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Tech experts: Health exchange site needs total overhaul

4:20 PM, Oct 17, 2013   |    comments
President Barack Obama & Secretary of Health & Human Services Kathleen Sebelius (Getty Images)
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WASHINGTON - The federal health care exchange was built using 10-year-old technology that may require constant fixes and updates for the next six months and the eventual overhaul of the entire system, technology experts told USA TODAY.

"The application could be fundamentally flawed," said Jeff Kim, president of CDNetworks, a content-delivery network. "They may be using 1990s technology in 2.0 world."

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Recent changes have made the exchanges easier to use, but they still require clearing the computer's cache several times, stopping a pop-up blocker, talking to people via Web chat who suggest waiting until the server is not busy, opening links in new windows and clicking on every available possibility on a page in the hopes of not receiving an error message. With those changes, it took one hour to navigate the HealthCare.gov enrollment process Wednesday.

Those steps shouldn't be necessary, experts said.

"I have never seen a website - in the last five years - require you to delete the cache in an effort to resolve errors," said Dan Schuyler, a director at Leavitt Partners, a health care group by former Health and Human Services secretary Mike Leavitt. "This is a very early Web 1.0 type of fix."

The site could be perfect, but if the systems from which it draws data are not up to speed, it doesn't matter, said John Engates, chief technology officer at Rackspace, a cloud computer service provider.

"It is a core problem in the sense of it's fundamental to this thing actually working, but it's not necessarily a problem that the people who wrote HealthCare.gov can get to," Engates said. "Even if they had a perfect system, it still won't work."

Outsiders acknowledged they can't see the whole system, but they said they feared HHS built a system that will need an expensive overhaul that would cause more headaches for people trying to buy insurance.

HHS officials did not respond to a request about the nature of the problems. However, they reiterated that wait times have been reduced or even eliminated as they continue to work to fix the system. They have added capacity so more people may use the site at the same time, and they moved one component from virtual space to actual hardware to reduce bugs. As of Wednesday, they did not have an update on numbers.

"I will be the first to tell you that the website launch was rockier than we wanted it to be,'' HHS Secretary Kathleen Sebelius said Wednesday at Cincinnati State Technical and Community College, adding that people have until Dec. 15 to enroll to ensure coverage beginning Jan. 1.

Engates said HHS has been opaque about the problems, and the tech industry doesn't know the extent of the issues. "There's no secrets leaking out," he said. "I'm sure everyone's looking for something to change the direction of the conversation, but it's just not there."

"I think it's a data problem," Kim said. "It always comes down to that."

And if that's the case, the problems are beyond "rocky," he said. Instead, it would require a "fundamental re-architecture." In the meantime, "I think they're just trying to shore up as quickly as possible. They don't have time to start from scratch."

"If I was them, and I'm just conjecturing, I would probably come up with some manual way of saying, 'Only people with the last name starting with 'A' can sign up today," he said.

But come March 31, when the first enrollment period ends, the "shore up" period may become a "re-architecting" period, Kim said.

On a good note, he said, after looking at available code, the site is "very secure."

Clearing the cache, which has helped make it easier for some people to enroll, could ultimately strain the system more, Kim said. That's because a "cookie" is stored on a person's computer that contains data, such as the person's name and address, that can then be quickly accessed when that person gets on the website again instead of having to be retrieved from the government's server.

But as HHS fixes errors, the cookies may not correspond with the updated website, so rather than allowing someone to quickly log in, they instead cause an error message. And every time a person clears his computer's cache, the government's website has to work that much harder to grab more data.

Requiring people who may not be Web savvy to use the site in any way other than a step-by-step easy process defeats the point of the whole system, Schuyler said. That includes laws mandating that insurers provide clear explanations about policies to people may make sound decisions and understand what they're buying.

"Most consumers will have no idea what 'clearing the cache' is and this will just cause more confusion and frustration," he said.

Engates said he believes most of the problems are caused by systems integration with other sites, such as the IRS. And that could be causing some of the problems people see as they make it past the initial application process. It's a series of questions meant to verify a person's identity and income. But after that questionnaire, visitors often encounter a series of error messages, or the page a person tries to click to doesn't come up. The data requests to other sites could be causing those problems, Engates said, which would mean the problem isn't with the HHS site itself.

"Maybe the site is submitting a request for more data, and that puts you in that trap again," he said. "It's a giant integration problem that they have to solve."

And as they try to fix those problems, there's another issue lurking in the background: Some HHS personnel were named essential, and not subject to furloughs because of the government shutdown. But that didn't apply to the other organizations they were working with, Engates said. So as HHS techs work around the clock to fix the problems, IRS techs may be prohibited from working at all.

In the meantime, HHS personnel can't say anything about the situation, it can be played politically as "bad," he said. If they say it will take two weeks to fix, they will be criticized because it's taking too long. But he expects that it's a problem that will be resolved soon, especially as the volume of visitors goes down.

"If you can get the system below some sort of threshold, it will perform as it's supposed to," Engates said. "It won't get any worse. It's going to get better little by little by little."

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