Connecting The Dots And Closing Loops: Data That Drives Health

(Pictured above: Ashley Randolph, Healthy Community Alliance Navigator)

At the Health Foundation, we truly enjoy highlighting our grantee partners and the amazing work that they do. Here is a spotlight from our 2021 annual report: Connections.

Research shows that social determinants of health such as housing, literacy, childcare, employment, financial assistance, nutrition, and food security are drivers of health outcomes. Social care service providers play an important role in improving the health of our community by helping to address those social factors. However, many community-based organizations do not have the ability or resources to track and analyze data, or to share that data with other public or nonprofit service providers.

A Health Foundation-funded project led by Healthy Community Alliance (HCA) is working to make it easier and more efficient for these service providers to analyze outcomes, share information, and reinforce the impact that social care services are making on community health.

The project, which launched in 2020 as part of a Health Leadership Fellows CALL to Action grant, tested the idea of how a Community Information Exchange (CIE) might help improve service coordination and referrals across agencies and systems to better address social determinants of health and related outcomes.

HCA partnered with WellConnected, LLC, and Fellows-led organizations to develop and test allco—a community data sharing platform that creates a social care data sharing network between and among different service providers and systems, similarly to how health care systems share patient data. This network of sharing social care information facilitates proactive, person-centered, and holistic community-based care.

Aligned with our midterm goal that community-based organizations are financially sustainable, strong, and working collaboratively with health and other systems, this community asset has already reached more than 40 health and human service organizations across three counties. In February 2022, allco announced that 211WNY’s call center would now be using the platform to track callers’ needs and make digital referrals, further closing the communication loop between service providers and ensuring community members have linkages to the services they need.

“Over the past year, we have seen significant examples and use cases of how this system is improving internal agency intake, communication, and referral, as well as cross-agency referrals and service coordination,” said Ann Battaglia, Chief Executive Officer of Healthy Community Alliance. “In the case of Healthy Community Alliance, we did not have a CRM or data collection tool for our internal information and referral. This tool has improved our internal community member tracking and our ability to report out on our outcomes.”

allco and the social care data sharing network have also been leveraged in the Strong Starts Chautauqua System Integration project, where cross-sector partners share information and referrals to improve service coordination and treatment for expectant mothers and young children impacted by substance use.

The data sharing network powered by allco was also used to efficiently and effectively coordinate and deliver the COVID Rent Relief Program funded by the CARES Act, ensuring those who were in the greatest need for housing assistance during the pandemic received it in a timely manner.

“It is also our hope that the community data will help care coordinators, community planners, and health advocates better anticipate needs and address the causes of poor health,” noted Battaglia. “Most important, however, we hope that improvements in referral and service coordination through technology will have a lasting impact on our community members who are most in need through improved access and connection to critical health and human services.”