OPINION:
As the White House hits the reset button on health care policy, it’s time to hit the off button for Heathcare.gov. The website is akin to a house that has been built without a solid foundation. The administration broke the first rule of tech geeks everywhere when it started the site: They built the framework before they knew how to secure it. The personal information of millions of Americans, gathered from seven federal agencies, is vulnerable, and is a lucrative prize for hackers.
According to the Identity Theft Resource Center, 34.1 percent of all data breaches that have occurred this year have been tied back to health care.
Since Obamacare was enacted, the way we get health insurance has changed, and it is not going back. If not this website, another will have to serve the American people. Healthcare.gov won’t stand the test of time, but there is a way to build a website to purchase health insurance that does. This is the tech blueprint I would recommend:
The treasure trove of data encapsulated in the system is a hacker’s heaven. Why do the hackers want a peek at customers while they are on the system? The exchange not only takes in the personal account information that is keyed in but it also interfaces with seven federal departments plus agencies of the customer’s home state. Identify the gems that the fraudsters would want to steal. Some of these gems could be a Social Security number, a recent tax return or a date of birth. Once the gems are identified, build out the security plan before the first Web framework or screen is built. Every time the system design touches a gem, ask the security team how to develop a watch plan that can either protect it or detect that the gems, in this case the personal data of Americans, are being taken.
Shopping for a new health plan should be as easy as shopping for a place to live. Today, we use rent or mortgage calculators to see how much living space we can afford. Why should shopping for heath care be any different? Separate the shopping for and research of a health insurance plan from the commitment to purchase the plan. Give the customer the ability to type a variety of different scenarios into the calculator and shop for the best options without disclosing who they are. This will take a load off the system, making it more accessible to those ready to make a purchase. The interface can also be designed to be both informative and fun, offering helpful tips and advice as they test out scenarios.
Amazon.com was not built overnight, and neither was the current online banking systems. They had master plans, but delivered a small set of key functionality at a time, often in 90-day deliverables. This allows the provision of a critical service to the customer, but in a focused way. The performance can be benchmarked, the security of the 90-day deliverable can be fixed, and any lessons learned can be rolled out with the next set of functionality.
Facilitate focus groups to test the customer interface so support calls can be avoided. Focus groups can help boldly break the system just by using it, either through sheer volume or by interpreting how to use the forms differently than the designers intended. I remember more than one time when working on building a new site, we built functionality in the lab that was common sense to us tech geeks. However, when real people “broke it” by using it in the way that made sense to them, we were able to use that knowledge to make it better. Boldly invite the focus groups to break and criticize the system. Use that feedback to rebuild the functionality that they tested.
Communication is key. Domino’s Pizza offers a quality and status check, and health care should, too. At every step in the process, let the customer save their application. Provide them with a status tracking number and offer them mobile or phone alerts to remind them to complete the process. At each step in the process, provide an opportunity for them to rate the quality of their experience.
Why does Healthcare.gov need to be taken off-line? Every day, we are talking about the status of its health. Rather, we should be talking about the health of millions of Americans who need to know what their health insurance options are. Technology may be the solution, but it shouldn’t be the focus of the conversation.
Theresa Payton is the former White House chief information officer in the George W. Bush administration and co-author of “Protecting Your Internet Identity: Are You Naked Online?” (Rowman & Littlefield, 2012).
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