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Camey Christenson2-1-1 San Diego
Driving Collaboration & Cross-Sector Data Sharing with a Community Information Exchange
Alana Kalinowski
2-1-1 San Diego
Peter Battistel
2-1-1 San Diego
Driving Collaboration & Cross-Sector Data Sharing with a
Community Information Exchange
The 2-1-1 San Diego Story & CIE Toolkit
Camey Christenson
Senior Vice President
Introductions
Alana Kalinowski
Director of Partner Integration
Peter Battistel
Chief Technology Officer
• Free, 24/7 service, 3-digit dialing code
• Access to community, health, social and disaster
services
• Tailored programs take the client beyond just a
referral—movement towards Navigation
211 San Diego/Imperial
• Systems change that fosters true collaboration
across networks
• Moving towards person-centered interventions
and interactions across healthcare and human
services
• Goal is to improve health and wellness for
individuals and populations
Community Information Exchange
Why a Toolkit?
• Share San Diego’s long history developing,
growing, and maintaining its CIE
• Support the nationwide movement around
capture and use of social determinants of
health data to promote individual well-
being as a foundation for more holistic
approach to community health
• Provide communities across the country
with insights and strategies on how to
approach development of a local CIE
This toolkit was made possible through a generous
grant from the Schultz Family Foundation
www.ciesandiego.org/toolkit
Toolkit Sections
Section 2:
State of the Field
Section 3:
Insights and Strategies
Section 1:
What is a Community
Information Exchange
Learn about the features and benefits of
developing a CIE, including how the CIE creates community
impact.
Discover the influences that shaped the conceptualization
and evolution of the CIE.
Explore the six strategies essential to developing an effective and sustainable
CIE.
What is a Community Information Exchange?
A community information exchange (CIE) is an ecosystem comprised of
multidisciplinary network partners that use a shared language, a resource
database, and an integrated technology platform to deliver
enhanced community care planning. Care Planning tools enable partners to
integrate data from multiple sources and make bi-directional referrals to
create a shared longitudinal record. By focusing on these core components,
a CIE enables communities to shift away from a reactive approach to
providing care toward proactive, holistic, person-centered care.
Core Components of a CIE
Community Information Exchange Partners
Healthcare SectorHealth Plans
Hospitals
Emergency Medical Services
Health Centers
Health Information Exchange
Behavioral Health
Public Health
Network Partners
Social Services SectorNetwork Partners
Housing
Multi-Service
Human Development& Aging
Employment
Nutrition
Legal
Primary
Care and
Prevention
Housing Stability Health
Management
Nutrition & Food
Security
Legal &
Criminal
Justice
Safety &
Disaster
Transportation Employment
Development
Personal Care &
Household
Goods
Financial
Wellness and
Benefits
Education &
Human
Development
Social &
Community
Connection
Activities of
Daily Living
Utility &
Technology
14 Domains: Risk Rating Scale
CRISIS CRITICAL VULNERABLE STABLE SAFE THRIVING
KNOWLEDGE AND UTILIZATION
BARRIERS AND SUPPORTS
IMMEDIACY
Shared Language
(SDoH)
Hub for social and health sites and providers
Resource Database and Bi-directional Referrals
• Shared taxonomy language for
referrals (AIRS)
• Dedicated resource staff
• Standards to listings and
requirements
• Inclusion/Exclusion Criteria
• Linked to health conditions
• Tracks resource availability and
unmet needs
Bidirectional Closed Loop
Referrals
Benefits of a CIE
The Impact of a CIE
Toolkit Sections
Section 2:
State of the Field
Section 3:
Insights and Strategies
Section 1:
What is a Community
Information Exchange
Learn about the features and benefits of
developing a CIE, including how the CIE creates community
impact.
Discover the influences that shaped the conceptualization
and evolution of the CIE.
Explore the six strategies essential to developing an effective and sustainable
CIE.
State of the Field
Proliferation of
Technology
Public Awareness of the Social
Determinants of Health
Evolving Funding Environment
Person-Centered Care
Cross-Sector
Collaboration
Research and
Policy Advocacy
State of the Field
Toolkit Sections
Section 2:
State of the Field
Section 3:
Insights and Strategies
Section 1:
What is a Community
Information Exchange
Learn about the features and benefits of
developing a CIE, including how the CIE creates community
impact.
Discover the influences that shaped the conceptualization
and evolution of the CIE.
Explore the six strategies essential to developing an effective and sustainable
CIE.
Section 3: Insights and Strategies
Identify the CIE Vision and Governance
Mobilize the Community Network
Prepare a Legally Compliant Framework
Adopt Interoperable and Scalable Technology
Cultivate Sustainability
Transform the Movement
Importance of Establishing CIE Vision and Governance
Collective Impact Model
The Five Conditions of Collective Success
Source: Kania, J. & Kramer, M. (Winter 2011). Collective impact. Stanford Social Innovation Review
Common Agenda
Shared Measurement
Systems
Mutually Reinforcing
Activities
Continuous Communicatio
n
Backbone Organization
Backbone Organization
Guiding the development of a shared vision and strategy
Maintaining a shared identity
Expanding the network of partners and funders
Aligning partners and their activities
Engaging target populations
Establishing shared outcomes and measurement practices to
facilitate ongoing learning and process
Action Checklist
1. Establish the Need for the CIE
2. Clarify the Vision
3. Create a Governance Structure
4. Plan for CIE Oversight
CIE Mission, Vision & Values
Mission: Empower communities to engage with people through a human-centered and data-
driven perspective
Vision: Enabling communities to change systems to improve equity and health
Values:
Movement: Driven by innovation and evolution
Meaningful: Create understanding through an informed and experiential lens
Efficacy: Enhance the power of the individual and the community
Engagement: Establish integrated, tailored and inclusive input and information
Interdependence: Build a Network of trusted, supportive partners
Identify Lead(s) or a Backbone Organization
Qualifications
•Committed to addressing health
and social problems through
technology
•Community reputation
•Involvement in the CIE since
inception
Assets
•Staff capacity and expertise
•Direct provider services
•High volume of callers
•Existing technology resources
•Existing relationships with social
and health service providers
•Experience serving in same role for
SD United
Roles and Responsibilities
•Manage brainstorming for initial
and ongoing use cases for
technology
•Develop and manages
technology platform
•Ensure compliance with
appropriate legal protocols
•Engage new and current partners
•Ensure CIE’s financial stability and
sustainability
2-1-1 San Diego as Backbone Organization:
Governance Structure
Individuals from 2-1-1 San Diego, network partner organizations,
and the advisory board also serve on workgroups that support
various aspects of the CIE’s development and management:
Policy WorkgroupShared Language Review
Workgroup
Healthcare and Housing
Workgroups
Workgroups
Section 3: Insights and Strategies
Identify the CIE Vision and Governance
Mobilize the Community Network
Prepare a Legally Compliant Framework
Adopt Interoperable and Scalable Technology
Cultivate Sustainability
Transform the Movement
Importance of Mobilizing the Community Network
Action Checklist
1. Develop a Partnership Engagement
Strategy
2. Create Shared Values and Language
3. Engage the Coalition of the Willing
4. Create an Individualized Partner Plan
Feasibility Assessment
Determine Initial Participation Level
Client State Target Time to Respond
Referral Status: Accept or Decline Within___hours
Outcome Status: Received services or other referral outcome on service
Within ____days
Support CIE Implementation and Ongoing Participation
Prepare a Legally Compliant Framework
Why is this important?
• Sharing data among multiple partners requires a solid
legal framework and protocols that comply with
federal, state and local regulations.
• CIEs that include health providers are required to
meet Health Insurance Portability and Accountability
Act (HIPAA) requirements for sharing Protected
Health Information (PHI).
• Other federal compliance regulations govern the use
of personally identifiable information (PII).
Action Checklist
1. Set Standards for Network Partners
2. Establish Standard Consent
3. Define Roles for Health and Non-Health Partners
4. Establish Standard Security and Privacy
Measures
Business Associates Agreement Participation Agreement Service Level Agreement
Develop Formal CIE Agreements
Privacy Practices
Develop Formal Data-Sharing Agreements
Terms and Services
Partnership Agreements: Data Use Agreement
Adopt Interoperable and Scalable Technology
Action Checklist
1. Analyze Data Systems and Information Sharing Environment
2. Establish a Dedicated Multidisciplinary Design/Technology
Team
3. Set Needs for Technology
4. Select Technology that Supports Interoperability and Shared
Record
Infrastructure/Systems
Platforms
• HMIS (Homeless Management Information System)
• Health Information Exchange (HIE)• ConnectWell (HHSA)• Emergency Medical Services across
cities• Food Bank• Career/Workforce (WIOA funds)• School Systems
• ETO/Social Solutions• Salesforce• Electronic Medical Record
• EPIC, CERNER, NextGen, OCHIN • CC3• Service Point• Excel• Clarity• Oasis • WATER• ACCESS• CommunityOS• CalJobs• STAR• FileMaker• CSTAR• Trilogy
Continuously Explore Opportunities for New Functionality
• Identify situations where real-time upstream alerts
could improve care coordination
• Explore opportunities to integrate data from
prevention efforts
• Monitor trends in using blockchain technology for
service coordination applications
Technology Platform Design
Executive Sponsor Product Owner Project ManagerCall Center Service
Subject Matter Expert
Community Subject Matter Experts
IT / System Subject Matter Experts
Salesforce Administrator
Architect / Developer
During 2-1-1 San
Diego’s the three-
month design phase,
the team invited
potential users to
attend multiple
sessions to test and
provide feedback on the system.
Prioritize Needs and Compare Technology Vendors
Evaluation Criteria RequirementsMaximum Possible Score
Reviewer Score
Qualifications and Expertise
• Organizational experience as it relates to the scope of this
project
• Depth and relevance of staff technical expertise and
experience
• Adequacy of staff to perform work
20
Costs • Reasonableness of costs 20
Record of Past Performance
• Relevant work examples
• Client testimonials and references
• Demonstrated ability to complete work tasks within project
timelines and project budgets
10
Merit of Proposal
• Thoroughness, clarity, and approach of Proposal
• Extent to which the proposed solutions meet the scope and
needs of this project
• Demonstrated understanding of project and requirements
10
Interview Questions
• Appropriateness and quality of responses to questions
• Demonstrated unique or exceptional knowledge of the work
required40
TOTAL 100
Shared Client Record
System Requirements
User Types and Log-Ins
Uniform Data Standards
Longitudinal Record
Bi-Directional Closed-Loop
Electronic Referrals
Care Team Management
Push Communication
ToolsInteroperability Open Source
Security and Privacy
Reporting
Establish Standard Security and Privacy Measures
• Standardize technical requirements
• Provide ongoing privacy monitoring
Security Guidance for Community
Information ExchangePartner IT Privacy and Security
Questionnaire
Section 3: Insights and Strategies
Identify the CIE Vision and Governance
Mobilize the Community Network
Prepare a Legally Compliant Framework
Adopt Interoperable and Scalable
Technology
Cultivate Sustainability
Transform the Movement
Cultivate Sustainability
Importance
• Communities need to begin developing a plan for the CIE’s financial sustainability
from the very early stages of the process to support the partner network and the
technology platform.
• Government agencies and philanthropic funders have played a major role in
providing communities with the initial grants and investments to create, test, and
implement innovative technologies.
• To ensure the CIE’s relevance and viability, communities need to develop and
secure financial and in-kind resources from diverse sources to guide the CIE from
its start-up phase to sustainable operations.
Action Checklist
1. Start Sustainability Discussions Early
2. Determine Sustainability Costs
3. Create Value Propositions for Key Sectors
4. Explore Different Business Models for Sustainability
Creating Value Propositions
CIE sustainability plan to share
with key funders and partners,
and has held ongoing
discussions with its Advisory
Board on the proposed
strategy.
HealthcareJustice-Involved
Education Public Safety EmploymentUtility and
Technology
Data Research Se l f Se rv ice
Opportunity: Without
addressing whole
person, health
outcomes will not
completely improve
for all
Target: Health Plans,
Hospitals, Health
Centers/Clinics
Impact: Improve
Patient Health
Outcomes
Value: Revenue
structure to support
approach and
intervention
(readmission, value
based care, healthier
members)
Opportunity: Lack of
early intervention
and wrap-around
services for children,
families and students
Target: Adverse
Childhood Effects,
Violence, Foster
Youth, Colleges
Impact:
Coordinated
supports for families
and service
providers
Value: Reduction in
Absenteeism
(increase funding for
schools), Graduation
Rates
Opportunity: Poor
prevention, release
and racial inequities
Target: Parole, Re-
entry, Recidivism
Impact: Early
connections can
prevent arrests and
support post-
incarceration with
whole person care
Value: Reduction in
government
spending by
decreasing jail
recidivism
Opportunity:
Increasing
incidences of
violence and
disconnected
prevention and
support resources
Target: IPV, Gun
Violence,
Neighborhood Safety
Impact: Early
intervention
resources to link
individuals and
families in crisis
Value: Local
capacity to prevent
violence and support
communities
Opportunity:
EAP programs, to
support personnel,
family and
workplace
Target: Workforce
Development,
Government
Impact: Ability to
access resources
and supports to be
successful in work
Value: Healthy,
happy and
productive workforce
Opportunity:
Technology divide
Target: Cell Phone
Carriers/Plans, Apps
Impact: Improve
access to resources
and information
Value:
Communication and
connected to needs
to target markets
OPP
OR
UTU
NIT
Y S
TREA
MS
Explore Different Business Models for Sustainability
• Establish a business model and monetization strategy
• Continually evolve and stay abreast of changing funding
climates and opportunities.
Transform and Shape the Movement
• Nationwide movement influencing local ecosystem of network
partners
• Role in building the field of health care and social service
collaborations:
• Conducting research
• Sharing best practices
• Convening conversations
• Championing efforts to standardize care with lens of achieving equity
and social justice
Importance
1. Nurture the Regional Ecosystem
2. Build the Field
3. Shape the Conversation
4. Champion the Movement
Action Checklist
Thank you!
Questions?