In the previous articles in this series, I discussed why resource guide-based tools aren’t sufficient due to the lack of accountability, connectivity, and collaboration involved. A network model supported by the proper technological infrastructure is more valuable to systems and organizations interested in tracking robust, actionable SDoH data. Being able to quickly identify the right resources is important, but it’s just one part of the journey.
In order to have visibility into client care, you need to track outcomes beyond the referral.
Once you’ve curated a list of network partners, each of them needs to be involved in the care coordination process. With the help of technology to track every action and interaction that occurs across all organizations in a network, we can keep a pulse on individuals no matter where they present their needs. We can only keep patients from falling through the cracks by tracking what happens after they leave the office.
The biggest danger of using resource guide-based tools is that they frequently use terms like “closing the loop,” “bidirectional,” and “care coordination” to obfuscate the fact that they can’t tell you anything that’s actually happened to your patients (or members). Are you truly “closing the loop” if you can’t measure the outcome of an intervention outside of your own organization, who administered the services, or how long it took? What information about your patients is actually important to track? Resource-guide based tools may only be getting you halfway there.
Standards for care delivery are rising.
Not all SDoH solutions work in all settings, and buzzwords can confuse people. If you’re looking for an SDoH solution in your community, make sure you understand the language being used. While some may define a “referral” as an information hand-off, others define it as actual, trackable data exchange between organizations.
When a case is created in Unite Us, it is followed to completion – meaning completion of care, not merely completion of referral. We then capture a structured outcome at the end, which is real, usable data indicating what intervention actually took place (and if not, what barrier stood in the way). Simply “closing the loop” is not always enough.
Resource guide-based tools can never prove their value. To know the effect an intervention had on a health outcome or cost of care, you need to know what that intervention was. If your “closed-loop” SDoH platform only tracks data around referrals – not care outcomes – true ROI measure will remain out of reach.
To learn more about the difference between Unite Us and resource guide-based tools: