Throughout his campaign, Governor-Elect Charlie Baker focused on jobs, education, and community building. We believe that his new administration can best make improvements in these areas with an approach focusing on public-private collaboration and outcomes—outcomes implemented through the best technology tools and measured with rigorous metrics. This type of approach would ideally work at scale, increase efficiency, and measurably improve opportunities and outcomes for citizens. It is a citizen-centric approach that the Governor-elect championed in a 2002 paper he wrote entitled “Rationalizing Health and Human Services.”
Information technology can support Baker’s vision by providing high-quality tools that are both efficient and transparent. Ideally, an IT strategy for the Commonwealth unites the best of three technical worlds:
- The IT enterprise: providing a cohesive, interoperable solution that spans agencies and the systems that support them;
- High-quality, consumer-grade technology: providing proven, familiar interfaces and systems;
- The nascent startup community: providing open, extensible and agile innovations that, when taken advantage of, could benefit government.
For example, in the enterprise space, advancements in cloud technologies based on open standards provide efficiencies of scale as well as enhanced privacy, security, and reliability for enterprise IT infrastructure. The cloud’s ability to manage data across discrete IT systems makes it possible to support common functions across previously disparate organizations. Cloud services can streamline care coordination, collaboration, relationship management, analysis and reporting within an extended organization like HHS, as well as across disparate systems that service common consumers – such as justice, education, workforce, health and communities. Developments in predictive analytics can provide real-time outcome measurement and personalize government services to each constituent.
The proliferation of consumer technologies, including smart phones, tablets, commodity devices commonly called “the Internet of Things” and applications will engage citizens in multiple ways, including appointment alerts, medication reminders, school progress, assistance to enroll in programs and services, job search, and job training supports.
It is clear that there are opportunities in government IT for new technologies and approaches—technologies that originate from the startup and civic technology space that foster agility, transparency and trust in previously unforeseen ways. The IT industry will play an important role here by supporting partnerships between the business and civic technology groups in our communities, as well as supporting the continued growth of the innovation sector, especially by making it more accessible and expanding it to underserved areas.
The state should expect partnership and accountability from the IT industry. At the same time, it should thoughtfully consider what capacities are necessary to comprehensively manage the government IT enterprise – from infrastructure, to large agency-specific systems, to shared services that cross systems, to partnerships with civic technology communities to spur innovation.
Massachusetts received a B- in the 2014 Digital States Survey. Technology can be a catalyst to improving outcomes. However, if technology is poorly implemented, it can be an impediment to success, or the cause of operational failures. The Massachusetts Health Connector is a case in point. Much has been written on this, including the review Microsoft authored at the request of the Patrick Administration. Going forward, the focus should be to ensure that pitfalls aren’t systemic, or repeated, and should emphasize policy and information technology oversight where there previously had been a breakdown across multiple agencies.
Similar attention should be placed on the lifecycle of IT within the state—with a clear strategy from vision to execution including:
- Use cases and product planning: What is the proposed value of the technology? What problems are solved? How will it benefit the user?
- Contingencies and fall-back plans: What is the backup plan should the technology not be implemented as promised?
- Buy vs. build analysis: Is it cheaper to buy off the shelf or build a custom solution?
- Comparison of best practices in other markets: How have other entities (including private sector) best implemented solutions? What can you learn from entities like the federal project 18F or the United Kingdom’s Government Digital Service?
- Compatibility of implementation with technology standards: how interoperable is the approach? What hooks are available for other technologies, including startups, to link into the implementation?
Finally, accountability to the end user should be prioritized. In the case of the Massachusetts Health Connector, this required providing a “user friendly” application, to encourage and expedite the selection of insurance, and recognition that system failure created risks that consumers would lose coverage and the state could incur additional IT and Medicaid costs.
State information technology leaders have an increasingly complex job. They must manage large enterprise implementations, enable consumer services and foster a culture of innovation to continuously improve the “product.” Similar challenges face IT leaders in other industries, such as health care. What is clear is that the success of health, government, education, and other enterprises serving these same consumers—the citizens of Massachusetts—is increasingly dependent on IT leaders and systems achieving high performance.
We look forward to partnering with the Baker administration in helping the state to deliver top notch services to its citizens while delivering on the Governor-Elect’s promise to improve jobs, education and the well-being of citizens and their communities.
William O’Leary is Senior Director and Chief Health Policy
Officer for Microsoft, Health and Life Sciences. O’Leary is the
former Secretary of Health and Human Services for the
Commonwealth of Massachusetts.
Cathy Wissink is Director of Technology & Civic Engagement
for Microsoft in Boston.