Smarter Care: Social Programs and Wellness in the Digital Age

Smarter Care: Social Programs and Wellness in the Digital Age Industry Perspective

Smarter Care: Social Programs and Wellness in the Digital Age

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Globally, leading organizations have recognized the clear link between the health and wellness of individuals, and the economic and social vitality of their communities.

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IBM Industry Perspective

Smarter Care: Social Programs and Wellness in the Digital Age

At the turn of the 20th century, German sociologist Max Weber wrote about the emergence of the modern bureaucracy and the changing role of civil servants. Weber astutely observed a shift in the post-industrial era, organizations transitioned from a charismatic leader model to an administrativestaff model, guided by formal codes and regulations.

This shift gave birth to the modern bureaucracy that millions of citizens globally rely on for their health and well-being.

Today, social service delivery models have evolved from Weber’s theories and are closely linked to efficient and effective information systems. Agencies have explored ways to increase interoperability and connect systems to obtain actionable insights from

the volumes of data they collect, store and manage.

IT systems have become an integral part of reform in the social sector, and have improved agencies’ ability to meet growing citizen demand.

Growing demand and emerging technology is certainly not just a phenomenon in the United States.

Globally, leading organizations have recognized the clear link between the health and wellness of individuals, and the economic and social vitality of their communities. In this white paper, GovLoop and IBMÂŽ have identified how agencies have leveraged technology to transform services. These trends have inspired the concept of Smarter Care, which places an emphasis on collaboration across government boundaries, social programs, life sci-

Smarter Care: Social Programs and Wellness in the Digital Age

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ences, health plans and providers. With the IBM® Smarter Care approach, communities have: Leveraged IT systems to obtain a holistic view

of a citizen across government programs.

Utilized new and existing data sources for

deeper engagement.

Enabled consistent and optimized delivery out-

comes at a lower cost.

Promoted interoperability of IT systems to

drive mission based efficiencies.

Emphasized wellness and preventative care ini-

tiatives.

Nicole Gardner, Vice President, Global Industry Leader, Social Security and Government Healthcare, IBM®, said, “Smarter Care is about the intersection of social programs and health care, and how we can promote the interoperability and a wider view of the individual or family, so we can help them maximize their productivity and participation in society.”

In addition, Nathan Greenhut, Government Center of Competence - Social Segment, IBM®, added, “Smarter Care looks at the holistic well-being of the individual 100% of the time, even when they are in a program, hospitalized, sick or well. The approach educates and engages individuals, caseworkers and communities together to fix problems at their source by coordinating care across multiple providers.”

The Smarter Care approach comes at a time when government agencies are under constant pressure to provide improved services to constituents. New communities of practice have emerged and operate under unique partnerships and relationships. This

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IBM Industry Perspective

has changed the way government provides assistance to those in need. Across the board, agencies are challenged to improve services, cut costs and gain efficiencies. Agencies must do this at a time when financial resources have been cut, staff has been downsized and annual funding is unclear. Joseph Fiorentino, Associate Partner, Global Business Services, IBM®, described the current state of service delivery for public sector institutions: “The scrutiny around fiscal management and operations is greater than ever before,” he said. Today, there are new technologies that are increasingly being developed and customers are expecting a lot more control and a lot more choice. The bottom line is that the demographics are changing, there is a growing and aging population, baby boomers are now senior, and there is a huge amount of growing demand, putting significant cost pressures on the system.

To meet citizen demand, organizations now must be sure they have developed and designed the proper IT systems. These demands have added additional pressures on the organization to break down silos and work across sectors to meet mission needs.

Below, Greenhut provided ten challenges faced by organizations:

1. Providing a holistic view of clients across all relevant programs.

2. Optimizing the service delivery process through improved collaboration between clients, partners and workers.

3. Improving benefits delivery and services while ensuring the proper use of resources.

4. Adopting new business models to address current and emerging service delivery challenges.

5. Addressing budget deficits and decreased in-

8. Reducing fraud, abuse and error.

vestment as well as mitigating fraud and errors at the door without additional work.

9. Eliminating disjointed and uncoordinated service delivery.

6. Responding to more frequent legislative changes and implementing policy changes quickly.

10. Promoting and enabling consistent decisionmaking by workers.

7. Turning data into actionable information on a timely basis.

DEFINING THE SMARTER CARE APPROACH Gardner explained, “The social programs marketplace encompasses government agencies and their partners that support in need and at risk citizens, monetarily or otherwise, to promote an economically vibrant and productive society.”

Cash Assistance Income Support Nutritional Assistance Housing Benefits

Health and Social Care coordination Claims management Health Insurance exchanges

Adult Care Services Long Term care Child welfare Child Support Enforcement Child Care

Old age pensions Funds Management Social Assistance

Government Healthcare

Government Pensions

Social Program Segments

Children & Family Services

Employment/ Labor

Employment benefits Employment Services Labor Market information

Disability & Workers’ Comp Long & short term disability Rehabilitation/ Disability services

At the heart of Smarter Care is interoperability, removing silos and building towards a holistic view of citizens and program participants. Fiorentino also addressed the importance of interoperability for service delivery. “For us [IBM®], the way we see Smarter Care is about bringing together more capabilities, people, process, technology to get a much better view of the individual, valuable insights into the lifestyle choices an individual make,” said Fiorentino.

Today, government agencies are applying insights from clinical data and social data to identify population and segment by risk profiles, and informed care approaches for individuals. This is contributing to new care protocols and agencies are seeing better outcomes emerging.This works because the Smarter Care approach enables providers to intervene early to prevent or delay the onset of the active disease, providers can take action, no matter where an individual is on the continuum of care. Providers can quickly identify an evidence-based and optimal course of action to deliver the best care available to deliver improved outcomes. This process saves costs and can be quantified by agencies.

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SMARTER CARE IN PRACTICE: ALAMEDA COUNTY SOCIAL SERVICES AGENCY The Smarter Care approach has developed new, innovative delivery mechanisms for agencies. One case study showing the power of transforming social services through a Smarter Care approach comes from Alameda County Social Services Agency (SSA). The Alameda County SSA employs 2,200 workers and works with organizations to support the needs of its’ citizens, providing assistance to approximately 11 percent of the 1.6 million residents and for programs related to: Employment Training Financial assistance Housing Homelessness Adult and aging services Children and family services Employment services

Like many public sector organizations, Alameda County SSA had client data dispersed across their organization. Employees manually entered data to track clients across systems, which led to potential errors in tracking benefits and inaccuracy of client files. To improve quality of care, the agency decided they needed to consolidate and unify customer data across programs.

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IBM Industry Perspective

At any given time, 1,200 caseworkers were responsible for 500 to 600 cases.The agency was constantly challenged to think of new ways to maximize employee productivity and track agency performance.

Alameda County SSA decided to overcome these challenges and improve service delivery by creating a single platform for tracking their customer data.

A report from IBM®, ROI Case Study, IBM SSIRS, Alameda County Social Services Agency, noted, “Alameda County SSA decided to deploy a unified platform for tracking all of the data related to its services, benefits, eligibility, clients, and other operationally critical data points.” Alameda County worked with IBM® to develop a robust solution to transform service delivery.

The County deployed a solution called the Social Services Integrated Reporting System (SSIRS) and deployed IBM® InfoSphere Identity Insight with IBM® Cognos and IBM® InfoSphere Warehouse.

The IBM® solution equipped Alameda County with capabilities in advanced entity analytics, business performance and integrated data warehousing. Additionally, the system was deployed and running

At any given time, 1,200 caseworkers were responsible for 500 to 600 cases. The agency was constantly challenged to think of new ways to maximize employee productivity and track agency performance.

within six months at the agency. The IBM ROI Case Study Report highlighted some of the outcomes of SSIRS:

ogy to process and people to transform service delivery. The efforts at Alameda County showed the power of collaboration, leadership and data to transform social services.

Consolidated data sources from various pro-

grams, which enabled administrators to disburse payments only if the client was eligible under program standards.

Provided notices to clients with pertinent in-

formation on their case, with instructions on how to best contact their caseworker.

Verified addresses and tracked address changes

of clients.

Automated status alerts are provided to case-

workers and administrators with up to date information on clients.

Delivered a ROI of 631% in a two-month pay-

back period and an average annual benefit of $24,725,000.

THE ANALYTICS FRAMEWORK Fiorentino said that analytics starts by connecting the dots, “You have to start by normalizing the unstructured and structured data. What this means is connecting the dots to bring all this data together.” One example is having consistency of identity across systems. For instance, an agency may have nine databases across seven specific program areas, all on the same individual. Organizations must be able to know that Joe Smith is the same as Joseph Smith to effectively track historical data and information pertaining to the individual. “A lot of organizations are doing this [gaining consistency across programs] through enterprise portals, digitizing documents through a document management approach and data warehouses,” Fiorentino said.

Alameda County represents an example of a government agency that effectively connected technol-

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PROMOTING COLLABORATION ACROSS PROGRAMS As clients are often part of multiple programs, client data often extends across programs and agencies. Greenhut shared a common scenario, “There is a household with a child that qualifies for a children’s health program and nutrition programs. In addition, in the same household there is an elderly person who qualifies for a health program. Instead of sending out three case workers to the same household, with a holistic view it may be possible to send out a case worker who can see the family at once and give better advice based on the entire family situation versus one person at a time.”

This process underscored how collaboration is essential to building a full view of citizen needs. This approach leads to a “no wrong door” policy, where a citizen can enter any government agency and be given access to the full breadth of support without being subject to navigating complex codes and eligibility requirements.

Fiorentino added, “At the end of the day you need to look at how do you serve the client best, and how do you respect the clients privacy, ensuring you are protecting information and are maintaing compliance. Striking that balance does not have a silver bullet, and is a challenging balance because it touches wide ranges of policies, culture, technology, legal, operational aspects.”

For agencies, this becomes extremely challenging as they often operate under different mandates, and collaboration efforts extend beyond government. Social services are increasingly becoming multi-sector, with non-profits, non-governmental organizations and private organizations becoming involved in the delivery of service.

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IBM Industry Perspective

Solutions must be developed that meet customer needs, and every client will have unique considerations. Agencies will always be challenged to meet the needs of the many against the needs of the few, but technology can help to develop a tailored and personalized approach to more complex cases.

“We need to share information so we can get a whole picture of a person to get them the health and social benefits they need in order to maximize their wellness, productivity and participation in society,” said Gardner.

EFFECTIVE LEADERSHIP TO DRIVE STRATEGY Without effective leadership, agencies will struggle to gain buy-in and truly capitalize on the Smarter Care approach. Technology plays an essential role in delivering services in a modern context, but requires a leader to chart the course and implement proper governance and implementation strategies.

As Fiorentino said, “A fundamental key to governance is leadership. We can put all the frameworks in the world around how to share data and secure data, but it’s really about leadership, a strong leader who can bring disparate groups together and have them share their data with the clients’ best interest in mind and balance privacy and security. It’s not easy, but that’s where it starts.”

Social programs play a vital role in providing assistance to those in need and are at the heart of a vibrant democracy. Agencies must continue to look at innovative solutions to improve the delivery of services to meet growing demand. As the role of government continues to evolve, agencies must be sure they are positioned to provide the right services, at the right time.

ABOUT IBM

ABOUT GOVLOOP

The world isn’t just getting smaller and flatter, it is also becoming more instrumented, inter- connected and intelligent. As we move toward a globally integrated economy, all types of governments are also getting smarter.

GovLoop’s mission is to “connect government to improve government.” We aim to inspire public sector professionals by serving as the knowledge network for government. GovLoop connects more than 65,000 members, fostering cross-government collaboration, solving common problems and advancing government careers. GovLoop is headquartered in Washington D.C with a team of dedicated professionals who share a commitment to connect and improve government.

IBM provides a broad range of citizen centered solutions to help governments at all levels become more responsive to constituents, improve operational efficiencies, transform processes, manage costs and collaborate with internal and external partners in a safe and secure environment.

Governments can leverage the unparalleled resources of IBM through IBM Research, the Center for the Business of Government, the Institute for Electronic Government and a far-reaching ecosystem of strategic relationships.

To learn more, visit http://www.ibm.com/smarterplanet/us/en/smarter_care/overview/

For more information about this report, please reach out to Pat Fiorenza, Senior Research Analyst, GovLoop, at pat@govloop.com, or follow him on twitter: @pjfiorenza.

GovLoop 734 15th St NW, Suite 500 Washington, DC 20005 Phone: (202) 407-7421 Fax: (202) 407-7501 Twitter: @GovLoop

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