A major Midlands health care provider has formed a tech-based partnership that will help address unmet health and social needs of the people it serves.
In April, Lexington Medical Center announced it was linking up with Unite Us, a New York-based software company that sets up coordinated care networks between health and social services providers.
Founded in 2013 by Dan Brillman and Taylor Justice, the company was originally launched to address the needs of veterans as they transitioned back into civilian life, and their families. Over the next decade, it expanded its reach to serve people across all walks of life who need connections to care.
According to recent data on the company’s website, Unite Us now has a presence in 44 states and has provided more than 21 million connections to care over the past decade.
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Partners in the company’s South Carolina network, known as Unite South Carolina, are connected through Unite Us’ shared technology platform, which enables them to securely send and receive electronic referrals to address people’s social needs.
“We are excited to implement this tool with our community partners across the Midlands,” said Lara Lott Moore, Lexington Medical Center’s vice president of community medical centers. “It helps us advance our vision to be a coordinated health care delivery system that is accessible and affordable and continually improves the health status of our communities.”
Partnership examines social determinants on health care
Lexington Medical Center is a 607-bed hospital in West Columbia. It anchors a health care network that includes five community medical centers and employs a staff of more than 7,800 health care professionals.
The partnership is a result of studies in health care trends the provider conducted starting in late 2021, according to Thomas Tafel, Lexington Medical’s community outreach manager.
One topic that stood out was the effect of social determinants on a person’s overall health care. These include environmental factors, access to fresh and healthy food, access to transportation, housing and primary medical care.
“We know that often when people arrive at the hospital, their quality of health has often been decided before we even make it to the doors as the results of these social determinants,” Tafel said.
Lexington officials wanted to try to find a way to help address some of these issues in patients’ lives once they leave the hospital setting.
Enter Unite Us, a cloud-based network that allows Lexington Medical’s social workers to study an individual patient’s needs and then seamlessly connect them with resources in the community that can help.
For example, a person dealing with food insecurity could be connected with local resources such as Harvest Hope Food Bank or other food pantries.
“The organizations receive a referral from us, almost like a medical referral but for a non-profit, and then the non-profit can contact the patient and then set up an interview to begin the process for them to receive help,” he said.
The platform also provides a way for social workers to follow up and check the patient’s progress with the referrals. For instance, if they discover a person with food insecurity has been referred to a food bank but never followed up, they can check back in and see if other issues, such as a lack of transportation, are preventing them from getting the food or other services they need, and then begin to address that need as well.
The system allows patients to be connected with a wide range of help, from assistance with food, housing, and utilities to mental health care, employment and skill-building such as financial planning.
Information on Unite Us is in real time
Unite Us security protocols enable the information to be kept strictly confidential, with only the hospital and participating nonprofits having access for client service.
Another advantage is that information on Unite Us is in real time, helping social workers avoid the possibility of giving patients outdated information or sending them to agencies that aren’t accepting new clients. It will also enable them to better connect patients with agencies in their county of residence. The bulk of Lexington Medical Center’s patients come from Lexington and Richland counties, but many also come from Orangeburg, Fairfield, Kershaw and Saluda, Tafel said.
The automatic referrals also allow patients to focus on their health and recovery, instead of having the added burden of visiting multiple agencies.
“It’s a closed loop referral system that gives us a real-time idea of where we can refer clients so they don’t have to tell their story five times to five different agencies,” Tafel said.
There is no cost for nonprofits and community service organizations to participate in the program, which is funded by the hospitals and other for-profit entities in the community.
The platform also offers an easy way for health care workers and social workers to collect and track data to see which social determinants are most affecting health in the region, Tafel said.
“We are at our core an independent community hospital, and this is a way we can look at how to provide the best level of care,” he said. “We can look at data and see, for instance, that one particular zip code is showing a high amount of food insecurity. Then, we can use the information to help develop a strategy to better target our community-based initiatives to address the need in that community.”
Lexington Medical Center is currently working to build up the number of organizations participating in the Unite Us platform.
“We are overjoyed to collaborate with Lexington Medical Center,” said Liz Walsh, director of customer and community success at Unite Us. “Their team is dedicated to connecting patients with the resources they need beyond the hospital's walls. Unite Us' software will empower this phenomenal team to amplify its impact. Our neighbors in need in the Midlands community will benefit most from this critical partnership.”
More information about Unite Us’ impact statewide can be found online. Those interested in learning more about the partnership can contact Tafel at email@example.com.