40% Higher Engagement with At-Risk Community Members ‘Trust’ Uses Technology to Foster Trusted Relationships

In healthcare, when it’s said that people have “fallen through the cracks,” it often means they are living with unmet health and social care needs. Trust, formerly Harmony Health, a developer of collaboration and engagement software for community-based, faith-based and healthcare organizations, aims to eliminate this problem. Leveraging the power of InterSystems IRIS® for Health™ data platform, Trust has created an innovative approach to closing cracks in the system and increasing access to care for at-risk individuals by harnessing the power of communities. The solution is simple on the front end, and sophisticated in the back.

At the height of the COVID-19 pandemic’s second wave, some populations were falling through the cracks related to vaccine access. Many efforts by health plans and government to reach people in underserved communities were ineffective. A California healthcare payer responsible for vaccine administration engaged Trust for help. “Messages sent out to the community saying you must get vaccinated, and here’s where to go, were falling on deaf ears,” says Vineet Gulati, CEO and Founder of Trust. “People just didn’t trust the messenger or the medium.”

The Trust app takes a different approach. It starts by empowering the local, community-based organizations and their workers with both messages and technology to deliver them. “Whether a priest, a volunteer, a promotor, a community health worker, or a doctor or nurse in a federally qualified health center,” Gulati explains, “they are already trusted by the people they serve.” This trust is essential for success. Community workers use the app to for simple text messaging, conversations, sharing content, documents, videos, and bi-directional translation allowing them to connect and engage with individuals. The app can support over 100 languages. The underlying platform analyzes responses and uses analytics and AI at the back end to help automate and tailor communications and actions to individual needs. These individuals become the seeds of connections which grow out through families and the community to influence and engage broader populations.

Trust’s initial work with the California healthcare payer and local community-based organizations reached about 50,000 people. “What started as a vaccine equity project quickly became something much broader,” notes Gulati. “With trust established, people started responding, in their native language, and engaging.” The community support programs expanded organically to address other needs, from food delivery and back-to-school activities post-COVID, to breast and lung cancer screening.

Today, organizations using Trust reach about 1.8 million people in California through a network of nearly 100 different community-based organizations (CBOs) that represent primary care providers, faith-based groups, housing providers, food banks, and others. And those CBOs are starting to use the platform to connect with each other to provide more comprehensive access to services. “A huge amount of communication is flowing that has never happened through a trusted channel before,” says Gulati. “We’re seeing 35% to 40% higher community member engagement because they are receiving messages in their own language from trusted phone numbers and trusted people.”

The Trust system tracks information from every engagement. Using InterSystems IRIS for Health, Trust can seamlessly integrate that information back into electronic health records or the systems that health plans use, or systems for getting uninsured people enrolled in Medicaid. “It’s important to note that of the 1.8 million people we’ve reached so far, not one came directly from a health plan member list,” Gulati says. These are potential members and their information flows from the outside in via Trust.

Over time, the Trust platform builds a detailed picture of community member needs and how they’re met. It can highlight critical aspects of those needs and care that otherwise would be hidden to health plans and providers. For example, someone may be registered for medically tailored meals through the MediCal [California Medicaid] program and receive meals through a community food bank. The person delivering the food will also do a mental health check as well. That information can flow back through Trust and to community organizations, healthcare providers, and insurers. “This human connection and data haven’t been captured before in a systematic way,” says Gulati, “and it’s some of the most important information you can have.”

According to Trust, over 1.3 million CBOs across the U.S. work in silos with limited resources to connect individuals and communities to the services they need. With InterSystems IRIS for Health providing the flexibility and scalability to connect more organizations and systems to share information, Trust is expanding to serve additional U.S. states “There’s nothing small about the problem or the number of people needing services,” says Gulati. “With Trust we don’t have to accept people ‘falling through the cracks’ anymore.”