By Anne Laurent, Director, CGI Initiative for Collaborative Government

August 6, 2010

Agency executives are working to comply with a host of new Office of Management and Budget (OMB) memos about IT project reviews and spending freezes, as well as the requirement to cut costs and speed delivery to meet a 5 percent budget reduction for fiscal 2012.

To assist executives in meeting these challenges and in managing their IT portfolios, the CGI Initiative for Collaborative Government recently published an Issue Brief, “Financial Systems Modernizations: How to Accelerate Value and Boost Savings.” It contains a host of useful approaches to improving efficiency and effectiveness in modernizing and implementing IT systems.

The Issue Brief captures recommendations from experienced former Chief Finance Officers and Chief Information Officers for accelerating value and reducing costs during financial and other IT system modernizations.

The 10 levers for rooting out cost and three recommendations for scoping implementations into smaller segments apply as agencies work to meet the requirements of OMB memos requiring them to identify and remediate high-risk IT projects, adopt new IT investment baseline management policies and adhere to new IT management and procurement policies coming soon.

For example, the brief recommends that agencies pay only for the service levels they need, noting that higher service level requirements correlate directly to higher costs. A requirement to have a system available 99.9 percent of the time, for example, requires more servers, backups and communications redundancy than a 99 percent or 98.5 percent requirement.

The brief also recommends scoping system implementations into segments that will eliminate the need for legacy or cuff systems. This approach not only meets the mandate to split IT projects into smaller segments with clear deliverables,

By Ryan Chandler
Consultant
CGI Initiative for Collaborative Government

Information exchange is becoming an increasingly important tool in conducting business for federal, state and local governments. Now, agency leaders and other government executives need practical guidance on creating an information sharing environment. Several agencies have taken an independent approach to developing information exchange platforms. The U.S. Environmental Protection Agency (EPA), for example, created the Exchange Network, a standards-based approach to exchanging environmental data among states, tribes and the EPA. At the foundation of all data exchange initiatives is the development of data and technology standards that make the flow of information possible and ensure the quality and security of that data.  

To ease the burden and reduce the risk associated with creating information sharing environments, organizations should look for previously defined data exchange standards. One candidate is the National Information Exchange Model (NIEM), developed in partnership by the Justice and Homeland Security Departments. To help potential adopters understand the NIEM and its application, the American Council for Technology-Industry Advisory Council (ACT-IAC) presented an executive panel, “NIEM:  A State of the Standard Address,” on June 9. Speakers Donna Roy, Director of the Enterprise Data Management Office, Department of Homeland Security; John Teeter, Deputy Chief Information Officer, U.S. Department of Health and Human Services (HHS); Dan Pitton, IT Compliance Director, National Highway Transportation Safety Administration (NHTSA); and John W. Harman, Data Standards Program, EPA, explored the use of the NIEM and the current state of the program. 

The NIEM is designed to develop and support standards and processes that can be used to share information broadly.  The model creates a common understanding across entities participating in an information exchange through defined standards, consistent data formatting and a set of tools and processes.  Originally developed for emergency situations, the model also supports day-to-day operations of agencies and organizations and has been adopted by several federal agencies and state/local governments nationwide.  With a number of documented success stories, the NIEM offers a proven information sharing capability with best practices built in.

The panel offered an array of perspectives on the use of NIEM, ranging from use in the Alabama Criminal Justice Information Center to application at HHS. The NIEM has been in use since 2008 at HHS as the information exchange platform for the Office of Child Support Enforcement to allow for information exchange between enforcement agencies and the courts.  Based on this success of NIEM in the healthcare domain, the HHS Health IT Standards Committee is considering using NIEM to help healthcare systems “talk” to each other in support of efforts to achieve meaningful use of electronic health records. Donna Roy, who also serves as Executive Director of the NIEM Program, says three strategic goals guide the NIEM program as it evolves: increasing accessibility, promoting the enterprise view of information exchange and building strong communities.Federal policy-makers have taken note of the NIEM’s successes. In the OMB Passback guidance for the FY2011 budget,

“Critical Success Factors for Large, Complex Information Technology Projects,” a new paper from the CGI Initiative for Collaborative Government, offers government executives a set of practical success factors that can help prevent the problems that often hobble large technology implementations.

Author Patricia Healy, a CGI Initiative Fellow and Executive Consultant at CGI, makes the key point that large-scale IT projects cannot be approached merely as technology efforts. Rather, she says, they “are, first and foremost, major change management initiatives that alter the way an organization operates, including what work it performs, by whom, where and using what processes.” Adding to the complexity, large IT projects also often link data for the first time – including data from sources outside the major IT initiative. While this can be disruptive, it also creates new information organizations can use to manage operations.

Healy, a former deputy chief financial officer at the Department of Agriculture, explains six key elements most often associated with the success of high-risk, high-cost IT projects:

•    Ensuring senior-level executive support (secretary and subcabinet/administrator) brings a holistic management vision, manages the cultural environment, addresses implementation challenges and focuses resources where needed.
•    Ensuring senior management-level involvement/commitment/expertise allows the organization to get the most strategic people on board and let them manage and communicate the needed changes throughout the organization.
•    Instituting and maintaining a strong governance structure helps senior leaders keep the project’s integrity intact by making goals clear and involving advisory boards, if needed, to keep the project on target.
•    Providing sufficient project management expertise and empowerment enlists project managers with solid skills and proven track records, so those best suited are in charge of managing people, events and culture.
•    Ensuring that requirements are adequately defined and avoiding scope creep.  To achieve this, leaders must be clear about goals and keep them to an achievable number.  Functional experts should develop requirements and other experts should be consulted to ensure they include the latest technologies and best practices.  In addition, customization of COTS solutions should be avoided and “back doors” in new software should be considered to allow for enhancement down the road.
•    Pairing a “big vision” with an incremental implementation approach.  A broad strategic conceptual framework for operations can accommodate changes to streamline operations, cut costs and realize efficiencies.

This strategy requires a well planned and well documented approach to implementation, with strictly defined requirements and goals to guide project managers throughout the process.  But if agency leaders bake these critical success factors into their large-scale IT projects from the beginning, they can look forward to reduced risk and lower costs at every milestone.

Facing a budget freeze and growing across-the-board budget reductions along with much greater scrutiny of spending, federal agencies are going to have to rely on tightly integrated financial and program data as they determine which actions to take and investments to make to improve efficiency and reap savings, according to CGI Initiative Fellow Vincette Goerl.

In addition, as she explains in the video interview below, this year’s budget process is an especially difficult one because of the new transparency expectations created by the publication of detailed information about Recovery Act spending. The FY2011 budget proposed by the Obama administration calls for a three-year freeze on non-security discretionary spending, accomplished through funding increases in high-priority programs and cuts in low-priority programs. And so, Goerl observes, agencies must become even more adept at allocating resources among programs.

On top of all this, Goerl points out, there are three different fiscal year budgets in play right now. The FY2010 budget is under a mid-year review, while the FY2011 budget is with the congressional appropriation committees.  Meanwhile, agencies are preparing their FY2012 budget requests, which are due to the Office of Management and Budget (OMB) in September. Compounding this cumbersome and confusing process are the economic pressures and budget constraints created by the recession along with calls from both the administration and the public to improve program performance and reduce levels of fraud, waste and abuse.

To respond to these pressures, she says, agency leaders must take a strategic, next-generation management approach to drive available funds to high-priority programs and find ways to create efficiencies in them.  More and more, executives need access to a wide range of performance and financial information.  Only by combining and analyzing this data can agency executives make the evidence-based investment and resource allocation decisions that bring the most mission performance for each taxpayer dollar.

Dim lights

As the Veterans Affairs Department (VA) considers how to overhaul its Veterans Health Information Systems and Technology Architecture (VistA) Electronic Medical Record (EMR) and clinical information system, there is no shortage of opinions on the best approach.  To help sort through the ideas, VA officials commissioned a working group from the Industry Advisory Council of the American Council for Technology (ACT-IAC) to recommend a path for modernizing the 25-year-old system.  

VistA is widely recognized as one of the most integrated health information systems in the world.  It delivers proven quality of care improvements in VA medical facilities and cost savings for the department.  The software provides a complete Electronic Health Record (EHR) for each veteran and supports day-to-day medical center operations by allowing providers and administrative staff to work with patient information quickly and efficiently.  Doctors base their treatment decisions on the comprehensive view of the patient contained in the system. EMRs include health problems, prescriptions, medications, and lab results, as well as hospitalization and treatment histories across all VA facilities.  Doctor also can place orders and receive automated reminders and alerts through VistA to improve care and reduce treatment errors.

The ACT-IAC report, “VistA Modernization Report: Legacy to leadership,” released May 4, recommends that the VA “commit to and announce a plan to move to an open source, open standards model” to develop the next generation of VistA.  An open source approach to software development would allow development  and collaboration across the VA as well as with other healthcare professionals, software programmers and others.  “Open source provides the best way forward in terms of engaging the entire community, making anything that is developed easy to enhance, flexible, and manageable in cost,” Ed Meagher, chairman of the IAC VistA working group, told Government  Health IT.

In the video below, Dr. John Loonsk, CGI Chief Medical Office and CGI Initiative Fellow, lays out the promise of a redesigned VistA, not only for the VA but for other healthcare providers, both public and private.  Dr. Loonsk, the former director of interoperability and standards at the Office of the National Coordinator for Health Information Technology (ONC), considers how best to leverage the VA’s experiences across the healthcare industry.   He outlines the importance of pairing doctors and other providers with software developers to ensure that the VistA redesign will meet the needs of providers and ultimately improve patient care.

Dr. Loonsk also emphasizes the importance of taking a modular approach to VistA redevelopment that will allow easy linkage with commercial health information systems. He underscores the consideration of setting and enforcing standards at all levels, ranging from technology and software all the way to standards of patient care, and he demonstrates just how complex a challenge the VA and the nation face in attempting to create broadly useful health information systems.

Dim lights

Government executives often long for more time to consult with peers to gain the benefit of the experiences of others who’ve served in their shoes. The rush of demands can crowd out opportunities for strategizing, collaborating and sharing lessons learned.

Academic research in public policy can help collect lessons across agencies, levels of government, national boundaries and disciplines, but the results often aren’t published in time to support executives when they are confronting challenges.

The ideal would be to combine the wisdom and expertise of longtime government executives with the breadth and depth of academic research in a marriage of practical insight and actionable analysis. This is exactly what we at the CGI Initiative for Collaborative Government try to bring to executives throughout government and we’ve just increased our firepower to do so sevenfold.

On Monday, April 19, we welcomed our first class of CGI Initiative for Collaborative Government Fellows during a celebratory reception in downtown Washington, at the Sidney Harman Center for the Arts.  At the same event, the George Mason University Department of Public and International Affairs appointed them Affiliate Professors.

Meet our seven new fellows and affiliate professors:

Roy Bernardi is a former Deputy Secretary of the U.S. Housing and Urban Development Department and former Mayor of Syracuse, N.Y. Roy is a truly experienced civil servant, having served at every level of government including as a public high school Spanish teacher and guidance counselor.

Vincette Goerl served as the very first chief financial officer for both the U.S. Customs Service and the U.S. Forest Service. A true CFO’s CFO, Vincette puts the lessons learned during her 36-year federal career to work as a CFO SAGE (Strategic Advisors to Government Executives, a Partnership for Public Service program) providing advice and counsel to CFOs and deputy CFOs governmentwide.

Patricia Healy began her 30-year federal career working at the National Medical Library on some of the very first online systems to index medical literature and make it available to doctors. She is a former deputy chief financial officer of the Agriculture Department and a CFO SAGE.

John Loonsk began a lifelong interest in medical informatics during a high school summer job creating taxonomy of liver diseases for the father of a friend.

by Molly O'Neill
CGI Initiative for Collaborative Government Fellow
Vice President, CGI

Earlier this month, federal agencies published their Open Government Plans as required under the president’s December 8 Open Government Directive. The plans identify how each agency would become more transparent, improve data quality and engage citizens. 

A few years ago, while chief information officer at the Environmental Protection Agency, I launched the National Dialogue for Improving Access to Information.  The purpose of the dialogue was to engage stakeholders and the public in a strategic planning process. But, as I learned this month, it really wasn’t an example of engagement in the process, but rather of soliciting ideas to inform the process – still a great first step.  

Since leaving EPA, I’ve continued to follow agencies’ citizen engagement activities to see how they are evolving.  One of the most interesting, complex and risky was the recent National Dialogue on the Quadrennial Homeland Security Review. The Department of Homeland Security (DHS) partnered with the National Academy of Public Administration (NAPA) to conduct this dialogue, which was rooted in stakeholder groups but open to the public. DHS and NAPA drew upon the viral nature of social media to spawn other conversations.

This public dialogue was unique. Most citizen engagement activities to date have involved soliciting ideas. This one was about engaging in a federal process.   It was done in three phases:

     1.    Get initial input/steering 
     2.    Solicit comments on the draft priorities based on this input
     3.    Seek comments on the final product.

The participants could actually see how the comments they were providing were incorporated (or not) into drafts and then a final plan.  Yes, they got to review the drafts along the way! This dialogue provided engagement on an iterative process – definitely an evolution from past dialogues.