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How Much Is Oracle To Blame For Healthcare IT Woes?
Nerval's Lobster writes "The state of Oregon blames Oracle for the failures of its online health exchange. The health-insurance site still doesn't fully work as intended, with many customers forced to download and fill out paper applications rather than sign up online; Oracle has reportedly informed the state that it will sort out the bulk of technical issues by December 16, a day after those paper applications are due. 'It is the most maddening and frustrating position to be in, absolutely,' Liz Baxter, chairwoman of the board for the online exchange, told NPR. 'We have spent a lot of money to get something done—to get it done well—to serve the people in our state, and it is maddening that we can't seem to get over this last hump.' Oregon state officials insist that, despite payments of $43 million, Oracle missed multiple deadlines in the months leading up to the health exchange's bungled launch." (Read more, below.)
"This isn't the first time Oracle's name has circulated in conjunction with the Affordable Care Act's digital drama. In November, USA Today published a piece suggesting that 'communication breakdowns' with Oracle Identity Manager had led to 'bottlenecks' in the registration process for Healthcare.gov, the federal online health exchange, which in turn prevented some users from signing up for healthcare. But a single contractor doesn't lie at the root of the federal Healthcare.gov's spectacular debacle: despite months of preparations, large sections of the site remained unfinished on launch day, and the completed parts crashed as soon as users began entering the site. According to multiple sources, the Medicare agency tasked with overseeing the project failed to adequately test, much less integrate, the site's complex elements ahead of launch day. Even if it didn't hold that much responsibility for the federal Website's issues, though, Oracle could find itself the target of much more blame in the Oregon case, where it was reportedly the sole contractor and overseer."
Oracle services may at times make a hash of things.
But we are too quick to blame Oracle and the developer of healthcare.gov for problems that come down to what is simply, a bad and incomplete spec that is impossible to build a good system against.
Indeed the "re-launch" of Healthcare.gov recently only works so much better because they scrapped the requirement that an application had to be completed in order for you to see prices (so you would not see the real price). The application process still is deeply flawed; but you can at least see raw static data now...
So don't place too much blame on Oracle for not succeeding at a Herculean task.
"There is more worth loving than we have strength to love." - Brian Jay Stanley
In any other context "can't deliver on time" means "you're fired and we're suing for breach of contract." In the software solutions market it means "we're going to ride your sunk cost fallacy into the ground, please send us more money."
When the bus is barreling towards you, throw them under it first!
HBI's Law: Frequency of calling others Nazis is directly correlated with the likelihood of the accuser being Communist.
I am talking about both because both face the same issues. They are trying to build a website against a spec that was never complete until very late, and even now had fundamental problems in implementation because of what they are trying to do.
"There is more worth loving than we have strength to love." - Brian Jay Stanley
Outsourcing and privatization of coding is a disaster waiting to happen for any company or government of sufficient size. When you lack the wherewithal in your own organization to make the project you're planning, you also lack the wherewithal to judge how much time/money/manpower it would take someone else.
That in-and-of-itself is a problem, but it also, as you noted, injects a middle-man whose biggest incentive is to keep on earning money past the deadline for the project, not finishing it. When you hire your own coders, their biggest concerns tend to be keeping a manageable workload for themselves and keeping their jobs. Humans are (usually) much more reliable than corporations.
The so-called cost savings of outsourcing projects are a lie too, but that's another rant.
My team has been talking about healthcare.gov and all the related woes for a while. Pretty much we're all in agreement that we should thank the baby jeebus every day it's not our project haha. Seriously though, for something this complex, if the team grows to over about 15 people it's doomed. And that's just YOUR side, I have a lot of experience interfacing to insurance providers' systems. Half the time the provider you're trying to connect to is broken and doesn't work per their API docs at a basic level let alone have proper capacity let alone have any sense of normal connectivity. I can't even imagine trying to talk to something as huge as the IRS. I bet it's 6 months before you can get a simple spelling fix on an API method pushed out to production.
I came to the datacenter drunk with a fake ID, don't you want to be just like me?
Everything seems to swing. But one thing is certain, always follow the money.
This whole 'contracting' affair on both the public and private sector does not produce the highest quality products. Why should it? None of the incentives are there.
The contracting company doesn't want to build something that works without flaws for a minimal profit. They want to have continuing profits. This is not unique to big corporations. Just try dealing with any contractor or mechanic. Sure if you *know* them, you can deal with them honestly somewhat. Or if you pay them enough... and they can cost a lot, you can get an honest deal.
At best, you hope they do a good job and that means you build a good relationship, and that means more business in the future. But of course, when this comes to government contracts, what that natural process means is that it gets called corruption.
On the other hand, you can have the builder operate it. There's some incentive there for them to do a good job as they get a cut of continuing operations. I think there is some hope that the 'cloud' will actually provide for better overall software. Although of course this results in vendor lockin and could potentially cause all kinds of other business problems.
Or you could build it in house. Then of course you run the risk of an overstaffed bureaucracy and unionized government workers.
There's no real easy solution. But I do think the dominant view has swayed too far towards contracting.
The key is only outsourcing part of the project, not the whole thing. If you are working alongside your contractor, you have a better idea of what they are doing and they have a better understanding of your needs. But if you hand over the entire project to a contractor, and you just try to oversee it, you are likely to run into communication problems which will definitely lead to unnecessary costs.
And you can bet that Oracle has lawyers ensuring they never actually meet the legal definition of fraud, and that the contracts have enough wiggle room to cover their asses.
But, I can also tell you that it's entirely common for companies contracting for this kind of thing to start off with the full knowledge that they've not asked for enough money to cover everything and get you a working system -- instead they rely on having to do changes and enhancements on a time and materials basis. And then they make a small fortune in quibbling over every little change.
I've seen several of these kinds of things where the contractors essentially knew there was no way to deliver the system on-time and on-budget. They just seem to build in the fact that once the client realizes it, the sunk cost is high enough they get to have a gravy train for some time to come.
It's not fraud, per se, but it's carefully managing the terms of your engagement with the knowledge the customer will end having to pay more and not really have much of a choice.
Sadly, it almost seems to be standard practice in the industry.
Lost at C:>. Found at C.
As much as I loathe guys like Mark Zuckerberg, I'll wager giving some of his script monkeys a few months to come up with a functional ACA website, and they'd probably do it, using largely open source tools to pull it off.
The world's burning. Moped Jesus spotted on I50. Details at 11.
> Mostly functioning.
Beats nothing.
> And with security like a sieve.
As if the Obamacare website that's designed to funnel personal data to Experian is any better...
A Pirate and a Puritan look the same on a balance sheet.