JMIR Publications

ABSTRACT

Background:

People with complex needs, such as those experiencing homelessness, require concurrent, seamless support from multiple social service agencies. Sonoma County, CA has one of the nation’s largest homeless populations among largely suburban communities. To support client-centered care, the county deployed a Care Management and Coordination System (CMCS). This system was comprised of Watson Care Manager (WCM), a front-end system, and Connect 360, which is an integrated data hub that aggregates information from various systems into a single client record.

Objective:

This study evaluated the perceived impact and usability of WCM in delivering services to the homeless population in Sonoma County.

Methods:

A mixed methods study was conducted to identify ways in which WCM helps to coordinate care. Interviews, observations and surveys were conducted, and transcripts and field notes were thematically analyzed and directed by a grounded theory approach. Responses to the Technology Acceptance Model (TAM) survey were analyzed.

Results:

Sixteen participants were interviewed, including WCM users (n=8) and department leadership (n=8). Three interdisciplinary team meetings were observed, and WCM users (n=8) were surveyed. WCM provided a central shared platform where client-related, up-to-date, comprehensive, and reliable information from participating agencies was consolidated. Factors that facilitated WCM use were users’ enthusiasm regarding the tool functionalities, scalability and agency collaboration. Constraining factors included the (a) suboptimal awareness of care delivery goals and functionality of the system among the community, (b) sensitivities about data sharing and legal requirements and (c) constrained funding from government and non-government organizations. Overall, users found WCM to be a useful tool that was easy to use and helped to enhance performance.

Conclusions:

WCM supports delivery of care to individuals with complex needs. Integration of data and information in a CMCS can facilitate coordinated care. Future research should examine WCM and similar CMCSs in diverse populations and settings.