Every Last Day is A First Day: Why I’m Tackling Digital Health Care
By Misu Tasnim, Director, Digital Service at the Centers for Medicare & Medicaid Services
After three years with the U.S. Digital Service — many of which I spent heading our team of technologists at the Centers for Medicare & Medicaid Services (CMS) — I swiped my White House badge for the very last time. Soon I’ll be an official employee of CMS, building out a permanent digital service dedicated to removing access barriers to and increasing usability of the services provided by this government agency. Though the location will change, my mission will remain the same as the day I started at USDS: Make life easier for everyday Americans trying to interact with their government.
As I’m reflecting on this career transition and important milestone for the Centers for Medicare & Medicaid Services, I want to look back at my journey.
As the Child of Immigrants, I Had an Important Job in My Family
My parents are from Bangladesh and they made incredible sacrifices to bring me to the United States as a child. They worked tirelessly to make sure I had access to opportunities and stability they could only dream about, but I also had an important job in my family. As the child of immigrants who were navigating complex bureaucracies in a new country, I often served as their translator and shepherd.
While my friends spent time after school playing sports or joining school clubs, I helped my parents translate forms and study for their citizenship test.
Government jargon can be hard enough to decipher by native English speakers, so for a child with English as their second language, the tasks often seemed impossible. With every hurdle we overcame together, my respect and admiration for my parents’ resolute determination grew.
My parents pushed me to excel academically and professionally, but it wasn’t until I began working for USDS in the White House that my parents could put aside their concerns of when I would finally get married, and simply say “We are proud of you.” I yearned to make their lives easier and somehow pay them back for everything they had done for me, and working here gave me that opportunity.
Understanding Government Helped Me Understand My Parents
My lived experiences not only helped me find my professional purpose and gave me an understanding of the constituents my work would eventually help; my work also helped me better understand my parents.
Throughout my time at USDS, every conversation I had with my parents about work gave me better insight into the challenges they had — and still have — interfacing with the government. I developed a deeper appreciation of the work they had done to navigate through the levels of local, state, and federal government bureaucracy.
They did all of this while also carrying the emotional burden that comes with the complicated label of “legal alien;” a designation that entitled us to the possibilities and opportunities my parents left Bangladesh to pursue, but that also demarcated us as separate from American citizens. I learned to forgive my parents for the hours I spent after school, reading and translating forms instead of participating in sports teams like my friends.
Advocating for Plain Language and Multi-Language Translations
Plain language, accessible information, user-friendly digital services — these concepts may seem obvious to those of us in the tech industry, but when applied to government agencies, they can be transformative for hard-working people like my parents who are just trying to do the right thing.
By working for the USDS, I finally had a seat at the table to promote these concepts and to make life easier for everyday Americans trying to interact with their government.
Hired as a “Digital Service Expert,” I sat in large rooms of people and advocated for writing in plain language and translating instructions into multiple languages. I made sure that everyone I worked with understood the importance and value of user research and usability testing before launching products.
A close-knit partnership began to flourish between the USDS and the Centers for Medicare & Medicaid Services, and I was lucky enough to lead the team at that agency.
I stayed up late at night combing through regulations in order to make the case for digitizing the enrollment form for Medicare. I pushed to streamline identity authentication so that senior citizens could apply without leaving the safety of their homes, and could therefore maintain quarantine during the COVID-19 pandemic.
This essential work, which has improved the lives of millions of Americans, was made possible by the inspiring partnership between these two agencies. Through collaborative energy and a shared vision, the leadership of both USDS and the Centers for Medicare & Medicaid Services made distant possibilities a reality in a time of crisis.
We soon realized that the work we had done was only scratching the surface and that we had the ability to dive in and grapple with some of the agency’s most complicated challenges.
As the partnership between USDS and CMS thrived, so too did our sense of mutual trust and respect. The combination of revered subject matter experts at CMS matched with best-in-class technologists from USDS made for a winning equation.
Going Deep to Transform American Health Care
The work we seek to address together requires long-term commitment and continuity to really understand the depth of the businesses and systems we seek to change; therefore, it is with great excitement that I will work to build the Centers for Medicare & Medicaid Services’ very own permanent Digital Service. We will continue to work closely with USDS to ensure we are all aligned on achieving the same goals, regardless of the length of the engagement. This move acknowledges the steep learning curve required to understand the American health care system and marries with the amazing talent pipeline that USDS injects into government.
I am fortunate to transition the best — and most impactful — job I’ve ever had into a permanent organizational structure at an agency that provides services to over 140 million people. As with all good things, my term will eventually come to an end, but the Digital Service at the Centers for Medicare & Medicaid will remain — open to new cohorts of mission-driven technologists trying to build a modern interface with our government.
If you’re interested in the work we’ll be doing, consider applying for the Digital Service at the Centers for Medicare & Medicaid or to USDS.
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