Health-Related Social Services Organizations Joining Manifest MedEx Network

Health-related social services (HRSS) organizations can now connect and exchange health and HRSS information through California nonprofit health data network Manifest MedEx (MX) to help those experiencing health-related social needs and support California Advancing and Innovating Medi-Cal (CalAIM).

Community-based organizations can join the statewide network and receive real-time admit, discharge, and transfer (ADT) notifications, alerting when a person is in the hospital, so that social care, such as providing access to housing, transportation, and medically tailored meals, can be appropriately arranged before or shortly after discharge. 

MX delivers an average of 3.3 million ADTs per month across a network that spans more than 140 hospitals, 19 health plans, and 2,600 ambulatory providers across every county in the state. It also delivers ADTs from organizations outside its network as a Qualified Health Information Organization (QHIO) in California’s Data Exchange Framework.

“Combining HRSS information with claims information and clinical data, including permitted behavioral health data, into a single longitudinal record provides a more complete picture of a person’s health, the factors affecting their health, and the services they are receiving,” said Erica Galvez, CEO, Manifest MedEx, in a statement. “We’re pleased to welcome these vital organizations to our network and to California’s broader health and social data sharing ecosystem.”

Among the first HRSS organizations to join the MX network is Illumination Health + Home, a nonprofit organization that serves individuals and families with integrated housing and healthcare services in Southern California. As an Enhanced Care Management and Community Supports provider under CalAIM, Illumination Health + Home primarily focuses on providing recuperative services, helping individuals experiencing homelessness recover safely and comfortably after a hospital visit in one of seven medical respite facilities in the Southern California region, while ensuring they get the wraparound services they need — such as case management, behavioral health services, and housing assistance.

“Knowing when our client is in the hospital, how to reach them, and important encounter information, such as their diagnosis details and primary care provider, is critical to ensuring we’re able to support them as soon as they leave the hospital,” said Michael Chavez, director of clinical care management at Illumination Health + Home, in a statement. “It helps us re-engage the client with their PCP to make sure they’re taking the right medications and getting the right medically tailored meal and allows us to quickly identify and coordinate additional services they need both while they are staying with us and after they leave.”

Healthcare Innovation recently interviewed Pam Schwartz, the executive director of Community Health Programs & Charitable Contributions for Kaiser Permanente, about the value of recuperative care and medical respite programs that provide care for people experiencing homelessness after a hospital discharge, including a discussion of the National Institute for Medical Respite Care’s new certification program.