June 2010 Policy & Practice 21 
focus 
By Judy Ann Bigby 
Within my first few weeks as 
secretary of health and human 
services for the commonwealth of 
Massachusetts, I was tasked with 
approving the Executive Office of 
Health and Human Services’ budget for 
the coming year. As a physician coming 
from the evidence-based world of medicine, 
my first instinct was to inquire 
about the secretariat’s annual goals 
and client outcome data supporting 
the proposed spending requests. Given 
that EOHHS includes 16 public agencies 
with a budget of more than $13 
billion, I expected to be inundated with 
data. I wasn’t. In fact, I found 
that agencies had difficulty collecting, 
organizing and reporting 
data, and therefore were not 
always aware of the results they 
were achieving. I soon learned 
that EOHHS wasn’t operating with 
any enterprise-wide strategic goals, 
and data regarding performance were 
spotty at best. 
What I inherited was an enormous 
secretariat comprised of many effective 
agencies, each providing services 
to the best of their abilities with limited 
budgets. However, they had been 
operating as silos for many years. As a 
result, agency executives didn’t have 
many opportunities to capitalize on 
their cross-agency commonalities, and 
often operated without critical information 
about how their programs were 
performing. Each agency referred primarily 
to historical spending patterns 
to inform future investments. 
Early in my tenure at EOHHS, I committed 
myself to changing the culture 
of the secretariat to one that makes 
client outcomes an integral part of 
our day-to-day conversations and uses 
data to inform policy and programmatic 
decisions. My emphasis on transparency, 
collaboration and results 
achieved across agencies led to the 
initiative now known as EHSResults to 
focus on the results we deliver to our 
clients. 
The planning for EHSResults began 
in 2007, with the formation of six 
working groups of senior-level agency 
representatives. Groups were arranged 
according to strategic goal areas that 
aligned with the Patrick–Murray 
administration’s top priorities: community 
first, education, effective government, 
health, jobs and self-sufficiency, 
and safe communities. Each working 
group included representatives from 
five to six agencies, each with different 
programs serving diverse populations. 
These working groups were tasked with 
identifying the major strategic goals 
that answered the question: “What 
should we provide to Massachusetts 
residents?” Major goals were broken 
into sub-goals in a cascading goal structure, 
and agency outcome measures 
supporting these sub-goals were identified. 
These outcome measures helped 
answer another important question: 
“How will we know if we’re meeting 
our goals?” Working group sessions 
culminated in what we refer to as 
our “strategy maps.” Despite varying 
agency missions and clients, all agreed 
on fundamental shared goals and goal 
components necessary for improving 
outcomes for their clients. The end 
products provided the backbone of our 
EHSResults work going forward. 
With our foundation firmly established, 
we looked at how to utilize 
technology to foster transparency and 
give life to our goals. We leveraged an 
existing business application to build a 
series of performance reporting “dashboards.” 
These dashboards provide 
senior-level users in our agencies with 
an overview of EOHHS’ strategic goals 
and how individual agencies perform 
against those goals. 
As indicated in the diagram, the 
dashboard illustrates an overview of 
EHSResults: Using Performance 
Measurement to Transform a Culture 
Judy Ann Bigby is the secretary of health and 
human services in Massachusetts. 
See Focus on page 39
staff spotlight 
ment or misappropriation of intellectual 
property, and (5) fines, sanctions, 
penalties and disallowances resulting 
from the vendor’s failure to perform its 
obligations. 
Damages Disclaimers and 
Limitations Must Be Mutual for 
Both Sides and Carefully Crafted 
to Lift the Limits for Certain 
Harms 
A damages disclaimer is a provision 
that disclaims responsibility for certain 
types of damages. Damages limitations 
impose a total cap on damages recoverable 
under the contract. The buyer 
should have both protections. If these 
provisions are included for the vendor, 
the vendor still should be liable for all 
damages arising from its indemnification 
obligations. 
Name . . . 
Freddy (Frederick) 
Wiggins 
Time at APHSA . . . 
Two years, two months 
Title . . . 
Conference Assistant 
Place of Birth . . . 
Washington, D.C. 
A Typical Day Starts With . . . 
Checking out the local/world news to 
see what’s going on out there 
And Ends With . . . 
Enjoying one of my many 
favorite television shows 
Life Before APHSA . . . 
Executive assistant at the D.C. Arts 
and Humanities Commission 
Life After APHSA . . . 
One day owning my own business 
Motto to Live By . . . 
Tomorrow is a new day; aim to be 
better than you were yesterday. 
June 2010 Policy & Practice 39 
Legal Notes 
from page 38 
Locally Speaking 
from page 22 
Focus 
from page 21 
EOHHS’ goals, and provides users with 
color-coded indicators identifying how 
well we are performing on any given 
goal. In this example, the indicators 
reflect our agencies’ ability to help clients 
achieve self-sufficiency and independence 
through employment. Users 
have access to at-a-glance indicators of 
how well we are performing on increasing 
our clients’ wages. 
Finally, more granular data are presented 
in graphs illustrating the performance 
of individual agencies—including 
historical data, targets, trending, 
comments, measure methodology, and 
data source. The dashboards are complemented 
by a variety of additional 
reports that provide customized data 
views needed by each audience—e.g., 
by goal area and by agency, and delivered 
to users via e-mail. 
Utilizing technology has also aided 
us in fostering transparency and sharing 
our goals and performance with the 
public through the recently-launched 
EHSResults web site: http://www. 
mass.gov/hhs/ehsresults. The web 
site does not merely “flip” the internal 
reporting to the public; it adds 
constituent-friendly explanations and 
context to our policies, priorities and 
performance. 
The benefits of EHSResults have 
been far-reaching. The reality of this 
undertaking necessitated cultural 
growth as an organization. Identifying 
inter-agency goals helps individual 
agencies recognize commonalities, 
share approaches, think of their work 
in terms of concrete client outcomes. 
The transparency inherent in the dashboards 
has highlighted data trends 
that inform our dialogue about policy. 
Similarly, our budget development now 
includes goals and outcome measures 
that inform our investment and divestment 
decisions, and we’ve integrated 
goals and measures into our senior 
manager performance objectives. 
We’ve also begun sharing information 
about our goals and performance with 
all 23,000 EOHHS employees and with 
the public at large. 
Often, we talk about our EHSResults 
work as a journey. The positive change 
behind our work is ongoing and we 
need to be nimble in order to adapt to 
future changing environments but with 
EHSResults we’re well on our way. 
coordination for Family Preservation 
and Family Reunification (combined), 
and 103 families were connected 
to DPSS economic assistance 
and received expedited services. 
Linkages’ work in progress includes 
working with both departments’ information 
technology staff to develop 
automated outcome tracking via 
enhancements to existing systems. 
Although this area has been a challenge 
because each department has separate 
data systems, it is an area we continue 
to explore. Further expansion of 
Linkages will continue through 2010. 
Future expansion includes strategies 
around outreaching to mutual families 
who are homeless or have a Welfare-to- 
Work sanction, to engage them and 
provide services. 
Service coordination may not be a 
new concept in the field of social 
welfare, but it is one that is being 
revitalized in Los Angeles County. We 
are confident that our interdepartmental 
collaborative partnership is helping 
to better the lives of children and their 
parents throughout the county, while 
meeting the goals of both departments.