>>Hello, and welcome to today's event, dealing government emergency responses beyond the pandemic. This is Bob Wooley, senior fellow for the center for digital government and formerly the chief tech clerk for the state of Utah. I'm excited to serve as moderator for today's event. And just want to say, thank you for joining us. I know we're in for an informative session over the next 60 minutes before we begin a couple of brief housekeeping notes or recording of this presentation will be emailed to all registrants within 48 hours. You can use the recording for your reference or feel free to pass it along to colleagues. 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We would like to hear what you think if you're unable to see with us for the entire webinar, but we're just like to complete the survey. As much as you're able, please click the survey widget at the bottom of the screen to launch the survey. Otherwise it will pop up once the webinar concludes at this time, we recommend that you disable your pop-up blockers, and if you experiencing any media player issues or have any other problems, please visit our webcast help guide by clicking on the help button at the bottom of the console. >>Joining me today to discuss this very timely topic are Karen revolt and Tim Burch, Kim Berge currently serves as the administrator of human services for Clark County Nevada. He's invested over 20 years in improving health and human service systems of care or working in the private public and nonprofit sectors. 18 of those years have been in local government in Clark County, Las Vegas, where you served in a variety of capacities, including executive leadership roles as the director of department of social services, as well as the director for the department of family services. He has also served as CEO for provider of innovative hosted software solutions, as well as chief strategy officer for a boutique public sector consulting firm. Karen real-world is the social program management offering lead for government health and human services with IBM Watson health. Karen focuses delivering exciting new offerings by focusing on market opportunities, determining unmet needs and identifying innovative solutions. >>Much of her career has been in health and human services focused on snap, TANIF, Medicaid, affordable care act, and child welfare prior to joining IBM. Karen was the senior director of product management for a systems integrator. She naturally fell in love with being a project manager. She can take her user requirements and deliver offerings. Professionals would use to make their job easier and more productive. Karen has also found fulfillment in working in health and human services on challenges that could possibly impact the outcome of people's lives. Now, before we begin our discussion of the presentation, I want to one, we'd like to learn a little more about you as an audience. So I'm going to ask you a polling question. Please take a look at this. Give us an idea of what is your organization size. I won't bother to read all these to you, but there are other a range of sizes zero to 250 up to 50,000. Please select the one that is most appropriate and then submit. >>It looks like the vast majority are zero to two 50. Don't have too many over 250,000. So this is a very, very interesting piece of information. Now, just to set up our discussion today, what I want to do is just spend just a moment and talk about the issue that we're dealing with. So when you look the COVID-19 pandemic, it's put immense pressure on States. I've been a digital state judge and had been judging a lot of the responses from States around the country. It's been very interesting to me because they bifurcate really into two principle kinds of reactions to the stress providing services that COVID environment present. One is we're in a world of hurt. We don't have enough money. I think I'm going to go home and engage as little as I have to. Those are relatively uncommon. Thankfully, most of them have taken the COVID-19 pandemic has immense opportunity for them to really do a lot more with telework, to do more with getting people, employees, and citizens involved with government services. >>And I've done some really, really creative things along the way. I find that to be a really good thing, but in many States systems have been overloaded as individuals and families throughout the country submitted just an unprecedented number of benefit applications for social services. At the same time, government agencies have had to contend with social distance and the need for a wholly different approach to engage with citizens. Um, overall most public agencies, regardless of how well they've done with technology have certainly felt some strain. Now, today we have the opportunity to go into a discussion with our speakers, have some wonderful experience in these areas, and I'm going to be directing questions to them. And again, we encourage you as you hear what they have to say. Be sure and submit questions that we can pick up later at the time. So Tim, let's start with you. Given that Las Vegas is a hub for hospitality. An industry hit severely as a result of this pandemic. How's the County doing right now and how are you prioritizing the growing needs of the County? >>Thanks Bob. Thanks for having me. Let me start off by giving just a little, maybe context for Clark County too, to our audience today. So, uh, Clark County is, you know, 85% of the state of Nevada if we serve not just as a regional County by way of service provision, but also direct municipal services. Well, if, uh, the famous Las Vegas strip is actually in unincorporated Clark County, and if we were incorporated, we would be the largest city in the state. So I say all of that to kind of help folks understand that we provide a mix of services, not just regional services, like health and human services, the direct and, and missable, uh, services as well as we work with our other five jurisdiction partners, uh, throughout the area. Uh, we are very much, um, I think during the last recession we were called the Detroit of the West. >>And, uh, that was because we're very much seen as a one industry town. Uh, so most like when the car plants, the coal plants closed back East and in the communities fuel that very rapidly, the same thing happens to us when tourism, uh, it's cut. Uh, so of course, when we went into complete shutdown and March, uh, we felt it very rapidly, not just on, uh, uh, tax receipts and collectibles, but the way in which we could deliver services. So of course our first priority was to, uh, like I think you mentioned mobilized staff. We, we mobilized hundreds of staff overnight with laptops and phones and cars and the things they needed to do to get mobile and still provide the priority services that we're mandated to provide from a safety standpoint. Um, and then we got busy working for our clients and that's really where our partnership with IBM and Watson, uh, came in and began planning that in July. And we're able to open that portal up in October to, to really speed up the way in which we're giving assistance to, to our residents. Um, re focus has been on making sure that people stay housed. We have, uh, an estimated, uh, 2.5 million residents and over 150,000 of those households are anticipated to be facing eviction, uh, as of January one. So we, we've got a, a big task ahead of us. >>All of this sounds kind of expensive. Uh, one of the common threads as you know, runs throughout government is, ah, I don't really have the money for that. I think I'd be able to afford that a diaper too, as well. So what types of funding has been made available for counties, a result of a pandemic, >>Primarily our funding stream that we're utilizing to get these services out the door has been the federal cares act. Uh, now we had some jurisdictions regionally around us and even locally that prioritize those funds in a different way. Um, our board of County commissioners, uh, took, um, a sum total of about $85 million of our 240 million that said, this will go directly to residents in the form of rental assistance and basic needs support. No one should lose their home or go hungry during this pandemic. Uh, so we've really been again working through our community partners and through our IBM tools to make sure that happens. >>So how does, how does, how does the cares act funding then support Clark County? Cause it seems to me that the needs would be complex, diverse >>Pretty much so. So as you, as folks may know him a call there's several tronches of the cares act, the original cares act funding that has come down to us again, our board, uh, identified basic needs or rental assistance and, and gave that the department of social service to go to the tunicate, uh, through the community. We then have the cares act, uh, uh, coronavirus relief funds that have, uh, impacted our CDBG and our emergency solutions grants. We've taken those. And that's what we was going to keep a lot of the programs and services, uh, like our IBM Watson portal open past January one when the cares act dollars expire. Uh, our initial response was a very manual one, uh, because even though we have a great home grown homeless management information system, it does not do financials. Uh, so we had 14 local nonprofits adjudicating, uh, this rental assistance program. >>And so we could get our social service visitor portal up, uh, to allow us to take applications digitally and run that through our program. Uh, and, uh, so those partners were obviously very quickly overwhelmed and were able to stand up our portal, uh, which for the reason we were driving so hard, even from, uh, beginning of the conversations where after going into lockdown into contracting in July and getting the portal open in October, which was an amazing turnaround. Uh, so the kudos that IBM team, uh, for getting us up and out the door so quickly, uh, was a tie in, uh, to our, uh, Curam IBM, uh, case management system that we utilize to adjudicate benefits on daily basis in Clark County for all our local indigent population, uh, and high needs folks. Uh, and then that ties into our SAP IBM platform, which gets the checks out the door. >>So what, what we've been able to do with these dollars is created in Lucian, uh, that has allowed us in the last 60 days to get as much money out the door, as our nonprofits were able go out the door in the first six months pandemic. So it really has helped us. Uh, so I'm really grateful to our board of County commissioners for recognizing the investment in technology to, to not only get our teams mobile, but to create ease of access for our constituents and our local residents to give them the help they need quickly and the way that they need it. >>Just to follow up question to that, Tim, that I'm curious about having done a lot of work like this in government, sometimes getting procurement through in a timely way is a bit challenging. How were you able to work through those issues and getting this up and provision so quickly? >>Uh, yeah, so we, we put together a, what we call a pandemic playbook, which is kind of lessons learned. And what we've seen is the folks who were essential workers in the first 60 days of the, uh, pandemic. We were able to get a lot done quickly because we were taking full advantage of the emergency. Uh, it may sound a little crass to folks not inside the service world, but it was, uh, you know, don't want you to crisis. It was things we've been planning or trying to do for years. We need them yesterday. We should have had them yesterday, but let's get them tomorrow and get it moving very quickly. Uh, this IBM procurement was something we were able to step through very quickly because of our longstanding relationship. Our countywide, uh, system of record for our financials is SAP. Uh, we've worked with Curam, uh, solution, uh, for years. >>So we've got this long standing relationship and trust in the product and the teams, which helped us build the business case of why we did it, no need to go out for competitive procurement that we didn't have time. And we needed something that would integrate very quickly into our existing systems. Uh, so that part was there. Now when the folks who were non essential came back in June and the reopening, it was whiplash, uh, the speed at which we were moving, went back to the pace of normal business, uh, which feels like hitting a wall, doing a hundred miles an hour when you're used to having that, uh, mode of doing business. Uh, so that's certainly been a struggle, uh, for all of those involved, uh, in trying to continue to get things up. Um, but, uh, once again, the teams have been great because we've probably tripled our licensure on this portal since we opened it, uh, because of working with outside vendors, uh, to, uh, literally triple the size of our staff that are processing these applications by bringing on temporary staff, uh, and short-term professionals. Uh, and so we've been able to get those things through, uh, because we'd already built the purchasing vehicle during the early onset of the crisis. >>That's very helpful. Karen, IBM has played a really pivotal role in all of this. Uh, IBM Watson health works with a number of global government agencies, raging from counties like Clark County to federal governments. What are some of the major challenges you've seen with your clients as a result of the pandemic and how is technology supporting them in a time of need and give us some background Watson health too. So we kind of know a little more about it because this is really a fascinating area. >>Yeah. Thank you, Bob. And thanks Tim for the background on Clark County, because I think Clark County is definitely also an example of what federal governments and global governments are doing worldwide today. So, um, Watson health is our division within IBM where we really focus on health and human services. And our goal is to really focus in on, um, the outcomes that we're providing to individuals and families and looking at how we use data and insights to really make that impact and that change. And within that division, we have our government health and human services area, which is the focus of where we are with our clients around social program. But it also allows us to work with, um, different agencies and really look at how we can really move the ball in terms of, um, effecting change and outcomes for, um, really moving the needle of how we can, uh, make an impact on individuals and families. >>So as we look at the globe globally as well, you know, everything that Tim had mentioned about how the pandemic has really changed the way that government agencies operate and how they do services, I think it's amazing that you have that pandemic playbook because a lot of agencies in the same way also had these set of activities that they always wanted to go and take part on, but there was no impetus to really allow for that to happen. And with the pandemic, it allowed that to kind of open and say, okay, we can try this. And unfortunately I'm in a very partial house way to do that. And, um, what Tim has mentioned about the new program that they set up for the housing, some of those programs could take a number of years to really get a program online and get through and allowing, uh, the agencies to be able to do that in a matter of weeks is amazing. >>And I think that's really gonna set a precedent as we go forward and how you can bring on programs such as the housing and capability in Canada with the economic, uh, social, um, uh, development and, and Canada need that the same thing. They actually had a multi benefit delivery system that was designed to deliver benefits for three programs. And as part of the department of fisheries and oceans Canada, the, um, the state had an emergency and they really need to set up on how they could provide benefits to the fishermen who had been at that impacted, um, from that. And they also did set up a digital front-end using IBM citizen engagement to start to allow the applications that benefits, um, and they set it up in a matter of weeks. And as I mentioned, we, uh, Clark County had a backend legacy system where they could connect to and process those applications. And this case, this is a brand new program and the case management system that they brought up was on cloud. And they had to set up a new one, but allow them to set up a, what we used to call straight through processing, I think has been now turned, turned or coined contact less, uh, processing and allowing us to really start to move those benefits and get those capabilities out to the citizens in even a faster way than has been imagined. Uh, pre pandemic. >>Karen, I have one follow-up question. I want to ask you, having had a lot of experience with large projects in government. Sometimes there's a real gap between getting to identified real requirements and then actions. How do you, how do you work with clients to make sure that process time to benefit is shortened? >>So we really focus on the user themselves and we take a human centered design focus and really prioritizing what those needs are. Um, so working with the clients, uh, effectively, and then going through agile iterations of brain, that capability out as, um, in, in a phased approach to, so the idea of getting what we can bring out that provides quality and capability to the users, and then over time starting to really roll out additional functions and, um, other, uh, things that citizens or individuals and families would need >>Very helpful. Tim, this is an interesting partnership. It's always good to see partnerships between private sector and government. Tell us a little bit about how the partnership with IBM Watson health was established and what challenges or they were brought into assist, where they brought into assist with back to requirements. Again, within the requirements definitely shifted on us. You know, we had the con looking at, uh, Watson on our child welfare, uh, side of the house that I'm responsible for and how that we could, uh, increase access to everything from tele-health to, to, uh, foster parent benefit, uh, kinship, placement benefits, all those types of things that, that right now are very manual, uh, on the child welfare side. Uh, and then the pandemic kid. And we very quickly realized that we needed, uh, to stand up a, um, a new program because, uh, a little bit for context, uh, the park County, we don't administer TANIF or Medicaid at the County level. >>It is done at the state level. So we don't have, uh, unemployment systems or Medicaid, 10 of snap benefits systems to be able to augment and enroll out. We provide, uh, the indigent supports the, the homelessness prevention, referee housing continuum of care, long-term care, really deep emergency safety net services for our County, which is a little bit different and how those are done. So that was really our focus, which took a lot of in-person investigation. We're helping people qualify for disability benefits so they can get into permanent supportive housing, uh, things that are very intensive. And yet now we have a pandemic where we need things to happen quickly because the cares act money expires at the end of December. And people were facing eviction and eviction can help spread exposure to, to COVID. Uh, so, uh, be able to get in and very rapidly, think about what is the minimal pelvis to MVP. >>What's the minimum viable product that we can get out the door that will help people, uh, entrance to a system as contactless as possible, which again was a complete one 80 from how we had been doing business. Um, and, uh, so the idea that you could get on and you have this intelligent chat bot that can walk you through questions, help you figure out if you look like you might be eligible, roll you right into an application where you can upload the few documents that we're going to require to help verify your coat would impact and do that from a smartphone and under, you know, 20 minutes. Um, it, it, it is amazing. And the fact that we've stood that up and got it out the door in 90 days, it's just amazing to me, uh, when it shows the, uh, strength of partnership. Um, I think we can, we have some shared language because we had that ongoing partnership, but we were able to actually leverage some system architects that we had that were familiar with our community and our other products. So it really helped expedite, uh, getting this, uh, getting this out to the citizens. >>So, uh, I assume that there are some complexities in doing this. So overall, how has this deployment of citizen engagement with Watson gone and how do you measure success other than you got it out quick? How do you know if it's working? >>Yeah. Right. So it's the adage of, you know, quick, fast and good, right. Um, or fast, good and cheap. So, uh, we measure success in this way. Um, how are we getting access as our number one quality measurement here? So we were able to collect, uh, about 13,000 applications, uh, manual NRC, manually folks had to go onto our website, download a PDF, fill it out, email it, or physically drop it off along with their backup. One of their choice of 14 non-profits in town, whichever is closest to them. Um, and, uh, and then wait for that process. And they were able to get 13,000 of those, uh, process for the last six months. Uh, we have, I think we had about 8,000 applications the first month come into the portal and about an equal amount of folks who could not provide the same documentation that it was needed. >>And self-selected out. If we had not had the, the tool in place, we would have had 16,000 applications, half of which would have been non-eligible would have been jamming up the system, uh, when we don't have the bandwidth to deal to deal with that, we, we need to be able to focus in on, uh, Judy Kenny applications that we believe are like a 95% success rate from the moment our staff gets them, but because we have the complex and he was on already being dependent upon the landlord, having to verify the rent amount and be willing to work with us, um, which is a major hurdle. Um, but, uh, so w we knew we could not do is go, just reinvent the manual process digitally that that would have been an abject failure on our behalf. So, uh, the ideas that, uh, folks had can go on a very, had this very intuitive conversation to the chat bot, answer some questions and find out if they're eligible. >>And then self-select out was critical for us to not only make sure that the citizens got the help they needed, but not so burnt out and overload our workforce, which is already feeling the strain of the COVID pandemic on their own personal lives and in their homes and in the workplace. Um, so that was really critical for us. So it's not just about speed, ease of access was important. Uh, the ability to quickly automate things on the fly, uh, we have since changed, uh, the area median income, a qualifier for the rental assistance, because we were able to reallocate more money, uh, to the program. So we were able to open it up to more people. We were able to make that, uh, change to the system very quickly. Uh, the idea that we can go on the home page and put updates, uh, we recognized that, uh, some of our monolingual Hispanic residents were having difficulty even with some guidance getting through the system. >>So we're able to record a, a Spanish language walkthrough and get done on the home page the next day, right into the fordable, there'll be a fine, so they could literally run the YouTube video while they're walking through their application. Side-by-side so things like that, that those are how we are able to, for us measured success, not just in the raw dollars out the door, not just in the number of applications that have come in, but our ability to be responsive when we hear from our constituents and our elected officials that, Hey, I want, I appreciate the 15,000 applications as you all, a process and record time, I've got three, four, five, six, 10 constituents that having this type of problem and be able to go back and retool our systems to make them more intuitive, to do, be able to keep them responsive for us is definitely a measure of success and all of this, probably more qualitative than here we're looking >>For, but, uh, that's for us, that's important. Actually the qualitative side is what usually gets ignored. Uh, Karen, I've got a question that's a follow up for you on the same topic. How does IBM facilitate reporting within this kind of an environment given the different needs of stakeholders, online managers and citizens? What kinds of things do you, are you able to do >>So with, um, the influx of digitalization? I think it allows us to really take a more data-driven approach to start looking at that. So, as, as Tim was mentioning, you can see where potentially users are spending more time on certain questions, or if they're stuck on a question, you can see where the abandoned rate is. So using a more data-driven approach to go in to identify, you know, how do we actually go and, um, continue to drive that user experience that may not be something that we drive directly from the users. So I would say that analytics is really, uh, I think going to continue to be a driving force as government agencies go forward, because now they are capturing the data. But one thing that they have to be careful of is making sure that the data that they're getting is the right data to give them the information, to make the right next steps and decisions. >>And Tim, you know, use a really good example with, um, the chatbot in terms of, you know, with the influx of everything going on with COVID, the citizens are completely flooded with information and how do they get the right information to actually help them decide, can I apply for this chap program? Or should I, you know, not even try and what Tim mentioned just saved the citizens, you know, the people that may not be eligible a lot of time and going through and applying, and then getting denied by having that upfront, I have questions and I need answers. Um, so again, more data-driven of how do we provide that information? And, you know, we've seen traditionally citizens having to go on multiple website, web pages to get an answer to the question, because they're like, I think I have a question in this area, but I'm not exactly sure. And they, then they're starting to hunt and hunt and hunt and not even potentially get an answer. So the chocolate really like technology-wise helps to drive, you know, more data-driven answers to what, um, whether it's a citizen, whether it's, um, Tim who needs to understand how and where my citizens getting stuck, are they able to complete the application where they are? Can we really get the benefits to, um, this individual family for the housing needs >>Too many comments on the same thing. I know you have to communicate measures of success to County executives and others. How do you do that? I mean, are you, do you have enough information to do it? Yeah, we're able to, we actually have a standup meeting every morning where the first thing I learn is how many new applications came in overnight. How many of those were completed with full documentation? How many will be ported over into our system, assigned the staff to work, where they're waiting >>On landlord verification. So I can see the entire pipeline of applications, which helps us then determine, um, Oh, it's, it's not, you know, maybe urban legend is that folks are having difficulty accessing the system. When I see really the bottleneck there, it got gotten the system fine, the bottlenecks laying with our landlord. So let's do a landlord, a town hall and iterate and reeducate them about what their responsibilities are and how easy it is for them to respond with the form they need to attest to. And so it lets us see in real time where we're having difficulties, uh, because, uh, there's a constant pressure on this system. Not just that, uh, we don't want anyone to lose their home, uh, but these dollars also go away within a December. So we've got this dual pressure of get it right and get it right now. >>Uh, and so th the ability to see these data and these metrics on, on a daily basis is critical for us to, to continue to, uh, ModuLite our response. Um, and, and not just get comfortable are baked into well, that's why we developed the flowchart during requirements, and that's just the way things are gonna stay. Uh, that's not how you respond to a pandemic. Uh, and so having a tool and a partner that helps us, uh, stay flexible, state agile, I guess, to, to, to leverage some terminology, uh, is important. And, and it's, it's paid dividends for our citizens. Karen, again, is another up to the same thing. I'm kind of curious about one of the problems of government from time to time. And Tim, I think attest to this is how do you know when Dunn has been reached? How did you go about defining what done would look like for the initial rollout with this kind of a customer? >>So I think Doug, I guess in this case, um, is, is this, isn't able to get the benefits that they're looking for and how do we, uh, you know, starting from, I think what we were talking about earlier, like in terms of requirements and what is the minimum viable, um, part of that, and then you start to add on the bells and whistles that we're really looking to do. So, um, you know, our team worked with him to really define what are those requirements. I know it's a new program. So some of those policy decisions were still also being worked out as the requirements were being defined as well. So making sure that you are staying on top of, okay, what are the key things and what do we really need to do from a compliance standpoint, from a functionality, and obviously, um, the usability of how, uh, an assistant can come on and apply and, um, have those, uh, requirements, make sure that you can meet that, that version before you start adding on additional scope. >>Very helpful. Jim, what's your comment on this since I know done matters to you? Yeah. And look, I I've lived through a, again, multiple, uh, county-wide it implementations and some department wide initiatives as well. So I think we know that our staff always want more so nothing's ever done, uh, which is a challenge and that's on our side of the customer. Um, but, uh, for this, it really was our, our experience of recognizing the, the time was an essence. We didn't have a chance. We didn't have, uh, the space to get into these endless, uh, conversations, uh, the agile approach, rather than doing the traditional waterfall, where we would have been doing requirements tracking for months before we ever started coding, it was what do we need minimally to get a check in the hands of a landlord on behalf of a client, so they don't get evicted. >>And we kept just re honing on that. That's nice. Let's put that in the parking lot. We'll come back to it because again, we want to leverage this investment long term, uh, because we've got a we, and we've got the emergency solutions and CDBG, and then our, uh, mainstream, uh, services we brought on daily basis, but we will come back to those things speed and time are of the essence. So what do we need, uh, to, to get this? So a chance to really, um, educate our staff about the concepts of agile iteration, um, and say, look, this is not just on the it side. We're gonna roll a policy out today around how you're doing things. And we may figure out through data and metrics that it's not working next week, and we'll have to have that. You want it. And you're going to get the same way. >>You're getting updated guidance from the CDC on what to do and what not to do. Uh, health wise, you're getting the same from us, uh, and really to helping the staff understand that process from the beginning was key. And, uh, so, and, and that's, again, partnering with, with our development team in that way was helpful. Um, because once we gave them that kind of charter as I am project champion, this is what we're saying. They did an equally good job of staying on task and getting to the point of is this necessary or nice. And if it wasn't necessary, we put it in the nice category and we'll come back to it. So I think that's really helpful. My experience having done several hundred sheet applications also suggest the need for MBP matters, future stages really matter and not getting caught. My flying squirrels really matters. So you don't get distracted. So let's move on to, let's do a polling question before we go on to some of our other questions. So for our audience, do you have a digital front ends for your benefit delivery? Yes, no. Or we're planning to a lot of response here yet. There we go. Looks like about half, have one and half note. So that's an interesting question. What's going to one more polling question, learn a little more here. Has COVID-19 >>Accelerated or moved cloud. Yes, no. We already run a majority of applications on cloud. Take a moment and respond if you would, please. So this is interesting. No real acceleration was taken place and in terms of moving to cloud is not what I was expecting, but that's interesting. So let's go onto another question then. And Karen, let me direct this one to you, given that feedback, how do you envision technologies such as citizen engagement and watching the system will be used, respond to emergency situations like the pandemic moving forward? I mean, what should government agencies consider given the challenges? This kind of a pandemic is brought upon government and try to tie this in, if you would, what, what is the role of cloud in all of this for making this happen in a timely way? Karen, take it away. >>Okay. Thanks Bob. So as we started the discussion around the digital expansion, you know, we definitely see additional programs and additional capabilities coming online as we continue on. Um, I think, uh, agencies have really seen a way to connect with their citizens and families and landlords, um, in this case an additional way. And he prepared them like there were, uh, presuppose assumptions that the, um, the citizens or landlords really wanted to interact with agency face-to-face and have that high touch part. And I think, um, through this, the governments have really learned that there is a way to still have an impact on the citizen without having a slow, do a face to face. And so I think that's a big realization for them to now really explore other ways to digitally explain, expand their programs and capabilities. Another area that we touched on was around the AI and chat bot piece. >>So as we start to see capabilities like this, the reason why Clark County was able to bring it up quickly and everything was because it was housed on cloud, we are seeing the push of starting to move some of the workloads. I know from a polling question perspective that it's been, um, lighter in terms of getting, uh, moving to the cloud. But we have seen the surge of really chatbots. I think we've been talking about chatbots for a while now. And, um, agencies hadn't really had the ability to start to implement that and really put it into effect. But with the pandemic, they were able to bring things up and, you know, very short amount of time to solve, um, a big challenge of not having the call center be flooded and have a different way to direct that engagement between the citizen and the government. >>So really building a different type of channel for them to engage rather than having to call or to come into an office, which wasn't really allowed in terms of, um, the pandemic. Um, the other thing I'll touch on is, um, 10 mentioned, you know, the backlog of applications that are coming in and we're starting to see the, um, the increase in automation. How do we automate areas where it's administratively highly burdened, but it's really a way that we can start to automate those processes, to give our workers the ability to focus on more of those complex situations that really need attention. So we're starting to see where the trends of trying to push there of can we automate some of those processes, um, uh, uploading documents and verification documents is another way of like, trying to look at, is there a way that we can make that easier? >>Not only for the applicant that's applying, but also for the caseworker. So there's not having to go through that. Um, does the name match, um, the applicant, uh, information and what we're looking on here, and Bob, you mentioned cloud. So behind the scenes of, you know, why, uh, government agencies are really pushing the cloud is, um, you heard about, I mean, with the pandemic, you see a surge of applicants coming in for those benefits and how do we scale for that kind of demand and how do you do that in an inappropriate way, without the huge pressures that you put on to your data center or your staff who's already trying to help our citizens and applicants, applicants, and families get the benefits they need. And so the cloud, um, you know, proposition of trying, being able to be scalable and elastic is really a key driver that we've seen in terms of, uh, uh, government agencies going to cloud. >>We haven't really seen during a pandemic, the core competencies, some of them moving those to cloud, it's really been around that digital front end, the chat bot area of how do we start to really start with that from a cloud perspective and cloud journey, and then start to work in the other processes and other areas. Um, security is also huge, uh, focus right now with the pandemic and everything going online. And with cloud allows you to be able to make sure that you're secure and be able to apply the right security so that you're always covered in terms of the type of demand and, um, impact, uh, that is coming through >>Very helpful. Tim, I'm going to ask to follow up on this of a practical nature. So you brought this up very quickly. Uh, there's a certain amount of suspicion around state government County government about chatbots. How did you get a chat much and be functional so quickly? And were you able to leverage the cloud in this process? Yeah, so on the trust is important. Uh, and I'll go back to my previous statement about individuals being able to see upfront whether they believe they're eligible or not, because nothing will erode trust more than having someone in hours applying and weeks waiting to find out they were denied because they weren't eligible to begin with, uh, that erodes trust. So being able to let folks know right up front, here's what it looks like to be eligible, actually help us build some of that, uh, cause they don't feel like, uh, someone in the bureaucracy is just putting them through the ringer for no reason. >>Um, now in regard to how do we get the chat bot out? I will say, uh, we have a, uh, dynamic it and leadership, uh, team at the highest level of County government who we have been already having conversations over the last year about what it meant to be smart government, uh, the department of social service and family services that I'm responsible for. We're already, uh, hands up first in line, you know, Guinea pigs volunteering to be on the front end of, uh, certain projects. So w we have primed ourselves for, for some of this readiness in that aspect. Um, but for citizen trust, um, the timeliness of application right now is the biggest element of trust. Uh, so I've applied I've I feel like I put my housing future in your hands. Are you going to deliver and having the ability for us to rapidly scale up? >>Uh, we typically have 120 staff in the department of social service that, that are adjudicating benefits for programs on daily basis. We've doubled that with temporary staff, uh, through some partnerships, uh, we're, we're gonna, as of next week, probably have more temporary per professional staff helping an adjudicator applications. No, do full-time County staff, because again, this rush to get the dollars out, out the door. So having a system where I can easily, uh, ramp on new users and manage them without having to be solely dependent upon an already, uh, overworked it staff who were trying to support 37 other departments in the County, um, around infrastructure needs has been greatly helpful. Sounds to me like a strong outcome focus and one that seems to work. Let's move on now to our audience questions. We're getting close to the end of our time. So let's jump into some questions from the audience. A number of you have been asking about getting copies of today's presentation within the next 48 hours. Government technology will provide all attendees with the link to the recording for your reference, or to share with colleagues. Well, let's go to our first question. So this is an interesting one. And Karen, this is for you did IBM work with other counties and States to provide digital engagement portals. >>We did Bob, uh, we've worked, um, so globally we've provided guidance on this. We work closely with New York city. They've been the integral part of the development also with our citizen engagement offering. Um, we work closely with the States. So we worked with New York city. Um, North Carolina was also another state who, um, improved their, uh, citizen engagement piece, bring up their Medicaid and snap, um, applications along with Medicaid. COVID testing along that. And I mentioned, um, the economic and social development in Canada as well. And we also work with the ministry of social development in Singapore. So a number of our customers had put up, uh, a global, uh, or sorry, a citizen engagement frontend. And during this timeframe, >>Very helpful. I don't know how much did you hear your mom provide you, but how much did it cost for initial deployment and what are the ongoing costs in other words, is this thing going to be sustainable over time? >>Yeah, absolutely. So total, uh, to date, we've spent about a $1.8 million on development implementations and licensure. A big chunk of that again has been the rapid extended of licensure, uh, for this program. Um, I think over a third of that is probably licensing because again, we need to get the dollars out and we need staff to do that and making the short term several hundred thousand dollar investment in a professional support staff and having them be able to work this portal is much cheaper than the long-term investment of bringing on a staff, printing a job, uh, during a financial difficulty that we're facing, uh, the single largest fiscal cliff let's get into that us history. Um, so it's not smart to create jobs that have a 30 year, one way to retirement, uh, inside our in unionized government environment here. So having this, the staff that would come on and do this and get out the door on these federal dollars was critical for us. Um, and there is a $800,000 a year, I believe so ongoing costs associated with licensure and, and the programming support. Uh, but once again, we're going to be moving, um, our traditional services into this digital front end. We'll be continuing this because we're, we're, we're facing, it took us, I think, six and a half, seven years to come back from the previous recession. Undoubtedly, take a little longer to get back >>From this one. Here's another interesting question, I guess really primarily Tim Tim was the solution on primarily on premise or in the cloud. >>So we'll, we've done a mix. Uh, the, and I'm starting a lot of feedbacks. I don't know if you all can hear that or not, but the, uh, I think we went on prem for, uh, some people because of the, uh, bridge into our service case manager system, which is on prem. So we did some management there. I do believe the chat bot piece of it though is in the cloud. So we're bringing it down to, from one system to the other. Uh, and, and part of that was a student negotiations and costs and worrying about what long-term is that we have a very stated goal of moving, uh, our Curam platform, which is on-prem, this is the backend. So how are we? We, we set our IBM Watson, uh, portal up, uh, and moving all of that on cloud, uh, because I mean, we've got, uh, a workforce who, uh, has the ability to retire at a very high rate over the next five years. >>And, uh, having 24 seven support in the cloud is, is as a, someone who would be called to respond to emergency situations like the is, is a much better Cod deal for, for myself and the citizen. So migrating, uh, and, um, our typical on-prem stuff up into the cloud, uh, as we continue on this, uh, evolution of what IBM Watson, uh, and the plug into our Curam, uh, system looks like Karen related question for another user is the portal provided with Clara County and others linked to other third-party backend office apps, or can it be, >>Yeah, the answer is it can be it's interoperable. So through APIs, uh, rest, uh, however, um, assistance that they need to be integrated with can definitely be integrated with, uh, like, uh, Tim mentioned, we, we went to the case management solution, but it can be integrated with other applications as well. >>Tim, did you use some other backend third party apps with yours? Uh, we did not. Uh, again, just for speed of getting, uh, this MVP solution out the door. Uh, now what we do with that on the go forward, it is going to look different and probably will include some, another practical question. Given the cares funding should be expended by December. Can this application even be employed at this late date? And you want to take a cut at that? Yeah, for us, uh, once again, we brought up earlier, um, the emergency solutions grants and the community development block grants, which have a Corona virus, uh, CV traunch, each one of those, and those have two to three year expenditure timeframes on them. Uh, so we were going to leverage those to keep this system and some of these programs going once again, that the housing needs, uh, will outstrip our capacity for years to come. >>I guess probably I should have said upfront Las Vegas has one of the worst affordable housing inventories in the nation. Uh, so we know we're going to be facing a housing issue, um, because of this for, for a long time. So we'll be using those two traunches of dollars, ESE, ESPs, uh, CV CDBG, CB funds, uh, in addition to dollars earmarked through some, uh, recreational marijuana license fees that have been dedicated to our homelessness. And when you consider this housing, uh, stability program was part of that homelessness prevention. That's our funding mix locally. Very helpful. So questions maybe for bolts for you on this one, you can probably also teach respond is the system has been set up helping the small business community. Um, this user's been canvassing and the general feeling is that small businesses have been left behind and they've been unable to access funds. What's your response on that? Karen, do you want to take that first? >>Um, yes. So in terms of, uh, the security and sorry. Um, but, uh, can you repeat the last part of that? I just missed the last part when you >>Behind it, but unable to access funds. >>Uh, yeah, so I think from a funding perspective, there's different types of, I think what Tim mentioned in terms of the cares funding, there was different types of funding that came out from a government perspective. Uh, I think there were also other grants and things that are coming out one, uh, that we're still looking at. And I think as we go into the new year, it'll be interesting to see, you know, what additional funding, um, hopefully is, is provided. Uh, but in terms of creativity, we've seen other creative ways that organizations come together to kind of, uh, help with the different agencies, to provide some, some guidance to the community, um, and helping to, uh, provide efforts and, uh, maybe looking at different ways of, um, providing, uh, some of the capabilities that the, either at the County or at the state level that they're able to leverage. But Tim happy to maybe have you chime in here too. >>Yeah. So I'll first start with my wheelhouse and I'll expand out to, to some of my partners. Uh, so the primary, small business, we knew the idea was a daily basis inside this realm is going to be landlords. Uh, so actually this afternoon, we're doing a town hall with folks to be able to roll out, uh, which they will go to our portal to find a corporate landlord program. Uh, so that I seem a landlord for Camille the application pack and on behalf of a hundred residents, rather than us having to adjudicate a hundred individual applications and melon a hundred checks. Uh, so that is because we were listening to that particular segment of the, uh, the business community. Now I know early on, we were, we were really hoping that the, the paycheck protection program federally would have, uh, been dispersed in a way that helped our local small businesses. >>Uh, more we did a, our economic development team did a round of small business supports through our cares act. Uh, our quarterly unfortunate was not open yet. It was just about 15, 20 days shy. So we use, uh, another traditional grant mechanism that we have in place to dedicate that. Uh, but on a go forward board, willing to Congress passes something over the next 30 days, um, that if there's a round two of cares or some other programs, we absolutely now have a tool that we know we can create a digital opening for individuals to come figure out if they're eligible or not for whatever program it is, the it housing, the it, uh, small business operations supports, uh, and it would apply through that process and in a very lightweight, so we're looking forward to how we can expand our footprint to help all of the needs that are present in our community. This leads to another question which may be our last one, but this is an interesting question. How can agencies use COVID-19 as a proof point providing a low cost configurable solutions that can scale across government. Karen, do you want to respond to that? And then Tim also, >>Thanks, Bob. So I believe like, you know, some of the things that we've said in terms of examples of how we were able to bring up the solution quicker, I definitely see that scaling as you go forward and trying to really, um, focus in on the needs and getting that MVP out the door. Uh, and then Tim alluded to this as well. A lot of the change management processes that went into re-imagining what these processes look like. I definitely see a additional, you know, growth mindset of how do we get better processes in place, or really focusing on the core processes so that we can really move the ball forward and continuing to go that path of delivering on a quicker path, uh, leveraging cloud, as we mentioned of, um, some, some of the capabilities around the chat bot and other things to really start to push, um, uh, the capabilities out to those citizens quicker and really reduce that timeline that we have to take on the backend side, um, that that would be our hope and goal, um, given, you know, sort of what we've been able to accomplish and hoping using that as a proof point of how we can do this for other types of, uh, either programs or other processes. >>Yeah, I think, um, the, you know, the tool has given us capability now there, whether we use local leaders leverage that to the fullest really becomes a coming upon us. So do we take a beat, uh, when we can catch our breath and then, you know, work through our executive leadership to say, look, here's all the ways you can use this tool. You've made an enterprise investment in. Um, and I know for us, uh, at Clark County, we've stood up, uh, enterprise, uh, kind of governance team where we can come and talk through all of our enterprise solutions, uh, encourage our other department head peers, uh, to, to examine how you might be able to use this. Is there a way that, um, you know, parks and rec might use this to better access their scholarship programs to make sure that children get into youth sports leagues and don't get left out, uh, because we know youth suicide on the rise and they need something positive to do when this pandemic is clear, I'm there for them to get out and do those things. >>So the possibilities really are out there. It really becomes, um, how do we mind those internally? And I know that being a part of listservs and, uh, you know, gov tech and all the magazines and things are out there to help us think about how do we better use our solutions, um, as well as our IBM partners who are always eager to say, Hey, have you seen how they're using this? Um, it is important for us to continue to keep our imaginations open, um, so that we continue to iterate through this process. Um, cause I, I would hate to see the culture of, um, iteration go away with this pandemic. >>Okay. We have time for one final question. We've already addressed this in part two, and this one is probably for you and that you've used the cares act to eliminate some of the procurement red tape that's shown up. Well, how do you somehow that's been very positive. How do you see that impacting you going forward? What happens when the red tape all comes back? >>Yeah, so I think I mentioned a little bit, uh, about that when some of the folks who are deemed non essential came back during our reopening phases and they're operating at the speed of prior business and red tape where we had all been on this, these green tape, fast tracks, uh, it, it was a bit of a organizational whiplash. Uh, but it, for us, we've had the conversation with executive management of like, we cannot let this get in the way of what our citizens need. So like keep that pressure on our folks to think differently. Don't and, uh, we've gone so far as to, uh, even, uh, maybe take it a step further and investigate what had been done in, in, in Canada. Some other places around, um, like, like going right from in a 48 hour period, going from a procurement statement through a proof of concept and doing purchasing on the backside, like how can we even get this even more streamlined so that we can get the things we need quickly, uh, because the citizens don't understand, wait, we're doing our best, uh, your number 3000 and queue on the phone line that that's not what they need to hear or want to hear during times of crisis. >>Very helpful. Well, I want to be respectful of our one hour commitment, so we'll have to wrap it up here in closing. I want to thank everyone for joining us for today's event and especially a big, thank you goes to Karen and Tim. You've done a really great job of answering a lot of questions and laying this out for us and a special thanks to our partners at IBM for enabling us to bring this worthwhile discussion to our audience. Thanks once again, and we look forward to seeing you at another government technology event,

>>From around the globe. It's the cube with digital coverage of AWS reinvent 2020 sponsored by Intel and AWS. >>Welcome back to the cubes live coverage of AWS reinvent 2020 I'm Lisa Martin and I have with me a cube alumni back, please. Welcome Scott Mullins, the worldwide financial services business development leader at AWS. Scott. Welcome back. Great to have you joining us, >>Lisa. It's great to be back on the cube and to be visiting with you today from virtual re-invent 2020. >>Yes. Reinventing reinvent. The last show that I got to host in-person for the cube was reinvent last year. And here we have this three week virtual event that started last week. So lots more even going on. I think I even saw a hundred thousand or so registered, so massive event, lots of news. So walk us through some of the highlights that have been announced at reinvent this year and some of the things that you're seeing the most interest from customers in. >>Well, I think one of the big highlights is 500,000 registrants that are reinvented 50,000 attendees last year to reinvent or 50,000 or so to 500,000 re registered for the event. So that's, that's, that's worth talking about in its own. Right. But I think, you know, one of the things, and you mentioned this, you know, more re-invent three weeks, uh, this year, as opposed to the four days that we normally spend in Las Vegas together, physically, when you do, when you do it digitally, you have the ability to actually include more things and more leaders talking about things. And so when we think about the announcements that are having impacts, uh, with financial services customers specifically I'd point to a couple of things and, you know, they're obviously gonna mention Andy's keynote, but there's going to be some things that you might go wait a minute. >>I didn't even see that announcement. Uh, and then maybe I could point you and the viewers to some other, other, um, keynotes or some other sessions that were announced. So obviously I think, uh, first and foremost in Andy's keynote, uh, hybrid, uh, was something that was a very, uh, big focus for him and I for a very long time, we've had the messaging of the right tool for the right job when it comes to any of your services. I think you could alter that today to say it's the right tool for the right job at the right time and in the right place. That makes sense for you and especially for financial institutions. Um, you could look at the announcements around containers, the announcements around Amazon EKS, distro, Amazon EKS, anywhere, and then also Amazon ECS anywhere, which allows our customers to actually, uh, put AWS container technology anywhere they would like to put it. >>You could look also at the additions of the one you and two you form factors to outposts. So no longer do you have to do the, the, the large for you, uh, foreign factor for outposts, smaller outposts for smaller spaces, uh, that particular will play well in the financial service industry. You may not have necessarily as much room for a full cabinet. You could also look from the hybrid perspective in the announcement we made, um, around red hat OpenShift on AWS, all of are giving customers the ability to choose how they actually want to deploy, um, and pursue a hybrid. I'd also point to some announcements we made around management and governance in the financial services, industry governance, uh, is a very important topic. Uh, we announced the management and government lens for the AWS well architected, um, uh, program, uh, that is focused on breath practices for evolving governance for the cloud. >>It has recommended combination of AWS services integrations with our partner network and vetted reference architectures and guidance for addressing regulatory obligations as well. I'd also point to some things we made around audits. I was specifically in Steve Smith's, um, session today, he talked about AWS audit manager. That's a new tool for continually assessing areas and environments for controls or risk compliance. That includes prebuilt compliance frameworks for things like PCI DSS and GDPR, uh, two things that are very important in the financial services industry and last, but certainly not least I'd point to the announcement around the AWS audit Academy. This is training for auditors to actually be able to audit clouds from an agnostic perspective. Any cloud, not specifically AWS that's tree, uh, digital training to do that. And then also an instructor led course specifically on how to audit AWS. So some very key announcements, both from the standpoint of services, uh, as well as additional layers of helping customers in the financial services industry in regulated industries actually use our services. >>So typical, re-invent typical in a lot of news, a lot of announcements, the 500,000 Mark in terms of registering. I hadn't heard that. That's amazing. Let's talk that this has been an Andy. Jassy had an exclusive with John furrier just a couple of weeks ago before. I think it was last week, actually. And we've been talking about this acceleration of digital business transformation because of COVID we've been talking about it, the entire pandemic on the virtual cube, talking about how companies it's really about right now, surviving and thriving to be able to go forward and companies that haven't accelerated are probably in some trouble. Talk to me about how AWS has been working with your financial services customers to help them pivot and move to the cloud faster, really to not just help them survive now, but thrive in the long-term. >>Yeah. Immediately when COVID hit and it hit at different times in different, in different parts of the world. Immediately when COVID hit, we saw the conversation that we were having turning from, Hey, what's my digital strategy to immediately, what are my digital capabilities? And what that really means is what do I have the ability to do tomorrow? Because tomorrow is going to really matter. I don't have necessarily the time to plan for the next several quarters or the next several years, what can I do tomorrow to, um, really, uh, support my, my own workforce and support my own customers and the obligations I have as a financial institution. The first thing we saw people do was to try and make sure that those who financial services work can work. You can look at the adoption of Amazon workspaces, as well as our, uh, Amazon connect, uh, call centers as a service. >>As two examples there at the RBL bank in India was able to move to Amazon workspaces in just 10 days to enable its teams to actually work remotely from home. When they couldn't come into the office, you can look at Barclays. Barclays is actually a presenter at re-invent this year. They'll have a session on how they use Amazon connect, which again is our call center as a service offering to enable 25,000 contacts and our agents to work from home when they can no longer work out of the, out of their traditional contact center. The second thing we saw a financial institutions joining was making sure that customer engagements could still be meaningful when digital was the only option, um, specifically here in the U S you could look at the work that each of us did with FinTech companies like biz two X or fins Zack, or BlueVine Stripe and cabbage in support of the care act in the U S you might remember that the cares act, um, hasn't provisions for funding for small businesses. >>This small business administration had a program called the paycheck protection program, and those organizations were active in providing funding, uh, to small businesses. Uh, through that program. I'll give you an example of cabbage cabbage had previously not been an SBA lender, um, but they were able to, in two weeks build a fully automated system for small businesses to access PPP funding using Amazon text track, to extract information from documentation that those folks submitted to get alone. That reduced approval times from multiple days to about a median of four hours to actually get approval, to get funding through the PPP program. And then just four months cabbage became the second largest PPP lender. They lent over $7 billion in funding, which was twice the amount of funding that they went last year in 2019 loans. So we were happy to support organizations like cabbage and those other FinTech companies, as they help small businesses in the U S get access to funding, uh, during this critical time. >>And as we know, as you said, critical time, but really life or death for a lot of businesses. And as we continue to go through these ways, but it's interesting that you talked about that the speed of facilitation that during such unprecedented times, AWS and this massive machine was able to continue moving at full speed ahead and helping those customers to pivot. You talked about the cloud connect. I had a conversation with a guest on the queue last week about that. And, and I now think about if I have to call in a contact center and that person might be from home. So, you know, we're fortunate that the cloud computing technology and people like you and AWS, or are able to power that because it's, it's literally essential, which is probably one of the words of the year, but being able to keep the machinery going and innovate at the same time has been, make or break for a lot of businesses. >>Absolutely. And you, you look at, you know, kind of one of the last year is that I'll point to is, um, financial institutions. Uh, anti-virus, we're were very much focused on making sure that that cannot fail, that they scaled. And so you can look at the work we did with, uh, with the, with FINRA FINRA is the primary capital markets regulator here in the U S and on a daily basis frame or processes about 400 billion market events on every night to do surveillance on our markets, that when COVID hit, we had unprecedented volume and volatility in the market. And FINRA was, was, um, looking at processing, uh, anywhere from two to three times, their normal daily market volumes that's anywhere from 800 billion market events to 1.2 trillion a night. And if you look at how they were able to scale, they're actually able to scale up compute resources in AWS. We're on a nightly basis. They're able to automatically turn on and off up to a hundred thousand compute nodes in a single day. That automatic ability to scale is, is the power you're talking about. Being able to actually turn things up when you needed it and turn things down when you, when you don't need it based on the volumes. >>Well, and that's going to be something key going forward. As we know that there will be one thing I think that I always say we can count on right now is uncertainty and continued uncertainty, but we've also seen I'm calling them COVID catalysts. You know, the, what you talked about with cabbage, for example, and how that business pivoted quickly, because of the power of cloud computing and emerging technologies, what are some of the things that you think as we go into 2021 in the financial services arena, what are some of the big tech trends that you think were maybe born during COVID that are going to be critical going forward? >>Well, you know, you, you, you had Melanie Frank from capital one on cube a couple of days ago, and she was talking about, you know, their shift to cloud and what that's really enabled, and it, and she kind of sums it up nicely. She says, look, we want to give our customers experience that are real time, and that are intelligent. And you just can't do that with legacy technology. That's sitting in, you know, kind of a legacy data center. And so I think that's going to be kind of the, the, the all encompassing statement for what's happening in the financial services industry. As I mentioned, you know, organizations overnight said, okay, wait a minute, let's take that strategy. And then let's put it aside. Let's talk about capabilities. What can we do? And I think, you know, necessity is the mother of invention. Um, and when you're faced with limitations and challenges, like we all have been faced with around the world and not just in the financial services industry, it, it breeds, um, invention and the, and the desire and the need to actually meet those challenges head on, in very engineered of ways. >>And I think you're going to see more invention and specifically more invention from the established players in the financial services industry. Cloud use is not just experimental on the edges anymore. You're going to see more organizations coming out of COVID. Um, having had those experiences where they actually stood up a context center and scaled it. And, and just a matter of a few days to, to thousands of agents, you're going to find, um, organizations saying, wait a minute, we, we can do remote work. We could, we have access to things like Amazon workspaces. So I think you're, you're gonna, you're going to see that, uh, be a, be a trend. I think you're also gonna see, um, w what Lori beer said in the keynote with Andy, you know, she, she made a very, very astute statement, and I don't know if people caught it, cause it's kind of neat in the middle of her conversation. >>She said, look, we're trying to infuse analytics into everything that we do at JP Morgan. I think you're going to see more and more financial institutions looking to do that, to actually leverage the power of analytics, to power everything we do as a financial institution. So I think those, those are a couple of things that you're going to see. Um, and then, you know, looking, uh, you know, kind of around the corner, I think you're going to continue to see more re-invention within the industry. And what I mean by that is you've seen many financial institutions over the last week, uh, with, uh, re-invent making announcements, you saw bank and we towel saying, Hey, look, we are completely transforming ourselves with AWS. Uh, just a few weeks before we even saw standard charter, the same thing HSBC said, the same thing, global payments earlier in the year said the same thing. And you're going to see more and more organizations coming out and talking about these strategic decisions to reinvent everything that they do to make the financial systems of the world work. And so we're really pleased to be partnering with those organizations to make those transformations possible. We're seeing a lot of invention within the industry, and we're very pleased to be a part of the reinvention of the financial systems around the world. >>It's interesting to hear that you, you see, even the JP Morgan, some of those legacy, big houses are going to be really pivoting. They have to, to be competitive and to be able to utilize analytics, to deliver those real-time services. Because as we all know, as consumers, our patients is wearing thin these days, but I agree with you. I think there's a lot of opportunity there that innovation is exciting and there will have to be reinvention of entire industries, but I think there's a lot of silver linings there. Scott. I wish we had more time, cause I know we could keep talking, but thank you for sharing your insights on this reinvented reinvent this year. >>I appreciate it. Thank you, Lisa. It's always a pleasure to be on the cube. >>Chris Scott Mullins, I'm Lisa Martin. You're watching the cubes coverage of AWS reinvent 2020.

>> Narrator: From around the globe, it's theCUBE, covering the Upgrade 2020, the NTT research summit, presented by NTT research. >> Welcome back. I'm Stu Miniman, and this is theCUBEs, coverage of Upgrade 2020. Of course, it's NTT's Global Research Summit. Really excited, we're going to be able to dig into healthcare, the health system of course, something that's been, top of mind for everyone around the globe this year, so happy to welcome you to the program. First time guest Mary Edwards. She is the president of provider at NTT DATA Services. Mary, welcome to the program, saying thanks so much for joining us. >> Hi, Stu. Glad to be here. >> All right. So why don't we start, as I tee it up. We're going to be talking about health care there, just a little bit of your background, your group inside of NTT DATA Services. >> Sure. So I've been at NTT DATA Services for a year, just about a year on the knows. Really glad to be here. I've been healthcare, all of my career over 30 years. At first in the Blues, in underwriting actuarial and strategy, then hop to consulting. I was a partner with Accenture for 20, well, yeah, I think 22 years, I was at Accenture. and then, I was leading a commercial markets portion of a platform as a service company for a couple of years, and then NTT called and I was really impressed with what I learned about NTT and delighted to join the firm as the president of provider. >> Well, Mary, I've got a little bit of background in some of the health I love, I go to innovation conferences, and they're like, "We have the opportunity to really transform markets, but it's so tough to make change." Well, you've been there for a year, and the last year, there's been a force in function to change the advent of telehealth and telemedicine. I've done plenty of interviews, and heck, me and my family have been to doctors, using those services, which, at the beginning of this year, I wouldn't have thought was possible. Some of these might be long term changes in impact on what's happening, but bring us inside, your customers, what are some of the pressing challenges they're facing? And it's been a little bit this, there obviously, are huge challenges, but there's also been an opportunity to make some rapid changes. >> Great question. Well, first of all, there's no place I'd rather be right now, than serving the health systems across the US, and certainly we have impact globally. It's dynamic time, lots of change, and as you say, with change comes opportunity. But also, it's a time of deep fragility, and a time when these clients really need help, not just from NTT, but from a variety of partners. And I know, I feel and my team feels, that it's a privilege to work in supporting them, through this very difficult time. And when I say difficult time, I mean, think about it, even before the pandemic, Chartists research was talking about the fact that likely 25% of rural hospitals would fail. Fast forward only a couple of months from that, research being published and across the industry, outpatient revenues are down 11% year over year, inpatient revenue down as well, labor expenses up by nearly 18%. And so there's a lot of pressures on the industry right now. And that's what I mean by just a very significant time to be in the industry and position to help. There's a huge recovery, that needs to happen from what our clients have experienced. First and foremost, top line. We've got to get the revenue back into the hospitals. The CARES Act funding doesn't last forever, and certainly, brings with it some obligations. So bringing in that top line growth, virtual health, which you mentioned, is a big part of that strategy. At the same time, they've got to deal with all the new delivery models or working models, work from anywhere is something that all businesses have to face, and incredibly, an incredible challenge for our health systems. Because of course, it's not just about how we do our individual work, but the interactions that they have to have in conducting the work that they do. So care from anywhere and work from anywhere, are huge concerns of our health system clients now. And you have to do that in industrialized ways, because you don't know where you're working day to day, you have to be able to have fast switching, right? Because we're not in control of where we work. Cities and states are telling us, what we have to do on a day in day out basis. There's a huge concept - >> Human. >> Oh, go ahead. Sure. >> Yeah, no, I just say, as you say, obviously, healthcare is rightly so a heavily regulated industry. So bring us inside a little bit, what are some of those opportunities, some of those innovations that providers are being able to take advantage? And have we opened the gates a little bit to help things move a little bit faster here in 2020, due to necessity? >> Yeah. Well, virtual care, you mentioned that earlier, has exploded. There's a lot of dialogue right now in the industry about whether that's forever. It will never go back to the low single digits that it was prior to the pandemic. I mean, prior to the pandemic health systems were happy if they could get to 10%. Overnight, virtual care went to 40%, 50%, increase overnight, and just continue to grow. CEOs across the industry prior to the pandemic, were really focused on digital front door strategies, the ability to enable consumers to enter the healthcare system, digitally and virtually. And so probably for the 18 months before the pandemic, most large system CEOs that I talked to, were working on those strategies. They're doubling down on those strategies, because the industry is reshaping around that digital future state. The cost pressures that we're seeing in health care, at the same time, require that they think about new operating and delivery models, certainly the industry will restructure, based on what we've gone through and continue to experience. And that will mean certainly changes in consolidation in the healthcare industry, right? As certainly certain systems will fail, right. Can't support what's happening around the economics of the industry. But also within our delivery and operations, there will be and we're already seeing a trend toward more pervasive outsourcing, moving offshore, taking particularly back office functions, whether it's IT or business processes, and looking for the help that can drive down the cost structure, better automate, and innovate on those processes and delivery models, and accelerate their journey to the digital future state of health. >> So Mary, help us understand NTT DATA Services, and NTT broader, what are the solutions? How are you helping your customers with everything we've discussed here? >> Sure, well, you can't enable those digital front door strategies unless you do things like get your applications to the cloud. You've got to be able to open up your environment to trade, if I say it that way, right? To exchange more broadly, even within your own ecosystem, within your own walls, the ability to connect doctors with doctors that before the pandemic didn't have a need to connect in the same way becomes important. So at NTT, we do everything, journey to the cloud. Certainly the security that's so important to those journey and also the digital future of health care. RPA, the introduction of bots and AI to workflows and operations in order to reduce cost. In my division in provider, we worked for nearly the last year on something we call, nucleus for healthcare, which is that digital front door enabled by digital foundation and which delivers through pre-selected capabilities scheduling, through virtual care visits to care coordination and payment, all integrated across the digital fabric, in order to accelerate the industry and certainly our health system partners achievement of that digital front door vision and the full digital future for healthcare. >> I love you talked about RPA automation, has been one of the top things we've been hearing this year. It's just a top sea level priority. We love coming to events like this, a lot of discussion of research looking a little bit forward down the road. What are some of the items here at Upgrade 2020, you want to make sure our audience get a little peek into? >> Yeah, well, you talk about automation, and I said a moment ago about offshore, we're thinking about no shore, right? So when you think about the application of automation and advanced analytics AI into business processes, it's not about moving business processes to a lower cost geography, it's about automating, and enabling through bots and whatnot, the ability to not have hands touch it, and really conserving your resources for the more complex things that have to happen. So I love that concept of no shoring, and really using technology to position humans for their best possible work, solving the harder problems that we face as an industry. I think about innovations in patient monitoring, and what we can take in terms of IoT, from other industries. And for instance, at NTT, we've been doing smart city with the city of Las Vegas, for a couple of years now. And we've got lots of AI around movement, heat, light, the physical context of things. You think about how you move that into healthcare. And it's certainly about patient observation, and creating safe spaces, where doctors and nurses don't have to travel in and out of rooms when there's a high contagion rate, but it's also about using AI, not just to watch the room, but to allow AI to alert when there's something very significant happening, what kind of movement in the bed, what does that infer in terms of what's happening in the patient's room, and alerting on that basis versus a visual monitor, if you will. There are other innovations. Oh, go ahead, Stu. >> Oh, no, so sorry, I thought you had said, please finish. >> Well, I was just about to say there are other innovations that we're working on, that are really about patient well being, patient companion. I think about the work we're doing at NTT disruption around something called Jibo, which is a robotics, very cool little guy who we've had some experience using it in our children's hospitals, right. It becomes like a really a companion of sorts. There are lots of applications for that kind of technology, especially in a pandemic time, when most of our patients are isolated and craving some human interaction and these capabilities can be like that, they can be companions, and they can provide the social interaction that really lead to health and well being. >> Well, so many important topics. Mary, thank you so much for joining us. Great to hear your automation, robotics in the people, at the center, of course, of what we look at in healthcare. Great to talk to you. Thanks so much for joining us. >> Thank you. Bye bye. >> Stay tuned for more coverage from Upgrade 2020. I'm Stu Miniman, thank you for watching theCUBE. (upbeat music)

>> Narrator: From theCUBE studios in Palo Alto in Boston, connecting with thought leaders all around the world, this is a cube conversation. >> Everyone welcome to this cube conversation here in the Palo Alto cube studios. I'm John Furrier your host of theCUBE, with a great guest here, Shanthi Vigneshwaran, who is with the Office of Strategic programs in the Center for Drug Evaluation and Research within the US Food and Drug Administration, FDA, is the Informatica Intelligent Disrupter of the Year award. Congratulations, Shanthi welcome to this cube conversation. Thanks for joining me. >> Thank you for having me. >> Congratulations on being the Informatica Intelligent Disrupter of the year award. Tell us more about the organization. I see FDA everyone's probably concerned these days making sure things going faster and faster, more complex, more things are happening. Tell us about your organization and what you work on. >> FDA is huge, our organization is Center for Drug Evaluation research. And its core mission is to promote public health by ensuring the availability of safety and effective drugs. For example any drugs you go and buy it in the pharmacy today, Our administration helps in trying to approve them and make sure it's so in term of quality and integrity of the marketed products in the industry. My office is specifically Office of strategic programs whose mission is to transform the drug regulatory operations with the customer focus through analytics and informatics. They work towards the advancement for the CDERs public health mission. >> What are some of the objectives that you guys have? What are some things you guys have as your core top objectives of the CDER, the drug research group? >> The core objectives is we wanted to make sure that we are promoting a safe use of the marketed drugs. We want to make sure there's the availability of the drugs that are going to the patients are effective. And also the quality of the drugs that are being marketed are able to protect public health. >> What are some of the challenges that you guys have to take in managing the pharmaceutical safety, because I can only imagine certainly now that supply chains, tracing, monitoring, drug efficacy, safety, all these things are happening. What are some of the challenges in doing all this? >> In our office there are challenges in three different areas. One is the drug regulation challenges because as drugs are being more advanced and as there are more increasingly complex products, and there are challenging in the development area of the drugs, we wanted to make sure here we have a regulation that supports any advancement in science and technology. The other thing is also Congress is actually given new authorities and roles for the FDA to act. For example the Drug Quality and Security Act, which means any drug that's they want to track and trace all the drugs that goes to the public is they know who are the distributors, who are the manufacturers. Then you have the 21st Century Cures Act, and also the CARES Act package which was recently assigned, which also has a lot of the OTC drug regulatory modernization. Then there's also the area of globalization because just as disease don't have any borders, Product safety and quality are no longer on one country. It's basically a lot of the drugs that are being manufactured are overseas and as a result we wanted to make sure there are 300 US ports. And we want to make sure the FDA regulated shipments are coming through correctly to proper venues and everything is done correctly. Those are some the challenges we have to deal with. >> So much going on a lot of moving purchase as people say, there's always drug shortages, always demand, knowing that and tracking it. I can only imagine the world you're living in because you got to be innovative, got to be fast, got to be cutting edge, got to get the quality right. Data is super critical. And can you share take a minute to explain some of the data challenges you have to address and how you did that. Because I mean I could almost just my mind's blown just thinking about how you live it every day. Can you just share some of those challenges that you had to address and how did you do? >> Some of the key challenges we actually see is we have roughly 170,000 regulatory submissions per year. There are roughly 88,000 firm registration and product listing that comes to us, and then there are more than 2 million adverse event reports. So with all these data submissions and organization as such as us we need it, we have multiple systems where this data is acquired and each has its own criteria for validating the data. Adding to it are internal and external stakeholders also want certain rules and the way the data is being identified. So we wanted to make sure there is a robust MDM framework to make sure to cleanse and enrich and standardize the data. So that it basically make sure the trust and the availability and the consistent of the data, is being supplied to published to the CDER regulatory data users. >> You guys are dealing with- >> Otherwise like it's almost to give them a 360 degree view of the drug development lifecycle. Through each of the different phases, both pre market which is before the drug hits the market, and then after it hits the market. We still want to make sure the data we receive still supports a regulatory review and decision making process. >> Yeah, and you got to deliver a consumer product to get people at the right time. All these things have to happen, and you can see it clearly the impacts everyday life. I got to ask you that the database question 'cause the database geek inside of me is just going okay. I can only imagine the silos and the different systems and the codes, because data silos is big document. We've been reporting on this on theCUBE for a long time around, making data available automation. All these things have to happen if there's data availability. Can you just take one more minute talk about some of the challenges there because you got to break down the silos at the same time you really can't replace them. >> That's true. What we did was we did leave it more of us I mean, step back like seven years ago, when we did the data management. We had like a lot of silo systems as well. And we wanted to look at we wanted to establish a, we knew we wanted to establish a master data management. So we took a little bit more of a strategic vision. And so what we ended up saying is identifying what are the key areas of the domain that will give us some kind of a relationship. What are the key areas that will give us the 360 degree lifecycle? So that's what we did. We identified the domains. And then we took a step back and said and then we looked at what is the first domain we wanted to tackle. Because we know what are these domains are going to be. And then we were like, okay, let's take a step back and say which is the domain we do it first that will give us the most return on investment, which will make people actually look at it and say, hey, this makes sense. This data is good. So that's what we ended up looking at. We looked at it as at both ends. One is from a end user perspective. Which is the one they get the benefit out of and also from a data silo perspective which is the one data domains that are common, where there's duplication that we can consolidate. >> So that's good. You did the work up front. That's critical knowing what you want to do and get out of it. What were some of the benefits you guys got out of it. From an IT standpoint, how does that translate to the business benefits? And what was achieved? >> I think the benefits we got from the IT standpoint was a lot of the deduplication was not theirs. Which basically means like a lot of the legacy systems and all of the manual data quality work we had to do we automated it. We had bots, we also had other automation process that we actually put into work with Informatica, that actually helped us to make sure it's the cost of it actually went for us considerably. For example it used to take us three days to process submissions. Now it takes us less than 24 hours to do it, for the users to see the data. So it was a little bit more, we saw the, we wanted to look at what are the low hanging fruits where it's labor intensive and how can we improve it. That's how we acted there. >> What are some of the things that you're experiencing? I mean, like, we look back at what it was before, where it is now? Is it more agility, you more responsive to the changes? Was it an aspirin? Was it a complete transformation? Was some pain reduced? Can you share just some color commentary on kind of before the way it was before and then what you're experiencing now? >> So for us, I think before, we didn't know where the for us, I mean, I wouldn't say we didn't know it, when we have the data, we looked at product and it was just product. We looked at manufactured they were all in separate silos. But when we did the MDM domain, we were able to look at the relationship. And it was very interesting to see the relationship because we now are able to say is. for example, if there is a drug shortage during due to hurricane, with the data we have, we can narrow down and say, Hey, this area is going to be affected which means these are the manufacturing facilities in that area , that are going to be not be able to function or impacted by it. We can get to the place where the hurricane tracks we use the National Weather Service data, but it helps us to narrow down some of the challenges and we can able to predict where the next risk is going to be. >> And then before the old model, there was either a blind spot or you were ad hoc, probably right? Probably didn't have that with you. >> Yeah, before you were either blind or you're doing in a more of a reactionary not proactively. Now we are able to do a little bit more proactively. And even with I mean drug shortages and drug supply chain are the biggest benefit we saw with this model. Because, for us the drug supply chain means linking the pre and post market phases that lets us know if there's a trigger and the adverse events, we actually can go back to the pre market side and see where the traceability is who's at that truck. What are all the different things that was going on. >> This is one of the common threats I see in innovation where people look at the business model and data and look at it as a competitive advantage, in this case proactivity on using data to make decisions before things happen, less reactivity. So that increases time. I mean, that would probably you're saying, and you get there faster, if you can see it, understand it, and impact the workflows involved. This is a major part of the data innovation that's going on and you starting to see new kinds of data whereas has come out. So again, starting to see a real new changeover to scaling up this kind of concept almost foundationally. What's your thoughts just as someone who's a practitioner in the industry as you start to get this kind of feelings and seeing the benefits? What's next, what do you see happening because you haven't success. How do you scale it? What how do you guys look at that? >> I think our next is we have the domains and we actually have the practices that we work. We look at it as it's basically data always just changes. So we look at is like what are some of the ways that we can improve the data? How can we take it to the next level. Because now they talk about power. They are also warehouse data lakes. So we want to see is how can we take these domains and get that relationship or get that linkages when there is a bigger set of data that's available for us. What can we use that and it actually we think there are other use cases we wanted to explore and see what is the benefit that we can get a little bit more on the predictability to do like post market surveillance or like to look at like safety signals and other things to see what are the quick things that we can use for the business operations. >> It's really a lot more fun. You're in there using the data. You're seeing the benefits and real. This is what clouds all about the data clouds here. It's scaling. Super fun to talk about and excited. When you see the impacts in real time, not waiting for later. So congratulations. You guys have been selected and you receive recognition from Informatica as the 2020, Intelligent Disrupter of the year. congratulations. What does that mean for your organization? >> I think we were super excited about it. But one thing I can say is when we embarked on this work, like seven years ago, or so, problem was like we were trying to identify and develop new scientific methods to improve the quality of our drugs to get that 360 degree view of the drug development lifecycle. The program today enables FDA CDER to capture all the granular details of data we need for the regulatory data. It helps us to support the informed decisions that we have to make in real time sometimes or and also to make sure when there's an emergency, we are able to respond with a quick look at the data to say like, hey this is what we need to do. It also helps the teams. It recognizes all the hard work. And the hours we put into establishing the program and it helped to build the awareness within FDA and also with the industry of our political master data management is. >> It's a great reward to see the fruits of the labor and good decision making I'm sure it was a lot of hard work. For folks out there watching, who are also kind of grinding away in some cases, some cases moving faster. You guys are epitome of a supply chain that's super critical. And speed is critical. Quality is critical. A lot of days critical. A lot of businesses are starting to feel this as part of an integrated data strategy. And I'm a big proponent. I think you guys have have a great example of this. What advice would you have for other practitioners because you got data scientists, but yet data engineers now who are trying to architect and create scale, and programmability, and automation, and you got the scientists in the the front lines coming together and they all feed into applications. So it's kind of a new things go on. Your advice to folks out there, on how to do this, how to do it right, the learnings, share. >> I think the key thing I, at least for my learning experience was, it's not within one year you're going to accomplish it, It's kind of we have to be very patient. And it's a long road. If you make mistakes, you will have to go back and reassess. Even with us, with all the work we did, we almost went back a couple of the domains because we thought like, hey, there are additional use cases how this can be helpful. There are additional, for example, we went with the supply chain, but then now we go back and look at it and say like, hy, there may be other things that we can use with the supply chain not just with this data, can we expand it? How can we look at the study data or other information so that's what we try to do. It's not like you're done with MDM and that is it. Your domain is complete. It's almost like you look at it and it creates a web and you need to look at each domain and you want to come back to it and see how it is you have to go. But the starting point is you need to establish what are your key domains. That will actually drive your vision for the next four or five years. You can't just do bottom up, it's more of like a top down approach. >> That's great. That's great the insight. And again, it's never done. I mean, it's data is coming. It's not going away. It's going to be integrated. It's going to be shared. You got to scale it up. A lot of hard work. >> Yeah. >> Shanthi thank you so much for the insight. Congratulations on your receiving the Disrupter of the Year Award winner for Informatica. congratulations. Intelligence >> Yeah, thank you very much for having me. Thank you. >> Thank you for sharing, Shanthi Vigneshswaran is here, Office of Strategic programs at the Center for Drug Evaluation and Research with the US FDA. Thanks for joining us, I'm John Furrier for theCUBE. Thanks for watching. (soft music)