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Cross-Sector Data in Action
August 30, 2018
Building Trust and Collaborating for Data Sharing
August 03, 2018

Cross-Sector Data in Action

The National Center for Complex Health and Social Needs, a new initiative of the Camden Coalition of Healthcare Providers, was created as a professional home for clinicians, healthcare leaders, social service service providers, researchers, public health officials, data scientists, policy makers, payers, consumer advocates, and others who are working in the emerging field of complex care. We are working toward better-integrated, more efficient care for the relatively small population with complex health and social needs, including necessities often considered "non-medical" such as addiction, housing, hunger, and mental health. The National Center for Complex Health and Social Needs is funded by AARP, The Atlantic Philanthropies, and the Robert Wood Johnson Foundation.
Written by Michelle Adyniec, RN, BSN; Cortney Bruno, MSW; Laura Buckley, MSW, LSW; Teagan Kuruna, MPH; and Dawn Wiest, PhD, of Camden Coalition of Healthcare Providers; and David Schwindt, a police officer with the Iowa City Police Department.

Individuals with complex health and social needs represent a small portion of the population but account for a large share of healthcare spending.1,2 For this group, chronic illness and social barriers to wellness underlie extensive utilization of medical services as well as frequent contacts with other sectors, such as housing, behavioral health, and criminal justice. Care coordination and service integration facilitated by cross-sector data sharing can help service providers understand and adequately address these individuals’ needs.3,4

Sharing data may sound like a daunting task, but with trusting relationships5 and knowledge of legal frameworks,6 collaborators may be able to begin sharing data with the technical resources they already have. Simple, yet effective, approaches can build a foundation for collaboration and shed light on complex health and social needs. Using low-tech approaches or starting with publicly available data makes the process accessible. The findings from initial data-sharing efforts can help partners garner support for the more expensive and time intensive task of building an integrated data system. Once cross-sector data are integrated into one system, program designers and practitioners can use the data on an ongoing basis to advocate for new resources, identify potential program participants, and guide practice decisions.

This brief draws on the experiences of 2 leaders in cross-sector collaboration, the Iowa City Police Department (Iowa City PD) and the Camden Coalition of Healthcare Providers (Camden Coalition), to show how cross-sector data can guide the development of innovative initiatives to improve people’s lives. The Iowa City Police Department, using strong relationships and Microsoft Excel, built the case for a Housing First program. The Camden Coalition relies on integrated data to inform the planning, implementation, and assessment of its jail-based reentry pilot project. Lessons from both organizations’ experiences can be instructive to other groups at all stages of the data-sharing process.

Iowa City Police Department: Making the Case for Housing First Through Cross-Sector Data

The Iowa City PD employs a downtown liaison officer to build relationships with individuals experiencing homelessness and identify opportunities to better serve the community and reduce homelessness. Seeing community collaboration as an effective tool to address homelessness, the Iowa City PD’s downtown liaison officer joined the Johnson County Local Homeless Coordinating Board (LHCB), an existing cross-sector working group including representatives from hospitals, community mental health centers, homeless service organizations, and the county sheriff’s office. The group began sharing its data to illuminate the high costs of service fragmentation and to demonstrate the benefits of coordinating services though a Housing First initiative.

Shared data can deepen understanding of the challenges that individuals face across sectors, and bring to the surface the cost of attempting to address individuals’ needs in silos. When the Iowa City PD joined the Johnson County LHCB, it brought data from the police department, housing sector, health, and mental health care sectors together. The goal was to identify and address the needs of chronically homeless individuals in Johnson County. The shared data confirmed what the working group suspected: a few chronically homeless individuals cycled repeatedly through the medical, mental health, and criminal justice systems.

The data-sharing process started off low-tech: Iowa City PD shared its publicly available data using a Microsoft Excel spreadsheet, and partners compared this information with their own data. Each partner did this manually—they compared the list the Iowa City PD provided with their own lists to identify patterns of high utilization across sectors. In addition to Iowa City PD and the Johnson County sheriff’s office, cross-sector partners included the community behavioral health centers, Abbe Health and Prelude Behavioral Health Services; 2 large Iowa City hospital systems, Mercy Iowa City and University of Iowa Hospitals and Clinics; and the only housing shelter in the area, Shelter House.

Johnson County LHCB members agreed to reach out to some of the individuals with frequent arrests and jail stays with whom they had rapport. Four of these individuals agreed to allow the cross-sector partners to share their data with one another. The purpose of the case studies was to track interactions each of the 4 study participants had with each partner’s services over the study period. The group collected and shared the study participants’ utilization data for the previous 4 years; these data were tracked and analyzed using Microsoft Excel. Members of the Johnson County LHCB suspected that these individuals would continue to have repeated encounters with their organizations over the study period, and that the cost of these repeated encounters would be high, perhaps even higher than the cost of providing these individuals with a home.

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