In prior years, San Diegans experiencing homelessness were transported by emergency medical services to hospital emergency departments, jails, or shelters without any coordination. Enter San Diego’s Community Information Exchange (CIE), which offers an innovative way to connect health and social service agencies to provide better care for individuals and the community as a whole.
According to the Regional Task Force on Homelessness in San Diego, there were 8,427 individuals experiencing homelessness in May; this is a 10% increase from the 2020 census. The unhoused are three times more likely than the general population to visit the emergency department each year, per research conducted by the Agency for Healthcare Research and Quality in 2017.
Karis Grounds, vice president of health and community impact of San Diego’s CIE, recently shared information about the program with Connecting for Better Health, saying the core intention of the program is to use information sharing to address equity and anti-racism.
San Diego’s CIE works hand-in-hand with its partner, San Diego 2-1-1, a local non-profit organization that offers a free, 24-hour confidential phone service and searchable online database of health and social services.
The CIE program, which has evolved into a comprehensive infrastructure for the community, stems from some thought leaders musing about how information sharing could help those experiencing homelessness.
In downtown San Diego, Grounds said, people experiencing homelessness were being transported by emergency medical services to the hospital emergency departments, jails or shelters without coordination between the agencies. After asking people to opt-in voluntarily, “we started sharing and coordinating better so they weren’t just released to the street, they were actually coordinated between these agencies,” she said.
The CIE program now comprises an ecosystem of multidisciplinary organizations – more than 120 in all – from a wide range that includes health plans, hospitals, federally qualified health centers (FQHCs), and social service providers such as those who serve individuals experiencing homelessness and older adults. This ecosystem uses “a shared language, a resource database, and an integrated technology platform to deliver enhanced community care planning,” said Grounds.
“A CIE enables communities to have multi-level impacts by shifting away from a reactive approach towards proactive, holistic, person-centered care,” she added.
As of September of 2022, more than 300,000 individuals had consented into San Diego’s CIE.
Grounds said that keys to the CIE’s success include its integration and interoperability, as well as its local governance structure. “CIE allows you to respond in real time, to be proactive with interventions based on the information that we are collecting in real time by partners in multiple sectors,” she said.
The program is primarily used for searches about an individual’s historical use of social or health care services to help create a supportive care plan for them. The program also is used to make and track referrals to external community and healthcare organizations, and to provide real-time alerts, such as when a patient is transported by Emergency Medical Services.
CIE has benefits on many levels, Grounds said, including for families and individuals, agencies, and the community. Its impacts include improved health indicators, quality of life, and the ability to address inequities.
Moving forward, San Diego CIE is continuing to grow its partnerships, including with 2-1-1 San Diego, and to work to align with statewide policies such as CalAIM and AB 133.