Management

A different diagnosis for HealthCare.gov

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The botched rollout of HealthCare.gov has put a spotlight on how the federal government manages IT and carries out procurement. In a Nov. 14 speech, President Barack Obama called government IT procurement a systemic problem. And Rep. Gerry Connolly (D-Va.), co-sponsor of the Federal IT Acquisition Reform Act, said the recent mishaps with what many call Obamacare have elevated the House-passed bill "from relative obscurity to prominence in the halls of Congress."

But what evidence exists that the rocky launch was caused by IT mishaps or acquisition failures? Proper medical treatment requires an informed and correct diagnosis, and government reform needs the same in order to be effective. So let me suggest a different systemic problem requiring a different curative regime: the government's need for improved program management.

Several years ago, a group of current and former government CIOs, chief financial officers, chief acquisition officers, budget officers and business managers came together to produce several white papers to address this matter. Let me draw from the capstone paper to outline my argument.

Concerned that unsuccessful programs continue to waste billions of dollars while still failing to deliver needed services, we voluntarily assembled to discuss the reasons for program failure and the necessary actions to ensure success. The focus of our discussions and studies was on building a program management capability that can deliver the government's mission in the form of outcomes and results.

The three basic challenges are:

  • Structure and policies. Agencies need organizational and cultural structures to enable policies and best management practices that consistently deliver results.
  • Skills and capacity. Agencies need to cultivate and maintain expertise, competencies, skills, and capacity to sustain a repeatable execution framework for delivering results.
  • Change management. Agencies need to develop and execute change management to transform current agency business environments into cultures of results.

The group made the following recommendations:

Governance:

  • Establish an overall governance structure to manage and oversee large programs.
  • Establish a consistent process for delegating authorities.
  • Establish reporting/approval mechanisms.
  • Establish a template for structuring and staffing each program team.
  • Develop consistent requirements for program management plans, including their placement in the overall governance structure.

Alignment and oversight:

  • Use strategic planning processes to align goals and objectives.
  • Establish common dashboards and metrics.
  • Establish knowledge repositories and mechanisms for their effective use.
  • Link control structures and align objectives and reporting mechanisms.
  • Establish customer and stakeholder engagement "touch points."
  • Establish business process synchronization to test regimens and deployment decisions.
  • Review staffing in terms of capacities and competencies and in the context of a department's human capital plan.
  • Establish critical success factors for program managers.
  • Establish formal linkages and objectives horizontally with stakeholders, including the Office of Management and Budget, the Government Accountability Office, Congress and other agencies.
  • Tie alignment activities, objectives and goals to an organization's strategic plan.

Career valuation:

  • Develop a communication plan advocating program management as a valued career path.
  • Establish a curriculum and certification program in program management.
  • Establish a departmental program management council to advise the deputy secretary and other officials, including newly appointed program managers, to share best practices and act as a "murder" board in the review of submitted program management plans.

Managing transformation:

  • Develop and implement an organizational transformation strategy and plan.
  • Address business process management, information management (including knowledge management) and human capital management.
  • Use organizational change management and project management disciplines to implement a strategy and plan.
  • Build change capability and capacity within the organization.

Would these program management practices have spared HealthCare.gov its disastrous debut? We'll never know for sure, but such steps would certainly have helped to flag the trouble spots much sooner.

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Reader comments

Tue, Dec 31, 2013

Would anyone happen to know of where I can find these white papers?

Mon, Dec 23, 2013

Could not agree more, the MAJOR problem was lack of good program management and OVERSIGHT that makes a PM adhere to good management techniques. Capturing the metrics that verify a project is on track (e.g. EVM (linked to a resourced IMS), Requirements Stability/Tracability, Design Stability/Tracability, Fault Opening/Closing, etc) is the basis for evaluating and ensuring progress. Developing Documentation (a la DOD 5000) captures the planning that ensures the required thought has gone into the project/program. From the Congressional Hearings, it was evident that none of this was present at CMS. No Project Management + Lack of Oversight = FAILURE!

Mon, Dec 23, 2013 Peter Gallagher

Agreed Alan - better PM would have surely helped but in this case the PM failure is more a symptom than the cause IMHO. The projects complexity and apparent lack of transparency along with architectural decisions appear to have doomed the initiative from the get-go. We will be trying to learn from this one for a long time...

Mon, Dec 23, 2013 Dave Roush Austin, TX

I would add as far as Change Management goes: Repeatable and traceable or auditable.

Mon, Dec 23, 2013

The premise that government should be involved with health care insurance is absolutely idiotic. Why waste time discussion a problem that should never have been tried in the first place.

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