An outside review of the rollout of Vermont Health Connect shows that a number of external factors contributed to the exchange’s rocky start, but it also identifies areas in which the state could improve its handling of future large-scale information technology projects.
Gov. Peter Shumlin called for the independent review at the outset of the legislative session and later hired Maine-based consulting firm BerryDunn, which released its report late last week.
The report acknowledges that the federally imposed launch date, changing federal expectations and requirements, Vermont’s failed negotiations with the tech firm Oracle and poor cohesion within the team provided by CGI, the state’s eventual vendor for the project, all hindered its implementation.
The BerryDunn report also suggests that understanding what external constraints could threaten a project’s viability is a crucial part of the planning process for future IT projects.
“Moving forward on this and other projects, defining activities that are reasonable and achievable based on identified project constraints is a key success factor,” the report states.
Its recommendations focus on how Vermont can complete the exchange as well as other health-related IT projects, known collectively as the Health Services Enterprise. The projects must be built over the next few years to lay the groundwork for a public universal health care program in Vermont.
The projects combined are expected to cost several hundred million dollars, and are only affordable with federal matching funds to cover as much as 90 percent of certain projects’ costs.
That funding comes with federal oversight requirements that in some cases involve deadlines.
In addition to being realistic about a project’s constraints, BerryDunn recommends that Vermont’s project teams strive for better communication and transparency among workers and managers – including the involvement of executive leadership much earlier when things begin to go wrong. It also calls for more clearly defined responsibilities within teams and improved vendor management.
The report focuses on the lead-up to Vermont Health Connect’s launch in October, said Richard Boes, the state’s chief information officer.
The state has already begun allocating its resources differently, he said.
Among other things, the state is fleshing out its Health Services Enterprise program management team. Stephanie Beck was recently drafted from within the Agency of Human Services to be the program’s director.
Beck has a background in human services and has worked for the agency for a long time, said Lawrence Miller, secretary of Commerce and Economic Development. The governor asked Miller to assist with the completion of Vermont Health Connect, and he is also familiar with the work being done on the Health Services Enterprise.
Miller described Beck’s role as focusing “upward and outward.” Beck understands the policy drivers and desired outcomes of the projects within the Health Services Enterprise, Miller said, and her vision will help ensure the systems meet the state’s needs.
Vermont has also begun the search to hire a program manager for the Health Services Enterprise. That person’s focus will be “inward and downward,” Miller said. They will be responsible for the operational components, making sure the new systems work properly.
One of the key takeaways from the BerryDunn report and his own experience working on Vermont Health Connect is that the policy experts didn’t have, or didn’t know how to, deploy their operational resources, Miller said.
“That was the gap, in my mind,” Miller said. “I think what we learned is we can do a much better job of delivering those tools to our appointed and long-term program staff. In my mind, we want our appointees to care passionately about the policy outcomes and then be provided the tools to do project management.”
When it comes to project management, tools can mean personnel, Miller added.
Boes said there should be statewide standards for vendor management and dedicated staff, in addition to project managers, within state government to monitor procurement and the work of outside contractors.
One of the key challenges in bringing Vermont Health Connect up to snuff has been getting the tech firm CGI, the state’s primary vendor for the project, to deliver on the work that’s expected of it.
“We should probably be taking a more proactive role in setting statewide standards for vendor management,” Boes said. “We do not currently have anybody who is a dedicated vendor manager on staff.”
The report states that CGI created a project team of more than 180 people who had little to no experience working together. An internal manager dedicated to overseeing contracted work could have identified that as a problem earlier and could have worked with executives at CGI to mitigate its impact on the project.
Boes said the recommendations in the BerryDunn report are important to implement across state government.
Roughly 70 percent of the state’s IT systems are outdated and will need to be replaced. The governmental agencies that rely on those systems invariably want them to perform additional functions, Boes said.
Technology systems are a core function of government in the information age, and their primacy is likely to increase.
“I want to make sure that we leverage these lessons for many projects, and not just Vermont Health Connect,” he said.
