Problems with the ACA Health Portal; Implications for Its Future Success
Posted Oct 14 2013 12:00am
As a general rule, I don't think that governmental units can develop software. Such organizations are too political, too subject to outside interference, and too hierarchical. The military consistently and repetitively has wasted billions of dollars on various failed projects. Here's a link to only one recent example (see: U.S. Air Force Blows $1 Billion on Failed ERP Project ). In fact, failed IT projects, particularly large ones, are the norm globally as I have previously discussed (see: Modeling the Costs of IT System Failures Globally ). I must say that I was wincing when the Obama administration placed an IT project, web access to the health insurance marketplace, at the center of its signature Affordable Care Act. The NYT has just published an investigative piece about the Health Portal and the news is far worse than you can imagine (see: From the Start, Signs of Trouble at Health Portal ). Below is only a short excerpt from it. Read the whole thing -- it's worth your time.
A round-the-clock effort is under way, with the government leaning more heavily on the major contractors, including the United States subsidiary of the Montreal-based CGI Group and Booz Allen Hamilton [to clean up the current problems with the health portal]. One person familiar with the system’s development said that the project was now roughly 70 percent of the way toward operating properly, but that predictions varied on when the remaining 30 percent would be done....Confidential progress reports from the Health and Human Services Department show that senior officials repeatedly expressed doubts that the computer systems for the federal exchange would be ready on time, blaming delayed regulations, a lack of resources and other factors. Deadline after deadline was missed. The biggest contractor, CGI Federal, was awarded its $94 million contract in December 2011....One highly unusual decision, reached early in the project, proved critical: the Medicare and Medicaid agency assumed the role of project quarterback, responsible for making sure each separately designed database and piece of software worked with the others, instead of assigning that task to a lead contractor. Some people intimately involved in the project seriously doubted that the agency had the in-house capability to handle such a mammoth technical task of software engineering while simultaneously supervising 55 contractors. An internal government progress report in September 2011 identified a lack of employees “to manage the multiple activities and contractors happening concurrently” as a “major risk” to the whole project. While some branches of the military have large software engineering departments capable of acting as the so-called system integrator, often on medium-size weapons projects, the rest of the federal government typically does not....CGI officials have publicly said that while their company created the system’s overall software framework, the Medicare and Medicaid agency was responsible for integrating and testing all the combined components.
So, in general terms, here are some of the problems with the government's health portal:
The Medicare/Medicaid agency has taken on the nearly impossible task of system integration for the entire project, coordinating some 55 contractors with an insufficiently talented cadre of personnel to perform such a task.
Political considerations delayed critical decisions relating to this complex project which was then squeezed into a narrow time frame. Republicans are now howling with glee over the botched health portal whereas they are the source of some of the problems.
Although the health portal looks relatively simple at the front-end, it is very complex at the back-end. There are interfaces to other key systems for such tasks as the consumer identify management and registration. Major contractors such as Oracle are quickly distancing themselves from the failing project: Senior executives at Oracle, a subcontractor based in California that provided identity management software used in the registration process that has frustrated so many users, defended the company’s work. “Our software is running properly,” said Deborah Hellinger, Oracle’s vice president for corporate communications. "The identical software has been widely used in complex systems," she said.
Despite warning signs, the government ballyhooed the health portal go-live, further overloading the poorly designed system and frustrating users. If they wanted to test the system, they should have just turned it on without any publicity and watched those who wandered in by accident.
This will be a difficult problem to remedy. Panic does not promote clear-headed thinking about a computer system that is performing poorly. Part of the problem may also be the other balky governmental and insurance company computers to which the health portal is interfaced. One more warning. The success of ACA is based on enrollment by younger, healthy individuals. These are people who participate in smooth e-commerce transactions and interactions on a daily basis using systems like Amazon.com and Google. Such "customers" are accustomed to sub-second response time and easy web site navigation. Once discouraged, they won't be coming back.