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Problem Solving.

A developer’s view on what went wrong with HealthCare.gov

Last minute changes rarely work to your advantage.

October 29, 2013

Barack Obama: "the number of people who've visited the site has been overwhelming, which has aggravated some of these underlying problems."

If you’ve listened to the news over the past two weeks, you’d know the rollout for Healthcare.gov, the Federal health-insurance exchange for the Affordable Care Act (ACA), has been far from smooth. From crashes to lost information, it’s clear the site has significant architectural issues.

Without getting into ideology on the actual legislation, let’s focus on the website itself. What could have been done about these problems BEFORE the website went live?


Without getting too technical, there are essentially two sides to each website: The “Client” side (or front-end) that contains the graphics and images that you see and the “Server” side (or back-end) that brings these images together and makes them functional through interaction with federal, state or insurance carrier databases.

For Healthcare.gov, there were at least half a dozen contractors involved from small design shops such as Development Seed and Teal Media to large conglomerates such as CGI Federal, United Health Group and Experian. Senate testimony seemed to imply that each had limited contact with the others during the process.

When developers on either side don’t communicate with each other it can make an entire website not work properly.

In addition, there was no management or one party responsible for all decisions. Scope creep took over with late-minute additions and changes to the site’s technology. For example, the administration decided in late September to not let people shop for health plans without first making an account.

Because of this last minute decision it made the first step in the marketplace process completely trial and error for the user. Back End Developers had it written in the code that the username to create an account had to include a number. However, on the Front End of this step there were no instructions for the user to do this.

Most of the users were not able to successfully create an account.

500 Million Lines of Code?

To give you a little reference, Microsoft Windows has around 50 million lines of code, Apple’s Mac OS 10 has around 85 million lines. Unofficial stats show Healthcare.gov with around 500 million lines of code.

If true, much of the fat is probably unnecessary and clearly rushed. It’s a safe bet the code was repetitive and repeatable functions weren’t wrapped up and re-used (see: lack of communication between developers).

On top of that, when you have issues navigating through 500 lines of code is like finding a needle in a haystack, and isolation of issues becomes burdensome.  When these problems are constantly repeating themselves in complex unnecessary code—then you probably shouldn’t have made this site go live.

Listening to Feedback is Key.

A few days before the launch there were tests to ensure that the website could handle the amount of traffic it was going to receive. It crashed after only just a few hundred people had tried to log on. This is not the time to cross your fingers and hope that it doesn’t happen when you launch the website.

HealthCare.gov went live and locked up almost immediately after 2000 users tried to attempt the first (and nonfunctional) step.

Things to Look Out for.

The website was in and out of being offline all weekend. Jeff Zients, who used to work as an administration official, has been brought on to oversee HealthCare.gov improvements. “We are confident by the end of the month of November HealthCare.gov will operate smoothly for the vast majority of consumers," he said. He has created what he refers to as a “punch list” containing issues that need to be fixed. These issues fall into two categories: performance and functionality.

The most concerning item on this punch list an “834 EDI transmission.” It’s the technical, back end reporting tool that you will never see. After every work day the federal health-care marketplace sends insurance companies these data files that basically tell them who you are and what type of policy you need. Somewhere along the way from HealthCare.gov to the insurance companies these messages may be getting morphed. If you were one of the few that did manage to sign up for healthcare the 834 code could have been jumbled to either be unreadable or be completely wrong.

Could this all have been fixed if the government had doubled checked everything and delayed the release date? Probably. Bottom line: make sure a website is fully functional before you launch it millions of people. In the meantime while that’s getting fixed, you can see some examples of state healthcare marketplaces that are working beautifully: Massachusetts, Kentucky and California


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