Data Sharing Ecosystem

The Problem

Up to 80% of an individual’s health is attributed to SDOH—social, economic, and environmental factors—while a mere 20% is influenced by medical factors. This is largely due to systemic social and institutional barriers that prevent residents from attaining the resources they need to be healthy and productive members of society. These factors may include unstable housing and employment, low access to healthy foods, lack of accessible public transportation, lack of insurance, unaffordable prescription drug costs and more. Despite this, the United States is the only major country to spend more on medical care than social care. Clearly, there is a disparity between healthcare resource distribution and efficacy, and with no mechanism to connect these sectors of the healthcare system, real change is unlikely to happen. Furthermore, because all agencies keep their own private records, there is no current mechanism or infrastructure to help view the full landscape of how a community at large utilizes its resources. With a system that misaligns resources to its community’s needs, has no or low capacity to measure the impact of community investments, and no venue to analyze actionable community data, the healthcare industry is stuck in the status quo.

Our Solution

Our goal is to establish a sustainable, data-driven, human-centered ecosystem of care that equitably addresses SDOH among residents of the Greater Houston area. As a first step towards achieving this mission, we propose to build a cloud-based Community Information Exchange (CIE) linking various local community-based organizations to each other, and to healthcare organizations to facilitate care navigation for social services in the Greater Houston area. The CIE will use a federated model such that it is the framework that will allow multiple organizations (healthcare and CBOs) with varied technologies to connect with one another for the purpose of coordinating care to meet social needs.