Featured Posts - Blog - The NIC Collaboration Hub2024-03-28T20:23:53Zhttps://hub.nic-us.org/blog/feed/featuredA New Training Program For The Next Normalhttps://hub.nic-us.org/blog/a-new-training-program-for-the-next-normal2021-03-23T18:24:36.000Z2021-03-23T18:24:36.000ZHub Adminhttps://hub.nic-us.org/members/NIC<div><p>By <a href="https://hub.nic-us.org/members/DanielStein" target="_blank">Daniel Stein</a></p>
<p>This quote from the latest newsletter from the California chapter of the National Association of Social Workers caught my eye: <em>“Public and private programs, agencies and organizations nationwide are preparing to build, rebuild, and grow in 2021 and beyond. And – as the pandemic has demonstrated every day – the need will be greater than ever to address socioeconomic problems, racial disparities, and health inequities with improved Interoperability and information-sharing.”</em></p>
<p>I couldn’t agree more, especially since the paragraph went on to urge readers to sign up for the Stewards of Change Institute’s new InterOptimability Training and Certification Curriculum. We created ITCC to address the specific need that NASW identified, and we’re grateful for the opportunity to partner with NASW to launch ITCC with its members.</p>
<p>That’s just the start. After years of development and testing with professionals across the country, we now invite individuals and organizations, large and small, to follow the NASW’s lead in signing up for this first-of-its kind program. You can learn more about it on the <a href="https://stewardsofchange.org/interoptimability-training-curriculum-certification-itcc-program/" target="_blank">ITCC page</a> of SOCI’s website, where <span style="color:#0000ff;"><a href="https://itcc.talentlms.com/catalog/info/id:128" target="_blank">you can also register</a></span> for the first course. We are encouraging people to participate in a learning cohort (limited to 20) to maximize learning and develop relationships, but individuals are also very welcome.</p>
<p>The ITCC is a unique educational initiative designed to fill the need for a systems-thinking approach for designing and/or implementing interoperability and information-sharing initiatives across health, human services and related programs. The lack of such an approach has had numerous negative consequences, including slowing the movement toward integrated, person-centered care, as well as impeding progress toward racial and socioeconomic equity.</p>
<p>ITCC confronts those challenges by providing organizational teams and individuals with the knowledge, skills and tools they need to work more effectively and collaboratively within and across their increasingly complex and interconnected fields. It’s also critical to point out that ITCC isn’t about just making learners smarter; rather, the program is designed to enable and accelerate systems-level change, while giving those who take the training the opportunity for certification that can increase their career and leadership prospects.</p>
<p>InterOptimability (think Interoperability + Optimization) is a unique methodology we created to build competencies that meet the demands of the modern workplace. This methodology is at the heart of ITCC, which offers a series of “training on demand” courses through its state-of-the-art, web-based platform. Its intent is to enable your organization to prepare for the convergence of programs that span the HHS continuum and to help you build capacity to embrace the social determinants of health and well-being.</p>
<p>Using a systems-level approach, ITCC helps prepare executives, program managers, supervisors and others in the public and private sectors to develop competencies needed to initiate, support and lead organizational change; facilitate cross-silo information-exchange; and leverage technical interoperability. ITCC helps create sustainability by providing a common vocabulary, a shared body of knowledge, and effective methods and tools that support change.</p>
<p>As the NASW rightly points out, the need for a program like ITCC is greater now than it has ever been. Indeed, we believe that better, more-responsible data-sharing and collaboration across domains will not only enable our country to more-effectively respond to health-related emergencies (including the one we’re living through today), but will also contribute to broad progress on racial and socioeconomic issues in society. SOCI is committed to tackling these problems and to furthering equality through all our work.</p>
<p>I’ll end with another quote. This one’s from Michael Becketts, director of the Fairfax County (VA) Department of Family Services. After a team of his colleagues took the first ITCC course during its testing period, here’s what he said: <em>“The ITCC program is genuinely unique and will be very helpful for addressing our Department’s work to integrate service delivery across multiple divisions. After taking the first course, our team unanimously found that it will further their work, while also improving our collective strategic planning.”</em></p>
<p>That’s exactly our objective in rolling out ITCC for private and public organizations in a wide variety of systems, sectors and domains. Let me know if you have any questions, then let’s get started.</p></div>A Recommendation to the New President: Use Interoperability to Improve Children’s Liveshttps://hub.nic-us.org/blog/a-recommendation-to-the-new-president-use-interoperability-to-imp2021-03-10T15:39:57.000Z2021-03-10T15:39:57.000ZHub Adminhttps://hub.nic-us.org/members/NIC<div><p>By <a href="https://hub.nic-us.org/members/DanielStein" target="_blank">Daniel Stein</a> and <a href="https://hub.nic-us.org/members/DavidARoss" target="_blank">David A. Ross</a></p>
<p>The $1.9 trillion Covid relief bill that’s headed for President Biden’s desk this week makes it very clear – wonderfully – that children will be a primary concern during his Administration. In particular, the legislations provisions will make a meaningful difference in the lives of kids in low- and middle-income families, mitigating poverty’s corrosive impact on millions of the youngest, most-vulnerable people in our country.</p>
<p>It’s a major step forward, to be sure, but there’s more to be done. Now we believe there’s a subsequent action he can take to engrain this progress and even-more-systemically fulfill his promise to “Build Back Better.” Our suggestion is this: Build a cross-agency coordinating council, and issue an executive order if necessary, to advance collaboration and planning among the numerous, disconnected federal programs and systems that aim to improve the health, safety and well-being of children.</p>
<p>Even at this deeply discordant time in our history, we believe most Americans could support that goal, just as they do the $1.9 billion rescue package. A deliberate effort to institutionally help children would be the “moonshot” of our generation, with positive impact that would last far into the future. While there would certainly be costs to fully implement it, the launch would be relatively inexpensive and the return on investment would be enormous.</p>
<p>The problem today is that government systems providing healthcare, social services, education, housing and other programs to assist children and families are mostly disconnected from each other. That means parents struggle to get the help they need – or even to figure out where to look for help – while service providers lack the ability to get a full picture of what needs have to be addressed. And that will remain the case even when the Covid legislation is implemented.</p>
<p>In short, we strongly believe the seamless, secure and confidential exchange of information is so important that it should be an explicit next step in his Build Back Better agenda.</p>
<p>The Affordable Care Act of 2010 (ACA) envisioned just this kind of approach to stimulate integration and coordination across the myriad agencies and organizations that serve children and families; indeed, some interoperability efforts were made during the Trump administration. Despite a broad consensus that this approach works, however, it hasn’t been widely implemented for a variety of reasons, many of them cultural and political.</p>
<p>Making this effort a priority, including creation of a Children’s Advocate in the White House, could induce actions in states and localities that most already believe are worth taking. Furthermore, provisions of the ACA specify that the federal government can pay up to 90% of a state’s costs of implementing interoperability, which would enable structural changes to permanently connect the relevant systems. The political lens through which some states have viewed the ACA has impeded wider use of those provisions, but presidential leadership – or, again, an executive order if necessary – could shift that reality.</p>
<p>It isn’t just children who would benefit. By its very nature, an interoperability initiative would lead to systemic changes that would contribute broadly to more-efficient and -effective programs and services for people of all ages, races and socioeconomic groups.</p>
<p>But children are the right initial focus. Helping them should be a cause that all sides of the political divide can agree upon and, quite simply, it’s the right thing to do.</p>
<p>The prescription we’re suggesting is not controversial. Interoperability has been enthusiastically embraced by the private sector and governments at all levels, irrespective of their leaders’ political leanings. It entails bringing a proven methodology to scale, beginning with leadership from the top, so we can get moving ASAP.</p>
<p>Taking this action would enhance and institutionalize the Administration’s goal of improving the lives of tens of millions of children who don’t get enough to eat, don’t have a decent place to sleep, don’t receive equal educational opportunities and, more generally, don’t have routine, equal access to the building blocks of health, well-being and life prospects.</p>
<p>Every politician says it: Children are our future. The President has now demonstrated that they are also his Administration’s priority. We believe that interoperability could be a key to ensuring that the changes being instigated today will endure and grow far into the future.</p>
<p><em><a href="https://hub.nic-us.org/members/DanielStein" target="_blank">Daniel Stein</a> is President of the Stewards of Change Institute.</em> <a href="https://hub.nic-us.org/members/DavidARoss" target="_blank"><em>David A. Ross</em></a><em>, ScD, is President and CEO of The Task Force for Global Health. </em></p></div>The Best Way to Improve the Future is to Shape Ithttps://hub.nic-us.org/blog/the-best-way-to-improve-the-future-is-to-shape-it2021-02-24T15:37:23.000Z2021-02-24T15:37:23.000ZHub Adminhttps://hub.nic-us.org/members/NIC<div><p>By <a href="https://hub.nic-us.org/members/DanielStein" target="_blank">Daniel Stein</a>, President, SOC Institute I’m happy to report that 2021 has gotten off to a good start for Stewards of Change Institute (SOCI), with the successful completion of three initiatives: <a href="{{#staticFileLink}}8490838101,original{{/staticFileLink}}"><img class="align-right" src="{{#staticFileLink}}8490838101,original{{/staticFileLink}}" width="206" height="268" alt="8490838101?profile=original" /></a></p>
<ul>
<li>Our <span style="color:#0000ff;"><a href="https://hub.nic-us.org/groups/sdoh-national-action-agenda" target="_blank">National Action Agenda</a> </span>(NAA) Symposium to Advance Upstream Social Determinants and Health Equity, held last month in partnership with the Stanford University Center for Population Health Sciences. Learn more <a href="https://hub.nic-us.org/groups/sdoh-national-action-agenda" target="_blank">about the event</a> and view its recorded sessions.</li>
<li>A <a href="https://hub.nic-us.org/groups/Pew-Civil-Justice-Technology-Project" target="_blank">court-improvement project</a>, with the Pew Charitable Trusts, to make the nation’s civil justice system more accessible, efficient and affordable. SOCI’s role in this effort was to identify emerging/innovative technologies and practices to help achieve those aims.</li>
<li>The “building” phase of our <a href="http://www.nic-us.org" target="_blank">National Interoperability Collaborative</a>, enabled by the Kresge Foundation and other generous sponsors. Today, with almost 1,300 members, NIC serves as the vehicle for driving the NAA and our other on-the-ground implementation activities.</li>
</ul>
<p>All of us at SOCI extend our deep gratitude to the supporters of our work – all of which shares this common goal: to advance socioeconomic, racial and health equity through better interoperability, information-sharing and use of pioneering technologies. Most of all, thank you to the hundreds of organizational leaders, government officials, technologists, scholars and other professionals who helped to make our symposium so successful, as well as the thousands who have participated (and continue to participate) in NIC, NAA and other SOCI activities. Now it’s time to move forward, and we plan to do that with the guiding belief that “the best way to improve the future is to shape it.” Here are just a few of the ways we intend to contribute to positive, systemic change in our country:</p>
<ul>
<li>Continuing the development, demonstration and deployment of <a href="https://hub.nic-us.org/groups/project-unify" target="_blank">Project Unify,</a> our proof-of-concept technical blueprint designed to significantly advance secure data-sharing across health, human services and other domains (child welfare, education, courts, etc.). Unify is initially being operationalized with the Integrated Care for Kids (InCK) project in New Jersey, which is an NAA supporter and implementation partner.</li>
<li>Implementation of the <a href="http://www.nic-us.org" target="_blank">NAA’s action recommendations</a>, notably including our work to make consent management a nationally accepted “utility.” This effort focuses on creating an open-source, replicable means of securing people’s approval (affirmative consent) for the sharing of their personal information. We are beginning to implement NAA’s key recommendations for structural change with NJ InCK, with the goal of creating models that can be customized to jurisdictions across the nation.</li>
<li>Providing knowledge, thought leadership, consultation and education, pointedly including SOCI’s new <a href="https://stewardsofchange.org/interoptimability-training-curriculum-certification-itcc-program/" target="_blank">InterOptimability Training and Certification Curriculum</a>. Initial organizations engaging with the program include the Fairfax County (VA) Department of Family Services and the California Chapter of the National Association of Social Workers. Learn more about ITCC, how it can benefit your work and <a href="https://itcc.talentlms.com/catalog/info/id:128" target="_blank">sign up for the first two courses</a>.</li>
<li>Planning and execution of SOCI’s 14<sup>th</sup> National Symposium, which will be held <em><u>in person</u></em> (hooray!) in California in early 2022. Its primary focus will be on assessing and furthering the progress of the NAA’s action recommendations (such as the consent utility), Project Unify and the InCK project in NJ. Write to <a href="mailto:info@stewardsofchange.org" target="_blank">info@stewardsofchange.org</a> to learn how you can support or participate in the symposium.</li>
</ul>
<p>Please take a look at our websites, <span style="color:#0000ff;"><a href="http://www.stewardsofchange.org" target="_blank">www.stewardsofchange.org</a></span> and <a href="http://www.nic-us.org" target="_blank">www.nic-us.org</a>, where you’ll find more information about each of our initiatives and much more. We also invite you to sign up for NIC’s “community of networks” so that you can help us shape a healthier, more equitable future for individuals, families and communities across the United States and, hopefully, beyond. </p>
<p><strong>Stewards of Change Institute has succeeded in building the National Interoperability Collaborative (NIC) and its “community of networks.” Now we are asking for your financial support so that – together – we can sustain our vital work.</strong></p>
<p style="text-align:center;"><a style="display:inline-block;max-width:564px;width:auto;text-align:center;text-decoration:none;border:none;font-style:normal;font-variant:inherit;font-weight:bold;font-size:16px;line-height:inherit;font-family:inherit;color:#ffffff;background-color:#cd8f00;padding:12px;min-width:180px;" href="https://hub.nic-us.org/support-our-work" target="_blank">Donate Now!</a></p></div>An Important New Initiative At The W3C Virtual Technical Plenary: Human Services Data Dictionaries! Join Us On Oct. 21.https://hub.nic-us.org/blog/an-important-new-initiative-at-the-w3c-virtual-technical-plenary-2020-10-14T13:09:13.000Z2020-10-14T13:09:13.000ZAmanda Taylorhttps://hub.nic-us.org/members/AmandaTaylor<div><h2> </h2>
<h2><a href="https://www.w3.org/community/humanservices"><img class="aligncenter wp-image-5045 size-full" src="https://nic-us.org/wp-content/uploads/2020/10/W3C-NIC.png" alt="" width="812" height="215" /></a></h2>
<p><br /> By <a href="https://hub.nic-us.org/members/EricJahn" target="_blank">Eric Jahn</a></p>
<p>Within many countries and across national borders, the internet is full of varying definitions or understandings for similar or even the same human services concepts. For example, the word "program" means different things in different circumstances and different sectors. The same is true for many common terms, even simple ones that we may intuitively believe have the same meaning to almost anyone. (Think "enrollments," "households," "exit," "homelessness" and many, many more.)</p>
<p>That is obviously not a good thing for lots of reasons. So, with impetus from the National Interoperability Collaborative's (NIC) Project Unify – which aims to demonstrate health and human services interoperability – the Human Services W3C Community Group is beginning to catalog and analyze the various dictionaries for overlap and gaps.</p>
<p>For those new to this organization, W3C stands for World Wide Web Community, which has members around the world. Our mission is to work together to develop standards, protocols and guidelines that improve the web’s functionality and usage.</p>
<p>The purpose of the Human Services Group within the W3C Community is to catalog, link, and improve upon the existing human services ontologies; identify critical gaps; and network with similarly minded people. Some areas of human services, such as healthcare, have very well-established web ontologies, while other areas may not even have standardized definitions or data models, let alone web ontologies.</p>
<p>If this work does not progress, it will be increasingly difficult to compare performance, provide deep learning, and interoperate across the numerous subdomains of human services. Conversely, having an established set of human services knowledge graphs will allow communities around the world to collaborate in deliberate ways and to diverge as they see fit but, in both cases, without having to figure out everything on their own.</p>
<p>The Human Services W3C Community Group will hold its first meeting – virtually, of course – at 2 p.m. EDT/6 p.m. UTC on Wednesday, October 21. If you’re a human services data professional, or just interested in making human services work better, please join visionaries from around the world for this important kickoff meeting, at which we begin to discuss the areas of work that we can engage in that will make a real, substantive contribution.</p>
<p>Here’s the <a href="https://docs.google.com/document/d/16p_YjqyJj4Tk3XpQPuhWXQ_Fzaf_GEmBWo7kpmuo8MU/edit?usp=sharing"><span style="color:#0000ff;">agenda/info for the meeting</span></a>, and here’s a link to <a href="https://www.w3.org/community/humanservices">sign up for the group</a>; please use the listserv/wiki/repository. Finally, with gratitude to the National Interoperability Collaborative for its support and partnership, please take a look at <a href="http://www.nic-us.org"><span style="color:#0000ff;">the NIC site</span></a>, too.</p>
<p>This is going to be an exciting and rewarding journey. We hope you’ll join us for it.</p></div>Modernizing the Civil Court System: The Time is Now – and You Can Participatehttps://hub.nic-us.org/blog/modernizing-the-civil-court-system-the-time-is-now-and-you-can-pa2020-09-30T14:37:40.000Z2020-09-30T14:37:40.000ZHub Adminhttps://hub.nic-us.org/members/NIC<div><p>By <a href="https://hub.nic-us.org/members/DanielStein" target="_blank">Daniel Stein</a>, President, Stewards of Change Institute</p>
<p>COVID-19 is unleashing numerous, profound consequences that we hear about on the news and feel in our own lives every day. One effect of the crisis that has received little attention to date, however, is its impact on the civil courts, where critically important personal matters such as child custody and eviction (among many others) are still playing out during the pandemic and will continue to do so into the future.</p>
<p>The need for the courts to digitize and modernize existed before the pandemic, of course, but now the urgency for reform is even greater in order to help the millions of Americans who face civil legal issues. To better-address that need, the Pew Charitable Trusts’ Civil Legal System Modernization initiative is partnering with the Stewards of Change Institute (SOCI) to help highlight how other domains, such as medicine, have grappled with complex problems like the digital divide and user privacy.</p>
<p>The intent of Pew’s initiative is to make the nation’s civil justice system more efficient, affordable and accessible. To achieve those aims, SOCI is working with Pew to identify emerging/innovative technologies and practices across the human services, healthcare, public safety and Information Technology domains – all of which already use advanced technologies. Once identified, Pew will conduct tests around the U.S. in the coming years to determine what works best. Ultimately, the objective of this work is to implement tools and approaches that level the legal playing field for millions of people for whom the courts are too often an impediment – rather than an opportunity – for achieving justice.</p>
<p>_______________________________________________________________________________________________________________</p>
<p><strong><em>Please <a href="https://www.surveymonkey.com/r/FB8VZZQ"><span style="color:#0000ff;">fill out this form</span></a> if you’re interested in participating in a focus group in October, November or December on this important project. </em></strong></p>
<p><strong><em>You can access a recording of our </em></strong><span style="color:#0000ff;"><a style="color:#0000ff;" href="https://hub.nic-us.org/events/soci-initiative-utilizing-technology-to-improve-the-court"><strong><em>recent webinar on the project here</em></strong></a></span><strong><em>. If you have questions or comments, please write to </em></strong><span style="color:#0000ff;"><a style="color:#0000ff;" href="mailto:info@stewardsofchange.org"><strong><em>info@stewardsofchange.org</em></strong></a></span><strong><em>. </em></strong></p>
<p>_______________________________________________________________________________________________________________</p>
<p>Those other domains are ahead of the courts when it comes launching innovations, integrating multiple systems internally and externally, using data as a strategic asset, and implementing governance models. The courts therefore lack some key learning when modernizing systems or utilizing new technologies that can be gleaned from other sectors that have been steeped in this work for decades. Drawing on the expertise of relevant professionals, a review of existing research and new research produced by Pew, a diverse working group of subject matter experts assembled by SOCI and its National Interoperability Collaborative (NIC) will offer insights into considerations when launching new tools and applications in the courts; they will also help determine what changes to court procedures, policies and rules would bolster the implementation and effective use of advanced technologies and practices.</p>
<p>Pew’s larger Civil Legal System Modernization Project seeks to make the courts more efficient overall by:</p>
<ul>
<li>Increasing the availability and quality of free online legal tools that help everyone navigate complex problems and connect to resources.</li>
<li>Developing, promoting, and evaluating technologies that improve how people interact with state and local courts.</li>
<li>Conducting research to identify policies that can improve outcomes for people involved in the civil legal system.</li>
<li>Building partnerships with the private sector, policymakers, and other stakeholders to advance comprehensive improvement to the civil legal system.</li>
</ul>
<p><br /> SOCI is assisting Pew by utilizing our large national network to virtually convene subject matter experts in focus groups in order to discuss technologies and processes that the courts can learn from in other domains. The multidisciplinary findings and recommendations of these focus groups will help Pew and its partners in the civil justice community to identify the next generation of tools that hold the potential to improve broad accessibility to and the affordability of civil justice. We will also create a framework to assess the methodology needed to adopt emerging, promising and/or next-generation technology innovations and expedite their application in the civil legal system, based the experiences of the other domains. To accomplish these goals, SOCI will:</p>
<ul>
<li>Facilitate engagement with stakeholders from the civil legal system and areas of intersection to include the Human Services, Healthcare, Public Safety and IT domains;</li>
<li>Ensure involvement by a diverse, skilled group of stakeholders who work with communities that intersect with the civil legal system to inform Pew’s ongoing work;</li>
<li>Help fulfill the civil legal system modernization project’s goal of assessing research, technologies and related changes to court procedures with the greatest potential for significant impact on improving access, affordability and efficiency of the civil legal system,</li>
<li>Elevate the awareness and importance of reforming the civil justice system in the eyes of the judicial, political and executive leadership across the health, human services, public health, public safety, education and IT domains, among others, and:</li>
<li>Share the progress and outcomes of Pew’s efforts through NIC’s Collaboration Hub to advance dissemination of the work, solicit feedback and build stakeholder support.</li>
</ul>
<p><br /> We welcome participation in the focus groups we’re putting together in October, November or December. Please <a href="https://www.surveymonkey.com/r/FB8VZZQ"><span style="color:#0000ff;">fill out this form</span></a> if you’re interested in joining this important effort. We recently held a webinar on the project; you can access <a href="https://hub.nic-us.org/events/soci-initiative-utilizing-technology-to-improve-the-court"><span style="color:#0000ff;">a recording of it here</span></a>. Finally, if you have any questions or comments about SOCI, NIC or this initiative, please write to <span style="color:#0000ff;"><a style="color:#0000ff;" href="mailto:info@stewardsofchange.org">info@stewardsofchange.org</a></span>.</p>
<p> </p></div>Read All About It: New Publication Focuses on Stewards/Stanford Projecthttps://hub.nic-us.org/blog/read-all-about-it-new-publication-focuses-on-stewards-stanford-pr2020-09-03T20:12:43.000Z2020-09-03T20:12:43.000ZHub Adminhttps://hub.nic-us.org/members/NIC<div><p>By <a href="https://hub.nic-us.org/members/DanielStein" target="_blank">Daniel Stein</a>, President, Stewards of Change Institute</p>
<p>Like so many others in the nonprofit world, those of us at Stewards of Change Institute (SOCI) do our work every day primarily because we deeply believe in our mission and are committed to improving people’s lives by advancing systems-level change.</p>
<p>I have to admit, however, that it’s also nice when our efforts get a little outside attention now and then. So I’d like to extend a metaphorical tip of my hat (I don’t really wear one) to GovReport – a new, California-based publication – for focusing on SOCI’s latest and most-ambitious initiative to date. It has a long name, but every word tells the tale: The National Action Agenda to Advance Upstream Social Determinants and Health Equity.</p>
<p>The NAA, which we’re conducting with Stanford University’s Center for Population Health Sciences, comprises a series of strategic, integrated elements that include a technical Proof of Concept project and the Stewards’ 14th National Symposium in early 2021. You can learn more about this exciting initiative, and can sign up to participate, by going to <a href="https://hub.nic-us.org/groups/sdoh-national-action-agenda" target="_blank">this page of the Collaboration Hub</a> of SOCI’s National Interoperability Collaborative.</p>
<p>Meanwhile, please take a look at the article on GovReport’s website; it’s also just below for your reading convenience. Either way, please let us know what you think by writing to info@stewardsofchangeinstitute.org or by posting a comment on the Collaboration Hub.</p>
<p><span style="font-size:14pt;"><strong>Article: Stewards of Change Institute teams with Stanford University on Equity Initiative</strong></span></p>
<p>By: <a href="https://www.govreport.org/author/dorsey-griffithgmail-com/" target="_blank">Dorsey Griffith</a> on August 27, 2020</p>
<p>The not-for-profit think tank <a href="https://stewardsofchange.org/" target="_blank">Stewards of Change Institute</a> (SOCI) and the <a href="http://med.stanford.edu/phs.html" target="_blank">Stanford University Center for Population Health Sciences</a> have joined forces on a year-long effort combining academic research, data collection and collaboration with people across multiple sectors to identify systems-level changes that can fundamentally improve population health.</p>
<p>Leaders of the <a href="https://hub.nic-us.org/groups/sdoh-national-action-agenda" target="_blank">National Action Agenda to Advance Upstream Social Determinants and Health Equity</a> say the effort aims to advance health equity and social justice, as well as value-based, person-centered care.</p>
<p><a href="https://stewardsofchange.org/team/" target="_blank">Daniel Stein</a>, president of SOCI, said the collaboration also will facilitate a more effective response to health crises such as COVID-19, which has laid bare long-existing – but not always obvious – economic, social, racial and health inequities.</p>
<p>“The pandemic magnifies the importance of this effort,” he said. “It brings a lens to the populations that have always been at risk, underserved and under-resourced. It highlights the pain of those populations, but also those several strata up now finding themselves in need of government services. On another level, it highlights the extremely fragile nature of our non-system systems to address these disparities.”</p>
<p>Stein acknowledged that the problems occupy a “gigantic space,” and that to be effective addressing disparities the effort demands sharing data across systems that traditionally have operated vertically. This approach is critical to getting a full picture of the influences affecting someone’s life, he said. He cited as an example a homeless man diagnosed with diabetes who is given medicine that needs refrigeration.</p>
<p>“He has no place to keep his meds, so it’s worthless,” he said. “You need to think across the stream.”</p>
<p>The National Action Agenda includes the development of seven workgroups organized around individual social determinants of health, including: food (hunger and access); neighborhood and physical environment; economic mobility; education; community and social context (race, integration); health care; and legal services. Each group will bring together academic researchers, community organizations, government entities and provider groups, among others. Additional activities include a webinar series led by former California Department of Public Health Director Karen Smith, a national symposium at Stanford University and a proof-of-concept implementation project.</p>
<p><a href="https://med.stanford.edu/profiles/david-rehkopf" target="_blank">David Rehkopf</a>, co-director of the Stanford Center for Population Health Sciences, said the collaboration sits perfectly with the center’s direction and mission.</p>
<p>“Our mission is to improve population health, and by publishing research papers we don’t do anything. We need to partner with others and bring people together. The innovative thing here is convening, to think through things to address problems. It’s a process of engagement and continuing to evaluate, to see what is working and not working with evidence from a variety of people.”</p>
<p>Rehkopf said individual policies and legislation can trickle down and affect massive improvements in health outcomes. He cited the impact of the federal and state Earned Income Tax Credit on reducing poverty, which he has for years studied and championed.</p>
<p>Both Rehkopf and Stein hope the collaboration among people from multiple sectors and with different backgrounds and voices will result in a handful of actionable recommendations that ultimately could be implemented to improve equity.</p>
<p>“Amid all the challenges going on right now there is an awareness and interest from a broader range of people to really work on issues of equity,” Rehkopf said. “Now is the time to do it and see what we can accomplish when we have this opportunity.”</p></div>Our COVID-19 Response: A Prescription for Enabling Real Progress on Health Equity – and a Request for Your Support to Make it Happen!https://hub.nic-us.org/blog/our-covid-19-response-a-prescription-for-enabling-real-progress-o2020-07-27T17:15:24.000Z2020-07-27T17:15:24.000ZHub Adminhttps://hub.nic-us.org/members/NIC<div><p>By <a href="https://hub.nic-us.org/members/DanielStein" target="_blank">Daniel Stein</a>, President, Stewards of Change Institute</p>
<p>As I digest the daily news about the coronavirus calamity, I’m reminded in a big way of our nation’s response to the last major public health emergency; i.e., the opioid epidemic. (It’s still with us, of course, and getting worse, but that’s a blog for another day.) A common denominator between these two crises is that the primary emphasis has been on saving lives, now and into the future. That, of course, is the right priority. </p>
<p>At the same time, however, it appears that once again we’re not seeing the “opportunity” that a major health crisis like the pandemic presents. That is, to seize the moment to make bold and systemic changes, ones that will enable us to make strides – and not just take small steps – to better detect, mitigate and otherwise get ahead of the next major threat to our collective health and well-being. The bottom-line idea is to ensure that the right information, in the right dose, gets to the right people, in the right way and at the right time. </p>
<p>Based on our 15 years of experience facilitating and advancing systems change, <a href="https://stewardsofchange.org/" target="_blank">Stewards of Change Institute (SOCI)</a> strongly believes there’s a highly achievable way our country can further that goal. Simply put, it’s to dramatically accelerate, integrate and leverage the concurrent implementation of both interoperability and the Social Determinants of Health and Well-Being. It’s the combination of those two approaches that’s the key, because we know for certain that they are effective ways of promoting progress in health, human services and other domains that impact all of our lives. </p>
<p><strong>Remediating Disparities and Driving Equity</strong></p>
<p>The value of finally, fully grasping the power of bringing together those approaches is that doing so will contribute to two huge advances at once: meaningfully remediating the racial, socioeconomic and health disparities that the pandemic continues to expose every day; while also building a more-effective, person-centered and equitable health/healthcare system, one in which collaboration and secure information-sharing with human/social services and other key domains becomes routine and expected. </p>
<p>We invite you – individually or through your organization – to join us in pursuing this mission by personally participating in, contributing financially to, or in other ways supporting <a href="https://hub.nic-us.org/groups/social-determinants/sdoh-action-agenda" target="_blank">SOCI’s new National Action Agenda to Advance Upstream Social Determinants and Health Equity</a>. We’re conducting this work through our <a href="https://nic-us.org/" target="_blank">National Interoperability Collaborative (NIC)</a>. </p>
<p>We’ve already assembled a growing team of highly respected researchers, subject-matter experts, technologists, policy and practice officials at all levels (community, state and federal), and other professionals across programs, systems and domains. And we would welcome your involvement in any of the workgroups that they’ve formed. Similarly, to make this work concrete, substantive and realistic (i.e., not just another well-intentioned plan that winds up on yet another shelf), we are actively seeking sponsorships, in-kind contributions and other financial support for this ambitious effort. <a href="https://nic-us.org/contact-us/become-a-sponsor/" target="_blank"><strong>Support our work >></strong></a></p>
<p><strong>Your Support Will Keep Our Vital Work Going</strong></p>
<p>I hope it’s clear that, even with limited resources, we’ve already been able to make significant progress this year. But like so many other nonprofits, our ability to move forward is being threatened every day by the economic upheaval in our country, and I think we can all agree that there’s so much left to do. We know there are many other highly impactful organizations also striving to achieve similar goals – systemic change and health equity – but we feel confident that our approach is not only unique, but also has the very real prospect of being successful. There’s only one way to find out, and that is to provide your support. So that is what we’re asking you to do now, and you’ll be in very good company.</p>
<p>For starters, there’s the Kresge Foundation, which enabled us to build NIC into the highly effective effort it is today. Then there are our sponsors/contributors for the Equity Action Agenda, which already include the <a href="https://mhsoac.ca.gov/" target="_blank">California Mental Health Services Oversight and Accountability Commission</a>, <a href="https://www.mitre.org/" target="_blank">Mitre Corporation</a>, the <a href="https://mihin.org/" target="_blank">Michigan Health Information Network (MiHIN)</a>, the Robert Wood Johnson Foundation’s <a href="https://dashconnect.org/" target="_blank">Data Across Sectors for Health (DASH)</a>, <a href="https://brighthive.io/" target="_blank">BrightHive Data Trusts</a> and <a href="https://www.feisystems.com/" target="_blank">FEI Systems</a>. And there are a growing number of additional supporters such as the <a href="https://www.pewtrusts.org/" target="_blank">Pew Charitable Trusts</a>, for which we’re conducting a civil justice technology project that will further broaden the Equity Action Agenda. </p>
<p>If you are part of an organization or philanthropy that focuses on the critically important issues we’re addressing, please consider joining this diverse group of supporters. If you need more information or have questions, please <a href="https://nic-us.org/contact-us/get-in-touch/" target="_blank">contact us</a>. Please read through the details of NIC’s <a href="https://nic-us.org/contact-us/become-a-sponsor/">sponsorship levels</a> to determine which one might be right for your organization and <a href="https://nic-us.org/contact-us/become-a-sponsor/" target="_blank"><strong>support our work >></strong></a> </p>
<p><strong>The Strategic, Integrated Elements of Our Unique Initiative include:</strong></p>
<ul>
<li>Our 14<sup>th</sup> National Symposium in early 2021, in collaboration with Stanford University’s Center on Population Health. This event will be the culmination of all the strategic, step-by-step activities outlined in this blog, and the symposium itself will focus on crystalizing, launching and, most importantly, implementing specific policy and practice actions. A few speakers to date – most of whom will also participate in the broader Action Agenda – include Dave Ross, CEO of the Taskforce for Global Health; Kshemendra Paul, Chief Data Officer for the U.S. Veterans Administration; Alfonso Lara Montero, Chief Executive of the European Social Network; Dr. Karen Smith, former Director of the CA Department of Public Health (who is co-leading the Action Agenda); David Rehkopf, Director of the Stanford Center for Population Health Studies; Pierre-Gerlier Forest, Director of the School of Public Policy at the University of Calgary; and Michael Wilkening, Special Advisor on Innovation and Digital Services to the Governor of CA; among others. </li>
<li>A Proof of Concept implementation, titled <a href="https://hub.nic-us.org/groups/project-unify" target="_blank">Project Unify</a>, to demonstrate that health-related data can be shared reliably and securely across Human Services and other domains critical to SDOH. The goal is to enable interoperability of a kind and to an extent that hasn’t been done before.</li>
<li>A webinar series focused on developing the Action Agenda and integrating it into the symposium; these interactive discussions are led by Dr. Smith, joined by our Stanford colleagues and other prominent thought leaders, innovators and subject-matter experts.</li>
<li>Collaboration with Stanford faculty (and others) to ensure this work is informed by research. Broad collaboration is also a fundamental element of the Equity Action Agenda because we believe that shaping additional research and activities is critical to ensuring this initiative grows into the future.</li>
<li>Outreach, advocacy and an ongoing <a href="https://hub.nic-us.org/groups/social-determinants" target="_blank">workgroup on the Collaboration Hub of SOCI’s National Interoperability Collaborative (NIC)</a>. We will also provide key learning/recommendations from the symposium, webinars and workgroup in a white paper, and will further extend this knowledge as a course in our new <a href="https://stewardsofchange.org/interoptimability-training-curriculum-certification-itcc-program/" target="_blank">InterOptimability Training and Certification Curriculum</a>.</li>
</ul>
<p>We are living in strange and unnerving times. But we unambiguously believe that we are being presented with a singular opportunity to instigate and implement fundamental, generational, historic change. With your help, participation and support, we feel deeply confident that it can happen. <a href="https://nic-us.org/contact-us/become-a-sponsor/" target="_blank"><strong>Support our work >></strong></a> </p>
<p> </p></div>ITCC, a New Training Program for a New Normal - Advancing Interoperability to Achieve Health Equityhttps://hub.nic-us.org/blog/itcc-a-new-training-program-for-a-new-normal-advancing-interopera2020-07-13T19:25:34.000Z2020-07-13T19:25:34.000ZHub Adminhttps://hub.nic-us.org/members/NIC<div><p>By <a href="https://hub.nic-us.org/members/DanielStein" target="_blank">Daniel Stein</a> </p>
<p><strong>InterOptimability Training and Certification Curriculum (ITCC)</strong></p>
<p><a href="https://stewardsofchange.org/itcc/" target="_blank"><img class="align-right" src="{{#staticFileLink}}6850716659,RESIZE_710x{{/staticFileLink}}" alt="6850716659?profile=RESIZE_710x" width="239" height="194" /></a></p>
<p>We’ve known for a long time that expanding interoperability and information-sharing across Health, Human Services, Education, Public Safety and other “domains” will enable more-effective responses to health emergencies such as the coronavirus pandemic, while also driving progress toward integrated, person-centered care. Today, it’s clear that the same approach will simultaneously contribute significantly to addressing racial and socioeconomic disparities and advancing health equity. </p>
<p>To help achieve all those objectives, <a href="https://stewardsofchange.org/" target="_blank">Stewards of Change Institute (SOCI)</a> is proud to introduce its <a href="https://stewardsofchange.org/itcc/" target="_blank">InterOptimability Training and Certification Curriculum</a>. ITCC is a first-of-its-kind program designed to further information-sharing and collaboration by providing organizations, teams and individuals with the knowledge, skills and tools to work more successfully within and across their increasingly complex and interconnected fields. ITCC achieves that goal through InterOptimability (think Interoperability + Optimization), a unique methodology that helps you further progress and sustainability by providing a common vocabulary, a shared body of knowledge, and effective methods and tools that support change. </p>
<p>ITCC utilizes an integrated, systems-level approach to prepare executives, program managers, supervisors and others in the public and private sectors to develop competencies needed to initiate, support and lead organizational change; facilitate data-exchange across silos; and leverage technical interoperability. </p>
<p><strong>Filling Today’s Fast-Changing Needs</strong></p>
<p>The need for ITCC is clearer now than it has ever been. That’s because, in addition to the other benefits of data-sharing and collaboration – to your own organization’s effectiveness and to systemically improve patient/client outcomes – they can also directly address the social justice issues that inhibit health equity. They do that by providing insights that highlight racial and socioeconomic disparities and their negative impact, as well as by offering timely information with which to make better, more-impactful decisions. In short, we believe improving interoperability will not only enable our country to respond more effectively to health crises, but will also contribute to meaningful racial and socioeconomic progress. </p>
<p>ITCC is the culmination of 15 years of knowledge that SOCI has accumulated through its work with thousands of government leaders, academic partners and industry experts in Health, Human Services, Education, Child Welfare, Public Health, Public Safety and additional domains that impact everyone’s health and well-being. We’re planning an interactive webinar to give you more details and to answer questions – so stay tuned! In the meantime, <a href="https://stewardsofchange.org/itcc/" target="_blank">learn more and register for the first course</a>. If you have any questions, please write to <a href="mailto:ITCC@stewardsofchange.org" target="_blank">ITCC@stewardsofchange.org</a>. </p>
<p><strong>Another New Initiative: Our Health Equity Action Agenda</strong></p>
<p>SOCI is committed to tackling health-related problems and promoting equality through all of our work. That’s explicitly the case with ITCC, and it’s at the core of another nascent SOCI effort: The <a href="https://hub.nic-us.org/groups/social-determinants/sdoh-action-agenda" target="_blank">National Action Agenda to Advance Upstream Social Determinants and Health Equity</a>. The leadership of this ambitious effort includes Stanford University’s Center on Population Health Sciences, as well as highly experienced subject matter experts such as Karen Smith, former Director of California’s Department of Public Health and other prominent thought leaders, innovators and change agents nationwide. </p>
<p>The Action Agenda encompasses a coordinated set of ambitious activities throughout this year and beyond, all designed to advance cross-sector data-sharing, interoperability and collaboration. The initiative’s elements include (but aren’t limited to): </p>
<ul>
<li>The Stewards’ 14<sup>th</sup> National Symposium in early 2021 with our Stanford University colleagues. It will be the culmination of all the Action Agenda’s integrated, strategic activities; the event itself will focus on crystalizing and implementing specific, actionable policies and practices at all levels.</li>
<li>A Proof of Concept, called <a href="https://hub.nic-us.org/groups/project-unify" target="_blank">Project Unify</a>, designed to demonstrate that health-related data can be shared reliably and securely across Human Services and other domains critical to SDOH. The goal is to enable interoperability of a kind and to an extent that hasn’t been done before.</li>
<li>Outreach, advocacy and ongoing workgroups on the <a href="https://hub.nic-us.org/" target="_blank">Collaboration Hub</a> of SOCI’s <a href="https://nic-us.org/" target="_blank">National Interoperability Collaborative (NIC).</a> The members of these multi-sector, multi-discipline groups already are helping develop our POC and symposium, as well as other parts of the Action Agenda. </li>
</ul>
<p>I’d like to express my sincere gratitude to the scores of NIC members who have been collaborating with us to further this ambitious effort. And, in particular, I want to thank the initial sponsors of the symposium and other parts of the Action Agenda: The Michigan Health Information Network, FEI Systems, the California Mental Health Services Oversight and Accountability Commission, and the San Francisco Federal Reserve. Please email me, <a href="mailto:daniel@stewardsofchange.org" target="_blank">daniel@stewardsofchange.org</a>, to learn how your organization can also join in and support this unique, important work.</p>
<p><strong>It took Stewards of Change more than 15 years to accumulate the knowledge, resources, experience and connections that we’re now bringing together in both ITCC and the Action Agenda. It took just a few months of a global pandemic to underscore just how important this work truly is – and can be. We now have the opportunity to do much more than just wait and see what the “new normal” in our country is going to look like; we believe we’ve got the wherewithal to help shape it. Please join us for the journey.</strong></p></div>NIC Webinars Continue – with Thanks to Presenters and a New Focus on Our Equity Action Agendahttps://hub.nic-us.org/blog/nic-webinars-continue-with-thanks-to-presenters-and-a-new-focus-o2020-06-22T19:39:54.000Z2020-06-22T19:39:54.000ZHub Adminhttps://hub.nic-us.org/members/NIC<div><p>By <a href="https://hub.nic-us.org/members/DanielStein" target="_blank">Daniel Stein</a> </p>
<p>When planning started for our weekly <a href="https://hub.nic-us.org/webinars" target="_blank">Let’s Get Technical webinars</a> about a year ago, we envisioned (and hoped for) at least a few dozen geekie professionals would participate each Friday. Today, with about 50 of these unique, discussion-focused events behind us, we’re delighted to report that as many as several hundred people have shown up for each of the 90-minute sessions, which we’re proud to say have contributed to the National Interoperability Collaborative’s mission by expanding learning and collaboration across a broad range of domains (Health, Human Services, Education, Public Safety, etc.). <a href="https://hub.nic-us.org/webinars" target="_blank"><strong>Check out slides, recordings, and more, from these 50 webinars >></strong></a> </p>
<p style="text-align:center;"><a title="In 1 Year! 50 Webinars | 5K+ Participants | 150+ Speakers" href="https://hub.nic-us.org/webinars" target="_blank"><img class="align-center" title="In 1 Year! 50 Webinars | 5K+ Participants | 150+ Speakers" src="{{#staticFileLink}}6212788654,RESIZE_710x{{/staticFileLink}}" alt="In 1 Year! 50 Webinars | 5K+ Participants | 150+ Speakers" width="710" /><br /> <span style="font-size:20px;color:#a5db19;line-height:1.5;">In 1 Year!<br /> 50 Webinars | 5K+ Participants | 150+ Speakers </span></a></p>
<p>On behalf of all of us at <a href="https://stewardsofchange.org/" target="_blank">Stewards of Change Institute (SOCI)</a>, which is <a href="https://nic-us.org/" target="_blank">NIC</a>’s nonprofit parent organization, I extend my deep thanks to all of my colleagues, old and new friends, and other supporters who have helped us organize these “deep dive” webinars. We’re particularly grateful to the scores of presenters who have made the time to lead conversations, answer questions, and stimulate activities during and after each one.</p>
<p><strong>About our 50th Webinar</strong></p>
<p>Last Friday’s webinar, "<strong><u><a href="https://hub.nic-us.org/events/convening-the-nation-to-solve-health-it-interoperability" target="_blank">The Sequoia Project: Convening the Nation to Solve Health IT Interoperability</a></u></strong>," was led by Sequoia CEO Mariann Yeager. <strong><a href="https://hub.nic-us.org/events/convening-the-nation-to-solve-health-it-interoperability" target="_blank">Check out the webinar's slides and recording >></a></strong></p>
<p>As with other NIC webinars that focused on the ONC’s National Accelerator initiatives, Sequoia has a goal – as the Recognized Coordinating Entity – to coordinate solutions that advance interoperability and integration activities, with particular focus on the Trusted Exchange and Common Agreement (TEFCA). These Accelerator programs hold great promise for developing a national infrastructure to enable bidirectional information flows that will not only enhance healthcare, but will also promote the integration of social determinants into the fabric of the nation’s HHS infrastructure. </p>
<p>That being said, I believe more attention is needed to ensure that the unique requirements for addressing SDOH factors (housing, nutrition, transportation, work, safety, education, etc.) need to be incorporated into the accelerator programs, so we don’t miss this unique opportunity to create systems that truly enable whole-person care across the spectrum of services. We look forward to contributing to this work and helping to embed SDOH into those inspiring national initiatives. </p>
<p><strong>A New Focus for NIC Webinars</strong></p>
<p>Starting in a couple of weeks, we’re going to resume our regular Friday webinar and shift its focus. We’ll still offer discussions/insights on a wide variety of topics relating to cross-sector information-sharing, and we hope you’ll join us for as many as possible. But we’ll also be highlighting an important theme in most of them: SOCI’s new <a href="https://hub.nic-us.org/groups/social-determinants/sdoh-action-agenda" target="_blank">Action Agenda for Advancing Upstream Social Determinants and Health Equity</a>. </p>
<p>We’re undertaking this ambitious initiative – along with scholars at <a href="http://med.stanford.edu/phs.html" target="_blank">Stanford University</a> and other organizational collaborators nationwide – because the need to implement systemic change in the U.S. has seldom been more apparent – and the opportunity to make meaningful progress toward that goal has rarely been greater. The intent of the Equity Action Agenda is to instigate and implement tangible, systems-level change across Health, Human Services, Education, Public Health, Public Safety and other domains that encompass the Social Determinants of Health and Well-Being. The need for doing so is starkly underscored by the racial and socioeconomic disparities being laid bare in our country every day. </p>
<p>The Equity Action Agenda encompasses a series of integrated, strategically coordinated elements throughout 2020 and beyond. They include:</p>
<ul>
<li>Our webinars, which will now primarily focus on developing the agenda and integrating it into a national symposium;</li>
<li>Our 14<sup>th</sup> National Symposium in early 2021, with our Stanford colleagues. This event will focus on crystalizing, launching and implementing specific policy and practice actions.</li>
<li><a href="https://hub.nic-us.org/groups/project-unify" target="_blank">Project Unify</a>, which is designed to demonstrate that health-related data can be shared securely across domains critical to SDOH to an extent that hasn’t been done before.</li>
<li>Collaboration with Stanford faculty (and others) to ensure this work is informed by research and so that this initiative continues and grows into the future.</li>
<li>Outreach, advocacy and a NIC Hub workgroup; key learning/recommendations in a white paper; and a course in our new <a href="https://stewardsofchange.org/interoptimability-training-curriculum-certification-itcc-program/" target="_blank">InterOptimability Training and Certification Curriculum</a>.</li>
</ul>
<p>Our Action Agenda’s specific, bottom-line objectives include: accelerating the integration of SDOH as an indispensable element of every domain’s efforts to streamline processes; focusing greater attention and resources on upstream activities; enhancing efficiency and reducing costs; and most vitally, improving outcomes, especially for the populations that are being disproportionately hurt by the pandemic.</p>
<p>Please <a href="https://hub.nic-us.org/groups/social-determinants/sdoh-action-agenda" target="_blank">join the team</a> if you want to participate in this unique effort. Meanwhile, feel free to share your input/questions in the comments section below, and/or by attending <a href="https://hub.nic-us.org/webinars" target="_blank">upcoming webinars</a>.</p>
<p> </p>
<p> </p></div>A Global Perspective on Corona-19: Moving Forward without a Roadmaphttps://hub.nic-us.org/blog/a-global-perspective-on-corona-19-moving-forward-without-a-roadma2020-06-15T15:56:48.000Z2020-06-15T15:56:48.000ZHub Adminhttps://hub.nic-us.org/members/NIC<div><p>By <a href="https://hub.nic-us.org/members/DanielStein" target="_blank">Daniel Stein</a></p>
<p>The assessment about Covid-19 from one of our presenters at <a href="https://hub.nic-us.org/events/global-perspectives-on-challenges-and-opportunities-from-covid-19" target="_blank">last week’s NIC webinar</a> was quite straightforward. <strong>“We don’t know what to do,” said <a href="https://hub.nic-us.org/members/PGFOREST" target="_blank">Pierre-Gerlier (PG) Forest</a></strong>, Director of the <a href="https://www.policyschool.ca/" target="_blank">School of Public Policy</a>, Calgary University. Against that stark but unsurprising backdrop, the 120-plus participants in the webinar went on to hear an array of important and insightful information.</p>
<p>Indeed, even as they agreed a clear path forward is still tough to see, all three presenters last Friday stimulated our thinking and provided significant ideas for possible next steps. Our other speakers were <a href="https://hub.nic-us.org/members/AlfonsoMontero" target="_blank">Alfonso Lara Montero</a>, Chief Executive Officer of the <a href="https://www.esn-eu.org/" target="_blank">European Social Network</a>, and <a href="https://hub.nic-us.org/members/KarenLSmith" target="_blank">Karen Smith</a>, former Director of <a href="https://www.cdph.ca.gov/" target="_blank">California’s Department of Public Health</a>. The webinar, which is available for replay if you missed it, was titled <a href="https://hub.nic-us.org/events/global-perspectives-on-challenges-and-opportunities-from-covid-19?context=past" target="_blank">“Global Perspectives on Challenges and Opportunities from Covid-19.”</a></p>
<p>What was clear from both our speakers and attendees was that it’s inevitable that pandemic cases will continue to increase everywhere. Karen was particularly concerned about the recent upsurge within the US, which she attributed in large parts to many states reopening “too early.” </p>
<p>Furthermore, all the presenters underscored that we are going to see long-term effects on people’s economic and mental stability, and we don’t know if health and human services systems are going to be able to keep up with this increase in demand. The challenge ahead was equally clear; that is, to make plans and take actions (even amid the uncertainty of the moment) that will enable the systems designed to help and protect people to better-prepare for the next major health crisis. </p>
<p>As Alfonso discussed his perspective on issues related to Covid-19, he shared that across all European countries, family networks are becoming weaker due to social isolation and the variety of difficulties people are facing as they try to access health and social services. This observation really stood out, because the problems he described in Europe are the same ones that the United States and Canada are facing. So, for all the differences among various nations and their approaches, it’s unmistakable that this really is a global problem – and we truly need to learn from each other in order to accelerate progress. </p>
<p>Attendees for the conversation last Friday, as is the case with our webinars every week, were highly engaged and provided their own important stories and insights. A few examples included:</p>
<ul>
<li>Many electronic health record platforms serve the global community. It would be helpful to identify existing assets to build upon and then address gaps among various countries.</li>
<li>Information needs to be coordinated and shared across healthcare, social services and emergency services.</li>
<li>A global forum on the Social Determinants of Health and Well-Being is needed now.</li>
</ul>
<p><strong>Let's Shape a National Equity Action Agenda to Advance Upstream SDOH</strong></p>
<p>The discussion made it clear that now more than ever, there’s a big need for a coordinated response between health <u>and</u> human services systems, as well as new research agenda to support that goal. For that reason and many others, <a href="https://stewardsofchange.org/" target="_blank">Stewards of Change Institute</a> – along with the <a href="http://med.stanford.edu/phs.html" target="_blank">Stanford University Center for Population Health Sciences</a> and additional organizational collaborators across the country – are creating a <a href="https://hub.nic-us.org/groups/social-determinants/sdoh-action-agenda" target="_blank">National Equity Action Agenda to Advance Upstream SDOH</a>. </p>
<p>The Action Agenda will include an integrated series of ambitious activities throughout this year and beyond, with the intention of advancing cross-sector data-sharing, interoperability and collaboration. We believe that this coordinated, strategic approach will not only contribute to a better response to health crises such as COVID-19, but will also advance person-centered care, broader health equity and social justice. Please <a href="https://hub.nic-us.org/groups/social-determinants/sdoh-action-agenda" target="_blank">join the team</a> if you want to participate in this unique effort. Meanwhile, feel free to share your input/questions in the comments section below, and/or by attending <a href="https://hub.nic-us.org/events" target="_blank">upcoming webinars</a>.</p>
<p> </p>
<p> </p></div>Project Unify – Updates From Person-Matching and Privacy & Security Workgroupshttps://hub.nic-us.org/blog/project-unify-updates-from-person-matching-and-privacy-security-w2020-06-01T18:19:42.000Z2020-06-01T18:19:42.000ZHub Adminhttps://hub.nic-us.org/members/NIC<div><p>By <u><a href="https://hub.nic-us.org/members/BrianDHandspicker" target="_blank">Brian D. Handspicker</a></u> </p>
<p>We really got into the weeds during <a href="https://hub.nic-us.org/events/geek-out-with-project-unify-a-deeper-dive-technical-session-on-ni" target="_blank">last Friday’s weekly NIC webinar</a>, discussing the challenges being tackled by our Project Unify workgroups on client/patient matching and privacy/security. The session’s presenters and discussion were spot-on for the objective that Unify is aiming to accomplish; that is, making it possible for information-sharing between Health and Human Services programs, systems and domains to take place to an unprecedented extent. </p>
<p>On behalf of <a href="http://stewardsofchange.org/" target="_blank">Stewards of Change Institute</a> and all of us working on the project, thanks again to the 190-plus participants in the webinar, which was fittingly titled <a href="https://hub.nic-us.org/events/geek-out-with-project-unify-a-deeper-dive-technical-session-on-ni" target="_blank">“Geek Out with Project Unify (Part 2): A Deeper Dive Technical Session on NIC’s Proof of Concept Project.”</a> Please join us for <a href="https://hub.nic-us.org/events/project-unify-part-3-report-from-the-interopathon-next-steps-and-" target="_blank">Part III</a>, which will begin at noon Eastern this coming Friday, June 5. <strong><a href="https://hub.nic-us.org/events/project-unify-part-3-report-from-the-interopathon-next-steps-and-" target="_blank">Register Now for Part III >></a></strong> </p>
<p>The presenters at <u><a href="https://hub.nic-us.org/events/geek-out-with-project-unify-a-deeper-dive-technical-session-on-ni" target="_blank">last week’s webinar</a></u> explored technical details of the project, including:</p>
<ul>
<li>an overview of Project Unify</li>
<li>discovering common patients/clients</li>
<li>supporting privacy and authorization best practice </li>
</ul>
<p><strong>Project Unify Overview</strong></p>
<p>For readers who don’t know much about Unify, it is a unique proof-of-concept demonstration designed to advance interoperability and information-sharing between Health and Human Services, as well as other domains – such as education, family courts, etc. – that impact health and well-being. <u><a href="https://hub.nic-us.org/members/KristineIMcCoyMDMPH947" target="_blank">Dr. Kristine McCoy</a></u>, Executive Director of the <u><a href="https://vnahg.org/" target="_blank">Visiting Nurse Association (VNA) Health Group</a></u>, and <a href="https://hub.nic-us.org/members/ArvinderSingh" target="_blank">Arvinder Singh</a>, CEO of Coherence Inc., discussed Unify’s goals, which include enabling a holistic, person-centered view of individuals and the services they receive. Meeting these goals will require supporting integration and interoperability across multiple information and policy domains. <strong><u><a href="https://hub.nic-us.org/groups/project-unify" target="_blank">Join Project Unify Group >></a></u></strong> </p>
<p><strong>Finding the Right Match</strong></p>
<p>Mark Vafiades, Senior Advisor at <a href="https://www.healthit.gov/topic/about-onc" target="_blank">Office of the National Coordinator</a>, initiated the discussion on Person-Matching by inviting webinar attendees to participate in the virtual “<a href="https://hub.nic-us.org/events/onc-working-session-patient-identity-and-matching" target="_blank">ONC Patient Identity and Matching Working Group</a>” on June 1st, 2020. </p>
<p><a href="https://hub.nic-us.org/members/RitaTorkzadeh" target="_blank">Rita Torkzadeh</a> and <u><a href="https://hub.nic-us.org/members/PradeepPodila" target="_blank">Pradeep S.B. Podila</a></u>, Public Health Information Fellow at the <u><a href="https://www.cdc.gov/" target="_blank">Centers for Disease Control and Prevention</a></u> then provided an update on the work of Unify’s Person-Matching Workgroup; that includes identification of clients/patients who may be matches; improving statistical confidence in matches; identity data linkage of high-confidence matches; and resolution of matching identity data inconsistencies. The following were identified as issues to address in future meetings:</p>
<ul>
<li>Identify matching algorithms, mechanisms and approached for more-successful, specific cross-domain applications</li>
<li>Explore or identify approaches and mechanisms to increase confidence/trust in the underlying matching framework through</li>
<li>Use of a Global Unique Identifier to promote confidence
<ul>
<li>Use of provenance of record creation</li>
</ul>
</li>
<li>Explore the use of non-federated and peer-to-peer identity-resolution frameworks</li>
<li>Identify governance templates to address operational, data and consent agreements</li>
<li>Draft "abuse cases" and other failure scenarios in which greater interoperability might create risks for vulnerable people and articulate design objectives to mitigate them<strong> </strong></li>
</ul>
<p><strong>Data Exchange Privacy Issues</strong></p>
<p><a href="https://hub.nic-us.org/members/ThomasSilvious" target="_blank">Tom Silvious</a>, Director of CSRA State and Local Solutions, and I provided an update on the work of Unify’s Privacy and Security Workgroup, including privacy requirements, varying legal requirements for multidomain privacy, and a discussion of static and dynamic authorization such as DS4P, Security Labels and Consent2Share. The following were identified as issues to address in future meetings:</p>
<ul>
<li>Cross-Domain Provenance – where does data come from so that Consent2Share can be requested?</li>
<li>Cross-Domain Trust – who defines trust relationships between organizations?</li>
<li>Trust Enforcement – how do we ensure that a domain receiving data abides by either static privacy mark requirements or Consent2Share requirements?</li>
<li>Data Ownership – beyond the question of consent, who owns the data, especially once in transition across domains with differing legal requirements?</li>
<li>Governance – what organization has responsibility for defining cross-domain data policies, procedures and rules? </li>
</ul>
<p><strong>Join the Project Unify Team</strong></p>
<p>If you’re interested in being a part of this exciting initiative, join <u><a href="https://hub.nic-us.org/groups/project-unify" target="_blank">Project Unify Group</a></u> by contacting its co-leader, <u><a href="https://hub.nic-us.org/members/DaveWalsh" target="_blank">Dave Walsh</a></u>. This collaborative group is looking for technical and subject-matter experts, developers, documenters and testers, along with anyone who just wants to gain a better understanding of how to provide interoperable, cloud-based solutions.</p>
<p>In our <a href="https://hub.nic-us.org/events/project-unify-part-3-report-from-the-interopathon-next-steps-and-" target="_blank">next webinar</a>, on June 5th, <strong>we’ll dive more deeply into the topic of confidentiality and privacy</strong>, and we’ll have an extended program that will include small-group discussions in online breakout rooms. <strong><a href="https://hub.nic-us.org/events/project-unify-part-3-report-from-the-interopathon-next-steps-and-" target="_blank">Register today >></a> </strong></p>
<p> </p>
<p style="text-align:center;"><span style="font-size:14pt;">Register for June 5th webinar, <strong><a href="https://hub.nic-us.org/events/project-unify-part-3-report-from-the-interopathon-next-steps-and-">“Project Unify (Part 3): Report from the InterOpathon, Next Steps and Additional Technical Components" >></a> </strong> </span></p>
<p style="text-align:center;"><span style="font-size:14pt;">Join <strong><a href="https://hub.nic-us.org/groups/project-unify" target="_blank">Project Unify Group >></a></strong></span></p>
<p> </p>
<p>Please share your comments/questions in the comments section below, and/or by joining in <a href="https://hub.nic-us.org/events" target="_blank">our upcoming webinars</a>. </p>
<p> </p>
<p> </p>
<p> </p></div>A Deep Dive on Project Unify: Bringing Together Health and Human Serviceshttps://hub.nic-us.org/blog/a-deep-dive-on-project-unify-bringing-together-health-and-human-s2020-05-26T14:36:37.000Z2020-05-26T14:36:37.000ZHub Adminhttps://hub.nic-us.org/members/NIC<div><p>By <a href="https://hub.nic-us.org/members/BrianDHandspicker" target="_blank">Brian D. Handspicker</a> </p>
<p>Inside joke: Based on the high level of enthusiasm and engagement in our <a href="https://hub.nic-us.org/events/project-unify-advancing-progress-on-building-cross-domain-interop" target="_blank">weekly webinar last Friday</a>, I’m proud to say that our proof-of-concept initiative, <a href="https://hub.nic-us.org/groups/project-unify" target="_blank">Project Unify</a>, is on FHIR! </p>
<p><strong>Insights From May 22nd Webinar</strong></p>
<p>More on that later. First, I want to thank the 230-plus participants in the discussion, which was a largely-technical update and brainstorming session titled <a href="https://hub.nic-us.org/events/project-unify-advancing-progress-on-building-cross-domain-interop" target="_blank">“Project Unify (Part 1): Advancing Progress on Building Cross-Domain Interoperability across Health and Human Services.”</a> Please join us for <a href="https://hub.nic-us.org/events/geek-out-with-project-unify-a-deeper-dive-technical-session-on-ni" target="_blank">Part II</a>, which will begin at noon Eastern this coming Friday, May 29. <strong><a href="https://hub.nic-us.org/events/geek-out-with-project-unify-a-deeper-dive-technical-session-on-ni" target="_blank">Register Now for Part II >></a></strong></p>
<p>Examples of the questions and comments from our team of presenters, as well as the attendees from across the U.S. and beyond, included the following: </p>
<ul>
<li>We know that formulas for identity matching (a critical component of Unify) are used in healthcare, and we know this approach will always result in some false positives and negatives. So why isn’t federated identity management considered? Can approaches from other interoperability accelerator projects be leveraged?</li>
<li>Can use-case scenarios be devised to examine potential negative repercussions of interoperability across domains? This question was raised because most use cases, including some that NIC is devising, are built on the premise that improved information-sharing and coordination leads to better outcomes.</li>
<li>There are so many state systems (ex., those related to Labor and Social Services) that are still running on COBOL programing language – and, as a result, will need federal support to move to 21st Century frameworks. The coronavirus pandemic has amplified the need to move this forward expeditiously!</li>
<li>Project Unify’s integrated framework will allow individuals/patients to access numerous streams of data that are being stored about them on a wide variety of different systems. Our attendees pointed to this part of the project as particularly important. </li>
</ul>
<p><strong>About Project Unify</strong></p>
<p>For readers who don’t know much about Unify, it is a unique proof-of-concept demonstration designed to advance interoperability and information sharing between Health and Human Services, as well as other domains – such as education, family courts, etc. that impact health and well-being. The ultimate goal is to enable a holistic, person-centered view of individuals and the services they receive. One of the information-sharing standards on which we’re focusing is the Fast Healthcare Interoperability Resources, or FHIR (ergo the inside joke at the start of this blog). <span style="font-size:10pt;"><strong><a href="https://hub.nic-us.org/groups/project-unify" target="_blank">Join Project Unify Group >></a></strong></span></p>
<p>The presenter’s at <a href="https://hub.nic-us.org/events/project-unify-advancing-progress-on-building-cross-domain-interop" target="_blank">last week’s webinar</a> discussed some of the benefits our project aims to provide by demonstrating that health, human services, education, and justice information systems can:</p>
<ul>
<li>discover common patients/clients</li>
<li>map and model data based on domain-specific data standards</li>
<li>exchange data among systems using domain-specific protocol standards</li>
<li>define content based on domain-specific vocabulary standards</li>
<li>implement exchanges based on security best practices</li>
<li>support privacy and authorization best practices </li>
</ul>
<p><strong>Project Unify Core Team Participants: Experienced, Diverse and Knowledgeable</strong></p>
<p>I’ll close by calling out our team of presenters, who did a terrific job of keeping attendees engaged for the entire 90-minute session. In particular, I’d like to thank <a href="https://hub.nic-us.org/members/KristineIMcCoyMDMPH947" target="_blank">Dr. Kristine McCoy</a>, Executive Director at <a href="https://vnahg.org/" target="_blank">Visiting Nurse Association (VNA) Health Group</a>, who is working with us to link Project Unify with the federal <a href="https://innovation.cms.gov/innovation-models/integrated-care-for-kids-model" target="_blank">Integrated Care for Kids (InCK) initiative</a>. Other presenters included <a href="https://hub.nic-us.org/members/DaveWalsh" target="_blank">Dave Walsh</a>, Unify’s co-leader; <a href="https://hub.nic-us.org/members/PradeepPodila" target="_blank">Pradeep S.B. Podila</a>, Public Health Information Fellow at the <a href="https://www.cdc.gov/" target="_blank">Centers for Disease Control and Prevention</a>; and <a href="https://hub.nic-us.org/members/SusanFox" target="_blank">Susan Fox</a>, Unify Engagement Community Manager. </p>
<p><strong>Join Project Unify Team</strong></p>
<p>If you’re interested in being a part of Project Unify’s efforts, join <a href="https://hub.nic-us.org/groups/project-unify" target="_blank">Project Unify Group</a> and contact <a href="https://hub.nic-us.org/members/DaveWalsh" target="_blank">Dave Walsh</a>. This collaborative group is looking for technical and subject-matter experts, developers, documenters and testers, along with anyone who just wants to gain a better understanding of how to provide interoperable, cloud-based solutions.</p>
<p> </p>
<p style="text-align:center;"><span style="font-size:14pt;">Register for May 29 webinar, <strong><a href="https://hub.nic-us.org/events/geek-out-with-project-unify-a-deeper-dive-technical-session-on-ni">“Project Unify (Part 2): A Deeper-Dive Technical Session on NIC’s POC Project" >></a> </strong> </span></p>
<p style="text-align:center;"><span style="font-size:14pt;">Join <strong><a href="https://hub.nic-us.org/groups/project-unify" target="_blank">Project Unify Group >></a></strong></span></p>
<p> </p>
<p><span style="font-size:10pt;">Please share your comments/questions in the comments section below, and/or by joining in <a href="https://hub.nic-us.org/events" target="_blank">our upcoming webinars</a>.</span></p>
<p><span style="font-size:10pt;"> </span></p></div>Responsible Data Sharing During (and After) a Pandemichttps://hub.nic-us.org/blog/responsible-data-sharing-during-and-after-a-pandemic2020-05-18T17:05:07.000Z2020-05-18T17:05:07.000ZHub Adminhttps://hub.nic-us.org/members/NIC<div><p>By <a href="https://hub.nic-us.org/members/DanielStein" target="_blank">Daniel Stein</a></p>
<p>Every day, the Covid-19 pandemic reinforces the need for responsible data-sharing across programs, systems and sectors at every level. At the same time, one potential upside of the crisis (if there can be such a thing) is that we may now have a unique opportunity to make real progress on filling that need.</p>
<p>As part of NIC’s commitment to improving health and well-being through better information-sharing, interoperability and collaboration – pointedly including by learning the lessons of the pandemic – we have embarked on a yearlong Action Agenda to instigate and implement real progress. And an important part of that agenda is our weekly webinar/discussion series, which focused last Friday on <a href="https://hub.nic-us.org/events/responsible-data-sharing-during-and-after-a-pandemic?context=past" target="_blank">“Responsible Data Sharing During (and After) a Pandemic.”</a></p>
<p>The webinar’s primary presenters were <a href="https://brighthive.io/" target="_blank">BrightHive</a> CEO <a href="https://hub.nic-us.org/members/MattGee" target="_blank">Matthew Gee</a> and the company’s Co-Founder and Head of Strategic Initiatives, <a href="https://hub.nic-us.org/members/NatalieEvansHarris" target="_blank">Natalie Evans Harris</a>. They led about 230 participants through a thoughtful conversation on what responsible data sharing meant before COVID-19 and what it means now. They also brought along guest speakers: Peter Sloan, Director of Research and Evaluation at <a href="https://tryingtogether.org/" target="_blank">Trying Together</a>; Michael Vente, Senior Director of Research and Data Governance at the <a href="https://highered.colorado.gov/" target="_blank">Colorado Department of Higher Education</a>; and Sara Jordan, Policy Council at the <a href="https://fpf.org/" target="_blank">Future of Privacy Foundation</a> – all of whom shared what the data-sharing experiences of their organizations and networks during the pandemic.</p>
<p><strong>The discussion broke down into four sections, which were 1) best practices in normal times; 2) starting from scratch in a crisis; 3) pivoting to meet urgent challenges; and 4) challenges unique to the pandemic.</strong> While BrightHive’s presenters covered these topic areas throughout the discussion, they also tailored the conversation by engaging participants in a discussion of how they are leading or participating in data sharing as it relates to Covid-19.</p>
<p>Among the encouraging, forward-thinking initiatives participants described were:</p>
<ul>
<li>Coordinating virus testing and reporting the results using Health Information Exchanges (HIEs).</li>
<li>Sharing data between departments of Education and Human services to increase EBT payments intended to replace school lunch programs.</li>
<li>Linking Homeless Management Information Systems with HIEs to improve transitions in care for Covid-19 positive homeless patients to shelter locations where they can socially distance.</li>
<li>Sharing data between CBO, early childhood providers and medical providers around the Social Determinants of Health and Well-Being.</li>
<li>Co-leading a coalition to expand Telehealth.</li>
<li>Strategizing how to conduct employee contact tracing and how it impacts workforce management.</li>
<li>Encouraging responsible data sharing between child welfare, substance use treatment and courts both at the case level (caseworkers/attorneys/service providers) and the systems level (policies that encourage data sharing among organizations for collaborative outcomes).</li>
</ul>
<p>These promising efforts show how data-sharing professionals are seizing the moment, given the current situation, and are moving the needle forward<strong>. That said, as this pandemic eventually eases or ends, how do we keep the momentum going? That was a looming question during last week’s webinar, particularly as it relates to convincing skeptics of data-sharing because of privacy concerns.</strong></p>
<p>Sara Jordan pinpointed this concern, saying that <strong>“privacy is a religion,” and the way many people think about it is tied to their core beliefs. So not everyone is going to be convinced that the data we’re asking them to share is going to actually remain private, but we can be governed by principles and policies that help people feel more comfortable about moving forward while addressing their very real concerns. And, necessarily, we should do so while continuing to be as transparent as possible.</strong></p>
<p>We hope and believe our weekly webinars/discussions contribute to those objectives. Moreover, through our broader <a href="https://hub.nic-us.org/groups/social-determinants/sdoh-action-agenda" target="_blank">Action Agenda</a>, we think it’s critical to keep driving progress – even during the pandemic – so that we’re ready to truly tackle challenges like racial disparities, socioeconomic mobility and health inequity when we get to the other side.</p>
<p>Please Stay tuned to our work and join NIC to participate in it if you can. In particular, be on the lookout later this year for a new course in our InterOptimability Training and Certification Curriculum that we’re constructing with BrightHive!</p>
<p style="text-align:center;"><span style="font-size:14pt;">Join <a href="https://hub.nic-us.org/groups/let-s-get-technical" target="_blank"><strong>Let's Get Technical Group >></strong></a></span></p>
<p style="text-align:center;"><span style="font-size:14pt;">Join <a href="https://hub.nic-us.org/groups/social-determinants" target="_blank"><strong>SDOH Group >></strong></a></span></p>
<p>Please share your comments/questions in the comments section below, and/or by joining in <a href="https://hub.nic-us.org/events" target="_blank">our upcoming webinars</a>.</p>
<p> </p>
<p> </p></div>Stewards of Change Issue Brief - Interoperability Insights: Demonstrating the Need and the Benefits of Connecting Health and Human Serviceshttps://hub.nic-us.org/blog/stewards-of-change-issue-brief-interoperability-insights-demonstr2020-05-13T17:12:15.000Z2020-05-13T17:12:15.000ZHub Adminhttps://hub.nic-us.org/members/NIC<div><p> </p>
<p>By <a href="https://hub.nic-us.org/members/BrianDHandspicker" target="_blank">Brian Handspicker</a></p>
<p>The <a href="https://stewardsofchange.org/" target="_blank">Stewards of Change Institute (SOCI)</a> has just released an important new <a href="https://hub.nic-us.org/resources/interoperability-insights-demonstrating-the-need-and-the-benefits" target="_blank">Issue Brief</a>, to which I contributed research and writing, titled “<a href="https://hub.nic-us.org/resources/interoperability-insights-demonstrating-the-need-and-the-benefits" target="_blank">Interoperability Insights: Demonstrating the Need and the Benefits of Connecting Health and Human Services</a>.” This paper examines the technical aspects of interoperability required to support integrated care and case management across multiple domains, including health, human services, education, housing, food and justice.</p>
<p>Such integration is being required for many national, regional, state and local initiatives, such as <a href="https://innovation.cms.gov/innovation-models/integrated-care-for-kids-model" target="_blank">Integrated Care for Kids (InCK)</a>, the ONC’s <a href="https://www.healthit.gov/topic/leading-edge-acceleration-projects-leap-health-information-technology-health-it" target="_blank">Leading Edge Acceleration Projects (LEAP)</a>, and a variety of multidisciplinary efforts by the Veterans Administration and Veterans Health Administration, the Visiting Nurses Association, United Way, and many others.</p>
<p>Multidisciplinary integration is especially critical today given the urgency of the coronavirus pandemic. This historic public health emergency clearly demonstrates the need to enable connections between social and health-related services to better assist a huge and growing number of people, most notably within racial and socioeconomic groups that were vulnerable even before the crisis arose.</p>
<p>The nation’s healthcare system, particularly for children, faces significant challenges in identifying and addressing risk factors for complex physical, behavioral and mental health conditions. That is largely because the earliest signs of a problem — such as chronic absenteeism, behavioral issues in school or problematic family situations known to child welfare programs — may present outside of clinical care. </p>
<p>To tackle these challenges, the InCK program proposes the integration of care coordination and case management across physical, behavioral and mental health, as well as other core services for children. Such coordination would enable more-holistic and -effective child- and family-centered care through enhanced information sharing, integration and infrastructure across a spectrum of service silos, including (but not limited to) health, mental health, child welfare, education and law enforcement.</p>
<p><a href="https://hub.nic-us.org/resources/interoperability-insights-demonstrating-the-need-and-the-benefits" target="_blank">SOCI’s Issue Brief</a> uses InCK, an initiative funded by the <a href="https://innovation.cms.gov/" target="_blank">Center of Medicare and Medicaid Innovation (CMMI)</a>, to illustrate the far-broader need for interoperability and information-sharing across programs, systems and domains. InCK’s work is in sync with another SOCI initiative, a unique Proof-of-Concept effort called <a href="https://hub.nic-us.org/groups/project-unify" target="_blank">Project Unify</a>, which is being created to demonstrate how information can be exchanged routinely, reliably and securely between the Health and Social Services domains, among others. </p>
<p><strong>The intent of both SOCI’s new paper and of the InCK initiative is basically the same, and it’s an important one: to provide practical guidance, tools and models that can be leveraged, replicated and improved over time to address the enormous and growing need for coordinated care across our nation.</strong></p>
<p><strong>About the author</strong> <br /> <br /> <a href="https://hub.nic-us.org/members/BrianDHandspicker" target="_blank">Brian Handspicker</a>, a key participant in Project Unify, is the Technical Lead for the <a href="https://www.niem.gov/" target="_blank">National Information Exchange Model (NIEM)</a> Health Community of Interest. He is a subject matter expert on mapping and modeling of information between clinical healthcare standards and non-clinical domains.</p>
<p> </p></div>Lessons from Our Other Health Crisis: The Opioid Epidemichttps://hub.nic-us.org/blog/lessons-from-our-other-health-crisis-the-opioid-epidemic2020-05-11T16:44:31.000Z2020-05-11T16:44:31.000ZHub Adminhttps://hub.nic-us.org/members/NIC<div><p>By <a href="https://hub.nic-us.org/members/DanielStein" target="_blank">Daniel Stein</a></p>
<p>Even amid the coronavirus tragedy, another major public health emergency continues unabated: our country’s opioid epidemic. So we decided it was important to focus on that topic during <a href="https://hub.nic-us.org/events/getting-evidence-into-practice-lessons-from-the-opioid-crisis" target="_blank">last week’s regular NIC webinar/discussion</a> with three officials of the <a href="https://www.ahrq.gov/" target="_blank">Agency for Healthcare Research and Quality</a>. AHRQ is a too-little-known federal agency that’s an important part of the Department of Health and Human Services.</p>
<p><strong>A key message from the presenters holds lessons for the U.S. response to Covid-19 as well; that is, we need to effectively move evidence into practice in order to fully address the crisis. In the case of opioids, that means both dealing with the addiction part of the problem and finding other ways to manage pain.</strong></p>
<p>The webinar was titled <a href="https://hub.nic-us.org/events/getting-evidence-into-practice-lessons-from-the-opioid-crisis" target="_blank">“Getting Evidence into Practice: Lessons from the Opioid Crisis,”</a> and the three AHRQ presenters were Medical Officer <a href="https://hub.nic-us.org/members/ElisabethKato" target="_blank">Elisabeth Uphoff Kato</a>, Staff Fellow Roland Gamache and Program Officer <a href="https://hub.nic-us.org/members/Suchitraiyer" target="_blank">Suchitra Iyer</a>. <strong>400 attendees from health, healthcare, social services and other public and private sectors and systems attended – a record high for our weekly webinar series!</strong></p>
<p>The stakes in learning the opioid epidemic’s lessons could hardly be higher. Indeed, the presenters agreed that if evidence had better-informed practice in the early days of that emergency, at least part of it could have been mitigated or avoided. They said that was because examining/analyzing all the opioid-related research and other evidence contributes to a more-accurate understanding of various treatments’ effectiveness and, more broadly, to better insights into the balance between harm and benefits.</p>
<p>In addition to hearing from our colleagues at AHRQ – whose mission is to improve the use of evidence – webinar attendees provided their own information and asked thoughtful questions, including:</p>
<ul>
<li>Remote physiologic monitoring can contribute to improved safety. For instance, this technology can warn providers, caregivers, emergency medical providers and the patients themselves if they are exhibiting signs of opioid-induced respiratory depression before it leads to overdose.</li>
<li>There is embedded bias in the administration of pain medications. For instance, research shows that some doctors administer different treatments for black and white patients because of the mistaken belief that they feel pain differently.</li>
<li>Systems seem too slow in reacting to patients’ needs. What’s the plan, an attendee asked, for providing genuinely patient-centered care that’s focused on health rather than pathology?</li>
<li>The CDC 2016 guidelines and all the policy/practice changes that followed dismissed the benefits of opioids, based on an AHRQ 2014 review of evidence related to their use. Yet the number of prescriptions for opioids has not diminished.</li>
</ul>
<p>One question that particularly resonated with webinar attendees was this: <strong>“As we look at the resources, methodologies and approaches that AHRQ is focused on now, what might be transferable or adaptable to the Human Services side as it relates to social factors and social determinants?”</strong> The presenters replied that AHRQ is currently conducting a number of projects related to the Social Determinants of Health and Well-Being (SDOH), including work with health and healthcare systems.</p>
<p><strong>A National SDOH Action Agenda</strong></p>
<p>We know there are clear linkages between SDOH and Opioid Use Disorder; the same is true between SDOH and Covid-19 -- which, for example, is taking a disproportionately higher toll on communities of color. To address these challenges and others as they relate to SDOH, NIC will be working with organizations such as the WIN Network, All-In, and many others across the country to develop a National <a href="https://hub.nic-us.org/groups/social-determinants/sdoh-action-agenda" target="_blank">Action Agenda</a> for Advancing SDOH. We invite you to join us for this exciting, multi-domain, multi-discipline initiative, which we’ll be rolling out throughout this year and beyond. </p>
<p><strong>Our AHRQ colleagues shared several resources during their webinar last week, including:</strong></p>
<ul>
<li><a href="https://hub.nic-us.org/resources/noninvasive-nonpharmacological-treatment-for-chronic-pain-a-compa" target="_blank">Noninvasive Nonpharmacological Treatment for Chronic Pain</a></li>
<li><a href="https://hub.nic-us.org/resources/opioid-treatments-for-chronic-pain-a-comparative-effectiveness-re" target="_blank">Opioid Treatments for Chronic Pain</a></li>
<li><a href="https://hub.nic-us.org/resources/nonopioid-pharmacologic-treatments-for-chronic-pain-a-comparative" target="_blank">Nonopioid Pharmacologic Treatments for Chronic Pain</a></li>
<li><a href="https://hub.nic-us.org/resources/clinical-decision-support-tools-and-components" target="_blank">Clinical Decision Support tools and components</a></li>
<li><a href="https://hub.nic-us.org/resources/cds-connect-pain-management-summary" target="_blank">CDS Connect: Pain Management Summary</a></li>
</ul>
<p> </p>
<p style="text-align:center;"><span style="font-size:18pt;">Join <a href="https://hub.nic-us.org/groups/opioid-epidemic" target="_blank"><strong>Opioid Prevention Group >></strong></a></span></p>
<p style="text-align:center;"><span style="font-size:18pt;">Join <a href="https://hub.nic-us.org/groups/social-determinants" target="_blank"><strong>SDOH Group >></strong></a></span></p>
<p> </p>
<p>Please share your comments/questions in the comments section below, and/or by joining in <a href="https://hub.nic-us.org/events" target="_blank">our upcoming webinars</a>.</p>
<p> </p></div>Building the Health Information Infrastructure – and Accelerating Progresshttps://hub.nic-us.org/blog/building-the-health-information-infrastructure-and-accelerating-p2020-05-04T18:18:51.000Z2020-05-04T18:18:51.000ZHub Adminhttps://hub.nic-us.org/members/NIC<div><p class="x_MsoNormal">By <a href="https://hub.nic-us.org/members/DanielStein" target="_blank">Daniel Stein</a></p>
<p class="x_MsoNormal">On May 1st, 2020, <a href="https://hub.nic-us.org/events/from-indiana-to-the-national-accelerators-covid-19-and-interopera" target="_blank">NIC webinar</a>, held in collaboration with Healthcare IT Connect was titled “Interoperability Insights” – and that’s exactly what the team of presenters provided. Specifically, they highlighted some of the key learning that’s taking place in the national initiatives – including Gravity, Da Vinci, Carin and FAST – that are part of the strategic efforts of the Office of the National Coordinator (ONC) to improve information sharing, interoperability, technology and information architecture. In addition, there was a presentation about <a href="https://hub.nic-us.org/groups/project-unify" target="_blank">Project Unify</a>, NIC’s proof-of-concept initiative that aims to link health, human services and other domains through a replicable, open-source API model. </p>
<p class="x_MsoNormal">The content of the webinar had originally been planned as an interactive session at the in-person HIT Connect Annual Conference, which unfortunately had to be postponed because of the coronavirus crisis (along with almost all other events). The good news is that we were able to adapt the session to provide many of its principal elements online. Alas, one thing we couldn’t do was present NIC’s almost-famous <a href="https://stewardsofchange.org/graphic-murals/murals-showcase/" target="_blank">Interoperability Mural Gallery</a>, which was going to be a highlighted feature of the in-person conference. </p>
<p class="x_MsoNormal">Over time, the initiatives discussed during the webinar will strengthen the nation’s capacity to share information and use it for data-driven decision-making to improve health outcomes, equity and operational effectiveness. Indeed, once these efforts are operational, they should help us to navigate many current challenges and to build technical resilience to address the effects of COVID-19 and other future emergencies. </p>
<p class="x_MsoNormal">We look forward to working with the ONC and its accelerator projects over time to ensure that, ultimately, we’ll have better systems to share actionable information across all relevant domains. We know that this will become even more important over time because the pandemic has already laid bare the many negative aspects of our current systems, notably including racial and socioeconomic inequities.</p>
<p class="x_MsoNormal"><strong>Related Discussions in the NIC Webinar Series:</strong></p>
<ul>
<li class="x_MsoNormal"><span style="font-size:10pt;"><strong>Gravity Project: </strong></span><span style="font-size:10pt;"><a href="https://hub.nic-us.org/events/overview-of-the-gravity-project-documenting-select-data-for-use-i">Documenting select data for use in medical systems to operationalize the social determinants of health</a></span></li>
<li class="x_MsoNormal"><span style="font-size:10pt;"><strong>Da Vinci Project: </strong></span><span style="font-size:10pt;"><a href="https://hub.nic-us.org/events/da-vinci-project-addressing-the-needs-of-the-value-based-care-com">Addressing the needs of the Value-Based Care Community by leveraging the HL7 FHIR platform</a></span></li>
<li class="x_MsoNormal"><span style="font-size:10pt;"><strong>Carin Alliance: </strong></span><span style="font-size:10pt;"><a href="https://hub.nic-us.org/events/The-Impact-of-Public-and-Private-Healthcare-Innovations">The Impact of Public and Private Healthcare Innovations</a></span></li>
<li class="x_MsoNormal"><span style="font-size:10pt;"><strong>FAST: </strong></span><span style="font-size:10pt;"><a href="https://hub.nic-us.org/events/getting-there-fast-barriers-and-solutions-for-adopting-fhir">Getting There FAST: Barriers and Solutions for Adopting FHIR</a></span></li>
</ul>
<p> </p>
<p class="x_MsoNormal" style="text-align:center;"><span style="font-size:12pt;"><strong>Project Unify's upcoming webinar, May 22, 2020. <a href="https://hub.nic-us.org/events/project-unify-advancing-progress-on-building-cross-domain-interop" target="_blank">Learn more and register >></a> </strong></span></p>
<p class="x_MsoNormal"> </p></div>We All WIN With These Measures and Insightshttps://hub.nic-us.org/blog/we-all-win-with-these-measures-and-insights2020-04-27T18:18:46.000Z2020-04-27T18:18:46.000ZHub Adminhttps://hub.nic-us.org/members/NIC<div><p>By <a href="https://hub.nic-us.org/members/DanielStein" target="_blank">Daniel Stein</a></p>
<p><strong>“Is there a way to begin to think about people, places, and the systems of society that drive health, well-being and equity outcomes?”</strong> That was the first question asked by Samova Saha (MD, MS) as she began her NIC webinar presentation last Friday, titled <a href="https://hub.nic-us.org/events/it-s-a-win-a-new-data-driven-approach-for-measuring-well-being?context=past">“It’s a WIN: A New, Data-Driven Approach for Measuring Well-Being.”</a> Soma is Executive Lead of the <a href="http://www.winnetwork.org" target="_blank">Well Being In the Nation (WIN) Network</a>, as well as Founder and Executive Lead of Well-being and Equity in the World (<a href="https://www.weintheworld.org" target="_blank">WE in the World</a>).</p>
<p><strong>That initial question set the tone for a highly engaging 90 minutes of learning that brought in 250-plus participants (a record for our weekly Friday webinar/calls!) and covered topics including WIN measures, what WIN is currently working on, and how WIN is assisting in the response to the COVID-19 pandemic.</strong></p>
<p>In a nutshell, WIN offers a set of common measures that were co-developed with over 100 organizations, federal agencies, and local communities. The measures cover domains and sub-domains related to the social determinants of health as they impact well-being and equity.</p>
<p><strong>One particularly important insight that Soma shared was this: “Out of the domains that relate to the well-being of people, places, and equity – it turned out that asking people how they felt about their own lives proved to be most important.” That’s an interesting point because it relates to the opportunities that individuals have in areas that significantly impact their lives, such as jobs, housing, and education.</strong></p>
<p>Soma’s presentation really hit home for participants, who responded with a broad range of questions that showed they were thinking concretely about how WIN’s work applies to their own. A few examples:</p>
<ul>
<li>How granular are these measures? Are they more granular than others that are widely used (e.g., zip codes and census)?</li>
<li>Can these be used to understand child well-being? Or is there another measure for children?</li>
<li>Was there any cross-check with Electronic Health Records and/or other clinical measures?</li>
</ul>
<p>Soma’s replies not only provided guidance for participants’ use of the WIN measures, but also helped steer the conversation to the urgent topic of COVID-19; specifically, she discussed how Delaware is utilizing WIN measures to help the state deal better with the mental health and addiction issues of its residents. That conversation also generated numerous comments and questions, including:</p>
<ul>
<li>Can the WIN metrics be used to improve the process of triaging resources, testing, and care-giving during the pandemic, for instance for jurisdictions wrestling with the distribution of Personal Protective Equipment?</li>
<li>What might the uses be for other stakeholders, such as law enforcement personnel and policy-makers, many of whom may have “compassion fatigue?”</li>
<li>Are there ways to better-determine the contributions specific programs and interventions can make to improve well-being? And can we come to a “common” understand of “well-being?”</li>
<li>Is there a need for a nationally sanctioned, locally instituted strategy to prevent, mitigate, and ameliorate the social mobility and isolation challenges of families in every community?</li>
</ul>
<p><strong>The engagement spurred by all these questions made for a rich conversation and underscored that now, more than ever, there’s a real need to instigate and implement realistic, systems-level change in public health. It’s because of this need that NIC is creating a <a href="https://hub.nic-us.org/groups/social-determinants/sdoh-action-agenda" target="_blank">National Social Determinants Policy Action Agenda</a>, which we believe is long overdue. </strong>As befits NIC’s name and mission, this ambitious initiative is designed to be highly collaborative, including by working with organizations such as the WIN Network, All-In, and many others across the country. We invite you to join us for this exciting, multi-domain, multi-discipline, coordinated effort that will roll out throughout this year and beyond. </p>
<p>Soma referenced <a href="https://hub.nic-us.org/resources/well-being-in-the-nation-win-measurement-framework" target="_blank">Well-being In the Nation (WIN) Measurement Framework</a>, during her presentation. She also shared two articles, “<a href="https://www.healthaffairs.org/do/10.1377/hblog20190626.126395/full/" target="_blank">Will the Federal Data Strategy Help Communities Win</a>” and “<a href="https://www.healthaffairs.org/do/10.1377/hblog20200102.85377/full/" target="_blank">Moving to a Learning Management System</a>.”</p>
<p>Please share your comments/questions in the comments section below, and/or by joining in <a href="https://hub.nic-us.org/events" target="_blank">our upcoming webinars</a>.</p>
<p> </p></div>The Pandemic Puts More Children at Risk of Abuse. Where’s the Aid for Them?https://hub.nic-us.org/blog/the-pandemic-puts-more-children-at-risk-of-abuse-where-s-the-aid-2020-04-23T14:41:23.000Z2020-04-23T14:41:23.000ZAdam Pertmanhttps://hub.nic-us.org/members/AdamPertman<div><p>By Adam Pertman</p><p>Senior Consultant, Stewards of Change Institute</p><p>The coronavirus crisis has put children in foster care – and those who need to be there – at serious risk in numerous, unnerving ways. To date, however, they and their families have barely been mentioned as potential victims of the pandemic, and the federal government has done too little to help them. That has to change as quickly as possible, either with targeted resources in the next economic stimulus bill or in separate legislation explicitly designed to assist the millions of people in this particularly vulnerable population.</p><p>Here’s the starkest example of the harm many professionals fear is already occurring: that an unknowable number of these girls and boys are being physically or emotionally injured today, right now, as you read this. But some are not being removed from their abusers’ homes because social workers (like many other people nationwide still trying to do their jobs) are stymied by a lack of resources; because the reporting of suspected abuse and neglect cases is dropping as would-be reporters hunker down and tend to their own concerns; and because some workers can’t leave their own homes, even to investigate complaints of child maltreatment.</p><p>To make matters worse, mental health professionals agree the mistreatment of children increases during periods of high stress. And we all know that we’re not only living in such a period, but also that it will more stressful for some time. Now add to this reality the fact that children’s emotional and physical injuries are very often detected and reported by teachers and other personnel in school; that families struggling to care for children with special needs aren’t receiving critical services and supports; that recruitment and training of foster and adoptive families are at a standstill; and that these are only a few examples of the unfolding tragedies that child welfare, medical, mental health and other practitioners are seeing in every community of every state nationwide.</p><p>It’s a formula for disaster for a population that was already vulnerable before this historic public health calamity began, and it will have equally far-reaching consequences for our country more broadly, because the personal, economic and social impact will ripple throughout society if we don’t start responding soon.</p><p>As a start, a broad coalition of local, state and national organizations that focus on child welfare – including the National Center on Adoption and Permanency, which I lead – has submitted a<a href="https://8d4423aa-ca00-43b9-b7fd-96d7d923616b.filesusr.com/ugd/1c1829_56799d7215c040ffaf56dc9f92dbfaab.pdf?index=true"> letter to congressional leaders</a> in both houses calling for legislation that would provide billions of additional federal dollars to take specific actions that include:</p><ul><li>Supporting families to keep children safe through activities such as bolstering locally driven prevention programs and diminishing the need for out-of-home placements;</li><li>Strengthening response and intervention systems by increasing funding to find relatives to care for children, to provide technology and protective resources for workers so they’re safe when they assist families, and to mitigate the pandemic’s impact on child welfare courts;</li><li>Addressing the needs of older youth already in or transitioning out of foster care by giving states additional money and flexibility in areas such as jobs, housing and financial support.</li></ul><p>As lawmakers and the president set their priorities during the coming days and months, they need to know that this is not a small, niche group looking for its share of federal largess during tough times. Here, with statistics from Child Trends, is a glimpse of the population that needs our attention and assistance:</p><ul><li>7 million infants, toddlers and children with disabilities who, with their families, are struggling with the sudden absence of health services and learning accommodations; another 43,000 are youth living in juvenile justice facilities, where social separation is tough to achieve;</li><li>8 million children being cared for by grandparents and others who are elderly – that is, adults at increased risk of complications associated with the coronavirus;</li><li>Almost a half-million children (most with special needs) living in foster homes, some with families unprepared for long-term placements and others waiting to return to their parents;</li><li>5 million children living with at least one unauthorized immigrant parent, meaning high stress and a lower likelihood of their families applying for social services or having health insurance.</li></ul><p>Legislative action is needed ASAP to start helping these children and families, but far more also must be done. Indeed, a strategy has to be developed to deal with the longer-term, transformative effects that the pandemic will inevitably have on the child welfare system – as it will on so many others.</p><p>First, however, immediate problems have to be addressed. Children being abused and neglected, from coast to coast, is an urgent one. Congress and the President simply have to step up. Now.</p><p><em>Adam Pertman, working from home in Massachusetts, is a Senior Consultant to Stewards of Change Institute and the National Interoperability Collaborative. He is also President of the National Center on Adoption and Permanency. Also contributing to this commentary were NCAP team members Allison Maxon Davis, Carol Bishop, Laura Ornelas and Ron Huxley in California; Carol Biddle in Georgia; Susan Livingston Smith in North Carolina; Jeanne Howard in Illinois; and Lynn Gabbard in Connecticut.</em></p></div>A Call to Action by Public Libraries: Advancing the Health of Communitieshttps://hub.nic-us.org/blog/a-call-to-action-by-public-libraries-advancing-the-health-of-thei2020-04-06T19:28:53.000Z2020-04-06T19:28:53.000ZHub Adminhttps://hub.nic-us.org/members/NIC<div><p>By <a href="https://hub.nic-us.org/members/DanielStein" target="_blank">Daniel Stein</a></p>
<p>What comes to mind when you think of public libraries? Do you perceive them as just a source of books or something more? Are they an important component of community life? Most pointedly, can they play a significant role in combatting a public health crisis?</p>
<p>Those were among the questions addressed during April, 3rd, 2020 NIC webinar/discussion, which was titled <a href="https://hub.nic-us.org/events/call-to-action-public-libraries-and-the-opioid-crisis?context=past" target="_blank">Call to Action: Public Libraries and the Opioid Crisis</a>. The presenters were <a href="https://hub.nic-us.org/members/LarraClark" target="_blank">Larra Clark</a>, Deputy Director for both the <a href="http://www.ala.org/pla/" target="_blank">Public Library Association (PLA)</a> and the <a href="http://www.ala.org/" target="_blank">American Library Association’s (ALA)</a> Public Policy and Advocacy Office; and <a href="https://hub.nic-us.org/members/KendraMorgan" target="_blank">Kendra Morgan</a>, Senior Program Manager of <a href="https://www.webjunction.org/home.html" target="_blank">WebJunction</a>.</p>
<p>Larra and Kendra explained that there are over 17,000 library locations nationwide, providing millions of programs and drawing 1.3 billion visitors each year (though not in 2020, for obvious reasons). Those numbers clearly illustrate that libraries are a highly accessible, trustworthy and extensive resource; most pointedly, they clearly are very well-used.</p>
<p>With that core understanding, <a href="https://www.oclc.org/en/home.html" target="_blank">OCLC</a> and <a href="http://www.ala.org/pla/" target="_blank">PLA</a> have worked together on research relating to how public libraries have supported their communities throughout the opioid crisis and how they are also partnering with organizations to support and meet the health needs of their communities. Based on their research, OCLC and PLA have created a <a href="https://hub.nic-us.org/resources/summary-report-public-libraries-respond-to-the-opioid-crisis-with" target="_blank">Call to Action report</a> to address key question/concerns and to assist libraries in moving forward. The Call to Action focuses on:</p>
<ul>
<li>Exploring community data</li>
<li>Community assets and connection with partners</li>
<li>Increasing awareness and knowledge of the issues among staff and the community</li>
<li>Library staff care</li>
<li>Offering community engagements and programming options</li>
</ul>
<p>Many of the 90-plus participants in last Friday’s NIC conversation were aware of the opioid-related role for libraries, and some shared that they’d provided opioid education presentations and Narcan trainings at their own local libraries. More broadly, participants shared their perspectives on what public libraries meant to them and how they utilized them. While there was a broad range of responses on frequency of usage, everyone had positive things to say, pointing out that public libraries provide: a safe space, a place for community gatherings, research and information, lots of books, and a place for children.</p>
<p>Larra and Kendra also shared the findings from their research, which involved case studies at eight sites. The studied programs and services included opioid public awareness campaigns, training on first aid and administering Naloxone, and providing life skills training for recovering opioid users. All these supports increased community resources and services, developed new partnerships, increased awareness, and positively impacted patrons’ lives; they also provided an opportunity for further learning and next steps.</p>
<p>Larra and Kendra stressed there are specific issues libraries must address so they can continue this work in the future. The stigma around substance use disorder and funding were two primary examples. In their research, Larra and Kendra said many libraries and their partners shared that some communities are concerned about providing substance use disorder programs, and some people who need help are afraid to ask for it. Additional issues, and some questions that arose about them last Friday included:</p>
<ul>
<li>With the variety of programs and services that public libraries are offering, are they considered “essential” during this coronavirus pandemic and forced to remain open?</li>
<li>Naloxone is effective, but is library access considered an effective strategy for reaching people who use opioids or is it more effective for reaching family and friends of opioid users?</li>
<li>Does raising awareness, which is one of the approaches that libraries utilize, help to ease the stigmatization around opioid use?</li>
<li>Can libraries highlight that genetics account for about half a person’s risk of addiction?</li>
</ul>
<p>NIC is a Community of Networks that strives to bring together individuals and organizations that are working to share information and shape collaborations on issues relating to health and human services. The library associations fit that description to a tee, which is why we invited them to present during one of our regular Friday discussions – and to join NIC’s efforts more broadly.</p>
<p>Please share your thoughts, questions and/or ideas by writing to <a href="mailto:nic@stewardsofchange.org">nic@stewardsofchange.org</a>, by joining in our <a href="https://hub.nic-us.org/events">upcoming webinars</a>, or by participating in one of our initiatives.</p>
<p><strong> </strong></p>
<p><strong><a href="https://hub.nic-us.org/resources/summary-report-public-libraries-respond-to-the-opioid-crisis-with" target="_blank">Learn more about the resources</a> that our presenters shared during April, 3rd, 2020 webinar.</strong></p>
<p> </p></div>A Need for Collaboration – and an Agenda for Progress – at a Time of Isolationhttps://hub.nic-us.org/blog/a-need-for-collaboration-and-an-agenda-for-progress-at-a-time-of-2020-04-01T13:54:11.000Z2020-04-01T13:54:11.000ZHub Adminhttps://hub.nic-us.org/members/NIC<div><p>By <a href="https://hub.nic-us.org/members/DanielStein" target="_blank">Daniel Stein</a></p>
<p>As daily life changes for everyone, we are all learning how to function in different, more-flexible ways. It is a learning exercise that feels – and often is – both individual and isolating. There’s an additional way to look at the lessons of the coronavirus crisis, however, and the title of last Friday’s (3/27/20) NIC <a href="https://hub.nic-us.org/events/collaborating-to-deal-with-today-while-preparing-for-tomorrow">webinar/discussion</a> describes it: “Collaborating to Deal with Today – While Preparing for Tomorrow.”</p>
<p>In a nutshell, the 90-plus participants in our weekly online conversation focused on how organizations – governmental, commercial and nonprofit – can more-effectively work together to address the pandemic’s devastating impact. At least as importantly, we also looked forward, brainstorming ideas for how we can collaborate to establish policies and practices that put a greater emphasis on prevention, early detection and other “upstream” approaches to deal with future public health emergencies.</p>
<p>One point of consensus was that greater integration of the Social Determinants of Health and Well-Being (SDOH) will significantly contribute to achievable, tangible progress on all counts. That belief – make that understanding – is also at the heart of Stewards of Change Institute’s (SOCI) new <a href="https://hub.nic-us.org/groups/social-determinants/sdoh-action-agenda" target="_blank">National Policy Action Agenda</a>, a multifaceted initiative that will shape systems-change recommendations throughout this year and then work to instigate their implementation into the future.</p>
<p>Examples of the other concepts explored during last Friday’s conversation include:</p>
<ul>
<li><a href="https://hub.nic-us.org/members/KarenLSmithMDMPH" target="_blank">Karen Smith</a>, former Director of California’s Department of Public Health and a leader of SOCI’s Action Agenda initiative, explained that building resilience at the community level is vital. Doing so, she added necessitates a better understanding and integration of SDOH.</li>
<li><a href="https://hub.nic-us.org/members/RobertTagalicod" target="_blank">Robert Tagalicod</a>, Senior Advisor in the U.S. Department of Health and Human Services, suggested that the Centers for Disease Control and Prevention should create a health threat data network, leveraging and connecting networks that are already in place.</li>
<li><a href="https://hub.nic-us.org/members/UmaAhluwalia" target="_blank">Uma Ahluwalia</a>, a Principal with Health Management Associates and a former Maryland county HHS Director, focused on the toll of the pandemic on child welfare and on the role of technology, pointing out that telemedicine is mature in healthcare but not human services.</li>
<li><a href="https://hub.nic-us.org/members/PGFOREST" target="_blank">Pierre-Gerlier Forest</a>, Director of Calgary University’s School of Public Policy, said the wall between health and human services in the U.S. fuels socioeconomic inequality, disparate health-related outcomes, and inadequate information-sharing that could promote progress.</li>
</ul>
<p>We conducted two informal polls during the course of last week’s webinar to gauge the impact of the COVID-19 crisis on the participants’ professional lives. Over half said it has already had a moderate to severe impact, and even more said the harm to their work would be even more severe if the crisis continues for several months. That was the unsurprising but disheartening bad news.</p>
<p>The more potentially positive news was that participants agreed this public health crisis may also be creating a climate in which individuals and organizations will be more amenable to improving interoperability, information-sharing and incorporation of SDOH. Another bright light, many added, is that they have been able to partner with local public health agencies to support the coronavirus response and have implemented disaster-management plans that helped move a majority of state employees to work from home and continue to manage all of their programs remotely.</p>
<p>Additional issues were discussed in the context of collaboration, as well as whether SOCI’s current Proof of Concept initiative – called <a href="https://hub.nic-us.org/groups/project-unify">Project Unify</a> – could contribute to solutions. The questions included:</p>
<ul>
<li>Since it is believed that the coronavirus may become seasonal, how can data from the pandemic be used to prepare for future health crises or to inform when people can safely return to work?</li>
<li>How can we prepare for the possibility that vulnerable populations, such as people with asthma, will be at greater risk if the C-19 crisis continues during natural disasters such as wildfires?</li>
<li>What improvements can be made to telehealth so this technology is available to more people (such as in rural areas) as well as for more purposes, including mental health and child welfare?</li>
<li>Probably most importantly, even as we combat the pandemic, how do we learn the vital lessons we need – relating to data and capabilities – to better-address the next disaster?</li>
</ul>
<p>It’s important to keep the conversation going and to support each other during this crisis. Please share your thoughts, questions and/or ideas with us by writing to <a href="mailto:NIC@stewardsofchange.org">NIC@stewardsofchange.org</a>, by joining in our <a href="https://hub.nic-us.org/events">upcoming webinars</a>, or by participating in one of our initiatives. Most importantly, please stay safe.</p>
<p>Learn more about the national symposium, webinar series, publications, NIC Collaboration Hub workgroups and other activities that compose our Action Plan, as well as how you can get involved, in <a href="https://hub.nic-us.org/blog/lessons-from-the-coronavirus-crisis-a-call-to-arms-for-real-actio">this blog</a> and <a href="https://hub.nic-us.org/events/collaborating-to-deal-with-today-while-preparing-for-tomorrow">this webinar</a>. <a href="https://nic-us.org/" target="_blank">NIC</a> is a project of <a href="https://stewardsofchange.org/" target="_blank">SOCI</a>.</p></div>When It Comes to SDOH, American Exceptionalism (Alas) is the Exceptionhttps://hub.nic-us.org/blog/when-it-comes-to-sdoh-american-exceptionalism-alas-is-the-excepti2020-03-23T20:26:19.000Z2020-03-23T20:26:19.000ZHub Adminhttps://hub.nic-us.org/members/NIC<div><p>By <a href="https://hub.nic-us.org/members/PGFOREST" target="_blank">Pierre-Gerlier Forest</a> </p>
<p>One factor that is often overlooked when considering the role of the Social Determinants of Health and Well-Being (SDOH) is American exceptionalism.</p>
<p>Most other advanced democracies have already attempted to integrate health policy and other sectors of social policy. Some have done it in the name of social cohesion, others have sought to facilitate the participation of all citizens in economic and social life, and yet others have finally recognized care and good health as social rights.</p>
<p>The situation in the United States is unique because of the wall that exists between health and social policy. The former is consuming close to 18 percent of U.S. GDP and, despite its terrible shortcomings, is a global symbol of medical prowess and innovation. Meanwhile, the latter is underfunded and underserviced as we can clearly see – unfortunately – during the current coronavirus crisis.</p>
<p>Social policy is identified with the mitigation of racial disparities and poverty within a political culture that tends to dismiss the advantages attached to the universal provision of social benefits. The U.S. is also known for the fragmentation of authority among multiple public institutions, starting with social and health programs at the federal, state and local levels.</p>
<p>The benefits of reconciling health and social programs far exceed the costs and inconvenience of disrupting entrenched habits. The United States could finally acquire the capacity to curb the cost curve by addressing the root causes of ill health and bad outcomes. Integration would also help invigorate the social mechanisms favoring individual advancement and mobility, which have been stalled for decades.</p>
<p>This social process, in fact, is self-improving, with each experiment contributing to our understanding of the connection between social pathways and population wellness. The work of the National Interoperability Collaborative – in particular its current initiative to develop a National Action Agenda on SDOH – aims to not only improve understanding, but to fuel genuine progress.</p>
<p><strong>Related posts:</strong></p>
<ul>
<li><strong>Blog:</strong> <a href="https://hub.nic-us.org/blog/lessons-from-the-coronavirus-crisis-a-call-to-arms-for-real-actio">Lessons from the Coronavirus Crisis: A Call to Arms for Real Action on the Social Determinants</a></li>
<li><strong>Discussion: </strong><a href="https://hub.nic-us.org/groups/social-determinants/forum/shaping-an-sdoh-public-health-agenda">Shaping an SDOH Public Health Agenda</a></li>
<li><strong>Past Webinar: </strong>Karen Smith & PG Forest - <a href="https://hub.nic-us.org/events/creating-an-agenda-for-sdoh-in-public-health-it-s-not-just-about-" target="_blank">The Coronavirus: An Unfolding Case Study on the Need for a Public Health SDOH Agenda</a></li>
<li><strong>Upcoming Webinar: </strong>03/27/2020 - NIC Open House - <a href="https://hub.nic-us.org/events/collaborating-to-deal-with-today-while-preparing-for-tomorrow">Collaborating to Deal with Today – While Preparing for Tomorrow</a></li>
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<td style="padding:5px;text-align:center;vertical-align:middle;"><a style="color:#ffffff;" href="https://hub.nic-us.org/groups/social-determinants" target="_blank"><span style="font-size:20px;color:#ffffff;line-height:1.5;">Join SDOH GROUP!</span></a></td>
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</table></div>Moving toward a national health information exchange systemhttps://hub.nic-us.org/blog/moving-toward-a-national-health-information-exchange-system2020-03-19T18:44:37.000Z2020-03-19T18:44:37.000ZPaul Wormelihttps://hub.nic-us.org/members/PaulWormeli<div><p>While we have made progress through new technology and federal rules toward making a national health information exchange system a reality, just about everyone who works in this space knows we have “miles to go before we sleep”. There are indeed local HIE’s that are quite successful, but few major operational state HIE’s and not a true national HIE system the likes of which we wished for when this work started. Now Niam Yaraghi writes in an article published by the Brookings Institution that maybe the Covid-19 epidemic will show us how important this really is and give impetus to the will to make it a reality<a>[1]</a>. </p><p>Part of what we are learning from the shortcomings of our ability to exchange information is that this is not just about health data alone and that more complete information exchanges are needed to inform decision-making about isolation as well as treatment during the Covid-19 crisis. If there were in place the kind of national health information exchange that also included things like travel information and social-determinants or related demographic data, we might be able to make decisions faster and better, or spot trends in population groups that need attention. </p><p>Yarashi argues that: </p><p>“A nationwide health information exchange could prove to be vital for early identification and even prediction of the centers of the epidemics. Such a system could enable the government to quarantine smaller areas before the virus spreads, or to efficiently allocate rare medical resources such as N-95 masks or test kits to providers in areas that are most likely to be at the center of the epidemic. Despite its benefits, the U.S. is still very far from having such an information network.” </p><p>As a nation, we should pay attention to the gaps in the availability of the information needed to make decisions at every level of wellness, and the need to integrate health, human services and other data in such an exchange capability. This epidemic should enlighten us about what we have yet to do and inspire us to make it so.</p><p> </p><p>Paul Wormeli<br />Board of Directors<br />Stewards of Change Institute </p><p> </p><p><a>[1]</a> <a href="https://www.brookings.edu/blog/techtank/2020/03/13/the-u-s-lacks-health-information-technologies-to-stop-covid-19-epidemic/">https://www.brookings.edu/blog/techtank/2020/03/13/the-u-s-lacks-health-information-technologies-to-stop-covid-19-epidemic/</a></p></div>Lessons from the Coronavirus Crisis: A Call to Arms for Real Action on the Social Determinantshttps://hub.nic-us.org/blog/lessons-from-the-coronavirus-crisis-a-call-to-arms-for-real-actio2020-03-17T21:30:02.000Z2020-03-17T21:30:02.000ZHub Adminhttps://hub.nic-us.org/members/NIC<div><p>By <a href="https://hub.nic-us.org/members/DanielStein" target="_blank">Daniel Stein</a>, <a href="https://hub.nic-us.org/members/KarenLSmith" target="_blank">Karen Smith</a> and <a href="https://hub.nic-us.org/members/PGFOREST" target="_blank">Pierre-Gerlier Forest</a> </p>
<p><a href="https://hub.nic-us.org/events/creating-an-agenda-for-sdoh-in-public-health-it-s-not-just-about-" target="_blank">On Friday, March 13, 2020</a>, as nearly everyone was focusing on our surreal new reality, 150+ researchers, subject matter experts, senior representatives of industry and government, and other professionals concerned with public health convened for a vital reason. A slide shown near the start of the 90-minute online session summarized its purpose succinctly: “Let’s Stop Talking and DO SOMETHING.” <a href="https://hub.nic-us.org/events/creating-an-agenda-for-sdoh-in-public-health-it-s-not-just-about-" target="_blank">Check out the slides, recording, and more >></a></p>
<p><strong>NIC's Goal: Create a National Policy Action Agenda for SDOH</strong></p>
<p>The coronavirus pandemic was front-and-center, of course, but the <a href="https://nic-us.org/" target="_blank">National Interoperability Collaborative (NIC)</a> also had another broad, long-term objective in mind when it started planning this convening months ago, when the words “worst public health crisis in modern US history” referred to the opioid epidemic. <strong>Today, NIC’s objective remains the same; that is, to create a National Policy Action Agenda by year’s end designed to improve our nation’s too-siloed health-related systems by meaningfully integrating the Social Determinants of Health and Well-Being (SDOH) into their work. </strong></p>
<p>Two examples of why that’s so important:</p>
<ul>
<li>This pandemic is demonstrating, with real immediacy, that we cannot rely on our very expensive healthcare system alone at a time like this; we need to build resilience in our communities and our people, and that requires a focus on SDOH.</li>
<li>And we are seeing a clear picture of the differential impact of this crisis on our nation’s most disadvantaged populations; remedying that reality mandates that we address the social determinants. </li>
</ul>
<p><strong>The Keyword Here Is “Action” </strong></p>
<p>Our goal is not just to provide another plan that people can discuss, dissect and discard. Rather, we will recommend specific, achievable actions for making progress, especially to move “upstream” toward a greater emphasis on prevention; we will delineate the actions we intend to take ourselves; and we will promote relationships and partnerships to galvanize actions by others. </p>
<p><strong>A Multisector Campaign, Join Us!</strong></p>
<p>We are building a virtual team to develop the agenda, and we welcome professionals who want to join us in this ambitious effort. To find out how you can participate, write to <a href="mailto:NIC@stewardsofchange.org">NIC@stewardsofchange.org</a>. </p>
<p>The NIC Action Agenda is being led by two of this blog's authors: <a href="https://hub.nic-us.org/members/KarenLSmith" target="_blank">Karen Smith</a>, MD, former Director of the California Department of Public Health; and <a href="https://hub.nic-us.org/members/DanielStein" target="_blank">Daniel Stein</a>, President of Stewards of Change Institute and Principal Investigator of NIC, which is a project of SOCI. The third author is one of our senior advisors who was a featured presenter during last Friday’s discussion. He is <a href="https://hub.nic-us.org/members/PGFOREST" target="_blank">Pierre-Gerlier Forest</a>, PhD, the Director of the School of Public Policy at Calgary University. Numerous other scholars and subject-matter experts in the public and private sectors are also participating in this multisector campaign, which includes: </p>
<ul>
<li><strong>A highly interactive series of webinars/discussions</strong> designed to educate professionals across domains and disciplines regarding the social determinants and, most importantly, to pull collaborators together so they can both inform the agenda and help lead or support its execution. <a href="https://hub.nic-us.org/events/creating-an-agenda-for-sdoh-in-public-health-it-s-not-just-about-" target="_blank">Check out the slides, recording, and more, from the first webinar in the series >></a> </li>
</ul>
<ul>
<li><strong>Ongoing discussions, planning sessions, sharing of resources and other activities</strong> relating to the Action Agenda. These will take place within the <a href="https://hub.nic-us.org/groups/social-determinants" target="_blank">SDOH Group</a> on the NIC Hub, as well as in other related and relevant Hub sections and groups. <a href="https://hub.nic-us.org/groups" target="_blank">Join one or more of the Hub groups, get involved! >></a> </li>
</ul>
<ul>
<li><strong>The 2020 Stewards of Change Institute National Symposium.</strong> The SDOH webinar series will be intentionally designed to shape the themes that will inform the agenda of SOCI’s symposium, which we’ll hold in late 2020 in collaboration with Stanford University’s Center for Population Health (and other Stanford schools as well). The symposium’s primary focus will be the social/human services domains and their technical connections to healthcare, public health and education (with the objective of better-incorporating the social determinants). More details about the symposium will be share on the NIC Hub.</li>
</ul>
<ul>
<li><strong>The Social Determinants: A Policy Action Agenda for Tangible Progress.</strong> We plan to produce this publication in order to provide key learning, recommendations and concrete actions steps drawn from the SDOH webinar series, symposium and input from the SDOH Group and other collaborators involved in this work. We will disseminate the publication widely, take consequential actions ourselves, bring others into this effort, and create an SDOH module for the Stewards of Change Institute’s interoperability training program, which will be available later this year. </li>
</ul>
<p><strong>Our Purpose, Why We Care!</strong></p>
<p>Our SDOH Action Agenda, at its core, is the reason we created NIC – so that we could marshal the collective voices of experts from across disciplines and domains in order to improve communications; further learning and collaboration; and, most importantly, contribute to improving the health of populations and individuals across the country, especially for those who are at greatest risk and/or are most underserved. </p>
<p>We know that the most important job for every country on earth today is to contain the coronavirus; to take every possible step to mitigate its impact on people’s lives (in too many ways to count); and to restore normalcy as soon as possible, though it obviously won’t happen soon. With that said, we also believe it’s necessary to start examining the numerous lessons that this unnerving crisis is already teaching us. That’s precisely what we’re aiming to do with one of those lessons; i.e., the myriad non-healthcare factors that clearly have to be addressed to more-effectively combat public health emergencies into the future. </p>
<p>There’s been a growing understanding of the critical need to incorporate the social determinants for years. It was accelerated by the nation’s opioid epidemic, which is still with us but is understandably getting little attention for the moment. Now we face an even bigger threat that all nations unequivocally need to deal with in unprecedented ways. We’re issuing this call to action with the hope that examining and applying critical knowledge about the value of SDOH will be high on the agenda. </p>
<p><strong>Related posts:</strong></p>
<ul>
<li><strong>Blog:</strong> <a href="https://hub.nic-us.org/blog/when-it-comes-to-sdoh-american-exceptionalism-alas-is-the-excepti">When It Comes to SDOH, American Exceptionalism (Alas) is the Exception</a></li>
<li><strong>Past Webinar: </strong>Karen Smith & PG Forest - <a href="https://hub.nic-us.org/events/creating-an-agenda-for-sdoh-in-public-health-it-s-not-just-about-" target="_blank">The Coronavirus: An Unfolding Case Study on the Need for a Public Health SDOH Agenda</a></li>
<li><strong>Upcoming Webinar: </strong>03/27/2020 - NIC Open House - <a href="https://hub.nic-us.org/events/collaborating-to-deal-with-today-while-preparing-for-tomorrow">Collaborating to Deal with Today – While Preparing for Tomorrow</a></li>
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<td style="padding:5px;text-align:center;vertical-align:middle;"><a style="color:#ffffff;" href="https://hub.nic-us.org/groups/social-determinants" target="_blank"><span style="font-size:20px;color:#ffffff;line-height:1.5;">Join SDOH GROUP!</span></a></td>
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</table></div>Improving Health and Human Services: It’s About Making Connectionshttps://hub.nic-us.org/blog/improving-health-and-human-services-it-s-about-making-connections2019-10-14T18:25:05.000Z2019-10-14T18:25:05.000ZHub Adminhttps://hub.nic-us.org/members/NIC<div><p> </p>
<p>By <a href="https://hub.nic-us.org/members/DanielStein">Daniel Stein</a>, President, <a href="https://stewardsofchange.org/" target="_blank">Stewards of Change Institute</a> | Co-P.I., <a href="https://nic-us.org/" target="_blank">National Interoperability Collaborative</a></p>
<p><strong>The 11th Annual Connected Health Conference | October 16-18 | Boston, MA</strong></p>
<p>When I first saw the title of this week’s <a href="https://hub.nic-us.org/events/the-11th-annual-connected-health-conference">Connected Health Conference</a>, “Designing for Healthy Habits and Better Outcomes,” I was delighted. After all, <a href="https://stewardsofchange.org/" target="_blank">Stewards of Change Institute (SOCI)</a> has been working for over 15 years to bridge the silos that historically have separated the numerous sectors and systems that contribute to everyone’s health and well-being. So the event’s title signaled that leading organizations in our country clearly “get” that it’s essential to infuse their work with factors and considerations other than healthcare.</p>
<p>Specifically, designing “healthy habits” entails taking into account how and where people spend their time. And achieving “better outcomes” necessarily means incorporating the social determinants of health and well-being (where we live, work, play and pray), since they constitute 80 percent of contributing factors to overall health. In other words, the event’s title is yet more evidence – along with the growing number of interoperability and information-sharing projects across our country – that the walls are indeed crumbling, and that’s very good news indeed.</p>
<p>I’m very proud of the positive role we have played in getting us to this point, often as a result of <a href="https://stewardsofchange.org/new-kresge-grant-renewed-commitment-equity-interoperability/" target="_blank">support from the Kresge Foundation</a>. Indeed, it’s becoming increasingly commonplace to see professionals at all levels working to make the vital connections about the “domains” that impact us all (health, human services, healthcare, public health, education, the courts, etc.). And, for a few reasons, I’m especially looking forward to participating in the upcoming <a href="https://hub.nic-us.org/events/the-11th-annual-connected-health-conference">Connected Health Conference</a>.</p>
<p>First and foremost, that’s because it’s heartening and inspiring to see progress being made with one’s own eyes, and <a href="https://www.connectedhealthconf.org/boston/2019/schedule">the CHC agenda</a> reflects that it’s really happening. Second, it’s always energizing to spend time with and learning from colleagues – such as those in the Healthcare Information Management and Systems Society (HIMSS), which is a strategic partner of SOCI.</p>
<p><strong>The Interoperability Mural Gallery</strong></p>
<p>Finally, all of us at Stewards of Change Institute are excited that we’ll be presenting our new <a href="https://stewardsofchange.org/graphic-murals/murals-showcase/" target="_blank">Interoperability Mural Gallery</a> for just the third time, after successful showings at two other major national events this year. Those were the <a href="https://hub.nic-us.org/events/ciesummit2019">Community Information Exchange Summit</a> in San Diego and the <a href="https://hub.nic-us.org/events/2019-medicaid-enterprise-systems-conference">Medicaid Enterprise Systems Conference</a> in Chicago.</p>
<p>The two dozen murals we’ll be displaying at the Connected Health Conference represent a sampling of <a href="https://stewardsofchange.org/graphic-murals/" target="_blank">the hundreds</a> that we’ve created over the years at Stewards symposia, trainings, strategic planning sessions and other events over the years. Together, in a way that we believe cannot be found anywhere else (and certainly not in as vivid a way), they essentially chronicle the history of interoperability’s path, the issues it encompasses, the successes and challenges it has faced over time, and offer a vision of the future moving into the next decade.</p>
<p>Most pointedly, these vivid graphic illustrations compose a first-of-its-kind exhibit designed to capture and expedite learning; to highlight key ideas relating to interoperability, information-sharing and collaboration; and to stimulate discussion across programs and domains. We hope and believe that the gallery will do all of those things at this week’s <a href="https://hub.nic-us.org/events/the-11th-annual-connected-health-conference">conference</a> in Boston. Please attend if you can and, if you do, stop by to tour the gallery or follow our updates on <a href="https://twitter.com/StewardsChange" target="_blank">Twitter</a>. I feel confident that, in these captivating pieces of art, you’ll see all the connections come together.</p>
<p style="text-align:center;"><iframe src="https://www.youtube.com/embed/videoseries?list=PLeI2juMpKM4N4_uJ03yuAo-JUGl2ZQqpJ" width="460" height="260" frameborder="0" allowfullscreen=""></iframe></p>
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</tr></tbody></table><p> </p></div>Thanks to You, a One-Year Anniversary for the NIC Hubhttps://hub.nic-us.org/blog/thanks-to-you-a-one-year-anniversary-for-the-nic-hub2019-09-16T23:38:22.000Z2019-09-16T23:38:22.000ZHub Adminhttps://hub.nic-us.org/members/NIC<div><p><a title="1st Hubversary Video" href="https://hub.nic-us.org/videos/1st-anniversary-of-the-nic-collaboration-hub"><img class="align-right" src="{{#staticFileLink}}3559965790,RESIZE_710x{{/staticFileLink}}" alt="1st Hubversary Video" width="273" height="192" /></a></p>
<p>When we launched the NIC Collaboration Hub almost exactly a year ago, we felt certain that this would be a valuable – even unique – tool to advance interoperability and information-sharing across the multiple domains that affect everyone’s health and well-being. Nevertheless, we had one gnawing concern: If we build it, will busy professionals around the country really come to use it?</p>
<p>Today, I’m delighted to report that the answer is “yes.” So I’m writing this blog to express the gratitude of all of us at the <a href="http://www.nic-us.org" target="_blank">National Interoperability Collaborative</a> to all of you who are not only participating in various ways on the Hub, but are also demonstrating that it’s of genuine benefit. </p>
<p>Here are just some of the numbers that indicate we’re on the right track:</p>
<ul><li><strong>The Hub now has over 800 members</strong> and is growing almost daily. These range from individual professionals working in <a href="https://stewardsofchange.org/wp-content/uploads/sites/2/2018/08/Six-Domains-Full-Document-Final-03-19-18.pdf" target="_blank">the six domains</a> in which NIC primarily operates to major regional and national organizations such as HIMSS, NACCHO, ASTHO, NESCSO and the Sequoia Project.</li>
<li><strong>Hub members have shared about 900 resources</strong>, with more being posted every week. Cumulatively, they offer a single destination where you can obtain relevant research and other important knowledge, share and gain relevant knowledge, and conceive and inform initiatives.</li>
<li><strong>The Hub has had over 81,000 page views from more than 12,000 visits, with an 86 percent engagement rate during the past year.</strong> During the same period, NIC has held a series of webinars and group calls with a unique aspect – participant discussion and collaboration on the Hub itself.</li>
<li>And the activity we’re probably most proud of (so far), is the <strong>active engagement we’ve gotten in the eight <a href="https://hub.nic-us.org/groups/">affinity groups</a> on the Hub</strong>; hundreds of professionals from governments at all levels, industry, nonprofits and academia have signed up for and participated to date.</li>
</ul><p><a href="http://www.stewardsofchange.org" target="_blank">Stewards of Change Institute</a> conceived the Hub for the same reasons that we created the broader NIC “community of networks” about a year earlier. That is, to provide the online (Hub) and on-the-ground (NIC) means for thought leaders, policy-makers, practitioners and other professionals to share information and work together for tangible, systemic progress in ways they hadn’t done before. That goes for advances within their own organizations and fields and, most critically, across the varied domains/disciplines that need to routinely communicate in order to make sustainable, enduring improvements in the health and well-being of everyone in our country, especially those among us who are most underserved.</p>
<p>If you haven’t <a href="https://hub.nic-us.org/main/authorization/signUp">signed up</a> to the Hub yet, we invite you to do so. Join one or more of the <a href="https://hub.nic-us.org/groups">groups</a>, contribute to or utilize the Hub resources, and start or engage in one of the conversations. Most importantly, let us know what’s working and what recommendations you may have about how we can make the Hub even more engaging and genuinely useful. Remember: It’s only one year old, so we’re making ongoing improvements based on the feedback we receive. <a href="https://www.surveymonkey.com/r/RVR3D72" target="_blank">Share your feedback!</a></p>
<p>To all of you who are already taking advantage of the various activities on the NIC Collaboration Hub, thank you again for your support, participation and inspiration. To those who haven’t yet joined our community, consider this a personal invitation to get on board. After all, we all want to reach the same destination. <a href="https://hub.nic-us.org/main/authorization/signUp">Join Today!</a></p>
<p> </p>
<p><a href="https://hub.nic-us.org/members/DanielStein">Daniel Stein</a></p>
<p>SOCI President and NIC Principal Investigator</p></div>Illustrating Interoperability: From San Diego to Chicago … and Beyond!https://hub.nic-us.org/blog/illustrating-interoperability-from-san-diego-to-chicago-and-beyon2019-08-26T20:07:45.000Z2019-08-26T20:07:45.000ZHub Adminhttps://hub.nic-us.org/members/NIC<div><p>The annual Medicaid Enterprise Systems Conference is always a great place to share ideas, learn about new initiatives and technologies, network with federal and state officials and engage with industry leaders from across the country. <a href="https://hub.nic-us.org/events/2019-medicaid-enterprise-systems-conference">This year’s MESC</a> – which took place in Chicago last week – was no exception. I’m gratified to say that <a href="https://stewardsofchange.org/" target="_blank">Stewards of Change Institute</a> had the privilege to show our innovative <a href="https://stewardsofchange.org/graphic-murals/murals-showcase/" target="_blank">Interoperability Mural Gallery</a> at the event.</p>
<p>It was the second time we’d presented a version of the gallery, which vividly showcases an array of concepts relating to interoperability, information-sharing and specific issues such as privacy and confidentiality, the social determinants of health, race equity and many more. Over the past decade, we’ve created and collected about 150 murals, which are drawn in real time with participants at our symposia, trainings, strategic planning sessions and other events. The murals help “make thinking visual” by providing graphic, visual, illustrative “notes” that convey complex topics that can be used for teaching and dissemination purposes.</p>
<p>The <a href="https://stewardsofchange.org/graphic-murals/murals-showcase/mural-gallery-2019-cie-summit/" target="_blank">gallery’s premier</a> was at the <a href="https://stewardsofchange.org/events/2019-community-information-exchange-summit/" target="_blank">Community Information Exchange Summit</a> in San Diego in April 2019. The expansive display of 30 of our murals that we showed there received strong reviews from attendees and organizers alike. As a result, several other major conference have expressed interest in bringing the gallery to their events, starting with MESC.</p>
<p>The gallery is still a work in progress. We expect that it will change in size and content from venue to venue to meet each conference organizer’s goals, key themes and available space. Wherever we take the gallery, our core objectives will always remain focused on sharing the accumulated knowledge about data-sharing and interoperability; stimulating thinking and new conversations; and providing vital information that attendees can learn from and actually use in their own work.</p>
<p>Please take a look at <a href="https://hub.nic-us.org/videos/participants-reactions-interoperability-gallery-2019-community-in">this new video</a> we’ve produced about the mural gallery, and let us know what you think. You can also see dozens of the murals at the <a href="https://stewardsofchange.org/graphic-murals/" target="_blank">Stewards of Change Institute website</a>. Better yet, come see them in person at an upcoming event. </p>
<p> </p>
<p>By Adam Pertman</p>
<p> </p></div>Innovative Information-Sharing: Administrative Data as a Strategic Assethttps://hub.nic-us.org/blog/innovative-information-sharing-administrative-data-as-a-strategic2019-06-17T23:05:52.000Z2019-06-17T23:05:52.000ZHub Adminhttps://hub.nic-us.org/members/NIC<div><p style="line-height: 1.5;"><a href="https://www.pewtrusts.org/en/research-and-analysis/reports/2018/02/how-states-use-data-to-inform-decisions" target="_blank" rel="noopener"><img style="padding: 5px; float: right;" title="The Data as a Strategic Asset project at The Pew Charitable Trusts" src="https://nic-us.org/wp-content/uploads/2019/06/400X400-300x300.jpg" alt="The Data as a Strategic Asset project at The Pew Charitable Trusts" width="200" height="200" /></a>Every day, state governments make decisions that affect their citizens’ lives. They determine which policies to enact and which problems to address. They establish how programs should be run and where budget dollars are best spent, as well as who qualifies for government assistance. To effectively serve the public, officials at every level of state government are tasked with ensuring that these daily decisions are prudent and well-informed. Consequently, states are increasingly turning to administrative data collected and maintained primarily for the routine management of programs and services – such as vital records, college enrollment data, and Medicaid utilization statistics – to make strategic decisions.</p>
<p style="line-height: 1.5;">While researchers have explored the use of administrative data in various areas (for example, identifying frequent users of emergency services), little has been published on this trend more broadly. As state leaders seek to harness data in innovative ways, what common themes, noteworthy successes, and notable challenges have the 50 states experienced across a broad cross-section of issues? To address that question, The Pew Charitable Trusts interviewed state leaders across the U.S. and reviewed relevant laws, documents, and policies in all 50 states. Last year, Pew published <a href="https://www.pewtrusts.org/en/research-and-analysis/reports/2018/02/how-states-use-data-to-inform-decisions" target="_blank" rel="noopener">a report</a> that is the culmination of that research, which provided the first comprehensive overview of how data are being utilized across the country. Its findings remain on-point and, if anything, are even more relevant today. Indeed, because of the longtime efforts of organizations like Stewards of Change Institute and initiatives such as the Institute’s new National Interoperability Collaborative (NIC), we’re all increasingly aware of the importance of sharing, analyzing and learning from data for a growing number of purposes.</p>
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<p><span style="font-size: 18px;">Join our upcoming webinar to learn how to better leverage administrative data!</span></p>
<p><strong>Date:</strong> June 25, 2019 <strong>Time:</strong> 12 pm - 1 pm ET</p>
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<td style="padding: 5px; text-align: center; vertical-align: middle;"><a href="https://hub.nic-us.org/events/a-webinar-in-the-nic-of-time-administrative-data-as-a-strategic-a" target="_blank" rel="noopener"><span style="font-size: 17px; color: #ffffff; line-height: 1.5;">Learn more & Register!</span></a></td>
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<p style="line-height: 1.5;">States traditionally use administrative data to prepare annual reports showing how funds were spent and the impact of particular programs. More recently, they have begun harnessing existing information through data analytics – reviews to identify meaningful information and correlations. Such efforts open up critical new opportunities for governments to make effective decisions. Analysts can uncover important insights by employing techniques such as integrating and cross-referencing data sets, undertaking calculations to show trends, finding correlations between various factors, running statistical experiments, mapping geographical data to show areas of high activity, and visualizing data in charts and graphs. Additionally, data analytics can reveal the root cause of a persistent issue, diagnose breakdowns in a system, highlight obstacles, and predict future phenomena, allowing leaders to make better-informed and more-strategic decisions. Using data collected from interviews with more than 350 state officials, the Pew study highlighted ways some government leaders have employed sophisticated data analytics:</p>
<ul style="line-height: 1.5;">
<li>Craft policy responses to complex problems. The Massachusetts Department of Public Health led an effort to integrate 10 data sets from five agencies. Findings from this analysis showed illegally obtained drugs caused more deaths than prescribed opioids and that individuals released from prison were 56 times more likely to die from an overdose than are members of the public. The state then enacted Chapter 52 in 2016 to address the opioid crisis’ contributing factors through treatment, education, and prevention.</li>
<li>Improve service delivery. Missouri health officials believed analyzing Medicaid claims data could improve patient outcomes. So they added claims information into an algorithm that factored in frequency of emergency services use by patients with chronic health conditions. Officials enrolled these Medicaid users in “health homes” – in which high-cost patients are assigned caseworkers who help coordinate the providers caring for them. The result was clearly improved clinical outcomes.</li>
<li>Manage existing resources. Delaware officials explored ways to use the state’s vehicle fleet more efficiently. After installing GPS devices, they received real-time data, such as unauthorized vehicle use and excessive idle time. Between 2008 and 20, the GPS data analysis allowed managers to better-allocate vehicles across the state, saving $874,000 by reducing the miles driven and fuel used.</li>
<li>Examine policy and program effectiveness. The District of Columbia performed a randomized, controlled trial using administrative data to assess how to most effectively boost participation in its Summer Youth Employment Program. The trial revealed the effect of various strategies on program attendance and provided administrators with the necessary information to choose the most effective course of action.</li>
</ul>
<p style="line-height: 1.5;">Such innovative uses of administrative data remain relatively rare for a broad variety of reasons, from budget limitations to the complexities of information-sharing across agencies to the need to respond to the latest crisis. As a result, there is too often insufficient bandwidth for the level of complex analyses contemplated here. Even so, the Pew study identified five key actions state leaders could take to address these challenges and maximize the value of administrative data: Plan ahead by setting up guiding goals and structures.</p>
<ul style="line-height: 1.5;">
<li>Build the capacity of stakeholders to effectively use data.</li>
<li>Ensure that quality data can be accessed and used by stakeholders.</li>
<li>Analyze data to create meaningful information.</li>
<li>Sustain support for continued data efforts.</li>
</ul>
<p style="line-height: 1.5;">The authors found states that had implemented a combination, or even all five, of the above actions in different policy areas. But no state has managed to apply these actions to a broad range of government agencies and achieve across-the-board improvements in how it develops policy, delivers services, manages its resources, and evaluates existing programs. The next frontier for state governments will be moving from the narrow, targeted use of data analytics to its comprehensive application across policy areas.</p>
</div>It’s Time to Add Prevention to the Fight Against the Opioid Epidemic; New Playbook Focuses on 11 Replicable Strategies to `Go Upstream’https://hub.nic-us.org/blog/it-s-time-to-add-prevention-to-the-fight-against-the-opioid-epide2019-02-19T16:12:39.000Z2019-02-19T16:12:39.000ZHub Adminhttps://hub.nic-us.org/members/NIC<div><p><a href="https://nic-us.org/the-opioid-playbook/" rel="noopener"><img style="float: right; width: 250px; min-width: 40px; padding: 10px; padding-left: 15px;" src="https://nic-us.org/wp-content/uploads/2019/02/playbook.png" /></a><br />
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<span style="vertical-align: middle;">There are countless ways to demonstrate the horror of our nation’s opioid crisis, from raw numbers (over 47,600 opioid-related deaths in 2017) to records set (fatal overdoses now exceed vehicular deaths) to OMG descriptions of the drugs’ toxicity. A couple of recent examples: During a routine traffic stop last April, state troopers in Nebraska seized a record-setting 118 pounds of fentanyl, enough of the synthetic opioid to kill 26 million people. The record didn’t last long. Just a couple of weeks ago, U.S. Customs and Border Protection officers in Arizona discovered more than twice that amount – 254 pounds – in the floor compartment of a truck loaded with cucumbers.</span></p>
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<td style="padding: 5px; text-align: center; vertical-align: middle;"><a href="https://nic-us.org/the-opioid-playbook/" rel="noopener"><span style="font-size: 18px; color: #ffffff; line-height: 1.5;">Check out the playbook. Tell us what you think. Share your plays.</span></a></td>
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<p><em>Check out <a href="https://nic-us.org/the-opioid-playbook/">the NIC Opioid Use Disorder Prevention Playbook</a>. Join the discussion about this first-of-its-kind publication, on the</em> <em><a href="https://hub.nic-us.org/groups/opioid-epidemic" target="_blank" rel="noopener">Opioid Group</a></em> <em>on the NIC Collaboration Hub. And mark your calendar for a webinar on the Playbook at 1 p.m. on Friday, March 8 (details to come).</em></p>
<p><em>The NIC Playbook will be an important focus of a unique, highly interactive convening we’re co-organizing in San Diego on April 24-26. The theme of the</em> <em><a href="https://ciesandiego.org/ciesummit2019/" target="_blank" rel="noopener">event</a></em> <em>is “Driving Cross-Sector Collaboration and Data-Sharing to Create Healthier Communities.”</em></p>
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“It is clear that vast quantities of opioids with increasing potency are flooding … the country,” says a report by the Massachusetts Taxpayers Association. “The epidemic has not stalled; in fact, it is poised to accelerate with alarming consequences” to people, communities and the economy. With stakes that high, it’s imperative that this crisis be addressed in every way possible, with the greatest emphasis obviously on saving and restoring lives. Those are clearly the primary objectives of efforts being made at every level today – from federal grants flowing to treatment and recovery initiatives, to local communities providing naloxone more and more freely. In our view, however, one potentially vital component of a truly comprehensive approach to addressing the opioid epidemic has received short-shrift to date: Prevention. We are <u>not</u> saying that the growing number of crisis-response efforts should be reduced in any way, because saving lives is clearly Job 1, but we are suggesting that additional attention and resources should go to “upstream” activities so that this public health emergency abates – and maybe even ends – over time. To promote movement toward prioritizing that goal, today the National Interoperability Collaborative (NIC) is publishing The Opioid Use Disorder Prevention Playbook on <a href="https://nic-us.org/the-opioid-playbook/">NIC’s website</a> and on the <a href="https://hub.nic-us.org/groups/opioid-epidemic" target="_blank" rel="noopener">NIC Collaboration Hub Opioid Group</a>, where anyone interested in the opioid issue is invited to leave comments, participate in a conversation and/or post information about their own projects that they think should be included in subsequent iterations of the Playbook. [NIC is an initiative of the Stewards of Change Institute and its leadership partner, AcademyHealth, with generous funding from the Kresge Foundation. The Playbook is also available on <a href="http://www.stewardsofchange.org">SOCI’s website</a>.] This first version of the Playbook describes 11 prevention-focused strategies (or “plays”) being tested around the country. In discussing those plays, the publication’s primary objectives are to:</p>
<ul>
<li>Present a clear picture of the state of knowledge on how to better detect and prevent opioid misuse, overuse and use disorders.</li>
<li>Focus greater attention on prevention, because it is essential to the long-term resolution of the opioid epidemic ravaging our country (and is part of the <a href="https://www.whitehouse.gov/ondcp/">National Drug Control Strategy</a>).</li>
<li>Offer guidance – to federal, state and local practitioners, legislators and other stakeholders – about existing “upstream” strategies that can be replicated or adapted for real-time use.</li>
<li>Create a virtual community, on the <a href="https://hub.nic-us.org/groups/opioid-epidemic">NIC Hub</a>, where people and organizations can share and vet “plays” expeditiously and broadly across the U.S.</li>
<li>Demonstrate the vital role of interoperability, information-sharing, integration and collaboration in any effective strategy to address a public health emergency.</li>
</ul>
<p>It is important to underscore that the Playbook’s contents represent a current snapshot of our evolving knowledge on how to address the opioid crisis, while also identifying the research and evidence-gathering that still must be undertaken to make better-informed decisions. Our intent is to regularly update the Playbook – most notably its plays – as we learn about new ideas and initiatives, and we welcome comments and contributions on the NIC Hub to keep it as up-to-date as possible.  </p>
</div>Lessons from the Field: How to Successfully Share Data across Programshttps://hub.nic-us.org/blog/lessons-from-the-field-how-to-successfully-share-data-across-prog2018-11-12T18:37:10.000Z2018-11-12T18:37:10.000ZHub Adminhttps://hub.nic-us.org/members/NIC<div><p>By <a href="https://hub.nic-us.org/members/MarySaraJones" target="_blank" rel="noopener">Mary-Sara Jones</a>, Industry Lead, Health and Human Services, IBM</p>
<p>Cross-program data-sharing has been one of the most popular topics at Health and Human Services conferences this year. Many states and counties are exploring different models of collaboration and integration, some focused on improving the client’s ability to engage with government, others on improving the agency’s ability to engage holistically with the client. Both approaches will be highlighted during the National Interoperability Collaborative’s upcoming “<a href="https://hub.nic-us.org/events/new-england-symposium" target="_blank" rel="noopener">Symposium in the NIC of Time</a>,” where IBM will be among the featured presenters.</p>
<p>In all cases, agencies must address the business and technical challenges relating to identity management and privacy regulations. The good news is that we are seeing success.  Although it is not rocket science, we have witnessed the level of effort wax or wane based on an agency’s approach. In all cases, the business challenges of data sharing – rather than the technical ones – tend to be more difficult.</p>
<p>I have compiled a brief list of key learnings gathered from successful clients that may help mitigate some of the complexity.</p>
<ul>
<li><strong>Begin by defining the business problem.</strong> Break the business problem into discrete, illustrative scenarios. They will help to identify <em>what</em> information needs to be shared, with <em>whom </em>and for what<em> reason</em>. Understanding the what, who and why helps to limit data-sharing to a tangible example for which legal counsel can then more clearly determine the risk. Scenarios should be detailed, identifying the actors, the actions, and the flow of data within and across agency boundaries.</li>
</ul>
<ul>
<li><strong>Determine what data users need.</strong> The scenarios will guide the answer to this question. Determining what data is needed for a worker to make more-informed decisions provides the super-set, if you will, of data. This should represent the maximum data that could be available with a client’s consent.</li>
</ul>
<ul>
<li><strong>Start with what can you share, not what you can’t.</strong> All systems, even the most-sensitive ones, include data that can be shared. By decoupling the data from the system, you will expand the shareable data. For example, the mental health system may include a person’s status as a veteran. Decoupling allows the status to be shared with the case manager without giving away the person’s participation in mental health programs.</li>
</ul>
<ul>
<li><strong>Consent does not unlock all data.</strong> Consent makes additional data available to a worker, but not all of it. Likewise, withdrawal of consent will not remove access one has based on role. This is the base data that one would have by virtue of their position and the agency or organization for which they work. Consent represents the maximum data available to a worker. It is the super-set of what a worker needs to optimize decision-making.</li>
</ul>
<ul>
<li><strong>Legal counsel is not the enemy. </strong>Once the business has defined the scenarios, it is important to work closely with legal counsel. The more legal understands the business needs, the risks and the implications, the more they will be able to support and guide you in how to proceed.</li>
</ul>
<ul>
<li><strong>Drive the change from the top.</strong> There is no substitute for strong executive leadership. Most successful agencies have had a strong champion at the top who empowers the business and is unwilling to accept no as an answer.</li>
</ul>
<p>As population demographics change, we see increasing numbers of families and individuals receiving services from multiple agencies or providers. Providing a holistic view will help reduce redundancy, improve productivity and, most importantly, achieve positive outcomes more quickly. Cross-program data-sharing can be complicated, but it is definitely possible, especially if you follow the footprints of those who have already achieved success.</p>
</div>Research in Canada Underscores the Importance of the Social Determinants to Improve Population Healthhttps://hub.nic-us.org/blog/knowledge-from-the-north-research-in-canada-underscores-the-impor2018-10-03T14:48:48.000Z2018-10-03T14:48:48.000ZHub Adminhttps://hub.nic-us.org/members/NIC<div><p style="font-size: 18px; text-align: center;"><a href="http://go.stewardsofchange.com/NIC-Oct-2018-Webinar-Register-Now.html" target="_blank" rel="noopener"><strong>Register Now!</strong></a>     <a href="https://hub.nic-us.org/groups/social-determinants" target="_blank" rel="noopener"><strong>Join the Discussion!</strong></a>    <a class="twitter-hashtag-button" href="https://twitter.com/intent/tweet?button_hashtag=SDwebinar18&ref_src=twsrc%5Etfw" data-size="large" data-show-count="false" data-text="@StewardsChange @NICnetworks">Tweet #SDwebinar18</a>
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<p>It may surprise some policy-makers to hear it, but the best way for government to use its financial resources to improve population health in a developed country is to spend more on social services rather than on health care.</p>
<p>Models using data from the United States, Canada, and across the 36 countries of the Organization for Economic Cooperation and Development (OECD) all show similar trends: a dollar spent on social services has a higher rate of return – compared to a dollar spent on health care – for achieving outcomes like longer life expectancy and lower mortality rates from preventable or treatable causes. Even deaths attributable to highly behavioral factors, such as diabetes or alcohol, appear to diminish as a consequence of more spending on social services.</p>
<p>In short, it is crystal clear that focusing more attention and resources on the Social Determinants of Health and Well-Being (colloquially, where we live, work and play) yields better outcomes in almost every way. Notwithstanding the evidence, however, health care spending dominates the way that the public and policymakers think about population health in most countries.</p>
<p style="text-align: center;">_________________________________________________________________</p>
<p><em>The Social Determinants of Health and Well-Being will be the subject of the second presentation in the Deeper Dive Webinar Series from the National Interoperability Collaborative (NIC). It’s titled “Knowledge from the North,” and will feature two of the Canadian researchers who conducted the study discussed in this blog, as well as other subject-matter experts. <a href="https://hub.nic-us.org/events/knowledge-from-the-north-what-canada-can-teach-us-about-the-socia" target="_blank" rel="noopener">Learn more about the webinar and register</a></em><em>.</em></p>
<p style="text-align: center;">_____________________________________________________________________</p>
<p>In the years prior to enactment of the Affordable Care Act (ACA), a consensus emerged in the U.S. that escalating health care outlays were among the <a href="https://www.ncbi.nlm.nih.gov/pubmed/21595114" target="_blank" rel="noopener">most serious policy challenges faced by the country’s government, businesses and families</a>. Total health spending at the time had reached 17.3 percent of GDP, higher than in any other modern economy. Yet it was generally agreed that Americans did not receive great value back from their investment, considering the health status of the population and the difficulty of assuring good access to care for millions of people.</p>
<p>The escalation of these costs is a huge concern for many reasons, but it is not a uniquely American problem. Indeed, the need to lower these expenditures is shared by public and private payers in many countries, <a href="https://www.conferenceboard.ca/docs/default-source/conf-pres-public/15-0120_p2_marchildon.pdf?sfvrsn=0" target="_blank" rel="noopener">including Canada</a>. As noted in an <a href="http://www.oecd.org/gov/fiscal-sustainability-of-health-systems-9789264233386-en.htm" target="_blank" rel="noopener">OECD report</a>, “Healthcare costs are rising so fast in advanced economies that they will become unaffordable by mid-century without reforms.”</p>
<p>Against that backdrop, a group of researchers at the School of Public Policy at the University of Calgary <a href="http://www.cmaj.ca/content/190/3/E66" target="_blank" rel="noopener">studied Canada</a> to see if a country with a publicly funded health care system could benefit from additional social spending versus health spending. Each Canadian province publicly reports spending on the health and social care systems (both of which are provincial, not federal, jurisdictions). We <a href="https://www.policyschool.ca/wp-content/uploads/2018/06/Provincial-Government-Budget-Data-Feb-2018FINAL-USE.xlsx" target="_blank" rel="noopener">assembled that data from historical documents</a>.</p>
<p>We took 31 years of provincial-level spending and overall budgets, demographics and macroeconomic variables – such as the unemployment rate – to build a model of how variations in spending allocations impact population health changes. Canada and the U.S. are comparable in that sub-national units (provinces and states) have jurisdiction over public health and social spending and, in both countries, the same relationship between social and health spending holds with population health outcomes.</p>
<p>In our study, we provide evidence that shows the ratio of social spending to health spending has an association with major population health outcomes in Canada. Important measures like life expectancy and potentially avoidable mortality appear to respond to social spending more than to health spending. Our conclusion: Governments trying to make the most of scarce resources could improve the health of their people by skewing more spending toward social services.</p>
<p>In Canada’s biggest province, Ontario, for example, we suggest that increasing the ratio of social-to-health spending by one cent for each dollar spent on health would have led to improvements in life expectancy of 5 percent per year and avoidable mortality of 3 percent per year. That redistribution would have been of less than 1 percent of the total health budget.</p>
<p><a href="https://www.healthaffairs.org/doi/10.1377/hlthaff.2015.0814" target="_blank" rel="noopener">This matches state-level research from the United States</a>. In both countries, spending on health care as a proportion of GDP is rising (in line with OECD country trends), while social spending has not seen the same increases. It is important to note that researchers – and countries – treat social spending differently. Education spending is included as social spending in the U.S. studies, but not in the Canadian. Further, other measures (ex., minimum wage legislation) might generally be considered to be part of social policy, but they are not included as such in government spending.</p>
<p>With or without the ACA, sub-state stakeholders in the U.S. are taking action. Hospital networks, in particular, have identified that investments in social care (e.g., housing) decrease the health care needs of their patients. Unfortunately, governments have been slower to appreciate the benefits of greater social spending; they tend to treat it as a cost, an outflow of money to solve a hopefully temporary problem. This phenomenon is known as the “wrong pockets problem.”</p>
<p>Researchers have suggested that an exclusive focus on health care expenditures in the discussion on how to institute reforms is misleading. Their argument, <a href="https://www.ncbi.nlm.nih.gov/pubmed/21447501">backed by comparative data from 30 industrialized countries</a>, is that the total amount spent on both health care and social services programs explains the variance in health-related outcomes. These findings have been confirmed by additional studies using <a href="https://www.rand.org/pubs/research_reports/RR1252.html" target="_blank" rel="noopener">other international comparisons</a>.</p>
<p>The good news is that a consensus is developing that the Social Determinants – not health care per se – are the greatest influencers of health outcomes, and most governments have begun to acknowledge that reality. The bad news is that this growing understanding hasn’t yet translated into significant policy changes on the ground. The stakes here are high. They are people’s health. Our research points to a path that Canada, the U.S. and other developed countries can follow toward a healthier future for their populations. Our hope is that they will indeed take it.</p>
<p style="text-align: center;">_________________________________________________________________</p>
<p><span style="font-size: 16px;"><strong>About the Authors</strong></span></p>
<p><span style="font-size: 14px;"><strong>Dr. Daniel J. Dutton</strong>: <a href="https://nic-us.org/wp-content/uploads/2018/10/Dan_bio-225x230.jpg" target="_blank" rel="noopener"><img class="align-right" src="https://nic-us.org/wp-content/uploads/2018/10/Dan_bio-225x230.jpg?profile=RESIZE_710x" width="225" /></a></span></p>
<p><span style="font-size: 14px;">Daniel J. Dutton is completing a two-year term as a Post-Doctoral Scholar at the University of Calgary’s School of Public Policy. In January, he is taking a new position as Assistant Professor at Dalhousie University’s Department of Community Health and Epidemiology.</span></p>
<p><span style="font-size: 14px;">His current research falls into three general categories: social and health economics, applied policy, and computational epidemiology. Most of his work is quantitative, utilizing large data sets and modeling strategies from economics and epidemiology. His primary interests are population-level exposures and their impact on poverty and health, how governments can address those exposures, and the distributional impacts of addressing those exposures. Currently that work focuses on homelessness, housing, and governmental policy. He also has an interest in methodological practice, including how research is done in applied epidemiology and the questions researchers answer.</span></p>
<p><span style="font-size: 14px;">He has taught or currently teaches econometrics, statistics, epidemiology, and population health classes and served on the City of Calgary's Calgary Equity Index working group. Dan completed his Ph.D. in Community Health Sciences with a specialization in Population and Public Health at the University of Calgary in 2014, his other degrees are in economics from Calgary (MA) and Queens (BAH). Prior to his Ph.D. Dan worked for a short time in the Ontario Ministry of Finance.</span></p>
<p><span style="font-size: 14px;"><strong>Dr. PG Forest:</strong></span></p>
<p><a href="https://nic-us.org/wp-content/uploads/2018/10/PG-Forest-Final-1-225x230.jpg" target="_blank" rel="noopener"><img class="align-right" src="https://nic-us.org/wp-content/uploads/2018/10/PG-Forest-Final-1-225x230.jpg?profile=RESIZE_710x" width="225" /></a> <span style="font-size: 14px;">Pierre-Gerlier (PG) Forest is the Director of the School of Public Policy and James S. and Barbara A. Palmer Chair in public policy at the University of Calgary. PG Forest also holds an appointment as Professor of Community Health Science in the Cumming School of Medicine.</span></p>
<p><span style="font-size: 14px;">Prior to joining the School of Public Policy in 2016, PG Forest was Director of the Institute for Health and Social Policy at Johns Hopkins University and a Professor with the Bloomberg School of Public Health. From 2006 to 2013, he was president of the Pierre Elliott Trudeau Foundation, a Canadian granting institution that encourages innovation in policy. In 2003, PG Forest was appointed to the G.D.W. Cameron Visiting Chair before becoming Assistant Deputy Minister and Chief Scientist (2004-2006) with Health Canada, the federal department of health. In 2001, he had joined the Commission on the Future of Health Care in Canada where as Director of Research, he was responsible for the evidence produced and used by the Commission and contributed directly to its publications.</span></p>
<p><span style="font-size: 14px;">Dr. Forest spent the first part of his academic career at Université Laval, in Quebec City, where he was Professor of policy analysis and public administration with the department of political science (1990-2007). He is the author of more than a hundred and fifty scientific papers and books; among others, notably: <em>Chang</em><em>ing Health Care in Canada</em> (Toronto, 2004) and <em>Paradigm Freeze</em> (Toronto, 2013).</span></p>
<p><span style="font-size: 14px;">PG Forest obtained a Master’s degree in Political Science at Université Laval (1984) and a PhD. in History and Socio-Politics of Science at Université de Montréal (1989).</span></p>
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