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How Would You Fix HealthCare.gov?
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Laurianne
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Laurianne,
User Rank: Author
12/5/2013 | 11:03:15 AM
Re: Nothing to commend
Jen, it's not the total I question. It's how they select the contractors. The private sector learned long ago that using the lowest bid IT contractors often gets you what you pay for. The goverenment strings together dozens of such shops.
JohnD981
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JohnD981,
User Rank: Apprentice
12/5/2013 | 10:10:08 AM
Does anyone even know what HealthCare.Gov is built on?
I confess I did not try very hard, but I found not a single statement anywhere telling us about the technology platform for HealthCare.Gov ...

Under the circumstances, I cannot imagine how anybody could comment constructively regarding what might be done to fix it.

 
Steve Naidamast
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Steve Naidamast,
User Rank: Apprentice
12/5/2013 | 9:25:16 AM
Re: Fix HealthCare.gov with a new site that is highly compartmentalized...
Re: David F. Carr

Compartmentalization has fallen out of favor with many youmger technical personnel as it seen as repetitive.  If so, why not simply make a generic\reusable component out of such code?

I have worked in such environments where this reduction in duplicate code is fostered and the end result is that the "reusable components" become such a mess in an attempt to satisfy all requirements that the woirk ends up being as bad as the worst messes you can imagine.

The other problem with such a paradigm is that of the "ripple effect".  You go into a component to modify it for one appliaction's use only to find that another is suddenly failing when it makes a similar call.

From these experiences I tend to promote compartmentalization of code no matter how repetitive because I will always know that the problems will stem from a single source, the application or system where a specific copy ofthe code is housed.

This is also why I receommended the development of state sub-sites since there are going to be differences between state requirements and the insurance companies that are going to sell there.  And true, in some cases, you would find quite a bit of code being redundant but so what?  All of the issues would be solely from the state-site being developed without any contagion from any other area of development.  And you could, under such circumstances, sucessfully outsourced the work to as many contractors as required since each state-site would have been develkoped by a single group of developers concentrating on their own set of requirements.

Of course, as several other people have already posted, even under more preferable development conditions, a strong, disciplined, management team on the government's behalf would have been required.  Unfortunately, from the responses I have been seeing in the press, I am under the impression that the original management team just didn't seem to be all that interested in seeing this project rolled out successfully but this is just my own impression...

 

 

 
James W
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James W,
User Rank: Apprentice
12/5/2013 | 8:53:03 AM
Goal setting
My first action would be to determine exactly what is expected.  It is hard to "fix" if you do not know what a fixed system does...
HealthCareLove
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HealthCareLove,
User Rank: Apprentice
12/4/2013 | 8:43:43 PM
Step back, change approach
The flow of the site has been improved. I echo the sentiment of simplifying the user experience so the tech team can focus on security and stability.

However, beyond that, we're still not addressing the fact that health insurance is cryptic to end users. For example the terms Bronze, Silver, Platinum, and Catastrophic do nothing to convey the meaning behind them. Instead of using arbitrary sounding plan levels why not immediately state what each level entails?

I suggest adding contextual education for the users. Use simple, concise language to explain the difference between copay and out-of-pocket expenses. Healthcare plans are complicated, but the site can be designed to make digesting all this data easier. The muddy information architecture compounds the perceived complexity of the site.

This education process should be part of the plan application - users should not have to read through multiple sites to be able to learn these things. People should come away delighted because they now understand what they're paying for and how the Affordable Care Act affects them. 

 
David F. Carr
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David F. Carr,
User Rank: Author
12/4/2013 | 5:54:52 PM
Re: Fix HealthCare.gov with a new site that is highly compartmentalized...
The compartmentalization you describe sounds a lot like the cloud architecture pods / "swim lanes" suggestion of the scalability consultants and authors we interviewed. So I'm not sure it's an approach that has really fallen out of favor (or maybe there's a distinction I'm missing).
David F. Carr
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David F. Carr,
User Rank: Author
12/4/2013 | 5:47:17 PM
Re: Simplify ... and don't reinvent the wheel
phadley068, Thanks for sharing your blog post. Good suggestions there. The only one I would question is the "remember people when they come back" suggestion. Yes, that's a common and recommended good usability trick, but I'd hesitate to recommend that they do anything too fancy with user identification right now, given that security is one of the outstanding issues with the site.
phadley068
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phadley068,
User Rank: Apprentice
12/4/2013 | 5:35:08 PM
Simplify ... and don't reinvent the wheel
I agree with those that say the government should have leveraged existing health insurance marketplace frameworks.  It still isn't too late to simplify the front-end (read specific suggestions on my blog at http://wp.me/p3TMI1-1q) so the tech teams can really focus on information security and back-end integration.  Ultimately, a simplified initial user experience will go just as far as an improved backend to improve customer (user) satisfaction.
StevenJ13
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StevenJ13,
User Rank: Strategist
12/4/2013 | 5:27:47 PM
Re: Bidding system
Lowest cost sometimes applies even you are even "in the club". A handful of companies have been providing this exact type of system (less the integrations) who would probably not even be considered if it was a so called "full and open" competition.  This isn't just this project but any government project.  It awards those who play the game the best – not those with the best solution.
David F. Carr
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David F. Carr,
User Rank: Author
12/4/2013 | 5:26:09 PM
Re: Nothing to commend
If the signup form data was at least captured correctly, it might be possible to go back and fix enrollments that were not transmitted properly to the insurance provider. The worst thing would be if it turns out the data of those seeking coverage was lost or hopelessly scrambled behind the scenes, even as the front end seemed to show them everything worked fine.

I agree the uproar over not getting access to the website will be nothing compared with what will happen if enrollments were irretrievably screwed up.
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