Policy & Practice August 2018

could ensure the man’s doctor knows what has happened, that his rehabilita- tion program is notified of his relapse, and that his support group knows to reach out. Beyond helping the individual, collecting, analyzing, sharing, and predicting with data can help refine and leverage insights for the benefit of multiple clients. Among promising technology and delivery models is the use of program matching algorithms. For example, if a treatment program in Indiana has success with a special- ized group that matches medical and demographic data with a single parent in Kentucky, today’s operating approach would rarely connect the dots. But, if a caseworker has access to the information and tools to predict the fit, the two can be matched. Of course, the data have to prove the success of the program, they have to assess the parent as a good candidate, and that data and program accessibility have to be shared across state lines. Moreover, that successful program could be rep- licated in other places and, through sharing data and predictive analytics, addicts everywhere could be more effectively matched with services that improve outcomes and reduce the overall cost of treatment and support. Examples of Success We have examples of data sharing making a difference. In Prescription Drug Monitoring Programs (PDMP), 45 states have executed memoran- dums of understanding (MOUs) to enable secure sharing of prescription data across state lines. This provides pharmacists and physicians with a way to identify patients who cross state lines to shop for pharmacies and abuse prescription drugs. The program currently processes more than 17.8 million requests and 39 million responses per month. Looking for ways to build on that success, the Opioid Crisis Response Act of 2018 stream- lines federal rules around PDMPs and encourages more information sharing. This is a welcome advancement, ideally followed by funding. Several states are utilizing state- of-the-art architecture to pave the

Concerns about security and privacy are hard-wired into regulations that often date back to the 1980s. Program funding and operations have always been separated, generally with each program having its own culture, benefit request forms, and custom system. Simply put, we need new oper- ating models and tools that support collaboration that addresses today’s needs. Data sharing across public and private agencies is one of the critical new models. It can help the addict and his or her family have a better life by providing a more comprehensive and better tailored match of services across the multitude of systems. It can also help continuously improve practice and policies by identifying programs that work, so scarce resources may be assigned more effectively. Integrating Multiple Points of Contact A single, struggling addicted parent might receive food assistance to feed the children and day care services while at work or treatment, Medicaid to ensure their medical care, mental health services, or community support services that often involve at least one stay in a rehabilitation facility, and subsidized housing. Public assistance programs often come with a work requirement and workforce develop- ment program. If lucky, the other parent is paying child support through the state’s child support program, engaging yet another “system.” There is a good chance the children of addicted parents are in the child welfare system. Too often, the children of addicts become ensnared as mom or

dad loses the ability to parent safely. If the addiction has ever resulted in a public overdose or criminal activity, that brings involvement with the police and courts, and likely housing with a foster family or congregate care. If, by chance, the parent lives in an area bordering another state, it is even more complicated: the parent may be involved in all of these systems in more than one state. In almost every case, an addict and their family are involved in many dif- ferent government and community programs. Each program is trying to help the parent and family, yet their operation and technology systems operate in silos. Would the loss of life be so great if the multitude of case- workers had a comprehensive view of the client or if the addict did not have to make sense of the complex maze of government and community program silos? Clearly, public and private agencies must change the approach and industry needs to provide the tools needed to fight this epidemic. Barriers to Data Sharing Often the answer to sharing data in public and private agencies is an emphatic “no.” It used to be that tech- nology was a huge barrier: antiquated legacy systems couldn’t talk to each other. Capacity, bandwidth, quality, nonstandard systems—these are all old problems. This isn’t true with modern technology. What about security and privacy? While security should always be a concern, most modern systems are accompanied by sophisticated security that can protect data and privacy even through the process of sharing. When it comes to privacy, sharing data does not have to violate a client’s privacy. Opportunities exist that enable limited data sharing while maintaining the protection of private information. For example, if a father overdoses on a street corner, responding police officers might want to have access to information that he is a father, so they are able to notify the local public chil- dren’s services agency that his children need to be checked on. Having some data connection to this man, other than his criminal record, could be key to helping his children. Further steps

DeniseWinkler is the Industry Director, Public Sector, Enterprise Services Division, at Unisys.

See Opioids on page 38

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