In hindsight, the Health Resources and Services Administration acted incredibly quickly to shake up its technology operations and reshape how it worked to disperse grant money to citizens and businesses after Congress passed the Coronavirus Aid, Relief and Economic Security (CARES) Act in March 2020.

The law charged HRSA, among other things, with overseeing the Provider Relief Fund that helped defer the costs to medical facilities for COVID testing and treatment.

But unlike many other agencies, the agency within the Department of Health and Human Services already had several of the technology pieces in place to make the shift to a new system and the issuance of grants much easier than anyone might have imagined. By September 2021, it opened up applications for the $25.5 billion Provider Relief Fund.

“We had so many billions of dollars to push out that we were really kind of focused because that was a completely new program to HRSA. We were really pretty busy for quite a long period trying to support that program, as well as other things. It was a lot going on at one time,” Adriane Burton, HRSA chief information officer, told Federal News Network during Workplace Reimagined.

“We used software as a service for all of our COVID systems that we deployed, whether it be Salesforce, Snowflake, DocuSign or Tableau. It was a lot quicker for us to deploy systems that way,” she continued. “We implemented Salesforce to support the health center vaccination program, and we had 17 million people that were actually vaccinated with that program. We had some integration with some of the Centers for Disease Control and Prevention systems as well for that initiative.”

By March 2021, HRSA received another $7.5 billion from the American Rescue Plan Act for the relief fund aimed at rural healthcare providers.

As of April 2022, HRSA says it has granted $21 billion from the CARES Act and ARPA funding. Funds will remain available for providers to apply for through June 2023.

Modernization paying off at HRSA

Over the past five years, HRSA focused its IT modernization efforts on taking advantage of cloud services and improving its underlying infrastructure.

Although HRSA put many newer applications in the cloud from the start, the agency’s IT team also was dealing with legacy technology, which created the need to integrate across many vendors and platforms, Burton said.

“The agility and really being able to rapidly deploy the technology and then just thinking long term, trying to make sure that we’re deploying modern and flexible technologies, that’s really what was driving the mission needs,” she said.

Equally critical, Burton added, was how quickly her team could deploy new capabilities. The cloud infrastructure made that easier and faster.

“What we’re finding is when we deploy, for instance, one system out in Salesforce, we find out that as new applications are needed, we’re able to leverage that same infrastructure as well, which is really helpful.”

Of course, for HRSA, the job wasn’t just to get money out the door. It also included oversight and tracking. Again, HRSA built on top of its existing cloud capabilities to address that challenge, Burton said.

“After the money had been dispersed to the healthcare providers, of course, you’d have the flipside that you’d have to implement systems for performance reporting about how the money was being used. We set up a Salesforce instance for the data collection,” she said. “For the healthcare providers, we use multifactor authentication for that. We also implemented Salesforce for our case management system for our Provider Relief Program, as well as Tableau. We initially started off with Tableau on premise, and then we found out that it was more effective to move it out to the cloud.”

HRSA also relied on artificial intelligence capabilities to help with fraud detection and understand different grant funding patterns.

“It really has provided that foundational framework that we used not only for the Provider Relief Fund, but we’re going to be expanding that data lake service for some of the other systems that have been rolling on premise. We’re going to be moving them out to the cloud as well,” she said.

Improved workflow processes across HRSA

The results of using a cloud infrastructure wasn’t just about the technology itself. It also changed how HRSA’s workforce meets its mission too.

Burton said the agency pushed grants out a lot faster, in five to 15 days versus the more typical timeframe of 30 to 90 days.

“We were able to streamline it to get the money out the door as quickly as possible. And each time we did it, we were able to get better and better,” she said. “There were some areas where people didn’t quite want to automate, but it was such a pain point, especially with the urgency of COVID, it became easier to get more and more automated.”

The additional automation tools enabled the agency to handle massive workloads in a tight timeframe, Burton said.

“We deployed, for instance, DocuSign for a lot of the forms when people are onboarded. We don’t have to fax forms back and forth the way that we used to before. In fact, we had started that initiative prior to COVID,” she said. “We had to roll out systems to support the Provider Relief Fund. We actually were able to leverage some of the work that we were doing for Provider Relief because we already were using DocuSign, and we were familiar with the technology.”

The same was true for Salesforce, which was in use in the HRSA contact center before the pandemic and which the agency now also uses for performance reporting. “We’re going to be using Salesforce more going forward with some of the different forms that we use for data collection from our grantees because it’s just a more flexible platform that can accommodate those changes quickly. Especially as legislation changes, some of those forms need to change as well,” Burton said.

HRSA’s experience with the technology reduced the need to train employees and accelerated cost avoidance as the agency improved processes. Also, employees now have more time to focus on high-value work, she said.

HRSA had to train current and new employees as it ramped up the Provider Relief Program, especially around using its new data mart. Burton said her office is constantly soliciting feedback to continue to improve the systems for mission needs.

HRSA’s data council, for example, received more interest and participation after employees saw the benefits of the data mart and the corresponding technologies, she said.

Data will continue to be a priority, as will cybersecurity, Burton said.

“Some of the things that we’ve been working on are expanding our data lake and setting up a service delivery model to support the various programs. That’s been a big focus for us,” she said. “Then, of course, cybersecurity is always a big focus for not just HRSA but all of government agencies, especially with zero trust as well as NIST 800-53 Revision 5. My priority is security and data.”

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