Pessimists Beware: This is the First of Three Blogs on Government Progress in Interoperability, Information-Sharing . . . and Social Determinants of Health and Wellness

It’s election season, so we all hear routinely from candidates across the political spectrum about what government doesn’t do, about how inefficient it is and about how it doesn’t really strive to serve people. I’m not going to take sides in that debate, but the optimist in me has to weigh in with this: What gets lost in the cacophony of nay-saying is the reality that, whatever problems may exist, significant advances are being made on some fronts and the opportunity for even more progress has never been greater.

That fact (yes, I believe it’s a fact) came to life for me throughout the Stewards of Change Institute’s recent 10th Anniversary National Symposium, which was held in partnership with Johns Hopkins University in Baltimore. Speaker after speaker at the three-day event provided chapter and verse about ambitious initiatives being planned and implemented across our country by federal and state agencies, as well as by organizations like the Robert Wood Johnson Foundation and by companies such as IBM, Google and Deloitte. These programs and projects differ in many ways, but they all have one thing in common; that is, they are designed to concretely improve the lives of individuals and communities by utilizing technologies that simply didn’t used to exist – but that, today, permit enhanced information-sharing and systems integration, facilitate lower costs and greater efficiencies, and most pointedly and importantly, enable better delivery of health and human services.

One panel at the symposium, in particular, illustrated the pervasiveness and potential of the positive developments that aren’t getting the attention they deserve. The panelists, who were senior representatives from a range of federal agencies (Centers for Medicare and Medicaid Services, Administration for Children and Families, Veterans Administration, Bureau of Justice Assistance, and Information Sharing Environment) described an innovative, collaborative effort that is enabling cross-system, cross-agency sharing in entirely new ways. They also discussed specific actions that will allow HHS to learn from and utilize a tremendous body of knowledge and experience gained over the past decade from ISE’s work with national security agencies. Watch this video for their presentations.

In addition, the panelists presaged that new federal initiatives would be forthcoming to encourage, support and fund further progress. In fact, just a few weeks after our Symposium, a “tri-agency” letter was published in which they announced the extension of important components of the Affordable Care Act relating to interoperability. Specifics are in the letter, but here’s a bottom line: Federal Funding Participation will continue for at least another three years, with a hint that it will become permanent, effectively meaning the government will cover 90 percent of the cost of developing and implementing a variety of IT components that increase information-sharing and interoperability between Medicaid and human services. Whatever issues critics may have with “Obamacare,” this is a positive development.

I’ll end this commentary by shining a spotlight on arguably the most promising sentence in the “tri-agency” letter. After explaining that the extended timeline is intended to give states the opportunity to support “optimal system integration between programs,” it adds: “These programs, by working together, acknowledge the social determinants of health and contribute to national health and wellness goals.” You read it right – Social Determinants of Health and Wellness, which were a major element of the Stewards’ Symposium and will continue to be a primary focus of our work going forward, are now officially front and center on the federal agenda.

This is a very big deal and deserves special attention. So it will be the focus on my next blog in this three-part series, in which I’ll also describe the multimedia training curriculum that Stewards of Change Institute is developing on social determinants, information sharing and InterOptimability (stay tuned on this one). Our goal, with funding from RWJF, is to assist the HHS community all levels in building its knowledge, skills and competency around these topics so they can better operate within a 21st Century work environment, thereby improving efficiency and, always, most vital, enhancing outcomes for clients.

These are exciting times. The optimist in me believes that, through vision and leadership, substantial and positive change is already occurring – and the best is yet to come.


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