2023 Report to OMB and the Public on Modernizing Agency Websites

Background

Section 3(d) of the 21st Century Integrated Digital Experience Act (21st Century IDEA)¹ requires the head of each federal executive branch agency to report annually (through 2023) to the Director of the Office of Management and Budget and the public on the agency’s progress to implement the requirements of the Act and modernize their websites and digital services. The information below details the efforts of the U.S. Department of Health and Human Services (HHS) to modernize the agency’s websites and digital services in 2023.

HHS Efforts to Date

Building on our work, HHS focused its efforts in 2023 on examining our impact, continuing to modernize to serve the public, and assessing agency and office budgets to support communications staff in improving the digital experience for customers. To continue to support the American public, HHS agencies and offices were called upon to be responsive and engaged. As demonstrated in this report, we continued to deliver instant and impactful digital communications for the American public.

1. Website Modernization and Measurement Efforts

HHS also continued to take several important steps toward website modernization for its existing websites.

First, many key HHS websites continued to adopt U.S. Web Design System (USWDS) design principles, creating more impactful and focused websites to meet the American public’s needs. HHS also continued efforts to publish content aligned with the Plain Writing Act of 2010. The Center for Plain Language graded HHS as an “A+” for organizational compliance and a “C-” for writing quality, in its 2022 Federal Plain Language Report Card. The National Institutes of Health, where the bulk of HHS websites are contained, continued to review and consolidate based on user analytic data.

HHS conducted another extensive combination budget and 21st Century IDEA compliance data call to transparently quantify current costs for meeting the user needs and the tenets of the 21st Century IDEA. In 2023, the total estimated cost to meet tenets outlined in the 21st Century IDEA stands at $94.4 million. HHS is using this information to impact and guide future budget requests to comply with the 21st Century IDEA and meet strategic goals. HHS’s Analytics Team relied on both agency self-reporting and the Digital Analytics Program (DAP) code on Department websites, to monitor compliance with the 21st Century IDEA.

In 2023, data calls showed that HHS has more than 794 unique and active websites, with several key websites actively using customer feedback to regularly assess and improve content and functionality. These websites and other digital communications platforms were maintained by about 839 full time employees (FTE) in 2023. In 2023, HHS received submissions for the Compliance Data Call and the Budget Data Call, which allowed agencies and offices to group multiple URLs into one response. These submissions included 794 URLS in the Compliance Data Calls and 660 URLS for the Budget Data Calls. See the Appendix for detail on both 2022 and 2023 responses to the Compliance Data Call.

HHS is using this information to roadmap and assess continued strategic modernization funding, staffing, resourcing, training, impact assessments, and prioritization. Not including FTE salary costs (about $93.6 million in 2023), annual digital communications efforts cost HHS about $530.8 million in 2023. These costs included operations and maintenance of websites, social media, email newsletters, phone apps, chatbots, etc.

2. Agency Success Stories

Throughout these Department-wide efforts, HHS agencies and offices continued to make progress on implementing a Digital Communications Strategy and modernizing to meet the 21st Century IDEA. Efforts in 2023 showcase recent modernization successes and impacts:

Helping People Find Support for Mental Health and Substance Use Disorder Issues

In May 2023, the Substance Abuse and Mental Health Services Administration (SAMHSA) launched FindSupport.gov, a user-friendly website, designed for the general public, to help people identify available resources, explore information about various treatment options, and learn how to reach out to get the support they need for issues related to mental health, drugs or alcohol, and other substances. FindSupport.gov provides an online guide that helps people navigate through common questions when they are at the start of their journey to better behavioral health, such as how to ask for help, how to help others, and how to search for a healthcare professional and/or support program that meets their needs.

The website provides information on how to find treatment and support based on insurance status, including Medicaid, Medicare, U.S. Department of Veterans Affairs health care, TRICARE, private insurance, and no insurance. It also features resources on how to set up an appointment so that when people meet with a health care professional, they can feel confident that they are taking the right steps.

The concept for FindSupport.gov was developed by SAMHSA in conjunction with the Digital Service at the Centers for Medicare & Medicaid Services and based on research showing that people were looking for an unbiased, trustworthy source of information on how to get support for mental health and substance use issues. FindSupport.gov was built to be a useful tool to meet the needs of the diverse public, and its development was based on input and usability testing of 18- to 85-year-old people across the country, from both urban and rural areas, of various races, ethnicities, and genders, with a variety of education levels.

The FindSupport.gov team also conducted web metrics analysis and an environmental scan of existing resources and consulted more than 50 subject matter experts from across HHS and other agencies. FindSupport.gov also features inclusive success stories in plain language that illustrate different types of behavioral health experiences; lists of how to talk to someone about getting help; steps on how to cope with mental health, drug, alcohol, or other substances; signs of when to seek help and tools to ask for help; and information on how to pay for treatment with or without insurance. Using human-centered design methods, site developers aimed to deliver a product that responded to the public’s needs.

In September 2023, HHS launched EncuentraApoyo.gov, the Spanish language version of FindSupport.gov. EncuentraApoyo.gov is not just a direct translation of the English website. The content has been culturally adapted to the Hispanic audience and includes stories reflecting the Latino experience in the United States.

Creating a More Consistent Experience and Messaging in the Office of the Secretary

The Office of the Secretary’s enterprise platforms have reached Level Three Adoption on the USWDS Maturity Model and have implemented Pattern Lab. This means that the Department’s flagship website, HHS.gov, the HHS Intranet, and the HHS Secretarial Priority websites all have adopted the USWDS design principles, user experience guidance, web standards set by the General Service Agency’s Technology Transformation Services, and the USWDS code base. This modernization effort has made the websites’ accessible, mobile-friendly, out-of-the-box features and components more readily available and streamlined website modernization efforts. In addition to the continuity the system provides with other government websites, the Office of the Secretary also took it as an opportunity to update and unite the visual design of HHS.gov, as well. An updated website logo uses the Department’s identity mark on printed materials, on the COVID-19 Vaccine Cards, as well on HHS’s mission tagline. These updates have helped strengthen and reinforce the brand identity of the Department.

Modernizing Patient-Focused Content at the National Cancer Institute

Starting in 2021, the National Cancer Institute (NCI) began a long-term effort to modernize their patient-focused web content in both English and Spanish. The project involves synthesizing content that previously had been fragmented across multiple areas of its website, Cancer.gov, and implementing a content strategy to create a single hub for patient-focused content about cancer types and other cross-cutting topics, to support people throughout their cancer journey. The goals of this project have been to help patients, caregivers, and people impacted by cancer find trustworthy, authoritative answers to their questions about cancer and to create a cohesive, modern user experience that supports information seeking throughout all stages of cancer care. To date, NCI has launched modernized hubs for four cancer types, with more content in development.

The effort to modernize NCI’s patient-focused web content incorporated all pillars of the 21^st Century IDEA, including accessibility and mobile-first design. NCI has strived to present a consistent visual design and agency brand identity through Cancer.gov using USWDS and having the NCI logo appear on every page of the website. Cancer.gov offers credible and comprehensive educational information about cancer in plain language.

User research indicates that patients, caregivers, and people impacted by cancer consider NCI to be a trustworthy source of cancer information. Content is regularly updated and reviewed by experts in oncology to provide site visitors with the latest evidence-based information. Patient-focused content is written in plain language to ensure that users of all education levels have access to up-to-date, current information about complex scientific concepts. Results of user research with participants of diverse backgrounds and education levels confirm that patients, caregivers, and others find Cancer.gov content to be understandable, helpful, and valuable information that meets their needs at all stages of the cancer experience.

Visits to all modernized topics increased, due to larger numbers of click-throughs from search engine results pages. Most of the modernized topics have seen large increases in visits, with traffic to some topics more than doubling. This translates to hundreds of thousands of additional visits in which people impacted by cancer have discovered NCI’s authoritative and trustworthy information.

In addition, all topics have improved on all search engine optimization (SEO) metrics, including ranking well for more search keywords, number of searches for which our content appears in the top ten search results, and higher search rankings overall. As a result of improved SEO, NCI’s content is easier to find, gets higher clickthrough rates, and ultimately provides more people with reliable and accurate information that answers their questions about cancer.

• Some modernized topics are featured on Google search engine results pages as featured snippets, site links, and indented results, expanding the number of users that may discover NCI content directly on search results pages, even if they do not visit the website.
• All modernized topics show increases in the number of pageviews per visit and average time spent on site, indicating that users are more highly engaged with the updated content.

The content modernization project has been completely informed by data, with users at the center of all work:

• Before the project began, NCI completed a discovery phase that included moderated interviews with patients and people impacted by cancer to understand their information needs, cancer information-seeking behaviors, preferred voice and tone for cancer information, and types of cancer information they prefer to receive from various channels (i.e., website, social media, email, multimedia). The findings from that research have guided content development, design, and information architecture decisions.
• NCI had a measurement plan that defines business and user experience goals for every content hub and established Objective and Key Results and Key Performance Indicators. The analytics verified that we have been successful in meeting our established goals and indicators. As described above, user behavior and testing have confirmed that the revised content meets user’s information needs and improves visitor engagement.
• Usability testing and user research have confirmed that users can easily and intuitively navigate within content hubs and can find what they are looking for. Themes that have emerged from user research emphasize that users trust NCI’s content, find the revised topics understandable and easy to navigate, and view Cancer.gov as a valuable source of cancer information.
• The medical illustrations used have a variety of diverse skin tones, which user research has found to be important to visitors who want to feel that content is inclusive of people from all backgrounds.

Cleaning the Content Slate at the Centers for Disease Control and Prevention

CDC’s project Clean Slate is an initiative to streamline and transform the enormous CDC website and greatly improve communication for all audiences. In 2023, health communication staff across the agency identified over 60% of existing cdc.gov content that will be archived.

A major accomplishment toward this effort has been the reduction of content on the CDC COVID-19 site. Although the COVID site captured detailed information critical for many different audiences during the height of the pandemic, it was time to make it easier for users to find key health information. Before Clean Slate, the COVID site had over 4,000 HTML pages and PDFs. After reviewing content, site managers were able to reduce to 200 HTML pages and less than 300 PDFs. This reduced the site footprint by more than 75%. Additionally, the National Institute for Occupational Safety and Health’s was able to retire over 13,000 HTML files and 8,000 PDFs in 2023.

CDC’s Archive.CDC.gov was a project undertaken and launched in 2023 and is related to the larger agency-wide Clean Slate initiative. Archive.CDC.gov is an elegant and easy-to-use solution for managing and publishing content to an agency archive. Archive publishing is integrated into CDC’s current Web Content Management System, allowing developers to publish pages to the public archive. The team also built a backup navigator to ensure that any pages that are removed completely from public view could easily be recovered if needed.

Archive.CDC.gov went into production in 2023 and already has over 12,000 archived pages currently available. CDC’s 2024 goals are to archive approximately 60% of its existing content. This will enable audiences to find and access the content they seek more easily.

Appendix

*Based on 1394 URLs in 2022 included in the Compliance Data Call responses. 

~Based on 794 URLs in 2023 included in the Compliance Data Call responses.

Endnotes

¹ Public Law 115-336, 132 Stat. 5025-5028.