THE BLOG

Blood, Sweat and Caffeine: The Making of HealthCare.gov

Sep 14, 2010 | Updated May 25, 2011

Over the past few weeks, you've probably noticed that GovLoop has created a new series called GovLaunch. Basically, we're highlighting the hot-off-the-press websites, apps and projects coming out of government - the "New Innovations of Government 2.0", if you will. In fact, we blogged about it on the Huffington Post in case you missed it!

So we thought we'd do a special one on HealthCare.gov. Yep, we already featured it as a Project of the Week and highlighted the HealthCare.gov Insurance Finder Widget, but we also wanted to ask the folks at HHS a few more questions to pull back the curtain so other agencies could benefit from their hard work to stand up this important resource. Our questions and their answers are below:


1. What is HealthCare.gov? Can you highlight some of the key content/features?

Its primary focus is helping people find the insurance coverage options that work best for their individual circumstances. It is the first ever website to bring together all private and public insurance options. The audience is key--we have a laser-like focus on consumers, which partly explains why we look so different from many government sites. It's also a one-stop shop for consumers seeking information on the Affordable Care Act and how it impacts their health care.

2. I saw in your comments on HHS in the Loop that HealthCare.gov was built "in 90 days, by the deadline set in the law." Can you say more about the law (assuming this is part of the historic health care legislation)?

Under the Affordable Care Act, we had to launch by July 1. Here's a site that describes what the web portal needs to be and do under the law: http://www.hhs.gov/ociio/regulations/webportal/index.html

3. What did it take to complete this project in 90 days? Who was involved (i.e. cross-disciplinary teams, citizens, number of people, etc.)?

Blood, sweat and caffeine on the part of a team of dedicated people. At least 50 people from across HHS had direct hands on some aspect of the project, and many more provided critical support. The vibe was as much of a tech startup as it was a typical site launch.

4. What were some of the challenges along the way and how did you overcome them quickly?

On the tech side, this was a huge lift in many ways: We had the assistance of a wonderful contractor, who helped us build the insurance-finder portion of the site. There were challenges all along the way, not the least of which was clearance of all content by multiple stakeholders. Still, we managed to present complicated information in plain language.

5. What has been the citizen response in the first few weeks?

We implemented a feedback tool asking visitors if a specific page was helpful (yes or no), and providing the option for additional comments. In the two months since we have launched Healthcare.gov, we have received over 15,000 yes responses. Healthcare.gov received more than 4,200 comments in the first two weeks, of which about 75 percent of them were positive, expressing appreciation for the helpful info. Of course not all feedback is positive, and we consider this project a collaboration with our users, using the comments to help direct website improvements. For example, we've added more information about the Medicare "donut hole" in drug coverage after many people told us they were confused. It's also very useful to have tens of thousands of proofreaders. Overall, we will use this feedback to strengthen the usability of the site and clarify the website content. Also, the blog, Healthcare Notes, will address several of the comment topics and questions.

6. I see that your are translating the website into Spanish - any other languages? Do you have to translate line by line or are there easy, one-click, open source tools that you're using for translation?

The Latino community has the highest un-insured rates in the nation, and for that reason Spanish was the first priority for translation. HHS uses a professional translation company specializing in website translation. Typically the translation company scans the site and then provides a word bank of translations for key terms specific to the topic of the site. A team of bilingual specialists reviews the translations in the word bank and works with related Government agencies to make sure terms, like "health care," are translated consistently across agencies. With the word bank approved, a site typically takes 90 days to translate. However, due to the importance of this website and the need for immediate translation, the launch of the Spanish HealthCare.gov site took place in roughly six weeks.

7. Since you had to build it so quickly, I am assuming that there is a broader vision that will be fleshed out over the next few months - what else can we expect from HealthCare.gov at full scale?

We just launched a widget for the health insurance finder that people can embed on their websites, and we will add price estimates and other cost and benefit information on Oct. 1. Although people will not be able to purchase plans through the insurance finder, it will be a comparative pricing tool that will allow people to look at competing plans side-by-side. In its first iteration, the insurance finder supports over 3 billion different permutations of data. In October, it will support many times more than that. We will continue to enrich the tool over the months and years. The Affordable Care Act will roll out from now through 2014 and beyond, and the site will explain new provisions of the law as they come on line. We'll build out more material on prevention and comparing care quality, to help people become more engaged in their own health and their role as consumers of care. We expect plenty more blood, sweat and caffeine.

8. Anything else you'd like to share with government colleagues as they launch similar projects?

We developed the site using the Agile model -- using multi-disciplinary teams to build separate parts of the project simultaneously, then bringing them all together. Our content, graphics and operations teams are co-located, allowing for face-to-face communications, constant collaboration and efficient iteration.