The challenges state health and human services agencies face in upgrading their IT systems go beyond gaining funding and completing years-long implementation projects, according to a survey released by the American Public Human Services Association (APHSA) and Microsoft.
The poll included responses from 67 agency program leaders from 35 states at various stages of modernizing their HHS IT systems.
The goals of the new systems included boosting access and self-service for clients and improving decision-support across areas including clinical, management, quality and policy.
Of the respondents, 43 percent installed a new IT system in the past 10 years; 57 percent had not modernized, but 55 percent of those said they plan to do so in the next three to five years. Nineteen percent cited lack of funding as the reason they had no plans to modernize.
Forty percent said that implementing a new system took three years or longer. Longer time frames were associated with complex IT environments with multiple legacy systems and with states with large constituencies.
All the states that modernized cited the need to extend system functionality with nondevelopers, and 80 percent said the amount of required customization and interoperability across programs and systems was not in line with expectations.
A separate research report looks at the challenges involved in modernization and makes suggestions to ease the path. It identifies several keys to success, including:
- Leadership and effective cross-boundary communication: Engage stakeholders from beginning to end by creating a team that represents all the groups that will be using the system so they have a say in implementation and functionality. Be clear about what defines success and make sure that everyone understands what will be required to achieve it.
- Select IT solutions that can effectively adapt to change: Choose a flexible platform, adopt an effective change management program and to plan for training and support.
- Employ benchmarks and measurement: Keep these long-term projects on track and encourage accountability, another key success factor in success.
- Use an incremental approach: Limit changes to the system while it is being built to reduce delays and increased costs. Use service-oriented architecture that integrates with legacy systems that will not be replaced.
Health departments in Tennessee and Louisiana are among those who have recently announced plans for massive systems upgrades. The Tennessee Department of Health want to adopt the open-source technology used by the Department of Veterans Affairs.