innovation


imagesDaniel Henninger, the author of the Wonder Land column in the WSJ, wrote today (10-29-2009) about “Obama and the Old Hat People.”  Today’s column is about the current health care reform proposals making their way through the US Congress, and the current emphasis on dramatically expanding Medicaid alongside the much-debated “public option.”  Henninger places the thinking behind these proposals squarely in the “old hat” category, calling them “pre-iphone” proposals.

Leaving aside the politics or the persuasiveness of his argument, his use of “old hat” thinking and “pre-iphone” proposals got me thinking about old hat, pre-iphone proposals in human services.  In this field we are all too familiar with the Medicaid model and its myriad rules, regulations, complexities, compliance pitfalls, and frustrations.  15 minute billing increments, arcane rounding rules, encounter forms, eligibility change management, concurrent auditing, and much much more are part of the daily lives of human services delivery systems and the people we support.  They are also a part of the infrastructure –human and technological–that human services organizations must have to survive.  We all have software designed to manage the minutia of the rules.

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It just doesn’t get much more old hat than that.  

Most human services organizations are moving to service models based fundamentally on the individual being served.  We call it person-centered-planning, self-determination, or any number of other names, but we are often stymied by old hat bureaucratic thinking.  In this time of technological innovation and social movements based on an increasing ability for individuals to belong to disparate de-centralized groups (social media being a very important example) AND an industry movement toward personal choice, we still haven’t been able to be very new hat, have we?

New hat would be a service delivery and funding model based on individually developed service plans.  New hat would be an iphone app that removes the bloat and just delivers the information relevant to that person in that moment.  I’m circling back, I think, to an earlier post about the need for innovation in human services.

 I want us to be post-iphone.  

We need to be new hat.

By now you’ve heard about the White House’s new Social Innovation Fund.  It should be just what I was wishing for, since, after all, I’ve been using much of this space to lament the lack of innovation in human services.  

It all reminds me of the time I spoke at a large gathering about the progress of a particular nonprofit.  They were very proud of their progress and accomplishments of the preceding year, and asked me to speak about their plan to increase creativity and cooperation across the enterprise.  At first I was very skeptical.  The very idea of “planned creativity” caused a little chill to run up my spine.  But I was too quick to judge. 

What the organization had done was to thoughtfully plan to get out of people’s way so they could be creative on their own.  The organization brought no canned expectations or creativity outcome requirements to the exercise.  They simply got out of the way and let people create hundreds of small creative innovations that each changed lives.  

It was wonderful.

Perhaps I am too quick to judge here, too.  I would be more encouraged though, if it seemed that the federal government was going to get out of the way so nonprofits could innovate.  While the language the White House is using seems to be proposing a top-down approach, complete with all the innovation-strangling bureaucracy that only the government can impose, let us hope that there is still time to provide input and guidance.  Let us hope and encourage the White House not to prejudge the innovation, but to unleash the pent-up creativity of a vibrant nonprofit community.  We have so much to offer.

Allison Fine, whose blog I’m adding to my daily reading, seems to agree.  Let’s hope we can all make this work.

Like many other organizations, the company I work for, Keystone Human Services, is exploring the use of social networking to expand  support of our mission.  Our approach to human services is community-centric. and our mission is to create opportunities and support people in becoming active contributing members of the community.  Until a few short years ago, everyone at Keystone understood the word “community” to mean the physical community—a neighborhood community, a school community, a faith community, a business . . . you get the idea.

Our understanding of community has definitely changed.  This blog is beginning to be a community;  Keystone has active groups on Facebook and other social networking sites; and, we are beginning to blog about our newest organization Keystone Autisn Services.  The past few months have been very exciting and encouraging as I watch the organization begin to engage with the questions that this change in approach brings.

We’re dividing our efforts as follows:  Blogging and microblogging/Social Networking/Online fundraising/friendraising/ and Cause Related Marketing.

Our bloggers and microbloggers are tweeting and blogging about special events like Pawsabilities, which benefits our service dog agency, about new service offerings, like the Adult Community Autism Program, and about volunteer opportunities.  On Facebook we have groups for our agencies and specialty areas, and causes for our services that rely on philanthropy to keep going.  We use Just Means to connect our message with other socially conscious business and non-profits, and we are embracing new opportunities to speak directly with our stakeholders.

We know we are in the early stages of understanding what these new ways of communicating mean to our organization and to the delivery of human services, but I do wish we were encountering more evidence that  other human services organizations  are trying these tools. 

Let me know your thoughts.  Is your organization choosing integration of these tools or are you firewalling to keep your focus on your traditional services? 

Looking forward to hearing your responses.

I’m blogging today from the PAR conference in Harrisburg PA.  PAR is a professional organization for Pennsylvania providers of services for people with intellectual disabilities and for people with autism.

Pennsylvania, like many other States, is revising the way it authorizes and reimburses for services, and the provider community, in some instances, is struggling to keep up.  Many human services organizations in this State simply haven’t needed to invest in systems until now; they could rely on the paper-based systems they had always used.  This creates an opportunity for all human services providers.

The opportunity lies in numbers.  If a large number of providers all need software tools at the same time, me have market leverage with the software companies.  As I written before, there is much room for improvement in offerings of our traditional IT vendors.  So, if you are one of the providers beginning your search for a software solution, I urge you to talk to your professional organization at the state or national level.  And if you are a professional organization, I urge you to prepare to guide your members through this process, and to demand improved performance from your tech vendors.  This may be the best opportunity we ever have!

I had the good fortune to attend the Clinton Global Initiative Exchange in New York last week.  In contrast to the rest of the CGI gathering, which is by invitation and membership only, the Exchange portion is more open.  It is intended as an opportunity for the NGOs, Foundations, and social entrepreneurs to meet, exchange ideas, and connect resources to needs.  It was exciting and daunting to be in a room surrounded by people who are doing such amazing things.

There were people working on clean water and climate change issues.  The Global Fund for Children, Little Star, Going to School, Global Water Challenge, and The Alliance to End Hunger, among many others, were there.  Curriki, You Tube, Flip, and TechSoup  were there.  It was energizing to be around so many good ideas at one time.  Especially encouraging was seeing the technology companies showing up asking what they could do to help.

Going to work every day should be more like that.  At Keystone Human Services, every day there are literally thousands of people going to work to make a difference in someone individual’s life, and by extension, all our lives.  One difference is that we don’t celebrate it enough, we don’t encourage its celebration enough.  

You may have discerned by now that I am going back to my innovation theme.  At CGI the air was crackling with innovative ideas.  While it would admittedly be tiring to face that every day, I know that the people I work with are no less smart and no less committed, both on the technology side and the service delivery/operations side.  Today we can begin to re-create that spirit within our own agencies.  I’m going to start by proposing our own version of CGI—pulling together in one room people with good ideas, people with resources, and people who know how to connect.  Sure, it will be on a much smaller scale, but it will still be energizing and humbling.

Other ideas, anyone?

Earlier this week I had dinner with George Pashel, the CEO of Esteam,  a Pittsburgh technology company focused on human services.  I was talking about the need for innovation in human services and the need to think in new ways about technology and information, when he challenged my premise.  Imagine!

He asserted that what the industry needs is less innovation and more standardization. 

Interesting.  I think he deliberately narrowed my use of the word “innovate” to make his point, but his point was worth making, nonetheless.  What he sees is an industry, a market sector, a “vertical” that is very un-self-aware (even the technology people in this field are frustrated therapists) with practitioners who don’t even have a common language to describe what they do. 

For example, if he responds to an RFP from an early intervention provider, that provider could have a very different “line of business” depending on the Country, State, County etc they are operating in.  That is unheard of in health care.  Neurosurgery is not different in California than it is in New York or in London.  Health care has HL7.  Human Services has a tower of babel controlled by competing funders and regulators.

His point is well taken.  It goes right back to the argument that Human Services needs to move to evidence-based practices.  That would then lead to more standardization.  He’s right to point out that the current situation makes for very challenging terrain for software companies, and vastly increases the liklihood that vendors and customers will completely misunderstand each other.

Ironically, though, I think it still points to the need for innovation.  We are increasingly strangled by conflicting regulatory requirements, unfunded mandates, unreasonable expectations, and outdated service delivery models.  I think we will need quite a bit of innovation and leadership before we can get to standardization.

Do we value innovation in Human Services?  I’m not sure we do, so I’ve started another page on this blog just for that.  I think I’m timely on this one, since the Stanford Social Innovation Review is also talking about it this month, and so are others.  

If we don’t value it and promote innovation in our own organizations and our own field, is it too much to expect from our technology vendors?   They, after all, try to match our organizational cultures as much as possible.  Have we met the enemy?

something to think about.

 

Jeanine

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