James Furbush

Leadership Insights

What Healthcare.gov’s Failed Roll Out Can Teach Health Care Leaders


By James Furbush | Nov 15, 2013 | Comments (0)


By now, we’re all well aware of the problems plaguing the healthcare.gov insurance exchange. While the politicians and media are hemming and hawing over what the technical problems mean for the Affordable Care Act’s future, there are lessons to be extracted from this ever unfolding saga for health care leaders.

Mistakes will happen; It’s how you respond that will define you

So, your plan didn’t execute like you thought it would. In fact, it was downright a mess. You might even be inclined to utter the phrase, “The [blank] is hitting the fan”.

Leaders put out fires big and small every day all day. Whether it’s a project that didn’t execute as planned, a plan that didn’t deliver the results as expected, or high-performing superstars that aren’t getting along, there will be never-ending challenges to deal with.

The mark of a great leader isn’t the one who can pull off a project with no mistakes, it’s the one who can learn from and correct the mistakes once they happen.

Leaders need to be transparent when mistakes happen. Putting a plan in place to course correct is important, but so is providing the roadmap for how those corrections will be made. It shouldn’t take just shy of a month for the American people to learn who will be fixing the website and that it should (hopefully, fingers crossed) be fixed by the end of November.

It’s not always easy to admit failure. It’s even harder to course correct in the face of adversity. But, it’s absolutely necessary when both things happen to be fully transparent. People won’t be led if they don’t know where, why, and how they are going to get there.

Speed and agility matter

It wasn’t an easy website to build, given all the government databases required to pull information from.

But, the problems with healthcare.gov are symptomatic of a larger problem in the way the federal government manages IT and procurement, according to Clay Johnson, CEO of the Department of Better Technology, a government software design firm.

In an interview with the Washington Post, Johnson reveals a few interesting tidbits about how software and technology projects get built by the government. The long and short of it is that the majority of these projects are unnecessarily expensive, filled with outdated regulations and other cumbersome hurdles (all systems bought by the government have to be Y2K compliant… in 2013), and have no tech experts managing them within the government.

Not surprisingly, most projects ultimately fail because they are the opposite of agile. They are lumbering dinosaurs when they need to be F1 racecars. Organizations that require six months of meetings to make a decision that then takes another two years to implement will be unable to survive when the pace of change is measured by weeks not months or years.

Building a health care organization that is agile enough to deal with change – in whatever form it takes – will be critical to avoid the same pitfalls that plagued the federal government’s roll out of healthcare.gov. Instituting a culture that embraces change, one that can accept failure, learn from it, and quickly set a new course toward success will help create that F1 Racecar.

Your patients have no patience for a subpar experience

The uproar over the website’s failure is well-deserved. But, one aspect of that uproar not being discussed is how changing technology expectations played into that reception.

It was only a decade ago when it was perfectly okay for web sites to slowly load, for music and video to buffer, and for a subpar technology experience on the web to be the norm. But, after a life-changing decade of modern web and mobile apps our expectations are more demanding.

An entire generation of patients (and all future ones thereafter) has always done their shopping at Amazon instead of a brick and mortar store. They’ve always bought music via iTunes. They prefer texting and email to actual phone conversations. Simple, beautiful, and easy-to-use mobile apps are the norm, not the icing on the cake.

Yes, the public was expecting healthcare.gov to deliver the always-availability of Facebook mashed up with Kayak’s search-and-purchase ease-of-use. That’s the experience that should have been delivered to the public, anyway. It was a failure of leadership to not to do so.

The experience you deliver to your patients has to be as good as or better than the experience patients get in their everyday, non-healthcare life. For example, are you building a patient portal for them to use? No? Why not? You should be and it should aspire to be as easy to use as Facebook, Skype, or Twitter for communicating, as easy as Google Calendar for scheduling appointments, and as easy as PayPal or Square for payment processing.

As NHL Hall-of-Famer Wayne Gretzky put it best: the good players skate to where the puck is, the great players skate to where the puck will be.

This new normal applies to the health care industry as well. If you’re not taking the same approach running your health care organization by skating to where your patients will be with the services and experience you deliver them, well, your competitors certainly are, and worse, your patients will start looking for a provider that does.

What lessons can health care leaders apply to their organizations from the healthcare.gov fiasco?

James Furbush is the Managing Editor of the Health Leadership Forum


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