engineering management 465
Leila@
group_presentation.pptxHealthCare.gov
A Failure Analysis by The Next Group
Team
Chris Blackden
Gianfranco Savino
Hillel Chaitoff
Kaan Over
Agenda
Background
Project Overview
The Failure
Starting Out
Identifying Stakeholders
Determining Requirements
Planning
System Timeline
The Design Approach
Software Development
Synthesis, Analysis, Optimization and Integration
Test and Evaluation
Keeping It Up
Operational Use
Lifecycle Support and System Retirement
Lessons Learned
Background
Project Overview
Patient Protection and Affordable Care Act
Health Insurance Exchange
Facilitate Health Insurance Sales
Easy-to-Use Interface
Central “Marketplace” for Health Insurance
The Failure
Oversight
Lack of Proper Management
Poor Requirements Management
Non-Incentivised Contracts
Deadlines
Not Met by Contractors
Not Enforced by Customer
Technical
Poor Infrastructure
Lack of Features
Project Overview:
Enactment of the Patient Protection and Affordable Care Act
Mandating the creation of a Health Insurance Exchange
The Failure:
General (Project) Management Oversights
Poor Requirements Management
Non-Incentivised Contracts
Technical Infrastructure Issues
Lack of Expected Features
Hillel Chaitoff () - [email protected] _Assigned to Hillel Chaitoff_
Identifying Stakeholders
Federal Government
POTUS
Congress
Supreme Court
Health Insurers
Healthcare Providers
Customers
Small Businesses
Self-Insured Individuals
Starting Out
Determining Requirements
Poorly Defined
Technical Requirements
Contract Requirements
Performance Requirements
Constantly Changing
New Requirements
Changes to Old Requirements
Workflow
Governance
Identifying Stakeholders:
Federal Government
Insurers
Healthcare Providers
Businesses
Individuals
Determining Requirements:
Poorly defined requirements...
Workflow and governance were not agile; could not handle introduction of new requirements or changes to old ones.
Hillel Chaitoff () - [email protected] _Assigned to Hillel Chaitoff_
Planning Timeline
April 19th 2010: HHS Creates OCIIO in part to handle development/launch of full HealthCare.gov site
January 26th 2011: OCIIO merged with CMS to work on HealthCare.gov site
January 3rd 2012: CGI Federal Hired by CMS to develop HealthCare.gov site and QSSI to build Identity Management System (EIDM)
August 20th 2013: CGI Federal presents screenshots of website instead of prototype because production of site was significantly behind schedule
September 26th 2013: CMS requested double hosting capacity for HealthCare.gov, 3 business days before launch
September 29th 2013: EIDM system fails, CMS assures stakeholders that site will be ready by October 1st
Design Approach
Highly complex project with high risk for failure further complicated by lack of clear direction from CMS
CMS required use of database platform that CGI Federal stated they were not able to develop for
EIDM was intended to be used for single point of logon, but was not designed for that requirement
Rather than prioritize functional aspects of the site, CMS chose to focus on non-critical functions, such as a spanish language version and an anonymous shopper feature,
Software Development
CMS had a ‘vision for functionality’, but never translated that vision into specific technical requirements
Requirements were frequently changed by CMS, resulting in inconsistencies in development
Developers followed an ‘Agile’ Methodology
Agile software development builds one piece of the whole, then tests it, and if successful, builds the next piece
Relies on heavy testing and consistent iteration to ensure success
Agile development also can create potential to develop off-requirements if they are not clearly set at the start of development
Testing was given a lower priority than launching the site in a non-functional state
Hillel Chaitoff () - [email protected] _Assigned to Chris Blackden_
Keeping It Up
Lessons Learned
References
GAO-14-694 - A Report to Congressional Requesters
OEI-06-14-00350 - HealthCare.gov Case Study
