Leveraging Health Information Exchange (HIE) Data to Demonstrate the Impact on Health Outcomes of Community Based Organization Interventions: Case Studies of Housing Placement and Medically Tailored Meal Program.

Abstract

ObjectiveTo evaluate the use of longitudinal Health Information Exchange data to assess changes in healthcare utilization and selected clinical outcomes associated with community-based organization interventions addressing housing instability and food insecurity.MethodsA retrospective pre-post study design was used to analyze two distinct community-based organization cohorts within a regional Health Information Exchange. The housing cohort included 228 individuals who received housing placement services, and the nutrition cohort included 786 individuals enrolled in a medically tailored meal program. Healthcare utilization and clinical outcomes were compared during the 365 days before and after program enrollment. Outcomes included inpatient admissions, emergency department visits, outpatient visits, length of stay, hemoglobin A1C, and body mass index. Paired t-tests were used to assess differences between pre- and post-enrollment periods.ResultsAmong housing program participants, emergency department visits decreased by 32% (p<0.05), while outpatient visits increased by 92% (p<0.001). Changes in inpatient admissions and length of stay were not statistically significant. Among nutrition program participants, inpatient admissions decreased by 20% (p<0.01), emergency department visits decreased by 18% (p<0.01), and length of stay decreased by 5% (p<0.01). Significant improvements were also observed in hemoglobin HbA1c (5% decrease, p<0.05) and body mass index (4% decrease, p<0.01).ConclusionsLongitudinal Health Information Exchange data can be used to evaluate healthcare utilization and clinical outcomes associated with community-based organization interventions. Findings suggest that housing and medically tailored meal programs are associated with improvements in healthcare utilization and selected clinical measures, while demonstrating the value of Health Information Exchanges as data repositories supporting whole-person care and program evaluation.