A different diagnosis for HealthCare.gov
- By Alan Balutis
- Dec 20, 2013
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:
- 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.
- 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.
- 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.