Trends in Public Sector IT

1. Trends in Public Sector IT Software Association of Oregon Technology and Procurement Event Salem, Oregon January 19, 2010 Planning for Oregon’s Health & Human Services Technology Needs Rick Howard, CIO Oregon Department of Human Services

2. Presentation Topics • Oregon’s health & human services technology plan. • Current state technology environment. • The creation of two new state agencies. • The health and human services enterprise in Oregon. • Sharing business services across multiple programs. • Office of Information Services strategic framework. • Future state technology environment. • IT investments in the next 24 months.

3. OR-DHS Technology Roadmap Highlights Current State 2009 Person Eligibility Infrastructure Case Management Insurance Quality Control Population Protective Financial Provider The Oregon DHS technology environment today… DHS Technology Needs Hierarchy Future State 2015 Innovative People-Centered • Increasingly expensive to support • Barrier to innovation • Duplicates information & business processes • Limits service coordination • Frustrates stakeholders Integrated Secure & Stable Infrastructure A series of incremental investments over the next six years will… • Improve security and access to data Source: Camellia Project: A Connected Health and Human Services Framework for Alabama. Microsoft & SEI. May 2007 • Increase worker productivity • Provide 24/7 access to DHS services 2009 - 2011 So that… The coordinated, consistent delivery of health and human services in Oregon will be enabled by an IT infrastructure that supports improved outcomes by providing a comprehensive view of the clients and populations we serve. • Support the health and safety of children • Track common clients across multiple systems • Share standard business processes 2011 - 2013 Coordinated Delivery of Health & Human Services 2013 - 2015 • Integrate master data management services • Connect systems of care

4. Health Care Reform in Oregon Oregon Department of Human Services: 2009 Oregon Department of Human Services: 2009 Director’s Office Direct Client Services Support Services Public Health Administrative Services Addictions & Mental Health Budget Planning & Analysis Medical Assistance Programs Children, Adults & Families Office of Financial Services Seniors & People with Disabilities

5. Health Care Reform in Oregon Governance Public Health Children, Adults & Families Public Employees’ Benefit Board Addictions & Mental Health Oregon Educators Benefit Board Seniors & People with Disabilities Office of Private Health Partnerships Medical Assistance Programs Oregon Medical Insurance Pool Shared Services Oregon Department of Human Services: 2009 Oregon Health and Human Services: 2010-2011 Oregon Health Policy Board Oregon Health Authority Department of Human Services Director’s Office Agency Director Agency Director Direct Client Services Support Services Public Health Public Employees’ Benefit Board Administrative Services Administrative Services Addictions & Mental Health Oregon Educators Benefit Board Budget Planning & Analysis Office of Private Health Partnerships Medical Assistance Programs Children, Adults & Families Office of Financial Services Oregon Medical Insurance Pool Seniors & People with Disabilities

6. Health Care Reform in Oregon Governance Public Health Public Employees’ Benefit Board Transforming Delivery of Health Care Expanding Coverage & Access Addictions & Mental Health Oregon Educators Benefit Board Improving Population Health Office of Private Health Partnerships Medical Assistance Programs Planning Oregon Medical Insurance Pool Shared Services Oregon Health and Human Services: 2010-2011 Oregon Health and Human Services: 2012 Oregon Health Policy Board Oregon Health Authority Department of Human Services Agency Director Agency Director Children, Adults & Families Seniors & People with Disabilities Administrative Services Administrative Services

7. The Health & Human Services Enterprise Oregon Health Policy Board Governance Governance Oregon Health Authority Department of Human Services Employment Child Support Shared Services National HHS Business Architecture Education K-12 Juvenile Justice Corrections Government Interoperability: Connected Systems, Shared Services

8. The OIS Strategic Framework

9. 2009 - 2011 2011 - 2013 2013 - 2015 IT Capabilities Timeline Summary Continue strategy implementation; establish enterprise support Evaluate as-is inventories; develop strategies; identify e-form opportunities Leverage Core IT investment and existing tools; continue planning • Evaluate as-is inventories of tools and document experience as input to strategy development. • Research SharePoint capabilities. • Develop strategies that leverage investment in SharePoint and existing tools for: • Enterprise Content Management • Collaboration • Portals • Identify initial opportunities for electronic forms and workflow. • Develop a Decision Support System (DSS) strategy that identifies tools to be continued, added or discontinued. • Develop a strategy for Service Oriented Architecture (SOA) framework to increase development agility. • Expand Data Warehouse and Data Store processes and utilities to provide generic capabilities. • Develop strategy to provide common Data Warehouse and Data Store framework. • Integrate SharePoint with existing tools. • Implement strategies by expanding use of SharePoint and existing tools for: • Enterprise Content Management (electronic forms and workflow and document management) • Collaboration • Portals • Integrate any additional tools with SharePoint as identified in strategies. • Implement Decision Support System strategy by leveraging investments to expand management reporting. • Implement SOA strategy to provide a common framework for services. • User and technical training and support. • Implement strategy to facilitate creation and management of data warehouse and data stores. • Continue strategy implementation through integration of SharePoint with additional tools to meet business needs for: • Enterprise Content Management • Collaboration • Continue implementation of Decision Support System strategy. • Integration of Portals with implemented capabilities. • Implement Service Oriented Architecture governance processes. • Establish enterprise support and consulting for implemented capabilities. • Continue future planning (evaluate capabilities and gaps in functionality based on business needs).

10. IT Capabilities Timeline 2009 - 2011 2011 - 2013 2013 - 2015 HHS Capabilities Roadmap 2009-2015 Capability Core IT Enterprise Content Management Collaboration Decision Support System Data Warehouses & Data Stores Portals Service Oriented Architecture

11. Next Investment Cycle: 2011-2013 Business Case Short List (Working DRAFT) - Sharepoint enterprise licensing* - Data Management Services: automated migration tools. - Service Oriented Architecture/Enterprise Service Bus* - IT Enterprise Management: Phase 2 - OR-Kids Child Welfare system Adult Protective Services. - Unified Collaborative Communications (UCC) Program* *Collaboration/Coordinated Service Delivery

12. For More Information DHS 2009-2015 Technology Plan http://www.oregon.gov/DHS/technology/cio_messages/2009/dhs-tch-pln-09-15.pdf A New Model for Human Care Management: Defining the Business of Health and Human Services http://www.aphsa.org/Home/Doc/NewModelforHumanCareManagement.pdf Rick Howard 503-385-7156 rick.howard@state.or.us

13. The Case for a National Human Services Business Architecture Document Links

14. Current State IT Environment: 2010 • Only limited amount of client information is accessible in a central location • Difficult to get to the data because it is stored in individual systems • Siloed applications • Inconsistent and duplicate data • Repeated functionality • Inconsistent security and access • Hundreds of custom interfaces make changes complex and expensive

15. Current Software Profile Computing platforms: - Mainframe operating system: z/OS supports web-based applications, as well - Mainframe computing toolsets and languages: UNIX, CICS, COBOL, MVS JCL, IBM utilities - Mid-range Server Operating systems: AIX and Microsoft supports both client/server and web-based applications - Mid-range Computing toolsets and languages: - Websphere, Powerbuilder, .NET, ColdFusion, SmallTalk, JAVA, J2EE Data base management systems: - DB 2, IMS, Sybase, SQL

16. 2015 Technology Plan Enterprise Capabilities Expanding Enterprise Capabilities Enterprise Content Management Collaboration Decision Support System Data Warehouses & Data Stores Portals Service Oriented Architecture Adapted from: Microsoft Institute for Advance Technology in Governments and Systems Engineering, Inc. (SEI). Camellia Project: A Connected Health and Human Services Framework for Alabama. May 2007

17. Medicaid IT Architecture Framework 2.0 Operations Management Member Management Provider Management Contractor Management Program Management Program Integrity Management Business Relationship Management Care Management

18. A Values-Based Technology Strategy The Oregon Department of Human Services (DHS) Mission Assisting people to become healthy, independent and safe.

19. External & Environmental Drivers Demands are increasing Budgets are shrinking Costs of service delivery are rising …and so are public expectations

20. Business Effectiveness Drivers Self-directed client services Automated workflow processes Coordinated service delivery …to do more with the same or less

21. Information Effectiveness Drivers Information exchange & collaboration Financial management & forecasting Analytics & decision making …are needed to improve client outcomes

22. IT Agility Drivers Control the costs of information technology Support a mobile 24/7 workforce Develop shared services …to respond quickly to changing needs

23. IT Architectural Principles Business Domain Business applications and technology decisions align with strategic direction and architectural guidelines. Business processes will be documented and defined and applications will be streamlined/integrated to address common business processes. Business requirements drive new technology initiatives. Systems comply with information security policies, procedures, and guidelines. Business continuity and application availability are addressed throughout the technology lifecycle. Information Domain Data is an enterprise asset and is shareable and accessible, when appropriate. Common vocabulary and data definitions are developed for each application.

24. IT Architectural Principles Solutions Domain Application functionality is partitioned into components and services for greater flexibility. Common or shared application services are reused when appropriate. Application services are designed as loosely coupled as possible. Technology Domain Industry proven technology standards and solutions are identified, defined, and leveraged. Technology systems are easy to use. Systems interoperability is improved.

25. Access to health care for all Oregon children under 19 • All-payer, all-claims database • Healthcare workforce database • Aggressive outreach and enrollment of eligible children • Coverage for 35,000 additional low-income adults under the Oregon Health Plan • Statewide registry of Physician Orders for Life Sustaining Treatment (POLST) • Paying for value Statewide adoption of electronic health records • Establish Health Care Workforce Committee • Setting high standards • Development of affordable small business health insurance product • Measuring and reporting • Medicaid Health Record Bank of Oregon • Guidance and support to community three-share agreements • Coordinated purchasing Transforming Delivery of Health Care • Expansion of school-based health clinics Expanding Coverage & Access • Stimulating system improvement and innovation • Development of baseline health benefit package Improving Population Health • Prevention and Wellness Fund for chronic disease prevention By December 31, 2010: Planning • Plan to provide access to affordable, quality healthcare for all Oregonians by 2015. • Obesity Prevention and Education • Tobacco Prevention and Education • Plan for the Oregon Health Insurance Exchange. • Oregon’s North Star goal for patient safety • Plan for the development of a publicly-owned health benefit plan within the Exchange. • Statewide healthcare acquired infection prevention program • Investigate and report on the feasibility and advisability of future changes to the health insurance market. • Statewide Health Improvement Plan The Oregon Health Authority