By Brian Cooper | November 8, 2019

Corey Mercy

Digital transformation can be seen all over the world across many industries and in the state of North Carolina. In 2017 North Carolina Governor Roy Cooper brought on a new leadership team at the Department of Health and Human Services (DHHS). This new team, led by CMS veteran Secretary Mandy Cohen, MD and Silicon Valley executive Sam Gibbs as Deputy Secretary for Technology and Operations, is taking the lead in this transformation with the creation of the Cloud Center of Innovation. Brian Cooper from the Digital Health Institute for Transformation (DHIT) sat with NC DHHS Deputy Chief Technology Officer Corey Mercy, to learn more about this initiative.

Q: Tell me about your role at the North Carolina Department of Health and Human Services.

I was promoted to Deputy Chief Technology Officer in mid-July 2019, and the intention there was to begin to have a more focused effort around new and emerging technologies in digital transformation. Part of my new role is to create a technology center that actively leads initiatives which contribute to digital transformation and the proliferation of new and emerging technologies across the Department. I am working with Chief Technology Officer Angela Taylor to build an organizational structure that encompasses:

  • Enterprise Architecture
  • Establishing a Cloud Center of Innovation;
  • Building a catalyst team; and
  • Moving the existing Health IT team into an integrated framework that expands across DHHS to focus on enabling ongoing success with our cloud computing strategy.

Some of the initiatives we are currently involved in and exploring include:

  • Supporting engagements that my team and I have with Medicaid Transformation
  • Looking at Blue Button 2.0 functionality
  • Looking at the Healthy Opportunities initiative
  • Exploring FHIR-based interoperability tools
  • Cloud computing

The Department has taken a stance in regard to our vision and direction for cloud computing. Just last week we approved our Cloud Strategy in which DHHS is committing to conduct 60% percent of its business via Cloud Technologies by 2025.

Q. What was the impetus for starting the Cloud Center of Innovation?

Many are aware that there are numerous enablers when it comes to cloud computing and what it entails. We have identified three key enablers:

  • Agility: We have recognized the importance of agility and adopting that first to take a more aggressive stance in our cloud strategy which will enable us to respond more quickly and nimbly to our Department and our Division needs, giving us the ability to accelerate the delivery of our new projects and enhancements as we leverage cloud technologies. It will also enhance our ability to react to changes in demand within the varying technology solutions, without having to over provision capacity which leads us to our next driver…
  • Efficiency: We are looking at reduced time to access technology as well as more access to new and emerging technologies, which enables us to consume only the technology capacity that we need. This translates to our ability to eliminate the practice of overbuying compute capacity to meet peak demands, which has historically been a practice within the IT realm when you are looking at traditional computing strategies and improved cost management.
  • Innovation: The third driver we recognize is innovation. This is where we engage, leverage, and pursue our aggressive cloud computing strategy, and enable and foster innovation by providing access to infrastructure and new technologies in a much more consumable and accessible fashion than we have historically been able to do.

Q. How are you engaging key stakeholders in a collaborative approach?

It is a huge undertaking, as we talk about cloud computing and shifting our organization. Operationally, with how we function within the technology space, cloud computing is going to be very transformational from a cultural and operational day-to-day aspect. As part of getting the technology center up and running and building the Cloud Center of Innovation (CCOI) and our Catalyst team, we have established a Cloud Advisory Council that has representatives from across the Department: Division Directors, Finance, General Counsel, Human Resources and numerous IT resources.

This Council is responsible for providing oversight and ensuring that the CCOI is progressing smoothly with our cloud adoption and cloud strategy, working to remove road blocks and to be an advocate and promote the journey of what transformation means for the Department. This will help ensure we are creating purposeful cross collaboration in parallel with the CCOI so we have the resources and partnerships to help ensure we have a successful path for our cloud adoption journey. The Council will also:

  • Authorize policies, frameworks, and standards;
  • Respond to governance reports; and
  • Further determine and set the future direction of our cloud strategy and partnership with the CCOI.

This has all been new work for us. To give you some perspective of our timeline, within three months of being on the job, we had a fully developed and ratified cloud strategy in place. We have been very aggressive in driving and moving our plans forward. In addition to approving our cloud strategy, we also commissioned six workgroups and we envision two to three higher level workgroups to be commissioned in the next month or two. These workgroups include:

1. Technical Specifications and Design – Composed of resources across the tech division that are focused on the technical elements of what needs to happen from a standards perspective to ensure that we are all consistent, building the environments based on the same practices and with all of the governance that needs to be in place.

2. DevOps – This workgroup will be looking at how we need to transform our development operations, and what that will mean to us as we are bringing cloud computing into the picture.

3. Application Rationalization – Building off work ongoing on for the last 10-12 months to look at our application portfolio. This workgroup will bring that information into additional cloud considerations as we start to look at how we will prioritize the workloads in our portfolio to best determine how we migrate those existing workloads.

4. Implementation Planning – This workgroup will put together a strategy and roadmap to operationalize our plan, and set milestones over the next 6, 8, 12, and 18 months for our cloud adoption strategy to ensure we are putting metrics in place to track our progress.

5. Procurement – This workgroup is focused on looking at how we are procuring and what it means in the cloud environment because we have specific laws and processes that we need to follow for procurements. We need to focus efforts around what that looks like in a cloud computing environment where the technology is readily accessible, not something we have to wait for as with a traditional procurement cycle that quotes out a bunch of hardware and waits for delivery. All of that goes away with cloud computing. If I need a server, I can literally login to a console of any one of our cloud providers and spin up a compute resource in a matter of minutes. That really changes our procurement process, and so we recognize that we need to focus on how that will work from a cloud computing perspective.

6. Finance – Our cloud strategy presents a big change culturally to how we operate, as we move from a traditional capital-based model to an operating expense model. This will require a lot of consideration and purposeful thought around what that means for us, because our current budget cycles are set up in support of CAPEX models. With cloud computing, however, you pay for what you consume and you pay on a monthly basis. I think there are several aspects to these differences that we will need to consider, as well as understand the tools we will need

to have in place to manage these costs and to have visibility in to what our operational costs are on a very proactive basis. As we start looking at how resources are utilized and consumed, there will be opportunities to shift and change how we consume those cloud computing resources and enable us to optimize our cost and our spending because we can look at trends and how the technology is being utilized. We can turn equipment off when it is not needed, or find ways to consolidate resources, or predict when there may be increases in demand, and plan for that so we can scale up our capacity for a specific period as needed; or we can scale that down so we aren’t running at peak load when less (bandwidth? Storage?) is needed.

As you can imagine, all of these workgroups will involve folks from across the Department. These workgroups are structured to have those subject matter experts at the table working with us to help us understand the nuances and challenges, coming up with ways to make sure they are successful across all of the areas in our cloud journey.

Q. Closing thoughts?

Our Department’s leadership promotes a culture that supports innovation across numerous fronts, including IT. I am very excited and humbled to be a part of this transformational journey.