Tarrant County, Texas, has become a national model for its innovative site to speed up testing for its residents.
This recorded interview is part of Leading in Crisis, an ongoing initiative from Government Technology, the Center for Digital Government and Oracle to highlight some of the incredible leadership and innovations in state and local government in response to the coronavirus pandemic.
Find more stories and resources at govtech.com/oracle360/leadingincrisis
When the coronavirus first hit Tarrant County, Texas, home of Fort Worth, officials worked quickly to launch an innovative site to speed up virus testing for residents. The site brings together many different partners and many entities, and it has made Tarrant County’s solution a model for other jurisdictions across the country.
In this video interview, Government Technology Content Studio Chief Editor Zach Patton spoke with Tarrant County Public Health Director Vinny Taneja to learn how the county was able to react quickly, and what this experience has taught them about working with private and nonprofit partners in the future.
Patton: Hello, and welcome to a new series of conversations that are a part of Leading in Crisis, an ongoing initiative from Government Technology and the Center for Digital Government. In these interviews, we will be highlighting some of the incredible leadership and innovations in state and local government in response to the coronavirus pandemic. I'm Zach Patton, the chief editor for the Content Studio here at Government Technology, and I'm extremely excited to be hosting these discussions.
I'd like to take a moment to thank our partners at Oracle for helping make this series possible.
Our first conversation centers on Tarrant County, Texas, home of Fort Worth, which launched an innovative new website to help speed up virus testing for its residents. The site brings together a lot of different entities and a lot of different partners, and it has made Tarrant County’s solution a model for other jurisdictions across the country.
Joining me today is Vinny Taneja, the public health director for Tarrant County. Vinny, thanks so much for being here.
Taneja: Thanks for having me here, Zach.
Patton: So, talk to us a little bit just about the pandemic in Tarrant County. Set the scene for us, and then talk about how you came up with the idea for the self-screening site.
Taneja: So the pandemic, you know, obviously it's worldwide, and the situation here in Tarrant County is no different. I mean, we've got over 5,000 cases [Ed. note: as of May 29, 2020]. For perspective, Tarrant County, as you said, is home to Fort Worth. We are now the 13th largest city in the country – surprise! The county itself is growing very fast. Over two million people live here and we're right next door to Dallas, which has a little bit more name recognition. But we're literally in the same metro area; they have about three million people; we have two million people. It's a big metroplex.
A highly concentrated population means there’s a possibility for a lot of disease activity. There have been about 5,000 cases here, about 150 or so deaths [again, as of May 29]. It’s relatively mild compared to other places like New York or L.A., but still very significant for our community.
And the idea came about that there was this growing need. We heard on social media, we heard directly from the public on our hotline that we need more testing capacity in our community, more options. Because in the beginning, only public health departments had the testing capability. But public health departments and their labs typically are not geared for mass testing. We're mostly surveillance laboratories. As commercial capacity came on board with private labs, we thought that, you know, the private sector will pick up the bulk of it and it will be OK. But the demand from the public was, ‘We need governmentally run testing sites.’
That's when we said, ‘OK, let's pull together some drive-through testing locations.’ And we formed a partnership with the city of Fort Worth and the University of North Texas Health Sciences Center and the city of Arlington. Arlington is our second major city in the county. They're not small by any means; there's over 400,000 people living in Arlington. Fort Worth is the bigger city with about 900,000.
This partnership got both together and we were sort of toying with the idea on how to register a lot of people so we could give them appointments and handle all the information. We had seen a couple of examples here and there of people using web-based tools. As luck would have it, we have an existing relationship with Adobe. Because they helped with our website, IT had a conversation with them and they said, ‘Hey, by the way, we're part of this Alliance for Innovation, a technology partnership. Oracle's our partner; Splunk and many other technology companies. And we have some core technology that we would like to develop with you if you're interested.’
So we did a demo with them and we're like, ‘Wow, this is the solution we're looking for!’ And that's how it all came together.
Patton: Wow. Yeah, it's kind of incredible the number of different partners being able to work together on that. How long did that process actually take to stand up the site? Who on the county side was involved in that, and what was the cost to you all? What did that look like?
Taneja: First let's talk about the cost. What made things better and easier was that there was no cost. A lot of our technology partners here – Oracle, Adobe, Splunk and many others that are part of the Alliance for Innovation – they've done a great service to the public by donating their time, software and efforts toward this. It makes things a lot easier, because when you have to go buy and procure things, it takes a little bit longer in government. Because again, it's taxpayers' dollars; you've got to bid it out the right way. When there's no money involved, that piece is taken care of. So that’s what made things faster.
The funny part is that what took longer was actually contracting. Even though there was no money involved, it took us almost a week and a half to get through attorneys on both sides, looking at our agreements and going through our governmental process of getting it through our governing entity, which is the county commission. This was all still very fast for government. From the word ‘go’ to once it was executed, it was literally less than a week to get the site up and running. It was with amazing speed that all these partners got from a concept to a go-live running website that did not crash -- it performed perfectly. And we made a lot of updates as we went along, but the first version was ready in less than a week and released out to the public with live appointments being available.
Of course, a lot of partners are on our side were involved as well, including our IT department and public health people at all the sites. The sites were being run by partner entities, like UNT Health Sciences Center, city of Fort Worth and city of Arlington. They all had input on it and we spent countless hours. That week I remember being so tired because, you know, you're already tired from running a public health operation in a pandemic. And then you have to get this thing up and running and they all need input decisions. So it was very, very challenging. But everybody worked so hard and got it done in less than a week. It was amazing.
Patton: That's incredible. Talk a little bit about how the site actually works for residents. What do they see when they go on there? I know it's a lot of self-screening and getting people targeted to the right help that they need. How does that work?
Taneja: Right. The site is really a self-screening tool. Our site is covidtesting.tarrantcounty.com. We understood that not everybody's going to want a test. Or even if they do, they may not qualify for a test. So it’s a self-screening tool with a lot of educational components built in.
You start with a ZIP code, and then it qualifies you based on that, because we were trying to limit that to Tarrant County residents. Again, being a large metro county, people from all over could come and overwhelm your system. We were trying to just stay focused within our community because Dallas had its own setup and multiple sites going. We wanted to make sure Tarrant County residents had that opportunity as well.
Once you put in the ZIP code, it walks you through a brief questionnaire, whether you have any symptoms or if you're a healthcare worker or first responder. In later iterations, we've opened it up to ask if you are a senior over 65 with or without symptoms; or if you are a person that has underlying health conditions with or without symptoms; or if you are now a retail store worker. Because as the economy is reopening, restaurant workers are coming back; retail store workers are coming back. And just by the nature of their interaction all day long with the public, they're more likely to get exposed to somebody. So we opened that risk criteria up, and this was done in phases. We went live on April 26, and a week later we loosened up the criteria. And then the second week we loosened up a little bit more.
The site goes through that questionnaire fairly quick. And then it qualifies you on if you can get an appointment for a test; otherwise it reassures you by giving you some information about how COVID has spread and what you should do to prevent the spread in your own family and at your workplace. That's the overall setup for the website.
Patton: You must have had to, in terms of outreach, let people know that the site existed. What did that look like?
Taneja: That happened in a variety of ways. We had partner cities that were pulling together at these drive-through locations. They advertise on their websites [and] through their social media. They put out flyers, word of mouth. And then from a county perspective, we launched a paid social media campaign on Facebook, Instagram and I think Snapchat. I believe that they had three platforms that they paid. And then of course, other efforts like putting information on NextDoor and on our website, and then a big effort is also talking to our media partners.
We have a county commissioner's court every week where they discuss matters for the county, governing entity decisions about contracts or how things are going with COVID, you know, how is public health doing? What are other partners doing? So a lot of discussion about our testing website happened in that commissioner's court. And really understanding where the needs are for the community, where future locations should be put in and so forth. That drives media attention to it. Because usually they're there covering with live cameras and things, and then there is an opportunity for interviews afterward. They put out good stories about how people can utilize the website and where these locations are.
All of that effort combined has been our outreach efforts for advertising the website and the tool that it brings.
Patton: That's great. And how has it been received by the community? Have you seen a lot of the kind of numbers that you thought you might see in terms of people using the site?
Taneja: Yeah. It kind of ebbs and flows. As you open up any new location on the new website, there's a lot of traffic and then it sort of declines. And that was kind of part of our decision-making process. The criteria in the beginning were a little bit tighter because we didn't want to just overwhelm the testing sites and then there's no appointments and people get frustrated. As the interest started to wane off, we made the criteria looser, so more people would qualify and then they would use the website. It's worked out great. Last I looked, we had close to 10,000 people that have screened on the website and gotten an answer about whether they qualified or not. And almost half of them had gotten an appointment. So that's a huge number: Close to 5,000 appointments have been issued in less than a month.
That is quite a tremendous effort in the community that has already been underway. And it's growing. As we look to add more locations, they're all going to funnel through this website and then people will have more access. And that way we hope that it would increase utilization of the website and also utilization of our test sites.
Patton: I want to back up a little bit, because I know that you talked about how this represents a partnership between a lot of different public sector entities, like the county, the city of Fort Worth, the University of North Texas, and you mentioned a couple of health centers as well. Has that been the kind of partnership that you guys have been able to pursue in the past? Or is that the kind of thing that you think paves the way for better partnerships on stuff going forward? What do you take away from this in terms of working with those other public sector entities?
Taneja: Partnerships have existed in the past for various reasons. In Tarrant County, one of the things I'm really proud of is that we do a good job on collaborating with other entities in our community. The collaboration spirit is very alive and strong. But to do it this fast and at this scale is obviously new to all of us. It's again, you know, common interest for everybody. That's helped bring together academic institutions and their clinical people; city leadership and their staff to do the logistics around the sites; medical entities, like UT Southwestern to help out with some guidance on where the sites need to be and, you know, sort of a post-survey on how the patient experience has been through those sites. So a lot of different public sector and academia type of partnership.
Then of course there’s the technology partnership with Alliance for Innovation. I mean, that's been just amazing because you have such horsepower behind what you want to do because it's a technology-driven solution to make it easy for everybody. We love that because that way we're not scrambling, staying on the phone, noting down names and OK, what time it your appointment. It's all taken care of.
Patton: What about those lessons in terms of that ability to, as you said, be able to stand up a site like this in a week or a week and a half. What do you take forward in terms of lessons about working with those private sector partners and being able to use those partnerships to be more agile and more nimble and able to react to these kinds of events?
Taneja: It does make things a lot faster when you have partners that are willing. Again, I can't thank enough all these technology company partners -- Adobe, Oracle, Splunk and many others that are part of the Alliance for Innovation. Without their help, this would not have been possible. And their leadership has been very generous. They've actually jumped on some of our calls to just see how things are going.
There’s always some snags you hit. Teams are assigned to different development projects, and here we got something that happened and needed a solution. But they've been able to divert worldwide resources. I mean, some of the teams they were able to divert are not here in the U.S. They're sitting in Australia or in India or somewhere. And they're like, okay, this team is busy, but we can assign you to that team and we'll get your issue taken care of.
I mean, it's just amazing to see how quickly they've been able to respond with no money involved. This is so tremendous, you know? They've done this out of the goodness of their heart.
And it's made things a lot faster. Talk to a public health department: We're always short on money. That becomes a challenge for us to go get approvals for dollars and go spend things. It takes a long time sometimes to get all of that organized. So to have partnerships like this come through in a major emergency like this helps out. And future development, if that can be done in a collaborative model like this to meet some public health needs, I think would be tremendous.
I know it's asking a lot for technology companies that are obviously in the market to make money. But if they have some pro bono dollars to help us out, we'd love to continue to utilize these opportunities.
Let me give you one example. There's been a conversation already that this was a great model to do mass registration for testing. How about we look ahead into the future and develop this tool to the core technologies there for mass registration for vaccination? Vaccinations are going to be coming. And the one way that we're looking at getting out of this COVID mess is to vaccinate everybody once the vaccine is available. So we're already having those conversations about how to do that. I don't know if that's going to be a paid effort or if it's going to be something that they can do pro bono. But the excitement is there. They're willing to listen. We're willing to kind of give our requirements and see what needs to be done and then see where we can take this.
Patton: As I said, this is our leadership in crisis series. What are the kind of qualities that have served you all well in Tarrant County in terms of leadership in crisis? What does that mean to you?
Taneja: It's a complicated answer, but let me try to boil it down to a few things that I learned.
One, I would say to use all the tools in your tool belt. We're in public health, so we think, OK, public health has to lead and do this effort. We think in a public health way. But what I've learned is that there are other parties and other sectors that are very willing and very capable of helping, the example being the Alliance for Innovation and their technology solution to help us out quick; or working with our political leadership to make policy-level decisions, whether it was stay-at-home orders or closing down schools or other things. I mean, public health alone could not have executed that. So use all the tools in the tool belt. Make sure that you communicate well and accept help that is being provided – I think that's the other piece.
And you’ve got to stay very, very flexible and nimble. I mean, just even during this site's development process, there were things that we wanted to do that just could not be accommodated. You just have to be willing to accept that not everything under the sun can be delivered in such a short amount of time. You’ve got to piece together what you can into a working solution. And then you come back and work on Version 2, Version 3 and Version 4. You can always improve upon that and add more capability.
What you need is a quick solution. It doesn't have to be perfect. It just has to be a working solution so you can get the greatest need met and then other things can come later.
Patton: Have you been in touch with other counties? Have other counties reached out to you about how to replicate this for themselves?
Taneja: Yes. We've been talking to other communities. There are some small and large health departments that are interested in our solution. In fact, I connected a smaller health department with AFI about adopting the solution. I don't know where they are in their process of doing that, but the immunization idea actually came from that small health department. They were like, ‘Oh, this is a great tool. Have you thought of this?’ And I'm like, ‘Oh no, I didn’t! But let's talk and see what we could get done.’
Patton: Any other parting advice for other counties, other jurisdictions? Specifically about tackling this crisis, but also the larger point of leading through crises in general.
Taneja: Working in government sometimes has its own challenges. I mean, we've got our processes and our ways, and it's very tied around procurement and how you spend money and how you engage different companies that are supposed to be your vendors. There are rules around that, on how you can communicate with them.
But what I've learned is that in a crisis, you're not above asking for help. Go ask for help, and you'll find partners that are willing to help. And they can do it. And there are government processes that actually allow for that to happen in a very quick way. Case in point, I had never thought that we could get it done this quick, but when we presented that this option was available, we found a new way. And the processes that we had in our county were very supportive of getting this done in a very short amount of time.
I mean, in government time, this is unheard of! From start to finish, two and a half weeks? That's just amazing! And it's because everybody came together, they saw the need, they saw the potential of the solution and we just made it happen. And that's the advice I would give: Don't let any opportunity pass. Explore it, ask for help. And you shall receive.
Patton: I love that. Well, Vinny Taneja, thank you so much for sharing your story with us and the experience there in Tarrant County.
Again, I'd like to thank our partners at Oracle for helping make this series of conversations possible. And, Vinny, many thanks again for all your amazing work.
Taneja: Thank you. Take care.
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