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.

The challenge

The Georgia Board of Health Care Workforce (GBHCW) serves communities in the state with a focus on medically underserved areas. The agency provides data reports on the physician, physician assistant, and nurse workforce and funds loan repayment programs to recruit healthcare workers to underserved parts of the state. However, healthcare workforce planners were having trouble estimating and meeting demand for practitioners across counties --especially as the COVID-19 pandemic drew many of them out of Georgia and into various hotspot states. Additionally, without publicly-available data on healthcare workers, GBHCW struggled to inform medical facilities with potential funding and staffing needs."

The agency saw an opportunity to leverage the DKAN open data platform where they were already hosting their data, combined with custom data services from our team. We worked with GBHCW to create data visualizations and tools that make it easy for staff, medical practitioners, and the public to access the information needed to build a resilient and responsive state healthcare workforce.

Client goal

We were tasked with crafting detailed, easy-to-read visualizations for data provided by the Georgia Composite Medical Board and the Georgia Board of Nursing. We also built robust, multifunctional dashboards that allow data to be searched across physicians, physician assistants, and nurses. The dashboards needed to:

• Host and display data resources with user needs in mind
• Show the number of licensed healthcare practitioners in a given area
• Display data in a clear, user-friendly, and accessible way
• Be easily adaptable and sustainable with the constant influx of new data
• Reflect diverse intersections within the data (gender, race, qualifications, etc.)
• Help legislators make data-based decisions to improve the healthcare field

Our approach

Because other state agencies were already using the open source Drupal framework to publish and manage government content, GBHCW chose the Drupal-based open data platform DKAN for their data dashboards. The agency also saved time and money by utilizing an existing contract with us, adding new digital products to pre-built infrastructure.

As the core maintainers of DKAN, we provided research-based recommendations and custom data design and development services to make sure the dashboards solved the right problems for agency staff and stakeholders. The project was so successful that the client reached out to us with the intent to create more dashboards to display patient care and underserved areas data.

Build for real user needs

We brought a human-centered approach to the data dashboards, and used the React.js library to build intuitive visualizations. We listened carefully to the desired outcomes, researched user needs, then made suggestions for how people could best learn about the demographic makeup and overall distribution of physicians, physician assistants, and nurses throughout the state.

Deliver early and often

For the redesign of the data dashboards, we used agile sprint cycles with daily stand-up meetings to develop and implement small chunks of working software quickly. We used test data provided by GBHCW to create proofs-of-concept, with graphs and charts that made sense of the various elements we knew the client wanted to showcase.

Align and adapt

Meeting regularly with project leaders at the agency ensured that the vision and work remained in alignment. Together we reviewed work that had been done, checked if adjustments were needed, and responded quickly to evolving requests or new data. Staying in close communication ensured there were no surprises and the client goals were met.