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
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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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