Snapshot:

• Client: Maryland Department of Health, Maryland Health Benefit Exchange (MHBE)
• Service Provided: Modernization of the Maryland Total Human-Services Integrated Network (MD THINK) (cloud-based shared services platform) and Maryland Health Benefit Exchange (MHBE) health insurance exchange system.
• Results: Enhanced scalability, data sharing, and service delivery; reduced operational costs; improved user experience and compliance with federal accessibility standards.

 

Introduction:

The Maryland Department of Health and Maryland Health Benefit Exchange (MHBE) both required significant technological upgrades. MD THINK’s legacy systems were outdated, lacked interoperability, and hampered data-sharing capabilities, resulting in inefficiencies across health and human services programs. Similarly, MHBE faced challenges with poor scalability, inefficient workflows, and accessibility issues, leading to low user satisfaction. Innosoft was tasked with modernizing both systems using advanced cloud technologies, human-centered design, and agile methodologies to enhance operational efficiency, security, and user experience.

Problem:

Both MD THINK and MHBE faced critical challenges with their outdated and siloed legacy systems, significantly limiting their operational efficiency, scalability, and performance.

• Outdated Infrastructure: The systems were built on rigid, standalone platforms that were difficult to upgrade. Each system operated in silos, which led to fragmented data storage and cumbersome operations, hampering service delivery.
• Lack of Integration: These legacy systems did not support data sharing between programs, preventing seamless collaboration across state agencies. For instance, MD THINK needed to integrate data from multiple health and human services programs, but the existing structure failed to support this level of interoperability. Similarly, MHBE struggled to share data with federal and external systems, limiting real-time interactions essential for processing health benefits efficiently.
• Accessibility Issues: Both platforms lacked compliance with WCAG 2.1 standards, making them difficult for users with disabilities to navigate. In an environment where diverse user needs must be met, the absence of accessibility features meant that many users, especially those relying on screen readers and other assistive technologies, were left underserved.
• Security Vulnerabilities: Due to the absence of modern DevSecOps practices, these systems were prone to security risks. Without automated security testing and real-time monitoring, sensitive health and human services data, including personal and financial information, were at risk of unauthorized access and breaches.
• Scalability and Performance Issues: Both MD THINK and MHBE were ill-equipped to handle the growing demands of users and increased data loads. With more citizens relying on these services for healthcare and other critical benefits, the platforms were increasingly prone to slowdowns, system outages, and poor user experience, creating inefficiencies in service delivery and program management.

In sum, both systems required comprehensive modernization to support efficient operations, enhance security, ensure accessibility, and improve scalability to meet evolving user demands.

Solution:

To address the challenges faced by MD THINK and MHBE, Innosoft implemented a comprehensive modernization strategy:

Cloud-Based Architecture:

• MD THINK: Migrated to AWS Cloud, transforming its infrastructure into a modular platform that allowed health and human services programs to operate in an integrated and scalable environment. This shift enabled seamless data sharing, improved security, and enhanced cross-agency collaboration. The modular approach allowed different programs to use shared services while maintaining flexibility for their specific needs.
• MHBE: Transitioned to a microservices architecture hosted on AWS, which improved scalability and system performance. This architecture allowed for modular updates, meaning individual components could be updated or scaled without impacting the entire system. This was particularly useful for handling increased demand during peak enrollment periods for health benefits.

Human-Centered Design (HCD):

• Innosoft conducted extensive user research, including interviews, focus groups, and usability testing to better understand the workflows and pain points of various user groups such as health exchange workers, grant applicants, and program administrators.
• User Personas and Journey Mapping: These tools were used to create more intuitive workflows and interfaces, ensuring that both MD THINK and MHBE platforms met the needs of all users, including those with disabilities.
• Both platforms were redesigned to be compliant with WCAG 2.1 and USWDS standards, incorporating accessibility features such as:
• Keyboard navigation for users who cannot use a mouse.
• High-contrast text and ARIA roles for better readability and usability with screen readers.
• Consistent navigation patterns and clear error messages to guide users through complex tasks efficiently.

Agile Development & DevSecOps:

• Innosoft adopted an Agile approach, breaking development work into two-week sprints that allowed for continuous iteration, quick feedback loops, and faster adaptation to changes. JIRA was used to document and manage EPICs, user stories, and tasks to ensure progress aligned with project goals.
• Continuous Integration/Continuous Delivery (CI/CD) pipelines were implemented for both MD THINK and MHBE, allowing for rapid, automated deployment of features with minimal downtime. This ensured that system updates could be deployed smoothly, improving overall system performance.
• DevSecOps practices were embedded into every stage of the development lifecycle, ensuring that security checks, vulnerability scans, and compliance with NIST 800-53 guidelines were automated. This prevented security risks and ensured that the systems were secure by design, with any vulnerabilities addressed as soon as they were identified.

Data Management & Integration:

• MD THINK: A shared data repository was established to centralize data from various state health and human services programs. This allowed for more efficient data management, improved service delivery, and better collaboration between agencies by ensuring that all stakeholders had access to accurate, real-time data.
• MHBE: Integrated with external federal systems like the Federal Data Services Hub (FDSH) to enable real-time data exchange for processing health benefits. The use of a RESTful API facilitated seamless communication between the state’s health insurance marketplace and external partners, ensuring smoother enrollment processes and faster service delivery.

By implementing this comprehensive solution, Innosoft significantly improved the performance, scalability, accessibility, and security of both MD THINK and MHBE, providing a modernized, user-friendly platform for Maryland’s health and human services programs.

Results:

1. Enhanced Scalability and Performance: Both MD THINK and MHBE now run on scalable cloud infrastructure capable of handling growing user demand, thanks to AWS. The cloud-based architecture allows for faster system upgrades and more efficient resource allocation, ensuring uninterrupted service delivery even during peak usage periods.
2. Improved Accessibility: Compliance with WCAG 2.1 standards ensures accessibility for users with disabilities. Features such as keyboard navigation, high-contrast text, and screen reader compatibility significantly enhance user experience, making the platforms more inclusive and user-friendly.
3. Streamlined Data Sharing: MD THINK’s shared services architecture facilitates cross-agency collaboration by centralizing data across health and human services programs. This improves operational efficiency by providing real-time, accessible data to various stakeholders. Similarly, MHBE’s integration with federal systems enables real-time data exchanges, expediting health insurance enrollment processes and other critical functions.
4. Operational Cost Reductions: The transition to a cloud-based platform significantly reduced hardware maintenance and operational costs. The modular system design allowed for easy updates and expansions without costly infrastructure overhauls. This efficiency has led to a more cost-effective approach to service delivery across both platforms.
5. Security Enhancements: Innosoft’s DevSecOps approach integrated automated security measures into the development lifecycle. By leveraging continuous security testing and compliance with NIST 800-53 guidelines, both MD THINK and MHBE achieved Authorization to Operate (ATO), ensuring robust data protection. This significantly reduced the risk of data breaches and ensured the protection of sensitive user information.
6. User-Centric Redesign: Through Human-Centered Design (HCD), both platforms were redesigned with user-friendly interfaces, enhancing the overall user experience. The responsive design ensures that users, regardless of device, can easily navigate the systems. This redesign improved satisfaction for a broad range of users, from state employees and policymakers to health beneficiaries and service administrators.

In summary, Innosoft’s modernization of MD THINK and MHBE transformed the platforms into highly efficient, secure, scalable, and user-centric systems, significantly enhancing operational efficiency, data accessibility, and user satisfaction across Maryland’s health and human services programs.