This came about mostly by the failure of decision makers in the past who were not computer literate and by the piecemeal stop gap fixing of obsolete stand alone computer application programs. Decision makers in many cases were led astray by self-serving Information Systems Managers who wanted to keep their programmers busy by developing new application programs that could have been purchased off the shelf at a fraction of the cost. Another area where they are lead astray is through “Bench Marking” or copying computer applications that do a function more efficiently. The problem is not with Bench Marking itself but with the misuse of it. Personnel doing Bench Marking focus on gaining efficiency for an individual application program and not how it fits in with the state’s information system. The result many times is in the creation a stand alone computer application.

So why are state leaders not aware of this problem. The answer is that they are but fixing the problem is difficult and costly. Its only when you look at the cost of not fixing the problem do you begin to grasp its significance. The possible saving throughout the state in all of the state’s management areas besides Medicaid fraud is simply not grasped by decision makers.

Here is how the new computer system works.
New way: The new computer system consists of a network of data processing machines (computers) each with application programs loaded on them connected through the net work to a number of databases each with specific related information stored on them. The data bases are called Relational Databases and each uses the Structured Query Language (SQL) in its Database Management System.

An example of how this works is that when an application program calls for information (querying) the request goes through the network, finds the appropriate data in one of the SQL databases and returns the data to the application program for continued processing. The system automatically prevents duplicated data from being stored in any of the data bases.

Old way: Application programs are written with the data they need stored within the application. When data is called for during processing of the application the request goes to a numbered storage location within the application, retrieves the data and sends it back for continued processing.
Note that the numbered location is a unique part of how these obsolete systems work. With hundreds of application programs used by the state each with their own data base storing duplicated information its easy to see why the maintenance of them can cost millions more than with the Database System.

The failure to manage Medicaid can rest on being able to trace fraud and prevent it through an SQL Database management system. This is reason enough to look into the replacement of current obsolete systems besides the significant savings in data processing costs.