Catalyzing Coordination: Technology’s Role in California’s Whole Person Care Pilots

In 2017, the California Department of Health Care Services (DHCS), recognizing that medical services only address part of a person’s overall health care status, launched the Whole Person Care (WPC) pilot program. It is designed to address not just the physical health but also the behavioral health and social needs of high-cost, high-need Medi-Cal enrollees — people who often have fallen through the cracks of the safety net. The program was created under California’s Medicaid Section 1115 waiver, and it runs through December 31, 2020.

One of the most fundamental barriers to truly integrating care — as WPC aims to do — is organizations’ ability to share data. If entities cannot effectively exchange information about the patients they share, then they cannot effectively coordinate care for those patients.

In attempting to establish common means of sharing data and coordinating care among myriad entities, WPC pilots must navigate a range of issues, both technological and organizational. While they are equally important, the technological issues offer tangible, actionable opportunities for innovation and are the focus of this paper. The paper, whose findings were culled from 25 survey responses and 20 in-depth interviews conducted with pilot participants, includes:

• A list of opportunities for technology vendors to develop more scalable alternatives to existing solutions for care coordination, identity management, data analytics, social service referrals, and a host of other capabilities vital to WPC and other care integration initiatives
• An overview of common challenges and critical decisions encountered by WPC pilots as they seek to implement technology solutions, including how to design data-sharing agreements and whether to adapt existing technologies or procure new ones
• Case studies of two counties that illuminate the innovative thinking and sustained effort that has led to technology-facilitated breakthroughs in care coordination

For a broader, higher-level look at how WPC pilot programs have fared thus far, see the Whole Person Care: A Mid-Point Check-In paper recently published by DHCS and authored by Harbage Consulting.