By John Escobedo

You've experienced it before, with anything from an app to a kitchen utensil. That feeling that says, "This is like an extension or augmentation of myself." Maybe you've felt the opposite and felt a tool was doing more harm than good in a daily task.
 
Human Centered Design likely played a role (or failed to) in any device, tool, or software that you use in daily life. Today’s managers and product owners create and follow processes and procedures to make sure daily operations happen smoothly. With an existing product, it’s easy to hone a set of behaviors that achieves good results. However, applying this to designing a new product can be more complex. How do you make sure a new product or service meets its user's needs? How can you make sure you're building something for the right audience?
 
One such methodology is Human Centered Design. It was pioneered by Bill Moggridge who was the cofounder of the design company named IDEO. They have created a website at www.designkit.org which teaches and advocates the use of Human Centered Design. 
 
What exactly is it? It’s a set of activities, frameworks, and protocols that encourage empathy towards the intended user. Ideally creating a product that best serves the audience in mind. It's tempting to compare it to working methods such as Scrum or Agile. However, those are meant to maximize results being done by a team while Human Centered Design is focused on never losing sight of and staying connected to the audience for which you are creating a product or service.

​How does it work? Human Centered Design takes many forms but I will focus on the methodologies described on www.designkit.org. The Field Guide to Human-Centered Design prefaces any distinct steps with sharing their seven mindsets: Empathy, Optimism, Iteration, Creative Confidence, Making, Embracing Ambiguity, and Learning from Failure. From the beginning it emphasizes that it is an organic process that is not meant to be a cookie-cutter solution to rigid problems. That being said, there are three phases that are described to help you guide your design and keep it human-centric: Inspiration, Ideation, and Implementation.
 
The Inspiration phase is where you not only define your audience, but also conduct interviews. As strongly as, "What are we building?" Human Centered Design makes you ask, "Who are we building this for?" It's a time to walk around in the shoes of your potential customers and ensure you understand their needs.
 
After gathering knowledge, you are ready for the Ideation phase. This knowledge needs to be analyzed and broken down into what can become concrete solutions. But first, you'll brainstorm and storyboard these ideas and see which have a real and supported possibility of working for your audience. After deeply researching the "who" and the "what" behind your product, you enter the Implementation phase. You'll start to build prototypes of things you want to make and a plan for how to build them, as well as how to define when you've succeeded. If these steps leave you stalling for what to do next, www.designkit.org has a number of methods for each of these phases to break any writer's block you may have. Some of these methods include "Conversation Starters" for the Inspiration phase, "Gut Check" for the Ideation Phase, and "Roadmap" for the Implementation Phase.
 
What's important to remember is that Human Centered Design is a set of tools and mindsets to steer you in the direction of designing for your audience. It places those who you will design for at the center of the process rather than a single creator in charge of all choices. Much like any framework, it's up to you to adhere to or ignore the guidelines it sets forth.

The next time you are using your favorite app, frustrated while searching in a store, or struggling with a new tool, you'll find that Human Centric Design can make a difference in your daily life.

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Research Administrative Management System (RAMS) is part of the VA’s Office of Research and Development (ORD), which works to improve the health and wellbeing of veterans. To do this, ORD focuses on the healthcare needs of veterans, research is done to identify those needs, and solutions are sought after and developed in response. This research is conducted in clinics and labs across the country by private and public researchers and reported to the ORD through VA-managed portals. ORD provides the public research field with tools to manage protocols, personnel, budgets, and laboratories in order to increase compliance, efficiency, and accuracy of reports, as well as reduce the burden of regulatory oversight on research activities. The work of RAMS allows for cleaner data for ORD, provides consistency for oversight reviews of research being done, and facilitates training and succession. Each field research office funded by ORD must be in compliance with Federal and industry regulations, and the RAMS Integration system tracks office compliance with these regulations through a communication portal specifically for ORD and research offices. This portal is important because the system of the VA ORD is widespread, with several project application and management systems that communicate with each other and with various local and central offices.
 
For the RAMS project, GeekSI provided software development enhancements for the program, specifically for the RAMS Integration project. Labs and clinics are constantly engaged in rigorous research to provide healthcare solutions to veterans, and the outcomes can range from application of patient care, to the installation of new or improved programs.  One of the projects that function through the ORD is the West Haven Center for Restoration of Nervous System Function in West Haven, Connecticut. The goal for this center is to develop new therapeutic approaches to improving the function and quality of life for veterans suffering from nervous system injuries, with specific focus on SCI, MS, and nerve injury. Another ORD-wide program is the Quality Enhancement Research Initiative (QUERI) program. The QUERI program works to improve the quality of healthcare for veterans by implementing research findings into clinical practice. These are great way to see the research funded by the ORD being realized in a practical setting, and the research conducted in these areas are largely self-identified by the researchers, who then justify funding to the ORD. The ORD partners with many institutions to conduct the best research possible, many partners including universities, nonprofit organizations, the private industry, as well as other federal agencies. There are ORD-funded centers across the United States. As an integral part of the VA, the Office of Research and Development relies on an intricate system of budgetary and research project management and tracking applications. RAMS is one such application.
 
Unlike the ORD Legacy systems project that GeekSI also worked on, which assisted ORD portal users in navigating the legacy systems and improved user experience, the RAMS Integration system pertains to enhancing the administration  and management of the Institutional Review Board (IRB) process. The IRB is required for conducting human research at the VA and provides a common centralized database for tracking and reporting on VA administrative research programs. The IRB process is in place to enhance the quality of human research by ensuring that the research that labs and clinics are engaged in is ethically sound and put under scientific review to make sure that local issues are addressed and that the research being conducted is beneficial to the health and wellbeing of our veterans. The portal is used in concordance with the various ORD portals, and because of that it requires sufficient server space to exchange numerous tools and resources, many of which contain multiple graphics and require large amounts of storage capacity. Due to the large bulk of information being stored within the RAMS Integration portal, the dedication to the administration of support was great. The RAMS Integration employs a configurable technology based on Microsoft (MS) SharePoint 2013, MS Structured Query Language (SQL) Server R2 Enterprise, MS SQL Server Integration Services (SSIS), a custom web user interface (e.g., Java, J2EE), and web services. This solution delivers content management, workflow, and data quality assurance, and improves ORD’s ability to track and report research projects.
 
With RAMS Integration, local research offices can do a number of things, including:

• Create and track administrative data for individual projects that are active or pending at local research sites, and manage research oversight committees and sub-committees;
• Track research personnel assignments;
• Track training requirements, and certifications;
• Manage laboratory space and equipment inventory including, space allocations and equipment and support required reporting to ORD.

 
Along with the RAMS Integration project, GeekSI continues to contribute to the ORD through our work on the ORD Legacy program to help users create profiles in the various ORD portals. The RAMS Integration administrative work GeekSI has done helps contribute to the smooth experience of VA researchers and the research they develop. And, as indirect as the work may seem, we had and continue to have a hand in contributing to the health of our Veterans. We Geeks take pride in creating positive change in our community.

​In 2015, all of us at Geek Sources, a Women-Owned Small Business (WOSB) specializing in information technology (IT), were honored to be selected to support the researchers and medical practitioners at the Department of Veteran Affairs (VA) dedicated to solving the puzzle of Multiple Sclerosis (MS). We were awarded a project with the VA and the Veterans Health Administration (VHA) to enhance the Multiple Sclerosis Surveillance Registry (MSSR) system to add critical new data elements for significant analytics. With a longstanding, successful history with the VA, we have also worked on the Veterans Benefits Management System (VBMS)-Ratings, VBMS-Awards, Eliminating Veteran Homelessness (EVH) system, Loan Guarantee (LGY) system, Memorial Enterprise Letters (MEL) system, and Research Administrative Management System (RAMS). In addition, our team of health IT (HIT) experts bring a wealth of VA health registry experience, including, but not limited to, the Traumatic Brain Injury (TBI) registry, the Embedded Fragments Registry (EFR), the Breast Care Registry (BCR), the Oncology (ONC) registry, the VA Eye Injury Data Store (EIDS), and the Clinical Case Registry (CCR). The enhancements we made to the MSSR are a prime example of our Geek expertise in big data and health informatics.

​​MSSR is a web-based registry application that provides clinical data surveillance tracking and longitudinal patient data analysis and reporting for the entire MS population within the VHA. In response to Congressional legislation, the system tracks and monitors the VA’s MS patient cohort, demographics, diagnoses, symptoms, and treatments over a span of time and geography. MSSR provides extensive health data analytics for the Multiple Sclerosis Centers of Excellence (MSCoE) directors, in addition to providing them with the MS Assessment Tool (MSAT) to assist MS specialists with the difficulty of diagnosis. The MSCoE in the East and West have endeavored to actively study and examine MS, publishing and sharing their findings for healthcare academia and other communities.

The VA’s MSSR system meets those needs. With over 30,000 Veterans who suffer from MS, 1500 new MS cases annually, and 125 new cases every month, MSSR provides a vast demographic that ranges in age and location, and “findings suggest that MSSR is generally representative of the larger MS population in the United States. The detailed healthcare utilization and cost data maintained by the VHA combined with data from MSSR provides a unique and demographically diverse MS cohort for future study.”

​For our part, Geek Sources was tasked with big data needs for inpatient/outpatient utilization, prosthetics, vital signs, vital statuses, death dates and causes, non-VA/fee-based medications, and Decision Support System (DSS) data - specifically laboratory, radiographics, pharmacy, and costs. Considering the VA operates “the largest integrated health care system in the United States” (per the VA’s website), this was no easy feat. Currently, the VHA includes “168 VA Medical Centers and 1,053 outpatient sites…serving more than 8.9 million Veterans each year.” ​To persist the Veteran’s heath record, the VA leverages the Veterans Information Systems and Technology Architecture (VistA), implemented in MUMPS, as its Electronic Health Record (EHR). To complicate matters in terms of big data, VistA has more than 130 installations deployed at different VA facilities across the nation. Hence, if a Veteran visits multiple facilities, it is possible that different portions of his/her health record exists in multiple instances of VistA. The VA’s Corporate Data Warehouse (CDW), an Oracle database (DB), contains exports from all the VistA instances. Consequently, these original data sources feeding the CDW are primarily decentralized and customized instances of VistA, which provide a disparate, non-centralized source of clinical MS data that makes reporting and analytics difficult. The CDW addresses some of these issues but has data quality issues and holes with respect to MS.

Geek Sources began the MSSR enhancements project by reviewing and confirming existing requirements, development artifacts, and testing artifacts, including user stories and acceptance criteria.
​We then held Joint Application Development (JAD) sessions with Subject Matter Experts (SMEs) and data source SMEs to verify the current data workflows from a business process perspective by performing the initial analysis of the state of the data sources targeted for the enhancements. The SMEs included clinicians, statisticians, and epidemiologists to review existing data models and schema within the CDW to identify potential tables and fields as sources for the data enhancements.

​We also analyzed existing interfaces to CDW, its Extract Transform and Load (ETL) code, the availability of data, the expected accuracy of the data, and the timing of data transfers and their frequency. Once the fields were confirmed, we reviewed sample data from CDW to determine the quality of the data prior to targeting the information for export. We then enhanced and developed ETLs in C#/SQL within Visual Studio to export and import the data using SQL Server Information Services (SSIS) into MSSR’s Microsoft (MS) SQL Server DB from CDW. In addition, we enhanced MSAT within Computerized Patient Record Systems (CPRS), the User Interface (UI) of VistA. This included enhancing the messaging to VistA. MSAT sends a Text Integration Utility (TIU) note with health factors through a VistA Integration Adapter (VIA) message, routed through the VistA Integration Engine (VIE), using HL7 messaging to VistA.

Geek Sources also developed new analytic reports using chart controls within .NET framework for the enhancements leveraged by the researchers. To ensure a quality system, we enhanced and developed master test plans, test cases, and scripts to verify the delivered user stories, epics, and traced requirements – all maintained within the Requirements Traceability Matrix (RTM). Geek Sources maintained requirements as well as code versioning and configuration management within the IBM Rational Jazz Toolset Rational Team Concert (RTC), Rational Requirements Composer (RRC), and Rational Quality Manager (RQM). Our enhancements were tested and passed for cyber security leveraging HP Fortify Secure, as well as ADA 508 compliance using Deque WorldSpace and FireEyes. We successfully executed the project, adhering to the Project Management Body of Knowledge (PMBOK) and quality standards, including the VA’s Project Management Accountability System (PMAS) using MS Projects and Primavera tools.

​Our MSSR Enhancements Project Manager, Cathryn Patterson, explains some of the hurdles overcome during the project: “The enhancement of MSSR was a flagship project for Big Data management at the VA. No one before us had been granted more access to the different health data sets as requested by the Business Owner. CDW-Raw is where data from multiple Veterans Integrated Service Networks (VISNs) are first loaded from across the nation before being mined, cleaned, and loaded into CDW-Prod. It is where a lot of the DSS data resides. We had to analyze huge datasets, and normalize them to display the new data in a meaningful way. ​Our data architect and Extract Transform Load (ETL) developer did all of this while working with the VA doctors and researchers. I have never been prouder of our Geeks – we overcame so many obstacles to enhance this powerful healthcare system that helps provide quality care to our Veterans suffering from MS.”

​For the first time ever, MS clinicians now have more meaningful data, which allows for more accurate diagnoses, treatments, and epidemiological studies. In so doing, the lives of all MS-afflicted Veterans have been made a little bit easier in the process, and Geek Sources has successfully contributed to advancing MS research – bringing us a step closer to finding a cure. Sheetal Nilak, our data architect on the project, reveals that “the customers were happy with the data that we pulled for them from CDW. This [data] will help them make better/faster decisions, evaluate treatment plans, and, thus, help Veterans.” By collecting, organizing, and delivering data from multiple sources in a single registry, MSSR makes it possible for the VHA and its employees to use this data to better diagnose and treat those Veterans that have been affected by MS, hopefully making their lives a little easier in the process.

According to the National Multiple Sclerosis Society, MS is “an unpredictable, often disabling disease of the central nervous system that disrupts the flow of information within the brain, and between the brain and body.” Part of the difficulty with diagnosing and treating MS is that its symptoms vary from fatigue and bladder problems, to dizziness and difficulty walking, to more psychological issues, like depression and lower cognitive functioning. ​

Unlike other diseases, MS is incredibly difficult to diagnose, with it being mistaken for Clinically Isolated Syndrome (CIS) or Neuromyelitis Optica, also known as Devic’s Disease, and vice versa. Unfortunately, this means that the patient must often take various drugs, try different rehabilitation programs, and see multiple specialists – relaying their history with the disease each time they encounter a new doctor or hospital. For anyone, let alone our Veterans, MS is a debilitating disease that makes everyday life activities, that we all take for granted, massively challenging, with sufferers taking various disease modification treatments (DMTs) within different rehabilitation programs under the care of several MS specialists.

With little private sector funding, Americans suffering from MS rely on the data integrity and longitudinal analysis of the VA’s MSSR system. Although the MSSR focuses on our Veteran population, the information it gathers and the data it creates on MS helps all Americans affected by the disease.

With our work on the Multiple Sclerosis Surveillance Registry, Geek Sources has been a pivotal force behind the furthering of MS research and, with our team of dedicated IT professionals, we continue to serve America’s Veterans by helping provide quality IT healthcare systems.

In our last blog, we explored ways to get young women more interested in STEM by increasing the representation of women in STEM-related careers in popular culture. While this is a great first step, it isn’t enough. We also need our government to help encourage the hiring and promoting of women professionals and Women-Owned Businesses (WOBs), especially Women-Owned Small Businesses (WOSBs). Currently, the federal government has programs in place to help WOSBs; however, they rarely, if ever, meet their goals for contracting WOSBs and there are virtually no repercussions for federal agencies who do not meet these goals.

​Create North American Industry Classification System (NAICS) Codes for Economically Disadvantaged Women-Owned Small Businesses (EDWOSBs) in Technology:
According to the United States Census Bureau, NAICS codes are “the standard used by Federal statistical agencies in classifying business establishments for the purpose of collecting, analyzing, and publishing statistical data related to the U.S. business economy.” NAICS may be a classification system, but it also helps small businesses have a better chance of being considered for big time jobs. Contracts will specify that the contract has been set aside for companies that are classified with certain codes, including WOBs, WOSBs, and EDWOSBs. The problem is that there are no NAICS codes for EDWOSBs in the technology category, meaning EDWOSBs don’t receive any more special consideration than WOSBs, even though they face even more hardships by being economically disadvantaged in addition to being women-owned.

Require a Minimum Percentage for the Female Workforce:
​Geek Sources is a WOSB whose workforce is 64% women and we are incredibly proud of that fact. Unfortunately, as a women-majority IT company, we are basically an unheard-of anomaly. Most companies don’t have a minimum threshold for hiring females, or if they do, it’s minimal. One group that does have a great track record of going above and beyond their required hiring amount for a specific demographic is Veteran-Owned Small Businesses (VOSBs). VOSBs go above and beyond their imposed requirements by employing a higher-than-average percentage of Veterans. However, VOSBs have an advantage because a lot of government contracts in recent years have required that the winning contractor have a minimum percentage of employed Veterans in order to apply for the project, encouraging contractors to team up with VOSBs.
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​Deniz Franck, our CEO at Geek Sources, states that “one way we could really see change is for the government to just nudge more business towards WOSBs that specialize in IT/Engineering.” If the government were to have the same or at least similar requirements for employing women as they do for employing Veterans, chances are we would see the number of women employed in IT rise. Franck takes this idea a step further, daring the government and the IT field to step up to the plate: “If they want to add a requirement that the workforce is 50% women, then we won't have any problem matching it.”

​​If we were to give more WOBs, WOSBs, and EDWOSBs the tools they need to compete for large and small contracts, we would see a rise in both the success of these businesses and the number of women in the workforce, especially in IT and other STEM fields. If women and young girls see that WOBs working in technology fields are getting the resources, recognition, and income they need and deserve, they’ll be more likely to enter the technology workforce themselves.

In January of 2016, the National Science Board released its biennial Science and Engineering Indicators report. While women have been showing overall progress, albeit slow progress, to being better represented in STEM fields, women still only make up about 29% of the science and engineering workforce. Additionally, as a company working specifically in tech, it is upsetting to learn that less than 11% of computer engineers are women. And it’s not because there aren’t women who are qualified – there are so many women out there with untapped potential who could help us achieve parity.
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According to the National Girls Collaborative Project’s summary of the report, when it comes to K-12 education, “female students' achievement in mathematics and science is on par with their male peers and female students participate in high level mathematics and science courses at similar rates as their male peers.” In other words, female and male students are equally successful in STEM-related courses in their formative years. So what keeps these female students from pursuing engineering degrees and careers at the same rate as their male peers? Representation. It’s hard to feel like a part of a community when you don’t see or hear about other people like you in that community. Young women need to know that there are women out there studying and working in engineering fields every day.

To help make women in STEM fields more visible, books, movies, TV shows, and news segments need to highlight these women and tell their stories. The new Ghostbusters movie may be a comedy and may focus on paranormal science, but it also shows three female physicists who speak using actual science and engineering terminology and who build the technology to save their city all by themselves. The Oscar-contender Hidden Figures takes a different approach but also tells the story of three female engineers. Based on a true story, the movie follows these women as they help NASA send the first American into space. Even more importantly, all three women are black, meaning not only women, but women of color are seeing someone who looks like them participating in STEM careers and making a difference.
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Here’s how you can make a difference: Encourage the women in your life to pursue what they’re passionate about, whether it be art, science, literature, or aerobics. And for females who show an interest and an aptitude for STEM fields, give them a little extra push. Show them examples of real and fictional women who have pursued these fields: Ada Lovelace, Katherine Johnson, and Marie Curie; Hermione Granger, Temperance “Bones” Brennan, and Scully. Let them know that both men and women can contribute to and succeed in these fields. Help them crack that glass ceiling little by little, until all that’s left is shards.

Here at Geek Sources, we are firm believers in helping our community and helping those who have served our community. Currently, we’re working on a project for the U.S. Department of Veterans Affairs (VA). We have worked on several projects with the VA over the years and are excited that we get to continue our partnership. Part of what we love about working with the VA is the opportunity to work with an organization that truly cares about the people it serves: America’s Veterans. These soldiers have done so much for us and we appreciate the opportunity to help them and those that serve them.
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Specifically, the application we’re currently working on serves the VA by helping generate letters sent from the VA to Veterans’ families. Letters to military families from the U.S. government have been around since the Civil War, with most letter-notification correspondence becoming regular practice during World War II. If you’ve ever seen Saving Private Ryan, you’ve seen one of the VA’s most important letter-generation services: Death notices. In the following clip, you can see an office full of women typing each individual letter.

These days, the VA is trying to streamline letter generation so that letters can be created, sent, and received in a more timely and efficient manner. The application we’re developing is called Memorial Enterprise Letters (MEL) and it integrates with the VA’s current applications, Burial Operations Support System (BOSS) and Automated Monument Application System (AMAS). When a Veteran passes away, their family must submit all requests concerning their loved one and their loved one’s memorial to the VA. When the VA responds to these requests, they do so using Resolution Letters. Our current project is to take the VA Resolution Letters application that already exists and improve it, specifically focusing on how to minimize the need for application users to manually input data into the letters that the application can generate on its own. Anita Dixon, a Business Analyst on the project, explains that, in its simplest form, “the purpose of MEL is to generate resolution letters based on applications received from families of Veterans that have passed away.” These letters allow the VA to communicate with the families of deceased Veterans quickly and respectfully.

While the MEL application’s ultimate goal is to generate these letters, the MEL application also has some extra features to help the users outside of the actual generation of letters. Dixon explains that “the MEL application has several reports that can be used by employees and management to monitor and share progress on the work being performed.” These reports allow users to monitor their progress and it allows administrators and upper management users to see how many letters are being generated and by whom. These reports allow the users to see what they’ve done and what needs improvement. Dixon believes that this opportunity for improvement should work across the application: “I am hoping that the MEL application will make the user’s job easier, with less opportunities for errors, and give them a pleasant experience doing their unpleasant work.”

​Unfortunately, the VA often has to do unpleasant work. Helping America’s Veterans and the families of deceased Veterans is a hard job that can be full of heartbreak. Keeping these Veterans and their families in mind is a necessity in a project like this. Dixon echoes this, stating that while she hopes the success of this project will cause the VA “to see the need to use a letter generation application” on a larger scale, ultimately she hopes that “the families of the deceased Veterans get better service.” And we’re working to do just that. As the project enters its final stages, we eagerly wait for the opportunity to see the application in action, knowing that it will affect not just the users at the VA, but the families of our country’s deceased Veterans.

Working in IT is incredibly rewarding, but it can often make you feel distanced from real people and real life, especially if you telecommute: You sit in front of a computer for a large chunk of your day and a lot of the interaction between you and your coworkers is via the computer or phone. You work on your project, attend your scrums, and finish your work items and, unfortunately, a lot of times you end up forgetting why you love technology: Technology enriches our lives and does so in a multitude of ways.

But how can those of us working in technology remember that our tech reaches beyond ourselves? The most important thing to remember is that, as IT workers, even though nearly all our work is done through a machine for an imagined user, the technology we work on directly affects real people.

​First we have the obvious people our tech affects: The users. Whether we’re creating a program, a website, a game, an app, or simply fixing glitches in an existing item, we do so with an end user in mind. This is the person whose needs and desires we are trying to cater to. But to push past our computer screens and into the real world, we must make sure that we don’t see these users as just a means to an end or as nuisances, who we can be rid of as soon as we change this line of code or clarify this epic. End users are both our bosses and our customers: We should want to impress them, make them happy, and give them the product they want. When our end user is happy, we’ve done our job right.

​​The other people our tech affects are a little harder to envision because we haven’t necessarily interacted with them. These are the people our tech affects but who won’t actually be using our product. These people are not users, they will probably never see our product in action, and they won’t be writing us a recommendation or dropping in on an elaboration session anytime soon. And yet, our product will affect them; it will hopefully improve and enrich their lives, or at least make it a little easier at times.

Information technology is a booming industry and new contracts and customers are popping up every day. As workers in this field, our work is reaching more and more people, affecting more lives, and making an even greater difference. It is our job to not only create the product our users want, but to make sure our work is about more than the product itself – our work is about the people the product is for and the people the product will impact.