What we can all learn from the healthcare.gov roll-out

In a recent NPR interview, Wired magazine’s Steven Levy discussed his report on the initial launch of healthcare.gov and the IT team that is working to re-vamp the site. Or, as the NPR host, David Greene says, “re-re-vamp,” since they are fixing their fix to the original rollout. The path to the next rendition of the website – Healthcare.gov 2.0 – and the IT lessons learned from the original rollout, are not that far off from what we see with many small businesses

Phase One: Patchwork Approach. According to Levy, “This was a website which was supposed to connect people to health plans, but it was created by 55 different contractors that didn't talk to each other and they didn't have really any experience in creating a mass-market consumer website. Basically it didn't work.” Levy explains later in the interview that with government big projects, everyone gets a piece of the project and no one is really in charge.

How many times does a business (usually over time and with the best of intentions to try to capitalize on the benefits promised by the latest technologies) outsource bits and pieces of its IT (or other aspects of its operations) to a number of different contractors and wonder why there is little synergy between the various solutions? This is exactly what happened with the government rollout of the Marketplace, albeit, with a much bigger price tag and under more scrutiny than any of us might ever have to face.

Phase Two: The Finger in the Dyke. After the initial launch of healthcare.gov last fall, CMS (the Center for Medicare and Medicaid services, the government branch responsible for the project) hired the “Ad Hoc” team of tech outsiders from Silicon Valley to revamp the site in order to get through the enrollment period. But, it was a rocky road because, according to Levy, there was a real culture clash between the young, tech wizards brought in to swiftly fix the problem and the technocrats. The federal bureaucracy slowed the “Ad Hoc” team down with a checklist of regulations, and they hit “cultural resistance” when they wanted to migrate some of the infrastructure to a third-party data center (Amazon Web Services) to increase reliability and lessen the load…but, they were told it just was not done in the government.  (And so, the government, like many businesses, resisted migrating some of their infrastructure to the cloud to increase efficiencies.)

Phase Three: Integrated, Long-term Solutions. While the re-vamped healthcare.gov did a passable job in the end, this “Ad Hoc” team knew that most of the site needed to be rewritten. According to Levy, even as the team was working 80-hour weeks to salvage the site, they had the foresight to look ahead to “Healthcare.gov 2.0” and began recruiting a second wave of programmers to develop a long-term solution for the next enrollment period beginning on November 15. This time, there will be one team with one vision managing the solution – not 55 independent contractors.

Levy concludes in his report:

 “Whether or not Marketplace 2.0 works as promised, the effort has already achieved a turnaround of sorts… the rescue effort has provided a blueprint for reforming long-moribund government IT.”

“While Affordable Care Act itself remains controversial, the government is finally using smarter techniques on the website that signs you up for it. That’s got to be healthier.”