Nutritional support is fast becoming one of the most recognized social determinants for success of medical care. But such support depends on accessing prompt updates on client health status. MANNA, the national-leading, Philadelphia-based nutritional therapy service for the homebound ill has teamed with its regional health information exchange, Healthcare Exchange (HSX), to give the food alliance the advantage of daily updates on healthcare developments of its served individuals. Encounter notifications and access to a clinical data repository based on an MPI of more than seven million patients puts MANNA dieticians in a new position as more-informed members of the healthcare team, allowing them to adjust diets, delivery schedules and counseling in near real time. With its proven ability to improve health and healthcare costs, MANNA has expanded its footprint, gained media attention and become a model across the country. Health information exchange will now enhance these results.