What is it? HealthCare.gov is a health insurance marketplace website that is owned by the federal government through the department of health and human services (HHS). Healthcare.gov website was mandated under the provisions of the Affordable Care Act (a.k.a Obamacare). And was designed to serve the then 36 states who opted to be part of a shared health insurance platform which offered citizens with insurance options on a market place style. It was first launched on October 1st 2013. HIT services provided: Patient (Consumer empowerment), Healthcare cost leverage, accessibility to information. Current Status: Healthcare.gov is still operational. Insurance application dates were opened a few months prior to the year in which the insurance will take effect. What happens is that, a consumer will get on the website, create an account, get access to all the options they have based on the information they provided and then shop for their coverage. Insurance options included all participating insurance companies and allowed you to compare rates. Insurance bought took effect the start of a new calendar year or later depending on which cycle a person registered and enrolled for insurance. Although this initial launch revealed major technical challenges and design flaws, this website was not discontinued but re-done to fix it as much as could be done.
Since this is an online platform, there are several ways to register for health insurance via healthcare.com. There are online assists to help navigate the site and there is a telephone assist to work the same process. Since the launch of this insurance marketplace website, bad design and other software problems has tried to cripple this site. The federal government has made considerable efforts to fix both the software and design issues on this site. Analysis of HealthCare.gov system design: The design of healthcare.gov required enormous work than anticipated. Although its design works better now, it has been a system/interface that is known to create ambiguity, frustration and dissatisfaction for users. In an article in the Washington post by Marburger and Sampsel on “A design critique of HealthCare.Gov”, it was apparent that a lot of things went wrong in the design of such a huge complex HIT platform. Some flaws that readily shouts out is the fact that the interface design was not intuitive enough. The help lines along with trained assists for the site were not enough to handle the sheer volume of people who accessed the site. There were also basic interface design problems (which included, information overload, poor form design, ambiguity of buttons and frustrating alerts that users kept encountering), that did not cater to users at all. There are simple design practices and etiquettes that could be done to minimize these problems. As we all agree that the solution is not as simple as it seems, considering that design played and continues to play a critical role in the development, adoption and implementation of HealthCare.Gov, here are a few design solutions that have been suggested to help. The site needs proper navigation. It also needed a baseline interface or page not only to welcome users onto the site but also to solicit information on where users are in their search process and help from there. The design team could have done a little bit more of feasibility analysis and general user needs survey to get an idea of what types of users they were going to get, what help they will need, what ways to optimize the whole registration and so on. Another issue was the fact that the front and back end software component was outsourced to different design/development teams who latter subcontracted parts to other companies. This was reported in Adrianne Jefferies article “Why Obama’s Healthcare Launch was doomed to fail” in The Verge on October 8th, 2013. HealthCare.Gov has gone through a redesign phase where most of the problems seem to be mitigated. During the re-design of HealthCare.Gov, Teal Media shared on their website that they were the lead visual design team responsible for the redesign. In their article “Healthcare.gov: Code Developed by the People and for the People, Released Back to the People” in the Atlantic (by Alex Howard on June 28, 2013), they share what they did to make the site design more usable and visually more appealing. It involved a whole different way to think about this HIT platform. This re-design has resulted in a cleaner, simple, and organized site. Another issue that the design team for this site had to re-visit was the issue of network traffic on the site. For some reason the site could not sustain the number of users that were accessing the site at a time and that caused the site to crash a lot. There were also issues with the overall architecture of the system. Weaver, Ovide and Radnofsky described the federal governments reaction towards public push back and the poor design of the site in their article “Software, Design Defects Cripple Health-Care Website” in the Wall Street Journal by pointing out some design problems and how the government hopes to solve them. Conclusions: With Healthcare.Gov design, it is clear that there was a moment in system design where things fell apart. There was no shared vision for what the HIT system (HealthCare.gov) was, it’s functionality and purpose. According to the Washington post- ABC News poll on the knowledge of this HIT platform for insurance, 62% of adult consumers felt they did not have enough information that would help them understand HealthCare.Gov. Users had minimum and/or poor training for the system. There seem to be a better way to go about building complex HIT platforms like these. Although the system is still functional, it could be argued that it not being discontinued or classified as a failed HIT system is based on influences and consumer needs beyond our knowledge. The cost of redesign and the time spent to patch up thing on this system cannot be regained.