Buckle Up: The Last Mile Use Cases Driving Real Change

Laura Young
Sep 23, 2025
3 min read

Interoperability isn’t a highway — it’s a maze of detours, potholes, and the occasional wrong-way driver. Everyone talks about “the last mile,” but too often, that’s exactly where patients fall through the cracks. At Converge, we’ve mapped out use cases that fix the most dangerous intersections in health and social care. Our library contains over 20 indepth use cases that cover the why, how, who and measures of success. Here are highlights from a few of our favorites — the ones that keep showing up on the road to better outcomes.

1. Discharge Follow-Up Alerts: Avoiding the Dead End After Hospitalization

When a patient leaves the hospital or a psych unit, you’d think the next step would be obvious: a follow-up. Yet nationally, follow-up rates within 7 days are shockingly low. (NCQA FUH measure)

The gap: One study found early outpatient follow-up after psychiatric discharge slashed suicide risk, but fewer than one-third of patients got that timely care (PMC study).
The fix: Alerts that go straight to community providers. Arizona’s HIE sent discharge notifications to behavioral health teams, boosting follow-up and cutting readmissions.

Call it a GPS reroute: “Hey, don’t miss the next turn.”

2. SDoH Data Exchange: When Housing Becomes the On-Ramp to Health

Housing instability is like hitting black ice — it throws everything off. Health systems are finally admitting that stable housing is as critical as any prescription.

The gap: CalAIM highlighted housing’s role, but providers complained about being left out of the data loop.
The fix: San Diego’s Community Information Exchange connected housing and health, helping agencies prevent homelessness and stabilize families.

The evidence is clear: sharing SDoH data leads to earlier, smarter interventions (ASPE Evidence Review). Yet most housing and health data still live in silos. Imagine fixing your car by checking only the tire pressure — that’s what care looks like without SDoH.

3. MAT Continuity: Keeping Recovery From Stalling Out

For people on medication-assisted treatment (MAT) for opioid use disorder, continuity is everything. Cut off the treatment, and relapse risk spikes.

The gap: Jails often release individuals with no connection to community MAT providers. Cue the revolving door of relapse and re-incarceration.
The fix: States piloting MAT continuity exchanges between corrections and community providers saw reduced overdoses and better treatment retention.

Think of it as keeping gas in the tank. You don’t stop halfway and hope the next exit has a station.

4. Crisis Care for SMI: Data at the Scene, Not in the Rearview

When crisis responders roll up, they rarely know a person’s history. That’s like sending roadside assistance without a jack or spare.

The gap: Crisis teams often work blind, repeating questions patients can’t answer or defaulting to ERs and jails.
The fix: Integrating HIE feeds into crisis systems in states like Georgia and Arizona allowed responders to see treatment history and crisis plans in real time. Result: fewer law enforcement hand-offs, better stabilization.

Evidence shows continuity and transitional interventions improve attendance and outcomes (Frontiers in Psychiatry). Crisis is no time for guesswork.

5. Opioid & Overdose Surveillance: No More Rear-View Reporting

Overdose data that shows up weeks late is like getting a traffic alert after you’re already in the jam.

The gap: Many states still lag weeks in reporting overdoses, leaving public health stuck in neutral.
The fix: Real-time EMS and ED feeds in states like Massachusetts and Rhode Island helped pinpoint overdose clusters and direct naloxone distribution where it was needed most.

The research is clear: real-time or near-real-time sharing saves lives, and delays cost them.

Why These Use Cases Matter

Each of these examples highlights the same truth: interoperability’s toughest problems aren’t about technology, they’re about the last mile. The wrong patient discharged without follow-up. The family falling through a housing gap. The individual losing MAT access after release. The crisis responder working blind. The overdose cluster spotted too late.

These aren’t bugs in the system — they’re breakdowns in the last mile. And fixing them is what turns interoperability from a nice word into a life-saving engine.

Final Thought

At Converge, we see use cases as the starting line for interoperability. Too often, organizations build technology first and hope adoption follows. Without a map, the road is full of detours, dead ends, and wasted effort.

Use cases change that. They give everyone a common GPS: