Design Thinking in action: North Carolina DHHS ePass

How IBM Design Thinking principles helped North Carolina better meet the needs of citizens seeking assistance

By | 3 minute read | September 2, 2020

The North Carolina Department of Health and Human Services (NC DHHS) delivers benefits to 2 million citizens and supports the needs of any North Carolina citizen seeking assistance in a wide range of areas, including medical, food, cash, and child care. In June 2020, NC DHHS released an improved online application portal for Medicaid and Food and Nutrition Services (FNS) known as ePass to reduce the burden on county Department of Social Services (DSS) and allow citizens to social distance while still having access to apply for services they need.

NC DHHS investment in building a successful ePass system began well before COVID-19. For seven years, the online NC DHHS ePass system has been available to citizens seeking assistance and applying for benefits. However, as time passed, user experience expectations evolved, and with more clients accessing the service using mobile devices, NC DHHS and IBM launched a project to redesign and update NC ePass

To ensure that the project delivered a solution that better meets the needs of the citizens of North Carolina, the project team used the IBM Design Thinking Framework. IBM Design Thinking has many proven benefits. Teams using the framework deliver projects that are more successful at meeting users’ needs, with design defects reduced by half, and rework time and costs saved. Design workshops actively solicit user feedback for incorporation into the solution design. Better designs and user understanding also helps teams to get projects to market faster1. The IBM team had already proven the benefits of the Design Thinking approach with the successful redesign of citizen benefits delivery with New York City HRA.

Applying Design Thinking principles, the team engaged with ePass sponsor users and stakeholders to identify user pain points. They found that most citizens access ePass with a mobile device and most lack access to desktop computers. This meant it was imperative that the updated ePass offer a visually appealing, accessible experience across devices. In addition, the application process itself was long and repetitive. Application language was difficult to understand, and caseworkers spent a lot of time correcting user errors – time that could be greatly reduced with a better online user experience.

Armed with these insights, the team explored solutions and prototyped designs for feedback, iterating the designs to better meet the users’ needs. The result is the updated ePass portal, featuring a clean mobile-friendly look-and-feel. On any device, it has an uncluttered, card-based modern layout that is easier to navigate. Screen elements like drop-down menus have more clickable space to make them quicker to use and more mobile friendly.

The ePass experience also offers every citizen a personalized experience. The citizen dashboard displays personal case alerts for a user and shows the status of their cases. Actions from the dashboard include uploading supporting documentation, recertifying or renewing benefits, and informing the agency of changes in circumstances or life events.

Screenshot of ePass platform

NC DHHS also overhauled the experience of applying for benefits. Questions on the online application form are presented in a left-aligned stack. Visual stacking of fields improves readability on a mobile device and also reduces errors by helping citizens not miss any questions. Lengthy content is packaged into sections so citizens aren’t overwhelmed by information but can read it in chunks.

In addition, simpler language is used so that citizens understand exactly what they are being asked. Unnecessary questions have been eliminated, saving citizens time and preventing frustration. NC DHSS now captures the necessary information but the citizen answers far fewer questions and case workers don’t spend time correcting incorrect applications.

The project culminated during the COVID-19 pandemic, when NC DHHS announced the release of the improved online applications that will “reduce administrative burden for county DSS and help applicants maintain social distancing when applying for these programs”, according to a press release from the agency. These important enhancements meant that in an environment of rapidly increasing citizen demand for services coupled with remote working challenges for agencies, the NC DHHS was ready to respond to its citizens’ needs and help them effectively with a mobile friendly, citizen-centered modern application system.

Hear more about how IBM and North Carolina Department of Health and Human Services improved the NC citizen experience in the IBM Health Forum replay.

Read the State of North Carolina announcement here

To learn more about how IBM Watson Health is transforming Health and Human Services, visit

  1. The Total Economic Impact™ Of IBM’s Design Thinking Practice Forrester 2018,


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