Slide presentations delivered on Day Two of the SOCI 10th Annual Symposium at Johns Hopkins University.

2. Day 2: Welcome /
Overnight Reflections
Daniel Stein
President & Co-Founder,
Stewards of Change Institute
#SOCI15

3. Join the conversation on Twitter!
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4. Roundtable Discussion
Scaling the Mountain of Interoperability –
Successful Steps and Lessons Learned From the Trek
• Josh Sharfstein, MD (moderator)
• William (Bill) Hazel, MD
• Michael Wilkening
• Theresa Cullen, MD, MS
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5. Data Informed Health and Human
Services
The Honorable William A. Hazel, Jr., M.D.
Secretary of Health and Human Resources,
Virginia, USA
Stewards of Change Roundtable
June 19, 2015

6. Policy, funding, workflow, people
Silos come in many forms...

7. The Virginia Health and Human Resources Secretariat is focused on six strategic issues.
Virginia Health and Human Resources
Virginia Health and Human Resources Secretariat
Healthy and Productive Virginians
Eliminating Intergenerational
Poverty
Thriving Children and
Families
An Aging and Diverse Population
Integrating Individuals with
Disabilities in the Community
Supporting and Valuing Our
Veterans and Volunteers
Financial Sustainability Performance Management
Customer- Centric
Data Aware
Promoting Pathways to the 21st Century Economy for All Virginians While Maximizing the Value of Commonwealth Resources
Cultural Competence Trauma Informed Systems of Care

8. Virginia is shifting from a ‘program-focused’ model to a more ‘Customer-Centric Coordinated Care’ model.
‘Customer-Centric Coordinated Care’ Model
Agency
Traditional Program-
Focused Model
‘Customer-Centric Coordinated
Care’ Model
Agency
Agency
Agency
Agency
Service
Delivery
Partner
Service Delivery
Partner
Agency
Agency
Agency
Services driven by individual, family, or community needs
Agencies recognize and consider the full range of services provided by other agencies, partners
and organizations
Services are considered more broadly factoring in role of social determinants

9. The illustration below provides counts of individuals served by program and agency annually.
Virginians Served Across Health and Human Resources Programs
NOTE: Population counts
between different programs
may overlap and are not
mutually exclusive.
1LIHEAP numbers represent
households and not recipients.
SOURCES: All SFY 2013
unless noted: VDSS Locality
Profile, LASER Report,
ADAPT (unique client
counts), APECS (number of
families served), Virginia
Medicaid at a Glance, VDSS
Annual Statistical Report,
DARS APS division Report,
DARS Virginia State
Rehabilitation Council Annual
Report, VDSS Measures (Cost
Effective Rate), OCS Strategic
Plan (2012-14), DBDHS 2014
Annual Report, CARS, DSA
Expenditure Reports
Medicaid –
Individuals with
Disabilities
225K
FAMIS/CHIP
182K
Medicaid –
Elderly
79K
Medicaid – Children in Low
Income Families
622K
Medicaid – Parents,
Caregivers and
Pregnant women
268K
Vocational
Rehabilitation
2K
Training
Centers
0.6K
Library and Resource Center
10K
Technology
Assistance
Program 1K
Tobacco-Use
Prevention
48K
Virginia
Relay
49K
Interpreter
Programs
2K
Independent
Living/Rehab
Teaching
3K
Education
Services
2K
Deaf Blind
0.196K
Youth and
Family Services
15K
Foster
Care
2K
Adoption
7K
Child Support
586K
SNAP
1,299K
LIHEAP1
242K
TANF
161K
Child
Care
43K
Adult
Services
54K
Vocational
Rehabilitation
Program
28K
WIC
340K
Family Planning
Services
79K
Agency
DARS
DBDHS
DBVI
DMAS
OCS
VBPD
VDDHH
VDH
VDSS
VFHY

10. How VA HHR is developing an analytics based culture
Analytics going forward
•Agreement on shared strategic business
goals for improved service
•Funding sources, bi-annual budget, grants,
etc.
•Procurement clauses that will support data
standards
•Executive Directives & Orders
•Pilot Projects

11. Visualizing Outcomes – Social
Network

12. Questions?

13. Join the conversation on Twitter!
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14. 14
Veterans Health Information Exchange
Overview
“Getting the Right Data to the Right Person at the Point of Care”
Theresa Cullen, Director, Office of Health Informatics
Office of Informatics and Analytics
Veterans Health Administration
Stewards of Change Institute ROUNDTABLE: Scaling the Mountain of Interoperability
– Successful Steps and Lessons Learned From the Trek
Date: Tuesday, June 23rd, 2015

15. Interoperability is Essential for Veteran Health
Equity
• Achieve Health Equity
• Holistic Veteran care across the continuum
• Triple Aim
Veteran (person) centered care
• Veteran access and ownership of medical information
• Veteran Partnership in decision-making
• After Visit Summary
Veteran (person) engagement
• Population management
• Clinical decision support, Clinical Reminders
• Internal and External reporting
Analytics & Decision Support
• Continuity of Care at Transitions
• Referral Management
• Purchased Care
• Access to Information across the Continuum of Care
Care Coordination
• eHealth Exchange
• Direct Secure Messaging
• Blue Button
• Future Innovations
Health/Social Information
Exchange
• Bidirectional health and human services data
Meaningful Use of the
Electronic Health Record
(EHR)
15

16. VA Health (and Human Services) Information
Exchange Strategy Through Engagement
 Empower Veterans
 Build and Expand the
Health And Human
Services Networks for
Sharing
 Integrate into Business
Process
 Resolve Data Retention
and Use Concerns
16
Veterans
Community
Partners
VA
Clinicians

17. Barriers to collecting/sharing/interoperable Data
Veteran
Authorization
Technical
Solutions
Health and
Human
Services
Data
17
…How Can We Improve Veteran Services & Access To Care
By Having Comprehensive Veteran Medical Records?
Veterans
Must Agree
to Share
Exchange
Direct
RHIE
Blue Button
Get and Use
The Data
67% of
Veterans
Seek or
Use
Private
Sector
Health
Care

18. VHA Interoperability: Social Determinants of Health
 VHA approach- change the vernacular
 Office of Health Equity
 Capturing Veteran’s health (and human services) information
 VHA Continuity of Care
 “Interoperability” - improving Veteran access to care
 Social determinants that affect health
 Inclusion of Appropriate Domains
 Support for recent IOM study
 LOINC analysis of data sets
 Specific Conditions (but it isn’t about conditions)
 Homelessness
 Polytrauma
 Post Traumatic Stress Disorder (PTSD)
18

19. VHA Exchange Partners – Nationwide
4
7
Partners Hospitals Clinics Hospitals
Owned
Practices
Labs Pharmacies Nursing
Homes
Other Ancillary
Sites
48 592 13,073 2,446 193 118 138 479

20. VLER Health Transactions FY14
• Combining usage
from VA and
private sector
providers, VLER
had helped
Veterans in every
State to share
medical records,
and hopefully
improved care
and outcomes.
20

21. Information Resources
14
• VA Website
http://www.va.gov/vler/
1 (877) 771-VLER (8537)

22. Join the conversation on Twitter!
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23. Interactive Activity #3
Harnessing the Power of Social Determinants, by
Creating Tools to Advance Information-Sharing
and Interoperability
Shell Culp, Facilitator
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24. Join the conversation on Twitter!
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25. Innovation Spotlight
Insights into the Future of HHS
-Powered by Watson
Claude Yusti,
IBM
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26. Join the conversation on Twitter!
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27. Roundtable Discussion
Federal Interagency Collaboration
– Perspectives, Pitfalls…and Progress
• Paul Wormeli (Moderator)
• Maria Cancian, PhD
• Jessica Kahn, MPH
• Kshemendra Paul
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28. Join the conversation on Twitter!
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29. Innovation Spotlight
Leveling Up – Virtual Simulations for Better
Child and Family Outcomes
Richard Gold (moderator)
Wade Horn
Christian Doolin
Beverly (BJ) Walker
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30. Join the conversation on Twitter!
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31. Ignite Sessions
Leading Change in Health and Human Services
Emerging and Next Practices
Vernon Brown, (moderator)
Co-Founder and Chairman of the Board
#SOCI15

32. Ignite Session #1
Case Commons
Kathleen Feely
Vice President for Innovation,
Annie E. Casey Foundation
#SOCI15

33. Emerging and Next Practices
for Health and Human
Services
Stewards of Change National Symposium
June 23, 2015

34. Information Is Power

35. The Future Is Now

36. The Status Quo

37. A Different Approach

38. A Different Approach

39. Putting New Technology to Work

40. What We Must Address

41. Reimagining Human Services

42. The New Technology Ecosystem in
Human Services

43. Helping the Helpers • Analyzing Results • Changing Lives

44. Ignite Session #2
NYC Homelessness Prevention Solution
Andrea Reid
& Jaclyn Moore
#SOCI15

45. Using Innovative Technology to
Fight Homelessness
Google 1

46. NYC Department of Homeless Services
One of the largest organizations of its kind
Employees Annual
budget
Third-party
service providers
150+2K+ $1B+
2

47. NYC Department of Homeless Services: GOALS
Reducing Homelessnes | Improving Lives
Employees Annual
budget
Case workers Third-party
service providers
X$1B+
• Prevention - - Homebase
• Outreach - - teams deployed 24/7
• Shelter - - temporary housing
• Housing Permanency - - keep clients in
permanent housing
• Organizational Excellence - - training for
optimal results
3

48. 2015 New York City Shelter Census
Serving the largest population of “at-risk of homelessness” in the United States
Total
population in
shelters
Families w
children in
shelters
Children under
18 in shelters
Average length of
stay in shelter
412
days
56K+ 23K+11K+
4

49. Top Contributing Factors Leading to Homelessness
Understanding Homelessness
Evictions
Domestic Violence
Overcrowding
Immediate Return
Prior History
31 %
21 %
18 %
15 %
58 % 5

50. Homeless Prevention: HOMEBASE leads NYC
prevention efforts
Combination of programs, services and resources brought together to combat homelessness
• Child and Family Services
• Welfare Services
• Health Resources and Services
• Substance Abuse and Mental Health Services
• Social Services
• Homeless Prevention Services
• Established in 2004
• 23 locations throughout NYC
• Shelter applications cut in half
• Services include:
○ Financial Counseling
○ Short-term emergency funding
○ Rental assistance
○ Employment services/referrals
○ Legal advice and referral
○ Connections to community resources
6

51. Challenge: Targeting Resources and Services More
Effectively
Prevention efforts can be improved
…enabling a massive gain in case worker productivity through technologyEarly Outreach and Better Allocation of Resources and Services Leads to Lower
Shelter Intakes. Case Workers and Service Providers Need:
● Quick and easy access
to information
● Data that is simple to
understand
● Ability to Assess, Rate
and Rank “At-Risk”
Population
● Better outreach strategy
● Automated business
processes
● Productivity tools
7

52. Enhancing Prevention: NYC Department of Homeless
Services Initiatives
Overcoming challenges leads to enhanced services to people in need
Innovative Technology: Using Google to Fight Homelessness
Rental Assistance Programs and Services
Homebase
8

53. Enhancing Prevention: NYC Department of Homeless
Services Initiatives
Overcoming challenges leads to enhanced services to people in need
…enabling a massive gain in case worker productivity through technology
Rental Assistance Programs and Services
• Nine new locations in FY 2015 (brings
total to 23 across NYC)
• Shelter intakes reduced by 70%
around Homebase centers
• Services incl
• State and City Rental Assistance Programs
• Tailored Services for Households Exiting Shelter
• Expansion of Legal Service Programs
9

54. Enhancing Prevention: NYC Department of Homeless
Services Initiatives
Overcoming challenges leads to enhanced services to people in need
…enabling a massive gain in case worker productivity through technology
Homebase
• Nine new locations in FY 2015 (brings
total to 23 across NYC)
• Shelter intakes reduced by 70%
around Homebase centers
• Services incl
• 9 Additional Locations throughout
NYC
• Increasing capacity to 20,000
households, from 10,000
• Strengthening Government
Collaboration
○ Co-Location with TANF Agency
○ Department of Education
○ NYC Public Housing Authority
Expansion of
Homebase
Program
10

55. Enhancing Prevention: NYC Department of Homeless
Services Initiatives
Overcoming challenges leads to enhanced services to people in need
…enabling a massive gain in case worker productivity through technology
Innovative Technology: Using Google to Fight Homelessness
• Nine new locations in FY 2015 (brings
total to 23 across NYC)
• Shelter intakes reduced by 70%
around Homebase centers
• Services incl
• Easy and Quick Access to Data and Information Affecting
Homelessness
• Data displayed in a rich and intuitive map-based view
• Data available in real-time and accessible from the field
• High-risk areas easily identified
• Correlating risk factors visualized
• Outreach and services prioritized based on risk and need
Case Worker
Management System:
enables service providers
to more efficiently allocate
resources and services
11

56. Predicting Homelessness Risk in Real Time
Evictions, Shelter Applicants, Ineligibles, Exits, Homebase Enrollments
Multiple critical data points in a single map-based view
Identify high risk locations and
correlate with other data points
12

57. Predicting Homelessness Risk in Real Time
Multiple critical data points in a single map-based view
Community Districts - Data Sorted by Case Worker Service Area
Search for data by region,
neighborhood or specific address
13

58. Predicting Homelessness Risk in Real Time
Multiple critical data points in a single map-based view
Outreach Hot Spots - Map Layers to Identify High Risk Areas
Correlating data points are viewed
via heat layers and color gradients
14

59. Predicting Homelessness Risk in Real Time
Multiple critical data points in a single map-based view
Case Records & Landlord Data
Case
Case Seq Number 001
Index Number Prefix
Case Status Active
Court Code Residential
Date April 12, 2014
Name Of Clerk LMARENTE
Date Of Another April 12, 2014
Number Something 100039718
First Names John and Jane
County 23
Case Index Numebr 20140013915
Landlord
First Name Houses
Last Name Nycha-Glenmore Plaza
Number 89
Address Line 1Christopher Avenue
Apartment 14C
City Brooklyn
State New York
Zip 11206
Easily searchable records and
history for streamlined,
transparent eligibilty.
Street and Birds-eye views
provide remote access to site
visits. Outreach planned
accordingly.
15

60. Data Sample: Eviction filings
“Antiquated” would be putting it nicely
16

61. The Bottom Line
NYC Department of Homeless Services is now better equipped to serve “at-risk” clients
Efficiency gains Productivity increases Lower costs
Automate manual processes
Reduce human errors and
inconsistencies
More time for client interaction
Targeted outreach efforts and
case worker activities
Better allocation of
resources and services
Reduction in shelter intake
17

62. Thank You
Andrea Reid
Assistant Commissioner
City of New York Department of Homeless
Services
33 Beaver Street, 20th floor
New York, NY 10004
Jaclyn Moore
Director, Community-Based Prevention
City of New York Department of Homeless
Services
33 Beaver Street, 20th floor
New York, NY 10004
18

63. Ignite Session #3
State Enterprise MOUs
Mike Wirth, - (VA Example)
Richard Gold, - (IL Framework Perspective)
#SOCI15

64. A 101 Introduction
UNDERSTANDING THE E-MOU
Office of the Secretary of Health
& Human Resources
Commonwealth of Virginia
www.ehhr.virginia.gov

65. How Do We Typically Service Citizens Today?
Program-focused interaction
Point-to-point communication with
multiple contacts
Citizen initiates all activity
48

66. A New Customer-Centric Coordinated Care Approach
Streamlined single communication
from citizen to government
Agencies communicate and
coordinate services
Government initiates activity
49

67. 50

68. Traditional Data Sharing from an Agency View
51

69. Coordinated Data Sharing
52

70. Enhanced Memorandum Of Understanding
53

71. E-MOU Components
This section outlines
E-MOU PROCEDURES
and processes:
 Adding, suspending &
terminating
partnerships
 Changes and
amendments
 Data exchange
requirements &
validations
 Breaches
This section outlines
each specific DATA
exchange and becomes
an integral part of the
overall agreement.
 Specific Requirements
for Data Exchange
 Attachments evolve
the E-MOU over time
This section is the overall
REUSABLE AGREEMENT
component of the E-MOU,
and includes:
 Definitions
 Partner Duties &
Responsibilities
 Data Usage
 Coordinating
Committee
 Dispute Resolution
54
AGREEMENT APPENDIX ATTACHMENT

72. E-MOU Attachment
55
Represents the OUTCOME of data
exchange conversations between
Partners
Outlines data sharing requirements:
Which agencies?
What specific data?
Defined business purpose?
How long?
Applicable law?

73. E-MOU Governance
56

74. The E-MOU Today
57

75. Feeding Analytics
58

76. Data Sharing – The Vision
59

77. Lessons Learned
• Shared understanding on goals
• Cuts down administrative latency
• Leverage “reframing” lessons learned
• BYGO through Transparency
• Templates focus on “empowering language”
• CISOs own less of the process
60

78. Next Steps
• VA working on v2; adding Education, Public
Safety and Elections
• E-MOU shared with NJ, IL and CA
• Evolve together
61

79. Questions?
62

80. Ignite Session #4
Center for Government Excellence:
Bloomberg Foundation
Open Data Initiative
Beth Blauer
#SOCI15

81. Center for Government
Excellence

82. Safety for Foster Children
• Mapped foster kids’ addresses with locations of the state’s most violent
criminals, registered sex offenders
• Dispatched safety assessments
Education
• MD designated best schools in the country by Education
Week five years in a row
• 87% of high school seniors graduated from high school
Decreased Violent Crime
• Decreased by 25% from 2007 to 2012
• Homicides down 27% in 2011 compared to 2006
Decreased Overtime
• Saved $20 million in overtime in public safety agency
alone
StateStat Impact

83. StateStat Impact
• Economic Stability
– One of nine states to maintain a AAA bond rating
during the recession
– $8.3 billion in spending cuts in first seven years
– Recovered 81% of jobs lost during the recession
– Expanded healthcare coverage to more than 360,000
Marylanders, most of them children
– 15th lowest foreclosure rate in the nation in 2012

84. Worked with city, county and
state governments, NGOs and
Non-Profits to develop Open
Perfrormance tools.
Socrata

86. What Works Cities is designed to accelerate cities’ use
of data and evidence to improve people’s lives

88. Johns Hopkins University
21st Century Cities Initiative

89. Johns Hopkins University
21st Century Cities Initiative

92. The Center’s Role
• Assessment
• Open Data
• Performance and Analytics
• Community Building

93. Center for Government
Excellence

94. Join the conversation on Twitter!
#SOCI15

95. Tonight’s Reception
Johns Hopkins University
Faculty Club
(5:30pm – 8:00pm)