This post is the fourth and last in a series produced for a Harvard Kennedy School field class on innovation in government. Our team is working with the U.S. Department of Veterans Affairs (VA) to improve services for family caregivers.
Meet Jeannette. She is a caregiver to her daughter, a Veteran who was injured in the Iraq War. After years of helping care for her daughter’s injury, Jeannette still searches for opportunities for herself. She needs “me time.”
Meet Bryce. He is the husband to an Afghanistan War Veteran who returned from combat with a traumatic brain injury (TBI). Bryce started to embrace this delicate role as both spouse and caregiver, and while he has sought help from VA, he’s also seeking tools that can help him teach himself as well as assistance and understanding from the community.
Thirteen weeks ago, our multi-disciplinary team from Harvard University came together to focus on family caregivers like Jeannette and Bryce. Through user research, prototyping, and user testing, our team developed a set of recommendations for how the U.S. Department of Veterans Affairs (VA) and the United States Digital Service at VA (DSVA) could more effectively serve family caregivers through digital tools.
Our user research found caregivers prioritize Veterans’ needs before their own; receive little formal onboarding and seek ongoing resources; suffer from little social and integrated support beyond engagement with their peers; and strive for a sense of normalcy, stability, and balance in their lives and in their care of the Veteran.
From these insights, we developed prototypes that led to our primary recommendation: a caregiver portal focused on accessibility, information, and connection, matched with a coordinator-facing secure messaging tool.
You can view our latest prototype here.
The Caregiver Portal features four key initial product elements:
1. Dedicated online account for caregivers: Caregivers and experts identified the need for a dedicated online caregiver account that would formally recognize caregivers and enable direct access to health and provider communication and information. A single sign-on would empower the caregiver to obtain and improve their own care—including respite and clinical care—and manage connected benefits. Caregiver accounts would also make this population more visible for VA.
2. Caregiver profile: A caregiver profile would offer the caregiver a personal and detailed identity. A caregiver profile would enable a simplified “onboarding” for new caregivers and allow VA to better assess the caregiver community and allocate resources according to evolving needs. An editable caregiver profile could also increase the customization of coordinators’ care recommendations. If de-identified and aggregated to protect privacy, caregiver profile data could be published as a “caregiver census” to inform further research and program design.
3. Secure messaging: The secure messaging tool would enable the caregiver to securely message with their coordinator and, eventually, other providers, to manage their care. Caregivers currently rely on phone, email, or resource-intensive in-person meetings to discuss aspects of care. As caregivers are often managing care for the Veteran, reducing the delay in conversation through a secure messaging system could increase caregiver engagement with the overall system of care and enable VA to improve care quality.
4. Resources: VA does not currently maintain a space for caregivers to easily find relevant resources customized to their needs. Navigating this dense network of tools and tips can be a challenge even for seasoned caregivers. To more effectively direct caregivers to existing programs, VA could implement a hub for VA-supported and -eligible resources.
To help with implementation, we created the above sample rollout plan and identified existing products that were similar to our proposed features. For instance, perhaps our portal could leverage identity and login functionality from VA’s myhealthevet, the existing veterans' online health administration platform. To build a caregiver portal, we would suggest an interdisciplinary team that would include a user experience designer, a technologist, and a product manager.
We are confident that our proposed solution has tremendous potential to impact the lives of both new and experienced caregivers, their Veterans, and improve the day-to-day experience of caregiving. We are hopeful and excited to see what DSVA and VA take from our team's work moving forward!
Thank you to DSVA and others across VA who partnered with us on this important project. Thank you to the DPI-663 teaching team for serving as mentors and advisors.
And most importantly, thank you to those within the caregiver space, from the experts to caregivers themselves, for providing us with insights from years of experience and analysis behind them. We have learned so much from you and stand with you!
Kate Spies, Dani Cinali, Amelia Sampat, Brandon Lee, and Matthew Spector