Romney announced that as part of his plan for reorganizing HHS, he was going to build a virtual gateway to eliminate the maze that providers and beneficiaries had to navigate to work with HHS-at the time a $12 billion leviathan. Less than two months after the start of his administration in 2003, Gov. HHS was referred to as “the maze” by human services advocates. Each had its own business processes (for common tasks like applying for benefits and eligibility determination) and used different forms to collect similar data. For decades, these agencies operated separately and constructed separate systems within their own fiefdoms. What followed is an adventure that resulted in something many people thought could not be accomplished-a virtual gateway to the 17 Health and Human Services (HHS) agencies in Massachusetts. But it was an irresistible challenge to me, because of the tremendous opportunities in government to help individuals and communities, using information technology. And it would entail a jolting salary adjustment from the consulting work I was engaged in at the time. Doing so would put me back in the middle of a significant “turnaround,” albeit in a public-sector context. Steve was calling to ask if I would consider coming back to state government during a fiscal crisis to lead the IT operation of the state’s Health and Human Services agency amid the most significant reorganization in its history. After that intense experience, I promised myself that I would do no more than one turnaround every 10 years or so! Then from 1999 to 2002, we both worked on the turnaround of Harvard Pilgrim Health Care, an HMO. Steve and I had worked together in Massachusetts government in the mid-’90s, when he oversaw operational services for the state my role was that of chief information officer for the state. In early January 2003, I received a call from a former colleague, Steve Kadish, who had just been appointed undersecretary of Health and Human Services for the incoming administration of Gov.
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