James E. Cabral, Abhijeet Chavan, Thomas M. Clarke, John Greacen, Bonnie Rose Hough, Linda Rexer, Jane Ribadeneyra & Richard Zorza
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Article extracted from Harvard Journal of Law and Technology
VI. TECH-SUPPORTED TRIAGE: THE KEY TO MAXIMIZING
EFFECTIVENESS AND ACCESS (BONNIE ROSE HOUGH &RICHARD ZORZA)
A. Why Triage?
It is a truism that courts, legal aid, and those in the bar serving low- and middle-income clients are overwhelmed with unmet legal need. It is also sadly true that these or to provide adequate services using the current delivery methods. The current delivery model — with its lack of coordination304 and misallocation of resources — is unacceptable.
We simply have to find a better way to triage legal services — to allocate the available services so they have the greatest impact on the greatest number of people. As we will show, technology provides the ability to gather data quickly and analyze patterns in outcomes to recommend cost-efficient choices.
We suggest a multi-component triage system that would be integrated with the present legal services delivery system. Full integration of the five kinds of triage we describe will require a technology driven system, which we discuss below. Adoption of a fully integrated triage system entails both managerial difficulties and risks to litigants and clients; these challenges and risks must be more fully explored. Our ideas should be considered a starting point for discussion, not a fully realized plan or recommendation.
B. How People Enter the Access to Justice Triage
System
Access to this triage system must be via data-gathering gateways, including the web, mobile apps, and voice systems. Ideally, every person would have an “access to justice” account, which would contain their basic information and a history of their prior interactions with the justice system. These accounts would also be able to import information from other systems, including information such as reported income, public benefits, employment history, and social service agency records. The data in this part of the system would be confidential and could only be released to other systems with the person’s permission.
After logging in through a secure portal, the person seeking access would answer some basic questions about her legal situation and the algorithms of the system would make recommendations and appropriate referrals.
A service provider’s triage system must effectively identify issues and available solutions, which will sometimes differ significantly from the stated problem that brought a client or applicant to the provider’s door. For example, a young parent may seek help with a child custody dispute. But it could be clear in a comprehensive triage system that the parent first needs help with a pending foreclosure to avoid housing instability that would create a strategic disadvantage in the custody case. Users would always be given the choice to explore only the specific issue that caused them to seek help in the first place.
The comprehensive intake procedure exists to ensure users are aware of additional possible legal solutions or complications. A triage system could deal with such situations through real-time links to the local court system. For instance, when a parent provided her name and address in a child custody dispute, the system could pull data from the court computer network to flag the pending case. The system could also use mathematical analysis of aggregated data to flag clients who meet demographic or geographic profiles that fit patterns of other known cases. The system could cross-check non-confidential data from other pending or closed cases to identify recurring opposing parties or other factors which might warrant an enhanced response to the new case.
The system should combine information from data sources with knowledge about which issues or fact patterns are more likely to correlate with certain common or predicted types of information likely to be provided by a user. These presumptions could be based on accumulated expertise or on data-mined patterns. For example, if experience or data shows that disabled applicants in a certain county are likely to have been given improper Medicaid denials, the system should ask questions designed to elicit the needed information even if the user is not yet aware of the problem. These presumptions should be regularly evaluated against actual case outcomes and altered as necessary.
E. What Is Needed to Build the System
The above is an algorithm-driven system. It must have the capacity to take data and find the underlying patterns in real-world behavior, derive protocols for how the institutions that make up the system should behave, and then apply these protocols. The process of developing the protocols can be human-driven, technology-driven, or a combination of both. To build the triage system, the partners involved need to agree on the types of data and on methods of interpreting that data that are likely to lead to actionable and measurable results. This will require technical compatibility between data formats if multiple database systems are involved.
Demographic data should be organized in formats that do not produce ambiguous or conflicting results. For example, if one system identifies senior citizens as fifty-five or older, but another only applies that designation to applicants sixty or older, those differences must be resolved. Other specialized data, such as legal problem codes, court case numbers, and the like should be collected according to agreed upon protocols. Outcomes should be vigorously evaluated for non-causal correlations or other factors that could lead to false interpretations. Legal services providers should also look to other disciplines outside of the legal system to evaluate whether correlations with medical issues, educational attainment, mental health factors, or other factors can enhance the predictability of whether a particular legal problem is likely to arise, or whether a particular type of assistance is likely to produce positive results. For example, if case data shows that a high number of children living in substandard housing in a particular zip code suffer from mold-induced asthma, then the triage system might automatically ask all applicants from that zip code whether their household includes any children who have asthma. A positive response would warrant follow-up questions about the family’s housing, even if the reason for which the applicant contacted the service provider was entirely unrelated.
The mix of issues will differ depending on variations in the service area. Questions for rural applicants may differ from those asked of urban applicants. Questions in high unemployment areas may vary from those asked of applicants from communities where unemployment is relatively low. The goal is to reduce reliance on one-size-fits all triage methods and to use the power of adaptable data processes to better guide resource allocation and advocacy decisions.
G. Conclusion
Many of us believe that the development of appropriate triage is critical to moving towards full access to legal services.328 Deploying triage will be controversial and difficult. Confidentiality, the potential burden on litigants, and the different cultures of participating organizations raise critical challenges. But, in the end, there is no other way to take the data about outcomes, and about litigants’ capacities and needs, and make sure that people get what they need to obtain access to justice. We propose that the court and legal aid communities, together with their partners, develop and engage in a multi-step triage development strategy.
*Please see the full article for all referenced material. This post has been condensed from it's original for an easier read.
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