CIO Shares What It Was Like Adjusting to a COVID World, Part II

Industry Insider — Texas hosted a Member Briefing on Oct. 13, delving into the most up-to-date government technology issues and trends with a high-profile state agency CIO based in Austin.

Ricardo Blanco, deputy executive commissioner for IT and chief information officer for Texas Health and Human Services, fielded questions from e.Republic* Chief Innovation Officer Dustin Haisler for about an hour at the Archer Hotel at The Domain.

(We have broken the interview into two parts and edited for brevity. Read Part 1 here.)

Audience: How do you (know) you’re doing your best to keep up as far as technology and the offerings just by the sheer nature of HHS and its size?

Blanco: The only thing that slows us down is if it’s a rule change as required by the Legislature. … From the permanent perspective, I have no roadblocks. The only thing we can slow down is ourselves. … I have an awesome team. And that’s why I’m saying … go meet with the deputy CIO. I have a great team, they’re going to take care of you, they’re going to answer all your questions. I don’t mind getting people visiting with me, but I have an awesome team. And they know what the mission (is). I have a lot of military vets, and believe me they’re mission-driven. My executive assistant, she’s a 30-year command sergeant major. … My day is very disciplined. … We knew we had good leadership. We have good leadership that knows the mission. We have employees that buy in ... . They know that if the system goes down it’s visible and it impacts millions of people. And they understand the business, and that’s the great thing about it. We’re not just IT; we train. We train with business. On the public health side during infectious diseases, whether it’s Ebola, COVID, we have cross-trained. I can be an incident commander leading planning and preparedness or emergency response. I am trained in that when it comes to hurricanes. I’m trained to do incident command and how do we support the Coastal Bend area? I’ve been on rapid advancement teams where we go in as part of a technology team to assess a structure. I have to say that in other jobs, probably not the same, but we have a very supportive executive leadership team, and that’s something that we have to continue. There’s a thing that I tell my team: You have to have that same sense of urgency to the program. You have to understand the business, we have over 240 lines of business, but I have people that know Medicaid, eligibility, whatever, public health and we do that. The other thing I do is I encourage them to go to the facility and understand what they did. I myself have gone to the adolescent ward of San Antonio State Hospital — if you want to get an experience, I have seen a 10-year-old with mental health issues. I guarantee you, you will appreciate the people providing direct care services that do not make a whole lot of money, but I guarantee they’re going to have a very stable network infrastructure. They’re going to have a solid PC. Because we want them to provide record services. Say hospitals, that’s kind of like the last line of defense. And so, for me, I appreciate what I do. I love my job. I appreciate it every day. And my staff appreciates it as well. You have a happy leader. You have that in staff.

Audience: You have a lot of great successes, you know, transformation in six weeks for the academics, that shows you guys are agile and what were the vendors. Well, what did you learn? And are there plans to look at things that are gaps? That you know, you could have done better? … Whatever might be some gaps that here we can all think about and go back to our tool belts to see how we can support you going forward.

Blanco: We call it how we’re going to thrive (during) COVID and … we looked at our contracts, and we said “OK, I’m looking at all my supply chain third-party contracts, and I want to make sure that whatever technology I have is able to withstand disruptions.” That’s the biggest thing. So that’s what brought us to the cloud. ... We look within our processes, our major regions. Yes, they are IT processes. Because as you can imagine, our organization requires compliance. So your processes are going to be rigid. Well we had to look at that. And so where can we be flexible? And that’s really hard because it’s important that people have processes, but you have to be flexible and you have to be flexible when you’re responding, not saying you break the rules or break the law, but you’ve got to use common sense. We looked at our contracts that we have with our vendors and from the procurement side, I think there’s this hesitancy. The contract structure is this way, and we’re spending $70 million, and we have to buy hardware. And I’m like, why? Why can’t we look at the language of the contract and say, “Well, maybe I don’t, maybe within your work year your vendor or organization can summon cloud services. Can I restructure my contract so I am not asking downtown for money? Can I take that $7 million, $17 million, and can I invest it in a hole invested in your company? I’m not going to not invest it, but can you help me get a new device?” … We’re doing that and that’s a big change. Because you have constraints like, “Oh, we got to buy hardware, we got to, but why? Why do we have to?” So those are things we looked at. We support our organization. People love us because we’re providing technology so they can work from home for us. On all our surveys it’s, “Yeah, we love it.” But it’s one thing to learn from COVID. But OK, you can use COVID as your continuous “What are you going to do different in it to deliver?” and that’s a cultural thing. … Those are the kinds of things that we learned immediately.

Audience: You mentioned the (Department of Information Resources) DIR (graphical user interface) GUI; the data is in. Great for DIR’s last few contracts with clauses in there for emerging markets. How do you find yourself when you work with a vendor that might have the contract, DIR finds the contract and then add who’s working to develop it?

Blanco: Until we believe that we have to make the investment to leverage our size and volume and benefits, not just other agencies but counties and cities and municipalities. We do that all the time. Because a lot of times we are representing the former Senate. So it’s something that we feel is going to benefit HHS, but it might not be available. But it could benefit other entities. Sure, we do that. We do that constantly. Cell service is less than my direct IP. How much do you feel your organization, which is massive and embraces your ideas, runs from low code and more rapid development? In cloud versus sort of the conventional traditional custom on site. We’re actually looking at doing a couple projects. The biggest thing to do, you want to convince your organization you pick the different variables, influential areas in the organization, and I will support it. Those that are very visible, whatever services they provide support in, and that’s how we’ve been successful.

Audience: You mentioned data’s Milky Way (and) back data. What is the percentage of data analysis that’s something that’s actually going to be occurring more often in terms of workforce looking at those positions in your organization?

Blanco: The mention of the SHARP, we actually created a data operations team. So we have data engineers, and we have data scientists that are supporting that analytics platform. And from there we’re building into the whole data stewards, something new within the enterprise, data governance. It’s getting people to understand what their roles are in data. And the biggest thing is making sure that people can see that a lot of business decisions can be made following, but I wouldn’t say that. I’m not going to say you’re going to make it 100 percent accurate, but you can make the best decisions based on that data. If you can have all the data, you can have it all over the place, but if you don’t know what to do with it, it doesn’t really help you. We found that if you can pay and tell a story from that data, it really helps when you’re trying to convince not only executives but also people downtown. And we’ve been very successful in doing so. I’ve gone downtown and provided those statistics based on data. It really paints a different picture.

Audience: What percentage of the data we do have do you feel is forward thinking, you know, providing that more of a proactive approach to your system versus reactive approach to it?

Blanco: I can only speak to what we’ve done on the public health side. I didn’t look at what we had in August of 2020, which was pretty low. As far as data, there was a lot of data cleansing that had to happen there to get where we’re at now. I don’t know percentage wise, whatever we put on that, but I can tell you getting to that point and getting the consuming from when it’s not accurate to the point where we have a program that there's a pretty substantial competence level and what we’re reporting, I think, on the public health side, we’ve done a very good job and it’s not just us partnering with expertise, vendors, other data sciences, DIR, expertise on this to get us to where we’re at. … We recently had one year with Medicaid data … now you’re going to have to start moving people to two different levels of coverage, whereas before everybody was getting coverage. What is that going to cost? And we’re not talking about if you make a decision, it’s going to cost this much money. You’re talking about potentially millions and billions of dollars in here to make the wrong decision. A lot of that data that now we’re harvesting and providing that analytics, it’s getting us very, very close as far as accuracy of what is it going to cost the state of Texas right when we do this online, and we’ve been working on that activity for probably two and a half years. I think we’re pretty close on the accuracy and confidence when it comes down to that. Those are just examples of where you can really utilize data to make the best decisions.

*e.Republic is Industry Insider — Texas’ parent company.