Sometimes, what ails us isn’t entirely a medical problem.
Say a diabetic patient develops frequent foot infections because he lacks transportation to get to regular checkups. Or maybe an elderly person is injured in a fall — again — in part because she doesn’t have the resources to install grab bars and railings.
Doctors and nurses may refer such patients to community organizations for help. But often there is no way for them to know whether the patient called the organization or that people there were able to help.
In an effort to close that loop, Nebraska’s health information system, known as the Nebraska Health Information Initiative, or NEHII, is partnering with a New York technology company called Unite Us.
The new NEHII-funded initiative, Unite Nebraska, is intended to break down barriers between medical and social care providers so they can better address those nonmedical issues that affect physical well-being, also known as social determinants of health.
“We’re really supporting every Nebraskan in living healthier lives and improving health outcomes across the state,” said Jamie Bland, NEHII’s CEO.
NEHII has been working to link patient records collected by physicians, hospitals, pharmacists and other health care organizations in Nebraska and western Iowa for more than a decade.
The system allows an ER doctor in Omaha, for instance, to check the medications and health history of a visiting Kearney resident who lands in her hospital.
Bland said adding community organizations that provide assistance with food, employment and other needs is the next step toward putting health information technology to work for the state’s residents.
The partners plan to begin rolling out the initiative in September, first in the Omaha-Council Bluffs area, then the Lincoln-Lancaster County area and finally the rest of Nebraska, with a goal of wrapping up by early spring. They also will connect border counties in adjacent states in order to capture people who come into Nebraska for care.
NEHII already connects more than 4 million people in Nebraska and western Iowa. Most of the state’s hospitals are part of the exchange. Some 64% of its skilled nursing facilities are sharing data already or in the process of doing so.
To date, 127 community-based organizations have engaged, including the YMCA, the Visiting Nurse Association, Food Bank for the Heartland and United Way of the Midlands, Lincoln-Lancaster and Fremont. Outreach to such organizations will continue through the launch and beyond.
The initiative won’t replace care management, patient outreach and follow-ups done by hospitals, doctors’ offices and insurance companies, said Bland, who was a nurse before she became a technician and worked in care management. Instead, it will provide a common platform where information is available so care managers can avoid stepping on each other’s toes.
Nor does the platform replace information lines like United Way’s 2-1-1, said Taylor Justice, president and co-founder of Unite Us.
Instead, it works with them, he said. Such systems might provide callers seeking assistance with two or three options and never know whether the caller followed up or, if they did, which option they chose. The initiative will allow partners on both sides of the aisle to track outcomes.
Stephanie Daubert, chief financial officer with Nebraska Medicine and a member of NEHII’s board, said health care goes well beyond medical care to factors such as safe housing, socialization and employment.
Health care providers need to see the full picture of their patients and their lives beyond clinic and hospital walls so they can identify and help eliminate potential barriers to their health and well-being, she said.
“By connecting health and social care providers,” Daubert said in a statement, “we can take care of the whole person and ultimately improve outcomes.”
Justice said the firm has already hired several people in Nebraska to help build relationships with community-based organizations.
The company has hired about 20 people in North Carolina, where it’s also building a statewide network. It likely will hire about that many in Nebraska.
Justice said there’s never been a more important time to build such a statewide infrastructure. While much of the response to COVID-19 so far has been in the medical realm, the second wave will involve social support systems, such as making sure kids out of school have access to food.
“We believe the future of health care is social care,” he said.
Justice said NEHII already is “at the top of the pedestal” among health information exchanges across the country.
In collaboration with the state, NEHII also maintains the state’s prescription drug monitoring program. The organization last fall added a research arm and a foundation to fund such programs.
“I think it will create a blueprint for the rest of the country,” Justice said of the new collaboration.
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