The care for medically complex children can be confusing for families. It can also consume large amounts of healthcare resources and can be very costly. Social determinants of health can also complicate an already complex situation. Children's Hospital Colorado set out to improve outcomes, increase patient and family satisfaction and reduce costs through the utilization of health information technology. Children's Hospital Colorado layered risks due to social determinants with a medical complexity algorithm to create what we believe to be a more accurate measurement of complexity. This risk scoring helps to determine resource assignment and utilization for our most complex patients.