How HHS Can Advance CX Through an Integrated Citizen-Centric Approach

By Bob Jeffcott, Principal Systems Engineer, Software AG Government Solutions
X: @Softwareaggov

Driven by President Biden’s Customer Experience (CX) Executive Order and the President’s Management Agenda (PMA), 2023 is the year where agencies are embracing new ways to better meet citizen and constituent needs.

For example, the Department of Health and Human Services (HHS) is taking steps to advance CX by working hard to support the coordination between benefit programs to ensure applicants and beneficiaries in one program are automatically enrolled in other programs for which they are eligible.

In addition, HHS is currently conducting CX-driven research to improve user website journeys, as well as reduce the time it takes for applications to be approved. Much of this will also be driven by a new department-wide data strategy around CX, cyber and interoperability.

While these are all critical aspects for advancing CX, these efforts can be further enhanced by taking a holistic, citizen-centric approach for obtaining data from a number of different sources within and beyond their particular agency.

Citizen-Centric Data Integration

With citizen-centric data integration solutions, case workers, supervisors, administrators and others can get the data they need from multiple sources quickly and efficiently, leading to service delivery that’s both timely and comprehensive. This can also advance overall interoperability efforts across all HHS agencies and departments.

As a result of true data integration, a wide-range of programs can be more responsive to citizen and patient needs – and allows HHS to better advance its mission of enhancing the health and well-being of all Americans.

The challenge is that comprehensive data is not always available to support the efforts of those delivering the services. Much of this is due to many of the systems being siloed, often in mainframes that were never designed to communicate with one another. These systems contain important data that determine eligibility for a variety of programs, as well as business logic developed over decades for the administration of these programs.

In addition, HHS’s modular approach to modernization has led agencies to acquire single-function point solutions from a variety of vendors, resulting in even more silos. By integrating the multiplicity of siloed systems that exist across various programs, HHS can become more efficient, cut costs and, most importantly, improve the delivery of services to citizens.

Immediate and Tangible Data Integration Successes

Data integration also delivers immediate and tangible benefits. For example, one state is keeping children safe by integrating its judicial system with education and HHS systems.

When an individual is arrested for a DUI violation, that information is immediately forwarded to a school district system that compares the name of the accused against the roster of school bus drivers. This enables school districts to quickly remove that individual, eliminating a potential risk to children who ride the bus to and from school. To the extent HIPAA regulations permit, other information about that individual, such as substance abuse or psychiatric problems, can also be conveyed to case workers to give them a fuller picture.

Another state where all HHS-related information and functionality resided on a legacy mainframe combined all eligibility functions for the Medicaid and Children’s Health insurance Program (CHIP), as well as Affordable Care Act (ACA) integration. As a result, a single portal for citizens was created that is now dramatically more convenient.

FHIR and Data Analytics Play Into It All

In addition, FHIR is certainly coming into the forefront with the CMS Interoperability and Patient Access rule. This presents an opportunity for State Medicaid agencies (SMAs) to better and more securely share patient data across the care continuum. This also plays into potential HHS CX transformations through more robust health data exchange capabilities.

For example, by using low-code platforms, SMAs can quickly develop APIs based on the FHIR standard, ultimately making it easer to access all patient data including clinical, claims, and encounter information.

These platforms also allow data transformation from any HHS application data source — such as mainframe and legacy data — just as easily as the latest cloud applications to FHIR standard resources. With this ability to pull data from any source, HHS agencies can also leverage data analytics tools for putting this information into the hands of data analysts more rapidly and securely.

With citizens expecting the same convenient digital experiences they enjoy in their personal lives, HHS is making tremendous strides in advancing its CX capabilities. By ensuring all back-end data is fully integrated and accessible, it will be even more possible to provide critical services in a more rapid and effective manner.