Department of Health and Human Services at The State of Nebraska the human element to digital Project partners
Department of Health and Human Services at The State of Nebraska The Human Element To Digital We speak to Lori Snyder, CIO, Information Systems & Technology at the State of Nebraska for the Department of Health and Human Services, to see how the state is using digital strategies to battle COVID-19‌
Written by
Andrew Woods
Produced by
Craig Daniels
State Of Neb raska
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020 will forever be remembered as the year that COVID19 triggered a dramatic halt to
life as we knew it, as billions of people were ushered into a world of isolation, economic disruption and total uncertainty. But behind the scenes, as the scientific community battled away to find a vaccine, there were many more working above and beyond to keep communities informed, healthy and safe. Lori Snyder is the CIO, Information Systems & Technology at the State of Nebraska for the Department of Health and Human Services (DHHS), the lead agency in the state on COVID response, which has five divisions: Behavioral Health, Children and Family Services, Developmental Disabilities, Medicaid Long-Term Care and Public Health. And three months into her new role at the
the software and the solutions we’ve put
DHHS, slap bang in the eye of the COVID
in place for the COVID response really
storm, Snyder is clearly up for the scale of
helped with the testing, getting test
the challenge in front of her. “I’m a pretty
results back and notifying people.”
quick study, so I’ve jumped into a lot of
Snyder has previously worked in health-
things,” she says. “And I think that the
care, manufacturing, mail services, insur-
state and the federal government have
ance, government, and with the military,
done a really good job in terms of putting
but has never really specialized in a
together solutions so quickly with no
particular industry. “I really like to learn,
notice, but at the same time, when you get
and I get bored if I’m not learning,” she
a few months in, you can see opportuni-
explains. “So, I try to keep that learning
ties to improve and make things better.
curve going. I was getting to the point in
For example, we have seen places where
my career where I wanted to help other
State Of Neb raska
img credit: State of Nebraska
people in some sort of service role. I
area in order to give better service as
needed to be in a leadership role where I
the logistics of rolling out new vaccines
could have a big impact. And so, with the
dovetailed with track and trace. “We’re
COVID crisis going on right now, it really
looking at places where we can commu-
gave me an opportunity to pitch in and
nicate with people in a way they desire,”
find a place where I can really help, not
she explains. “Which is such a normal
only typically where you would assist a
thing in the E-commerce world, but we
company in moving forward, but in terms
didn’t have time to build this into track
of helping save lives.”
and trace. So, we’re finding ways to do
One of the key COVID challenges that
things online, through texting, and email,
Snyder and the State of Nebraska had to
where before it was a call – now a contact
face was communication and the devel-
tracer will reach out and get the informa-
opment of new ways to expand that
tion from the individual. We’re now looking www.theinterface.net
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at places where we can track symptoms
in that first group (healthworkers), right?
and use that tracking to help people know
But as you get deeper into the popula-
when to go into work, or to help them
tion, it’s not as clear who is going to alert
provide a letter to their employer for tax
people when they’re next. Who’s going
credits through the Cares Act.”
to encourage them to sign up? Who’s
Although vaccines are being rolled
going to help them remember which kind
out across the globe, there are many
of drug they had, since there are multiple
logistical challenges inherent in such a
doses? If they had Pfizer first, they then
campaign, with transport and storage
need the Pfizer second dose. If they had
being two notable concerns. “We’re look-
Moderna at first, they need the Moderna
ing at not only getting the vaccine from
second dose. Who’s looking at systems
the manufacturer, but also to the places
to track and curb the adverse reactions?
providing the vaccine,” Snyder says.
Now, a lot of these systems are in place,
“And in this case, it’s critical because
but we’re going to extend the capabilities
we’re using ultra-cold storage. So, you
in some way because maybe some of this
can’t give it to every provider who would
work was done by a provider in the clinic
normally receive a vaccine. You have to
previously, and now we need to reach a
select those who have that ultra-cold
wider population. Sometimes you have
storage. And then, how are we going
people who don’t have a regular provider,
to help the people within the State of
as maybe they’ve moved, or maybe they
Nebraska to get that vaccine? So, the
just don’t go to the doctor that often. And
hospitals help identify the people who are
so, they may need help finding out where
“ We have seen places where the software and the solutions we’ve put in place to help with the COVID response really helped with the testing, getting test results back and notifying people” — Lo r i S nyd e r C IO
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to go to get the vaccine. So, there’s all
picture together, showing the life cycle
these extra things around the edges that
of a person and all the things that they
get us looking to either take the systems
might need for support mechanisms for
we have in place and extend them, or
COVID and vaccinations. I think it’s been
looking to add some extra components,
very helpful to take that strategic holis-
such as the Microsoft Vaccine solution.”
tic approach, and look at the solutions
Contact tracing relies on exposure noti-
we have, making sure they integrate well
fications that identify people who were
together, ensuring that the data commu-
exposed, beyond just word of mouth.
nicates well together to improve the
“It’s one of those problems where you
service we’re providing to the folks who
start reaching out to community leaders,
live in the State of Nebraska.”
or chambers of commerce, or provider
The context and background to this
groups or whatever, that identifies even
work is stark. The clock is well and truly
more needs. And so, we’re really trying
ticking, as Snyder, her colleagues and her
to put that together in a holistic picture.
peers try to gain an upper hand during
I just gave a presentation to the gover-
this pandemic while people continue to
nor of the State of Nebraska, to put the
fall sick. The key to control is the spirit of
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partnership and collaboration. “I’ve met
no-code types of solutions, like Microsoft
with 48 different people or companies,
Dynamics 365, or the Microsoft Power
from other state leaders, to vendors, to
Apps,” says Snyder. “We were doing that
providers, to staff members and external
anyway, but what this pandemic has done
parties who are trying to solve this prob-
is accelerate how we need to get those
lem,” she reveals. “It’s really jump-starting
things going faster or where we can lever-
things for me and enabling me to put that
age some of those technologies or some
whole picture together for my leadership
of those small pieces of the puzzle toward
team, so that we can make good deci-
solutions for the pandemic, while still
sions about what we do to support the
realizing we have these bigger projects
people in the state. Some of the things we
that will continue progressing, and that
were doing anyway but were not related
will still come to the table within their own
to COVID. We are now looking at how we
timeframes.”
can best serve the State of Nebraska and the folks here better.” The I Serve Nebraska Portal is a new
“Government sites often have these little rectangles on their websites and I call it ‘pick-a-box,’” she explains. “And
data warehouse built upon the concept of
people try to figure out where to go to get
serving Nebraskans better with improved
the benefits they need. And so, they might
access, user experience and data around
select a box and it takes them down a
Economic Assistance and Medicaid. “We
path and ‘no, that’s not it.’ And they come
were looking at how we could provide
back to the top and they eventually figure
smaller solutions using low-code and
it out. The next time they come back,
“ I think it’s been very helpful to take that strategic holistic approach, and look at the solutions we have, making sure they integrate well together” — Lo r i S nyd er CI O
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they can’t remember that and so they
intelligence so that people can answer
go through the same pick-a-box, right?
the questions just once. We can now help
What we are trying to do with this new
them identify what benefits they qualify
portal is make this intuitive and easy for
for by merging those applications into
those first-time users, as they’re proba-
one. Plus, how can we pre-fill information
bly already feeling like they don’t want to
for them? None of these things are rocket
reach out for help. We want to make this
science in the E-commerce world, but
easy for them so we’re not compounding
you don’t always see it in the government
that struggle. Now we have multiple appli-
world.”
cations and if you maybe qualify for two
Snyder is visibly moved by the spirit
or three benefits, you have to go through
and commitment shown by vendors
that process two or three times. We want
during these challenging times as they
to drive the questioning in the appli-
join forces to develop highly anticipated
cation with better design and artificial
solutions. “Vendors are really thinking
State Of Neb raska
about the problems as thoroughly as they
what they are doing with exposure noti-
possibly can,” she enthuses. “When I look
fication, because I know that they are
at demos, let’s say on vaccine manage-
diverting other work in order to do this.
ment or something like that, and you start
And at least Google and Apple in the U.S.
thinking about all the different scenarios,
are offering some free technical capabil-
these solutions are coming to the table
ities for states, governments and cities
really well thought-out. People are invest-
to use. Well, that kind of thing doesn’t
ing thought time where maybe it wouldn’t
always happen, right? People are taking
have been invested quite so dramati-
this so personally they’re doing it on
cally, and quite so quickly, before. I think
their personal time, too. They’re invest-
there’s a personal nature to this because
ing really deep thinking and thought and
it matters to people’s lives.”
work and development time in this, which
“I was talking to folks from Apple and
is testament to the good in people and
Google yesterday and thanking them for
the good that we see coming out which
img credit: State of Nebraska
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wouldn’t usually be visible. I really believe in win-win vendor partnerships.” According to Snyder, Microsoft has been super supportive in terms of understanding technologies and finding faster ways to go to market, things they can do to speed the processes up “while still giving a really high-quality solution, allowing us to bring other vendors to the table to do the implementations”. Snyder’s department has a small legislator app going live in just four weeks. “Which is kind of unheard of,” she laughs. “That’s the beginning of the contract to the deliverable, so that’s a pretty fast cycle, especially in state government. Microsoft was very instrumental in bringing the vendor to the table, getting the licensing done, making sure we understood how to get through all the technical steps so we could launch. This will be a cloud launch with a very small app, but start to finish, exactly what we need to track our legislative bills.” A second app going live is the legislative bill tracking, to allow constituents to send questions to provide visibility on who has been contacted for answers and making sure the answers get back to the right people. Snyder and her team have also been working with Cordova Solutions and Microsoft, plus collaborative work with Snowflake regarding how they’re going to move data to the Cloud while making public health data available so “that we can do better work in the COVID space and ultimately the broader public health and Medicaid areas”. Snowflake has been really instrumental in looking at workflows, helping to identify gaps, providing ideas and solutions, and then ultimately providing vendors who can implement. There have also been fruitful working relationships with Qualtrics and the State Of Neb raska
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“ All of this is about getting people everything they need. And making sure they feel dignity in doing this. Everything we do comes from this really caring spot” — Lo ri S nyd e r CIO
Salesforce team in implementing some of its COVID solutions. Teamwork and partnerships during COVID have obviously worked across state lines too, as people cross state borders, potentially transporting this disease. “Our solutions work better if your neighboring states are working alongside you. We have people in our state crossing borders every day, maybe going to jobs, school or visiting relatives who live across these state borders,” Snyder explains. “If we deploy some of these solutions in a way that you can still get the information flowing across the border, we are going to have a better solution for the people in our state. So, a lot of good can come out of this. I think sometimes people are afraid of that collaborative notion and sometimes people want to develop things on their own, but I’m really about accomplishing results and that means leveraging others in a positive way and allowing them to leverage my knowledge as well State Of Neb raska
and having us all work together to identify
for her clients to interact, thus freeing
better solutions more quickly. Learning
the DHHS staff so they can really spend
from someone else is on one hand free-
more of their time with clients. An exam-
ing, but more importantly, it gets us to
ple is the new portal, iServe, which is
solutions faster.”
currently being deployed. iServe is a
Snyder is working hard to bring her
smart app that asks learning questions
private experience, as well as that of her
to make it easy for clients to apply for
vendors, to the table to help drive things
benefits without answering extra ques-
in a direction that makes it a lot easier
tions. “Instead, they can spend their time getting to know them, understanding
img credit: State of Nebraska
their needs, maybe helping them qualify for more benefits than they’re aware of, but really making good decisions to help them get the help they need. This really is something that’s helping people maintain their dignity, and to get them on their feet if they’re facing some initial or one-time adversity. Or they might have something long-term or ongoing. We’re making it efficient for them so they can spend their time taking care of whoever it is they’re taking care of whether that’s themselves or a loved one and not spending their time on a computer trying to figure out how to get the benefits that they need. The Snowflake data warehouse for example is a chance to pull the data together so the state can use it for people’s good. Not only can we use that to provide benefits better, but we’re going to be able to use it to find ways to produce those benefits more cost-effectively so we can use that money more wisely for the people of the www.theinterface.net
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State of Nebraska. We’re also going to be able to use it in the public health area to help drive better health for the State of Nebraska folks, because if we can find trends or better ways to serve them, so they get the health information they need, maybe we prevent some diseases beyond preventing COVID. It further supports our mission of helping people live better lives.” Anytime Snyder looks at an IT project, she centers in on the human element. “It’s that emotional connection that helps people understand what you’re trying to do so that the people working on that feel that sense of urgency? When they feel that sense of urgency and they feel that sense of connection, they go that extra mile so the people using these processes and tools feel better about their jobs and lives. It creates this circle of goodness.” “All of this is about getting people everything they need. And making sure they feel dignity in doing this. Everything we do comes from this really caring spot. And I love that. It makes you feel that people really are in this to serve the people of Nebraska. They’re really in it because they care. And this is meaningful to me. I want to spend my life and my time giving back.”
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