Iowa, Healthcare Software, Lessons to Learn

Disclaimer: This is not a political blog or platform for political conversation. However, it’s hard to ignore the mess that the Iowa caucus has become. So, bringing it back to what we care about for these thoughts, I see a useful, albeit somewhat obvious to the experienced, cautionary tale of the dangers involved when launching an enterprise wide software solution.

Managing the complexity of the Iowa caucus is probably a lot like managing the complexity of products, sales, marketing, and claims for a mid-large health plan. A decision – and a financial investment – was made to streamline a “time honored process”. But clearly, some things went off the rails and didn’t work as planned. Was it a functional or non-functional error? Maybe a combination of both?

Functionally, what went wrong? It is apparent that the app just didn’t work. Or maybe the user experience (UX) was problematic which required changing the PIN at the last minute. Scale could have been an issue too.

But even if it had worked, it seems that the nonfunctional requirements and the lack of attention to them would have doomed this effort anyway. Deployment caused some problems. It appears the app was launched using a Big Bang approach, which is inherently risky, but then the process was also haphazard and uncoordinated. Maybe a more thoughtful and incremental approach that included incremental, phased deployment, testing, and user training would have resulted in a better outcome.

Perhaps most damning – there was no enterprise-wide buy-in to use the app by the event organizers. As the chaos evolved on February 3^rd, it seemed very few individuals were committed to using it. Some caucus members clearly ignored the app, while others punted the responsibility to deputies. Adequately preparing the organization for launch, a crucial step for ensuring the success of the broad operational strategy, was either missed entirely or just not executed effectively.

So why is this a good case study for health plans? For starters, software is just the tip of the iceberg. It makes efficiencies and value possible, but not assured. Success is dependent on the combination of functionality, deliverability, and collaboration from people across the enterprise – perhaps with help of consultants or vendors – to embrace the software, to “own” it and make it real. This is the only strategy that can make universal change possible and we have seen enormous success when all the elements are inline. But that’s never assured, and it’s something that we – and all vendors and health plans – should continue to focus on.