Tuesday, November 01, 2011

The Facts Can Set Us Free

[From time to time, we offer posts from guest bloggers with particular expertise. Today, we're pleased to offer this contribution from certified Project Management Professional (PMP) Gail Stern. In it, she proposes a solution to one of the more vexing problems of the current PCIP (Pre-existing Condition Insurance Plan) model: the fact that there is no (current) way to verify the insurance status of any given individual.

As a side note, this solution could also provide factual confirmation of one other data point of contention. Can you guess what that is?]

I’m an IT Infrastructure Project Manager, so a good portion of my professional time is spent documenting and communicating facts on which my Customers and Teams agree. These include tasks my projects will accomplish (as well as those already completed), the issues a Project Team encounters and how they will be resolved. Working within IT Infrastructure means that the projects I manage to successful completion are in support of software that enables a corporation’s mission and is used by a corporation’s customers and associates.

Almost 30 years of marriage to The Professor means that I hear about the challenges of finding affordable health insurance (NOT health care) for the citizens of our Great Country.

My greatest and most valuable skill as a leader of, and guide to, my Project Teams is my ability to ask probing questions. So here it is –

WHEN will Insurance Carriers begin feeding some very simple information into a current information storehouse that will contain the FACTS about whether an American has private insurance coverage?

Proposed Project Charter – creation of a Warehouse of Insurance Coverage Data (WICD) that would validate the health insurance coverage status of every American.


1.Valid and current information would make available the FACTS about who is privately insured and who is not. Availability of WICD is no guarantee that this information would be used by the right people (AKA State Employees, State and Federal Legislators and The Press, all of whom are so fond of using un-validated information as facts), but it’s a start. I know, it’s a blue sky thought. But if we could speak consistently about using available facts, it’s support for the right direction.

2.To make WICD available would be a mighty task of cooperation amongst Carriers, and a huge technical challenge to make correct information flow on a regular basis.

A gut level sizing of such a venture would start with documenting requirements; determining and communicating design; communicating with stakeholders at all levels; selling the value of such a cooperative effort to Carriers and the benefits to Legislators and The Press; acquiring funding; and hiring Project Staff (at a minimum: IT Architects; Software and Human Factors Engineers; Hardware, OS, Database, Network, and Storage Engineers; data center Support Staff; Project Managers; Testing Coordinators; Technical and Business Testers; Training Coordinators; Trainers; Procurement Professionals; Communication Staff). With executable plans in place, the first release of WICD might be ready by November 2016 if we started today.

Carrier scope must be nationwide, and given the current ease of running IT Projects with geographically distributed project resources, project staff could reside in any state, which implies NATIONWIDE EMPLOYMENT. And that’s just to get WICD built. To keep it operating acceptably will require a staff of Skilled Software, Hardware, and Support Engineers and Communicators, because to keep people and systems talking is an ongoing support challenge. Who knows what the follow-on enhancements would include.

3. Data scope would be simple – include only information that uniquely identifies each citizen and their health insurance coverage status. Personal and private health information is arguably irrelevant.

4. The begging questions that WICD would satisfy: WHY isn’t this information available for validation today? Without it, My State is mandated to offer tax-subsidized health insurance coverage to anyone who says they’ve not had health insurance coverage for the past six months. Does My State trust and verify? No, because there is no vehicle today that enables this.

My proposal is to make simple FACTS widely available in a current, straightforward way. Without this, My Tax Dollars are being wasted.

Why is this not available today? I think I know why – no one is selling the importance of making this a priority. The issue of available dollars, people, and time are secondary to selling how relevant and valuable this system could be, and to whom.

I’ve never run a project that wasn’t fraught constantly with politics that had to be managed to enable successful project completion. Stakeholder approval of a project charter, and support and cooperation to manage and deliver that charter are the keys to overcoming the politics. Easy is not the operative word; relevance, cooperation and support are.

Thanks, Gail, for sharing your insights and expertise on a crucial subject, and Congratulations on your debut Guest Post.
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