PA NAVIGATE

Enter your zip code below to start your search and get connected, today!

In January 2024, HSX launched its PA Navigate service, which is a statewide program it’s hosting in partnership with other Health Information Organizations (HIO) across Pennsylvania.

The PA Navigate service enables healthcare organizations to collaborate, using a referral platform, in an effort to serve individuals with needs related to Social Determinants of Health (SDOH).  

For PA Residents….

• Search for community-based services using the newly launched PA Navigate Website.
• Enter your Zip Code to find services of interest close to you.
• Some Categories of Available Services include:
  • Childcare
  • Clothing
  • Employment
  • Financial Strain
  • Food Insecurity
  • Housing Insecurity / Homelessness
  • Medical Access/Affordability 
  • Transportation
  • Utilities

For Healthcare Organizations Interested in Locating Community-Based  Services…

• Search for community-based services using the newly launched PA Navigate Website.
• Enter the Zip Code of relevance to find services of interest close to the individual in need.  Some categories of Available Services are listed above.

For Healthcare Organizations Interested in Using PA Navigate to Screen Individuals and Make Electronic Referrals…

• Contact HSX Member Services for participation information at memberservices@healthshareexchange.org. 
• Healthcare organizations that leverage PA Navigate to screen individuals and/or make electronic referrals can expect to:
  • Have a best-practice screening tool available for use to identify individuals with SDOH needs within the PA Navigate platform
  • Locate, based on need, relevant services for patients and consumers
  • Use the PA Navigate platform to electronically refer individuals to an identified Community Based Organization (CBO) that is equipped to provide these needed services, 
  • Use the PA Navigate platform to know when the CBO has “closed the loop” to understand the outcome of the individual’s referral. Knowing the referred individual is receiving services or wasn’t eligible for services helps the referring organization to understand if the SDOH need is being met or if it still exists.
• In most cases, healthcare organizations that want to fully leverage PA Navigate will be able to integrate the referral platform with their existing electronic healthcare record, care management platform, or other system of record.

For Community-Based Organizations…

• Use of PA Navigate is offered at no cost. 
• A CBO can easily join PA Navigate and claim its listing in the service directory and opt in to receiving electronic referrals from participating healthcare organizations.  
• CBOs can use the PA Navigate platform to demonstrate their community impact to their funders. 
• To sign up, visit the newly launched PA Navigate Website and click Sign Up in the top, right-hand corner. 

Metropolitan Area Neighborhood Nutrition Alliance (MANNA) is a non-profit organization based in Philadelphia that provides nutritional support to individuals with major illnesses. MANNA delivers medically tailored meals (Food is Medicine) and provides nutrition counseling to those struggling with serious conditions such as cancer, diabetes, renal disease, and HIV/AIDS. As a Community-Based Organization (CBO) partner of HSX, MANNA receives real-time notifications if one of its clients is admitted to a hospital so they can hold meals and, more importantly, notify MANNA when a client is discharged. HSX has worked with a panel of MANNA clients to measure changes over-time in healthcare utilization and health outcome of people availing themselves of MANNA’s meal service and nutrition plans. Significant reductions were documented in the number of ED visits and hospital stays. So too, reductions in Hemoglobin (A1C) were observed as were improvements in Body Mass Index (BMI). Learn more about the collaboration here.

HSX partnered with Pathways to Housing PA, a nonprofit that provides housing and support to individuals experiencing chronic homelessness, many of whom face behavioral health and substance use challenges. Using its Clinical Data Repository, HSX delivers daily alerts to Pathways when residents are admitted to or discharged from regional hospitals, enabling real-time care coordination during critical transition periods. These alerts help social workers and clinicians proactively engage with residents to prevent overdoses and support recovery. HSX has also demonstrated improved health outcomes for Pathways residents and found significant reductions in ED visits and hospital stays, along with increased outpatient care. Learn more about the collaboration here.

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Coding Social Needs: Standardizing SDOH Data Collection

Unmet social needs can negatively impact a person’s health. 

To support the collection and use of social needs data (also referred to as social determinants of health (SDOH) data), the PA Navigate Team, along with its vendor, Findhelp, have adopted standard SDOH terminology, as created by the Gravity Project, for use throughout the PA Navigate platform. 

In May 2017, the Gravity Project was started to help standardize social needs (SDOH) data. Experts from across various healthcare groups, including clinical providers, federal and state government, human services agencies, payers, technology vendors and community-based organizations were brought together to build a standard set of social needs data for use in clinical care and for SDOH data sharing in digital or computerized platforms.

The Gravity Project helps define how care partners communicate information, setting the language, structure, and data types so that health and social services can collaborate, coordinate, and support patient’s social needs.

Behind the scenes, PA Navigate Social Needs Assessments are encoded using the Gravity Project’s standard SDOH terminology. 

Standardizing SDOH data improves the exchange of this type of data for improved patient care, coordinating patient care across multiple providers, clinical research, public health, facilitating payments, and to lower healthcare costs.