Software Platform to Help Address Social Determinants of Health
Did you see the recent announcement that Kaiser Permanente (KP) will use a social determinants of health (SDoH) platform to connect patients with social services and community-related resources? Since I’ve written about how we can make our communities healthier by leveraging all resources more effectively, I was actually more intrigued by the platform they would be using.
The platform was developed by Unite Us a tech company that connects the health care delivery side (think health systems, physicians, insurers, Medicaid) with available community resources (think United Way, 2-1-1, local government) in order to address patient SDoH.
What are SDoH?
We know the provision of health care itself accounts for only 20 percent of what impacts an individual’s health. That means addressing the other 80 percent is essential in improving an individual’s overall health and well-being. The chart below, from the County Healthy Rankings, a collaboration between the University of Wisconsin’s Population Health Institute and the Robert Wood Johnson Foundation, describes the remaining 80 percent.
With these in mind, the United Us platform provides a more efficient connection point between providers, patients and resources to address these needs.
Intriguing, right? I thought so.
In using the platform, health care providers can match patient needs, like food insecurity and housing, to local resources relevant to those specific needs. The platform uses a screening tool and decision support to determine whether and what SDoH may be present for an individual. The information is also integrated into the EHR. Individuals are then matched with available local resources. The software is bidirectional. It allows real-time information and communication on what resources are needed and whether/when those resources have been accessed.
For KP, their initiative is called Thrive Local. It will launch this summer. Their goal is to have it available to all members within three years—that’s 12.3 million people directly and 68 million people in the communities they serve, KP indicates. Their network will track community partner referrals and service outcomes to measure the degree to which participants’ needs are met.
While KP is the most recent addition to the list of clients for Unite Us, the company’s website indicates they are already up and running in 20 locations across the country. Those include statewide efforts like in North Carolina as well as a finalist for New York state’s Delivery System Reform Incentive Payment (DSRIP) program for Medicaid enrollees.
The North Carolina effort, the NC Resource Platform, is designed to be available to all North Carolinians, systems, payers, and providers at no cost. It is described as a “a robust, integrated resource database, website, call center, and care coordination platform for clinicians, social workers, care coordinators, families and others to connect people to the community resources they need.” The system will allow for tracking of system-wide outcomes.
I think the KP and NC approaches are great projects to pursue, but as I thought about it further, the platform could be used by so many other entities. For example, it could be deployed by units of government, Medicaid Managed Care Organizations, Medicare Advantage plans, health systems, and physician groups. I could also see it integrated into new Alternative Payment Models, like Accountable Care Organizations and medical homes.
Because the Unite Us platform serves as a real-time, flexible means to understand needs and deploy resources, it can create new efficiencies and facilitate uptake. This then provides real opportunities to help people in tangible ways. An extremely important goal to have, and an innovative technology to address it. My only concern is that we wind up more aware of needs without having available resources or capacity to address them. I hope I am wrong.
What do you think?
Jennifer Boese is the Director of Health Care Policy at CLA. She is a highly successful public policy, legislative, advocacy and political affairs leader, including working in both the state and federal government as well as the private sector. She brings over 20 years of government relations and public policy knowledge with her to CLA. Well over half of her career has been spent dedicated to health care policy and the health care industry, affording her a deep understanding of the health care market and environment, health care organizations and health care stakeholders. Her role at CLA is to provide thought leadership, policy analysis and strategic insights to health care providers across the continuum related to the industry's ongoing transformation towards value. A key focus of that work is on market innovations and emerging payment models. Her goal is to help CLA clients navigate and thrive in an increasingly dynamic health care environment.
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