Speaker Spotlight: Q&A with Colorado Office of eHealth Innovation

As our annual Government Innovation Colorado is approaching, we had the opportunity to interview Stephanie Pugliese, the Director and Gabby Burke, the Senior Health IT Project Manager from the Colorado Office of eHealth Innovation about their upcoming keynote session at the event.

Q1: Can you give us a little bit of background about the SHIEcosystem? What inspired you to focus on developing social-health information exchange infrastructure?

An increasing body of research demonstrates that health-related social needs, such as access to healthy food and reliable transportation, are more crucial to improving health than medical care alone. This has led to a growing focus on integrating these social needs into healthcare practices. In Colorado, as is true across the nation, our social care system is often fragmented, with providers and individuals wasting time on duplicate data entry and manual follow-ups.

Office of eHealth Innovation (OeHI)’s approach to SHIE in Colorado has been envisioned as a way to balance individual organizational preferences in technology with the increasing need to better integrate these disparate systems. This has been a focus for the OeHI since 2018, and we have evolved our approach based on our own successes and lessons learned, as well as by observing how other states and localities have approached this work. Given the Colorado health technology ecosystem, we determined that a two-pronged approach—both to uplift work already happening in communities and to build the infrastructure to connect this work—was the best path forward for the state.

Q2: Can you provide examples of successful partnerships that significantly contributed to the development of the SHIEcosystem?

The initial build and launch of SHIE has been a truly statewide effort. OeHI has been fortunate to establish relationships with more than 75 different agencies and organizations across the state throughout the SHIE discovery process. We are particularly proud of the progress we have made internally with other state agencies—OeHI’s partnerships with the Department of Health Care Policy and Financing (Colorado’s Medicaid agency) and the Department of Local Affairs have been especially crucial in getting this effort off the ground.

At the federal level, the Centers for Medicare and Medicaid Services (CMS) has also been an incredible partner and supporter of this work. Building this system initially solely to support Medicaid members has allowed our state to secure significant matching federal dollars, enabling us to develop this custom interoperability solution.

Q3: What were some of the key challenges you encountered during the development of the SHIEcosystem, and how did you overcome them?

Colorado SHIE is a first-of-its-kind solution in the nation. Developing the SHIE strategy and contract required significant changes to the way state government typically operates—creating an agile program within the constraints of state contracting and developing an application with a hybrid ownership structure between the state and two vendors posed substantial challenges.

Another key challenge is establishing buy-in and trust with providers and Community-Based Organizations (CBOs). These groups often experience fatigue from the constant introduction of new technology solutions, including those proposed by the state, that have failed to deliver as promised. We aim to address these challenges through relationship and trust-building, while recognizing the importance of having tangible results to demonstrate to our partners before many are willing to commit to collaborations.

Q4: How do you ensure that the SHIEcosystem remains adaptable to future technological advancements and changing community needs?

OeHI’s SHIE approach is explicitly built for the future. The SHIE platform is modern, adaptable, and modular. This means that as technology evolves and community needs change, the SHIE platform can decommission or retool specific portions of the solution without undoing the work that has already been done or forcing significant changes to the provider and CBO experience. Additionally, by working with community partners to understand their current and preferred experiences with this technology, we are building the SHIEcosystem to connect and interact with each group based on their preferences and system design.

Q5: What advice would you give to other government agencies looking to innovate and collaborate with community partners in a similar way?

Innovation in government is incredibly challenging, but we all know that the public sector is made up of some of the most scrappy, dedicated individuals in the workforce. We have found that a key to innovating at scale is setting realistic expectations and starting with what has already been done. Often, technology is not the barrier—trust is. Much of this work is already happening in communities, so first focus on understanding the landscape, then elevate the community-driven work that is already underway. Finally, collaborate with your communities to build or iterate on technology based on the very real needs of community partners.

Q6: How can attendees at this session leverage the insights and experiences shared by Colorado Office of eHealth Innovation to enhance their own projects or initiatives?

We hope to convey that creativity and innovation in government are not only possible but happen every day. We hope people feel empowered to invest time and energy in building trust, practicing reflective listening, and building on what has already been accomplished to create successful and sustainable technology in government. Authentic partnership and listening have been key to our successes, both in working with our fellow state agencies and with our community collaborators.

Stephanie and Gabby will be speaking at our upcoming Government Innovation Colorado on October 8 in Denver! Claim your complimentary pass today to learn more about OeHI’s SHIE approach. https://publicsectornetwork.com/event/government-innovation-show-colorado/