As the global pandemic continues to affect people's lives across the country, federal officials and industry leaders have been adapting and acting swiftly to scale up digital services and tools to support the public health crisis response.
“What has really come to the fore in this crisis is the way we deliver health care in this country,” said Department of Veterans Affairs Chief Technology Officer Charles Worthington during GovernmentCIO Media & Research’s Digital Services virtual event Wednesday. “We can leverage digital products a lot more than we have historically.”
This includes rapidly adopting remote services for health care beneficiaries and the federal workforce, such as telehealth, and uncovering areas to deploy existing technical capabilities to quicken timely operational processes. “Being able to respond to the crisis digitally is going to just accelerate what I think everybody's been working on and have poised themselves to be able to handle,” added Okta Federal Healthcare Lead Michael Giroux.
The VA witnessed a massive increase in telehealth visits necessary to support the functional capacity of health care clinics overwhelmed with sick patients and to keep veteran beneficiaries safe from potential COVID-19 contagion.
The agency has observed a significant increase in the use of telehealth services by beneficiaries since the pandemic began — from 2,400 video-based health care appointments a day to 26,000 — which has also given it a much-needed push to quickly upgrade its IT services to complement existing beneficiary services in the long term.
“[The rising need of telehealth] afforded us the opportunity to really accelerate our modernization into a scalable-solution,” said VA Executive Director of IT End User Operations Jack Galvin. “We not only took our on-premise and increased its capacity, but we expanded it to the cloud. Now we have a commercial-cloud instance of VA Video Connect, which helps us stay ahead of the demand, and it's still rising.”
The U.S. Digital Response, a volunteer organization of technologist teams brought together to help all levels of government respond to COVID-19, has also been at the forefront of scaling inexpensive technical solutions, such as those centered around benefits claims information and cloud migration.
“There's been a large wave of benefits both being released by the government, but also an increase in demand for those benefits — ranging from unemployment to small business assistance food stamps, security, and housing security support,” said Raylene Yung, CEO of U.S. Digital Response.
With government facilities that have been or are currently shut down, the teams are also trying to make the benefits applications process more remote-friendly.
“Previously, a benefits application process required a wet-signature work or in-person visit,” Yung said. “We are now really trying to figure out how to support all of these things in a remote environment that is still able to scale and work well for people.”
A majority of this work includes updating legacy mainframe systems that have been overloaded, as well as improving web services to eliminate difficulties searching for available COVID-19 financial assistance.
“There was a lot of confusion initially around [if someone had] to apply for regular unemployment insurance and not be eligible [for COVID-19-related health insurance], to then be eligible for the pandemic version, so [there was] a lot of work is around user experience, communication and understanding,” Yung explained.
Unemployment claims systems have also come under heavy stress during the pandemic, causing an inability to handle large amounts of claims data and requests.
“We had one state that we talked to that said they saw a 5,000% increase in application requests overnight,” she said, adding that state call centers were severely overloaded as well.
Supporting mostly local and state governments' move to the cloud or handle of data reconciliation — like what agencies like CMS are doing — the team also is finding ways to make common solutions easily sharable.
“We've seen that many of these states are actually solving the same problems independently. Now, we're trying to take a little bit of a step back and ask, 'What are systems that all of these states can benefit from?'” Yung said.
The Department of Health and Human Services has also seen how problems across agencies can be solved by utilizing scalable, collaborative digital solutions in response to COVID-19.
Brandon Edwards, the technical lead for ReInvent Grants Management at HHS, said his team’s pre-award risk assessment digital tool used to evaluate grantee applications has been adopted by certain groups for COVID-19 post-award risk assessment.
Called the Grants Digital Dossier (GDD), the tool reduces the time it takes for grantors to understand whether or not grantees are eligible for awards — from a matter of four to eight hours, to minutes — by automatically collecting information about grantees located across disparate systems in government, like sam.gov and the Internal Revenue’s Service’s Form-990.
The team created the tool after hearing about grantors' pain points, but applying it to post-award risk assessments had not been previously considered until now.
“In an emergency situation like a pandemic, the tool could be leveraged to do it [quickly],” he said.
One possible agency use case is in the evaluation research grants at the National Institutes of Health, which funds more than 60,000 research and training grants every year to support 300,000 researchers at over 2,500 institutions. A tool like the GDD could speed up the process of awarding grants associated with the billions in released COVID-19 research funds, as well as evaluate financial risk after the grant is awarded to the proposed research.
“I think what this time has proved probably for a lot of organizations is that you know when push comes to shove, you actually can be pretty responsive, adaptive, agile and flexible,” Worthington previously said.
“It's much more about taking the problems that are right in front of you, talking to your citizens or your customers about those problems, and then making changes to plans based on what's needed now," he added during the event. "That's true in a pandemic, and that's also true in just your average government IT project. We need to apply these lessons more broadly."