* Olga Blanco * * 07/24/2013 * * BSHS/ 375 * * * * * * * * Interoperability Paper * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Administration for Children and Families. * Mental Health providers work to promote opportunities to people with mental health illness to improve their ability to seek treatment, socialize with others, and work towards a job and a better living condition for themselves with the most appropriate therapeutic support. Mental health services operate under specific principles which are for services to be delivered by mean of comprehensive system of care which points out the most appropriate and least restrictive setting to deliver the highest level of functioning. There should also be continuity of care within the state and between the public and private sectors. The ranges of these services within the system must respond to the needs of the individual consumers and the population served.

Interoperability means the ability of health information systems to work together within and across organizational boundaries in order to advance the effective delivery of healthcare for individuals and communities. For Human services provider, the ability is critical to meeting objectives. Interoperability affects care delivery, continuity of care, and the ability to share information with patients for patient engagement. For the Administration for children and families, the three methods of interoperability would probably be information sharing/exchanging, improve service delivery, and provide better outcomes for children and families.

The National Information Exchange Model (NIEM) Human Services (HS) Domain was established by the Department of Health and Human Services (HHS) and recognized by the NIEM Executive Steering Council in March 2012 to support information sharing and promote interoperability between and beyond Human Service organizations and federal, state, local and tribal agencies.

The initial scope of the NIEM HS Domain will be determined by the HS Domain
Governance Group. Here are some Examples of data exchanges to be considered by this group:

• New York City HHS Connect: A network of NYC agency exchanges that serve over 3 million people with a wide range of needs from applying for standard benefits to the more complex needs of socio-economically disadvantaged New Yorkers (Niem Pg12)
• Child Support Required Data Exchanges: State child support agency computer systems are required to support automated interfaces with various health and human services agencies within the state. The minimum data elements for data exchange for these interfaces are defined at the federal level. These data elements can be utilized to develop baseline data exchanges for interagency exchanges at the state level. (Niem Pg 12)
• Criminal and Child Abuse to Child Care and Foster Parent Licensure Agencies Exchange: Obtaining background checks for prospective foster parents is time consuming and, in many states, only yields criminal background or abuse and neglect data for that one state. There are similar issues with the hiring of staff to provide childcare services at state or county-run childcare centers. An exchange that expedites the sharing of information between the providers and a national criminal and child abuse and neglect database would allow appropriate foster parents and childcare providers to be licensed and would reduce the number of inappropriate licenses issued, better protecting children from potentially harmful situations. (Niem Pg 12)
• Vulnerable Populations Emergency Locator Exchange: A hurricane or other natural disaster affects a state or region. Through the electronic transmission of human service information and Global Positioning System tracking, emergency personnel can more quickly reach the individuals who are most vulnerable. When persons involved with HS agencies (foster care, preventive services, food and nutrition services, etc.) cross county or state lines, their case information could be transmitted to other states to insure the continuation of needed services. • Child Welfare to Homeless Services Exchange: A family involved with the child welfare system in a given jurisdiction enters the homeless service system. Upon entry, workers in both systems would be alerted and could maintain family services and ensure the safety and well-being of the involved children.
• Income Verification Exchange and Assistance Eligibility Exchange: A single mother loses her job which, she believes, makes her eligible for some local, state, and/or federal benefits. She doesn’t know which. Rather than visiting each office individually in-person (food and nutrition services, housing assistance, cash assistance, heating/energy assistance, child care, etc.), she can now go to one central location and, through an income verification and other exchanges, receive real-time information about and apply for the benefits to which she and her family are eligible.
• PARIS (Public Assistance Reporting Information System): A repository of data transmitted by states to the PARIS for various purposes within the Temporary Assistance to Needy Families program. (page12)

Every time a clinical system is changed, the interoperability is affected. When using most systems now days, there are certain tests and upgrades that need to be followed which can cause difficulties for the providers, and the organization as a whole. A standardized system will be developed and used to log technical issues and business requirements submitted by the HS Domain Community of Interest (COI). Once submitted, the Business and Technical Committee will review, track and resolve the issues and address the business requirements. This Operations and Maintenance Plan will be updated when the standardized issue and requirements management system and its use are defined. While analysts will be tasked with migration, the best-performing organization leaders will ensure that interoperability strategies, software, and work methods smooth the upgrade path. This will minimize downtime, shorten testing timelines, and reduce impacts on clinicians.

* Reference: * * • Administration for Children and Families, Human Services Interoperability Initiative, * Project Charter and Project Management Plan, Version 2.0, dated April 2012. * https://www.acf.hhs.gov/sites/default/files/assets/niem_hs_domain_om_plan_2012_0615.pdf * * * * *