2013-10-14

Health Exchange Glitchware: Find the Responsible Contractor in the Haystack

Which among the numerous recipients of taxpayer-subsidized contracts to work with CMS worked on the glitch-plagued health care exchanges?  A Sunlight Foundation post lists many (all?) of the contractors associated with the Affordable Care Act (ACA). Unfortunately, this list is a superset of work performed for the agency. The New York Times reporting mentions CGI Group, Booz Allen Hamilton (Snowden's employer), Development Seed (home page) and Oracle (identity management component). 
An NPR blog post quotes Clay Johnson, a former government worker, who blames the contracting process. True -- this is an area overripe for reform. But this near-platitude misses the point. Some of the same contractors mentioned in the Sunlight report have performed satisfactorily on major complex efforts for the Department of Defense. For instance, Northrop Grumman worked on the X-47B UAV project, which succeeded in landing a large unmanned aerial vehicle (drone) on the aircraft carrier USS George H.W. Bush for the first time within two years of its first test flight. This system was smart enough to know when a landing had gone amiss and was able to fly itself back to home base instead of crashing in the ocean. These projects are not without problems -- including cost overruns and lobbying influences, but they show that positive results are possible at the same time as the inevitable taxpayer humiliations are endured.

The impression remains that had the health exchange project been properly managed and executed, success was within reach.

More facts need to come to light. Where is the information technology press on this? What problems were posed by the short timeframe, limited funding or other less obvious constraints?

In the meantime, here's a start at the Monday morning quarterbacking:
  • HHS should have enlisted help from major government contract managers, such as those at Mitre, government labs, the Defense Acquisition University, the CMMI Institute 
  • Great consideration for reuse of existing software and infrastructure, not only from commercial [Ed: and open source] sources as many have suggested, but from existing government portals. Consider, for instance, those that already provide important functions for millions of veterans and their families 
  • Use existing frameworks for management and development, such as DoD Architecture Framework or UPDM 
  • Provide greater design transparency to publicly vet the overall architecture with other interested parties, such as what NIST has done with cloud and Big Data technologies 
  • Hire an independent project journalist with access to all on the project team

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