Healthcare’s Lesson for Government IT

By Amir Azarbad, Health Industry Executive. Follow him on Twitter at @azarbadamir.

July 29, 2016

The public sector could learn a lot about customer-centric transformation by adopting the methods of an unlikely model: the healthcare industry. Both sectors are largely paper based, slow to adopt technology, and unable to deliver customized services. But the Affordable Care Act has forced the industry to transform its core business, resulting in a fundamental re-alignment away from one-size-fits-all rigidity to a more user-centric experience. Government could easily rip a few pages from that playbook.

Leading up to the implementation of the Affordable Care Act, the healthcare industry researched success stories from other consumer-facing industries — financial services, air travel, wireless telecommunications, and retail sales. Each of these industries underwent significant transformation from analog one-way “take it or leave it” marketing to digitized two-way web-mediated interactions. They have a 15-year head start on healthcare, figuring out how to focus on the consumer, deliver solutions and engage with its customers through new channels at lower costs. These are key success factors for the healthcare industry, and these frameworks can be applied to government entities as well.

For the healthcare industry the first critical step was to understand the consumer “journey” across the ecosystem. In the bad-old days, a member would have to interact with multiple agents, who themselves would connect to a number of disparate systems to research, enroll, and receive benefits. Isn’t this how Americans navigate multiple government agencies today, even the ones that are “web enabled”?

We literally have to put ourselves in the chair of a member, without preconceptions of what they “should” want, or what they “should” do, and follow the Golden Rule: how would we want to be treated? What information do we need? What choices do we have? How can we execute the decision in a convenient, reliable, and secure way? How will we know if our order has been accepted, how are we welcomed or informed, and what if we change our minds? You’d be surprised, but just getting folks to sit down and ask those questions was a key piece of the puzzle. It resulted in a more streamlined and seamless experience for people just browsing through, as well as those who rely on us to help them manage their chronic conditions.

After a few months of structured, broad-based, actionable input, we created detailed journey maps that had the consumer at the center, and we had a storyboard of the end to end process! If you have ever seen a documentary about how animations are made, it looked just like that. Government entities can do exactly the same thing — map out the journey of an American looking for services, discovering and enrolling for them, and finally receiving them. The recently launched “vets.gov” did exactly this, and is now consolidating and rationalizing over 1000 points of contact to make life easier for Veterans. It’s a play that works, and it’s a play that scales.

But, this is only half the story, knowing why you want to transform, and what needs to be changed. The second and arguably the most difficult part is making sure that the people who are charged with implementation are aligned — economically, operationally, and behaviorally — to the new way of doing business.

For the healthcare industry, the realization of a service oriented operating environment was a seismic shift, and required important changes of the relationship between the “business” teams and the information technology (IT) teams. It triggered a change in the traditional procurement models: in the past, business teams typically not only defined the requirements, but they also picked the tools and even the vendors. Today, most requests for proposals are led by IT teams with a smaller group of key business experts. This is a trend that can be seen across the major insurers with significant change in posture and complexion. Unsurprisingly, people are reluctant to change, and this one has been met with significant resistance. Perseverance matters. It is the only way commercial entities will survive.

Hence, the public sector could learn a lot from healthcare about how new capabilities and solutions are made available to customers. We used to get away with 12–18 months’ delivery cycles. But the transformation journey is driven by much more rapid changes in process and workflow, which requires nimble response and transparent accountability. The days of large monolithic systems delivering solution across the value chain (and generations of developers) are gone like the dinosaurs. The healthcare industry has to react to regulatory and operational changes quickly. It has to adopt new delivery methodologies that are responsive, affordable, and flexible. Government, like healthcare, cannot be expected to provide every requirement up front, and make long bets (and predictions) on the future operating environment and consumer needs. Government, too, needs to be responsive. This requires a change in process.

We are also emphasizing the use of open source solutions. The ability to retarget existing components without having to commit to a specific vendor (whose economic incentive is to sell licenses forever) has yielded significant value in the industry. Government can do exactly the same thing: move away from vendor-lock and long-term license contracts towards outcome-based procurement with people who are incentivized to provide excellent service. It works.

There is significant value for the government entities to leverage the lessons learned from the most recent industry to fundamentally transform its approach to the market, and its customer-facing execution: healthcare. Of course not every lesson will map perfectly, however, there are certain canonical actions they can take now: understand the customer journey, deliver process management solutions regularly and fast, and leverage open source solutions as much as possible to stay on the cutting edge of value and service.

Amir Azarbad has led the strategy, design, and implementation of transformative technology solutions in the healthcare industry. He believes that the transformation of the industry will be consumer centered, and he is especially focused on creating an integrated ecosystem to enable providers and empower the consumer.

The views, opinions, and positions expressed by the author of this article do not necessarily reflect the views, opinions, or positions of the Beeck Center for Social Impact + Innovation at Georgetown University or any employee thereof.

Originally published at beeckcenter.georgetown.edu on July 29, 2016.