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August 2016
Policy&Practice
27
I
n virtually every industry, there is demand for faster and
more nimble approaches to information technology (IT)
transformation. Take the auto industry where, according
to a 2013
Harvard Business Review
article, the typical
automotive design cycle had shortened to just 24–36
months; five years earlier this same cycle took 60 months.
1
The impetus for change in the automobile industry
seems fairly obvious; car makers had to keep up with
customer demands for better, more efficient, and more
technologically advanced cars so they sped up innova-
tion cycles. Taxpayers and recipients of public services, including
health and social service programs, have the same expectations. Yet
government, and particularly the health and social service agencies
and the vendor community that serves them, sometimes may make
it appear that we are still acting like it is 1999. However, the tired
attempts to rip-and-replace siloed systems with yet another mono-
lithic transfer system are coming to an end.
A variety of forces is demanding this change. First, the speed
and level of technical innovation are simply mind blowing. Second,
the pace of regulatory change has never been faster. The Health
Information Technology for Economic and Clinical Health Act, the
Patient Protection and Affordable Care Act of 2010, the enhanced
federal financial participation (FFP) for Medicaidmodernization, the
time-limited Office of Management Budget A-87 cost allocation waiver,
and the newly adopted Comprehensive ChildWelfare Information
System rule, among other regulatory and funding changes, are both
encouraging—andmandating—that we do things differently.
Despite some great successes in the industry, there have been
simply too many costly failures and modernization efforts that do
little more than re-platform antiquated legacy technology (and
the associated business processes that go with them). Often these
projects take too long, cost too much, and make only moderate
improvements in the efficiency or effectiveness of case practice if
they reach production at all.
There are signs, though, that the industry is quite rightfully moving
toward a more nimble approach to IT transformation. When viewing
the business and IT environment through the lens of the capabilities
needed to support a new business model, technology becomes the
solution enabler, not the solution itself. The initiatives taking such
a view typically leverage a more incremental approach to planning
and an agile development approach to deliver results quicker, help
mitigate risk, and allow strategy adaptation, if needed, mid-stream.
As is often the case with large-scale change, the temptation could
be for the pendulum to swing too far the other way. Indeed, an
“agile” approach that does not include a clear roadmap for reaching
the desired end state, or that fails to account for realities such as the
length of a public procurement cycle, is likely destined to fail.
However, with a rather straightforward four-step planning
process that can be accomplished as quickly as 60 days, an agency
The world of health
and human services IT
Transformation is changing.
Illustration via Shutterstock