Health info exchange streamlines foster care services

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Connecting state and local government leaders

The Arkansas Division of Children and Family Services’ SHARE eases coordination with physicians, lowering staff burden and health care costs.

Like most states, Arkansas’ foster care programs are spread thin as limited staff juggle numerous complex cases, but the state’s health information exchange is helping smooth operations and service delivery. 

In 2021, there were more than 391,000 U.S. children in foster care, according to the U.S. Health and Human Services Department. These individuals may experience increased behavioral and mental health issues due to emotional trauma or maltreatment, according to the American Academy of Pediatrics, highlighting the need for effective coordination among foster care and public health programs. 

That’s where the Arkansas State Health Alliance for Records Exchange (SHARE) digital infrastructure comes in. 

The streamlined HIE helps to shrink data gaps, share critical health information faster and improve workflow efficiency, officials said at the 2023 State Healthcare IT Connect Summit. 

“Our mission is to improve the delivery of information and the quality of health care for Arkansas … We do that [by] creating a secure suite so we can share clinical data,” said Justin Villines, a policy director at the state’s Office of Health IT (OHIT). 

In Arkansas, once a child enters the foster care system, the Division of Children and Family Services (DCFS) collects their social history information and assigns a caseworker. Children  are also identified within the state’s master patient index, which houses full medical record histories. Their current primary care provider is then notified by email of the individual’s custody change, Villines said.

Newly enrolled foster children must see a new physician within 72 hours, OHIT Director Anne Santifer said. This time-sensitive requirement can disrupt the child’s ongoing treatment or therapy services, and data gaps between the old and new physician may delay proper care, she added. 

The SHARE HIE, however, enables caseworkers to push the child’s health data to providers ahead of a visit via a secure messaging system empowered by DirectTrust, a nonprofit that supports HIEs. 

SHARE creates an automated custody report with the child’s identifiable information, data on when they enter or leave the foster system and their case worker’s email address so physicians can better plan treatment and care plans, Santifer said. Physicians also receive real-time notifications of changes in the child’s custody status or medical interventions such as hospital visits and discharges. 

“The goal is to automate as fast communication as possible to DCFS themselves, but also to our community using the HIE database,” Villines said. The HIE includes a web-based portal called the Virtual Health Record, which is the front-end of SHARE, he added in an interview with GCN.

The VHR provides aggregated data from more than 110 hospitals and 3,000 health care sites in the state in a readable format to provide a holistic view of the patient data such as clinical documents, clinical results, demographics, insurance information, next of kin and other factors, Villines said. SHARE is housed by the Arkansas Department of Health and operates on the NextGen Connect platform, Villines said. 

Information sharing across government agencies and the health care provider community ensures individuals receive comprehensive care and supports smoother transitions of care info, he said. SHARE also reduces the number of physician queries to caseworkers, reducing provider and DCFS staff burden. 

When key players leverage the HIE, it helps to avoid costly duplicative treatments and testing, reduce medication errors and prevent hospitalizations and readmissions, according to the SHARE website. 

“We’re all trying to reduce that overall cost of care,” Santifer said.

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