Quality Monitoring

RAND Corporation, HRSA HIV/AIDS Bureau (HAB)

Goals for This Chapter

This chapter is designed to help you:

  • determine how you will monitor provider use of the newly integrated system
  • understand whether and how the newly integrated system and accompanying service coordination is positively affecting client outcomes
  • understand whether and how the newly integrated system and accompanying service coordination is affecting staff workloads and ability to meet goals
  • understand what changes may be needed to either system functionalities or training after initial system launch.

Monitoring System Use

Once your integration system is launched, it will be important to understand if and how providers are regularly using the new information available to them. Providers have many competing demands and may not always immediately see the benefit of entering new information into the shared system or using information newly available to them for client service coordination. However, data integration will only be successful if providers are entering shared information in a timely fashion and using the information newly available to them in their day-to-day work.

Questions to Ask Yourself

  • What data do we currently collect about system use?
  • What data would we need to collect to successfully monitor system use? What level of effort will it take to collect this new data?
  • Do we have the staff capacity to monitor system use?
  • What mechanisms do we have in place to encourage and enforce system use?

Lessons Learned

The following are some critical lessons learned by those at the performance sites about monitoring system use.

  • It is important to regularly monitor the frequency and the method in which providers are using the newly integrated data system. This can be accomplished through usage reports run through the system itself or more informally by checking in with providers and asking how they are using the new system and new information.
  • One way to ensure use of the new system is for program funders to include it as a requirement in contracts with provider organizations.

Understanding Impact of System Integration

Launching an integrated data system requires significant funding and staff time on the part of integrating organizations. After making such a substantial investment, you will want to know whether the availability of new information is having a positive impact on client outcomes and staff workloads. You will want to establish a few key goals and track metrics related to these goals to determine the impact of the system.

Questions to Ask Yourself

  • How will we define success for the newly integrated system? What will success look like for clients? For staff?
  • What metrics will we track to determine whether the newly integrated system is having the desired impact and outcomes?

Lessons Learned

The following are some critical lessons learned by those at the performance sites about understanding the impact of system integration.

  • Being able to articulate impacts of the integrated system is crucial to ensure ongoing provider buy-in and to secure ongoing or new funding for the system.
  • Monitoring metrics should cover outcomes that are meaningful for all contributing organizations (e.g., tracking medical and housing outcomes).
  • Organizations can work with the data system vendor to set up reports that track how often providers are accessing the new client data elements.

Determining Whether Additional Changes Are Needed

Once you have determined goals for the system and established the routine collection of metrics for monitoring progress toward these goals, you can use this information to determine whether additional changes are needed. For example, you might find that staff are still missing crucial pieces of information for service coordination. Or you might find that adding additional flags or alerts could greatly enhance service coordination.

Questions to Ask Yourself

  • How often will we review quality monitoring data? Who will be involved in this process?
  • How will we solicit staff feedback to determine whether additional changes are needed?
  • How will we pay for added functionality if it is needed?

Lessons Learned

The following are some critical lessons learned by those at the performance sites about determining the need for additional system updates/changes.

  • Providers and organizational leaders often might not understand what kinds of functionality or information-sharing are most helpful until they begin using the integrated system and service coordination processes.
  • Ongoing, already established provider meetings can be an excellent venue for soliciting staff feedback on system functionality and whether additional changes could be helpful.
  • Decisions about additional system functionality should be made jointly with all organizations contributing data to the integrated system to ensure awareness and maximize potential impact.
  • If possible, it is important to build in funding for system maintenance, technical support for unplanned problems, and ongoing improvements into programmatic budgets.

In Closing

One of the goals of this toolkit is to demystify the process of data integration and make it more accessible to service organizations in general. Although the integration of data systems might seem challenging, it can provide substantial gains in saving provider time and improving service coordination. By answering the questions in this guide and considering lessons learned from previous implementers of data integration, we hope you will have a better understanding of the step-by-step process of planning and implementation and gain confidence in your ability to navigate the process.