HMIS Tools and Gadgets Vakil Kuner, City and County of San Francisco Jeffrey Ward, El Paso Coalition...

HMIS Tools and Gadgets

Vakil Kuner, City and County of San Francisco

Jeffrey Ward, El Paso Coalition for the Homeless

Justin Graham, Maricopa HMIS Project

September 13-14, 2005St. Louis, Missouri

Sponsored by the U.S. Department of Housing and Urban Development

September 13-14, 2005 St. Louis, MissouriSponsored by the U.S. Department of Housing and Urban Development

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Presenters

• Vakil Kuner, IT Director / CIO - Human Services Agency, City and County of San Francisco

• Jeffrey Ward, El Paso Coalition for the Homeless

• Justin Graham, Maricopa AZ HMIS Project

Biometrics After Two Years of Experience



Vakil KunerIT Director / CIO - Human Services Agency

City and County of San Francisco


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What Is Finger Imaging?

• Elements1. Sensor2. Image processing

software3. Image database4. ‘Matching’ software

•It’s not so simple•Which finger?•How many fingers?•What’s the protocol?


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How Finger Imaging Works

• Image is scanned• Software finds minutiae• Software converts

coordinates to number

Key Points:

• Image is not saved• Number can not be

converted to an image• No two numbers are

identical, i.e., the same finger will always produce a slightly different number

• Process is proprietary

Minutiae


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HMIS Components

Shelter Reservation System• 25 Shelters & intake points

• DSL connection to Internet• CCSF control of desktop• 2,500 Shelter beds

Permanent & Transitional Housing

• 50 Housing sites• DSL connection to Internet• Provider control of desktop• 1,500 Housing units

growing to 3.500


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Why Use Biometrics – Goals

1. Improve unduplicated count accuracy2.Reduce fraud3.Protect client confidentiality4.Use tax dollars wisely - cost effective


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What Problems Are Created?

• Law enforcement – must be incompatible• Advocates – must be secure• Implementation – must be easy to use in the field• Client population – many have poor fingerprints• Search system - designed for high false negative


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Image Reading Issues

• Client population has 10% - 15% rate of unreadable fingers• Abrasion• Substance abuse

•Systems are designed for low false positive, high false negative.

•False positive rate .00016& with one finger

•False negative rate 12.0% with one finger

•Need a backup system - photos

•Two fingers reduce false negative to 1.4%


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System Design Issues

• Tradeoff of database capacity vs. search speed• Matches are ‘close enough’, not exact

Searches look at the entire database

• Our numbers:

• System must do 17,463 matches per second

• 2,300 searches per night at shelters• 41,000 records in database (6-10 months)• 94,300,000 matches are required within …• 90 minute check in period


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Hardware vs. Software Solutions

• Hardware solution• Blade server does 5,000+

matches per second• Failover is automatic• Add blades if need more

capacity• Secure, hardened servers• Cost $65,000 (BioLink)

• Costs are 2002 and likely have changed

• Software solution• SQL server or Oracle

servers. Match rate ?• Failover more difficult• Cluster servers if need

more capacity• More difficult to secure• Cost $200,000 not

including hardware (Digital Persona)


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Goal Report Card

1. Improve unduplicated count B+2. Reduce fraud

B+3. Secure A4. Cost effective B5. Incompatible with law enforcement A

• Client acceptance B+• Advocate acceptance C• Provider acceptance D


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Provider Issues

• Startup Problems

• Low use of finger image for check-in (5% - 25%)

• Addressing these issues by

• Enrollment too long• Cleaning client fingers• High breakage rates of

image readers

• Training issues• Staff turnover• Buggy software

• Continual training• New software system• Surprises


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Surprises (??? or #*%!!)

• Where’s the vendor?• Moscow???• Time Zones, cultural issues, communication

• Can we image a corpse?• Yes – if you change the system parameters


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Recommendations

• Be aware of issues• Search speed• Backup system when imaging does not work• Rugged finger image devices• Get buy-in from shelter staff and support them • Security is an important technical issue

• Market continues to change rapidly• Look at lots of vendors• Evaluate both hardware and software solutions• Do not count on your vendor being around long term

Applying Technology – Developing A Simple ID Card System



Jeffrey Ward, El Paso Coalition for the Homeless


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Some HMIS Applications Are More Difficult Than Others

Two areas have presented major challenges to our HMIS implementation:

• Applications that have high transaction volumes• Emergency Shelters• Van Transportation

• Applications that require additional security for client protection• Domestic Violence Shelters


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Common Limitations to Implementation

HMIS implementations share common constraints. Technology applications must be developed that work within these limitations:

• Limited Budgets• HMIS group• Client agencies

• Limited ability to modify software

• Limited ability to change agency procedures


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“Trial” Approaches – High Volume

The first method doesn’t always work – our unsuccessful approaches include:

• Standard software solution • Too slow for existing agency procedures

• Finger imaging• ID server too costly for our HMIS

• Modified legacy system• Duplicated effort/duplicated database


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“Trial” Approaches – High Security

• Standard software solution • Agency concerns about security

• Not sure about system capabilities – zero risk goal • Loss of client protection away from DV shelter• Intimate stalker concerns

• Publicity over commercial credit data theft – lowered trust in computer system security

• Unique “code” for DV clients in HMIS• Identified client as a resident at DV shelter• Added risk of client duplication within system• Required special handing by other service providers


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The Simple ID Card:A Work-in-Progress

• Provides benefits to participating homeless individuals:• Reduced wait times/faster processing• Limited information helps to protects privacy

• Reduces agency service times• Simple interface to existing software; Provides

positive ID to our HMIS software and reduces the risk of duplication

• Encourages consistency and accuracy within HMIS


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The Simple ID Card A Work-in-Progress

• Technology is available, simple, inexpensive• Works within our limitations – a “bookend”

solution• Allows for an incremental implementation• Increases participation in HMIS• A lost card does not place personal information at

risk


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The Simple ID Card

We limit information to:

• Client’s Photo• Bar-coded HMIS ID• Human readable HMIS ID

Participation is voluntary


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The Gadgets – Pilot Program

The pilot process should utilize existing resources

• Existing 4.0 Meg camera $ 0• Existing color printer $ 0• Demo software and Word/Excel $ 0• Existing lamination equipment $ 0• Existing wireless network $ 0

• Barcode readers $ 100 each

The pilot project should identify problems and build support


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The Gadgets – Implementation

Approximate costs per site for card preparation:

• Camera $ 200 – 400• Software $ 300 – 400• Card printers $ 850 –

2,000+

• Barcode readers (each) $ 85 – 400• Memory barcode readers (each) $ 100 – 350


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Lessons Learned – So Far

• Never miss an opportunity to share your ideas, strategies and concerns – great ideas often come from unlikely sources

• Listen to your client agencies – their buy-in is essential

• Engage your DV shelters early – they will probably not trust your system until they begin to trust you. Example: The Chair of our HMIS Privacy/Confidentiality Committee came from our primary DV shelter


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Lessons Learned – So Far

• Build enthusiasm and gain feedback through simple, hands-on technology demonstrations

• Confirm acceptance by homeless clients during pilot testing

• Assemble small successes into an overall system• Keep chipping away as new problems develop• Try to keep initial investments low enough that:

• You are not afraid to start over if it doesn’t work• You will buy and try the hardware

• Focus on “bookend” technologies that work within your current limitations


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Summary

The diversity of our agencies make an HMIS implementation different from “normal” software implementations; Industry models don’t necessarily work

Because of software limitations and the common reluctance of agencies to change their procedures, HMIS is often stuck between “bookends” that we cannot control; Our focus should be on technology and strategies that we can control

An iterative approach using simple technology and extensive pilot testing can be very effective in this environment

Don’t be afraid to try the gadgets and see how they might work for you; You can start right now


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Hands on Technology

Examples of barcode hardware and simple ID samples are available for demonstration:

• USB barcode scanner• Wedge barcode scanner• Symbol “keychain” memory barcode reader• Example of free barcode font available from Internet• Sample laminated and plastic card ID’s• Sample badge preparation software• Camera to software transfer • Sample barcode scan to database application• BioLink U-Match finger scan reader

Client/Employee ID Cards



Justin Graham, Maricopa AZ HMIS Project


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Status of Implementation

• Four agencies using ID cards• Central Arizona Shelter Services (CASS)• Phoenix Rescue Mission (PRM)• Streets of Joy• Day Resource Center (DRC)


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CASS Breakdown

• Largest homeless shelter in Maricopa county• Serves on average 400 clients a night• Check-in time before ID cards – 1 hour 15 mins• Check-in time with ID cards – 15 minutes• Employees are using ID cards for entry into the

shelter facilities


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ID Card Information

• Information on the cards:• Client Name• Client Date of Birth• Picture of Client• HMIS Client ID• Barcode of Client ID• Agency Information


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Startup Cost Breakdown

Product PricePrinter $1,620.00Software $349.00Camera $249.99Printer Cartridges $92.86ID Cards (500) $38.48Tripod (Optional) $40.00Light (Optional) $15.00 TOTAL $2,405.33


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Technology Vendors

• Same vendor used by all agencies for card production; Other vendors available across the country

• Different cameras in use by the agencies; Minimum of 3 mega pixels is necessary for a clear picture ID


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Technical Setup

• Check with HMIS software vendor for products that are compatible with the software

• Research and price different vendor solutions• Research available technological grants to pay for

the equipment• Test technology with a training website if possible• Purchase equipment and do behind the scenes

setup for the staff• Provide lots and lots of training for the staff


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Staff Procedure

• Easy as 1, 2, 3 for the staff:• Step 1: Take a picture• Step 2: Download picture and create the ID card• Step 3: Print out the card and verify the information

• The following presentation are sample staff training slides about using client ID cards. Please feel free to modify it to meet your individual needs


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Advantages

• Reduce check-in time at shelters/out-patient facilities

• Reduce duplication of clients within the system• Cards with a barcode can be used for scanning

the client for an individual or group service such as a class with a barcode scanner

• Cards have been welcome at financial institutions as a form of identification

• Client picture can be attached to the clients’ profile in the HMIS software where available


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Disadvantages

• Re-creating cards for clients that lost them• Increased amount of training for staff and staff

turnover• Staff tend to have more anxiety over ID cards

than clients• On-going costs of cards and ink• Increased duties for the agencies technological

staff


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Lessons Learned

• Staff need lots of training to accept the new responsibility:• Show examples of how it has helped other agencies.• In very basic steps show how the process works (see

attachment)• Have a paper instructional sheet showing staff the

process of creating ID cards• Allow the staff to take and download sample pictures

and create sample cards to get used to the system before working with clients

• There is never enough training


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Equipment Links

• Card printer and accessories• http://www.fargo.com/

• ID Card Software• http://www.ttsys.com/badge_ezbadges.html

http://www.fargo.com/

http://www.ttsys.com/badge_ezbadges.html

Client ID Card Tutorial



Justin Graham, Maricopa AZ HMIS Project


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Creating ID Cards

• Creating ID cards is as simple as 1, 2, 3:• Step 1: Take a picture• Step 2: Download and create the ID card• Step 3: Print out the card


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Step 1: Take a Picture

• The first step in creating a picture ID card is taking the picture

• A tripod can be used to help steady the camera or if you want to use the camera’s timer

• A good light source is necessary for a clear picture


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Step 2: Download and Create

• The next step is to download the picture using the camera’s software

• Use the ID card software and type in the clients’ information

• Check with your IT staff to see where they setup the download area for the pictures


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Step 3: Print

• The last step is to print out the ID card

• ID card printers take a little longer than paper printers, please be patient

• If you have problems with the printer, please contact your IT staff


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Finished Card

• Now you have the finished ID card for the client

• Please verify the information is correct on the card before giving it to the client


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Tips

• Practicing taking pictures of the office, outdoors, etc. to get comfortable with the camera

• Practice downloading the pictures to the computer to get comfortable with the software

• If you have questions, please ask versus assuming; There is no such thing as a stupid question


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Questions

Questions????

HMIS Tools and Gadgets Vakil Kuner, City and County of San Francisco Jeffrey Ward, El Paso Coalition...

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Transcript of HMIS Tools and Gadgets Vakil Kuner, City and County of San Francisco Jeffrey Ward, El Paso Coalition...