University Hospitals and Unite Us Join Forces to Expand and Improve Community Health and Social Care

UH caregivers can now follow-up online to see if patients connected with recommended resources; if not, they’ll help with hurdles that prevent access

UH Clinical Update | June 2022

In the past, when a physician or other caregiver referred a patient for assistance or resources outside University Hospitals – perhaps for social services, a helpful community-based program, or even a prescription from a pharmacy – he or she would have no idea what ultimately happened.

No one could answer the question, “Did my patient ever get there?"  Something as simple as a lack of transportation, or confusion about how and where to go, might have derailed a patient from following up.

This spring, University Hospitals (UH) unveiled a new partnership with Unite Us, an organization that enables us to better connect our patients to the services they need, and to address any barriers that might be in the way.

Unite Us is a national organization first founded in 2013 in New York to make sure people who face such complications get the additional help they need.

Now UH and Unite US are part of a coordinated care network of health and social care providers, called Unite Ohio. The two entities now have a secure shared technology platform, enabling them to send and receive electronic referrals, address people's social care needs, and improve health access across communities.

Often, the most important factors in over-all wellbeing - housing, food, transportation, and employment – are the hardest for some patients to secure.

So this collaboration of UH with Unite Us will strengthen the coordinated care network of health and social care providers and bring together community-focused organizations, so that people in our communities will find it easier to access necessary resources, says Peter Pronovost, MD, PhD, UH Chief Quality and Clinical Transformation Officer.

“We know that the majority of health outcomes depend on factors beyond the walls of a hospital – healthy habits, food insecurity, housing, and social isolation," says Dr. Pronovost. “University Hospitals is excited for this partnership and the opportunity to connect every patient to the organizations that address these social influencers of health."

The network provides a secure, central point of contact where healthcare providers, social service organizations, and individuals can access and refer people to needed services while monitoring progress and measuring outcomes.

Unite Us services will be available in all Ohio counties where University Hospitals has a presence. However, UH Lake Health clinicians will not participate until 2023 when Lake Health caregivers will be technologically integrated into the UH system.

The Unite Ohio network in Ohio is composed of community partners from local and regional businesses, community organizations, faith-based organizations, healthcare organizations such as Cleveland Clinic and MetroHealth Medical Center, schools and more. All will work together to ensure a continuum of care to improve the overall health and well-being of our community.

“We are thrilled to partner with University Hospitals as we continue to expand the network to support individuals and connect them to much-needed resources. Our team works collaboratively to support and train network partners that coordinate care no matter where in the state people live. Our goal is to increase equitable access to care and services," says Toni Cunningham, Unite Us State Network Director for Ohio.

Training on the new platform for several groups of caregivers began in March and is continuing over the next several months.