healthcarereimagined

By AARON BOYDAPRIL 25, 2023

Agencies are approaching the White House’s mandate with an eye for getting important information and access to as many people as possible.

While the Biden administration’s biggest customer experience—or CX—effort to date is being led by technologists in the Office of Management and Budget, the nine “Life Experience” projects are, for the most part, decidedly low-tech.

The administration is pursuing major improvements to the way Americans interact with the government, beginning with nine projects across five “life experiences,” with a focus on improving that customer interaction without regard for traditional barriers and siloes erected around agencies.

“Technology underpins everything we do as the federal government,” Federal Chief Information Officer Clare Martorana told Nextgov in an interview. However, “it isn’t necessarily the individual piece of software or the code we’re shipping. It comes down to how are we bringing all of these people along on the journey: both our vendor partners—the external people that are helping us build technology—but also our federal employees—making sure that they have the right knowledge and training—and building off of the best practices … that [the U.S. Digital Service] drives across government.”

Those efforts are only tangentially related to technology and, of the nine projects at the center of the Life Experience CX program, only four of them have any meaningful technology component.

That is a feature of most of these projects, not a bug.

“How do we ensure that as we’re building out solutions we’re building them in a way that it’s accessible and addresses everybody in the population and does so equitably—not just the most tech savvy people with the newest phones and the fastest broadband,” USDS Administrator Mina Hsiang told Nextgov.

“We all have different degrees of technological access, technological literacy and engagement with a bunch of other aspects of the economy that affect how we appear in technological spaces,” such as a person’s credit history—or lack thereof—Hsiang noted. “All of these things affect your access to different tools as they’re developed.”

For example, under the program targeted toward families with children in the 0-5 age range, only one of three projects relies on technology: a pilot to create a text messaging service that state-run programs can use to inform families of available benefits and send reminders about upcoming deadlines.

While the program promises to help families who are most in need of these benefits, not all have access to a cell phone or the necessary broadband service to take advantage. That said, cell phone access among low-income Americans is incredibly high. A 2021 Pew survey found 97% of Americans had a cell phone—a number that held across multiple low-income brackets, including people making less than $30,000, $30,000-$49,999 and $50,000-$74,999

The 0-5 program doesn’t have the resources or authority to provide cell phones and service to those without, officials told Nextgov, but that doesn’t mean those people will be left without help.

“All three of our portfolio projects under 0-5 are designed to be responsive to feedback we heard directly from families,” said Maya Mechenbier, project lead at USDS for the 0-5 projects. “We asked about modes of communication and support in which we could support families through this life experience—and modes of communication that fit into their lives. So, meeting families where they are.”

For the majority, the best mode of communication is SMS, which sparked creation of the U.S. Notify program through the General Services Administration’s Public Benefits Studio.

But the 0-5 program wanted to ensure they reached everyone, prompting the other two low-tech projects: offering a physical newborn supply kit with things every family needs in the early days after a baby is born and creating a “benefits bundle” that social workers can help tailor to each family’s unique needs.

Even the choice to use SMS was guided by the preference toward low-tech. For example, email and other similar forms of digital communication require smart phones or computers and reliable broadband access, which can all create more barriers for low-income families. SMS—while still technically digital—offered the lowest-tech option.

“The theme here is that it doesn’t have to be too scary or too complicated,” one 0-5 program official told Nextgov.

“[If] I’m an individual who has just experienced a natural disaster or just lost my job, I don’t care about what the different agencies are and the programs at different agencies and which ones I might be eligible for. I have a need,” Hsiang said. “One of the interesting challenges for us to work through is how do we make those appear more seamless to the user.”

While in some cases that might mean creating a better website, fine-tuning an app or gathering better data for analytics, people and processes always come into play.

“I haven’t found a technology problem in government that we hadn’t solved many years ago in the private sector,” Martorana said. “We have policy, budget, legacy IT challenges, people who are unfamiliar with modern technology in [an] agency and haven’t had the opportunity to be trained or be exposed. … It’s as much the people and the process needing to change. It’s why I think this EO is one of the most significant things from this administration—in addition to equity.”

Martorana also stressed the importance of continuing improvement work long after these specific projects have wrapped—particularly when it comes to the technology components.

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“If you’re not shipping code every day, every week, you have to build the discipline out to be able to achieve that,” she said. “Otherwise, you get so disconnected from your customer that you have to put customer demands on a backlog.”

Support from the top

Where there is a technology component, the administration is sending support from USDS—a group designed to parachute into other agencies to help with particularly complex or challenging IT deployments.

The group has a mixed success rate. It was established after a team of industry technologists joined the Obama administration to fix the healthcare.gov portal and has had successful offshoots at the Veterans Affairs Department andDefense Department; meanwhile at other agencies—like the Small Business Administration—the engagements have been less successful.

For these CX projects, Hsiang said USDS can act as a bridge between siloed federal agencies.

“To a certain extent, we’re inventing a path forward. One of our capabilities is that we can work between agencies,” she said. “We can help bring agencies together and help provide some of that connective tissue and work through the complex questions.”

But the biggest support provided by USDS is institutional knowledge from folks who have done these things before—though usually from outside government.

“Obviously, USDS doesn’t have enough people to deploy to every single agency that has anything that they want to do in CX. But we really are focused on supporting agencies and helping provide capacity for major programs and consultations in areas where that’s helpful,” Hsiang said. “[We’re] bringing the expertise and folks who have done it in the past.”

The Federal CIO’s Office is helping with financial support, primarily through the Technology Modernization Fund, a central account managed by OMB and the General Services Administration from which agencies can borrow—or be granted—funds for impactful IT modernization projects.

The TMF Board set aside $100 million for CX projects, for which OFCIO is hoping the nine projects will apply.

“They are all eligible to apply,” Martorana confirmed. “We’ve been strongly encouraging them to apply. But each individual agency takes their own time in the process.”

Meanwhile, OMB is also working to connect agencies—through these nine projects and other CX efforts—going through similar experiences or working through similar problems.

“We don’t have to start at every agency on a blank piece of paper,” Martorana said. “That is why it’s really important that we’re writing these playbooks down.”

If these nine projects are successful, Martorana and Hsiang hope those playbooks will be the ignition for an explosion of CX programs throughout government.

“A lot of what we want to do is tell stories of how this can be successful,” Hsiang said. “The more that we have worked on this and we have agencies and programs where we have done this and it has gone well … it de-risks it and it makes it something that feel[s] like you can take it on.”

Barbara Morton, Veterans Affairs’ deputy chief veterans experience officer and lead for the Transitioning to Civilian Life project—who has been working on her agency’s customer experience issues since 2016—sees similar potential here.

Morton said, from her perspective, there are two main goals for the project:

“First and foremost, really responding to the pain points that we hear from transitioning servicemembers. We know in VA, data shows us that roughly half of transitioning servicemembers don’t engage with VA. … We’re curious why might that be,” she told Nextgov.

But there is a secondary potential benefit, as well.

“I love this as a pretty juicy, giant proof of concept,” she said. “To step outside of just the VA space, as well, and apply human-centered design insights and see how we can create solutions that cut across different agencies and bust the barriers—the siloes—of bureaucracy. … Understanding that for us—the collective ‘us’ in government—to be able to be what the people want us to be: Really give those services and support.”

She added that the aim is to understand how government as a whole can provide services “in a more human-centered way, rather than any of us feeling more like transactions.”

And that includes improving services for those who are not tech-savvy or tech-enabled.

“I do understand the concept of, ‘You want to provide as much bang for your buck with the resources you have,’ and maybe the digital option would be the most popular or the most widely utilized,” Morton said. “But that can’t eliminate our need and duty, frankly—and our opportunity—to think about the functional equivalent non-digital solution as well.”

This is the first in a multipart series exploring the Biden administration’s push to improve citizens’ experiences with government. The series will take a deeper dive on several projects mentioned in this article.

Article link: https://www.nextgov.com/cxo-briefing/2023/04/low-tech-side-bidens-push-improve-life-experiences-government/385564/

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