title: Envisioning a social-health information exchange as a platform to support a patient-centered medical neighborhood: a feasibility study.
abstract: BACKGROUND
  Social determinants directly contribute to poorer health, and coordination between healthcare and community-based resources is pivotal to addressing these needs. However, our healthcare system remains poorly equipped to address social determinants of health. The potential of health information technology to bridge this gap across the delivery of healthcare and social services remains unrealized.
  We conducted in-depth, in-person interviews with 50 healthcare and social service providers to determine the feasibility of a social-health information exchange (S-HIE) in an urban safety-net setting in Dallas County, Texas. After completion of interviews, we conducted a town hall meeting to identify desired functionalities for a S-HIE.
  
  
  METHODS
  We conducted thematic analysis of interview responses using the constant comparative method to explore perceptions about current communication and coordination across sectors, and barriers and enablers to S-HIE implementation. We sought participant confirmation of findings and conducted a forced-rank vote during the town hall to prioritize potential S-HIE functionalities.
  
  
  RESULTS
  We found that healthcare and social service providers perceived a need for improved information sharing, communication, and care coordination across sectors and were enthusiastic about the potential of a S-HIE, but shared many technical, legal, and ethical concerns around cross-sector information sharing. Desired technical S-HIE functionalities encompassed fairly simple transactional operations such as the ability to view basic demographic information, visit and referral data, and medical history from both healthcare and social service settings.
  
  
  CONCLUSIONS
  A S-HIE is an innovative and feasible approach to enabling better linkages between healthcare and social service providers. However, to develop S-HIEs in communities across the country, policy interventions are needed to standardize regulatory requirements, to foster increased IT capability and uptake among social service agencies, and to align healthcare and social service priorities to enable dissemination and broader adoption of this and similar IT initiatives.
authors.affiliation: Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Mail Code 9169, Dallas, TX, 75390-9169, USA, OanhK.Nguyen@UTSouthwestern.edu.
authors.forename: Oanh Kieu
authors.initials: OK
authors.lastname: Nguyen
authors.forename: Connie V
authors.initials: CV
authors.lastname: Chan
authors.forename: Anil
authors.initials: A
authors.lastname: Makam
authors.forename: Heather
authors.initials: H
authors.lastname: Stieglitz
authors.forename: Ruben
authors.initials: R
authors.lastname: Amarasingham
mesh_terms: D001291:Attitude of Health Personnel; D055812:Community-Based Participatory Research; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration; D005240:Feasibility Studies; D006301:Health Services Needs and Demand; D006801:Humans; D033181:Information Dissemination; D007373:Interinstitutional Relations; D008490:Medical Informatics; D008507:Medically Underserved Area; D018802:Patient-Centered Care / Q000458:organization & administration*; D012947:Social Work / Q000458:organization & administration*; D012959:Socioeconomic Factors; D013781:Texas; D019037:Urban Health Services / Q000458:organization & administration; D035862:Vulnerable Populations
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