Complete and accurate information on a patient’s social determinants of health (SDOH), including specific needs related to food, housing, and transportation insecurity, can help their clinicians and social services providers take a more holistic approach to an individual’s health and well-being. In order to meet demand for an extensive number of SDOH use cases, the healthcare ecosystem is working intensely to mature SDOH data exchange standards. In parallel, it is important for continued investment in the use of these standards to test them out and to develop innovative methods that can enhance the comprehensiveness of health IT systems and improve care referrals and bi-directional exchange across organizations. Specifically, one that emphasizes a person-centric approach and coordinated medical and social services, interoperable systems, and access to and use of appropriate information at each point of care.

The University of Texas at Austin’s Dell Medical School (Dell Med) answered this call as a 2021 recipient of ONC’s Leading Edge Acceleration Projects (LEAP) in Health IT. Dell Med is developing a comprehensive and integrated information system to manage patients’ access, consent, and navigation using a mobile digital platform using non-proprietary standards for implementation with a person-centric approach to the design.

The system’s design will help clinical providers identify patients’ social service needs, make referrals to social service organizations to address those needs, and receive information back from the social service organization, thereby closing the loop on the social service referral. This “closed loop” system is known as Fast Healthcare Interoperability Resources® (FHIR)-enabled Social and Health Information Platform (FHIRed-SHIP).

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