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FCW : November 15, 2013
November 15, 2013 FCW.COM 19 Operators of the beleaguered Health- Care.gov site could take a few hints from Hindu lore and Eastern philoso- phy to x things, according to two of the architects of the world s most mas- sive national ID system. FCW discussed HealthCare.gov s problems with Srikanth Nadhamuni, formerly the technology head of India s Aadhaar national biometric identi ca- tion system, and Raj Mashruwala, who led the biometrics development on the project. They said simplicity is the key to scalability --- and service-level agree- ments don t hurt either. HealthCare.gov s creators have faced blistering criticism since the site s Oct. 1 launch for drastically underestimat- ing the traf c the site would attract and for the dif culty it has had in provid- ing even the most basic functionality. In contrast, India s Aadhaar plat- form --- arguably the most ambitious biometric identification and public welfare network ever undertaken by a national government --- is success- fully obtaining and storing voluntary ngerprint and iris scans from all of India s 1.2 billion people with the aim of straightening out tangled welfare payments throughout the country. Since it began the project in 2009, the Unique Identi cation Authority of India (UIDAI) has signed up 400 million people who submitted ngerprint and iris scans at 30,000 enrollment centers around the country. The project assigns a unique 12-digit number to each partic- ipant for his or her lifetime that serves as proof of identity and residence in the country. The project is slated for comple- tion in 2019. Like the U.S. health care program, UIDAI s aim is to deliver government subsidies into the right hands, as well as --- in India s case --- set the foundation for paperless nancial transactions. Aadhaar s data storage needs are higher than those for HealthCare.gov because Aadhaar stores images of ngerprints, irises and faces. HealthCare.gov only keeps bio- graphical information and plan choices. HealthCare.gov needs less tech, more jugaad Srikanth Nadhamuni and Raj Mashruwala have some ideas to improve HealthCare.gov, based on their work on a similarly complex system in India BY MARK ROCKWELL that would have allowed users to browse plans without registering for an account. That decision was made just two weeks before launch, and the change created a surge in demand on the account-registration portion, lead- ing to the most visible early failures. Republicans are convinced that politics drove the decision to require users to register. "I m going to venture to guess that the regular bureaucrats did their job [and] the political appointees manip- ulated the system to hide data they didn t want the public to know," Rep. John Shimkus (R-Ill.) said at the Oct. 24 hearing. Sebelius, however, testified on Oct. 30 that the intent was to reduce a potential pain point in the system --- having millions of casual brows- ers querying multiple insurance plans. The decision to delay launch of the site s Spanish-language version was made for the same reason, she said --- moves that seem "ironic at this point." Others are blaming the procure- ment process. "How [do] we end up with contractors who say essentially everything is all right when it isn t?" Rep. Anna Eshoo (D-Calif.) asked. "That s going to take a bipartisan effort to really bring about a x." In fact, there is already a biparti- san effort in play to reform IT pro- curement. The Federal IT Acquisi- tion Reform Act (FITARA), which the House passed as part of the National Defense Authorization Act, man- dates that CIOs at civilian agencies have agencywide budget and hiring authority and be presidential appoin- tees, among other things. If nothing else, FITARA would have provided HHS leaders with undeniable visibility into the development of the HealthCare.gov portal. CMS is a large component of HHS with mandatory funding streams of its own, and it operates independently of HHS to an extent not widely appreciated. It will be up to the administration and Congress to connect the dots regarding the launch problems and their causes. But because HealthCare. gov was so public and tied to a contro- versial policy that is still the subject of defunding efforts, the procurement issues endemic to federal IT were put on display as never before. U.S. CIO Steven VanRoekel is among those seizing on that silver lin- ing. Speaking at the ACT-IAC Execu- tive Leadership Conference in Octo- ber, VanRoekel praised the boldness of HealthCare.gov. Even with all the launch problems, he said, "we should all be proud that something this com- plex, this integrated to legacy sys- tems...was done at Internet scale." "There are aspects of government that made it hard to move at the speed at which you would love to move, [including] procurement and the way we implement technology," he added. But he argued that the launch provides a "teachable moment" for examining how government acquires and imple- ments IT. ■ Health IT
October 30, 2013
November 30, 2013