Just as a person’s single hea lth problem can have several root causes, the same often is true for those trying to deal with the underlying reasons for a patient’s ailment.

Poverty, a physical disability or severe mental disorder — or a combination of all three — often inhibits a patient’s treatment, local nonprofits were told during an informational session last week. Lack of transportation and inconsistent access to care add to the problem.

TAV Health Network hopes to bring all of the resources together to improve communication and coordination between residents who need services and those who provide them. TAV is partnering with the United Way of Brazoria County and Stephen F. Austin Community Health Network to implement its program in the county.

“The first thing we do, we create safe sharing networks of community health partners,” TAV Vice President of Strategy Clayton Walberg said at a recent conference with local leaders in the health community. “The second thing we do is service coordination and accountability across all network participants. Finally, we measure outcomes tied directly to health, quality and financial performance.”

TAV Health Network is a new, digitized way of connecting all health providers within a given area, including hospitals, physicians, nonprofits and schools. With a patient’s permission, their data can be uploaded into the TAV portal that other providers can access.

For instance, if a child is newly diagnosed with autism, the portal can share that information with appropriate groups to get the family the assistance it needs.

“For example, in San Antonio, we were approached by a local philanthropy group who wanted to provide better services for families with autism,” Walberg said. “Those families, once they figured out they were dealing with autism, it was their job to figure out care. … So, we built Autism Lifeline Links and let every family in the greater Bexar area know, if my child was just diagnosed and I just put them in school or they’re aging out of school, what do I do? They’ll automatically be routed to the right organization.”

TAV Health Network is specifically designed to reach underserved patients who struggle to get the care they need. The more health providers or health services that join the network, the easier patients can be connected to services that work best for them, Walberg said.

“I think it’s going to be such an amazing thing for our community and for our neighbors,” said Christy Frey, executive director of Brazosport Cares food pantry in Freeport. “We talk about in our mission statement we need to collaborate in the community. Especially with hunger, hunger is just a piece of poverty. It’s too big for one organization to conquer.”

TAV Health’s ability to track patient demographics — household size, income, poverty level — can help providers understand what obstacles people might be facing when it comes to accessing care. TAV Health also tracks whether proposed solutions are successful and unsuccessful and why so they know what to recommend the next time someone is in a specific situation.

“For example, we can see a woman doesn’t have transportation, she lost her husband, and would prefer a woman drive her,” Walberg said. “Not only have I seen a referral, I have a response that comes back to me in your network.”

TAV Health also can designate “top performers” within the network, meaning they evaluate care providers or related services based on how quickly and how well they respond. In one example Walberg gave, a statistical analysis showed one nonprofit service went from meeting community needs to suddenly not meeting any needs.

An investigation showed the group ran out of money to help people and had to shut its doors. One of TAV Health’s goals is to prevent that from happening.

TAV Health plans to launch in a small part of Brazoria County and expand from there, though it has yet to determine its starting point, Walberg said. Which health care and service providers sign up for the network will determine how quickly it can achieve its goal of serving all of Brazoria County.

Elizabeth Parrish is a reporter for The Facts. She can be reached at 979-237-0149.

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