Envisioning cooperative resource directory information infrastructure in Minnesota

Minnesota residents can look for information about a range of human services on MinnesotaHelp.Info®, a resource navigation program supported through partnership among several public entities (including the state’s Department of Human Services and Board on Aging). Minnesotans can also look for information about human services via 2-1-1, which is operated by United Ways of Minnesota and their partners. There are many other sites for specific kinds of services, such as LawHelpMN.org (run by Minnesota Legal Services State Support, previously featured on this blog) and the Minnesota Food HelpLine. On top of all this, various healthcare systems across the state have recently partnered with companies like FindHelp and Unite Us, which each offer their own service directories.

And yet despite this abundance of directories, providers of health and human services across the state have indicated that improvement in the availability of information about community resources is still one of the top priorities on their wishlists.

It seems clear that this need for better information can’t be met by building yet another website. So, what should be done?

Convening a “Co-Creation Process” to address this problem

Since 2021, Stratis Health – a nonprofit organization that facilitates system change in the healthcare sector – has served as convener, facilitator, and subject matter expert to a network of healthcare providers, health plans, resource directory providers, community organizations and other partners across Minnesota, through ongoing multi-lateral dialogue that they call a “Co-Creation process.” Together, they are collaboratively developing a shared approach to connect people with resources that can address their social needs and improve health outcomes. 

Among a range of other strategies to build capacity to address social needs, participants in this process have prioritized the development of shared infrastructure for resource directory information that could be used by all members of the network to help people connect with human services. 

In 2023, Stratis Health invited me to help design and facilitate a workgroup focused specifically on the challenge of resource directory information supply. On my recommendation, they also invited into the process people who already do the work of directory information management in Minnesota – including many of the organizations listed above.

This may sound counterintuitive, but I believe that if we really want to find new solutions to this old problem, we should bring together the people who are already working on it, and get them to talk to each other – because they know it best, and are best positioned to make lasting changes.

Reframing the premise: how do we cultivate a healthy information ecosystem?

Across months of reflection and deliberation in 2023, this resource directory workgroup affirmed that – given the range of resource directories that are already managed in Minnesota – any promising new strategy should seek to align and support existing directory information management efforts, rather than try to make them obsolete.

This workgroup deliberately reframed the problem, from a question that is often initially posed as being about a singular website, to a question about the health of our information ecosystem. When we no longer assume that websites are magical solutions to social problems, we can ask: how might we enable these distributed systems to work together in ways that add up to more than the sum of their parts? 

With that goal on the table, I invited the workgroup participants to articulate a set of values that they all share: how would they describe the qualities of successful resource directory data infrastructure? Here’s what emerged from the resulting dialogue: 

• Accessibility of data, across many contexts and many tools for many needs; 
• Reliability of information, which requires precision and ongoing verification; 
• Equitability of arrangements, to ensure that the system fairly benefits people in need and community organizations that might otherwise be marginalized; and 
• Sustainability to ensure that this work can be done for the long haul. 

These values might seem straightforward – but taking them seriously leads to some significant strategic insights.

Since different users have different needs, and this information needs to be used in many different contexts, one tool cannot possibly achieve accessibility for all.

Since we heard from directory maintainers that organizations don’t always reliably provide accurate and timely updates to information about their own services, we know that a successful strategy can’t depend on organizations updating their own information.

Since any effort must be sustainable, we can’t expect any single grant to result in success.

The group then analyzed the archetypal institutional design patterns that we have articulated through Open Referral’s strategic framework:

• registers (i.e. “official lists” of specific kinds of providers),
• utilities (i.e. universal data service providers)
• collaboratives (i.e. cooperative networks of directory maintainers)
  
  [Read here to learn more about each of these models.]

Ultimately, the workgroup recommended a strategy that would holistically integrate all three of these patterns to establish sustainable, universally-accessible infrastructure that leverages the assets and expertise that are already at work in Minnesota’s communities. 

This strategy entailed: 1) clarifying and enhancing the domain-specific responsibilities for resource data management across a network of dedicated stewards; and 2) synthesizing this distributed output and assuring the quality of comprehensive statewide output through the bottom-line responsibility of a designated “resource data utility.”

Reconvening in 2024: a deep dig into the details

In October of 2024, Stratis Health convened (and I helped design and facilitate) a two-day workshop to further develop these recommendations into an actionable strategy. Participants included representatives of social service directory maintainers (including all of those mentioned above – from 2-1-1 to MNHelp.info to domain-specific specialists such as the Food Group and Second Harvest, and health systems that are engaged in community health navigation in partnership with tech companies like Findhelp and Unite Us). 

Together, we affirmed the vision and values articulated by last year’s workgroup, and then dug into the details of the proposed strategy, in order to articulate the criteria and necessary conditions for success. 

We applied multiple methods to articulate this strategy, so that it could be grounded in a strong sense of shared understanding from a range of viewpoints. This began with drawing our complex systems – so that we could visualize what otherwise might feel very abstract and hard to grasp.

First, I invited representatives of each organization to draw their own system – visualizing their respective focus areas, prioritized users, technology and data stewardship capacity. We then heard each organization present their drawing. This enabled us to learn more about the work of everyone in the room, and deepen our understanding of the current landscape.

Participants then paired off to draw one-to-one collaboration scenarios in which two organizations might partner to exchange data for mutually-beneficial purposes. This enabled us to identify specific value propositions that participants perceived to be most important and actionable, in relatively straightforward situations: data tit-for-tats. 

Finally, having analyzed each respective system and a range of value propositions that could emerge from collaboration among members of this network, I invited participants to describe “many-to-many” collaboration scenarios in which multiple resource directory maintainers (“data stewards”) could work together with support from a core coordinating role (a “data utility”). 

Throughout the course of the second day, we considered what conditions would need to be true in order for such a scenario to work; what “propitious conditions” would increase the likelihood of success, and how we might mitigate possible risks of failure. 

Balancing centralization AND distribution: a collaborative network, anchored by an accountable utility

By the end of the second day, we analyzed several different proposals for implementation of the recommended strategy – and observed that there was a certain degree of agreement in the room.

Participants agreed that: 

• A designated “data utility” should publish aggregated, comprehensive, quality-assured resource data as an “open access” service – meaning, any compliant system would be able to access and use the public data service produced by the utility.
  
  • The Utility will need to be sufficiently resourced in order to play this role.
     
  • The Utility should operate under accountable oversight to ensure quality and equitability.

• Designated “resource data stewards” could hold specific responsibilities for collecting and maintaining information about human services within a given service domain and/or geography. These roles would be held by organizations that are best positioned to manage relationships among service providers in their specialized field (such as legal aid, etc).
  
  • Resource data stewards would presumably be responsible for collecting and sharing directory data on a given schedule, in accordance with standardized criteria. 
    
  • Stewards need to be appropriately incentivized for the labor of resource data management to be sustainable; participants recognized that the obvious way to structure compensation could be on a price-per-record basis – subject to monitoring and oversight to avoid unfair gaming.
    
• A governing body – representing members of this network, and perhaps also impacted parties from government, human service sector, and community – would set criteria for data quality and delivery, inclusion/exclusion policies, incentive arrangements, and more.

Participants were enthusiastic about the details of this emerging strategy, but also strongly recommended starting small – with an actionable pilot that may only involve a small number of participants to test these assumptions and demonstrate feasibility. 

(We observed that many healthcare sector participants were eager to address the challenge of “closed loop referrals,” but we also recognized that this topic area is complex enough on its own terms – and making progress on this problem will make it easier to subsequently develop those kinds of care system integration strategies.) 

Read the full reportout from this workshop here in this PDF shared by Stratis Health.

Moving to action: let’s work together on the path ahead

We are so grateful to all workshop participants and their respective organizations for investing two days of time in the process of deliberating among peers to find cooperative paths to sustainable and reliable resource data infrastructure.

Stratis Health is now sharing these recommendations back with the broader Co-Creation network. For anyone in Minnesota interested in exploring these opportunities, I encourage you to get in touch with Senka Hadzic.

Meanwhile, I’m also eager to explore opportunities to support similar processes in other communities. Reach out to learn about how this approach to participatory strategy can be brought to your community.

And stay tuned for more information about this innovative approach for facilitating participatory design workshops! Big thanks to the Ostrom Workshop at Indiana University, for their ongoing support as we develop these design strategies. We are also pleased to note that this design workshop and the associated toolkit was supported in part by the Midwest Big Data Innovation Hub‘s Community Development and Engagement program (under NSF awards # 1916613 and 1916518).

To learn more about Open Referral’s workshop methodology, and inquire about opportunities to organize similar workshops in your community, please reach out.