The City of Long Beach is addressing one of the biggest challenges facing large U.S. urban health departments: improving complex and often outdated participant management and data systems to strengthen their increasingly vital role of protecting and promoting public health. By rooting out inefficiencies in the way it collects and uses data, the City’s Department of Health and Human Services is seeking to develop a more integrated services approach to participants, a goal with benefits not only for the public but for the Health Department as well.
Long Beach ranks among the top 30 health districts in the country, with a $117 million budget and over 300 staff operating nine locations that handle more than 400,000 participant visits a year. Long Beach, like most other health jurisdictions across the nation, lacks a common intake process. Many of the individuals and families visiting a participant most likely engage in multiple services, but because data is not cross-referenced there is little chance to know how many unduplicated participants are served and the intensity of service level per person across multiple programs. It can be difficult for an individual or family to know what programs are accessible to them. Internal referrals to other Health Department programs are prompted by data and do not consist of this information, causing participants to have to navigate the system themselves. Eligibility for each program is determined each time a person goes to a different program, causing participants to have to repeat sensitive information. Since the programs are not connected with data, it hampers participant’s ability to improve their health and the Health Department’s ability to manage cases.
Still, there is no shortage of data; in fact, the Long Beach Health Department actually uses about 80 databases to operate 30 different programs. Currently, data is compartmentalized by grant designation and databases that do not communicate among each other, meaning each database is often housing much of the same information as others. Therefore, the department is seeking the most appropriate data management platform that works across programs and utilizes staffing, participant care and other helpful metrics, which could generate significant efficiencies, better customer service, and better health outcomes.
The objective is to create a more human-centered systems design that achieves improved service utilization and resourcing. As a first step in this process, the department is conducting a review of the kinds of data now being collected by its various programs and encouraging a change in mindset towards greater openness and cross-agency collaboration. To support this work, the City of Long Beach will partner with FUSE Corps to host an executive-level fellow for one year who will advance the efforts of the Health Department to develop an integrated service delivery model by analyzing current systems and implementing new solutions. The search for synergy among complex parts is an elusive priority for urban health departments: success in Long Beach could serve as a national showcase.
PROJECT SUMMARY & POTENTIAL DELIVERABLES
The following provides a general overview of the proposed fellowship project. This project summary and the potential deliverables that follow will be collaboratively revisited by the host agency, the Fellow, and FUSE staff during the first few months of the fellowship, after which a revised scope of work will be developed and agreed upon by the Fellow and the host agency.
Starting in September 2018, it is proposed the FUSE Fellow will conduct an overview of data collection and participant processing services currently in practice in Long Beach, including interviews with participants to hear their observations and suggestions. Alternative practices in other urban health departments will also be examined. The fellow will then embark on an analysis of that material, formulating a best practice strategy for both participant flows, grantor needs, staff needs and data management. This will be followed by a systems analysis of how best to make that strategy work internally, including an assessment of and recommendations for technological options to put the strategy in practice. The year will conclude with pilot tests of the most promising options, leading to recommendations for an integrated business design that would be ready for future implementation.
The fellow’s success in this endeavor will be evaluated based on several factors. The fellow will apply a strong background in business and systems analysis, preferably but not necessarily in health care or public health, to the central task of evaluating current business practices and devising a new model to increase efficiency and cooperation among programs. It will be necessary to engender a sense of participant and staff participation in crafting the new departmental systems design and inspire a feeling of unity behind it. This also involves building relationships across other City agencies, especially the Technology Services Department. The final two or three months will be dedicated to running pilot tests to validate concepts for improved business design, culminating in a blueprint for future implementation.
Finally, the fellow will need strong project management skills to both oversee a complex process of change and help guide acceptance of that change across a wide spectrum of stakeholders.
- Conduct a landscape assessment: Get up to speed on departmental business practices with regard to participant management and data collection. Establish relationships with bureau managers to understand the range of programs and services offered. Build ties with the City’s Technology Services Department to get an overview of current technology and planned deployments.
- Engage and align stakeholders around goals: Gather information in informal interviews with participants, seeking out suggestions to improve their experience. Work with staff to identify the greatest inefficiencies and listen to recommendations for improvement, creating a climate of collective effort. Research business models employed by similar health departments and build cross-agency relationships.
- Analyze data and devise solutions: Utilizing the information gathered, begin a detailed systems analysis with an eye towards selecting data metrics that establish the greatest efficiencies across multiple programs. Undertake a process analysis of participant flow patterns, particularly looking at opportunities for a common intake system. Design a more user-friendly participant services and data management plan and present it to the director and bureau managers, along with the technological options to put the plan in practice. Make recommendations and assist with the assessment of those solutions to arrive at the best two possible plans.
- Implement pilot tests: Design and implement pilots to test the two options on a scale big enough to evaluate their efficacy. Closely monitor implementation and troubleshoot as necessary. Based on the outcomes, select the most suitable technological platform and prepare a roadmap for its full-scale implementation.
- Kelly Colopy, Director, Long Beach Department of Health and Human Services
- Ginger Lee, Bureau Manager, Collective Impact and Operations, Long Beach Department of Health and Human Services
- At least 15 years of professional experience in a relevant field, particularly with a strong background in business and systems analysis, along with project management.
- Superior critical thinking and analytical skills.
- Ability to synthesize complex information into clear and concise recommendations.
- Ability to relate with strong emotional intelligence and empathy to a wide variety of diverse audiences.
- Excellent stakeholder engagement skills and the ability to use facilitative leadership techniques to coordinate stakeholder activities.
- A team-oriented leader who can also be a self-motivated, independent worker.
- Sufficient, though not necessarily in-depth, understanding of and comfort with technology and systems.
- Persistent in obtaining information and creatively resourceful in identifying technological solutions to systems management problems.
- Ability to create direction and change with direction from leadership, within potentially resistant environments.
- Exceptional written and verbal communication skills with an ease in public presentations.
- Commitment to inclusion, or the need for solutions to support all people in a community regardless of race, religion, gender, sexual orientation, income level, housing status, immigration status, or ethnicity.