Marina Nitze
‘We Left a Legacy’: Marina (Martin) Nitze on Creating Lasting Change within the Department of Veterans Affairs
| Marina Nitze served as the Chief Technology Officer at the VA from 2013 to 2017, where she founded the first agency-level team of the U.S. Digital Service. Prior to that, she served as Senior Advisor to the U.S. Chief Technology Officer, and part of the first cohort of the Presidential Innovation Fellowship. |
Marina Nitze entered public service with intense skepticism, believing the government was incapable of change. By the time she left public service five years later, she and her team had helped introduce system-wide change at the Department of Veterans Affairs (VA) that inspired similar transformation at other agencies.
Marina played a key role in the conception of the U.S. Digital Service, and also its earliest execution within the VA. Below, Marina discusses how to build a digital service team and how to cleverly turn a slide deck into official policy.
June 19, 2024
Kathy Pham:
Marina, tell us about your journey to the U.S. Digital Service.
Marina Nitze:
I was in Seattle and had nothing to do with the public sector. I was convinced government was broken and there was nothing we could do about it. I was also active in the local tech startup scene, and saw a contest for the best use of open data with the city of Seattle with a $20,000 prize. I thought, “You can’t build anything for $20,000.” So I applied to the mayor’s advisory board that oversaw the challenge.
I was accepted and I volunteered to run the committee. I canceled the challenge and I converted the $20,000 budget into the very first Startup Weekend Government Edition, where we brought a hundred local startup folks together at city hall with the city’s IT team. It was all about relationship building.
Around that time, I saw a video of Todd Park at TechCrunch Disrupt talking about a new thing called the Presidential Innovation Fellows (PIF) program. He said if you sent in your resume, they’d add you to their email list. I never thought in a million years I would be selected for this program. Many months later I got a call from Richard Culatta at the Department of Education asking me to be his PIF. I got offered the job on the crazy condition that I move from Seattle to DC the following week. So I found a friend to live in my apartment and take care of my cats, and I went to D.C. for six months — despite still believing government is a place where you can’t make any progress. This was July 30, 2012.
Everyone I knew warned me I would be smashing my head against a wall. But six months to the day after starting as a PIF, I joined the White House Office of Science Technology Policy (OSTP) as a Senior Advisor. That first week, President Obama was serious about fixing the Department of Veterans Affairs (VA) disability claims backlog. He invited Todd Park to a meeting about it, and Todd asked if I would go instead because he had a scheduling conflict. At the time, I knew nothing about the VA, nothing about Veterans, nothing about disability claims. But I went to this meeting and immediately fell in love with this problem that was a big process engineering challenge.
I pitched the idea of me flying around the country for six months, documenting Veterans who were experiencing the disability claim process. I built the largest process map I have ever built and presented it in the Roosevelt Room. Six months after that, on July 30, 2013, I was appointed the Chief Technology Officer of the VA. And one of my early goals — although it took three years for this to happen — was to build a VA digital service team.
Kathy:
What was your first day like as CTO?
Marina:
I had effectively been auditing the VA from the White House for the previous six months. People weren’t wildly welcoming: They had a mission, they had a plan to solve it, and I was going to meddle with it. So my first days were very lonely. My job description was to redefine the art of the possible for how America honors and serves its Veterans.
When I came to the VA, Todd was already pitching an idea called GovX, which was a predecessor to USDS. I considered staying behind at the White House and joining. It was not getting traction, but then HealthCare.gov happened on October 1, 2013. The government also shut down that day. I drove to the Centers for Medicare & Medicaid Services (CMS) offices in Maryland, but nobody was there. Everybody had gone home.
Around this time, Jen Pahlka came in as Deputy CTO. She was picking up the baton for the idea that would become USDS. Meanwhile, once I knew I was up for the CTO job, I pestered the VA incessantly for a head count of three PIFs. That group became me, you [Emily Tavoulareas], Mollie Ruskin, Tom Black, and Ben Willman. We sketched out on a dry erase board what we thought our VA work could entail, like a website that actually works. (Imagine!) I had very specific ideas around automating disability claims. We also wondered: What if the VA had an internal technology team? It was the concept of USDS.
After I left OSTP, I started attending the Presidential Management Agenda meetings on behalf of the VA, because we didn’t have a Deputy Secretary, and I was the only one with a White House badge, which meant not standing in the hot sun waiting for security. In one of them, Casey Burns and I presented a slide suggesting a VA agency digital services team with a headcount of 75 people. I expected this slide to be deleted, but it went through. And then it was announced as a formal part of the president’s management agenda.
Kathy:
Sometimes you write a slide or a memo expecting nothing in particular, but then it goes all the way to the top, and now you have headcount or money. So Marina, what was the VA digital services team like?
Marina:
Matthew Weaver was the first hire, and that took forever and ever and ever. We tried and tried and tried, we’d get stuck, we’d fix the thing and we’d start over and we’d get stuck again at the next step.
It’s a funny time to look back on. I had this idea of a VA digital service team for years. But when they were about to show up, I was like, “Oh my God, where are they going to sit? I don’t have chairs. I don’t have passwords. Nobody will let me work on their projects. I’ve got nothing.”
Emily:
Were there any particular turning points during that time that you were fighting to hire the 75 staff?
Marina:
There was a big disagreement about whether technologists could review other technologists’ resumes. Everybody was like, “No, it’s illegal.” But it turned out it was not illegal at all. When we unlocked that, it changed the way the VA did hiring in general. Now psychiatrists review other psychiatrists, so it totally flipped how hiring worked.
Kathy:
When did people start to arrive? And what were the early projects?
Marina:
It was mid-January 2014. I had projects like the Veteran Employment Center that needed help and attention, but people did not want to work on that. They wanted to work on Electronic Health Records (EHR), service treatment record interoperability, and the Veterans Benefits Management System (VBMS). I didn’t think VBMS was a good place to start because it was a $2 billion behemoth and we didn’t have any kind of strategy. Whereas the Veteran Employment Center, we had invitations and opportunities. I felt like we should lean into the spaces that invited us.
Everybody comes in and they see how slow VBMS is. They fall prey to Baumol’s cost disease and think: “If we save six minutes per claim in VVMS by moving it to the cloud, then that’s like 300 million minutes.” But you can’t add it all up across a system and be like, “Look at our millions of minutes.” You actually gain zero extra minutes. We ended up focusing more of our attention on the external Veteran-facing systems (websites) and not internal systems.
Kathy:
How did news coverage and presidential mandates influence the projects you worked on?
Marina:
The healthcare claims backlog was our magical moment. So was gaining Secretary Bob McDonald. It meant we had a new ally. He thought, “Obviously let’s create My VA.” He would invite me to meetings to plan My VA because he saw it as a really valuable tool, and realized we already had this digital services team. Bob flew out to Silicon Valley to do recruiting. He really leaned into helping. And then Vets.gov became our mission in a way that it had not before.
Around this time we created the Dominic video, which took off like wildfire and gave us momentum. Dominic was not cast, but I could not have cast a better Veteran if I tried: he really blew up any stereotypes one might have about a Veteran experiencing challenges. He was funny, smart, and very tech-savvy, yet he was turned away again and again. It was a genius idea to go to the White House Office of Presidential Correspondence and find letters from Veterans about healthcare. The video took off — it went viral in the government. People in the Office of Management and Budget (OMB) were emailing me about it. And that gave an opening to say, “Let’s put a form on Vets.gov.”
Up until that point, we had only been approved to put plain language explainer text on it. This was our first chance at building functionality, and people started using it. Then we achieved the momentum to get responsibility and budget.
Emily:
I want to highlight the importance of Courtney Eimermann-Wallace during those field interviews. Courtney was an engineer. She saw things differently than we did. And I don’t think it’s typical for user researchers to take engineers into the field. She was making changes on the fly and taking notes and coming away from those interviews with a punch list of things we never would’ve noticed. That’s another really big takeaway for me: The power of those cross-sectional teams, especially in the field.
Kathy:
Marina, what work did you do that stuck around and had a legacy? And what work are you most proud of?
Marina:
Modernizing the Board of Veterans Appeals. The VA won a Sammy for customer experience, and it was not that long ago that we were on the front page for fucking Veterans over every possible way.
The VA is enormous. It’s the largest integrated healthcare system in the world. It has 400,000 employees. We left a legacy, and now we influence other agencies. Other agencies reach out to me to this day, asking, “Hey, we want to be like the VA. What could we learn?” That is the coolest thing.
One of my main theories of change is “going second.” I do something first, and that creates the positive peer pressure to make the change everywhere else. The VA was a huge lever: We made changes in tiny places first, and then we influenced the customer experience of the entire federal government. Now all these state and local governments are thinking about user experience, too. That’s pretty awesome.
Kathy:
That’s an amazing example of building and building. All these nuggets add up, and now you have a legacy. Thank you, Marina.
Marina:
See you soon.