I heard Lee Becker, Chief of Staff of the Veterans Experience Office (VEO) of the VA speak at a recent Medallia conference and was blown away by his remarks. I reached out for an interview because I wanted to share with a broader audience his thoughts on what it’s like to drive change within a massive organization, what’s at stake, and what success at the VA might mean for government services in broader terms.
A Navy Veteran with a background in medical care and case management, Lee is one of the architects behind a turnaround at the VA, and he believes the same solid customer experience (CX) principles they have implemented there can transform the way other federal agencies work, too.
“The fundamental challenge of government is figuring out how you make room for experience when financials and operations are the focus.”
As the largest health care system in the U.S., the Cabinet-level agency employs more than 380,000 people. It directly serves more than 9 million people, and indirectly over 50 million, many of whom are in crisis. The annual budget is more than $200 billion.
A 2014 scandal surrounding long wait times that led to dozens of patient deaths was “kind of a flashpoint,” Lee said. It brought to light the VA’s simmering problems with over-burdened facilities as it struggled to handle increased demand for its services due to the wars in Iraq and Afghanistan.
Additional federal funding was allocated to address those issues, but the VA still lacked the capability to address a critical question: How could they win back Veterans’ trust and provide an ideal experience going forward?
According to Lee, “by using CX data and insights to improve service recovery, performance, and overall outcomes for our Veterans. An intentional approach is key – you need solid fundamentals and deliberate effort. Customer service is transactional excellence, but customer experience is relationship excellence.”
The VEO was established in 2015, generating excitement and becoming a rallying point.
Lee explained that it’s no accident that government agencies aren’t traditionally CX friendly: “The challenge with CX and government is that government is held accountable primarily on financial and operational metrics, often because that’s how Congress and regulators look at it. The question is always, ‘How are you spending taxpayer dollars?’ You have to have good stewardship and provide the greatest value.”
Understanding customers wasn’t in the equation.
But as in any size organization, once leadership made it a priority, things began to change. “We didn’t have the mechanisms before to understand the voice of the customer/Veteran. We didn’t have the CX capability…not because it’s not important, but because incentives aren’t aligned that way in government.”
They looked to industry for examples and set about integrating best-practice CX capabilities into the VA’s organizational structure.
Initially, they modeled their efforts on Amazon, Starbucks, and other B2C behemoths that function on a comparable scale. “You have to look at and be open to learning who is doing it best,” Lee said. “Then we dove in to gain an understanding of our customers.”
They worked with qualitative and quantitative data to determine what to measure, examined the Veteran’s journey, and worked with multiple personas. What they found changed everything.
It turns out that one of the best ways to focus on serving the needs of 20 million Veterans was to “open the aperture” to also focus on the needs of the 35 million caregivers, family members, and survivors who play a critical role in delivery of care. They found that the ecosystem has a direct and enormous impact on outcomes, regardless of the gender, ethnicity, service dates, age, or wellness needs of individual Veterans.
Expanding that field to take all aspects of a Veteran’s circumstances into account allows the VA to provide services more efficiently and effectively. “It sounds very simple, but without the right tools in place, it has been difficult for VA to be proactive in the past in addressing Veterans’ needs,” Lee said.
Before CX became the focus of the organization, it was frustrating (if not impossible) for VA staffers – many of whom are family members of Vets or, like Lee, Vets themselves – to provide an ideal experience.
“It was very clear to me early on that we didn’t have the tools and systems we needed,” Lee said. But what they did have was “the power of our incredible employees, who are dedicated and want to make a difference.” The next question, Lee said, was “how do we harness that tremendous passion and desire for service, and pair it with the right systems and tools to provide the ideal experience and impact?”
They devised a four-pillar approach to CX that addresses Data, Tools, Technology, and Engagement to arm and empower VA employees to “own the moment” and improve the journey for Veterans.
They gathered qualitative and quantitative data from Vets, families, caregivers, survivors, and employees. Brand surveys for macro journey maps and transactional surveys for micro journey maps identified Moments that Matter and are driving improvements on strategic, operational, and programmatic levels.
In addition, they’ve invested in social media and digital listening platforms, and employ digital comment cards (DCCs) to invite feedback. “We’ve done a lot of work there but have a long way to go. Our next step is maturing our listening posts and getting feedback within the organization as part of Employee Experience (EX).”
Using the data collected to design services and initiatives helps provide a consistent experience and reduces friction. One example is the Red Coat program, which places easily identifiable greeter-navigators throughout VA medical centers to help patients find their way to appointments.
Welcome Kits and Quick-Start guides also disseminate much-needed information. Another initiative is an innovative CX leadership program called “Own The Moment” for staffers that trains participants to take an active role in operations – “to lead with your feet, not from your seat,” says Lee, himself a graduate of the program.
“There are, literally, thousands of phone numbers,” Lee said, so it can be hard to know who to call. But now Veterans have a special one-stop-shop number they can turn to: VA 311. “Giving folks one number in case all else fails is really important.” The VA also operates a 24-hour White House complaint line for Vets.
A six-year effort to redesign their website, VA.gov, to make it more welcoming and user friendly is also paying off. The site now sees more than 10 million visitors a month.
Next on the horizon is modernizing the patient advocate system and other tools. One key task is integrating more than 200 VA databases. Until now, updates to core data in a Vet’s profile in one database wouldn’t automatically apply across all the databases, resulting in inconsistent and incomplete information.
“We’ve done a lot of work already on the front end,” Lee said, “but we have to orchestrate the data on the back end to fuel the front end. Service will be more seamless once that work is completed.”
Lee feels this component is particularly important. “You can have the other three pillars, but it’s a two-way street. We need to understand the pulse of the community and truly understand its needs, and we need to share information and insights.”
To that end, there are now more than 160 Community Veterans Engagement Boards also known as CVEBs. These groups are organized and enabled by local entities, and with connections to commercial and nonprofits enterprises, can respond to Veterans’ needs in innovative ways.
“It’s a fantastic mechanism,” Lee said. “Issues can be raised through a local version of a customer advisory board. This enables us to get insights, for example, if one locality is saying ‘hey, we really have a homeless issue,’ or another is having an employment issue. We can address community needs, which differ between, say, New York and Montgomery, Alabama.”
Because of their strong impact, the VEO has been asked to be the lead partner agency for CX for the federal government. “We think there’s no reason why every government agency can’t use this framework. If they use the four pillars, starting with understanding and learning from what works for industry, it can really work in government. It starts with really, truly understanding who your customer is.
“We’re very lucky to have had the opportunity to take a crisis and turn it into a benefit for Veterans and the public. And it’s our duty to then share this knowledge with other agencies. So we’ve been very transparent, and it’s been gratifying.
“CX opens up a whole new world and it can be overwhelming. The way in is to start by focusing on a particular use case and be strategic,” Lee advises. “It pulls threads to show the value of CX, and helps you get the buy-in from leadership to do it right. You might not know all the data points going in, but if you have 60-80%, start, learn, and go from there.”