Rapid improvements in data collection, analysis, and planning are driving wholesale changes to information management in human services organizations. As a result, leaders of these organizations are bracing to keep up with increasing internal and external requirements.
Several factors are accelerating human services organizations' IT adoption. States' increased reliance on Medicaid, particularly state-based waivers, has dramatically increased the complexity of reimbursement and service quality management. HIPAA has focused attention on client information privacy and security, while increased access to inexpensive broadband Internet connections makes information more readily available.
This sharpened focus on data and information is rapidly drawing more organizational processes into consideration for IT automation. Yet organizations are running into new technology issues as they move beyond basic tools such as word processing and e-mail.
To make the process smoother, organizations need an enterprise-wide approach. Harvard professor Andrew McAfee describes the process of moving to an enterprise-wide approach as starting with “Function IT” that assists with tasks, then moving to “Network IT” that facilitates interactions, and finally ending up at “Enterprise IT” that specifies business processes.1 McAfee notes that enterprise IT applications are “purchased and imposed…by senior management” and cannot be adopted without “new interdependencies, processes and decision rights.” The change management effort required to implement Enterprise IT requires strong CEO and board support, as well as clear, well-articulated information management processes.
The Joint Commission recognizes this need in its behavioral healthcare standards for the management of information. The standards' goal is to improve organizational client care, services, governance, management, and support processes. Information management processes must:
Identify information needs
Design the information management system structure
Capture, organize, store, retrieve, process, and analyze data and information
Transmit, report, and display data and information
Safeguard data and information
To take all this into consideration, using enterprise resource planning (ERP) tools is an effective way to implement an enterprise-wide information management process. Yet these IT solutions are daunting for even the most profitable companies. Many organizations instead attempt to integrate several applications to approximate ERP tools' capabilities. The resulting low ERP adoption rate in healthcare organizations in general is mirrored in human services and behavioral healthcare organizations.
To be successful, organizational goals and objectives, such as performance improvement, must come first in process design. An organization might focus on improving client outcomes within financial and other resource constraints. Best practices and/or evidence-based practices provide excellent guidance for process design, as clients, families, and funding sources require more evidence to demonstrate the benefits of services.
Information to plan, deliver, document, and improve services typically is collected in paper and electronic formats. Information management process design must establish consistent information management policies and procedures to ensure underlying data quality and to manage accuracy, completeness, and timeliness of current and future data, as well as future data requirements.
Many successful human services organizations are beginning to address enterprise information management. To ensure individual component compatibility of the enterprise system, policies and procedures have to be developed. Practical considerations include the following:
Network design. As the network expands to serve more users, locations, and applications, network management overhead increases. Consider virtual private network (VPN) Internet technology (allowing users to access the network from other locations), lower maintenance Internet browser-based applications, and an internal portal to serve as a secure single point of access for all applications.
User names and passwords. Nobody likes to remember separate user names and passwords for multiple applications. Applications that integrate network user name and password management (e.g., Microsoft's Active Directory) simplify this process. Identity management software can help to address this issue.
Software compatibility. As new software applications are purchased, focus on compatibility. Integration is easier when all applications rely on common database and reporting tools (e.g., Microsoft SQL).
Organization. Traditional organizations have management structures that illustrate management responsibilities. This structure usually is embedded in human resources information systems (e.g., managers have greater security clearance than line staff). Yet accounting and clinical information systems may require more flexibility, as cross-departmental processes and service locations often don't appear in organizational charts.
Therefore, consider adopting an information management chart that defines organizational “information units.” An information unit is defined by management as a portion of the organization that must be uniquely identified when configuring all software applications so that, for example, financial, human resources, and clinical information for the information unit can be analyzed in isolation from the activities of the rest of the organization.