To repair its troubled health-care website, the Obama administration may need to add project workers with fresh talent, take portions of the system off line for days or weeks, and conduct more comprehensive tests to prevent crashes and delays, technology experts say.
“You tend to have a group of insular experts who are close to the project and have pride of ownership, and they really try to make it right,” said John Halamka, chief information officer at Beth Israel Deaconess Medical Center in Boston, in a phone interview. “It’s best to say pride doesn’t matter here.”
Facing two potentially hostile U.S. House hearings on its flawed exchange website over seven days, the administration has already changed the direction of its work on the site, creating a hit list of upgrades they seek to check off in the coming weeks as two new advisers take control. The changes will be made on the fly, a decision that may be challenged by Republicans during the hearings.
Jeffrey Zients, the president’s soon-to-be economic adviser, was named a management specialist for the exchange by President Barack Obama, beginning work yesterday. The Chief U.S. Technology Officer Todd Park has been advising on potential changes since the health-insurance exchange site opened on Oct. 1 and immediately froze up after being visited by millions of curious Americans.
The debacle involving healthcare.gov, the exchange websites created under the Patient Protection and Affordable Care Act of 2010, ranks in the annals of high-profile IT projects gone awry, which can inconvenience thousands of people, waste money and sully companies’ and governments’ reputations.
United Continental Holdings Inc. delayed thousands of passengers and hundreds of flights in a series of software breakdowns in 2012 after the merged United and Continental stitched together multiple computer systems.
The London Olympics’ website last year was ridden with technical problems that hampered ticket sales. A botched upgrade to Britain’s National Health computer systems in 2002, dismantled in 2011, wound up costing billions of pounds.
There are tools available to keep software that doesn’t quite work from shutting down the system, said Ron Nicol, a senior partner at the Boston Consulting Group Inc. That was the situation in the website’s opening week, with parts of the system -- such as the registration software -- cutting off access to the entire site.
The computer maker Sun Microsystems, now owned by Oracle Corp., a decade ago created the “train model” of software development, in which only the most rigorously tested code made it onboard quarterly updates to its Solaris operating system.
‘On the Train’
“If your feature is run through quality assurance and tested, you get on the train,” he said.
There are also a number of available software tools to help get the website running, though some will require a shutdown, software and website experts said in interviews.
The contractors could also make use of automated software testing tools that can simulate users with different conditions and income levels, said Scott Lundstrom, an analyst at market researcher IDC. That would let them examine the system’s ability to return risk-adjusted prices for various consumers,
Halamka, of Beth Israel Deaconess, questioned the administration’s decision to make changes on the fly, a possible point of contention between the site’s administrators and critical Republicans at House hearings scheduled for tomorrow and Oct. 30.
Attempting to patch the website with updated software code while it’s still live may also be problematic, said Halamka, who oversaw repair of a network crash a decade ago at Beth Israel that prevented doctors and nurses from viewing images, ordering tests, and sending e-mail for three days.
“Everyone was so anxious to jump back on the system that we let users back on after a partial fix,” Halamka said. “That was a complete mistake. A partially functioning system is worse than a non-functioning system” because it can lead to faulty data and incomplete database transactions. That will cause more problems further down the line, he said.
The administration has recently reset priorities for the site’s 55 contractors, according to a person familiar with the project. Instead of fine-tuning their own work, the contractors will be reorganized into teams that focus on the most serious issues, those affecting large numbers of people or that prevent the completion of enrollment, said the person, who asked not to be identified since the changes aren’t yet public.
An example of a priority item is the fact that many users have become stuck moving from one stage of enrollment to the next, the person said.
Jonathan Wu, co-founder of ValuePenguin, a consumer data and research site that analyzes health exchange offerings, isn’t sure the changes offer a quick fix. The administration is likely to encounter problems anywhere in the system where the work of different contractors intersects, he said.
“This system touches a lot of components,” Wu said in a telephone interview. “They weren’t built by the same people. They’re not all in the same room or even in the same building.”
Collecting data from federal agencies to determine customers’ eligibility for tax subsidies and transmitting enrollment information to insurers are likely to be priorities for fixes, he said.
Window shoppers are another problem, said Dan Mendelson, president of Avalere Health, a consulting firm in Washington, and Joel Ario, a former administration official and managing director at Manatt Health Solutions.
“Very few people want to get to the checkout counter now,” Ario said. “Why would you want to pay in October for something that’s not going to give you any benefits until January?”
While the administration made it easier over the weekend for people to shop without first identifying themselves, the process remains imperfect. Casual shoppers can’t see exactly what they’ll pay for a plan because the site shows only average prices for two broad age groups -- under and over 49 years old. It’s also not possible with all plans to view what drugs or doctors are covered, Mendelson said.
“If you want to know what drugs are covered, they hyperlink you to the plan site and some of the hyperlinks are broken,” he said. “It’s ugly.”
The changes in direction by administrators for the site follow the president’s decision to ask Zients and Park to get involved with the repairs.
Zients, 46, a former acting director of the Office of Management and Budget, was named in September to replace Gene Sperling as director of the National Economic Council starting in January. He is now a managing partner of Portfolio Logic Management LLC, a Washington-based investment firm specializing in health-care services.
Zients is expected to start work on the site immediately, White House Press Secretary Jay Carney said yesterday. He will join Park, a former co-founder of Castlight Health Inc., a closely held online health-care shopping site for consumers, in helping to administer the repairs.
The website’s contractors will face questioning tomorrow during a hearing by the House Energy and Commerce Committee. Kathleen Sebelius, the Health and Human Services secretary who holds ultimate responsibility for the site, is set to be questioned by the panel at an Oct. 30 hearing.
Republicans led by Senator Pat Roberts, who like Sebelius hails from Kansas, are calling for Sebelius to resign or be fired because of the site’s failure.
At the same time, House Speaker John Boehner’s office has requested that the Obama administration brief House Republicans on the implementation and failures of the Affordable Care Act. He made the request after members of his Republican Party found out that the administration is briefing House Democrats today.
“Far too much information about Obamacare’s rollout is being concealed from the public,” Brendan Buck, Boehner’s spokesman, said in an emailed statement. “All members -- as well as the American people -- deserve answers for this debacle.”