Research Paper Mixed-methods study of integration of housing and medical data systems for enhanced service coordination of people with HIV Vivian L Towe 1 , Laura Bogart 2 , Ryan McBain 3 , Lisa Wagner 1 , Clare Stevens 1 , Shira Fischer 3 and Sarah MacCarthy 2 Abstract Introduction: Housing is a determinant of HIV-related medical outcomes. Care coordination has been successfully used to treat patients with HIV and can be improved through electronic exchange of patient data, including housing data. Methods: Primary data were collected from four sites across the U.S., each comprising partnerships between local HIV medical and housing providers. Between March 2017 and May 2018, we conducted a mixed-methods evaluation, focusing on preparatory activities, implementation of tasks related to data integration, and service coordination. Nineteen focus group discussions were conducted with providers, organizational leaders, and clients. Ten interviews were conducted with data system vendors and administrators. Site visits, logs, and progress reports provided information about data integration progress and other activities. Results: Key activities included changes to client consent, setting up data use agreements, and planning with data system vendors. Sites selected one of three models: one-way data transmission between two systems, bidirectional transmis- sion between two systems, and integration into one data system. Focus group discussion themes included: challenges of using existing data systems; concerns about the burden of learning a new data system; and potential benefits to providers and client, such as having more time to spend delivering client services. Discussion: Using health information technologies to share data has widespread support, but uptake is still met with resistance from end users. The additional level of complexity differentiating this study from others is the exchange of data between service providers and care providers, but sites were able to accomplish this goal by navigating extensive barriers. Keywords HIV, housing, medical informatics, data systems, information dissemination, patient care management Introduction Housing is a significant social determinant of HIV- related outcomes. 1 Homeless people with HIV (PWH) are less likely to achieve viral suppression, 2 likely due to lower access to healthcare and antiretroviral treat- ment use, as well as competing survival needs. 1–4 Homeless individuals are also more likely to be unin- sured and to have recently used emergency or inpatient care. 5 Housing should be addressed in coordination of care and services for PWH. Care coordination has been widely and successfully used for PWH. A comparative effectiveness study in the U.S. found that virally unsuppressed patients enrolled in an intensive care coordination program were significantly more likely to achieve viral suppres- sion at 12-month follow-up, compared to people not enrolled. 6 In low- and middle-income countries 1 RAND Corporation, Arlington, VA, USA 2 RAND Corporation, Santa Monica, CA, USA 3 RAND Corp Boston Office, Boston, MA, USA Corresponding author: Vivian LTowe, RAND Corporation, 1200 South Hayes Street, Arlington, VA 22202, USA. Email: vtowe@yahoo.com International Journal of Care Coordination 2020, Vol. 23(1) 43–51 ! The Author(s) 2020 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/2053434520913206 journals.sagepub.com/home/icp