Do we really need a “tech surge?” Or, more to the point, do we really need to use an Iraqi war reference when fixing a healthcare website?
The Healthcare.gov fiasco cannot get any weirder than instigating a health IT “tech surge” to resolve the challenges with the Healthcare.gov website, except for maybe these three points:
Tech Surge Point 1
There are at least 55 different contractors involved in the Healthcare.gov site. Yes, that is right – 55 different contractors. Will a tech surge, which would add even more people, help the situation?
Tech Surge Point 2
According to Brooks Law, “adding manpower to a late software project makes it later.” This principle was outlined in a 1975 book by Fred Brooks entitled The Mythical Man-Month. Essentially, adding incremental people to an already late software development project just further delays it. Is a tech surge the right answer?
Tech Surge Point 3
Who is involved in this tech surge? Well, right now, no one really knows. White House press secretary Jay Carney had no answer to the question. What we do know is that Jeffrey Zients, former economic advisor to President Obama, has been tapped to lead the surge. Is leading a tech surge a job someone actually wants?
The Real Points: Planning and Leadership
The quasi-launch of Healthcare.gov proves one essential point: Good planning and strong leadership are critical to implement large initiatives successfully. We may need to remember the Deming concept of Plan-Do-Check-Act again.
But even a former Google intern knows this. Here is what Timothy Lee wrote in a Washington Post article:
“Not only will more programmers not necessarily speed up the development process very much, it could actually make things worse. That’s because existing programmers will need to spend time training the new programmers, assigning them tasks, and coordinating their efforts with the new, larger development team. Just as supervising me may have taken my boss more time than just doing the work would have, so adding more people to the HealthCare.gov team may actually lengthen the time it takes to build the HealthCare.gov website.”
Sounds like he experienced the Brooks Law first-hand.
To pile on a little more, Rusty Foster in a The New Yorker article entitled “Healthcare.gov: It Could Be Worse” points out:
“The Times also quoted an ‘insurance executive working on information technology,’ who said that ‘we foresee a train wreck’ because ‘we don’t have the I.T. specifications.’ He also said that ‘the political people in the administration do not understand how far behind they are.’ I’ve been a software contractor for the better part of fifteen years, and no one spends that long developing software without being involved in a few troubled projects. One thing they all have in common is that ‘train wrecks’ are never a surprise to anyone working on them. They are not discrete events; they are part of drawn out processes. We only saw the wreckage of Healthcare.gov on October 1st, but the contractors have been working on a wreck for almost two years.”
Planning was missing as well as the accountability and sanity checks. See the above reference to Deming again.
Brooks and Deming may have it right. There is little doubt that their advice should have been used and heeded in this project. Brooks Law, in particular, needs to be considered as this “tech surge” is unleashed.
Within this story, there are many lessons to all health IT professionals and all managers and leaders involved in major software development and implementation projects. Four key lessons include:
- Plan the work and work the plan
- Do the right things right as often as you can
- Lead with clarity and accountability
- Communicate early and often
The Jon Stewart Law
When news becomes funnier than comedy, we know it is time to do more than put a marketing spin on the fixes (aka “tech surge”). The time is now to work diligently, understand the real issues, identify the real fixes, and then embrace the four key lessons at a minimum.
There might be a new law, too. It is the Jon Stewart Law, which states: “The less you think about what you are doing, the more likely you will appear in comedy news sketch.” Watch this clip from The Daily Show with Jon Stewart and vow never to have one of your health IT projects show up here!
Latest posts by Jon Mertz (see all)
- 5 things I learned in 10 years in healthcare - June 14, 2016
- Millennials on a Mission: Health IT Leader, Jenny Sabol - February 3, 2016
- Giving #HITthanks. Share Your Health IT Gratitude! - November 24, 2014