Integrated health and human services information systems to enhance population-based and person-centered service

摘要

In this issue of the American Journal of Preventive Medicine, Vaithianathan and colleagues1 have made a valuable contribution in demonstrating how administrative data from human services systems can be used to develop a predictive risk model that identifies children at high risk of maltreatment and could support targeting of prevention and early intervention services. They integrated data from the New Zealand public benefit and child protective services systems to develop their risk algorithm. It is particularly relevant to the U.S. now as many state and local governments are using the impetus of national healthcare reform to redesign health and human services information and service delivery systems.As the authors note, predictive risk modeling (PRM) is most advanced in healthcare utilization, and it is an increasingly important tool in a wide range of innovations to improve quality and "bend the cost curve" in the U.S. healthcare system. The integration of data from multiple sources, including all-payer claims databases and electronic health records, is providing the foundation for identifying individuals at high risk, targeting interventions for chronic disease management, reducing hospital admissions and readmissions, improving end-of-life care, and recognizing many other opportunities for improvement. A whole new industry is emerging to capitalize on the analytic promise of "Big Data.In recent years, heightened attention is also being directed to modernizing the information systems that support human services. The National Human Services Interoperability Architecture (NHSIA) initiative sponsored by the Administration for Children and Families (ACF) within the U.S. DHHS and the National Workgroup on Integration (NWI) of the American Public Human Services Association (APHSA) are at the forefront of efforts to improve service delivery and business-process models that bring information technology integration and interoperability to the human services world. The Stewards of Change has facilitated this work by convening technical experts from academia and the private sector; senior federal, state, and local government officials; and front-line practitioners.