Stewards of Change June 10, 2013 Linda I. Gibbs Deputy Mayor Health and Human Services City of New York 1
Welcome to Worker Connect Provides real-time access to select client data from five City agencies. Uses innovative data share technology to pull data from agencies. Worker Connect is not a database! Data sharing in accordance with all applicable laws and regulations. Users are provisioned according to their role. If you don t need it, you don t see it! Currently 7,000 authorized City employees from 10 Agencies use this system. 2
Current Uses for Worker Connect Use Case Confirm client s address/location Client address Examples of Relevant Data Confirm family s location in the shelter system Find collateral contacts Locate family members/relatives Verify family s building and landlord information Verify income/financial situation Confirm child care enrollment Confirm family s benefits status Verify identity of family member Find child s birth certificate Confirm family composition DHS placement, placement history and shelter information NYCHA TDS tenant information, DOF landlord information, family composition, child care provider information, employment information All data with address information, DOF tenant information, NYCHA tenant information DOF SCRIE landlord information, NYCHA tenant information DOF SCRIE household income information, NYCHA TDS household income, HRA benefits and employment information, pay stubs, lease agreements ACS ACCIS Child care enrollment and provider information HRA Public Assistance, Food Stamp, Medicaid case information Any document with photo identification of client - Driver s license, US passport, Medicaid Card Birth certificate image NYCHA TDS household composition, DOF household composition, HRA household composition, ACCIS child care enrollment 3
2013 Plan for Adding Data Sources to Worker Connect Data Source Request from Current Users Work in Progress Complexity of Integration Policy Priority DOE Automate the Schools (ATS) ACS CONNECTIONS DOC (Post Incarceration) DOP (Post Incarceration) HPD (Section 8) NYCHA (Section 8) DFTA HRA Adult Protective Services NYS DOL Wage Reporting System NYS DOH PSYCKES DHS CARES 4
Worker Connect for HHC Health Homes Health and Hospitals Corporation (HHC) Health Homes became Worker Connect users in July 2012. As of May 2013, 72 users have been provisioned access to Worker Connect. Access to Worker Connect enhances engagement and coordination efforts to successfully implement Health Homes in accordance with the Affordable Care Act. Use Case Verify current address/contact information for locating/finding eligible enrollees Ensuring service and care coordination Referral to Community and Social Support Services Care Coordination and Health Promotion Verify that client is in the shelter system Verify client s benefits and Medicaid status Verify the client is a veteran Description Finding eligible patients. Using current contact information to locating individuals and seek their enrollment in the Health Home program. Engaging and retaining health home enrollees in care. Coordinating and arranging for the provision of services. Supporting adherence to treatment recommendations, and monitoring and evaluating the enrollees needs. Identifying available community-based resources and actively managing appropriate referrals. Engagement with community and social supports to coordinate services. Ensuring appropriate access to resources such as public benefits. Engaging and retaining Health Home staff enrollees in care; coordinating and arranging for the provision of services; supporting adherence to treatment recommendations; and monitoring and evaluating a patient s needs, including prevention, wellness, medical, specialist and behavioral health treatment, care transitions, and social and community services where appropriate through the creation of an individual plan of care. Access to shelter placement information for processing Medicaid applications for clients. Working with patients to apply for SNAP (food stamps), Social Security Income, and other types of public assistance, benefits, and housing subsidies. Verifying Medicaid status for enrollment. Accessing information to prompt workers to check to see if a client has veterans insurance, and potentially flag them for other benefits and supportive services such as veteran-specific housing. 5
Worker Connect Usage 120,000 100,000 80,000 60,000 40,000 20,000 0 Number of Transactions by Month Aug-10 Oct-10 Dec-10 Feb-11 Apr-11 Jun-11 Aug-11 Oct-11 Dec-11 Feb-12 Apr-12 Jun-12 Aug-12 Oct-12 Dec-12 Feb-13 Apr-13 ACS DFTA DHS DJJ DOC DOF DOHMH DOP HHC HRA Worker Connect currently has approximately 6600 provisioned users 6
ACCESS NYC Overview - Benefit Information. One Place. ACCESS NYC is an online resource that allows users to screen for eligibility for 30 City, State, and Federal programs. Users are also able to: Find out how to apply for programs; Download blank and pre-populated applications; Search for office locations and open a map; Get information on what documents are needed to apply; and Create an account to return at a later date. ACCESS NYC also allows users to apply online for 4 benefits: SNAP (Food Stamps) School Meals Senior Citizen or Disabilities Rent Increase Exemption Medicaid/Family Plus renewals ACCESS NYC is available in 7 languages English, Spanish, Russian, Arabic, Chinese, Korean, and Haitian Creole. 7 7
ACCESS NYC: Current Usage Statistics Number of visits Cumulative Number of visits to ACCESS NYC Homepage 3000000 2500000 2000000 1500000 1000000 500000 0 2006 2007 2008 2009 2010 2011 2012 2013 Year Number of visits to YEAR ACCESS NYC Homepage 2006 35,885 2007 119,824 2008 222,589 2009 354,814 2010 424,519 2011 640,127 2012 765,488 2013 (Jan. to May) 275,142 Total visits to date 2,838,388 ACCESS NYC averages 2,000 page visits a day. To date 643,445 ACCESS NYC accounts have been created. On average ACCESS NYC receives 200 Helpdesk tickets per month. 244,380 Medicaid Renewals Applications, 2,218 SCRIE/DRIE Applications, 29,572 School Meals Applications and 145,774 SNAP (Food Stamps) Applications have been submitted through Access NYC. 8
HRA s Virtual Client Service Center By summer 2014, HRA will leverage ACCESS NYC to create a Virtual Client Service Center that will allow clients to apply and fully manage their benefits online. It will provide an expanded self service client account, including: Additional online applications and recertifications Case change request (e.g., add a child) Electronic case record (e.g., view data, notifications, and stored documents) Document management and upload (e.g., reuse verification documents previously provided to the agency and add new documents) Client calendar (e.g., appointments, notifications, case milestones) Online help The Virtual Client Service Center will create a platform for the City s other health and human services agencies to build on. 9
Mission Primary Care Information Project Improve the quality of care in medically underserved areas through health information technology Data-driven quality improvement NYC Penetration Over 8,000 providers 1,064 small practices 31 large practices 63 community health centers 54 hospitals & outpatient clinics Over 3 million patients
EHR ADOPTION IS ONE OF SEVERAL FOCUS AREAS AT PCIP NYC DOHMH: PRIMARY CARE INFORMATION PROJECT EHR Adoption & Meaningful Use Federal Regional Extension Center Quality Improvement & Pay for Quality Patient Centered Medical Home e-prescribing Interoperability Health Information Exchange Interfaces Public Health Monitoring Chronic Disease Surveillance Diabetes Registry Pay for Performance
THE DATA WE GET IS USED TO PROVIDE FEEDBACK TO PATIENTS AND TO DO POPULATION HEALTH SURVEILLANCE Provider dashboards Population health BMI distribution Obesity in NYC Patients: BMI Distribution in 2010 Data from 217 PCIP practices which returned non-error values from 9/2/2011-9/11/2011.
Example of Smart EMR Design
Data-driven quality improvement across 150 PCIP practices From 2009-2011* Doctors delivered 3 times the number of recommended preventive services Improved diabetes management for 81,000 patients Improved blood pressure for 96,000 patients 58,000 smokers got access to cessation programs *Unpublished estimates; data from 150 practices on EHR Oct 2009-Oct 2011