The challenge

The U.S. Department of Veterans Affairs (VA) is working to improve the confusing experience many Veterans have when navigating multiple VA sites built on a mix of legacy technologies.

Having launched a reinvigorated VA.gov in 2018 as an important step to a unified Veteran-first digital platform, the agency still needed to build out a common content management system (CMS), establish consistent descriptions for services, and organize the information in an accessible way for Veterans in need of health care.

Client goal

The large-scale pilot effort focused on using one of the regional VA Medical Centers as a model for all future VA.gov content. This would empower the VA to:

• Provide better healthcare management and scheduling online
• Explain benefits clearly and provide intuitive paths to apply for them
• Help minority and women Veterans find services specific to their needs
• Provide online connection with care coordinators
• Establish a model for content publishing and governance VA-wide

We integrated the new CMS with the existing site architecture and helped create standards for content and design that make it easier for VA staff to do their jobs—while directly improving quality of life for millions of Veterans seeking health care and benefits.

Our approach

Working alongside our partners Agile Six and Nava in collaboration with the U.S. Digital Service at VA and other organizations, our team was one of many moving parts in a complex project. We provided technical leadership and modeled transparent communication practices that helped the various teams work effectively together.

The technical strategy shifted to a “decoupled” approach partway through the project, requiring us to integrate the new CMS backend with the VA’s existing frontend system so that Veterans and caregivers could access content across multiple platforms. Agile practices helped us navigate this and other evolving priorities in a large ecosystem undergoing significant changes.

Smooth the technical transition

We managed the move to the new CMS without “pausing” the old site so the VA could re-use their existing front-end technology instead of starting from scratch. This meant we had to juggle content being served from two sources (GitHub and Drupal) during the transition, while training VA staff to use the new CMS effectively. We also set up a CI/CD pipeline for automated testing to ensure healthy functioning systems.

Find out what people need

To make sure health services and benefits are easy to find and understand, we tested navigation and content with real people, including unique groups like women, minority, and LGBTQ Veterans. We also interviewed VA staff responsible for maintaining the website, to understand their pain points and develop authoring and approval processes that make their jobs easier.

Empower a Veteran-first approach

The VA has been working to pave the way for a Veteran-focused digital experience, and this project was a landmark moment in propagating that approach throughout the organization. Human centered design and plain language are no longer the sole purview of digital experts — we developed systems that allow VA staff across the country to participate in the modernization of service delivery.

CivicActions, along with our partner Fearless, facilitated Drupal 10 upgrades across the Centers for Medicare and Medicaid Services (CMS) suite of websites, bringing improvements for editors, better security and accessibility, and community contributions to streamline upgrades for large- scale Drupal. The new Claro administration theme is cleaner, clearer, and more accessible.

The new rich text editor CKEditor 5 provides many UI enhancements and an improved user experience. The most significant change from previous versions of CKEditor is that editors must now use a predefined set of elements to configure the content, which leads to fewer instances of invalid markup patterns making their way into the published site. Since invalid or non-semantic markup is often the cause of accessibility issues, this is a major upgrade. In addition, the improved Layout Builder experience makes it easier for content editors to control more complex layouts, while still keeping consistent with CMS Design System standards.

The 8 sites included in the upgrade, which occurred ahead of schedule, were: CMS.gov; Medicare.gov; Openpaymentsdata.cms.gov; Data.medicaid.gov; Data.healthcare.gov; SDIS.medicaid.gov (internal CMS site); PFS.data.cms.gov (internal CMS site); QIC.cms.gov (internal CMS site); and Provider Data Catalog (data.cms.gov/provider-data).

The challenge

Alternative text is a complex topic, as it is difficult to account for every possible scenario or to provide sufficient context for each image. However, in order for web pages to be the most accessible, any contextual images that have been added must include good quality, descriptive alt text. Our team was tasked with updating the image upload editorial interface within Drupal to help editors add better, more useful alt text for the images they were uploading.

We completed a full, cross-disciplinary project with our partners Friends From The City and Agile Six. The project included discovery to determine exactly which areas would be best to focus on, building a functional prototype for user research, and ultimately implementing improvements determined from that research to create a better, more informed user interface for Drupal editors.

Client goal

Our goal was to create a better alt text experience for Veterans visiting VA.gov. To achieve this we had to improve the user interface within Drupal to:

• Streamline and simplify the image upload form
• Clearly identify the alternative text field
• Add client-side validation for common errors seen within existing alt text
• Provide clear and concise error messages for editors to correct mistakes
• Educate editors on how to create descriptive and accurate alt text and why it is important

Building on Drupal, an open-source content management system (CMS), we wanted to improve the image upload editorial interface by implementing guardrails to prevent poor quality alt text through the enforcement of accessibility best practices while also reducing frustrations for CMS editors who are writing the alt text - ultimately resulting in better quality alternative text for people who rely on it to access visual content on VA.gov.

Our team worked cross functionally with our partners to explore solutions that were not only technically feasible, but also solved a variety of user needs by following human centered design practices. Research was a key component to improving the alt text on VA.gov, from gathering and analyzing statistics on current alt text to conducting user research sessions. The final design that was implemented was a direct result of iteration based on user feedback and thought partnership with our team and the product owners at the VA.

Determine which metrics to target

The current alt text for images within Drupal was evaluated based on multiple criteria - did the alt text contain a filename; was the alt text concise; was the alt text redundant; was the alt text accurate. The last criterion is very contextual, however the first three are more subjective and we decided to target those metrics to start focusing our improvements.

Identify Improvements

We created an interactive prototype to test with users. We analyzed the feedback from those research sessions to determine the best way to incorporate validation into the alt text field with the least amount of user disruption. We also determined additional user interface updates that would make the entire image upload experience a simpler and easier task for the editor.

Educate Drupal Editors

We created training articles within the Drupal Knowledge Base to help editors contextualize alt text and more fully understand what it is and why it is important. By helping editors understand the experience a Veteran might have if an image they upload has poor alt text, they will better understand the content they need to provide to improve this experience.

The challenge

The Centers for Medicare & Medicaid Services (CMS) help millions of people every year find and enroll in health care programs. Planning a large-scale web and content management project to improve the customer experience of their multiple websites, the agency launched a design challenge for the vendors that were finalists for the contract.

We did a fast-paced collaboration with our partners Fearless and KPMG to submit deliverables in just 8 business days (including page designs, content recommendations, an API, and a clickable prototype with a smart chatbot). Our team won the challenge because the agency saw we could help them achieve their goal to better serve Medicare beneficiaries.

Client goal

The task was to redesign the Medicare Part D section of the medicare.gov website, which helps people understand insurance options for their medication needs. For all their digital platforms, CMS needs to:

• Meet public expectation for easily navigable online services
• Securely manage personal info and transactions for millions of beneficiaries
• Provide friendly online experience for people facing stressful health situations
• Serve diverse groups of users with competing wants and priorities
• Support agency staff in publishing clear and accurate public-facing content

Our approach

Within the time constraint for this compressed agile design sprint, we conducted lean versions of the activities we would normally do to make sure the site was effective for Medicare recipients. Daily collaboration among all team members, from Design to DevOps to Developers, allowed us to quickly test and iterate on every step.

We used Drupal as our preferred open source platform and the CMS design system, which builds on the U.S. Web Design System. Together, these tools provide a solid foundation for accessible government websites — a key goal for agencies like CMS that serve diverse and aging populations.

Human Centered Design played a critical role in our process of building a site that would be intuitive and useful to older Americans seeking information about their drug coverage options.

Understand the needs

We talked to real Medicare beneficiaries to understand the challenges they faced in navigating the site. Based on what they said, we created a key persona to drive our scenario-based approach — ensuring that our work solved real problems and created value for users. We also evaluated the existing site to see how well it met standards for usability.

Offer customized guidance

To help visitors feel comfortable navigating complex information about benefits coverage, we created several experience options for them to choose from. They could explore the site on their own, use the guidance wizard, or ask questions of the interactive chat bot. We also improved the Search function to deliver more relevant results.

Clear the path to success

We focused on removing obstacles to help more people successfully find the information they needed. This was done through intuitive navigation and labels, scannable and actionable content, and a refreshed, accessible design. We tested our solutions with users and iterated based on their feedback.

The challenge

The Centers for Medicare and Medicaid Services (CMS) provide healthcare benefits to millions of people every year. But the websites and digital tools that help people find and enroll in these programs were built on a myriad of aging technologies and were confusing to navigate. CMS needed to streamline and update its online platforms to improve the customer experience while establishing more efficient backend workflows for agency staff.

This is an enormous and complex task, involving the modernization of Medicare.gov, CMS.gov, CMS open data portals, and many other public facing apps that serve multiple user groups — including beneficiaries, caregivers, health providers, data professionals, and government stakeholders.

WECMS helps more than 100 million Americans every year apply, find, and enroll in healthcare programs. The information and tools provided are essential components in supporting CMS' goals of creating a truly consumer-focused, streamlined, efficient, and omni-channel experience for beneficiaries and their caregivers. The overall intent for this contract is to ensure continuity of operations for the Americans it serves and the WECMS program, which maintains, designs and implements open source software digital services for CMS’ flagship websites, tools, components and applications on Healthcare.gov, Medicare.gov, CMS.gov, and 7 Open Data catalogs. In addition to engineering and design continuous improvements on these established websites, this contract provides security compliance, devops, system infrastructure, content strategy, information architecture, training, documentation, content editor support, public call center dev support, Section 508 improvements, mobile application development, and tooling and systems expertise.

Client goal

When this multi-year transformation is complete, CMS will be able to deliver on its mission more effectively. CivicActions is providing agile development, DevOps, and human-centered design (HCD) services to help the agency:

• Improve the content editing experience for staff
• Modernize legacy systems and tools
• Replace proprietary technologies with open source
• Support active, informed healthcare consumption

Our approach

Collaboration is the key to success in a project of this scale and complexity. With multiple partner vendors (including our primary partner Fearless) and disparate stakeholders across many organizational layers, we work hard to keep lines of communication open and be up-front about potential problems.

Balancing stakeholder priorities, user needs, technical complexity, and CMS deadlines, we created a roadmap that minimizes risk and maximizes opportunities for success. Then we went to work on “quick wins” — tasks we could complete right away that would make the biggest difference for users.

Address the holistic customer experience

We knew that each CMS application is part of a huge public-facing ecosystem of digital tools, with many touchpoints. To address the entire experience that a person would have in navigating the systems, we drew on the agency’s own knowledge of their beneficiary community, working with them to refine and document how each person interacts with CMS online. The resulting holistic view helped us identify how we could improve that experience iteratively.

Adopt a data-driven strategy

To make sure we built the right solutions, we immersed ourselves in the CMS mission from the operational, technical, and UX perspectives. We dug into existing user research, reviewed analytics reports, conducted stakeholder interviews — then created user personas and journey maps to refine the project scope and goals. All this data is managed in a shared repository of user insights and project knowledge, which we refer to as we prioritize the work to be done.

Replace proprietary software with open source

We are “reverse engineering” multiple custom-built Microsoft.NET applications (such as the Medicare Eligibility and Premium Calculator and the congressionally-funded Physician Fee Schedule (PFS) Lookup Tool with modern, open source solutions. As we recreate all these applications in Drupal, we’re making guides and code documentation that outline the entire system — allowing CMS to maintain control of its own technologies and avoid vendor lock-in. We are also migrating CMS open data platforms from Socrata (proprietary) to an open source solution using DKAN 2.