Add a Play #14: When it works, make it known.

[KateKrontiris]

In my experience, part of the reason that everyday Americans don't trust government is that they simply don't see its presence, authority, or resources in their everyday lives. There are lots of reasons for this, but sometimes, it is because government is actually working well, doing what it needs to do.

As part of the USDS Playbook, I would recommend adding a play: "When it works, make it known."

Just as a truly digital government should seek to understand what people need, it should also inform people when it has built a quality service in the manner that suits their needs. We citizens could serve to be reminded of the value that government offers to our lives when it works well, so that we can rebuild faith in public institutions.

[I got on Github for the first time so that I could make this comment. Apologies if I put it in the wrong place - and thanks for incorporating its intent into your process.]

[pburtchaell]

Your comment is in the correct place @KateKrontiris. Issues are the universal way of communicating on GitHub.

[cew821]

good idea @KateKrontiris! And welcome to Github! 👍

[wvchris]

OK, so let us talk about what works. Back in the late 1970's a small band of dedicated employees in the VA build a file keeping and specification system called the Distributed Health Care Programming (DHCP) system. It has served the VA for over 35 years an is still running the hospitals in the VA. It was adopted by the Department of Defense to run their nearly 200 hospitals around the world, they call it CHCS-1. The VA has changed the name of their success to the name VISTA. Both CHCS-1 and VISTA are still running hospitals in those organizations. The beauty of the model was that the end user had input to the applications and the databases are using the same tools for the most part. The Indian Health Service has also adapted the DHCP model to their needs as well. So three governmental services are using the same tool kits to different purposes. Now the VA and the DoD have both tried to break up the DHCP model so that COTS solutions can be substituted. But as adopted, the evolved VISTA model is over 160 different aspects of the hospital with their data stored in its relation to the patient. The data is integrated and able to be extended almost infinitely. The COTS products are too stilted and fixed to be adapted to the way that health care is practiced at each hospital and clinic. The Aphorism that "When you have seen one hospital, you have seen one hospital." is very true. Every hospital does their business slightly differently. The failure of the VA and the DoD has been that they have tried to nail down any change that may be developed in the field. By doing that they hasve robbed themselves of the brilliance of the people at the point of care and the both halves of the "Golden Pair", a Subject Matter Expert (physician/nurse/clerk/pharmacist/Radiologist/etc.) and a Programmer there to do rapid prototyping. Many times they can build in an evening an application that would take a commecial opperation 18 months to 2 years to complete. It was like this from the start with VISTA and MUMPS. Rapid Prototyping is second nature to the VISTA/MUMPS programmer. So as we have moved VISTA out of the VA and into Open Source. Doing so, we have fulfilled the return of VISTA to the people who paid for the government employees who made this tool kit possible. We are also expanding VISTA to what it should be, a continuously enhanced tool kit with a very powerful database that is both fast and scalable. VISTA is a very data driven model and can be extended in many ways to adapt to new data structures. It is bounded, but the boundaries of those bounds is very big. MUMPS can make a very small system look like a very big system. VISTA in the community hospitals has already saved the adopters a lot of money. It has helped these hospitals already get Meaningful Use 1 and well on their way to Meaningful Use 2.

[cew821]

@KateKrontiris This is a great point. We are brainstorming ways to allow people to tag a specific play with links to examples, or other resources relevant to the play. If folks have ideas about the best way to implement this, please chime in!

[KateKrontiris]

@cew821 That's great to hear - and thank you for following up ... really living out the intention of my suggestion, I see! :) Much appreciated. I'm actually working on a larger research project to try to understand why it is that most Americans have such a hard time actually "seeing" their government in their daily lives. I wrote a post about what I'm hoping to investigate and accomplish here (http://katekrontiris.com/post/97689649627/uhhhh-government#notes) and seeing collaborators of any stripe to take action on what we find. Hope the folks here want to be involved!