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Kathleen Sebelius: Failed IT Project Manager?
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asksqn
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asksqn,
User Rank: Ninja
4/18/2014 | 9:29:43 PM
Don't Cry for Kathleen
Get real.  As Secretary of HHS, Sebelius didn't have to write the code of the epic fail HHS dot gov site in order to get slammed for it.  As the person at the top of that particular pyramid, she rightfully fell on her sword.  But I personally won't be shedding too many tears for Kathleen as she will most likely end up as a multi-million dollar lobbyist for the same industry she was tasked with watching. 
MedicalQuack
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MedicalQuack,
User Rank: Moderator
4/18/2014 | 3:45:58 PM
Re: Let's go back to 2009...
Thanks for the kudos but I'm no genius in that department just wrote about what I saw.  Maybe it's that hands on background with writing an EMR years ago and integrating it with billing software that does it for me:)  I call it "data mechanics" and I'm just by nature, logical, the scariest thing walking around is a logical woman:)  Coding even accentuated it for me in my views.  I just visualize and of course I read a lot as well.  I spent a couple years at a doctors' office and was a great fly on the wall too as I studied their work flow so I could understand better to design a tool for them, not me:) 

I had already been following some great people though in what they were doing as well such as Dr. Halamka at Harvard who's really a good guy and should really even get more credit that what he does.  Heck I said he should have been nominated somewhere in a post back then.  He gets it and he's grounded with "the real world" and that's what makes him so valuable.  Logic and and real world values combined with any tech and coding skills, very hard to find in one person.  As a matter of fact we have too many that are in the "gray" area out there today.  I had to eat plenty of my dog food and I just learned a lot earlier as everything I created was now the crown jewels either:)  Thank goodness everything wasn't trash either on the other side (grin). 

Sure numbers could have been higher but still a success but now the real works begins after enrollment, fixing all those algos that have to work together with government, insurers, doctors, etc. otherwise you can be enrolled but if you don't get care, what have we done?  Now it's time to deal with all the killer algorithms that were created along the way too as there's a lot of code brought together here that was never connected like this before either. 

http://ducknetweb.blogspot.com/2014/03/obamacare-one-big-attack-of-killer.html
David F. Carr
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David F. Carr,
User Rank: Author
4/18/2014 | 3:00:46 PM
Re: Let's go back to 2009...
@MedicalQualk,

Interesting that you called it that the HHS Secretary job would prove to be "all about health IT." I suspect she came into office thinking the job was alll about healthcare policy, with IT as a detail that others would be responsible for worrying about. Yet the lack of management for IT had very direct consequences for undercutting the policy. Even with the latest enrollment #s trending above expectations, I can't help believing the numbers would be higher if not for the website embarrassment. Certainly, the political fallout was immense, undercutting the whole notion of competence in government.
5Tool
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5Tool,
User Rank: Strategist
4/16/2014 | 9:08:25 PM
Re: Could you have done better than Kathleen Sebelius?
If you ask all your subordinates if the project is "really" on-time, someone along the line will ask for more time and an IT project will never get done.
Thomas Claburn
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Thomas Claburn,
User Rank: Author
4/15/2014 | 7:28:20 PM
Re: She's a politician, not a techie, but...
>She's a politician, not a techie, but... 

I wondering how long it will be feasible to manage technology projects without really understanding the technology involved. Executives who don't realize what they're getting into technologically seem destined to experience this problems again.
rradina
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rradina,
User Rank: Ninja
4/15/2014 | 10:16:36 AM
Re: Could I Have Done Better?
Granted, there were many political motivations for states dumping their resident's problems on the fed but it isn't like all states had to build their own.  By removing the federal exchange option and forcing this down to the states (funded of course), each state would have the freedom to collaborate and figure out if it's own makes sense or if several neighboring states could team up and share responsibilities.  I guess my thoughts turn to transportation.  Each state has it's own transportion department and the fed typically provides 85% of the funding for "interstate" type projects.  Obviously this is an oversimplification but from an administrative perspective, fed pays billions to state to fulfill a need.  Whether it's healthcare or transportation, why would we want this responsibility vested in a single source rather than deferred to the states?

Regarding incenting the insurance companies to do this... insurers already have all the SMEs regarding what they need to sell a policy.  The only missing piece is funding (the rules around income and the level of government subsidies.)  Guessing here but I suspect the funding piece is fairly standard.  There might be regional cost factor adjustments for COLA and medical cost variances.  Plus, why wouldn't insurers be interested in doing their own thing and keeping the fed out of their business?
SaneIT
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SaneIT,
User Rank: Ninja
4/15/2014 | 8:02:23 AM
Re: Not a Barbarian
Part of the problem here is that we don't really know if the numbers have been reached.  How many people were dropped from other plans or how many have completed the registration process and will actually pay for the plans they selected.  I don't think we'll really know how that last minute push really went for another year as those registered users either start making payments or drop off of the map.  This issue is twofold, yes the health care issue is a big one and I think you'll be hard pressed to find someone who says that acquiring health care in the US shouldn't be made easier but the issue we are addressing isn't the availability of health care it is the train wreck of a highly technical project that many people saw going wrong very early on.  I can't say that I would have wanted to be responsible for that project but there were enough signs early on that it was not going smoothly that it frustrates those of us who do this every day.
MedicalQuack
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MedicalQuack,
User Rank: Moderator
4/14/2014 | 6:05:59 PM
Let's go back to 2009...
Back in 2009 before Sebelius or Deparle took office, got my head bit off for these two posts:0

http://ducknetweb.blogspot.com/2009/02/kathleen-sebelius-kansas-governor-for.html

http://ducknetweb.blogspot.com/2009/03/nancy-ann-deparle-and-kathleen-sebelius.html

This was before either one stepped foot in office.  If you know what I call "data mechanics" and looked at where things were moving at that time and how fast, then it was obvious that insurers and others with their groves of Quants and other module building experts were going to tromp on them and someone was going to get duped and I guess they did.  DeParle knew when to get out of Dodge and now sits on the board of CVS but Sebelius could have maybe left sooner with dignity, but we all know that didn't happen. 
cumulonimbus
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cumulonimbus,
User Rank: Strategist
4/14/2014 | 5:47:53 PM
Not a Barbarian
The criticism here seems a litte harsh given that she made the numbers in the end. Perhaps this is more of a political statement. People are resistant to change even if it is perceived as life-saving? Go figure.
RobPreston
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RobPreston,
User Rank: Author
4/14/2014 | 4:27:45 PM
Re: Could you have done better than Kathleen Sebelius?
The buck stops with her, plain and simple. The failure of the biggest technology project (and probably any other project) in the history of the HHS is her legacy as the chief executive of that organization. She's not a scapegoat. She was the chief executive.
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