The Technology We Need to Protect Children
It's critical to give caseworkers and everybody else involved in protecting kids a complete, shared picture of every vulnerable child's life.
The federal Protect Our Kids Act of 2013 created a bipartisan commission with the goal of zeroing out fatalities from child abuse and neglect. No one from the technology community is on the commission, which convened for the first time last month. If we've learned anything from the launch of HealthCare.gov, it is that technology that works is essential to the successful implementation of any policy and must be part of the dialog up front.
The reason technology matters so much for protecting vulnerable kids is because we can use it to organize what we know about a child from whatever source, whether inside or outside of government, into a shared picture that gives everyone involved a clearer understanding and catalyzes a coordinated path to action. As the experience of the United Kingdom has demonstrated, when we put the needs of the child rather than those of the bureaucracy at the center, we can save lives.
After a rash of tragic child deaths, health ministry officials in the UK realized that medical personnel did not have any good or timely way to access or combine available information about whether a given child had a child-protection plan or was a regular visitor to emergency health services, both significant indicators of a history of abuse. In response, the ministry created a child-protection database that allows for virtual collaboration between medical practitioners and child-welfare caseworkers. The result: more-timely interventions that have been quite effective in preventing an escalating pattern of abuse.
The lesson here is simple and compelling. If abundant information is to help government serve its people better, then it does not matter what entity created that data. All that matters is that when UK health officials want to know if a child is likely to be at risk they can answer the question.
This is hardly news. It is an approach that has long been known -- and followed -- in the best health care. In leading-edge medical practices studied by Michael Porter and Thomas Lee, patient-centered models, such as the one followed by Geisinger Health System in Pennsylvania, consistently lead to faster treatment, improved outcomes and lower costs. At Geisinger, chronic-care teams now even include pharmacists -- a shift that has resulted in fewer strokes, amputations and hospitalizations.
With children, as with health care, putting those served at the center of the information web is a powerful lever for continued innovation. Consider the trailblazing example of Indiana's Department of Child Services, whose performance had long been hampered by the state's old child-welfare case-management system and the technology on which it was based. Two years ago, state officials created a new integrated child-welfare information system, MaGIK, using a case-management application called Casebook developed by a nonprofit supported by the Annie E. Casey Foundation. Casebook links together all the relevant input of caseworkers, supervisors, administrators, teachers, doctors and parents in one place.
Since going live in July 2012, the new system's data-driven design has begun presenting actionable intelligence to caseworkers to help increase, for example, the frequency of in-person visits with children in care, which is a powerful predictor of child safety. And the new system's real-time analytics are helping to measure the impact of agency initiatives -- highlighting, for example, a reduction in the percentage of stays in foster care that last under 15 days from 13.9 percent to 4.9 percent. That's an important indicator that foster care is being used only when absolutely necessary, minimizing the risk of needlessly disrupting children's lives when better alternatives exist.
Obviously, governments need to spend their resources on technology that really works, not just on what is offered by companies that know best to how to navigate elaborate procurement processes. They need to build software more intelligently and with more input along the way from real users. And they need better in-house capability to use available technology to innovate.
But beyond specific questions of technology, the most powerful lever for safeguarding children and improving their lives is to commit, systematically, to using the best available tools to give everyone -- from doctors to teachers to family members to caseworkers -- a shared, data-rich and up-to-date picture of a vulnerable child's life. In the world of child welfare, technology isn't a nice-to-have efficiency tool; it's a must-have life-saving device.
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