ABSTRACT: The design of a database management system is described as an attempt by an urban teaching hospital to improve the quality of care and contain costs of Alternate Level of Care (ALC) patients. Preliminary research findings indicate that particular discharge problems, discharge plans, and demographic characteristics of patients are related to prolonged ALC lengths of stays. These findings have helped staff to identify patients most at risk resulting in improved discharge planning.
ABSTRACT: This paper examines issues related to applying information technology in behalf of mental health service delivery systems. Each of these issues has an impact on how well information technology has been able to serve the mental health system. These are not primarily information technology issues. They are concerns that have to do with the structure of the mental health system; the way management might use an information system; and the role of money and power in the mental health system. How these issues are resolved will have a major impact on how well the promise inherent in information technology is realized in the coming decade.
ABSTRACT: This paper describes a research project on the process of collecting information for psychiatric social history. Three interview conditions are described: unstructured human interviewing, multiple-choice structured interview delivered by human and the same structured interview delivered by computer. Subjects were patients' parents. Ten subjects were interviewed by computer and fourteen by persons. Unstructured interviews were obtained from old social histories. Structured interviewing collected significantly more information than unstructured interviewing. A comparison of structured human and computer interviews showed greater extremes of response with fewer discrepancies of fact in the computer condition, indicating greater candidates of subjects in that group and therefore greater validity of data collected by computer.
ABSTRACT: With the increase in specialization of our health care delivery system has come the increased demand for accountability and information. SwdB, a tailor-made data base application, is designed to assist the hospital social work director in managing daily operations, planning and tracking resource utilization, monitoring the impact made by social workers, and meeting hospital social work accountability requirements. Both patient data and worker productivity data are included with reports individually prepared to suit the needs of the particular hospital administration. Implications for how such a program can modify social work management information systems as well as the impact such programs can have on social work practice are discussed.
ABSTRACT: This paper presents the results of a research project designed to assess the impact of an automated case management system on the time utilization and attitudes of human services employees. Based on this 10 week evaluation study, the desired benefits in efficiency, effectiveness and quality of work life were not achieved. Limitations of this study were the constraints in the length of time the evaluation could be conducted and the small sample size available. The findings of this research highlight the need for employee assistance program managers to be sensitive to and knowledgeable about the potential sources of stress as well as the potential benefits in introducing computer technology into the human services delivery system.
ABSTRACT: This paper reports on a two-year project which developed a computerized multiagency database of respite service users. The project's primary aim was to make seven non-profit respite programs technologically self-sufficient in terms of clinical information. The outcomes of computerization for these agencies are discussed, as well as modifications during the post-project period.
ABSTRACT: Allocative efficiency in community-based long-term care focuses on using purchased in-home supportive services to maximize the expected days of stay in the community of program clients. The paper discusses a DSS to assist case managers to best accomplish this objective. Exposition includes: the optimization principles; a demonstration that the requisite necessary and sufficient conditions of optimization hold; an implementation of the principles in a computational non-intensive algorithm based on a model of communication-based long-term care in California that accounts for program priorities. The decision support system that informs case managers about best practice is demonstrated. The gains from its use are evaluated. A 15.4% increase in the community days stay attributable to program is expected from its use.
ABSTRACT: The complex and changing context of vocational rehabilitation requires that practitioners continually upgrade their knowledge. The computer offers the capacity to combine and present current information to persons with different levels of experience and training. Still, access to computer resources can be difficult for novice computer users. Ask About Vocational Rehabilitation Counseling (AAVRC) is a natural language computer data base that has been developed to ease access for typical vocational rehabilitation personnel. The content of AAVRC was developed in response to questions posed by a sample of rehabilitation practitioners. The data base content will be reviewed by professionals and consumers of rehabilitation. This is a practical approach to constructing a data base and most likely will lead to a different knowledge base than if it was constructed solely from teachers and experts in the field.
ABSTRACT: The experience of a human service organization which made the commitment to computerizing their client records early in the 1980's is described. The development of this system was plagued by several difficulties due, in part, to the fact that personal computer LAN technology was fairly new and few consulting companies had direct experience with these types of applications. As well, for certain human service organizations the 1980s was a time for reconceptualizing how services were provided based on the ideologies of consumer empowerment, community integration and normalization. This shift translated into new ways of making service decisions, hence new needs for information and strategies for its use.
ABSTRACT: Drug addiction research is conducted to monitor the delivery of services, improve the treatment process, increase retention, evaluate the outcomes, and reduce the relapse rate. Efficient information technology facilitates effective program management and credible research. Integrity House, a traditional drug-free therapeutic community with a variety of outpatient programs, maintains several databases (intake information, the clinical file, and the daily activities file). A flat file database program with an integrated word processor is used since it is easy to learn for people with no prior computer experience. Sophisticated statistical analyses are performed by transferring the data to a university mainframe. Database management allows staff to evaluate treatment process, identify trends, and study relationships between residents' characteristics and process variables.
ABSTRACT: This paper describes the use of computers to manage the Connecticut Clearinghouse, a resource center on alcohol and other drugs. Software packages were used to manage information on resources; to develop a database for monitoring client activities; to create a mailing list; and to publish a newsletter. The paper addresses the selection process, equipment requirements and technical support for computer software. It focuses on introducing computer technology to a small staff, including staff resistance and techniques to overcome barriers to implementation. Discussion centers on the role for supervisors in providing support and making training available to staff to facilitate computerization.
ABSTRACT: In-house custom software development is an important opportunity for human service agencies. This paper presents a continuum of software development alternatives. Three discrete options, internal, external and collaborative, are described. Collaboration is illustrated in detail using the "CATS" example. While it is not a panacea, the benefits derived from collaboration are worthwhile.
ABSTRACT: This presentation describes a unique networking experiment taking place in Bombay, India. The project represents the cooperation between law enforcement organizations responsible for implementing a plan for assisting street children in the city. This network has grown largely out of its own inner momentum with the help of the Coordination Committee for Vulnerable Children (CCVC). The CCVC acts as the liaison with the state government, Municipal Corporation, Police and Community Organizations in order to facilitate the development and the coordination of this preventive and intervention program.
ABSTRACT: The requirements for management information systems in human services are conceptually little different from those of many other programs or industry sectors. Yet numerous attempts to develop effective systems for casework services and programs have been unsuccessful. There is ready recognition of the potential for the utilization of information technology but little awareness of the pitfalls inherent in its implementation. A pilot project revealed that critical determinants of success are a function of the quality, extent and nature of the collaboration between agency practitioners, managers at all levels, and system designers. It was found that the technical expertise of the information technology specialist contracted to develop the system was less important. Although there were many interesting technical challenges and components of the project this paper focuses primarily on the model underpinning the system and its implementation within pilot agencies.
ABSTRACT: There are significant social investments in families uprooted by homelessness. There are no data clearly delineating types of families helped, and how long help has sustained them. Computer technology was utilized to track eight hundred and seventy-five homeless families who received networked services from both public and private providers in a case managed family shelter from 1983 to 1987. Discussed are secondary data in case files and primary data from field interviews on longitudinal residential history, employment, familial and demographic changes, and service needs. Policy questions focus on current residential stability and community reintegration.
ABSTRACT: To address the inability of the elderly to travel for shopping, a scheme of teleshopping for social service clients was developed and tested in Gateshead and Bradford. Both schemes included information services and met with considerable success. After government cutbacks, private industry moved in, building on the public experience. Resistance to teleshopping services relate to psychological reasons, traditional elderly services, and other factors, but future possibilities for expansion in the public sector are being explored.
ABSTRACT: Graduate social work curricula and human service organizations (HSOs) are behind in the use of current information technology (IT) for professional social work practice. Knowledge and use of computer run client advocacy based management information systems (CAMIS) are key prerequisites to the management of professional practice in HSOs. Discussion is augmented by focus on an automated CAMIS (IBM-PC, Rbase) used in the classroom as well as agency settings. Software demos are available.
ABSTRACT: Using microcomputer abilities, Problem Solving in Case Management (PIC) provides students with the opportunity to learn case management skills through applying the problem solving process to a simulated client situation. The Computer Assisted Instructional Program (CAI) enlists a user-friendly format and was designed and scripted using an Apple Macintosh IICX computer system with HyperCard software (version 1.2.2).
ABSTRACT: Advanced information technology such as diagnostic programs, decision support systems or therapeutic computer games are likely to have far-reaching effects on the nature of social work practice, on the condition that they can be accepted by rank and file workers in human services organizations. This exploratory study was designed to develop a valid instrument that can test the extent to which social workers are willing to use the three most common types of advanced information technology: (I) computerized assessment package (CA), (2) decision support system (DSS), and (3) therapeutic computer games (TG). The instrument was field-tested with 74 Israeli social workers. Social workers clearly differentiated between the types of information technology with preference for therapeutic computer games (TG, DDS, CA, mean acceptance = 4.14, 3.91, 3.47, respectively). The differences between TG and CA, and between DDS and CA were statistically significant in paired t-tests (p = .000 and .003 respectively).
ABSTRACT: This paper describes two interactive video disc programs that have been designed to teach social work practice skills. One pro gram is designed to teach students how to apply crisis concepts in a simulated interview with a client and the other program is designed to teach students how to assess institutional racism and sexism in an agency context The purpose in presenting these two programs is to demonstrate how interactive video can be used as a training tool in social work education, and also to encourage other educators and trainers to begin to develop their own interactive video programs.
ABSTRACT: The development of a telecommunication system for social work is described. It was initiated by schools of social work and supported by a national research association. Its purpose is to give communication aid to schools as well as social workers and clients for local, national and international cooperation and it suggests participation.
ABSTRACT: This paper describes the current situation of computer education in the schools of social work in the Netherlands, new policy in curriculum development, and the development of a new comprehensive curriculum on computer applications. The basic philosophy of the curriculum and a firm relation to social work practice are discussed. To illustrate these developments, an outline of the curriculum for social casework is presented as a kind of status report.
ABSTRACT: The use of information technology has reached the professional care for mentally handicapped. Students in schools of social work in the Netherlands will use a prototype of a care information system, learning to appreciate these applications for planning and evaluating the care process. Curriculum material will be developed according to the Dutch 'National' Curriculum Computer Applications for schools of social work.
ABSTRACT: Traditional expert systems attempt to represent logically the complex decision rules used by experts. This approach has some defined successes but has been less effective with multi-dimensional problems such as characterize clinical situations. Research suggests that effective expertise is based more on memory than on analysis and logic. The article discusses the nature of memory-based expertise and questions the feasibility of capturing it through expert systems. Training based on computerized case simulations is suggested as an alternative. The paper also discusses the need for knowledge on the specific impact interventions have on distinct subgroups of consumers. This knowledge can be used to guide training and assist consumers in making key decisions.
ABSTRACT: The paper is an examination of the problems and promise of knowledge creation and representation in the Human Services. It is the general proposition of the paper that expertise found in welfare agencies can be exploited to develop expert system software. The contention of the paper is that the knowledge base of a system is never complete, that disciplines vary in terms of what constitutes acceptable levels of proof and measurement of certainty; that limitations intrinsic to an expert system are not limitations of design, but are limitations demonstrating conceptual and theoretical limits in the simulation of dynamic expertise; and finally that an acceptance of the limitations of knowledge acquisition and representation may paradoxically lead to the design of usable expert systems.
ABSTRACT: The introduction of commercial expert systems shells for common desktop computers offers human service agencies a new area of computer application to add to the word processor and the spreadsheet. Expert systems can be used to develop knowledge based applications which automate policy manuals, provide tutorial support in training situations, provide support in decision making situations, etc. Further, the low cost, extensive documentation, and short learning time allow agencies to develop applications unique to their needs or allow individual employees to develop applications that help them with some aspects of their work.
ABSTRACT: Advocates for the application of computer technology in the human services assume that it promotes practice and organizational effectiveness as well as efficiency. Opponents claim that it fragments practice and reinforces the worst, most punitive, and counter-productive aspects of bureaucracy. While each of these positions rests on conflicting theoretical assumptions about the nature of practice, organizational structures, professionalization and information technology, proponents and opponents alike have failed to provide evidence to support their positions or even to recognize that these issues can be framed and tested empirically. This paper proposes the use of a comparative research design for studying the effect of computerization on program effectiveness and outlines a range of variables which need to be taken into account in adding the differential impact of computerization an social device.
ABSTRACT: This paper deals with the question of why some human service organizations are more innovative in their use of computers than others, particularly in the area of strategic planning. Rather than focus upon the technology, per se, it explores the propensity for and context within which human service managers apply computers to matters of strategic importance. It begins with a summary of the two dominant theoretical traditions within which organizational behavior has been viewed. These contrasting perspectives are then applied to the extensive body of empirical findings related to organizational innovation. The result is a discernment of key variables or variable clusters, which provide the basis for alternative accounts of innovative behavior. The emergent use of computers for strategic planning serves as the focus of the study.
ABSTRACT: Theories on organizational structure and the value of information informed observations of patterns of information use by workers in a human service organization. Differences were found in the type and frequency of information used by workers at three different levels-executive, manager and direct service. Findings suggest a gap in the education and training of human service practitioners; suggest effectiveness and efficiency improvements through an organization based design of information systems. To facilitate this, schools of social work must teach the decision-making purposes and processes at each level of the organization. Schools also must expose students to the technologies available to support practice decisions.
ABSTRACT: Much has been said and written concerning the influence of intrinsic personal and professional factors on the use of computers in general and in the social services in particular. For example, much has been made of the negative attitudes of professional personnel towards computer use. Little data however has been forthcoming to demonstrate the accuracy of this viewpoint. Theoretical analyses of the computerization process have mentioned three general issues in overcoming the imputed outcomes of these negative attitudes. An ex post facto study on computer acceptance by social workers, employed in municipal social service agencies (MSSA) in Israel, where a computerized case management system was implemented, was conducted. The impact of (1) intrinsic attitudes towards computer utilization in Human Services; (2) organizational factors; and (3) system design related factors on system acceptance was explored. It was found that readiness to computerize was related mainly to organizational and system design factors and not, contrary to expectations, to intrinsic attitudes of social workers. Implications of these findings on system implementation are discussed.
ABSTRACT: Human service organizations are beginning to utilize computerized information systems for a variety of purposes. This new information technology is expected to have a major impact on human service organizations. However, work to date has explored the impact of information systems designed for administrative and managerial tasks while clinical information systems focusing on direct practice have yet to be studied systematically. In this paper, is described the impact of a clinical information system on the work of line workers and the HSO as a whole. Five stages in the problem solving process are identified: Information collection, information processing, professional judgment, decision making, and action. They are viewed as stages in a feedback loop such that the action sequence of one cycle leads to an information collection stage in the subsequent cycle and so on. The possible impact of a C IS on practitioners at all levels from line worker to HSO clinical leadership is analyzed at each of these five stages. A case example of the CIS developed for the foster care service in Israel is utilized as an illustrative example.
ABSTRACT: As human service workers implement computerized information technologies, they operate in areas in which problems of power, depersonalization, and the invasion of privacy are central. In attempting to understand and resolve these issues, studies of computer ethics deal with moral values, economic policy, and other social change impacts associated with computerization. Unfortunately, the diffuse focus of ethical discourse in computing is confusing. This paper, in clarifying the relation of "computer ethics" to issues of personal freedom, social control, and social inequality, seeks to provide human service workers and other professional computer specialists with a framework for identifying the social effects and moral dimensions of computerization.
ABSTRACT: Modern ideas in social work are subsumed under the term "new thinking." Controversies in its concepts directly reflect controversies in attitudes toward computer application. Fundamental to modern problems with technology is the persisting dispute between two philosophical traditions. On one side there is the fennel and technically oriented thinking; on the other the reflexive, dialectical and hermeneutic approach. The reappearance of the conflict in actual discussions is described considering data storage, formal methodology and the social impact of computer use.
ABSTRACT: Much has been written about the effects of new technology on the human services and about its possible implications for agencies, practitioners and service users. There is also an important and expanding literature on the implications of new technology for society as a whole, including much which addresses issues of social justice. Until recently, however, there have been only a few attempts to explore the range of issues specifically concerning the relationship between social justice and the human services. My main purpose here is to start to sketch out the parameters of the field of study relating new technology to social justice in the human services and to explore some of them in depth. Three examples of different definitions of social justice are introduced, viz.: justice as equity; flexible individualized justice; and empowerment. Then normative and ethical considerations in relation to new technology in the human services are briefly reviewed. In the main body of this paper these issues are brought together in relation to three key areas (i) the manager/professional interface (ii) strategies for new technology implementation-top down or bottom up and (iii) the relationship between social worker and service user. Finally some conclusions are drawn about the possibilities for a synthesis between competing visions of social Justice.
ABSTRACT: The computer is a necessary instrument for social work. When agencies computerize they usually do so without much hardware or software knowledge. So, in the best American tradition, they turn to an expert, the systems analyst. And, equally, in the American tradition, this expert offers an ideal solution. The only thing wrong with this perfect scenario is that the solutions seldom meet user needs. This paper examines this situation and suggests ways for agencies to avoid getting more systems analysis than they need. And it offers suggestions for creatively implementing the necessary switch to computer technology.