Trends in state health and human services (HHS) website design

Many of our clients are state government professionals working on the technology side of health and human services agencies. The article below is based on our experience working with professionals in this space.

Intended reader: Government staff involved in web redesign efforts

Reading time: 7 minutes

Key Topics: Why states are revamping sites, What states are doing, Best practice examples,What scope is typically outsourced, Lessons learned and challenges

 Why are states revamping their HHS sites?

In the past few years, states have launched efforts to update their websites for a wide range of agencies. This includes public-facing functions such as employment offices, vehicle licenses, and tax collection offices. And now a trend has emerged with states updating the websites of their health and human service agencies. This includes Medicaid programs, but also child welfare, public health and mental health functions.

This trend is driven by 2 major factors:

  1. Newer technology, particularly around web architecture– This creates new opportunities for the state IT enterprise, and also creates urgency around bringing legacy systems into compliance with modern standards.
  1. An expectation by more of the general public for a streamlined service experience– Most Americans have come to expect a simple, helpful path towards getting what they need from all service providers (including public and private).

Newer technology

One of the main drivers for updating state HHS websites is the need to align legacy web technology and approaches with modern options. Many states developed their websites using older versions of Sharepoint, and those versions are no longer supported. Some state websites were designed to work best with very old versions of browsers. Most were designed before the general use of APIs. Some states are still hosting their websites on-premise, and are looking to move all operations to the cloud.

User expectations

Interacting with state HHS programs is only one small part of a members’ experience with technology systems. With the widespread use of internet-based services, members have come to expect a smooth technology experience that allows them to maximize what they can do for themselves (self-service). They also expect this experience to be simple and similar to what they experience in other areas of their digital life, like retail and banking.

What are states setting out to do?

States are focusing on several key areas, including:

  1. Enhancing the experience of users of their website (both members and program provider users)
  2. Streamlining  presentation of existing program information
  3. Porting some program offline functions to an online model
  4. Increasing agency transparency by reporting of data and sharing copies of vendor contracts  

A few best practice examples

We recently reviewed 6 state websites for a best practices scan:

  1. Arkansas
  2. Minnesota
  3. New Mexico
  4. Ohio
  5. Oklahoma
  6. Texas

Based on our review, states are using their new websites to focus on several key areas of self-service and education for providers and members. The table below provides a summary of our findings.

Functional AreaWhat Best Practice States are Doing with their Websites
Provider Enrollment & RegistrationOnline services provider enrollment and registration for Medicaid program and behavioral health service delivery programs
Licensing & CertificationOnline databases and services for board managed licensures and certifications for individuals in a variety of fields.
WICIncluding information on requirements, eligibility, and application paths for the WIC program.
Vaccinations & ImmunizationsIncluding information on required school vaccination schedules, vaccine availability, flu shot availability, vaccine registries and information for other vaccines.
Opioid AddictionIncluding educational information on opioid misuse and overdose prevention, naloxone, data on the opioid epidemic, prescription opioid disposal, prescribing guidelines and opioid treatment programs.
DiabetesIncludes diabetes prevention, diabetes management, healthy lifestyles programs, information for providers on diabetes, and diabetes research.
Hand Offs to Local Health DepartmentsIncludes food safety permits & inspections, HIV/AIDS programs and testing, children’s health services, and women’s health services.
Vital RecordsIncludes access to birth, death, marriage, and divorce records.
Prescription Drug Monitoring ProgramIncludes registration for pharmacist and prescribers, data, and legislative requirements.
Eligibility for ServicesIncludes eligibility for services under the developmental disabilities administration, behavioral health administration, and public health administration.

What scope are they outsourcing? What are they doing in house?

Overhauling a website that was likely launched 20 years ago can be an overwhelming task. Most states  choose to outsource several key components of the project, including:

  • Project management– Key efforts include managing schedules, change management, and scheduling of state resources.
  • Tech infrastructure– Key efforts include standing up a migration environment, conversion of existing code and IT assets, testing and custom development efforts.
  • Content development – Key efforts include identifying priority services and user personas to use to drive site redesign, and development of test cases to be used by development team.  

What are some of the lessons learned and challenges?

A lot can go wrong in a project like this. Based on what we have seen in recent projects, there are 2 critical areas to get right:

  1. Governance, governance, governance– Without a clear governance process, it is very challenging to move a project forward. Your project will require collaboration across many different business units. Each of those units has different goals and priorities.  There will be many times that a decision will be required, and some unit priorities will be selected over another in order to move forward. Besides the internal decision process challenge, it is important to keep in mind that the overall effort centers around moving the agency to be more public facing (via an enhanced website focused on improving the user experience). As such, there will be more complexities introduced into the decision-making process. Without a clear governance process at the outset, your project will almost certainly be late and of less quality than you want.
  2. Have a plan for what happens after go live–  So much effort goes into getting to go-live for the new site, that it is easy to miss how important the ongoing operation of the improved model is. If you do not have a plan for updating content and continuous improvement of your new site, your website will just become static and outdated again.  

How You Can Address the Challenges of Updating Your State’s HHS Website

Besides your own research into this topic, there are a few key tactics that can help you overcome the common challenges related to updating HHS websites.

Besides your own research into this topic, there are a few key tactics that can help you overcome the common challenges related to updating HHS websites. We provide this type of assistance to our government clients, and are happy to have a conversation anytime. If our services and expertise are a fit for your needs as you develop or execute your strategy, engaging with us is a simple process. If we are not the right fit, we are happy to make a referral to another firm who may be.

  1. Keep the end user experience central to your design focus. Remember, your customers are immersed in an online world outside of your website. Their online experience with social media, banking, and retail have created an expectation of self-service, speed and simplicity. In order to meet these expectations, you should engage a firm with deep expertise in the space, but that also has a practice area focused HHS website users persona development. It is critical to align technical design with real person use patterns.
  2. Include operational success in your initial planning. If you only plan for the design, development and implementation of your new website, you will fail after go-live. You must set your efforts up for successful and sustained operations from day 1.  
  3. Review and update your decision-making processes (governance) related to the effort before beginning the project. You will encounter challenging decisions early on in the planning stages of the project. Investing in a shared and relevant framework for making project decisions is one of the most important things you can do for project success.  
  4. Think about website content differently, and get assistance creating it – Most internal users (government employees) think very differently about the content that is helpful on a website compared to your external customers (members, providers, and other members of the general public). Your staff are already overtaxed with their normal duties and overall project efforts for the website redesign. Asking them to create (or repurpose) content for the site in a way that end-users will value is most likely unrealistic.