By Katie Kerwin McCrimmon
Its not quite time to hang the Mission Accomplished banner, but managers of the long-disastrous Colorado Benefits Management System (CBMS) say they are well on their way to fixing it.
While Kristin Russell, Colorados secretary of technology and chief information officer, is barred from overseeing IT at Colorados health exchange, she vowed that CBMS will work and will connect seamlessly with the exchange system by Oct. 1. Thats the target date for the exchange to open to customers. (Click here to read about tech troubles that could hobble the $66 million health exchange system.)
We will be ready. We feel very confident in what we are doing. We are on track and will be ready to deliver, Russell said.
But the fact that Colorados legislature set up the health exchange as an independent public entity, not a state agency, complicates how Russells office can work with the exchange.
The legislature felt very strongly that this needed to be separate from the state. I do not have any oversight or any involvement in the technology operations at COHBE (the Colorado Health Benefits Exchange), Russell said.
That means that a bridge between the two systems must work, but the two groups are not allowed to coordinate their IT work. As for CBMS, Russell said the news is much better than it has been in years.
Gov. John Hickenlooper is the third governor to grapple with the CBMS mess, which has cost Colorado taxpayers hundreds of millions of dollars. Since 2004, the system has failed to work properly in getting food stamps, health and public assistance benefits for the poor, spurring lawsuits and federal audits. Hickenlooper went for a Hail Mary pass and in 2011 lured Russell from Oracle where she had been vice president for global IT, overseeing data centers and computing operations worldwide.
Russell said she began getting calls from the media before even arriving in Colorado asking how she planned to fix CBMS. Since then, Russell and one-third of the governors cabinet have held powwows every other week to sort out exactly how to fix the mess. Last year, Colorado lawmakers approved spending another $38 million to turn CBMS around.
CBMS managers earlier this month updated members of the legislatures Joint Budget Committee. They said the system is much improved, but warned that the most challenging nine months lie ahead of us including resource and time constraints. During the rest of this year, managers said they face an aggressive production schedule, significant system builds along with integration with the health exchange.
There are also multiple directives coming forward regarding health care reform about which we have many questions, a report for the JBC said.
In an interview after the hearing, Russell invoked one of the most famous tag lines ever to emerge from Silicon Valley Steve Jobs ad for Apple: Think Different.
Russell was describing the intensive approach that Hickenlooper and his team have taken to fix CBMS.
It just shows the Hickenlooper administration thinks differently, Russell said. This (CBMS) is a huge problem. We want to be the administration that helps to fix it and gets on the right path so we leave a positive legacy for administrations to come.
Step No. 1 was figuring out what was wrong. Both Russell and Sherri Hammons, chief technology officer for the Office of Information Technology, headed out into the field to shadow county assistance officers.
Hammons remembers watching as a workers mouse froze and the cursor started jumping around the screen.
It was very clear that something was wrong behind the scenes, Hammons said.
She asked the worker how often the problem was happening.
Every day at about 11, the worker responded.
When Hammons quizzed the IT staffers at the state, it turned out that they were running reports in the middle of the day that were interfering with how the system was functioning in the field. That was a simple fix: no more reports in the middle of the day.
The system also had many other complex problems. It was notoriously slow because every time a caseworker and client in the counties clicked to update a field on their computer screen, it had to wait for approval from the central system.
It was running on a Citrix environment. That was causing a ton of latency, Russell said. Every time they did anything, it was going all the way back to the state before refreshing on the desktop.
Managers since have shifted to a cloud-based system so that updates happen immediately.
It looks more like when youre online. People are very familiar with that. The old technology was cumbersome, Hammons said.
Managers also have created county user groups to get continuous input on how to improve the system. Some of the requests from workers are simple such as, I want to be able to cut and paste from this screen to a different screen.
Through the user groups, IT managers also found bugs that were bothering workers but tricky for technicians to duplicate.
Those were bugs on the back end. We couldnt see them, Hammons said.
With the new system, we could find freezing screens and fix them, Hammons said. Its a lot faster now. They were waiting 12 seconds between screens. Now thats a lot smoother.
The system still has some strange quirks. Every time caseworkers and clients would save data even if they were just trying to get a preliminary estimate CBMS would generate a letter and send it to the clients home. Clients would sometimes end up receiving multiple contradictory letters about their eligibility for benefits.
When they would fill in a form, they would go down and hit submit. That was generating client correspondence: Youre eligible. Youre not eligible, Russell said.
Of course those letters created much anger and confusion among county workers and clients.
That is why communication is so critical. We didnt know they were using the submit (function) to get estimates, Russell said. Were trying to get maniacally focused on the user experience.
As of June 2011, Russell said CBMS was handling only about 60 percent of transactions in four seconds or less. By June of 2012, that number had climbed to 84 percent. Mangers are aiming for at least 90 percent.
So people are seeing that difference. Its making a huge impact to their workflow. The system is performing better, she said.
Both women said there was intensive pressure to junk the entire CBMS system, but that would have been far too costly and time-consuming. Instead, they had to find the problems within the system and fix them.
Its like you have a 200-page book and it doesnt have any chapters. You want to go and change a few words. It would be really hard to do that (find particular words without chapters). So we segmented it into chapters. That made sense and now its easier to work on the system, Hammons said.
Its also easier to find when a problem code repeats itself.
In the past, a technician would fix a problem in one place without knowing that the same problem would recur in codes later in the chain. Sometimes attempted fixes were further breaking the system, Hammons said.
There was a lot of pressure to rip and replace the system, Russell said. But it was 9 million lines of code. This is very complex code based on all the rules of eligibility. It would have taken years to recreate and redevelop that code.
Whats more, managers could not simply shut down the system for an overhaul. In fact, they needed it to serve more people than ever. Colorados economy, like the rest of the U.S., started tanking in late 2008, meaning that caseloads were growing. CBMS had to function for 337,000 people in May of 2009. That number has climbed to about 470,000 as of February of this year, according to report for the JBC.
You cant just take a system like that offline and tell people, Just wait while we fix it. The code itself needed to be preserved, Russell said.
While CBMS is functioning much better, Russell said that keeping it working will be a constant challenge.
IT (information technology) is like a garden. If you stop tending it, it will stop bearing fruit.