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Transforming Worker Experience through Access and Interoperability

MONDAY, 4:30 – 4:50PM. Transforming Worker Experience through Access and Interoperability. Rahul Puri, Chief Software Architect, New York City Health and Human Services Joe Fleischman, Project Manager, New York City Health and Human Services. Overview of New York City.

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Transforming Worker Experience through Access and Interoperability

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  1. MONDAY, 4:30 – 4:50PM Transforming Worker Experience through Access and Interoperability Rahul Puri, Chief Software Architect, New York City Health and Human Services Joe Fleischman, Project Manager, New York City Health and Human Services

  2. Overview of New York City • An estimated 8.6 million people live within NYC’s five boroughs • Its $1.2 trillion economy is the second largest municipal economy in the world (Tokyo is first) and 13th largest economy globally • Its municipal government employs more than 250,000 individuals among 90+ agencies, offices and boards • The government provides thousands of services for citizens including educating 1.1 million school children; collecting 12,000 tons of refuse a day; maintaining 1,700 parks; and providing a safe place for some 35,000 homeless individuals and families each day • The City’s operating budget is approximately $57 billion • About $1 – $1.5 billion of that budget is invested in IT Annually HIMSS 2010

  3. Overview of HHS-Connect – Vision • Client/Customer • Multiple Access Channels • Online Search & Application Tools • Client Information Record • Single, Consolidated View of Information • Ability to Manage information • External Partners • Cross-Program Data • Resource Optimization • Holistic View of Client information • Electronic Case Files & Automated Forms • Inter/Intra-agency Collaboration • City Employee • Holistic View of Client/Customer information • Electronic Case Files & Automated Forms • Inter/Intra-agency Collaboration • Collaborative Case management • Remote Access to Information through Mobile Devices • Agency • Cross-Agency Data • Resource Optimization • Employee Retention HIMSS 2010

  4. Worker Survey • One of the key operational outcomes of HHS-Connect is improving the worker experience vis-à-vis helping New Yorkers • HHS-Connect conducted a baseline survey of health and humanservices workers • Respondents were 503 client-facing workers across the nine HHS-Connect agencies • Online survey • December 9-19, 2008 • Anonymous and confidential • Margin of error is 4.5% • The survey will be conducted annually to measure improvements in the worker experience and help set direction for the HHS-Connect program HIMSS 2010

  5. More than half of all supervisors (55%) do not believe that City agencies effectively share client information Q13: “Do you agree or disagree with the following statement: New York City agencies effectively share client information?” N=503 HIMSS 2010

  6. Workers think their experience would be improved with better data-sharing capabilities Just over a quarter of workers (29%) think City agencies effectively share client information More than 8 in 10 workers (84%) say their jobs would be easier if they could access client data from other City agencies Unsure 11% Unsure 24% No 4% Agree 29% Disagree 47% Yes 84% Q14: “Would it be easier for your to do your job if you had access to client data from other New York City agencies?” Q13: “Do you agree or disagree with the following statement: New York City agencies effectively share client information?” N=529 HIMSS 2010

  7. More than 8 in 10 workers (86%) would like to access clients’ date of birth and address from other agencies Date of birth, 86% Address, 86% Proof of identity, 79% Household composition, 76% Name of client’s caseworker(s), 71% City services client receives, 71% Income information, 70% Age and number of dependents, 69% Social security number, 68% Medicaid eligibility/info, 65% Medical history, 65% Proof of employment, 64% Immigration records/citizenship, 57% Education records/certificates, 52% Non-Medicaid health insurance, 52% Criminal record, 52% Foster care records, 47% Q11: “What kind of information would make helping clients easier when they are referred to you from other agencies?” N=529 HIMSS 2010

  8. Worker Connect Business Case • Conducted business use case meetings with over 25 user groups from 11 agencies • Built over 150 business use cases across 25+ user groups • Conducted legal and policy reviews with all 5 source data agencies (ACS, DHS, NYCHA, HRA, and DFTA) • Developed change management and training approach HIMSS 2010

  9. New York City Children’s Services – Division of Child Protection (DCP) DCP performs approximately 60,000 child abuse/neglect investigations each year. Allegations are reported into the State Central Register. Child Protective Specialists (CPS) must make contact within 24 hours with someone who can confirm the safety of the child at the moment, and are required to physically visit a child within 48 hours of the report to the Central Register. CPS responsibilities include assessing risk and safety based upon reported allegations, protecting children in imminent danger, and providing preventative measures for those who might be at further risk. At the outset of an investigation, having as much information as possible is critical. Caseworkers are not always provided with the information they need to start their investigation. Many times, only a limited set of information is available from the initial report to the State Central Register. Sometimes parents are unwilling or unable to provide information regarding the whereabouts of their child. Time is of the essence for DCP. DCP is mandated to conduct a full investigation within 60 days of receiving an initial report of child abuse/neglect. The ability to access contact information for a child’s relative(s) and other leads will assist DCP in meeting the 60 day investigation mandate. The ability to find collateral contacts is central to assessing a child abuse/neglect report to determine the correct course of action. These sources of information are especially helpful when trying to locate a missing child and non-school age children. Access to multiple agency information on the worker portal, as well as to documents (e.g., landlord/lease information, pay stubs, utility bills) will facilitate identifying primary and collateral contact information. In addition, documents with photo IDs (e.g., drivers licenses, passports) are invaluable to verify the identity of individuals in an investigation. HIMSS 2010

  10. New York City Children’s Services – Division of Child Protection (DCP) HIMSS 2010

  11. HRA – Office of Child Support Enforcement (OCSE) The Office of Child Support Enforcement (OCSE) is responsible for ensuring that children are financially supported by their non-custodial parent. OCSE provides services to about 400,000 families. Seventeen percent of these families receive cash assistance and 83% do not. All families may apply for child support services. Services are provided regardless of income, cash assistance, or immigration status. Families applying for cash assistance are automatically referred to OCSE for child support services as a condition of eligibility. Families not receiving cash assistance may apply for services by visiting the Family Court in their respective borough. There are five basic child support services: 1) locating noncustodial parents (the parent without the child), 2) establishing paternity (legal fatherhood), 3) establishing child support and medical support orders, 4) collecting and distributing child and medical support, and 5) enforcing child and medical support orders. OCSE’s objective is to secure a court order for child support and to ensure that the support order is enforced. The first step in this process is locating the noncustodial parent in a timely fashion and verifying their financial situation. Upon locating a noncustodial parent, a summons may be served requiring them to attend a child support court hearing. OCSE is also responsible for enforcing support orders where an NCP may not be agreeing to the terms of the support order. In these cases, locating an NCP is the primary goal. Access to address information and scanned documents which include an address will facilitate these processes. During child support hearings, the amount of the child support order is determined, including financial and medical support based on an NCP’s financial situation. The income level of an NCP is used to determine the level of child support an NCP is required to pay. OCSE users are required to validate that the information provided is accurate, and that the client is disclosing all income sources. Access to data in the Worker Portal will allow users to more thoroughly investigate an NCPs net worth, ensuring that all income sources are disclosed during the hearing process and, as such, ensure that children and families are receiving adequate support. HIMSS 2010

  12. HRA – Office of Child Support Enforcement (OCSE) HIMSS 2010

  13. High Level Architecture HIMSS 2010

  14. Information Exchange Deliverables Data Models Application I Application II Application III Application IV Information Exchange Inventory Integration Layer Phase n Phase I Phase II NIEM Core Infrastructure Protection Places People Person Location HHSC Canonical Exchange Schema (NIEM Conformant) Health & Human Services Organization Immigration Things Contact Info Property Events Metadata Intelligence Activity Canonical Exchange Data Model Legend Person Screening Criminal Justice International Trade XML Based Exchanges Emergency Management Non-XML Exchanges HIMSS 2010

  15. HHS-Connect High Level Data Model Purpose • Document Data Architecture Layer – collect COTS data model and custom extensions that provide service components used to support business capabilities or business processes • Document a high level conceptual data model of information subject areas and major entities managed by HHS-Connect systems Contents • HHS-Connect Abstract Logical Data Model (Left) • Documentation of COTS data models • Documentation of COTS data model extensions • Application data views – subset of COTS data model + extensions • Data dictionaries • Process for collecting and maintaining data modeling through project lifecycle • Suggested data object naming standard HIMSS 2010

  16. The participation of any company or organization in the NHIN and CONNECT area within the HIMSS Interoperability showcase does not represent an endorsement by the Office of the National Coordinator for Health Information Technology, the Federal Health Architecture or the Department of Health and Human Services. Thank You

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