the S-HIE helps caregivers to accurately assess risk, monitor patient outcomes, and control for factors outside the traditional domain of healthcare. With this data, providers can further stratify patient populations, directing the right kind of care to satisfy the full spectrum of patient needs and thereby improving population health outcomes.

Despite great enthusiasm on the side of both community-based providers and medical, mental, and behavioral health providers, interoperability remains a key roadblock to exchanging social health information. Although EHRs are required to facilitate the electronic transfer of health information, such a requirement does not apply to social health information. EHRs typically lack the data framework to house social health data and existing data transfer protocols do not include social health data as a standard data item. These challenges can be overcome through additional software development, new transfer protocols, or the use of a care coordination system that facilitates the transfer of medical and social health data.

The S-HIE is an exciting development that strengthens the collaboration among community providers and medical, mental health, and behavioral health providers. The emergence of the S-HIE and eventual widespread adoption of the technology promises great benefit for providers of all types and patients under their care.

[i] Robert Wood Johnson Foundation. Health Care’s Blind Side: The Overlooked Connection Between Social Needs and Good Health. 2011.

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