iConnect: What a Long Strange Trip It’s Been

The initial funding for the system was allocated in 2013, yet it took two years before the agency completed procurement and signed a contract. This delay foreshadowed future challenges.

Originally, the implementation and transition to the maintenance phase were expected to occur by June 30, 2018. The project had an anticipated cost of $7.4 million and a cap of $9.6 million. 

The reality: implementation continued until June 2024 when APD deemed all contracted items completed despite critical functionality from the original contract remaining undelivered. Public records indicate payments to the vendor exceeded $12 million during the 9-year implementation phase with additional payments of nearly $3 million since. Agency staff recently testified that total project costs were more than $19 million. 

Private sector end users, forced to use the system pursuant to agency rule, have reported significant issues with system performance and efficiency since they started using it. Many report the necessity to hire additional staff to manage the workload imposed by iConnect input. This contradicted the agency's assurances to legislators that the system would reduce costs for private providers. Compounding these issues, several providers faced recoupment of Medicaid payments due to documentation failures caused by iConnect malfunctions. Support is provided by APD staff who frequently lack familiarity with the vendor’s software and are often unable to resolve user issues effectively.

The system also lacks common features such as native print capability, a mobile application, and support for all commonly used browsers and operating systems. Additionally, there have been concerns regarding HIPAA compliance, with reports of providers seeing protected health information of individuals they do not serve. The extensive list of problems cannot be fully covered in this blog post. For those interested in learning more, I recommend watching the committee meeting here and reading the iLab report available from the Committee in its meeting packet here.

Several factors contributed to the system's difficulties:

• Lack of understanding of end-user needs and capabilities;
• Insufficient engagement with external end users and other stakeholders during planning and implementation;
• Unclear system requirements;
• Ineffective oversight of the contracted vendor;
• Limited transparency with policymakers and the public.

The Legislature has finally taken an active role in overseeing the iConnect system. In the last session, they delayed the requirement for providers to use the system to record documentation and commissioned the independent iLab assessment presented to the Committee. This session, both the Legislature and the Executive branch must decide on the path forward based on the findings. Options under consideration must include:

• Repealing the mandate requiring providers to use the system for federally mandated record-keeping that is the responsibility of providers to maintain;
• Rebidding the iConnect system after establishing clear requirements with associated acceptance criteria;
• Effectively engaging all stakeholders, particularly end users, throughout all project phases;
• Establishing effective interoperability between internal state systems and systems used by external entities;
• Ensuring robust oversight to monitor vendor performance relative to contracted requirements;
• Developing processes to incorporate technological advancements and improvements during the project's lifecycle.

With a renewed focus on effective project management and oversight, iConnect could still fulfill its potential to significantly benefit those served by APD. The responsibility now lies with the Legislature and the Executive branch. I will continue to track developments and report as decisions are made throughout the session.