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What Healthcare.gov Can Teach Future CIOs

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Michael Brown

June 20, 2016
CIO Lessons
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We’ve all seen the extensive media coverage on the challenges with the launch of Healthcare.gov. The website was created to serve as a hub for citizens to learn about and purchase health insurance. A traffic forecast from the Congressional Budget Office estimated that approximately seven million people would use the site within the first year. Unfortunately, due to the incredible amount of technical problems, very few people have actually been able to use the website the way it was intended.



Much has been written about the politics of the botched launch, but the problems that have ensnared the healthcare exchange website have less to say about ideology than they do about technology management. Development of the site was outsourced to a contractor, who subsequently subcontracted out separate areas of development like the frontend and security. Multiple sources have indicated that aside from technical issues, many problems stemmed from the Centers for Medicare and Medicaid Services lacking the internal managerial capability to effectively act as systems integrator for the project.


This problem is not unique to government projects and represents a skill set that any business planning on designing an IT system must possess. As the wave of next-generation solutions are introduced, this will be particularly true for CIOs who will be confronted with the challenge of balancing higher performance and increased uncertainty, over reliability and integration. With that in mind, establishing best practices for CIOs to implement fast, flexible, and auditable development processes are key to IT success in the enterprise.


Gartner provides a four step model (Strategize and Plan, Develop Governance, Execute, Measure and Improve) for preparing an entire organization to effectively manage vendor relationships. More specifically, when managing the technical development process, CIOs should focus on properly communicating initial project requirements, how and when changes in requirements will be managed, and creating structures to monitor vendor performance at timely intervals. Ensuring organizational readiness is particularly important when engaging outsourcers, who utilize high performance agile processes, creating a mismatch in capabilities and negating the benefits of flexible development.