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What was really behind the U.S. healthcare Web site fiasco

Last fall one of the biggest IT projects in the world was a laughingstock.

Healthcare.gov, the Obama administration’s portal to register Americans for a new health insurance exchange was staggering under the number of people trying to access the site, which launched late because of project delays.

Why it turned into a fiasco was explained recently by Mikey Dickerson, a Google Web site reliability engineer appointed temporary deputy CIO to sort out the mess. According to Computerworld U.S., it took him less than 20 minutes to explain to an audience what was wrong. There’s a video of his presentation with lessons for any CIO or project manager.

First, a little background: Healthcare.gov allows Americans to do comparison shopping for public and private health insurance. By one account it has information on 1,000 insurance carriers and more than 5,000 individual plans and products, as well as links to state-administered insurance exchanges. That means a lot of integration was needed.

However, for some unexplained reason — perhaps bureaucratic, perhaps political — it became unnecessarily complex. Dickerson said the organization and system were “ridiculously fragmented and dependent on dozens of vendors and dozens of products” on a single Web site that were supposed to work together.

Not only that, a number of the integrators hired to do the work didn’t have the experience of working on a highly-available project of this size. Was it because the government chose the lowest bidder? Dickerson doesn’t explain.

There were many news stories before the portal launched about the project being behind schedule, so it shouldn’t be a surprise that Dickerson said performance monitoring was absent. In fact, staff found out how bad the site was doing by watching CNN. After quickly installing monitoring software his team found the site was up 43 per cent.

Finally, he said the environment at Healthcare.gov wasn’t designed to get the best work software developers. He quoted from an unexplained document that asked what were the engineers wearing. I’m not sure whether that was an HR questionnaire, but he suggested that the bureaucracy thought it  was more important that staff wear a shirt and tie than getting good code out.

Some good developers are prima donnas, Dickerson said bluntly (Editor’s note: for some readers this is validation of an obvious truth). “If you want access to more of them finding a way to deal with that helps,” he added. If developers sense in a job interview that a tie is more important than doing good work, he said, they’ll go elsewhere.

Government, he suggested, doesn’t get it.

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