Introducing the Human Services Interoperability Innovations Grantees

The challenge:

• In order to link datasets between different agencies or organizations, it is often crucial to share sensitive identifiers like Social Security numbers (SSNs) or other private identifiers. While the ability to share this data can result in improved service delivery, legal and privacy constraints can often make this type of sharing difficult.

The strategy:

• The Georgia Policy Labs developed a strategy for using SILK (a Solution for Identifying Linkage Keys), a tool that helps agencies securely link their data without sharing sensitive fields.
• SILK transforms an SSN or other sensitive value into a secure hashed value using a secret key called a Salt. Any SSN hashed with the same Salt will always produce the same hashed output. Partners can then link datasets using the hashed fields, eliminating security and confidentiality risks. SILK makes it easier to create a data sharing agreement (DSA) between agencies or organizations by reducing the amount of personally identifiable information that needs to be shared.
• The hashing solution includes encryption for less sensitive fields or those that require probabilistic matching. The solution is ready to be used as a desktop application by two or more agencies or to be built upon with matching algorithms for a more complete integrated data solution.

Barriers and solutions:

• Substitution of SSNs presents a challenge. For example, often parents of young children will use their own SSN if their child does not yet have one. This results in the parent and child having the same hash value for their SSN. This can be solved by using additional fields (e.g., date of birth) when matching datasets.
• Some agencies use code SSNs, which indicate something specific about the record. In order to avoid these code SSNs causing matching problems in the hashing process, partner agencies must share their codes with each other.
• Finally, typographical errors in entering SSNs can result in flawed hash values, requiring extra care to prevent human error.

The challenge:

• Youth in out-of-home care often have complex healthcare needs.
• These needs are best met, and the youth and families and caregivers are best served if there is an efficient coordination and communication between care givers, child welfare professionals, and healthcare providers. 

The strategy:

• The Kentucky Department for Medicaid Services established a new linkage between TWIST (The Worker Information SysTem, the state’s child welfare information system) and KHIE (Kentucky Health Information Exchange, the state’s repository for health information used to facilitate the coordination of healthcare services).
• This linkage allows child welfare workers in the field to have a self-service portal to access important health information about their child clients in out of home care.

Barriers and solutions:

• In the legal domain, it was necessary to create a data use agreement between each of the involved parties, which required conducting a legal privacy analysis. 
• In the information technology domain, the project had to build a bridge between two information technology systems. To integrate these two systems, the KHIDS project team used application programming interfaces (APIs) and Single Sign On (SSO) applications.
• Introducing new systems to caseworkers in the field who are often already managing a large caseload can present a unique challenge. To ensure this new functionality was actually used in the field, the team kept core principles in mind: the tool had to be valuable in the field, most importantly by saving the caseworkers time, and training had to be thoughtful and comprehensive.