When Deborah Norton left a hospital job to join Harvard Pilgrim Health Care Inc. in 1999, she figured it would be "a nice gentle ride."Being an IT executive in the hospital setting was, she explains, stressful.
Not only that, her
new employer had landed on the cover of Newsweek
, which touted Harvard Pilgrim
as the "best HMO" in the country.But Norton's dreams of a cushy glide-into-retirement job were short-lived.Shortly after she joined the nonprofit payor as director of finance for the Massachusetts region, she learned the awful truth.
The Wellesley, Mass.-based health plan, the result of a series of mergers, was in deep financial trouble.After revisiting its books, Harvard Pilgrim
revealed that it had lost $227 million in 1999, the year it outsourced the majority of its IT operations to Plano, Texas-based Perot Systems Corp.
In hindsight, the plan "did not have the level of cultural and technical integration needed for a successful merger," she
But the ever-optimistic and hard-charging Norton
took the bad news in stride.Rather than bail out, she became the vice president of corporate information management in 2000 and dove head-first into a series of information technology projects that helped the struggling payor get back on its feet after it had plunged into receivership.
Corralling the talent of the Perot
helped complete the installation of a consolidated financial management system, one that would keep more accurate tabs on the payor's revenue stream and expense centers.Its old financial system contained two different general ledgers, representing the plan's premerger forebears, Harvard Community Health Plan and Pilgrim IPA.Reconciling the two was a complex undertaking that resulted in the plan's failure to understand its own financial condition, Norton
explains.With the new financial system from Redwood Shores, Calif.-based Oracle Corp.
, Harvard Pilgrim
can now analyze its revenue and claims streams easily, Norton
In addition to the financial system upgrade, Norton
helped launch a Web-based, self-service feature called HPHConnect.The service enables members, employers and care providers to initiate many transactions on their own across the Internet, cutting back on call center traffic.For example, physician offices use the system to determine patient eligibility, check benefit levels and check on claims status."It is cheaper and more efficient than having doctors' offices call us," Norton
says. After her boss left in 2002, she was promoted to chief information officer, assuming responsibility for nearly 800 employees (including Perot staff) and an annual budget of $102 million.As CIO, Norton began rebuilding the organization's massive data warehouse, a storehouse of financial and medical information generated on behalf of Harvard Pilgrim's 888,128 members.
Norton's crew has moved the warehouse from its cumbersome mainframe environment, which required an extraordinary amount of customized code to transfer data.A five-stage effort with a $32 million price tag, the data warehouse project is still under way.When complete by early 2007, the data warehouse will enable staff to create their own reports, analyzing claims to a degree that was impossible before, Norton
Now, with Harvard Pilgrim's
financial woes long forgotten, Norton
sits comfortably perched atop its IT operation.She shrugs off the notion that there is anything special about her leadership role in a male-dominated field.
Leading a meeting of Harvard Pilgrim's
Technical Infrastructure Steering Committee (composed of 13 men), Norton
easily blends in with the "computer guys," conversing fluently in techno-speak,she
learned programming while acquiring her
MBA,and laughing heartily at the wonky humor shared by network analyst types.
For example, when the discussion turns to the sudden demand for network access tokens,devices that flash an ever-changing ID number needed to log into Harvard Pilgrim's network remotely,one IT staffer dryly suggests a solution: Hand out dummy tokens to the people who are asking for them, he
says, implying that these would-be users are more interested in having the token as a status symbol than actually logging on remotely.The comment sparks howls of laughter from the committee members.
When the laughter subsides, however, all eyes turn to Norton
understands the broader business issues that lie beyond the domain of programmers who spend their days hunched before computer monitors.She's
the leader who knows how to communicate often-cryptic IT subject matter in English."We will need to come up with criteria for who gets one of these toys," she
says, referring to the tokens,many of which will be used by vendor partner staff who need access to the network to run test programs.The access need is legitimate, even though it creates more work for the IT crew.
reminds the group that even vendor staff who gain access to Harvard Pilgrim's network must still adhere to the payor's "zero-tolerance" security guidelines, which regulate Internet use.For Norton
, it's just one of the countless details that informs the maintenance of a modern health plan's infrastructure.
Priority 1 Installing a UnitedHealth Group platformHarvard Pilgrim
is turning to the UnitedHealth Group
for its core administration system, which is, as the metaphor-mixing Norton
says, "the big megillah, like a heart and lung transplant."A $100 million project set for completion by the end of 2008, the migration to a new membership system was foisted on Norton
out of necessity.Harvard Pilgrim's
10-year-old membership system, from Rockville, Md.-based Amisys Synertech Inc.
, runs on a soon-to-be-defunct operating system from Palo Alto, Calif.-based Hewlett-Packard Co.
To make matters more complicated, Norton
says United's existing platform is better suited to meeting the needs of consumer-directed benefit plans, those tangled insurance packages that call on members to foot more of the healthcare bill.
United's front end will make life much easier on Harvard Pilgrim's
call center staff, Norton
adds."Today, if you are a member services rep, you need a Ph.D. to use our system.You have to go through six to eight subsystems just to answer members' questions.The United platform makes it easier to collect and cull information."
was in the final phases of selecting a new core administration system before United even popped up as a candidate.Harvard Pilgrim
had been in discussion with the Minneapolis-based plan about a joint marketing program, she
explains."As we came to understand United's capabilities to serve this arrangement of joint marketing, the light bulb went off," she
says."They are a slick technology operation."
United will host the administrative system remotely from data centers in New York, New Jersey and Minneapolis.Because the application is hosted, Norton's crew will not have to install upgrades."We can leverage United's spending on its own technology," says Norton
, who will migrate Harvard Pilgrim's
business to the new system on an account-by-account basis as plans are renewed.
Priority 2 Finishing the data warehouse
As it nears completion, Harvard Pilgrim's data warehouse symbolizes just how far the payor has come since its days of insolvency.With interfaces to its Amisys system, the payor's old warehouse was a cumbersome piece of IT machinery
that required considerable labor to maintain, Norton
Rather than do that, once a year Norton
top IT managers at a daylong retreat at her
beach house in Manomet, Mass.There, the IT
team huddles, reviewing wish lists from managers across the organization and assigning costs to them."We do not have cocktails until we have the numbers," says Norton
.The senior leadership of Harvard Pilgrim
then decides what must be done.Norton estimates that Harvard Pilgrim
spends about $14 million annually on infrastructure costs.
When Harvard Pilgrim's
Amisys system crashed for 10 days in 2003, it cemented Norton's focus on network uptime and security.The Amisys crash was likely occasioned by an interface that malfunctioned, explains Norton
, who worked 20-hour days during the outage.In contrast, network security can be undermined by outside forces beyond her
That's one reason Norton
staged a wide-scale network outage in the summer of 2004, when the Democratic National Convention
was taking place in downtown Boston and the Red Sox were chasing the pennant in nearby Fenway Park.It would be just such a time, she
reckons, that a terrorist attack might take place.And with Harvard Pilgrim's
primary data center just a stone's throw from Fenway, the simulated outage was more than a mere academic exercise.In the exercise, Norton's IT crew in Harvard Pilgrim's
backup data center in Quincy had to get the payor's entire operating platform up and running after an imaginary dirty bomb wiped out the Fenway data center.
Key lesson?"We were not prepared for a bomb or fire," Norton