Outreach workers cannot track which individuals they have contacted across shifts because there is no shared field database

A street outreach worker in San Francisco encounters a person living in an encampment on Monday and spends 45 minutes building rapport, learning their name, their veteran status, and that they have an untreated leg infection. The worker logs this in their own notebook or their nonprofit's internal CRM. So what? On Wednesday, a different outreach worker from a different nonprofit visits the same encampment and has zero knowledge of Monday's interaction — they start from scratch, asking the same questions, which the homeless individual experiences as dehumanizing and bureaucratic. So what? The individual becomes distrustful and disengaged, refusing to share information or accept referrals, because they have told their story dozens of times to dozens of workers with no result. So what? Critical health and safety information (like the leg infection that is now showing signs of sepsis) is not escalated because the Wednesday worker did not know it existed and the Monday worker's shift ended. So what? The person ends up in an emergency room via 911 call, costing the city $5,000-$15,000 for an ER visit and potential ICU stay that could have been prevented with a $200 clinic visit flagged during outreach. So what? The ER treats and releases them back to the street with discharge instructions they cannot follow (keep wound clean and dry, take antibiotics with food, follow up in 3 days) and the cycle repeats. This persists structurally because SF has 30+ nonprofit outreach organizations, each with their own data systems (or no system at all), and HIPAA concerns are used as a blanket excuse to avoid data sharing even though outreach notes are not protected health information. The city's ONE System (HMIS) exists but outreach workers find it too slow and cumbersome to use on a phone in the field, and many nonprofits resist entering data because it could be used to evaluate their performance.