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IXchange Blog

February 8, 2021

HIE and Data Exchange, Help Care Coordination for the Homeless

Homelessness is rising across the country, especially here in New York City. Unfortunately, homelessness has risen 59% in the last decade. These are levels not seen since the Great Depression.

Many homeless suffer from mental health issues, substance abuse problems and chronic medical conditions. When faced with a health crisis they often seek care in their closest ER.

This growing public health issue resulted in a grant to help identify and exchange information on the homeless. While Healthix is an HIE, it is also a non-profit. We take our mission of Mobilizing health information across our communities to advance patient care seriously. Healthix saw a need and understood how our data could help be a part of this collaborative effort.

The ability to identify homeless patients fits into a broader effort to provide data on social determinants of health (SDOH). “The problem right now is there isn't a consensus in the industry about how this information should be exchanged between a provider and the HIE.”  Thomas Moore, SVP Innovation at Healthix. “Many providers serving large Medicaid populations send us SDOH through the recognized PRAPARE standard. We pull the data in using this standard, and make it to available to our participants.” 

In addition to identifying the homeless, Healthix can send alerts to providers if their patients become homeless. These efforts are just the first step in the larger goal to better serve the homeless in NYC.


Watch Tom Moore explain how we are assisting with care for the Homeless.


Photo: Man under bridgeReal Life Examples of Alerts in Action: 
When The Institute for Family Health, a New York City FQHC, received an alert from St. Luke’s Hospital for an ER visit from Brian*, a 60-year-old diabetic without a stable home who had 130 prior visits to multiple EDs within the year, a care manager rushed to the hospital to intervene. She walked Brian to their Harlem facility and immediately began planning his services. That day, the Institute connected Brian to primary and behavioral healthcare providers, helped him apply for SNAP, and placed him in a Bronx homeless shelter.
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