HealthCare.gov ‘like night and day’

December 2, 2013 in Medical Technology

HealthCare.gov, the government’s hobbled health insurance website, is fixed and running smoothly, CMS officials announced Dec. 1 in a rare Sunday telephone news briefing.

It took 400-plus software adjustments, hardware overhaul and a revamp of the decision-making process, they said.

Julie Bataille, director of the CMS Office of Communications, acknowledged at the start the operational update that there is more work to be done. However, both Bataille and Jeff Zients, management expert and advisor to CMS and HHS, spotlighted the recent successes. Zients, acting director of the Office of Management and Budget, previously served as CEO of the Advisory Board Company.

“”he bottom line: HealthCare.gov on Dec. 1 is night and day from where it was on Oct. 1,” Zients said, during the call.

[See also: What happened to Healthcare.gov?.]
   
Zients pointed to progress on several aspects of the site:

  • Average system response time is lower than 1 second
  • Error rate is consistently below 1 percent
  • Software fixes and hardware upgrades have resulted consistent uptime of 90 percent (compared with 40 percent a month ago).
  • Establishment of a 24/7 monitoring and operations center and team to ensure optimal system performance
  • Capacity for concurrent user target of 50,000, supporting a minimum of 800,000 users a day.

[See also: HealthCare.gov security risks laid bare.]

Zients listed some of the root causes of the site’s earlier failure, such as the “unacceptable user experience, very slow response time, inexplicable user error messages and frequent website crashes and system outages.” Root causes of the problems, he said, included hundreds of software bugs, inadequate hardware infrastructure and a general lack of system monitoring. The staff also identified weaknesses in how the site was being managed.

He also cited slow decision-making among the root causes of the site’s troubles.

“HealthCare.gov was fixable,” Zients said. “We needed to get the team working with the speed and urgency of a high-performing private sector tech company.”

The government tapped QSSI as contractor and systems integrator. The QSSI team, he said, provided “fresh eyes” and dedicated teams of experts focused on system monitoring, software fixes and hardware upgrades. Zients worked with QSSI to roll out a management structure with clear accountability and rapid decision-making, he said.

The team has knocked more than 400 bugs and software improvements off the punch list over the past two months, a feat that eliminated critical glitches and making improvements to user experience throught the site, Zients said.

There is more work to be done, but Zients is scheduled to leave his post at the end of the year, prompting seven senators, all Democrats, to urge President Obama in a Nov. 26 letter to appoint a CEO to oversee HealthCare.gov.

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