UK pins hopes on OSS to avoid Healthcare.gov
A tale of two governments: UK healthcare tech system reforms highlight where America went wrong.
As demonstrated with last month’s case of UK government mangling of agile IT implementation, when bureaucrats get their fingers in tech pies, the result can be less than sweet.
Case in point: When Obama’s controversial health care reforms came into place, legions of opponents leaned back and waited for some sort of apocalypse scenario. And lo, it came to pass, Healthcare.gov, the site built to ensure millions of Americans could finally gain access to affordable healthcare (boo, hiss), debuted to a chorus of resounding glitches. Within hours of going online, the internet was awash with complaints that drop downs weren’t working, it was impossible to log-in, and pages were failing to load.
It wasn’t necessarily the brutalist Soviet nightmare doom mongers were hoping for, but it was enough to generate headlines like, “Obama Spent $634 Million to Build Broken Healthcare.gov Website” and “Head fake! Is Healthcare.gov only an empty shell MOCKUP of a working Obamacare exchange?”.
Not quite. Actually, what had happened was a perfect example of what can go wrong when you outsource. As the Verge points out, this website comes from the same people that staged one of the most technologically sophisticated election campaigns of all time. Healthcare.gov however, was not created by the elite team of technicians that powered Obama to vicory. The bulk of the work was done by Canadian firm CGI Group, who subcontracted up to 15 other firms for different aspects of the site.
It wasn’t all bad though. The front end of Healthcare.gov, which launched in June, was built by Aquilent, who then subcontracted Washington based startup Development Seed, who are very much adherents of zeitgeisty Silicon Valley practices. Working on agile principles, the team published their code on GitHub, and ultimately created a product that married form and function beautifully, whilst allowing for speed, scalability, all at minimal cost.
In entrusting a closed-source proprieter to take on the back end of what promised to be an incredibly complex project, the Obama administration adroitly demonstrated exactly why awarding contracts to a solitary bidder can be a terrible idea. The best pitchers certainly aren’t always the best people for the job – and there are an awful lot of companies out there who are great at landing contracts, but not so skilled at following up on the actual job.
Any project on this size was guaranteed to have some teething issues, regardless of how is was developed. But, thanks to their poor decision making, the US government is now saddled with a system riddled with bugs that only the CGI Group can fix, and a system that is fundamentally poorly designed – something that’s a lot mere serious than a few initial glitches, and far harder to fix. And while problems persist, the many fierce opponents to the project are smugly nodding their heads and ruefully sighing, ‘I told you so’, as what promises to be a game changing resource for so many Americans fails to take flight.
Migrating Spine from a closed-source proprietary project to an system centered on open source technologies is in keeping with the UK Department of Health’s IT Strategy, which calls for the adoption of open standards to increase interoperability and interconnectivity between government sources.
Additionally, delegating infrastructure responsibilities to primarily open-source companies over one IT oligarch also means that costs won’t be solely absorbed by one giant corporate sponge – minimising the risk of the astronomical cost related heckles currently being thrown Obama’s way.
Before Spine 2 goes live, a complete redesign of hardware, software and code will have to take place. However, after the initial hump, in the long run this should allow for a more limber service that can be easily tested against by third-party suppliers, as well as reduced deployment costs.
With the throb of discontent humming from across the pond, this was auspicious timing for the NHS to announce their break with Oracle. And, should the UK government accidentally follow past form and develop a crooked Spine 2, at least there will be plenty of scope for fixes – which is sadly not the case for the ailing Healthcare.gov.