Design and Framework of a Technology-Based Closed-Loop Referral Project for Care Coordination of Social Determinants of Health
PCIC CEO Kallol Mahata co-authored a new publication in Population Health Management, "Design and Framework of a Technology-Based Closed-Loop Referral Project for Care Coordination of Social Determinants of Health."
| Screening for social determinants of health (SDOH) has been mandated by health systems nationwide. However, a gap exists in closed-loop referral for care coordination between health care and social services. This article presents the framework of a technology-based project to facilitate closed-loop referral between health care and social service agencies in Greater Houston by leveraging and connecting the existing care coordination technology infrastructure. Ten health care and social service organizations in Greater Houston participated in the demonstration project initiated in January 2023. The authors leveraged and linked regional health information exchange (HIE) technology with a master patient index of >18 million, and sector-specific care coordination platforms to build closed-loop referral capacity between HIE-participating health care organizations and social service organizations to meet patient SDOH needs. Evaluation efforts will assess the reach, adoption, implementation, and the effectiveness of the closed-loop framework in improving social and health outcomes. | Read Article |
