Table 2.

Identified Themes Around S-HIE Implementation

Category	Theme
Perceived need for S-HIE	Health-related issues are an impediment to reaching the social service goal of self-sufficiency.
	Social service providers may be the primary source of support for vulnerable individuals struggling to manage chronic illness.
	Unmet social needs are an impediment to effective chronic disease management.
	Better communication between social service and healthcare providers is needed.
Shared enthusiasm for potential value of S-HIE	A S-HIE could improve cross sector communication, coordination, and efficiency.
	S-HIE data could help demonstrate positive outcomes and impact of social services on health outcomes.
Social service–specific barriers	Potential redundancy and inefficient workflows due to lack of interoperability between S-HIE and existing information systems.
	Limited IT capability among smaller social service groups.
	Uncertainty about adequate training to ensure privacy and appropriate use of S-HIE data.
	Uncertainty about accountability and risk in case of an information security breach.
Healthcare-specific barriers	Seamlessness and interoperability.
	Perceived potential for misuse of S-HIE data.