Elements in this come from an existing project; however, nothing from said project or persons involved is directly mentioned or implied to within this story. This is (mostly) a design exercise.

The agent takes a seat near what was once a lake you could barely see the far edge of. You can see all of the shorelines now. Today looks like it’s going to be hot, just like previous days. And with the diminished quality of water in the region, it’s going to be more important they are able to connect their clients with the new state mandated resource measures in addition to the usual check-ins. As the agent puts themself in position to receive updates to the new mandates, their communicator signals another change in policy.

“Those who were previously vaccinated against the 2020/21 strains of the corona virus must revalidate their vaccination status with their closest insurance carrier.”

Since the nationalization of medical insurance, it has been a pretty common occurrence that those persons who have previously had checkups, vaccinations, or even a change of family status, have had to re-validate in order to continue receiving national and state support for medical needs. CMS has become a challenging, but fruitful partner with these endeavors. Often, their agent’s ability to not only navigate the regional policy changes, but also quickly identify and connect with those to whom those policies would have negative consequences has been a beacon in these challenging times. For example, national and state measures such as the recently updated license for manual control of automated driving and transport vehicles have made it difficult for some of CMS’s clients to meet with the best insurance carrier for their needs. CMS agents have become threads to these benefits for many, especially those in aging and recently-isolated communities.

The agent finishes the mandated 10 minute meditation session before reviewing the days client itinerary:

  • Lucy S, 64 with family threads of circulatory issues
  • Haurmi H, age unknown, recent refugee, needs medical profile
  • Damion A, age restricted, veteran
  • Clark K., 90 and looking to move into assisted living
  • Clark S., 60 and looking at wellness options now that Clark K. will be moving out

The good thing about this list, the agent knows only two of these will be long conversations - likely the Clarks. But, they have to travel to some of the most extreme ends of the region. This state in particular has recently enacted travel and automated speed restrictions. The agent usually doesn’t have to worry about the tolls, but the speed restrictions do hinder timeliness. At least one of these meetings might slip in the recommended appointment window. There’s also a potential for electrical outages. The last time they traveled across this region, they were in the middle of a data transfer when an electrical storm stifled connections. It took four hours, plus a few quick classes in SQL-for-Gov to work out a solution with OIF (the Office of Information Facilitation). The agent checks their communicator for the backup readiness, and sets up an additional battery bank, just in case they need to “go manual” and connect using the less secure cellular option.

The OIF has been looking forward to getting more reports from agents. Since the major reorg a few decades ago, an increase in the ability for agents to address issues in the field has led to a total reshaping of how CMS measures success. Before, there was a harder line of operation between departments. Groups such as CMMI, OEDA, and OIT knew there needed to be more connective measures between their groups, but the shape of the org made that difficult. A radical idea - an adaptation of Rendanheyi - changed not only how CMS worked, but how CMS shaped Medicare and Medicaid as a necessary and fulfilling part of the nation’s new definition of wellness. On a day like today, the OIF is getting a chance to see yet another agent be a manifestation of this new posture.

The agent is part of OIF’s class number three. What OIT used to called NEO, the OIF has resorted to a simple numbering system. They are running concurrent tests of a few proposed career tracks, alongside a new distributed communicator. This communicator combines the security of the gov ID card, along with a feature adapted from Estonia’s cephalopod framework. Essentially, each time the agent passes thru certain frequencies of light, it squirts “ink” into that frequency. That “ink” validates the agent’s status, traces their location, and also ignites a bilateral org skeleton - one half which manages client data and interactions, the other half which manages the agent’s employee information. Neither of these halves touch. The “ink” is the only tonal record and that too is temporary. Much like any radio frequency, it dulls over time, can be mixed with others, etc. OIF believes they have developed a means to capture the most important tones of an agent’s ink, and is able to use this within the bilateral-like platform to learn and improve operations at nearly the speed of the agent making connections with clients.

The agent has made it to the first client. The weather is still holding well, but the time it took to get to this client is concerning. The communicator is already showing recommended movement for the upcoming appointments. One of them is already blinking, indicating that the appointment window is not favorable. This might not look good to their management profile. But, this is the human side of what’s been automated. perhaps the agent will have a few minutes to call that client and maybe they can quickly find another window before the day closes.

The OIF has been working hard on understanding these scenarios. The software has been restricted from making too many decisions for the agents (it has been described as “aggressive” by several information officers). There has been some early data from class number one towards the empowerment of agency when needing to reschedule or adjust appointment windows. However, this change in the analysis of “ink” has been a hard one for some of the contacting groups to adopt. When OIT broached being human-centered in the early 2020s, it was these kinds of revelations which opened CMS’s eyes to what cannot be so easily programmed. Since the inception of OIF, the philosophy of being life-centered has taken this approach to levels not previously dreamt. Contractors working with “ink” not only need to consider the wants of policy, but also the wants of the agents, clients, and even client’s living arrangements. The amount of data is enough to make anyone’s head spin. Procuring the services of contractors who don’t just understand being life-centered, but actively do it themselves (this is a contract requirement for both primes and subs, which must be proved by “ink” of their own), has been a tough adjustment for an industry which has also had to learn how to lean on technologies and services no longer sparked by Silicon Valley and MIT - now it’s Nairobi, Singapore, and LaPaz showing embedded systems which live with humans, not dictate them.

The communicator buzzes again. Another policy change. This one effects the agent’s family directly. A new enhancement to the message allows the agent to forward this change to the affected family member, but not in the same language they are reading it. Along with the OIF’s knitting information and operations, there’s also been a significant upgrade to communication practices. Policy notifications to agents are immediately ready for multiple audiences outside of CMS to read, hear, view, and touch (smell-based messaging was used for a while, but the use of some scents created undesired side effects for some population groups). An impressive adaptation of what is left from Facebook’s messaging API, CMS is able to take a policy, and have it transliterated in real time for agents (including their recommended actions), insurers (along with APIs for near-immediate integration), and citizens (across 60 languages and dialects). CMS, as with other resilient government programs, moved slowly-then-quickly to pick up the pieces from the past years of regulatory changes to many of the vendors they utilized. Probably more luck than talent, CMS didn’t just pick up people, but also learned new skills. Rendanheyi showed CMS how to be a different organization, and every level rose to the occasion to become it.

The agent’s heart rate rises, this isn’t good news. Their communicator signals that it’s time for another meditation session. However, a 10min session isn’t in the cards with the movement of appointment windows. They opt for the 2min session (a 6-count in/out versus the 10min visualization session). While their heart rate doesn’t return to normal, it does come closer to CMS’s range for agent work allowing them to continue with client appointments. CMS is trusted by these clients, not making a best effort to meet with them would betray that hard-won trust. The agent understands this. While also noting the serious conversation which awaits them once their workday ends.