Quality Progress - December 2013 - 14

keePingcurre government Critical Condition T Sick Obamacare website affects millions as White House scrambles for a cure the botched rollout of the website built to allow Americans to enroll in a health by the consulting firm kantar uS insights.3 "nobody is madder than me," President insurance plan under the Patient Protection Barak obama said as he spoke about the and Affordable care Act-also known as problem-ridden website-technology that's obamacare-will go down in history as one at the very heart of his plan to bring health of the biggest technology debacles ever. coverage to millions of Americans. Since its launch oct. 1, millions of the online marketplace is central to the people who used www.heathcare.gov to 2010 law to reform the u.S. healthcare sys- find a health plan have encountered error tem. every American will be legally required messages, delays, crashes and stalled ac- to have health insurance after Jan. 1 or face counts.1 a penalty.4 the federal exchange and similar the snarls didn't end there. the reports state websites are meant to be one-stop features and, finally, enroll the person in a plan. System snafus initially, obama blamed the website meltdowns on an overwhelming number of visitors.7 Software engineering experts identified fundamental issues with the website's design and function, however. Some software engineers have suggested the website's consumer end, designed by one contractor, is not "talking to" the website's back end, which was created by a generated from the federal exchange shops for health insurance for Americans on new enrollees and sent to insurance who can't afford coverage and don't get it different contractor.8 "Anyone in software engineering will tell providers were riddled with errors-such as through employers. you that cross-group coordination is one of syntax mistakes and transposed and dupli- Complex project the hardest things to get right, and also one cate data. insurers also reported receiving the federal exchange is a huge system of the most crucial, because while program- multiple enrollments and cancellations that's composed of multiple systems with mers are great at testing their own code, without time stamps from the same people. hundreds of integration points, making it testing that their code works with every- insurers resorted to contacting enrollees innately difficult to manage, said robert body else's code is much more difficult," directly to follow up.2 charette, president of itABHi corp., a busi- wrote software engineer David Auerbach in Just six people successfully enrolled on the first day it opened. of the 9.47 million ness and technology risk management a recent Slate column.9 many of the problems also stem from a consultancy.5 the website must fuse with people who visited the site the first week, disparate platforms of other large govern- only 36,000 were able to complete the en- ment agencies in addition to the systems of rollment process, according to an analysis state exchanges and insurance providers. 6 the federal design element that requires users to create accounts before shopping for insurance. making all users go through the registration process created logjams that blocked most exchange website other users from the marketplace.10 also must do many Project management missteps things: verify a Building a system takes more than good person's identity, programming. it also requires sound project legal residence and management. the centers for medicare and income; record his medicaid Services (cmS) oversaw the entire or her personal project while also monitoring the develop- information; match ment of the state exchanges.11 the enrollee with ing the cmS and most of the government plans; calculate has no experience running a project this subsidy eligibility; large, wrote Steve Bellian, a professor of provide compari- computer science at columbia university, in son shopping 14 QP * www.qualityprogress.com the flop isn't that surprising, consider- health insurance a cnn column.12 http://www.heathcare.gov http://www.qualityprogress.com

Table of Contents for the Digital Edition of Quality Progress - December 2013

Up Front
LogOn
Expert Answers
Perspectives
Keeping Current
Read Their Minds
Mr. Pareto Head
Behind the Results
Overview of the Money
Regional Variations
Earnings Rise With Experience
Certifi ably Valuable
Rewards for Master Black Belts
The Service Quality Platform
3.4 per Million
Quality in the First Person
Career Corner
ASQ Enterprise and Site Members
QP Toolbox
QP Reviews
Back to Basics

Quality Progress - December 2013

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