This session explores how a Canadian health system built a nationally leading Social Drivers of Health (SDOH) model within Epic by replacing the standard foundations tools with a fully co‑designed, community‑integrated approach. As Yasir Khalid noted, unlike organizations that "implement what Epic has provided as out of the box," his team "created something based on subject matter expertise" and aligned it directly with local resources. 

The team developed a directory of 300+ community organizations, enabling clinicians to initiate real‑time referrals for food security, housing, legal aid, financial supports, and more. Patients receive resources in their preferred language through MyChart, SMS, or digital notifications, enhancing autonomy and engagement. 

Epic has recognized this model as a gold standard, and early data shows strong clinician adoption and meaningful patient impact. The presentation will outline the co‑design journey, implementation strategy, and emerging outcomes such as reduced ED visits and improved patient‑reported measures.