Wednesday, October 23, 2013

Quality Indicators for PPACA's Health Exchange

The AP reported:

A review of internal architectural diagrams obtained by the AP revealed the system's complexity. Insurance applicants have a host of personal information verified, including income and immigration status. The system connects to other federal computer networks, including ones at the Social Security Administration, IRS, Veterans Administration, Office of Personnel Management and the Peace Corps.

The government spent at least $394 million in contracts to build the federal health care exchange and the data hub. Those contracts included major awards to Virginia-based CGI Federal Inc., Maryland-based Quality Software Services Inc. and Booz Allen Hamilton Inc.

Complexity is a widespread management phenomenon and is integral to PPACA's health deform, which will spread Bush's high deductible health plans like a Santa Anna wildfire.  Note the five interfaces listed above, plus the need to connect to insurance company systems.  Also, The Carlyle Group's Booz Allen Hamilton did work on the health exchange website, a project that came in three times its expected cost.

Poor design and a lack of pre-release testing contributed to the debacle:

Congressional investigators have concluded that the government's Centers for Medicare and Medicaid Services, not private software developers, tested the exchange's computer systems during the final weeks. That task, known as integration testing, is usually handled by software companies because it ferrets out problems before the public sees the final product.
The HHS team rolled out an untested, complex system and the public experiences it daily.  This story is too common in today's world. 

For HHS history buffs:  President George W. Bush kept Tom Scully from testifying on Medicare Part D to an upset Congress.  I'll venture President Obama does likewise with HHS Secretary Sebelius and HHS Chief Marilyn Tavenner.  Scully went on the become a PEU with Welsh, Carson, Anderson & Stowe.  We'll see which PEU's call Tavenner and Sebelius after their public dis-service.