Despite challenges, state HHS departments modernizing their IT

The survey polled 67 agency program leaders from 35 states.
By Mike Miliard
11:15 AM
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Slowly but surely, state health and human services agencies are recognizing the transformative potential of information technology, according to a report published this week by the American Public Human Services Association (APHSA) and Microsoft.

The survey, “A Promising Future for HHS Transformation – The Real Impact of IT System Modernization,” polled 67 agency program leaders from 35 states at various stages of modernizing their information technology systems, gauging the status of those who have implemented solutions for eligibility determination and benefit issuance, case management and online self-service – as well as those who had not yet modernized.

The report sought to learn more about agencies’ experience with organizational transformation planning efforts, the agencies’ system life-cycle challenges, and the impact and benefits the agencies experienced from IT modernization, say APHSA officials.

“Many states are taking a forward-thinking and visionary approach to transforming their programs and modernizing IT systems,” said Laura Caliguiri, managing director, U.S. Public Sector Health and Human Services, Microsoft. “Human services agencies are leveraging technology advancements and best practices, enabling an incremental strategy to ensure immediate benefits from the new systems and are able to accommodate policy and program changes.”

Its findings suggest that with strong leadership, due diligence and good program management practices, departments are seeing incremental benefits expected of IT modernization, officials say – but a number of challenges remain.

Some of the survey's takeaways with regard to IT implementation:

  • 43 percent of agencies have implemented a new HHS IT system within the past 10 years;
  • 57 percent have not modernized, although most (55 percent) plan to do so over the next three to five years;
  • 19 of respondents had no plans to modernize, mainly due to lack of funding;
  • 22 percent are very likely to consider the cloud for future system deployment. 

As for timing, 47 percent of agencies surveyed experienced an implementation timeframe of more than three years when implementing a new system, APHSA found. Long timeframes generally correlate to agencies with a larger number of business rules and practices to re-engineer complex IT environments with multiple legacy systems, requiring extensive training and support.

States with larger constituent populations also report longer implementation timeframes, but the programs themselves (e.g., Temporary Assistance for Needy Families, Child Welfare, etc.) did not have a direct correlation.

With regard to benefits, state agencies planning to modernize (55 percent) expect a new system to meet about 63 percent of their needs in the areas of customer-centricity, improved self-service and improved decision-making, the survey found.

There are frustrations along the way. Of the states that modernized, 100 percent cited the need to extend system functionality with non-developers, and 80 percent felt the amount of required customization and interoperability across programs and systems was not in line with expectations. These deficiencies were perceived as factors that lead to project delays and contract and scope modifications.

But the states surveyed offered their perspectives on best practices. The APHSA report found that

  • Leadership and communication are key. Technology can help facilitate effective communication throughout and across organizations, but only when those organizations define clear goals and work together to support implementation of the technical tools.
  • IT must be nimble and responsive to change. HHS environments are dynamic and changing rapidly, and technology must be able to adapt.
  • Gaining cost efficiencies requires effective use of benchmarks and measurement. IT deployments are long-term projects, typically taking years to complete. Ensuring the projects stay on track means defining guideposts and measuring against them.

“State human service agencies average spending $40 million over a three-year implementation timeframe, but the time has never been more opportune to benefit from IT advances to achieve the mission of HHS agencies,” said Tracy Wareing, APHSA executive director.