#SystemsofCareInsights: Beyond Network Effectiveness (1/3)

Systems of care allow clients to seamlessly receive care from multiple health and human service providers. They improve access to care and encourage accountability for health and human services organizations. 

Systems of care are defined as referral systems across health and human service agencies supported by technological capital (e.g., community referral technologies, updatable resource directories) and human capital (e.g., community health navigators, call center operators, social workers). The implementation of these systems of care has been encouraged by both state and federal public agencies, and thus, many states and municipalities now have overlapping care systems. 

For example, veterans and military families have access to many different systems of care beyond AmericaServes networks. The G.I. Bill grants veterans access to education benefits, utility assistance offers aid in paying for necessary utilities, and the Supportive Services for Veteran Families program provides veterans and their families access to affordable housing. All of these systems overlap and interplay with one another to provide the communities they serve with the best possible care. Systems of care can also overlap extensively in times of great need, such as environmental events. If a community faces a natural disaster, greater demands will be placed on systems specializing in housing assistance, food assistance, or transportation. When states and municipalities have numerous robust systems of care equipped to handle these demands, their communities will receive better service.

But evaluation practices for systems of care have not advanced and adapted to pace with the networks. New metrics need to be introduced to evaluate and compare these systems. In a joint IBM report (lead author: Julia Carboni), NNSI researchers and collaborators investigate the performance of systems of care referral technologies across three distinct metrics: accuracy, efficiency, and effectiveness.


In the study, researchers define accuracy as whether the first agency referred a client to provided services. Efficiency refers to the speed with which clients receive services once they have entered the system. Finally, effectiveness is defined as whether the client received services. These metrics enable researchers and future network evaluators to capture real-time interactions within the system, providing an operational view at the whole-network level. 

To measure network performance across these metrics, researchers analyzed the operations of 11 geographically bound systems of care. These systems in question are AmericaServes networks– “the [United States’] first coordinated system of public, private, and non-profit organizations working together to serve veterans, transitioning service-members, and their families” (AmericaServes, 2021). These 11 networks operate in New York, North Carolina, Pennsylvania, Rhode Island, South Carolina, Texas, and the District of Columbia. AmericaServes networks offer 21 different categories of services (e.g., financial and income support, physical and mental health care, transportation, employment assistance, etc.).

The help-seeking process within AmericaServes networks is as follows: 

americaserves network

AmericaServes networks utilize technology provider Unite Us to maintain the platform that houses the data on referral progress and organization/client information. Researchers analyzed data from the Unite Us platform within a 30-day window in 2020– just before each respective state’s COVID-19 response. By analyzing these service episodes amongst the three metrics of accuracy, efficiency, and effectiveness, researchers were able to characterize the performance and functioning of these AmericaServes systems of care.

Researchers also explored the impact of different types of services on network performance. By comparing and contrasting services of varying levels of complexity, researchers were able to discover how performance varies across different services– from straightforwardly simple to highly complex.

In our next series of blogs on #SystemsofCareInsights, we aim to share with you the central insights of this research and what implications these results present to the operations of current systems of care, both from a management and policymaker perspective.

Want to learn more? Check out the full research article here:

Collaborative Networks: The Next Frontier in Data Driven Management | IBM Center for The Business of Government. https://www.businessofgovernment.org/report/collaborative-networks-next-frontier-data-driven-management