Community Information Exchange Is Unlocking New Health Coordination in California

Community Information Exchange (CIE) is a new model for providing shared, secure access to data in order to deliver more effective and coordinated support across a community’s diverse population. A CIE is a hub for integrating systems of care, providing technology tools and governance for cross-sector collaboration and care management to address social determinants of health and health equity.​ 

In a landscape increasingly recognizing health as much more than healthcare, CIEs are a critical step forward to bringing social services, behavioral health, public health, and healthcare providers together to progress toward true population health. CIEs are a network of care team members who have access to a technology platform integrating health and social information within a system that can manage data and support real-time collaboration and coordination.

In California, three powerful examples of CIE already in action are showing the way:

  • 211 San Diego/CIE started out as a toll-free hotline in the 1980s and has now grown to include a CIE resource connecting local residents with community, health, and disaster services around the clock. Help is delivered in more than 200 languages, with the backing of a “database of more than 6,000 services and resources that are updated on a real-time basis” according to their mission statement. In the 2021–23 fiscal year, 211 San Diego served more than 290,000 clients.
  • Serving Communities HIO (SCHIO) in Santa Cruz County connects more than 100 organizations, including healthcare, behavioral health, and social service organizations. To support Santa Cruz County’s Whole Person Care effort, SCHIO also implemented the Together We Care, CIE, under its governance, which includes both a care management and closed loop referral workflows, in addition to its health and social information exchange. 
  • North Coast Care Connect (NCHIIN) in Humboldt County is a network of health and social services providers coordinating care on shared clients and leveraging technology to exchange relevant information and coordinate referrals for services. Partners on the growing CIE network include WIC, school-based health services, their local agency on aging, nonprofit clinics, and disability services. NCHIIN is averaging 32,693 record transmissions a month for their community.

Applying CIE strategies for pressing behavioral health epidemics

Communities large and small across the country are working on solutions to address the dual epidemics of mental health and substance abuse crises for their residents. Opioid use disorder was declared a public health emergency by the U.S. Department of Health and Human Services (HHS) in 2017, a declaration that was renewed by HHS Secretary Xavier Becerra in 2023. At the recent National Governors Association meeting, over half of the Governors addressed mental health as a top priority for their administration, and over one-third of Governors committed their support to combating substance use disorder and overdose during their annual reports.

In these sensitive behavioral health cases, CIE coordination is an especially vital connection to information about an individual’s health and social needs, and it provides a platform for the care team members engaged in their care to collaborate and coordinate in real time. In addition to the data delivery services, CIEs are also strategic partners in ensuring compliance and security for highly regulated sensitive personal health information. 

From working with local governments, public health, social services, and behavioral health organizations as VP of Community Change at Intrepid Ascent, I’ve seen that there are three areas of common hesitation when establishing a CIE model:

  1. Consent: While the majority of people will opt in to sharing their behavioral health information when asked, there is significant nuance to getting this right with patients. This recent JAMA article is a great starting point for clinicians and health leaders. 
  2. Data governance: Community health leaders are rightfully concerned about what sharing will entail. CIEs can play an essential role in building trust and ensuring the privacy and security of behavioral health data. 
  3. A robust data framework: As organizations explore signing on to the national TEFCA program as well as California’s Data Exchange Framework, it is clear that the details matter. Clear and transparent data sharing governance structure, legal agreements, policies, and procedures are the foundation to effective CIE.

Person-centered care requires CIE-based data sharing

Life is complicated, and it is rarely linear, especially for individuals with behavioral health needs including opioid use disorder. In order to promote true health and well-being, health and social organizations need to continue to coordinate and align on care.  

A robust data infrastructure is a fundamental requirement for care coordination to happen efficiently. Learn more about your clients’ needs and how data exchange and health and social care networks, such as those in a CIE, can help. CIE-based data sharing can help you provide more person-centered care. As we’ve seen in the 10 years working to support community connections, there is significant demand for coordinated community care and integrated community solutions.