3 Ways the State of Hawaii Can Quickly Fix Their Contact Tracing and Workers Compensation IT Problems. Hint: The Cloud, Artificial Intelligence, and Machine Learning

Tags: Cloud Computing, Machine Learning, Artificial Intelligence, Bot, Microsoft, Twilio

The State of Hawaii – and many other states across the United States – are in a total technological hurt bag.

There is more at stake here than just solving for COVID; this is also how we make the state’s services more resilient and prepared for any natural disaster.

I grew up in the Midwest, where it was common to hear an idiom repeated: Make hay while the sun shines. For those not familiar with the art of making hay, wet weather is problematic. Baling hay when wet can cause all sorts of problems. Which would not be so good come the middle of winter, when you need to feed your livestock. So, it is essential to make hay when it is nice outside, though you most likely would prefer to do other, fun things.

It is safe to say our state and many organizations have not made fair use of the “nice weather” before the global Covid-19 pandemic. There has been work to modernize technology infrastructure, but not with any sense of urgency, nor a real encompassing digital transformation. I am not aware of any planning sessions in which anyone said, “what would happen if one-third of our state population had to apply for unemployment within a single week?”. And that is unfortunate.

There is more at stake here than just solving for COVID; this is also how we make the state’s services more resilient and prepared for any natural disaster.

OK, so that is how we got here, now what do we do?

1) Embrace Cloud Technology

The state executive branch implemented Microsoft’s Office 365 Platform in 2016 under its third Chief Technology Officer (CIO), Todd Nacapuy. But they have not fully embraced Microsoft’s 365 platforms, as it could be the foundation for most if not all of the state’s communication system and many digital workflows.

If the state were fully utilizing Microsoft Teams for their voice and chat communications, they would have been able to transition to work from home without skipping a beat. Also, departments like Labor and Industrial Relations (DLIR), the home of the state’s unemployment system, would not have needed months to fail to build its first emergency call center in Kakaako, or need to use the convention center – they could have implemented a virtual call center, where state employees continued to work from home.

Any sufficiently advanced technology is indistinguishable from magic. And in this case, the state lacks the imagination to conjure up any magic right now.

Cloud licensing is flexible and allows the state to add/remove users, as necessary. Also, most cloud services are billed by consumption, meaning they only pay for what is used. Need to process additional claims this week? No problem, scale-up – without having to purchase other hardware. When new servers are required to solve a problem, that’s the epitome of inefficiency.

2) Artificial Intelligence and Machine Learning

Without going into too much detail or confusing things – let’s agree that Artificial Intelligence (AI) is Machine Learning (ML). And in this scenario, the state should look at Microsoft’s Azure Cognitive Services.

These are several pre-built and packaged services that simplify the use of AI without requiring ML expertise. For example, computer vision is a service that can analyze content in images – want to know if the picture submitted has a cat in it? You’d use this. Want to convert handwriting to text? Use the Ink Recognizer. Want to extract text and values from documents? There’s a service for that, Form Recognizer. You might see where I’m going here.

Using these types of smart technologies, both DLIR and the Department of Health’s (DOH) could quickly create chatbots. Using a service like Twilio’s Autopilot, users can author bots that understand voice and text-based communication - there's even a prebuilt Covid-19 chatbot template available with Q&A data from the World Health Organization. This technology can triage the simple questions, need to know the status of your unemployment claim? Or when your next payment is sent? Talk to the bot. Need to clear up something more complicated? The bot can escalate you to a human agent, and now your chances of getting someone live on the phone are much better.

Agents can handle multiple texts or chat conversations at once when even the most experienced of staff can only manage one phone call at a time.

To take it to the next level, they can integrate these new bots with Twilio’s Flex, their cloud contact center platform, enabling staff to answer text and chat-based conversations easily. Agents can handle multiple texts or chat conversations at once when even the most experienced of staff can only manage one phone call at a time. Enabling chat would go a long way to reducing hold times.

These tools would solve for outbound messaging as well. Twilio’s Programmable Voice and Messaging can be used to automate contact tracing calls and texts. Freeing the staff to do the talking when necessary, but avoiding the hassle of repeatedly dialing and leaving messages when they don’t reach a person.

3) Digitalization

The big challenge we hear currently is the DOH contact tracing program is dealing with an excessive number of documents. That’s right, old fashioned paper forms.

Faxes can stay, for now – There’s a plus side to paper and pen – they are economical, fast, and does not require power or access to the internet. So, I am not going to poo-poo anyone from using them in an emergency. However, what you do with those forms makes all the difference.

The current way the state is processing them – is manual. Labs and clinics fax their data to the state, where it can be collated, shared, and reported. Faxes would not be such a problem if this process were digitized. The state has an opportunity to use a combination of cloud technology again with AI to relieve the humans of the laborious process of data entry and let them focus on the critical work.

Fax is essentially a scanner – and that’s a step you must take to digitize any paper document – So having your data come in via fax at this point would be the equivalent of having staff scanning the documents.

We could get crazy and also add it to a data warehouse, so other departments or organizations, such as the University of Hawaii or the Hawaii Data Collaborative, could reason over and model with it.

Where the process should change, though, is instead of an old school fax machine that must print what it receives, they should be using technology like Twilio’s Programmable Fax service. The faxes remain in a digital format, an image file, and are saved into cloud storage. My preference would be Azure – since the state already uses Microsoft 365, sticking with Azure speeds up implementation and slots into their current security model.

There are a few ways to go about the next steps. But, it boils down to using those as mentioned earlier Azure Cognitive Services to recognize every new fax, extract the data values, and save them somewhere convenient. Maybe a spreadsheet, preferably a database like Azure Cosmos – so it is easily accessible.

We could get crazy and also add it to a data warehouse, so other departments or organizations, such as the University of Hawaii or the Hawaii Data Collaborative, could reason over and model with it. I’ll spare you the nerdy details, but there are secure ways to share sensitive data for collaborative work; you can lookup homomorphic encryption for your reading pleasure.

4) Automation

I know I said three ways, but if we’ve gone this far, we might as well add some icing on the cake.

The low hanging fruit from an automation standpoint would be what DOH could do with that newly digitized data from the AI forms processing. They could connect a tool like Microsoft’s Power BI to publish a live dashboard. The media would love this.

But let’s not stop there. Going back to those Microsoft 365 licenses, the state already has active – without getting into the weeds of Microsoft’s licensing – they include some access to the rest of Microsoft’s power platform, including Power Automate and Power Apps.

Power Automate can help move data around – and even facilitate data entry (or extraction) to legacy systems. A procedure is known as robotic process automation (RPA). Similar to a macroinstruction, or macro, or how formulas in Excel workbooks can automate operations on a worksheet. RPA can automate repetitive tasks by recording the steps you use to do something on a computer and allowing the system to repeat that for you – the application tabbing through fields and entering data as necessary. Sometimes referred to as screen scraping, because you can retrieve, or scrape, the data displayed by an app to the screen.

Power Apps can empower a team to build and share low-code apps using pre-built templates, drag-and-drop simplicity. Instead of needing a full fledge software developer, a knowledgeable power user can essentially use a PowerPoint-Esque designer to combine controls into an app. Imagine what the DoH or DLIR could do with this internally.

Standing on the Shoulders of Giants

We’re not alone. Other’s are dealing with these same problems and have been successful. We can look to other states and countries that have solved these problems already.

Invite and activate the community; many organizations have volunteers available with the skills to implement these types of technologies. The Code for Hawaii team comes to mind immediately, a brigade of a more extensive, national organization Code for America. The city once took advantage of the Code for America program, projects like Adopt-a-Siren and Honolulu Answers were completed; unfortunately, none of the work exists any longer, the city failed to maintain them. However, the brigade, the community organized and sustained result lives on. State and local leaders fail to take advantage of and engage with such community groups.

State and local leaders fail to take advantage of and engage with such community groups.

A key piece for any successful contract tracing program is exposure notification. Apple and Google have announced joint efforts for such an Application Programming Interface (API). An API is a mechanism with which various software programs can communicate uniformly. These particular APIs are only available to Federal or State public health authorities– so this limits what civic-minded developers can do to help. However, if DOH was to engage with the Code for Hawaii brigade officially, they could enable access to these APIs, and the unit could quickly build the state a contract tracing app.

I believe we can sum up these technology challenges as a lack of diversity – diversity of ideas, precisely – a direct result of having a single party controlling State politics for so long.

Additionally, there is what I call a paradigm of impossibility when folks aren’t exposed to new ideas; they don’t realize what is possible or think modern technology is too advanced to use. If kept in a tight channel, or when the IT staff is the “department of no,” people can’t recognize when a new option is available; I like Arthur C Clarke’s quote: “Any sufficiently advanced technology is indistinguishable from magic.” And in this case, the state lacks the imagination to conjure up any magic right now.

Also, I did not write this to point out blame, but it is safe to say Governor David Ige has been front and center for the whole journey. Ige started his political career in 1986; he represented the Pearl City and Aiea communities as a State Representative from 1986 to 1994.

He then moved to the state Senate. Interestingly he served as the chair of the Senate Committee on Ways and Means from 2011 to 2014, arguably one of the most powerful positions in the legislature, controlling spending. Between this and his current role as Governor, he has had ample opportunity to influence the state’s technology roadmap.

Politics aside, here we are, not from a lack of planning – but more of a failure to innovate. Sure, the state has had a few big wins in the name of technology modernization, but are they? Is implementing electronic payroll, moving to a modern email platform, and implementing some digital signature tools a win?

I recently watched an interview with the current State (CIO) Douglas Murdock, published by Transform Hawaii Government. In it, Murdock says, after finishing a five-year Enterprise Resource Planning (ERP) modernization, the state will modernize its time and attendance process. No one would argue that time and attendance do not need to be modernized, but I am surprised that all his available resources have not been redirected to supporting the State’s Covid-19 response for now.

But I digress; this was not supposed to be a political essay.


By Derek Gabriel, CEO