Q&A: Unite Us Chief Operating Officer Esther Farkas describes how data sharing can help improve community health in Illinois

By

Shane Ersland

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Unite Us works to improve people’s health and well-being by connecting community members to resources through technology. For nearly a decade, it has worked with community-based and health organizations in Illinois. 

Unite Us Chief Operating Officer Esther Farkas served as a speaker at the 2024 Illinois State of Reform Health Policy Conference last month. She discussed some of the organization’s accomplishments and goals with SOR in this Q&A.   

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SOR: You participated in the “Improving Children’s Health & Welfare” panel at the SOR conference. Can you share some of the key takeaways from the panel and discuss your experiences supporting child welfare and behavioral health organizations?

EF: “I had a great time on the panel. It was a great conference. The biggest takeaway for me is how critical cross-sector collaboration is in addressing child welfare effectively. If you look at the panel participants, you had a health plan executive, a telehealth provider, a director from the state Department of Child and Family Services (DCFS), and a technology solutions provider like us that specializes in enabling that type of collaboration between all these sectors by making it easy to coordinate care for families.

Everyone expressed similar sentiments. There is widespread frustration with the current level of collaboration and a strong desire to do more for families. There was a lot of positive energy and optimism about the potential to improve. Many states and participants in these state systems are considering modernization to better support families.”

SOR: One of your fellow panelists was Heidi Mueller, director of DCFS, who discussed the BEACON project, an Illinois statewide initiative to address youth behavioral health. In your experience, what are the key components to support a statewide initiative?

EF: “The key to launching a successful statewide initiative lies in strong leadership and a well-defined vision. This is fundamental because driving change effectively hinges on adept change management. Heidi and the broader state leadership team excel in these aspects, with a particular emphasis also placed by directors. 

Specifically, the state must establish a robust network of service providers when discussing behavioral health programs. This network should include both clinical and community-based options. Not every individual with behavioral health issues needs immediate clinical help. As such, it’s vital to have community-based services that offer comprehensive support that addresses a person’s broader needs. Focusing solely on behavioral health without considering other aspects risks failing to fully support individuals and their families in their recovery journey.

Integrating into a broader network of services enables the identification of additional needs an individual or their family might have. For instance, it is crucial to inquire about their need for food, transportation, or job assistance.

Moreover, to ensure state-level accountability, it’s imperative to establish a network of community-based organizations and services. This network should leverage appropriate technology for collecting data. Collecting structured data allows us to analyze and identify where additional resources or support might be necessary. This data-driven approach enables us to make informed decisions and implement evidence-based changes. We currently work with several states and notice an increasing demand for rapid feedback and data-based program enhancements.”

SOR: Can you elaborate on the importance of structured data?            

EF: “Structured data significantly enhances the effectiveness of programs, particularly those in areas like child welfare, foster care, family assistance, and other government initiatives. Its primary advantage is allowing for rapid iteration, enabling program operators to directly address identified needs rather than making assumptions. This precision helps strategically direct efforts towards areas of most significant impact and ensure that assistance meets the requirements of those in need. Additionally, structured data is critical to accurately measure the success of these programs, as each has its own criteria for what success looks like, yet it often needs help obtaining the necessary data to evaluate its performance accurately.

Furthermore, the current landscape of government programs tends to be fragmented, leading individuals in need to navigate through a maze of services, consuming valuable time and often leading to frustration. Thus, these programs must consider strategies that streamline access to care and support, ensuring equitable access for all who need it. By doing so, we aid individuals more effectively and enhance the overall efficiency and impact of government assistance programs.”

SOR: Data sharing is crucial for closed-loop referrals and integrated care. How do you facilitate timely and secure data sharing across providers without compromising security? 

EF: “Data sharing is crucial to the care coordination platform we developed at Unite Us. Our incredible legal team together with outside advisors who are leading thinkers in the privacy and healthcare space implemented many of the mechanisms we have in place to ensure secure data exchange. Our two veteran founders, Dan Brillman and Taylor Justice, started the company to assist their friends returning from overseas and transitioning to civilian life by helping them figure out their next steps and how to meet their needs. From the very beginning, we needed to ensure that the services and access to those services were secure and private. We wanted to do right by them.

The platform we operate enables the secure exchange of data at a very high level and automates permissions without requiring manual intervention. This is crucial for operating efficiently. Governments need to be more efficient, and one way we can help is by automating some of these processes.

There are regulations governing where and how data can be shared. How do people seeking access to services ensure they can consent to that? How do they know their information is kept private and secure? These are things we believe people should not have to think about. They should be automated by technology. This way, community organizations can focus on getting people fed, providing them with transportation, and offering employment assistance. This is the fundamental principle on which we built our platform.”

SOR: How does this model accommodate interoperability?     

EF: “Interoperability is a popular term in healthcare today, but its meaning varies depending on who you ask. It has taken me most of my career to understand it truly. Some people see interoperability as a simple spreadsheet, while others view it as the technical integration of two systems. Some think of it as the ability to communicate using the same language.

Like privacy and security, interoperability is fundamental to our goals. We want to facilitate care coordination, which involves many different sectors working together to provide care for an individual. All parties involved should be able to coordinate care using a single system. This system should also easily communicate with their record-keeping systems, enabling them to work efficiently and spend more time helping people instead of dealing with technology.

That’s the system we’ve built, and it’s all about seamless access to a client’s record. It involves obtaining consent once and then being able to view and coordinate care for an individual, regardless of the entity you belong to.”

SOR: How do health systems operationalize connections with community-based providers? 

EF: “Our health system partners are deeply connected to their communities, which is essential. Many hospitals have social workers and care coordinators who are familiar with their communities and know where to refer people for assistance. We aim to assist them in making these referrals and providing follow-up care more efficiently. This involves integrating with the electronic health records (EHRs) they use and accessing bi-directional data without leaving the EHR system.

Each hospital has a surrounding community that needs to be connected to track patient movements and coordinate care. The easiest way to enable this is through effective technology, allowing people to concentrate on their daily tasks. We should consider it a platform that helps people complete work faster and get help faster.”  

SOR: How would you describe Unite Us’ presence in Illinois?

EF: “We have been operating in Illinois for almost ten years and have built strong relationships in Chicago. We offer over 26,000 programs on a platform that connects people in need with services. We have facilitated nearly half a million patient interactions and made nearly 20,000 referrals over the past few years. This demonstrates that many people in Illinois are using Unite Us technology to access care, whether it originates in the community, hospital, healthcare, or government settings.

We take pride in our work in Illinois. The state has many high-need urban and rural communities, and our ability to operate in both settings and connect people with the help they require makes us a unique solution for the state.”

SOR: Illinois’ request for a Medicaid 1115 demonstration waiver focused on health-related social needs was just approved. What specific strategies can be employed to support the implementation of the waiver?

EF: “We are excited about the state’s innovative approach to social care and hope to be part of the implementation. We have extensive experience with waivers and reimbursement models. North Carolina was one of the first states to implement an 1115 reimbursement model almost four years ago. We are proud to have partnered with the state, and a recent evaluation showed savings of $1000 per member annually resulting from the program. It’s an early evaluation, but it’s an excellent program for state accountability, state programs, providing access to social care, and ensuring we can evaluate and allocate funds to it.

In the end, communities can only support these programs if funding is available. We talk a lot about moving care into the community; however, we still need to discuss how we will do that. Private dollars and philanthropy primarily fund the community, but that has to change. More states should consider allocating government funds to community-based organizations to help them support those who can benefit from the community before needing to enter the health system. North Carolina is an early model for discussing a data-driven approach to evaluating that.

It is widely believed that meeting people’s basic social needs will make them healthier, require less hospitalization, and allow them to stay in their homes. However, this intuition must be supported by accurate data and an assessment of the necessary funding to help communities provide that care. This is precisely what’s happening in North Carolina, and I expect to see it in Illinois in the next couple of years.”

This Q&A has been edited for clarity and length.

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