A FRAMEWORK FOR INTEGRATION & INTEROPERABILITY ... - WWP

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Data collection. Information processing modules: • Collection, curation,. • Consolidation,. • Data Quality & V
A FRAMEWORK FOR INTEGRATION & INTEROPERABILITY IN SOCIAL PROGRAMS (benefits & services) International Seminar on Integration of Databases & Information Systems for the Improvement of Public Policy ~ Rio de Janeiro & Brasilia, Brazil ~ April 2016 Kathy Lindert, Global Lead for Delivery Systems for Social Protection & Labor,The World Bank

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The poor & vulnerable often face multiple constraints, risks, barriers. These constraints differ by context, family, and life-cycle.

Low Skills & Education

Limited Productive Assets Limited Access to Finance

Unemployment, Under-employment, Inactivity Substance Abuse

Violence, Crime, Conflict

Remoteness, Distance Slums, Poor Quality Housing

Low wages, Low quality jobs, Informality

Teen Pregnancy

Poverty

Legal Troubles, Governance Challenges

Child, Elder Care Taking Responsibilities

Aspirations, State of Mind

Disasters, Shocks

Family Challenges Disability, Aging

Malnutrition Lack of Basic Services (WASH, Energy, etc)

Health Shocks, Illness, Injury

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As such, most countries offer a myriad of social benefits & services to common target populations Families

Pregnancy & ECD

Childhood

Youth

Conditional Cash Transfers (CCTs) UCTs

Birth, Child Allowances

Food Stamps

Maternity Benefits

Housing Subsidies

Nutrition Supplements

Utility Subsidies Transport Subsidies Family Services

Public Works Scholarships

School Feeding, Supplies, Transport Services for At-Risk Youth

Parenting Services ECD & Nutrition Child Care Services

Intermediation, Counseling, Psycho-Social Support Services Disaster Services

Active-Age Adults

Child Protective Services

In-Work Benefits Unempl. Assistance Unempl. Insurance

Disabled

Elderly

Disability Assistance

Social Pensions

Care-Giver Allowance

Contributory Pensions

Disability Insurance

Survivor & Death Benefits

Food Stamps

Sickness & Injury

Utility Subsidies

Transport Subsidies Training & Skills

Active Aging Services

ALMP / Activation Services

Financial & Productive Inclusion Services Legal services

Social & Long-Term Care Services

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But the delivery of multiple benefits and services by numerous agencies can result in fragmentation

Many

Separate programs delivered in “silos” Sharing common target population

Lack of coordination to take advantage of synergies With separate management and delivery by different

institutions, sectors and administration levels. Each intervention with its own requirements, operating rules and implementing mechanisms. => Many agencies, many programs, and lots of resources, but not enough results on improving well-being of the poor and vulnerable. 4

Fragmentation => Inefficiencies for Various Stakeholders

For Policy-Makers / MOF: Lack integrated view & coordination across programs • Can’t tell “who benefits from what?” • Lack info to support decision making and links to broader policy framework

For Local Providers / Social Workers



• Policy Makers

For Implementing Agencies: • • •

Inefficiencies of processes Inaccuracies (fraud, errors, etc) High cost of investing in and maintaining IT systems

Citizens / Clients

Implementing Agencies

• •

Inefficiencies from duplicate processing & redundant data entry (heavy burden on staff & systems) Complex bureaucracies & rules for multiple programs Lack full picture of clients needed for integrated case management

Local Providers / Social Workers

For Citizens / Clients: •

• •

High burden of navigating complex processes & providing information repeatedly Low quality service delivery Barriers to access

As such, many countries are shifting from separate programs to “integrated systems” Many separate social programs

Integrated Systems

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From Programs to Systems: Why Integrate? For Efficiencies

For Effectiveness Of Programs • The poor and vulnerable have multiple needs & vicious circles require joint actions • Synergies from “bundling” or coordinating benefits & services – with fewer duplications of programs • Improved service delivery, responsiveness • More equitable access via common “gateway” for eligibility based on objective information

• •





In Processes & Service Delivery Lower burden to applicants of navigating complex processes Lower burden to staff & agencies from duplication of business processes and redundancy in information (less paperwork!) More transparency and accountability; facilitate oversight, monitoring, detection & prevention of fraud and double-dipping 7 More effective for emergency response

Delivery Chain: Most social programs pass through similar implementation phases or “business processes” Business Processes for Registering & Determining Eligibility (Population = all clients / potential beneficiaries)

Business Processes for Program Delivery (Population = beneficiaries)

Program Case Management

Outreach

Intake & Registration

Assessment Of needs & conditions

Enrolment Decision

Determine Benefits / Service Strategy Service Transaction & Payments

Personal Identification Information (ID)

Socio-Economic Information

Other Information on needs & conditions

Monitor Outcomes

Grievance Redress 8

Instead of operating in a parallel & fragmented manner, these commonalities can present opportunities for “Integration”

Outreach

Program 1

Intake & Registration

Assessment Of needs & conditions

Enrolment Decision

Determine Benefits / Service Strategy

Personal Identification Information (ID) Socio-Economic Information

Program Case Management Monitor Outcomes

Service Transaction & Payments

Grievance Redress

Other Information on needs & conditions

Outreach

Program 2

Intake & Registration

Assessment Of needs & conditions

Enrolment Decision

Determine Benefits / Service Strategy

Personal Identification Information (ID) Socio-Economic Information

Program Case Management Monitor Outcomes

Service Transaction & Payments

Grievance Redress

Other Information on needs & conditions

Outreach

Program 3

Intake & Registration

Assessment Of needs & conditions

Enrolment Decision

Determine Benefits / Service Strategy

Personal Identification Information (ID) Socio-Economic Information Other Information on needs & conditions

Grievance Redress

Program Case Management Monitor Outcomes

Service Transaction & Payments 9

Examples of integration along the delivery chain Common Registration & Eligibility Systems (e.g., via Common Application Forms, Single Windows, & Unified Social Registry Systems) Coordinated Benefits Delivery or Management (e.g., via linking of beneficiary registries or integrated payments)

Program 6

Program 5

Program 4

Program 3

Program 2

Program 1

Integrated Case Management & Referral System (Sharing info across providers of benefits and services)

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What do we mean by “Integration” and “Interoperability?”  In Social Policy, “Integration” can have many meanings and “degrees:”  “Consolidating” or “Unifying” programs or systems, for example: 

Fully merging multiple programs into a single program (as was the case when four programs were consolidated into one, to create the Bolsa Familia Program in 2003)



Fully unifying systems into a single common system (such as the creation of a Unified Social Registry as a common gateway for registration and eligibility for multiple programs)

 “Linking or connecting” of people to multiple programs or of systems to each other,

for example:  Adopting an “Integrated Approach” to social policy by connecting people to multiple benefits

and services (e.g., via referrals, integrated service centers, etc.)  Connecting processes, components or systems for coordinated service delivery

 “Inter-operability” is the ability of two or more independent systems to communicate and function together by sharing information and using that information to make better decisions 

Inter-operability recognizes that the entities are separate



But requires clear “rules of the game” and tools for operating together

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Integration & Interoperability require actions at three levels (holistic approach) Not just the “back office” of information systems

Start by putting clients & citizens at the center DELIVERY CHAIN

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2

1

Clients & Citizens

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What do we mean by “integration” at level of “citizen & client interface”?

Linking people to bundles Of benefits & services

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Citizens & Clients

Improving “User Experience:” •

• •



I can apply for various programs at same time I know where to go & who to consult in my community Applying is easy: I won’t have to miss a day of work just to apply for benefits Services are accessible 13

Citizen Interface & the importance of the “front office” ~ Common Application Forms, One-Stop Shops, Single Service Windows, Integrated Service Centers, Online Platforms, etc. Before: Multiple unconnected channels

After: Integrated channel

Program 1 Program 1

Program 2

Program 3

Families must apply for each program separately

Citizen Service Window

Families can apply for many programs with common application form – and receive services at single window

Program 2

Program 3

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Some Considerations for Citizen-Centered approach  Despite the common emphasis on “shops” “windows” or “centers,” it

isn’t only about the physical place or infrastructure:  Citizen-centered and service oriented culture

 Trained staff, from call-center operators to social workers to managers, and

so forth  Digital interface also emerging as an important part of the service “window” –

e.g., online “check-my eligibility,” application forms, benefits tracking, notifications, alerts, queries, grievances, etc.

 The importance of incorporating User Experience and feedback into

design and implementation (e.g., US food stamps applications process)?  Information tools to support the front line….  Importance of client authorization and legal framework for information

sharing

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Integration via Interoperability of Information Systems

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Clients & Citizens

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Information Systems support key Business Processes along the Delivery Chain for Social Programs Data Analytics, Monitoring, Reporting

Client Information Systems (Transactions) Social Registration & Eligibility Info Systems (SRIS)

Objectives: Intake, eligibility, coordination, monitoring

Population = all applicants

Beneficiary Registry Information Systems

Case Management Information Systems

Objectives:

Objectives:

Track benefits & beneficiaries, Support payments, Monitoring, Coordination to detect duplications, gaps; NOT for eligibility determination

Support case workers for referrals, counseling, monitoring, reporting, especially in working with complex cases

Population = beneficiaries

= beneficiaries, depending on level of complexity

of specific programs

Population

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Interoperability of information systems involves: Business Processes

Identification and sharing of common business processes and harmonization of concepts…

Information (data) IT Systems

Governance

Sharing of information across agencies, programs, and systems ~ with security & confidentiality…Crucial role of Unique Identifiers (ID) to link data across systems.

Shared access layer, applications, IT services, IT infrastructure … with Info Security (access controls, single sign-on, network security, data security and privacy, etc.)… Clarity of governance, including Institutional arrangements, MOUs, legal agreements,18 policies for data sharing & information security.

Inherent Tensions: Culture of Information Sharing vs Information Confidentiality, Security Principles: • Culture of sharing and joint problem-solving for integration & interoperability • Combined with principles of “minimal sharing” (need-to-know basis)) needed to achieve objectives • Plus clear rules and protocols for authorization, access, updating, confidentiality, privacy and security

Information Sharing & Interoperability

Information Confidentiality & Security Concrete Tools: • • • •

National legal policy, legislation, and regulatory framework for information security (access, use, content, encryption, standards, emergency management & backup) MOUs and data sharing protocols for access, use, content, etc. Implementing Strong Access Restrictions: Levels of access (need-to-know basis); assign and track all access to computers and data systems within the ID 19 environment; and Restrict physical access to all data. Network security: Install and maintain a firewall configuration to protect data; and Implement an encryption standard for data both in transit and at rest

Four examples of integration & interoperability via information systems supporting social programs Example

Purposes

Type of integration / interoperability

1. Unified Social Registry Information Systems

Registration and Eligibility

Fully shared, common systems for use by multiple programs & agencies (unified, shared)

2. “Integrated” Beneficiary Registries

Coordination, detection Linked information systems of duplications across (interoperable) programs

3. Data exchange with other information systems

Authentication, Links between separate Information quality information systems (sourcing, cross-checks) (interoperable)

4. Information systems supporting “integrated case management”

Supporting effective case management, referrals, and service coordination

Links between information systems across multiple agencies 20 (client records, case portfolios)

Example 1: Systems for registration and eligibility determination are more likely to be shared across programs due to common target groups and eligibility concepts (Unified Social Registries)

Common?

Could be?

Can’t be?

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Photo from participatory process to map which social programs could share a Common Application Review for the Intake & Eligibility Phase (Montgomery County Maryland) US Department of Health & Human Services / Administration for Children & Families (ACF), “LOTC-NHSIA Reuse of Common Services,” January 2014.

As such, many countries have developed Unified Social Registries to serve as a “gateway” for multiple programs Single Window for Client Access

Are visited by mobile teams

Or apply at local offices Or apply online

Unified Social Registry Information DATA System (U-SRIS) (Population = all potential beneficiaries)

Registration & Data collection

Social Registry Database

Information processing modules: • Collection, curation, • Consolidation, • Data Quality & Validation, • Transformation => processed data

Program Management Information System

DATA

Program Management Information System

DATA

Program Management Information System

DATA

Program Management Information System

DATA

Program Management Information System

DATA

Program Management 22 Information System

Unified Social Registry Information Systems require Interoperability with User Programs at the various levels: Common business processes for Outreach, Intake & Registration (including common application form & interview), assessment Business of needs and conditions (harmonized concepts) across Processes User Programs

Information (data) IT Systems

Governance

Harmonization of concepts, data formats; Defined information flows across the business processes (data collection, entry, transmission, transformation, and use by User Programs)

Shared IT systems to support information flows across the business processes + sharing of information with User Programs (automated, queries, etc.) Legal & institutional arrangements for “host agency; Data sharing protocols 23 for User Programs (sharing “minimal” or full information?) Policies & tools for Information Security

Example 2: Countries also sometimes “link” beneficiary registries across programs for the purposes of coordination  Linking “back-office” administrative

information on beneficiaries and benefits across programs (and agencies)

BR for Program 1

BR for Program 2

BR for Program 3

“Integrated” Beneficiary Information System BR for Program 4

BR for Program 6

 This facilitates coordination, monitoring, and

tracking of receipt of multiple benefits and services across programs

 This type of Interoperability requires:

BR for Program 5



Linking via unique identifier (unique ID or alternate identifiers)



IT systems that can communicate with each other



Data sharing protocols between agencies

 Need a “culture of sharing” … but also

principle of sharing “minimal” information24 across programs – intersection only and with consent

Example 3: interoperability of social information systems with other information systems (data exchange ~ linking information systems) Unified Social Registry Information System

Beneficiary Registry Program 3 Beneficiary Registry Program 1



Beneficiary Registry Program 2

Integration layer – via ID

Civil & Population Registries

Tax System

Social Security Contributions & Benefits

Labor & Unemployment Info Systems

Health Insurance

Etc.



Property & Vehicle Ownership



This facilitates: 

Authentication (ID)



Quality of information (cross-checks, verification)



Data sourcing … and reducing the amount of information that must be provided by applicants



Coordination, broader policy view



Possibly, linking of “informal sector” with “formal sector” (e.g., linking applicants or beneficiaries of cash transfers with systems for taxes, social security,, labor)

This type of Interoperability requires: 

Linking via unique identifier (unique ID or alternate identifiers)



IT systems that can communicate with each other



Data sharing protocols between agencies

Need a “culture of sharing” …but also principle of sharing 25 “minimal” information across systems – intersection only and with consent

The challenge of interoperability across information systems in the absence of a Unique ID  Many countries lack a national “Unique ID” (foundational ID) 



Within a single program – or a single system (such as a unified social registry), the “workaround solution” has been to assign a functional ID to individuals and families. 

This isn’t ideal, but it works – and many countries with fairly advanced systems have been using this “workaround” solution



Albeit with imperfect ability to authenticate and ensure uniqueness, which can result in fraud and errors – as well as the multiplicity of costs of assigning and distributing numerous ID cards

The limitations of not having a national Unique ID become even more apparent when trying to link information across separate information systems, i.e., with interoperability. 

Unique ID is really the KEY to unlocking the system in terms of linking data across information system



Workaround solutions – such as crossing data with multiple “alternate identifiers” are suboptimal

 There are many advantages to having a Unique ID: interoperability across info systems,

ensuring uniqueness, efficient authentication, increased outreach for coverage of the 26 poor, potential for continuous updating based on frequent data exchange, lower overall costs of identification in the long-run

Example 4: The need for Interoperability to Support Integrated Case Management Clients often need multiple benefits and services

Social work case management can help them navigate and access those services in an integrated way

Establish case (or close it) Monitor progress, quality, case outcomes

Services are often provided by multiple agencies

Manage case info

Service

Service

Service

Service arrangements, referrals, placements

Develop Service Plan

Access to, and management of, information for integrated case management is complex… 27

Information Challenges in Integrated Case Management 





Multiplicity of record keeping across agencies: 

Multiple agencies maintain information pertaining to the same client.



As such, multiple case records are often established and maintained or the same client by different human services agencies per their procedures.

Evasive Concept of the “Assistance Unit” 

Data is typically maintained per individual (for both person data and case data).



Agencies may have legal access only to those clients they are serving and not to other persons in a household.



The client group may change over time and linkages must be managed as the composition of the client group changes (e.g., changes in family composition)

Sensitivities in sharing info across agencies: 

Data shared across agencies will likely be subject to rigorous management policies – and harmonizing these policies can be challenging



Culture of sharing? In practice, agencies can be protective about allowing other entities to access or update their information (e.g., information on child residence that could affect multiple programs or be sensitive due to child protection concerns)



How much information to share? Who decides what’s needed to achieve balance of confidentiality, privacy, and proactivity to detect and meet clients’ needs? 28



Emerging topic: client access to own data…. Who in the “family” has such access?



=> Clear rules of the game needed for business processes, information, IT, and governance!

Integration & interoperability also require institutional coordination

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Clients & Citizens

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Institutional, Financing & Governance Aspects

Institutional Aspects Clarity of roles & responsibilities

Financing Who bears cost of multi-user systems?

Legal foundations… and barriers Information security & confidentiality policies

Institutional “home” for any centralized systems Culture! Of collaboration and information sharing

Governance

Efficiency gains may occur in agencies not bearing the costs

MOU’s for data sharing protocols & data access

Policies & procedures 30 for info sharing… & follow up!

CONCLUDING REMARKS: 1.

Many countries seek to “Integrate” their social programs to improve effectiveness and efficiency – and reduce fragmentation

2.

Most social programs (benefits and services) pass through similar implementation phases along the delivery chain

3.

This provides opportunities for integration – either by sharing common processes and systems or by linking systems

4.

Integration and interoperability require coordinated action along the delivery chain at three levels:

5.

6.

a.

Client interface

b.

Information systems

c.

Institutions & governance

In the area of social programs, there are many opportunities for interoperability of information systems: a.

Unified Social Registries (for common registration and eligibility “gateways”)

b.

Linked or “integrated” beneficiary registries (for coordination and monitoring across programs)

c.

Data exchange with other information systems (for authentication, information quality, etc.) – UNIQUE ID is KEY!

d.

Integrated case management

All of these types of interoperability require investments and clear “rules of the game” for: a.

Business processes

b.

Information

c.

IT

d.

Governance

e.

& information Security across the board

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… because coordinating, delivering & receiving social programs shouldn’t be so complicated

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THANK YOU

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