Testimony on NYC’s COVID-19 vaccinations, service design, and their websites

To: NYC Council – Joint committee hearing with Health, Technology, and Aging
From: Noel Hidalgo, Executive Director 

Re: Covid-19 vaccinations and their websites (link to hearing)

Wednesday, 17 February 2021

On behalf of the BetaNYC community, we would like to say thank you for hosting this open conversation.

Thank you Council Members for all of your thoughtful comments. Thank you Borough President Brewer for including BetaNYC as a member of Manhattan Vaccine Task Force.

Getting access to a COVID-19 vaccine is highly personal. I am Puerto Rican, I have a pulmonary disease, and I have spent the year mourning the loss of friends and their family members. In my neighborhood, we’ve lost over 100 small businesses

For the last six weeks, I’ve been saying the same thing, digital technology is a critical tool in how government services are delivered in the 21st Century. Now, we are watching in real time what a massive government technical and design failure looks like in real time.

It is insulting for this administration to willfully sideline government technologists and designers who sit in the Mayor’s Office. Refusing to employ them in this crisis furthers the digital divide and perpetuates racism, ageism, and ablest mentalities.

The roll out of these websites is a complete failure of “Service design” — “a practice that refers to creating a better understanding, and improving upon programs at any stage. For a program, product, policy or service to be effective, many factors come into play: the context in which it operates; the value that potential clients perceive to their lives; daily processes and workflows; staff skills and perspectives; clarity of communications; and, physical environments, among them. It considers people, processes, communications and technology as part of the solution.”

The Mayor’s Office of Opportunity and the Mayor’s Office of the Chief Technology Officer and DoITT have experts who are skilled at addressing product design, mitigating software failures, and are not being employed to solve these issues. The Mayor’s own Intergovernmental Affairs has said that these websites are not the problem, the lack of vaccine is the real problem.

I say bull.  For nearly a year there has been a service design and technology leadership vacuum. Dating back to April 2020, we have seen digital information tools and service design processes sit on the sidelines. Since March, we have known that this virus was disproportionately affecting communities of color. Yet, equity issues were marginalized until we had the data to see the impact of the tragedy. Yet again, this Administration refuses to address known inequities and deploy service design and collaborative technology leadership. 

While the Mayor has said he would build a bridge between the tale of two cities, NYC Mayor Bill de Blasio has built a wall between the vaccine and those who are not digitally savvy, those who have a disability or don’t read english fluently, those who don’t have the means of transportation, time, or energy to figure out the city’s myriad of vaccine resources.

Unlike the start, we know how to end this pandemic. It starts with the vaccine and ends with leadership and service design.

No technology tool can replace poor or missing leadership.

Immediately, the following must work together to address lingering usability and accessibility issues with the City’s vaccine finder and appointment scheduler — the DOHMH Citywide Health Emergency Field Operations (CHEFO), DOHMH IT and the subcontractors who are providing the vaccine website scheduling app, NYC DoITT’s Application Services department, NYC Opportunity’s Civic Service Design Studio and Product Lab, and NYC Chief Technology Officer’s NYC Digital Services Department.

This team must focus on:

  • Making every site WACAG 2.0 compliant.
  • Perform user testing with vulnerable and underrepresented communities. Currently, the sites do not have labels for screen readers to use. 
  • Ensure that every site works for a variety of mobile interfaces AND there should be device testing before sites go live.
  • Create a citywide scraper that shows all available appointments at Federal, State, City, and pop-up locations.
  • Provide professional translations on city websites so that non-English speakers have a fighting chance of getting the vaccine.
  • Vaccine location data and accessibility data of that location must publish a centralized location and in a machine readable file. Currently, the vaccine finder website does not have accessibility information nor transit information. 
  • Vaccine scheduling slots should be openly visible. People should not have to click through days nor locations to see what is available. Again, these sites need user testing with diverse communities.

After yesterday’s testimony from NYC DoITT and NYC Health and Mental Hygiene, BetaNYC has more questions than answers. Below is a list of questions that should be answered by all of the city’s technology vaccine providers.

Re: Websites

  • Who is responsible for user testing the sites before they go live to the general public?
  • What audiences are being employed / used to test the sites before they go public?
  • What type of accessibility / disability testing is done before the sites go live to the public?
  • What type of mobile device testing is done before the sites go live to the public?
  • What type of security testing is done?
  • Who is translating the sites and what languages are they translating?
  • Based upon user testing, what type of improvements have been made?
  • Based upon public feedback, what type of improvements have been made?
  • How difficult is it to publish availability time slots to the general public?

Re: technical coordination

  • How is the Mayor’s Office of Intergovernmental Affairs coordinating efforts?
  • What type of cross agency working groups have been established?
  • What type of internal service design working groups have been established?
  • In regards to user testing or product design, has the NYC Opportunity’s Civic Service Design Studio and Product Lab or NYC Chief Technology Officer’s NYC Digital Services Department been asked for their feedback?
    • Have internal DOITT or DOH staff been used for user testing?
  • Who is leading technology coordination across the following?
    • DOHMH Citywide Health Emergency Field Operations (CHEFO) and IT
    • NYC DoITT’s application services department
    • NYC Opportunity’s Civic Service Design Studio and Product Lab 
    • NYC Chief Technology Officer’s NYC Digital Services Department 

Re: in-person vaccination experience

  • How is the city collecting in-person vaccination feedback? What improvements have been made based upon that feedback? 
  • How many locations have scheduling navigators? What languages do they speak?
  • How many locations are staffed with translators? How are translators selected?
  • What type accessibility guidelines are set up per location? Is signage consistent across all sites?

Additional questions:

  • How difficult will it be to publish a centralized location of all vaccine locations in NYC (federal, state, local, private providers, and related pop-ups)?
    • Would it be possible to include hours and accessibility information? 
  • How difficult will it be to publish scheduling availability / what vaccines slots are available?
  • How difficult will it be to centralize federal, state, city, and private providers vaccination data?
  • When did the DOH start requiring race and ethnicity data to be collected from all vaccine providers?
  • How frequently are people missing appointments and what tool is being used to reschedule individuals?

While BetaNYC supports all efforts to centralize vaccination registration and supports CM Levine’s legislation, we are concerned that current leadership at DOHMH or DoITT are NOT equipped to achieve this task. We call upon the City Council to empower NYC Civic Service Design Studio and product team to manage the process of integrating, deploying, and testing a centralized vaccination portal for ALL New Yorkers, not just the ones who are fortunate enough to have the time, access, and literacy.