Accenture Software for Health and Human Services Nurturing the new digital ecosystem

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1 Accenture Software for Health and Human Nurturing the new digital ecosystem How software solutions can enable the convergence of health and human service delivery

2 With more families than ever relying on social programs from food and housing programs to employment assistance government agencies are under pressure to meet the increased demand. In the United States alone, 13.7 million people are unemployed, 48 million are receiving food assistance and 73 million receive government funded health care. 1 And the implementation of the Affordable Care Act is likely to move millions of new families into the world of government services, many for the first time in their lives. Yet today s social programs continue to operate in isolation, due to independent and disconnected systems or entrenched silos of agency cultures, regulations, and processes. 1.Outcomes and Impact: Insights from the 2012 Human Summit at Harvard University 2

3 Hindered by government agencies lack of integration and collaboration, individuals and families seeking assistance are often unclear which services may best fit their needs and whether they are eligible for them, delaying their return to self-sufficiency. In turn, budget-strapped agencies are carrying the financial strain of supporting these programs as well as being uncertain about the big picture of beneficiary needs. While some families are fortunate enough to stumble on the right services, many are unable to find a clear path through the maze of programs available to best meet their needs (Figure 1). Likewise, workers within the program are often discouraged or prevented from looking beyond the boundaries of their own program and policy area, missing the opportunity to gain a deeper understanding of the underlying issues around the root cause of dependency. Accenture believes that while technologies have done much to disrupt the private market landscape, their current level of maturation could also make governments work easier. The digital age demands unprecedented speed and efficiency. Citizens, accustomed to efficient online services from a variety of sources, are actively seeking ways to manage their lives in real time and expect to interact with government agencies in the process. By adopting a digital mind-set 2 that uses technology as an enabler to drive transformation, agencies can release IT s strategic value and provide better crossprogram support to the citizens they serve. Figure 1. The health and human services maze Working age adults Early, elem., & sec. education Child support services Food programs Health care Higher education assistance Disabled support Mental health Vocational training Children s insurance Birth/childhood Immunization Worker s compensation Prenatal care Cash assistance Veteran s benefits Survivor pension Nursing home/assisted living Re-employment training Child welfare Unemployment benefits Employment services Employment accidents Disease management Housing assistance Adult protective services Flu shots Long-term care Disability pension Health case management Seniors/elderly Copyright 2013 Accenture. All rights reserved. 2. Every Business is a Digital Business, Technology Vision, Accenture

4 Eliminating the obstacles to self-sufficiency Health and human services stakeholders recognize that they can no longer operate solely in their own silos, yet the multidimensional nature of their programs adds complexity. Take, for instance, the current difficulties of an imaginary family, the Millers, where both parents lost their jobs and, eventually, their home. Their request for housing assistance is met by the housing agency and within the outcome-focused goals set by the agency. But the accommodation itself is a long way from Mr and Mrs Miller s job training programs, their childcare provider and the medical support required for their disabled child. In short, solving their housing problem has made the Millers logistical and personal issues a great deal more complicated. The housing officer provided a solution completely relevant for the agency, but failed to address the full range of the family s needs. Rather than identifying itself by its specific function, the housing agency could align itself with its broader purpose as one of a network of services helping to address families needs relative to their individual journeys to selfsufficiency. Forward-thinking government agencies understand this approach and see the convergence of traditional health and human services programs as an opportunity. Since 2009, Accenture has collaborated with Leadership for a Networked World to deliver the annual Human Summit at Harvard University. The Summit focuses on the Human Value Curve framework (shown in Figure 2) - created at the Summit to help human services organizations serve families like the Millers more efficiently and effectively. As human services organizations advance along the curve, the enabling business models support new horizons of outcomes. Progress along the curve in this framework for transformation requires continual improvement and growing maturity in governance and policy making, business process and technology. Gaining maturity in multi-program governance and policy, shared common business processes, and enabling technologies can position government agencies well in handling fundamental elements that human beings need to realize their potential health, shelter, nutrition, income and social inclusion. Figure 2. The Human Value Curve framework Generative Business Model. The focus is on generating healthy communities by co-creating solutions for multidimensional family and socioeconomic influences. Integrative Business Model. The focus is on addressing the root causes of people s needs and problems by coordinating and integrating services at an optimum level. Efficiency in Achieving Outcomes Generative Business Model Integrative Business Model Policy and Governance Maturity Business Process Maturity Collaborative Business Model. The focus is on supporting people in receiving all the applicable services by working across agency and programmatic boundaries. Collaborative Business Model Technology Maturity Regulative Business Model. The focus is on serving people who are eligible for particular services while complying with policy and program regulations. Regulative Business Model Effectiveness in Achieving Outcomes Copyright Leadership for a Networked World 4

5 Building the digital ecosystem The core requirement to provide a single entry to services for citizens is the solid foundation of appropriate enabling technologies. A digital ecosystem in the form of a flexible, adaptable, standardsbased technology infrastructure provides government agencies with the ability to support an interconnected and interoperable set of services across an increasing number of agencies, programs, service providers and service delivery models as well as preserve existing IT investments and realize higher returns for minimum additional cost. New digital ecosystems can help break down historical program silos and connect services in new ways. By taking advantage of the new wave of software solutions to integrate service delivery, health and human services agencies can provide a common access point to connect the various stakeholders in a consistent way. In doing so, governments can help citizens to expedite their path through the maze of programs and services and set a clear direction on their journeys to self-sufficiency. Figure 3. Digital ecosystem straightens the pathways to self-sufficiency Policy Makers and Regulators Federal State Local Academia Auditor Service Providers Health Mental health services Financial Public service Private providers DIGITAL ECOSYSTEM Employers Adults Citizens Administrators Legislators Finance system State staff Boards/ Commissions CIO & IT staff Seniors/ elderly Children Copyright 2013 Accenture. All rights reserved. 5

6 Digital ecosystem characteristics Key characteristics of the new digital ecosystem include: 1. Ease of use new systems must be quick to learn and well supported. 2. Ability to integrate across agencies technology must enable better sharing of data and services across agency boundaries. 3. Compliance with existing and emerging standards in particular, those from the technology industry such as OASIS, W3C, and WS*I, and from the federal government including MITA, NIEM, NIST, FTRM and others. 4. Low total cost of ownership and low maintenance costs cost effective to implement and to keep up-to-date with policy and regulatory changes. 5. Maximizing the value of existing investments new vendor-independent architecture can enable agencies to swap or upgrade vendor components over time without having to abandon applications built on top of them. 6. Software built on Service-oriented Architecture (SOA) principles component reuse, open standards compliance, and standard service interaction facilitate a build once, use many mind-set, reducing application development time and cost. 6

7 A platform for transformation Today, Accenture is working with health and human services organizations to implement SOA-based architectures as the foundation for their digital ecosystems. Our modular system builds layers of services that focus on the citizen or family seeking service. Let us take a closer look at how a four-layered architecture can help agencies create the new digital ecosystem. Client identification services With citizen data stored in a variety of legacy sources throughout the enterprise, the enterprise SOA should include a client identification service layer, integrating tools that help clarify the identities of citizens within the various systems. This foundation is critical to support cross-agency integration (Figure 4). Figure 4. Client identification services Client Identification Common Client Index, MDM, Identity Resolution, Biometric Data Source Data Source Data Source Data Source Data Source Data Source Data Source Copyright 2013 Accenture. All rights reserved. Technical services Once the identification service layer is created and linked to a common client index or master data management solution, the next layer of the integration platform contains a set of common technical services required by virtually every application. This service layer provides the first opportunity for cross-agency standardization on third-party products supporting key technical functions. Standards compliance and existing third-party reuse are also included, since many organizations have invested heavily in security or enterprise content management product solutions (Figure 5). Figure 5. Technical services Technical Security ECM Reporting Business Intelligence Data Telephony/ IVR GIS Client Identification Common Client Index, MDM, Identity Resolution, Biometric Data Source Data Source Data Source Data Source Data Source Data Source Data Source Copyright 2013 Accenture. All rights reserved. 7

8 Application services The next layer of technology architecture enables component reuse, as it integrates a variety of tools and common services that support routine application business functions across the enterprise. Service calls to a rules engine to determine program eligibility or benefits level or to a Business Process Management or workflow tool to determine the next step in a business process are just some of the types of application services that can be standardized in this layer of the architecture. Presentation services are also included in a layer to provide access to applications from mobile or tablet platforms, as well as the traditional Web-based computers. Standardization across this layer is critical to provide solutions that are easy to maintain at low cost and can be shared across multiple organizations (Figure 6). Figure 6. Application services Application Technical Client Identification Rules Security BPM/ Workflow ECM Reporting Business Intelligence App Server Data Decision Support Telephony/ IVR Common Client Index, MDM, Identity Resolution, Biometric Presentation Data Source Data Source Data Source Data Source Data Source Data Source Data Source Copyright 2013 Accenture. All rights reserved. GIS 8

9 Composite applications The final architecture layer supporting a new digital ecosystem is the composite applications layer. As the name suggests, this layer does not involve the complex, monolithic application solutions of the past. Instead, it supports business service applications by tying together application, technical and identification services to meet specific business needs. These composite applications have the potential to be much thinner, since their focus is on interconnecting components that all applications use. For example, a portal can be used by citizens to gain access to all services, the rules service determines for which programs they may be eligible, the Business Process Management service defines the next step after they apply, and the application server handles the interaction with the technical service layer and the appropriate data sources. The portal may make use of presentation services to be highly customized for the applicant, displaying questions in the language of their choice, and allowing them to proceed at their own pace. The portal is integrated with telephony and Interactive Voice Response services, allowing the citizen to call the agency or call center and the calltaker can access the same data available to the citizen online meaning there is one version of the truth (Figure 7). Initially, composite applications may be deployed using business processes similar to those in the legacy systems they replace. Also, these composite systems may have duplicative data capture or benefits determination processes when first deployed to speed the learning curve for state workers and other service providers. A service-oriented architectural framework not only allows this, but also facilitates its eventual replacement with business-function-oriented processes that might have common citizen intake as their focus, regardless of the benefit programs for which they may be eligible. Figure 7. The new digital ecosystem for health and human services Composite Applications Eligibility EBT Child Care Health Benefits/ Plan Selection MMIS Child Welfare Application Rules BPM/ Workflow App Server Decision Support Presentation Technical Security ECM Reporting Business Intelligence Data Telephony/ IVR GIS Client Identification Common Client Index, MDM, Identity Resolution, Biometric Data Source Data Source Data Source Data Source Data Source Data Source Data Source Copyright 2013 Accenture. All rights reserved. 9

10 Accelerating transformation Today, health and human services organizations are experiencing unprecedented change and service pressure. Yet the convergence of service delivery across traditional program boundaries provides an opportunity to improve outcomes for the families they serve as never before. For more than a decade, Accenture has been pioneering the concept of the new digital ecosystem to straighten the pathways through the existing service delivery maze. As momentum builds to achieve a new way of working, with the right software and support to achieve stronger integration and easier collaboration between agencies, governments can help vulnerable families and individuals more easily access the support they need when they need it, while agencies can meet their outcome targets rapidly, efficiently and effectively. 10

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12 Contact us To find out more about using technology to transform health and human services, please contact: David M. McCurley T: E: About Accenture Accenture is a global management consulting, technology services and outsourcing company, with approximately 266,000 people serving clients in more than 120 countries. Combining unparalleled experience, comprehensive capabilities across all industries and business functions, and extensive research on the world s most successful companies, Accenture collaborates with clients to help them become high-performance businesses and governments. The company generated net revenues of US$27.9 billion for the fiscal year ended Aug. 31, Its home page is www. accenture.com. Accenture Software combines deep technology acumen with industry knowledge to develop differentiated software products. It offers innovative software-based solutions to enable organizations to meet their business goals and achieve high performance. Its home page is Accenture Software for Health and Human delivers solutions to drive health and human services transformation, and help government organizations help those in need, faster. Its home page is HPSsoftware. Copyright 2013 Accenture All rights reserved. Accenture, its logo, and High Performance Delivered are trademarks of Accenture. This document is produced by consultants at Accenture as general guidance. It is not intended to provide specific advice on your circumstances. If you require advice or further details on any matters referred to, please contact your Accenture representative.