Academic journal article Social Work

Client-Controlled Case Information: A General System Theory Perspective

Academic journal article Social Work

Client-Controlled Case Information: A General System Theory Perspective

Article excerpt

Information technology (IT) use in human services extends over three decades. Schoech (1999), LaMendola (1988), Nurius and Hudson (1988), and others began designing IT applications for the human services in the 1970s. However, little has changed from Vallee's (1986) observation that the vast majority of human services agencies use information technology only for management purposes, using centralized information systems, despite the widespread availability of the World Wide Web. According to Vallee, such systems are a product of a management-driven design process and reflect management values. In contrast is a network system that is the product of a bottom-up process and reflects end-user values. For social workers, an important end-user value is sharing data collaboratively to meet clients' needs.

This sharing reflects the increased attention given to collaboration among human services agencies. The need for increased collaboration was noted almost two decades ago (Sauber, 1983), but remains a largely unmet goal. IT may be a solution.

The following case example illustrates some of the issues involved when a parent needs to obtain and share case information regarding a child who has special health care needs.

   Carl is a two-year-old child with Down syndrome.
   An early intervention school-based
   program requires documentation of his diagnosis
   to qualify him for services. A counseling
   agency requires the same documentation to
   qualify Carl's family for counseling and respite
   services. Currently, his mother has to sign a
   release of information from Carl's physician
   and the medical center. To do so, she not only
   has to go there in person, but also has to arrange
   transportation and child care for Carl
   and his siblings. The release of information
   then travels a circuitous route. First, the medical
   records department processes it. Carl's
   chart is retrieved if it is available, copied
   (hopefully legibly), and mailed to the requesting
   agencies. Next, it is processed through the
   agencies' records departments. Eventually it is
   available to the person of people who need it
   to determine eligibility. In addition to extra
   stress for Carl's mother, this process is expensive,
   duplicative, and inefficient and sometimes
   takes weeks to complete.

Using general system theory (GST) (Bertalanffy, 1968) principles, I examine effective IT use and compare it with the typical way information has been exchanged among agencies; the major difference is the way in which the client is incorporated in the information flow. I propose a client-centered and client-controlled Web page to increase the input and output an agency receives and produces, thus accelerating the delivery and quality of human services. Client eligibility for services is assumed, and no additional service delivery network is proposed. Rather, I focus on the exchange of information between human services agencies and a client or the client's family.

Literature Review

General System Theory

Sauber (1983) viewed GST as "primarily concerned with the problems of relationships, of structure, and of interdependence rather than with the constant attributes of objects" (p. 54). GST has been criticized in the social work literature for being too deterministic (Brueggemann, 1996), not useful (Thyer, 2000), or simply outdated (Hudson, 2000). A selective review of the literature reveals that GST has been used empirically in clinical social work practice (Bagarozzi, 1982; Manor, 1997), in organizational research (Bojovic, 2002; Maruyama, 1990), and with information system design (Cummings & Guynes, 1994; Leach & Whitman, 1999).

The focus of this article is on the organizational and information system aspects of GST. Bojovic (2002) used GST as the basis for modeling several dynamic variables in a rail freight system, and Maruyama (1990) demonstrated how GST sheds light on the impact of divergent epistemologies on causal loop thinkers. …

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