SANTA CRUZ — Nonprofit Santa Cruz Health Information Exchange announced Tuesday that it is partnering with three local health organizations to coordinate care for patients.
The health information exchange was founded in 1996 as a platform to exchange data between providers, hospitals and labs. It is governed by local community health care leaders and connects more than 100 organizations, including primary care, county clinics, community service providers and others.
Tuesday, the health information exchange launched Together We Care, an initiative that connects health care and social services providers through the cloud-based software program ACT.md.
The health information exchange has partnered with the Santa Cruz County Health Services Agency, Salud Para La Gente and Santa Cruz Community Health Centers in Together We Care as stakeholders. The three organizations each have their own branch program of the initiative: Whole Person Care — Cruz to Health, Moving Health Care Upstream and Complex Care Management, respectively.
“With Together We Care we are taking a big step toward truly whole person care,” said Mimi Hall, director of Santa Cruz County Health Services Agency in a prepared release. “By truly coordinating care with and for people in our community and bringing together providers of medical and social care on one platform, we are transforming access and outcomes to build a healthier community. We are pleased to partner with SCHIO in implementing the ACT.md system here in Santa Cruz.”
Through Together We Care, case managers and social services providers can connect with local food banks, Housing Matters, transportation agencies and other organizations to fill the “gap in care” outside of health care, according to Holly Hughes, project manager of Together We Care. Health care providers can access ACT.md, but they are not intended to be the primary users, she said.
At the start, Together We Care is expected to serve about 2,000 county residents and help coordinate care across organizations, according to Bill Beighe, chief information officer of the health information exchange. Vulnerable residents refer to an underserved population who may be at risk of homelessness, may not have access to social services and health care and have multiple chronic health conditions, he said.
“Everyone has a stake in wanting to see improvements,” Hughes said, adding that this gap in care is a result of health systems not having the infrastructure or tools to address patients’ needs outside of health care, or the needs of the whole person.
The health information exchange is in conversation with information and referral service 211 Santa Cruz County as a future stakeholder, Beighe said.