Health for all: Applying an equity lens to public health systems

Editor's note: Read this if you are a CTO, CIO, or administrator at a college or university. This is the first blog in a series on business lessons and best practices from American literature. For this series, interviewees select from a list of American literary quotes through which to view, and discuss, their focus or industry. The goal? To generate some novel insight.

The interviewees: David Houle and Joseph Traino, consultants at BerryDunn
The focus: Higher education
The quote: “Our inventions are wont to be pretty toys . . . They are but improved means to an unimproved end.”  -- Henry David Thoreau, Walden; or, Life in the Woods

Thoreau wrote this shortly after the Industrial Revolution. How does its cynicism apply to higher education during the Digital Revolution?

David Houle (DH): It speaks to my basic philosophy about applying technology to the needs of higher education clients. I’m not a “technology for the sake of technology” cheerleader. 

Joseph Traino (JT): People often believe that applying new technology to a business problem is going to solve the business problem. That rarely happens. For example, most higher education clients have a student information system. These clients often feel that, in order to resolve certain issues, they should update the system software, whereas the issues are often resolved by updating business practices to be more efficient and effective. 

DH: Right. We are often brought in to identify needed technology changes but end up stressing practices, processes, and people. If staff can’t correctly use a new technology, then the technology will not provide a real, valuable service.

When implementing a new technology, what’s the #1 thing that a higher education institution can do to prevent or avoid “an unimproved end”?

JT: Fully understand the technology’s impact on stakeholders, such as students, faculty, and staff, and answer the “why?”

DH: Keep people in mind and gain their buy-in when making technology decisions.

What technology, or technology-related change, is going to have the biggest effect on higher education over the next five years?

DH: Clients love to ask us this question (laughs). And if I truly knew the answer, I’d be on some Caribbean island right now, filthy rich and sipping a piña colada. That said, I think the technology demands of the new workforce are going to have the biggest effect. To paraphrase the new workforce: “I don’t want to stare at a green screen. And what in the world is DOS?” Conversely, the personnel who used to support these homegrown, in-house “green screen” products want to retire and leave the workforce. 

JT: I agree that the demands of the new workforce will continue to affect higher education and steer institutions away from term-based courses and programs and toward more flexible, student-centric courses and programs. From a technology standpoint, I think AI and bots are going to replace many of the manual processes that we still see today in higher education. These new technologies will create greater efficiencies—but also possibly reduce jobs—at institutions.

DH: Higher education leaders with vision have already grasped this idea of cutting administrative costs wherever possible, because those costs are not what place students in seats—or in front of screens. On the flip side, advising is currently an underserved area in higher education. So there is an opportunity for leaders to reallocate administrative resources to fulfill advising roles and to help students—such as at-risk and first-generation students—not just in the classroom, but through their learning journey.

Circling back to the Thoreau quote, I’m sure many higher education staff fear technology will lead to “unimproved ends” for their careers. How do you navigate those fears when working with clients? 

JT: It’s certainly a challenge. We currently face some of those fears when working with IT departments—more services are being moved to the cloud, and there is less of a need for on-site database administrators and system administrators, as an example. Alluding to what Dave said about advising, I think many higher education jobs can be shifted to provide interactive high-tech, high-touch services to students.

DH: And to be blunt, some people don’t want to shift, don’t want to change. The people part is the most challenging part of technology adoption. 

In this discussion about technology, we keep returning to people—and the people side of change. Are higher education clients typically responsive to the concept of change management?

JT: There’s typically some reticence, and a lack of understanding about the value of change management. In most cases, change management requires an investment beyond the technology investment. But change management is key to success. 

DH: Reticence is a good word. Yet I do think that views about change management are changing rapidly. Higher education leaders who have been through a significant system or process change now seem to understand the value of change management and know that change management is a necessity, not a luxury. 

In the end, are you confident that new technology is going to benefit students and their educational goals? 

DH: I’m unsure if technology improves the quality of education. However, I am sure that technology increases the options for the delivery of education. And greater flexibility in education delivery is certainly beneficial, especially because the traditional student is now non-traditional. Ongoing and 24/7 access demands in education are here to stay.

JT: I agree with Dave wholeheartedly. I think technology will help improve the means to the end, but I’m not sure if technology is going to improve the end. Technology is just one part of the education equation. 
 

Editor's note: read this blog if you are a state liquor administrator or at the C-level in state government. 

Surprisingly, the keynote address to this year’s annual meeting of the National Alcohol Beverage Control Association (NABCA) featured few comments on, well, alcohol. 

Why? Because cannabis is now the hot topic in state government, as consumers await its legalization. While the thought of selling cannabis may seem foreign to some state administrators, many liquor agencies are―and should be―watching. The fact is, state liquor agencies are already equipped with expertise and the technology infrastructure needed to lawfully sell a controlled substance. This puts them in a unique position to benefit from the industry’s continued growth. Common technology includes enterprise resource planning (ERP) and point-of-sale (POS) systems.

ERP

State liquor agencies typically use an ERP system to integrate core business functions, including finance, human resources, and supply chain management. Whether the system is handling bottles of wine, cases of spirits, or bags of cannabis, it is capable of achieving the same business goals. 

The existing checks and balances on controlled substances like alcohol in their current ERP system translate well to cannabis products. This leads to an important point: state governments do not need to procure a new IT system solely for regulating cannabis.

By leveraging existing ERP systems, state liquor agencies can sidestep much of the time, effort, and expense of selecting, procuring, and implementing a new system solely for cannabis sales and management. In control states, where the state has exclusively control of alcohol sales, liquor agencies are often involved in every stage of product lifecycle, from procurement to distribution to retailing.

With a few modifications, the spectrum of business functions that control states require for liquor—procuring new product, communicating with vendors and brokers, tracking inventory, and analyzing sales—can work just as well for cannabis.

POS

POS systems are necessary for most retail stores. If a state liquor agency decides to sell cannabis products in stores, they can use a POS system to integrate with the agency’s ERP system, though store personnel may require training to help ensure compliance with related regulations.

Cannabis is cash only (for now)

There is one major difference in conducting liquor versus cannabis sales at any level: currently states conduct all cannabis sales in cash. With cannabis illegal on the federal level, major banks have opted to decline any deposit of funds earned from cannabis-related sales. While some community banks are conducting cannabis-related banking, many retailers selling recreational cannabis in places like Colorado and California still deal in cash. While risky and not without challenges, these transactions are possible and less onerous to federal regulators. 

Taxes 

As markets develop, monthly tax revenue collections from cannabis continue to grow. Colorado and California have found cannabis-related tax revenue a powerful tool in hedging against uncertainty in year-over-year cash flows. Similar to beer sold wholesale, which liquor agencies tax even in control states, cannabis can be taxed at multiple levels depending on the state’s business model.

E-commerce

Even with liquor, few state agencies have adopted direct-to-consumer online sales. However, as other industries continue shifting toward e-commerce and away from brick and mortar retailing, private sector competition will likely feed increased consumer demand for online sales. Similar to ERP and POS systems, states can increase revenue by selling cannabis through e-commerce sales channels. In today’s online retail world, many prefer to buy products from their computer or smart phone instead of shopping in stores. State agencies should consider selling cannabis via the web to maximize this revenue opportunity. 

Applying expertise in the systems and processes of alcoholic beverage control can translate into the sale and regulation of cannabis, easing the transition states face to this burgeoning industry. If your agency is considering bringing in cannabis under management, you should consider strategic planning sessions and even begin a change management approach to ensure your agency adapts successfully. 

Read this if you are a police executive, city/county administrator, or elected government official, responsible for a law enforcement agency. 

“We need more cops!”  

Do your patrol officers complain about being short-staffed or too busy, or that they are constantly running from call to call? Does your agency struggle with backed-up calls for service (CFS) or lengthy response times? Do patrol staff regularly find themselves responding to another patrol area to handle a CFS because the assigned officer is busy on another call? Are patrol officers denied leave time or training opportunities because of staffing issues? Does the agency routinely use overtime to cover predictable shift vacancies for vacations, holidays, or training? 

If one or more of these concerns sound familiar, you may need additional patrol resources, as staffing levels are often a key factor in personnel deployment challenges. Flaws in the patrol schedule design may also be responsible, as they commonly contribute to reduced efficiency and optimal performance, and design issues may be partially responsible for some of these challenges, regardless of authorized staffing levels.
 
With community expectations at an all-time high, and resource allocations remaining relatively flat, many agencies have growing concerns about managing increasing service volumes while controlling quality and building/maintaining public trust and confidence. Amid these concerns, agencies struggle with designing work schedules that efficiently and optimally deploy available patrol resources, as patrol staff become increasingly frustrated at what they consider a lack of staff.

The path to resolving inefficiencies in your patrol work schedule and optimizing the effective deployment of patrol personnel requires thoughtful consideration of several overarching goals:

• Reducing or eliminating predictable overtime
• Eliminating peaks and valleys in staffing due to scheduled leave
• Ensuring appropriate staffing levels in all patrol zones or beats
• Providing sufficient staff to manage multiple and priority CFS in patrol zones or beats
• Satisfying both operational and staff needs, including helping to ensure a proper work/life balance and equitable workloads for patrol staff

Scheduling alternatives

One common design issue that presents an ongoing challenge for agencies is the continued use of traditional, balanced work schedules, which spread officer work hours equally over the year. Balanced schedules rely on over-scheduling and overtime to manage personnel allocation and leave needs and, by design, are very rigid. Balanced work schedules have been used for a very long time, not because they’re most efficient, but because they’re common, familiar, and easily understood―and because patrol staff are comfortable with them (and typically reluctant to change). However, short schedules offer a proven alternative to balanced patrol work schedules, and when presented with the benefits of an alternative work schedule design (e.g., increased access to back-up, ease of receiving time off or training, consistency in staffing, less mandatory overtime), many patrol staff are eager to change.

Short schedules

Short schedules involve a more contemporary design that includes a flexible approach that focuses on a more adaptive process of allocating personnel where and when they are needed. They are significantly more efficient than balanced schedules and, when functioning properly, they can dramatically improve personnel deployments, bring continuity to daily staffing, and reduce overtime, among other operational benefits. Given the current climate, most agencies are unlikely to receive substantial increases in personnel allocations. If that is true of your agency, it may be time to explore the benefits of alternative patrol work schedules.

A tool you can use

Finding scheduling strategies that work in this climate requires an intentional approach, customized to your agency’s characteristics (e.g., staffing levels, geographic factors, crime rates, zone/beat design, contract/labor rules). To help guide you through this process, BerryDunn has developed a free tool for evaluating patrol schedules. Click here to measure your patrol schedule against key design components and considerations.

If you are curious about alternative patrol work schedules, our dedicated justice and public Safety consultants are available to discuss your organization’s needs.

Editor’s note: If you are a state government CFO, CIO, project or program manager, this blog is for you. 

This is the second blog post in the blog series: “Procuring Agile vs. Non-Agile Service”. Read the first blog. This blog post demonstrates the differences in Stage 1: Plan Project in the five stages of procuring agile vs. non-agile services.

Overview of Procurement Process for Agile vs. Non-Agile IT Services

What is important to consider in agile procurement?

Here are some questions that can help focus the planning for procurement of IT services for agile vs. non-agile projects.

Plan Project Considerations for Agile vs. Non-Agile IT Services

Why are these considerations important?

When you procure agile IT services, you can define the scope of your procurement around a vision of what your organization intends to become, as opposed to being restricted to an end-date for a final delivery.

In an agile project, you get results iteratively; this allows you to constantly reassess requirements throughout the project, including the project plan, the guiding principles, and the project schedule. Your planning is not restricted to considering the effect of one big result at the end of the project schedule. Instead, your plan allows for sequencing of changes and improvements that best reflect the outcomes and priorities your organization needs. 

Since planning impacts the people-aspect of your strategy, it is important to consider how various teams and stakeholders will provide input, and how you will make ongoing communication updates throughout the project. With an agile procurement project, your culture will shift, and you will need a different approach to planning, scheduling, communicating, and risk management. You need to communicate daily, allowing for reviewing and adjusting priorities and plans to meet project needs. 

How do you act on these considerations?

A successful procurement plan of agile IT services should include the following steps:

1. Develop a project charter and guiding principles for the procurement that reflect a vision of how your organization’s teams will work together in the future
2. Create a communication plan that includes the definition of project success and communicates project approach
3. Be transparent about the development strategy, and outline how iterations are based on user needs, that features will be re-prioritized on an ongoing basis, and that users, customers, and stakeholders are needed to help define requirements and expected outcomes
4. Provide agile training to your management, procurement, and program operation teams to help them accept and understand the project will present deliverables in iterations, to include needed features, functionality and working products
5. Develop requirements for the scope of work that align with services and outcomes you want, rather than documented statements that merely map to your current processes 

What’s next? 

Now that you have gained insight into the approach to planning an agile project, consider how you may put this first stage into practice in your organization. Stay tuned for guidance on how to execute the second stage of the procurement process—how to draft the RFP. Our intention is that, following this series, your organization will better understand how to successfully procure and implement agile services. If you have questions or comments, please contact our team.
 

Editor’s note: If you are a state government CFO, CIO, project or program manager, this blog is for you.

What is the difference in how government organizations procure agile vs. non-agile information technology (IT) services? (Learn more about agile here).

In each case, they typically follow five stages through the process as shown in Figure A:
 

Figure A: Overview of Procurement Process for Agile vs. Non-Agile IT Services

However, there are differences in how these stages are carried out if procuring agile vs. non-agile IT services. 

Unfortunately, most government organizations are unaware of these differences, which could result in unsuccessful procurements and ultimately not meeting your project’s needs and expectations. 
This blog series will illustrate how to strategically adjust the standard stages outlined in Figure A to successfully procure agile IT services.

Stage 1: Plan project
In Stage 1, you define the scope of the project by identifying what your organization wants, needs, and can achieve within the available timeframe and budget. You then determine the project’s objectives while strategically considering their impact on your organization before developing the RFP. Figure B summarizes the key differences between the impacts of agile vs. non-agile services to consider in this stage.

Figure B: Plan Project for Agile vs. Non-Agile IT Services

The nuances of planning for agile services reflect an organization’s readiness for a culture shift to a continuous process of development and deployment of software and system updates. 

Stage 2: Draft RFP
In Stage 2, as part of RFP drafting, define the necessary enhancements and functionality needed to achieve the project objectives determined in Stage 1. You then translate these enhancements and functionalities into business requirements. Requirement types might include business needs as functionality, services, staffing, deliverables, technology, and performance standards. Figure C summarizes the key differences between drafting the RFP for a project procuring agile vs. non-agile services.

Figure C: Draft RFP for Agile vs. Non-Agile IT Services

In drafting the RFP, the scope of work emphasizes expectations for how your team and the vendor team will work together, the terms of how progress will be monitored, and the description of requirements for agile tools and methods.

Stage 3: Issue RFP
In Stage 3, issue the RFP to the vendor community, answer vendor questions, post amendments, and manage the procurement schedule. Since this stage of the process requires you to comply with your organization’s purchasing and procurement rules, Figure D illustrates very little difference between issuing an RFP for a project procuring agile or non-agile services.

Figure D: Issue RFP for Agile vs. Non-Agile IT Services 

Stage 4: Review proposals
In Stage 4, you evaluate vendor proposals against the RFP’s requirements and project objectives to determine the best proposal response. Figure E summarizes the key differences in reviewing proposals for a project that is procuring agile vs. non-agile services.

Figure E: Reviewing Proposals for Agile vs. Non-Agile IT Services 

Having appropriate evaluation priorities and scoring weights that align with how agile services are delivered should not be under-emphasized. 

Stage 5: Award and implement contract
In Stage 5, you award and implement the contract with the best vendor proposal identified during Stage 4. Figure F summarizes the key differences in awarding and implementing the contract for agile vs. non-agile services.

Figure F:  Award and Implement Contract for Agile vs. Non-Agile Services 

Due to the iterative and interactive requirements of agile, it is necessary to have robust and frequent collaboration among program teams, executives, sponsors, and the vendor to succeed in your agile project delivery.

What’s next?
The blog posts in this series will explain step-by-step how to procure agile services through the five stages, and at the series conclusion, your organization will better understand how to successfully procure and implement agile services. If you have questions or comments, please contact our team.