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A doctor's five real-life suggestions for saving HealthCare.gov

 

In an opinion piece titled "How to Fix the Glitches" for the New York Times Wednesday, Dr. Ezekiel J. Emanuel vice provost at the University of Pennsylvania and an oncologist  who has advised the White House on health care reform, offers some interesting suggestions about to how to resuscitate a dying Healthcare.gov.  

If any of us were on the operating table, what skill-sets would we ask for to make sure that we survived? 

This is the same question everybody should be asking of what the A-Team should really look like to make sure that Healthcare.gov doesn’t die.-- After all it’s pretty clear that up until now the only people caring for this dying website may be some interns or residents in training.

If the chief surgeon does not understand what he is going to find when he opens up Healthcare.gov, and what he needs to do about it, it doesn’t really matter about his ability to give orders.

Here are five real-world suggestions:

1. Understanding the nuts and bolts of complex health data.

Anybody who steps in to build a team to resuscitate Healthcare.gov needs to understand the complexities of enrollment systems, payroll systems and insurance systems to know how that data should ultimately be tied together.  

If the chief surgeon does not understand what he is going to find when he opens up Healthcare.gov, and what he needs to do about it, it doesn’t really matter about his ability to give orders because he will have no way of giving instructions to even the best technologists about where to look, and what to do, and what potential obstacles to look for.  

The key people in the industry who understand the complexities of these systems are few and far between, but they have all had some kind of management role in a large insurance company, health care data company or perhaps even a state-level exchange.

2. Understanding the complexities of health insurance, purchasing and pricing.

For decades employers, brokers and insurance companies have been struggling with a process called “open-enrollment” that typically happens every fall.  

No matter how many times a company goes through this process it is an absolute nightmare for a Director of Benefits in any large corporation.  

Why would anyone believe that bringing in individuals with no expertise or understanding of what is involved in this process could help build a website for millions of individuals to purchase insurance and make decisions?  

Anybody that joins the resuscitation team now should have experience in what consumers are looking for, and ensure that every possible output of the website is logical.

3. Understanding how to build a great customer experience.

There is no question that Silicon Valley has figured out how to create delightful customer experiences better than anyone. But health care is different.  

'Without understanding health care delivery and the nuances of the system, it is impossible to deliver customer satisfaction and also be able to measure it credibly without truly understanding the needs of the individual who trying to buy insurance.  

The biggest mistake is to stack the deck with individuals who are trying to resuscitate Healthcare.gov who know nothing about health or care and only know about “gov.” We don’t need technicians; we need health care Super Stars to fix the problem.

4. Understanding how to communicate.

The biggest challenge for the Obama administration has been anticipation and communication. A key part of the A-Team needs to be individuals who credibly understand the problems and is able to communicate to the public about what to anticipate that people will believe.  

Imagine if you were in the waiting room of a hospital expecting to get news about how the surgery of your family member is going. Who would you want to hear from -- the billing manager or the surgeon?  

A key flaw in the entire strategy has been establishing an effective communications platform that delivers reliable, concise, coherent information to people who don’t even understand what health insurance is and are looking for help.

5. Understanding how to measure results.

A major gap in the rollout is the gaping black hole of how many people have actually enrolled and purchased an insurance plan.  

It’s a simple question.  

Yet, all of the focus has been on building a really slick website, but it appears that little attention has been given to reporting results.   

The only way we will ever know if the Affordable Care Act is really improving access, reducing costs and enhancing quality is if we have the expertise to know how to collect, analyze and communicate that information. 

A key member of the team needs to be somebody from a senior leadership role who has worked with various stakeholders in the healthcare industry, who has analyzed health care data, and who knows what it means to help create a framework for communicating results, irrespective of whether they are good or bad.

As the ObamaCare team scrambles to respond to the Code Blue, and if people without these key skill sets are not part of the crew, then the prognosis for Healahcare.gov, or any part of the Affordable Care Act, is bleak.

Dr. Sreedhar Potarazu is an acclaimed ophthalmologist and entrepreneur who has been recognized as an international visionary in the business of medicine and health information technology. He is the founder of VitalSpring Technologies Inc., a privately held enterprise software company focused on providing employers with applications to empower them to become more sophisticated purchasers of health care. Dr. Potarazu is the founder and chairman of WellZone, a social platform for driving consumer engagement in health.