This article is from the source 'nytimes' and was first published or seen on . It last changed over 40 days ago and won't be checked again for changes.

You can find the current article at its original source at http://www.nytimes.com/2017/02/24/opinion/designs-on-the-va.html

The article has changed 2 times. There is an RSS feed of changes available.

Version 0 Version 1
Designs on the V.A. Designs on the V.A.
(about 13 hours later)
We proceed with certain routine activities expecting the worst. We will face long lines when we go to the D.M.V. We will struggle to reach the right representative when calling the I.R.S. We will be on hold forever while attempting to challenge an insurance claim or change a flight reservation or cancel cable. We anticipate an ordeal in these instances and are rarely disappointed.We proceed with certain routine activities expecting the worst. We will face long lines when we go to the D.M.V. We will struggle to reach the right representative when calling the I.R.S. We will be on hold forever while attempting to challenge an insurance claim or change a flight reservation or cancel cable. We anticipate an ordeal in these instances and are rarely disappointed.
The larger the entity, the greater the torment. As an organization’s systems, processes, employees and regulations change, the path from start to completion becomes that much more onerous. And so it has been with the Department of Veterans Affairs.The larger the entity, the greater the torment. As an organization’s systems, processes, employees and regulations change, the path from start to completion becomes that much more onerous. And so it has been with the Department of Veterans Affairs.
The department might seem like a weird focus for a design column. But in a continuing effort to explore design for what C. Z. Nnaemeka has termed “the unexotic underclass” — the people often ignored by those claiming to save the world (single mothers, veterans, people over 50 unable to find work, etc.) — I am highlighting recent efforts that improve the daily lives of the 21.8 million veterans now in the United States.The department might seem like a weird focus for a design column. But in a continuing effort to explore design for what C. Z. Nnaemeka has termed “the unexotic underclass” — the people often ignored by those claiming to save the world (single mothers, veterans, people over 50 unable to find work, etc.) — I am highlighting recent efforts that improve the daily lives of the 21.8 million veterans now in the United States.
I spoke recently with Sarah Brooks, who was, until she left her post in January, the first-ever chief design officer at the V.A. A Presidential Innovation Fellow in 2014-15 who was part of the team that went on to start the Veterans Experience Office, Brooks told me about the community of designers and technologists across state and federal government who are trying to make citizen services work better for everyone, whether that means improving how people move through immigration, get food stamps, or get access to veterans benefits or Social Security and health care.I spoke recently with Sarah Brooks, who was, until she left her post in January, the first-ever chief design officer at the V.A. A Presidential Innovation Fellow in 2014-15 who was part of the team that went on to start the Veterans Experience Office, Brooks told me about the community of designers and technologists across state and federal government who are trying to make citizen services work better for everyone, whether that means improving how people move through immigration, get food stamps, or get access to veterans benefits or Social Security and health care.
There is an ecosystem of players driving this work: the Presidential Innovation Fellows program; United States Digital Services; and the Lab at OPM, run by the government’s Office of Personnel Management. With the new administration, many are choosing to leave — but many others aren’t, and remain committed to the idea that they are working for the American people.There is an ecosystem of players driving this work: the Presidential Innovation Fellows program; United States Digital Services; and the Lab at OPM, run by the government’s Office of Personnel Management. With the new administration, many are choosing to leave — but many others aren’t, and remain committed to the idea that they are working for the American people.
The use of design to improve things like software and web interfaces began to ramp up in 2013 with the work of Amber Schleuning, deputy director of the V.A. Center for Innovation, and Martin Martin, the V.A.’s CTO and a former Presidential Innovation Fellow. In 2016, after Robert McDonald, who was secretary of the V.A. until the end of the Obama administration, issued a public memo acknowledging that the appeals process was failing veterans. The department subsequently partnered with Congress, state and local government officials, veterans service organizations and others to try to fix it. The use of design to improve things like software and web interfaces began to ramp up in 2013 with the work of Amber Schleuning, deputy director of the V.A. Center for Innovation, and Marina Martin, the V.A.’s CTO and a former Presidential Innovation Fellow. In 2016, after Robert McDonald, who was secretary of the V.A. until the end of the Obama administration, issued a public memo acknowledging that the appeals process was failing veterans. The department subsequently partnered with Congress, state and local government officials, veterans service organizations and others to try to fix it.
The department’s U.S. Digital Services team began by looking at existing assets — outdated forms, tracking software, desperately unexciting stuff in need of radical transformation. They talked to V.A. employees about what their frustrations were and to veterans about theirs. One example? The application for health benefits was unopenable unless one happened to have a specific version of Internet Explorer and a particular version of Adobe Reader.The department’s U.S. Digital Services team began by looking at existing assets — outdated forms, tracking software, desperately unexciting stuff in need of radical transformation. They talked to V.A. employees about what their frustrations were and to veterans about theirs. One example? The application for health benefits was unopenable unless one happened to have a specific version of Internet Explorer and a particular version of Adobe Reader.
Accomplishing just about anything with the V.A. — scheduling a medical appointment or getting hired or filing a claim — whether online or in person was challenging, to put it mildly. There were 457 websites people had to navigate to connect to V.A. services before the agency started a new service delivery platform in November 2015, vets.gov, which will eventually be the one place for all V.A. transactions. Each has different branding, a different login, a different interface. “It’s layers of changes, policy additions,” Brooks said. “Nothing gets taken away.”Accomplishing just about anything with the V.A. — scheduling a medical appointment or getting hired or filing a claim — whether online or in person was challenging, to put it mildly. There were 457 websites people had to navigate to connect to V.A. services before the agency started a new service delivery platform in November 2015, vets.gov, which will eventually be the one place for all V.A. transactions. Each has different branding, a different login, a different interface. “It’s layers of changes, policy additions,” Brooks said. “Nothing gets taken away.”
The team took inspiration from high-profile success stories like the redesign of gov.UK in Britain (where individual websites, each with their own home page, were streamlined into a one-stop entry point that allowed you to pay your parking ticket or get a marriage license). Gov.UK was instrumental in bringing practices for web design and user experience from the commercial world into government. The notion of citizen as customer, rather than cog, drives these projects. A visitor to a governmental website should be treated like a customer to Amazon.com — the experience should be quick, convenient and intuitive, one that he or she would engage with again.The team took inspiration from high-profile success stories like the redesign of gov.UK in Britain (where individual websites, each with their own home page, were streamlined into a one-stop entry point that allowed you to pay your parking ticket or get a marriage license). Gov.UK was instrumental in bringing practices for web design and user experience from the commercial world into government. The notion of citizen as customer, rather than cog, drives these projects. A visitor to a governmental website should be treated like a customer to Amazon.com — the experience should be quick, convenient and intuitive, one that he or she would engage with again.
In government, that’s radical. A quick caveat here: Helping governmental agencies treat their constituents like customers they hope to retain should in no way be translated as advocacy for the privatization of those functions (as seems to be the desire of the current administration). Rather, government can benefit from public-private partnerships that bring some private best practices into public sector work. Brooks said: “Trust is our share price. We don’t have market pressure, but we do have to deliver on our promise to care for veterans. We’re trying to measure how we’re doing with our customers just as the private sector has been doing, so we can quickly make improvements where people are getting stuck.”In government, that’s radical. A quick caveat here: Helping governmental agencies treat their constituents like customers they hope to retain should in no way be translated as advocacy for the privatization of those functions (as seems to be the desire of the current administration). Rather, government can benefit from public-private partnerships that bring some private best practices into public sector work. Brooks said: “Trust is our share price. We don’t have market pressure, but we do have to deliver on our promise to care for veterans. We’re trying to measure how we’re doing with our customers just as the private sector has been doing, so we can quickly make improvements where people are getting stuck.”
Amber Schleuning, deputy director of the V.A. Center for Innovation and a fourth-generation veteran, never thought she’d work at the V.A. But she began to hear from others she served with, her dad (also a veteran) and his friends about the problems they were having interacting with the system.Amber Schleuning, deputy director of the V.A. Center for Innovation and a fourth-generation veteran, never thought she’d work at the V.A. But she began to hear from others she served with, her dad (also a veteran) and his friends about the problems they were having interacting with the system.
“We decided we had to do something,” she told me. “I had this idea of talking to veterans and learning what their issues were. I began to learn about things like human-centered design” and started with “this smushy idea that we didn’t know enough, so let’s just start talking to people and build some qualitative data to better understand what’s going on here.”“We decided we had to do something,” she told me. “I had this idea of talking to veterans and learning what their issues were. I began to learn about things like human-centered design” and started with “this smushy idea that we didn’t know enough, so let’s just start talking to people and build some qualitative data to better understand what’s going on here.”
This endeavor took human-centered design as its starting point, and Schleuning’s use of “smushy” is appropriate. Human-centered design means designing for people by first understanding what they actually need. In the case of the V.A., not having the input of staff members and the veterans themselves would have made this project untenable.This endeavor took human-centered design as its starting point, and Schleuning’s use of “smushy” is appropriate. Human-centered design means designing for people by first understanding what they actually need. In the case of the V.A., not having the input of staff members and the veterans themselves would have made this project untenable.
Among the first projects was a tool to improve the V.A.’s benefits claims process. Few of us, veterans or not, would report many satisfactory experiences filing claims anywhere, but trying to do that at the V.A. was on another level. Tens of thousands of veterans already wait longer than five years for a final appeals decision, and the V.A. continues to face rapid growth in its appeals workload. Some 80,000 veterans have appeals older than five years; 5,000 have appeals older than 10. The number of pending appeals climbed by 35 percent to more than 450,000 between 2012 and 2015 and is projected to soar to more than 2.2 million by the end of 2027 if there’s no significant reform.Among the first projects was a tool to improve the V.A.’s benefits claims process. Few of us, veterans or not, would report many satisfactory experiences filing claims anywhere, but trying to do that at the V.A. was on another level. Tens of thousands of veterans already wait longer than five years for a final appeals decision, and the V.A. continues to face rapid growth in its appeals workload. Some 80,000 veterans have appeals older than five years; 5,000 have appeals older than 10. The number of pending appeals climbed by 35 percent to more than 450,000 between 2012 and 2015 and is projected to soar to more than 2.2 million by the end of 2027 if there’s no significant reform.
The real work is shifting the employees’ perspective and the users’ experience. In the case of the claims project, the form used to look like this:The real work is shifting the employees’ perspective and the users’ experience. In the case of the claims project, the form used to look like this:
And now it looks like this:And now it looks like this:
Other recent projects include improving the forms required to connect with mental health services, modernizing call centers and expediting the hiring process (essential at a time when the department lacks the doctors it needs). To test new ideas, they’ve started the V.A.’s Innovators Network, a community of employees at 22 V.A. medical centers across the United States. In the past, V.A. employees have been instrumental in pioneering such innovations as the implantable cardiac pacemaker and the first successful liver transplants. The Innovators Network is designed to support that sort of collaboration; it recently held a prosthetic limb hackathon, for example, where veterans shared their personal stories and all participants worked on prototypes for better solutions.Other recent projects include improving the forms required to connect with mental health services, modernizing call centers and expediting the hiring process (essential at a time when the department lacks the doctors it needs). To test new ideas, they’ve started the V.A.’s Innovators Network, a community of employees at 22 V.A. medical centers across the United States. In the past, V.A. employees have been instrumental in pioneering such innovations as the implantable cardiac pacemaker and the first successful liver transplants. The Innovators Network is designed to support that sort of collaboration; it recently held a prosthetic limb hackathon, for example, where veterans shared their personal stories and all participants worked on prototypes for better solutions.
This work is hard. It isn’t glamorous or lucrative. It doesn’t garner accolades in the design press, but, Schleuning said: “Veteran feedback has been extraordinary. It feels like every single one of these one-on-one interviews ends with, ‘Wow, no one has ever asked my opinion before.’ It’s great they’re happy about it, but it frustrates me: It shouldn’t be so shocking that you’re being asked your opinion about something that’s serving you.”This work is hard. It isn’t glamorous or lucrative. It doesn’t garner accolades in the design press, but, Schleuning said: “Veteran feedback has been extraordinary. It feels like every single one of these one-on-one interviews ends with, ‘Wow, no one has ever asked my opinion before.’ It’s great they’re happy about it, but it frustrates me: It shouldn’t be so shocking that you’re being asked your opinion about something that’s serving you.”