After 12 billion pound healthcare IT failure, U.K. shows that governments must adopt Agile and have their own delivery organization.
With the massive failure of the healthcare.gov launch in the United States, people are talking about why such an important software development initiative turned into such a failure. The U.S., however, is not alone in these kinds of failures. The United Kingdom government spent 10 years and 12 billion pounds on the failed NHS-IT electronic patient records program. Now, 12 billion pounds is about 16 billion Euros or 20 billion U.S. dollars. Ouch! I picture the Queen in earlier times shouting “off with their heads!” Instead the U.K. Government started listening to people who knew about Agile and technology development – they created the Government Digital Services (GDS) which is a 300 person department with the skills to deliver digital services online. In a recent interview with NPR, Mike Bracken, head of GDS, discussed the successes their initiative had in the first two years since it was formed. Bracken mentions many Agile principles GDS are using to deliver a government that is digital at its core. Some of the highlights are:
- Optimizing for business value: GDS is only going after the processes and services most used by citizens, such as passports, tax filing, benefits, etc. Within these areas they further optimize, so GDS is delivering digital versions of the highest value services first. Some processes and services may never be automated because the business value is not there, and that is OK.
- Incremental delivery: GDS is delivering services in an iterative and incremental fashion. They are not trying to get it all right the first time. Instead they are getting the most important parts right, and then learning what works and what needs improvement.
- Cross functional teams: GDS teams are cross functional, with developers, process and policy experts, UI designers, testers, etc.
- Collaboration over contract negotiation: GDS has thrown out all of the traditional procurement processes and procedures. Instead of building contracts based on some wild ass guess wrapped in 300 pages of documentation, GDS admits they have no idea of where or what they need to do in 3, 5, or 10 years. Instead they focus on working collaboratively with users and stakeholders, quickly (1-3 weeks) delivering small amounts of working tested software to their users and getting their feedback.
Bracken was visiting Washington D.C. to talk to government officials and influencers to help them understand how the UK government is bringing digital services in a fast and cost effective manner to its Citizens. For everyone’s sake, I hope the bureaucrats in DC are listening. The $600 million spent could be a more cost effective lesson than the UK, or it could be a failure that is repeated over and over, just like in the movie Groundhog Day.
US healthcare costs in the are rising disproportionately compared to quality of care, what are the options to solve the problem? For Profit or Single Payer?