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When Connected Care Creates Better Communities

Why smarter cities build citizen-centered social programs backed by big data analytics.

The closer kids live to a park, the less likely they are to be overweight. This correlation is only one example of the interdependencies between public health and myriad other components of an individual’s life. In reflecting on a career in public health, Dr. Jonathan Fielding, now-retired director and health officer of the Los Angeles County Department of Public Health, said this: “An innovative strategy that introduces improved population health outcomes and closing the health gap are goals to be shared across all parts of government.”

Fielding was speaking at a Governing roundtable event that focused on the importance of social services agencies viewing citizens holistically to make better decisions for improved outcomes. The roundtable convened bright, experienced minds to discuss pervasive problems encountered by social services agencies, the most vexing of which is the status quo of routinely using a disconnected approach to solve interconnected problems. 

According to Fielding, while health behaviors such as eating habits, tobacco use, alcohol consumption and exercise determine 30 percent of our health, it is social factors such as education and employment that determine 40 percent and educational factors -- including where we live -- that determine another 10 percent.  For example, people who live in suburban communities are at a higher risk for high blood pressure and are more likely to be overweight because of more time in the car spent commuting rather than walking to work or exercising. There are also links between poverty and poor health. Low educational attainment also plays a role in longevity.

“Chronic diseases and poverty are interconnected in a vicious cycle -- it is the poor who are most at risk for developing serious health conditions, and it is these conditions that can create or exacerbate poverty,” says the World Health Organization.

The consensus of roundtable attendees was that communication and collaboration, backed by increased intelligence through data, is important if we are to get ahead of these problems and have a chance at overcoming them. Fielding noted that evidence-based approaches can improve health outcomes, and fellow attendee Dr. Steven Golightly, director of the Los Angeles County Child Support Services Department, agreed: “Better utilization of data will allow us to better use limited resources.” To put it simply, government should leverage data, build smarter approaches and integrate solutions so it can help achieve better results.

See how the following two municipalities are taking smarter approaches to social services.

Austin, Texas: Optimizing Resources and Connecting People

Austin -- a 2010 IBM Smarter Cities grant awardee -- is a dynamic, growing community brimming with music and artistic culture, a mass of technology entrepreneurs and start-ups, and a civically engaged and environmentally conscious citizenry. 

Municipal leaders had a high benchmark for Austin. They wanted it to be “the most livable city in the nation.” But to do this, they needed to address some persistent problems, one of which was a large disparity between East Austin and West Austin. City leaders pointed out to the Smarter Cities team that residents in East Austin did not experience the same quality of life as those in West Austin, did not participate in government at the same rate and felt frequently disengaged from the greater Austin Community. 

Austin leaders asked the Smarter Cities team to help them create social prosperity for all citizens; address physical and economic barriers; evaluate infrastructure parity, human capital development, education, neighborhood affordability, homelessness and economic development opportunities; analyze the interconnectivity of the social service infrastructure with an overarching city strategy; and explore opportunities to leverage City of Austin Independent School District data sources.

Like the attendees of the Governing event, Smarter Cities team members identified increased collaboration as a crucial step, in this case particularly across the City of Austin and the Austin Independent School District. Looking at citizens holistically, Austin could more effectively optimize resources to connect people to needed programs and create a more citizen-centered experience to achieve sustainable outcomes. 

Smarter Cities also recommended the Austin Department of Health and Human Services develop a strategy and roadmap to transform how social services are provided and implement technical solutions such as case management, analytics and reporting to allow better information sharing and improved outcomes.

Learn more about Austin’s Smarter Cities journey.

Alameda County Social Services: Interconnected and Intelligent

Alameda County in California, like many counties across America, was struggling to keep up with the demand of citizens in need. The story is familiar -- budget cuts and staff shortages impeded the Social Services Agency’s ability to help citizens still reeling from the recession. Individuals in need stood in long lines, only to be told they needed to come back with more information. Benefits expired because recipients didn’t reapply in time and inundated caseworkers were not able to proactively help those who needed assistance.

Don Edwards, the assistant director of Administration and Information Services for the Alameda County Social Services Agency, says the situation was difficult for employees of the agency as well, as it was not uncommon for caseworkers to have over 500 customers at a time. Edwards saw fresh hires who were overworked and not able to keep up with demand burn out and become jaded.

Edwards, who spent a decade in a banking industry career, says the key to improving the agency’s situation was applying business practices to social services -- including a focus on efficiency and a more intelligent interaction with customers. 

Edwards advocated for a holistic view of citizens that would take into account not one facet of a customer’s life, but many, and enable caseworkers to anticipate issues and proactively solve problems. But the agency had a huge hurdle to overcome -- disparate data. Each of the agency’s five departments had a separate system, creating siloed information that made it impossible to view citizens holistically. The agency was data rich, but information poor.

The solution was the Social Services Integrated Reporting System (SSIRS), which provides a single, seamless view of customers’ relationship with Alameda’s social services agencies over the course of their lives. Among other things, it can track a child moving through foster care to his or her emancipation as an adult, where he or she may still receive food stamps or other benefits. SSIRS can show how a family grows and changes over time through deaths, births and marital status. Because agencies can see the whole picture of a customer’s life through the entire span of services, they’re able to coordinate service delivery to best match customer needs and minimize service gaps or overlap.

Caseworkers can now proactively help customers because they have real-time visibility into their case. SSIRS also helped the agency reduce the amount of people receiving benefits to which they weren’t entitled. In the first year, Alameda County saved $11 million.

Learn more about Alameda County’s transformation.


For more information on how big data analytics can help improve social services in your agency, check out the Governing issue brief, “Coordinating Citizen Care and Services.”

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