Background:

The Health Resources and Services Administration (HRSA) is dedicated to providing equitable healthcare access to underserved communities. Its reach extends to over 30 million underserved individuals, 58 million pregnant women, infants, and children, 576,000 people with HIV, and 1,800 rural counties and municipalities.

For over two decades, REI Systems has been a trusted partner to HRSA, helping the agency implement innovative approaches to meet its mission. This includes HRSA’s adoption of Agile development, DevSecOps, microservices, and UX (user experience)/UI (user interface) design.

These efforts have led to significant improvements across the agency, enabling HRSA to deliver services more efficiently and effectively to those who need them most.

Our Approaches:

AGILE

Agile is an iterative and collaborative approach to project management and software development that emphasizes flexibility, adaptability, and customer satisfaction. It simplifies projects by breaking them into small, manageable tasks and constantly adjusting the process based on feedback and results.

REI aims to create agile government enterprises by enhancing citizen experience, improving service delivery, and promoting trust and confidence between agencies and citizens. Our team of Agilists use our Agile Delivery Framework for efficient implementation. Driven by a unified vision, our experts aim to deliver value at scale, enabling agencies to operate more quickly, effectively, and affordably.

At HRSA, Agile was adopted to address the need for adaptability in the face of frequent legislative and policy shifts. Traditional waterfall methods, being inflexible, risk-prone, inefficient, and siloed, often fall short in comparison.

In 2011, we introduced Kanban teams at HRSA. Originally developed by Toyota for manufacturing, Kanban has been adapted across various sectors, including software development, often alongside Agile approaches. Kanban emphasizes visualizing workflow, limiting work-in-progress, and continuously refining processes to boost efficiency, minimize waste, and optimize workstreams.

In recent years, we transitioned our entire organization to adopt Agile methodologies across projects involving over 20 federal agencies.This shift has also affected our work at HRSA, as we increasingly use Agile practices and teams to provide high-quality products and services that support the agency’s mission.

REI led the way in transforming HRSA’s Electronic Handbooks development, delivery, and maintenance into a fully Agile framework. We formed 20+ Agile development teams with over 200+ team members and used a release train approach to synchronize the development, integration, and promotion of code across different environments to production. This process also helped spread Agile adoption throughout HRSA.

The team used various strategies to ensure cohesive, coordinated, and unified development. One such strategy was using the Scrum-of-Scrum approach, which involves multiple Scrum teams working together to deliver complex projects. Additionally, the team maintained a continuous integration and delivery (CI/CD) pipeline, which allowed for faster and more frequent delivery of working software.

To ensure consistent quality and collaboration, the team adopted a behavior-driven development (BDD). The team also used a “Test First” strategy, writing tests before code, to ensure the code met the desired functionality and performance requirements. These strategies helped us maintain high-quality standards throughout the development process.

REI’s release management plan ensures well-planned, tested, and controlled software deployment using CI/CD automation, along with pre- and post-deployment checklists.
This approach reduces disruption or downtime risks and enables prompt, dependable delivery of new features and enhancements to users.

Impact:

• Fewer disruption risks and ensures timely, reliable delivery of new features and improvements.
• Facilitated a swift $2 billion disbursement under the CARES Act within 12 days thanks to REI’s EHBs program approach and architecture.
• Adapts to ever-evolving business needs for higher customer satisfaction.
• Enhances customer engagement during sprint demos, promoting transparency and visibility into project progress.
• Identifies and resolves issues early, leading to higher-quality software through continuous testing and integration.

DEVSECOPS

Across government, DevSecOps is helping deliver faster, secure, and streamlined software development, fostering collaboration and deconstructing barriers between development, security, and operations teams. At HRSA, DevSecOps practices were used to retain a shared understanding of agency requirements and implementation.

REI also provided maintenance and application support for several EHBs projects. By employing automated testing, we ensured high quality of product delivery.

Impact:

• High levels of automation enable continuous testing and deployment, while increasing release cadence, reducing defects, and lowering technical debt and costs.
• We incorporated some of the most advanced tools in the industry into our CI/CD pipeline. These tools include Selenium, nUnit, and xUnit for automation testing, Coverity, blackduck, and netsparker for security testing, and SonarQube for code quality.
• These tools automate unit, regression, and security testing, resulting in lower testing, improved reliability, decreased deployment costs, and faster release cycles.

MICROSERVICES

Microservices are an approach to software development where small, independent services communicate through APIs. They are owned by self-contained teams, making applications easier to scale and faster to develop. This approach enables innovation and faster time-to-market for new features.

The REI team modernized the HRSA EHBs platform to make it more up-to-date and flexible. The new platform uses the latest web development technologies and practices like user-centered design, Test Driven Development, and DevSecOps automation.

With this modern approach, new features in the platform can be released faster through CI/CD processes. It is also secure, feature-rich, and complies with accessibility guidelines. These updates have increased user satisfaction and adoption rates.

Several of these microservices were developed using open-source software such as .Net core, Angular, Bootstrap, and others. The team has also used open-source predictive analysistools such as R to automatically identify quality issues based on historical data.

Today, around 25 microservices alone are being used across EHB products. REI closely worked with HRSA to improve the security posture by centralizing all the microservices following HRSA guidelines. The microservice architecture has made things easier, improving security and agility, and allowing faster changes across 160 HRSA products.

Additionally, microservices help reduce redundancy and duplication of effort. In a monolithic structure, teams would often build their own modules and there was less awareness of what common features could be shared. However, with microservices, everyone is becoming more aware of the common features that can be reused, leading to less duplication of effort and more efficient use of resources.

From a technical standpoint, there is an increased awareness of where and how to use microservices correctly and consistently. Internal review groups review designs and checklists to ensure existing features are refined, upgraded, or reused instead of creating something new. These reviews have been very helpful for teams to ensure they are using microservices effectively and efficiently.

Impact:

• Faster run times and improved user interfaces.
• Enhanced system usability.
• Keeps up with the ever-changing demands of customers and technology.
• More satisfying and efficient user experience.

UI/UX

UI and UX are interrelated but distinct facets of product design, emphasizing user-friendly and accessible interfaces for digital products and services. Government agencies often grapple with having to accommodate diverse users with different technical skills, accessibility requirements, and language preferences.

HRSA’s specific UI/UX challenge involved a mismatch between its requests and the delivered outcomes. Given the swift expansion of business functionality, achieving consistent design across various products and platforms was crucial. Our goal was to deliver a final product that aligns with the agency’s vision that is desirable, feasible, and valuable.

REI enhances prototyping by creating high-fidelity Axure prototypes, allowing stakeholders to visually confirm requirements. By following U.S. Web Design Systems (USDWS) principles and the 21st Century IDEA Act, we craft consistent guidelines for screen components to maintain compliance. These prototypes enable stakeholders to assess new features through interaction, navigation, and visual inspection.

We collaborated with HRSA to finalize UI components and color palettes, ensuring a consistent appearance throughout the application.

From a customer experience perspective, REI instituted an internal UI/UX governance committee that project teams must go through when introducing new capabilities or changes that affect user experience. The forum ensures alignment with existing standards and maintains consistency in user experience.

The team also considers whether the changes are user-intuitive and whether they can reduce the number of clicks required for a task. Before we introduce anything to customers, our teams must go through this internal process.

Once the team has approved a design internally, we create a functional prototype to show customers. The high-fidelity prototype allows customers to click through and see a visual representation of the new capability. This approach adds value because the customer isn’t just relying on low-fidelity wireframes and verbal explanations. The prototypes also ensure consistency in design patterns and elements, such as color, buttons, and menus, across EHBs, which can enhance user experience.

Impact:

• Ensures alignment with user requirements and expectations.
• Enables developers to understand the design with clarity and use the appropriate platform components to achieve desired outcomes.
• Our high-fidelity prototypes enable user testing and feedback to confirm whether the product meets their needs before development.

Advancing HRSA’s Mission with Modern Approaches

Our partnership with HRSA has been instrumental in enabling the agency to meet its mission of enhancing access to healthcare services foruninsured, medically underserved, and vulnerable populations. By implementing Agile development, DevSecOps, microservices, and UI/UX design approaches, we have helped HRSA achieve significant improvements in its operations. Overall, our efforts have resulted in better customer experiences, higher-quality software, increased efficiency, and faster time-to-market for new products.

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