HHS technology vision for the future – navigating your next to #DigitizeHHS
To a great extent, the future of Health and Human Services (HHS) technology is the present of the commercial sector: modular, agile, loosely coupled, and best-of-breed. The difference is the speed of implementation and complexity.
Government systems need to meet a number of constitutional obligations and operate in a regulatory environment more complex than what commercial sector systems face. Government has many more stakeholders, from government agencies, interest groups, to each and every citizen, both taxpayer and benefit recipient. Achieving consensus while meeting regulatory requirements is always more complicated and a tedious process.
The commercial sector today
The commercial world today is being driven by a need to simplify an organization’s management of technology. Today’s cloud enabled world removes the need and the extra expense of managing individual servers. Abstracting computing through containerization or technologies such as Amazon’s Lambda enables organizations to reduce cost (cloud and platform technology providers achieve economies of scale that are hard to match in even the largest environments) and focus on the business. Platforms (Salesforce, Microsoft Dynamics, Pega, etc.) abstract the layers needed to provide business services, and discrete tools abstract processes thus avoiding green field development to solve a business problem.
Another characteristic of today’s commercial technology world is the startup culture. Even large-scale, foundational technology organizations (e.g., Google) incubate small, agile firms that focus on smaller problems with niche solutions, but do it better than all others. These small, niche solutions can be integrated through services and APIs, often times available as services in the cloud. There are start-ups that focus on items such as citizen portals; it is possible to imagine start-ups that focus on small increments, for example rules for a single program.
The HHS world of the future
HHS has taken to the cloud in earnest in just the last five years. There is a large scale “lift and shift” of existing infrastructure to the cloud. Standalone servers are being virtualized, virtual servers moved to the cloud. The future will see greater abstraction – virtual servers will be containerized, services will be taken from the traditional stack and cloud services will be utilized.
Solutions will be built by niche-players who provide best-in-class applications. Risk, always a paramount concern in the public sector, will be mitigated by reducing the criticality of any given component. The “too big to fail” model of single vendor implementations, already fading with the focus on agile procurements and modular solutions, will disappear faster than anybody thinks. States will realize that picking a small company with the best fitting solution for today is a safe bet because in the growing world of startup culture and open technologies, there is always another start up creating even better technology that can be plugged into a modular platform.
The role of the systems integrator
Traditionally, large scale systems integrators (SI) brought the process and technology capabilities needed to create and implement solutions. Additionally, the large scale and concurrent financial resources enabled a perception of comfort and lower risk – a big SI could be sued to perform and had the money to get the job done. History has shown, however, that the large SI is better at counter-suing and threatening Armageddon if more money is not provided to finish the project. This isn’t just a public sector problem- the rise of modular, small solutions is driven, in part, by the commercial sector’s desire to reduce risk and maintain leverage over its service providers.
In today’s world, and in the future, a SI will be vital. They still provide a set of process and technical resources to augment capabilities, share knowledge, and reduce risk. But now states don’t have to contract the whole project to one (or a few) solution providers, betting that it will work. They can use agile procurements and niche solutions based on a service-based architecture to build the solution they need. The SI can (and should) be the glue that ensure it all sticks together – PMO, Architecture Team, QA etc.
It is a rare, perhaps even nonexistent, to find a government agency that has enough scale to build cross-industry knowledge base of best practices to drive its own modular projects and ensure the niche solution “bricks” make a house, not a pile of rubble. The role of the SI is changing, but they are not going away.
The outlines of the future of HHS technology can be seen in the commercial world today – understanding today’s technology will point to how HHS agencies will transform their operations and systems to meet their unique regulatory and operating environments.
Rick leads the Government Healthcare practice at Infosys for the US and Canada. He has 20+ years experience in healthcare and public sector.