The State of Connecticut, like many others, had to create a way for residents to buy health insurance under the federal Affordable Care Act of 2010, better known as ObamaCare. Peter B. Nichol was one of the leaders who helped make that happen.
He first served as director of IT and then head of IT from September 2014 to June 2015 at Access Health CT, Connecticut's health insurance exchange. In both positions Nichol helped devise and deploy the systems that run Access Health CT, which went live on Oct. 1, 2013. A finalist for the 2015 MIT Sloan CIO Leadership Award, Nichol recently joined PA Consulting Group as a healthcare expert.
What was the key to getting Access Health CT up and running? First, we brought in leadership with experience running large-scale operations. Second was understanding the controls to put in place and [the importance of] allowing people on the ground to voice concerns, so we can be proactive. And third, we had a very detailed approach to how we were going to check and go live with the exchange.
And we made sure we had realistic expectations: Initially we cut 30% of the scope of the project on the Day 1 go-live because the team just couldn't do it; there was too much complexity. At some point, you have to say, "We have to cut some of this so we can be successful with core capabilities."
We had end-to-end enrollment and prescreening and a lot of cool things that allowed someone who was uninsured to enroll in eight and a half minutes. But that meant some functionality didn't get in.
What was your biggest accomplishment at Access Health CT? Inspiring the team to truly believe we can make a difference in people's lives. Technology is interesting, but strategy — not technology — is going to drive a lot of the transformation. And the human component is what determines success.
You need an ecosystem of people who believe you can make a difference. If you can build that inspiration, then it's pretty impactful.
Is that approach applicable in other areas, even at for-profit companies? I think so. I think you have to create a purpose regardless of the industry.
You said that you're proud Access Health CT "believed in the impossible." What seemed impossible? [At] other organizations, you had big challenges, but you also had policies, procedures and instructions to lean against. But here those policies and procedures didn't exist. Some of the things we take for granted as executives didn't exist. Even simple stuff wasn't there. It had to be built. But once we had those in place, we realized this was going to work and it might just be possible.
How did you go about tackling the impossible? The strategy was a risk-diversification approach. And it was very much a business process outsourcing model. We said anything we don't have core competency in, get rid of it. We can't build call center applications, so let's find out who is an expert in that space and have them work with us. We did the same thing with development.
As time went on, we picked up pieces, but we realized we could never hire enough people to get this completed, so we had to rely on vendors and switch them to true partners to make them viable.
The other thing that comes to mind, we had a very strong program management office. We quickly separated the IT PMO from the business PMO, so one was focused only on business processes and how to move those forward, and the second was focused only on IT.
Why was that separation important? There were so many things being discussed that we had to have more detailed conversations that were beyond "How are things going?" You had to have an open discussion on where the status was and a lot more detail and context around the challenges. And there were so many stakeholders and players involved. So it was key to have everyone engaged around the same type of ideas.
You have some intense hobbies — triathlons, scuba diving, flying. More and more IT folks are into those types of activities. What's up with that? It's a cool business because you meet a lot of people who have eccentric backgrounds. But there's a commonality of pushing normal off the table.
Do these activities teach you anything about being a leader? With flying, when you're in the cockpit you're making decisions quickly and they're all important. It's the same thing with business. Those decisions impact people, careers and families.
But I do spend a lot of time doing typical workouts and a lot of meditation. When you're in a meeting, having presence of mind is essential. Being able to focus on what people are saying with nothing else distracting you, that's a true sign of leadership.
You're certified as a project management professional, a scrum master and a Six Sigma Master Black Belt. Which do you find most valuable? I'd have to say the PMP because having an understanding of how large-scale waterfall projects work is important. That said, it's rarely used, but it's like your academic background: It does help provide context when you're solving problems.
When you think about innovation, it's not about one or two bright people in the room, it's really about having a process for innovation. Getting people together, coming up with ideas, understanding how that's going to be disruptive, and how you're going to bring that to market.
It's the same thing with PMP. It definitely helps to have a framework for how you solve problems. That framework can be communicated to other folks with similar backgrounds and you have a common terminology. They understand "plan" and "ROI," and it's then easier to communicate when you're dealing with dozens of teams in different locations.
Why move into consulting? We did some great things at Access Health, but I realized that I enjoy working closely with customers and ultimately with the patients and the members. And with PA Consulting, I'm in the healthcare space, I'm focused on truly trying to make a difference in people's lives. That's where my passion is and where I want to focus.
You have an active Twitter account and website. How do you manage social media? It absolutely takes a lot of time, and there are really no shortcuts. But what I'd say about these social platforms is they help build ideas. Part of it is having a platform to share ideas. I tweet out cool stuff, but also some truly original ideas. The few people who view that information are the leaders I work with, and those are the folks I'm trying to target.
So when you find time, focus on the topics you're interested in. If you're not engaged, you're going to miss some of the cool stuff that could impact your business.