Welcome To EGO7

Utilizing over 12 years of technology experience, EGO7 consults highly discriminating companies by providing strategic consulting and solutions from online marketing to business process management and anything in between.

Author:  Anthony Jones
Date:  15 November 2013

The rollout of healthcare.gov - a perfect example of what not to do

“We are going to build the most sophisticated, highly automated software platform with a feature set that will rival the most popular software services and it will be a huge success.” Very sexy isn’t it. This was not meant to be a direct quote – but if I was at those initial planning meetings I am fairly sure this was the message. In my years of experience as a technology consultant this is how, many times, an initial conversation starts with many non-technically minded stakeholders with deep pockets and a grand vision. In this case it’s the Obama administration funded by tax payer dollars – approximately $300 million of them.

This is not meant to be a politically driven rebuke of the Affordable Care Act and its’ well guided intentions or a comprehensive analysis of such an ambitious undertaking. A thorough analysis would be nearly impossible at this point as much of the hard facts have not been revealed. Where are you when we need you Mr. Snowden? In my world the grander the vision and the more all encompassing a service usually marches side-by-side with a much higher probability of unexpected outcomes or outright failure.

Being the dutiful consultant that I am, I objectively look at the healthcare.gov initiative through the lens of Lean Startup and Agile Development methodology – which I do regularly. This has become a significant portion of my business and I believe these principles apply to companies of all sizes from startups to large institutions. To start, I view the Affordable Care Act and healthcare.gov as a new business line and e-commerce website, respectively, of a large corporation - the Federal government.

Those of you who are not familiar with Lean Startup or Agile Development the concept is pretty simple. The start of any new venture is a hypothesis that needs to be proven. This proof reveals itself through a series of “experiments” based on the build, measure, learn approach. Its’ principles promote discovery, are iterative and agile, in order to identify misguided assumptions early and support quick reactions (pivots) via real world learning through measurement. Rather than commit a lot of time, money and resources to create what a few people think is the perfect product or solution, initially deliver only what is absolutely necessary to learn what stakeholders (customers, business partners, etc.) want - all else should be eliminated. In sum, the goal is to create a Minimum Viable Product to bring to market a product or service. In this case it is a service.

What is the hypothesis? Provide a method for all Americans without health insurance to sign up and buy health insurance via the Federal government. I believe Lean Startup and Agile methodology could have been applied to the Affordable Care Act and healthcare.gov launch which would have preempted the current usability issues.

Create a Minimum Viable Product (MVP)

#1 Get out of the building (in the case the White House) and test the product solution

The Affordable Care Act has mandated many provisions regarding individuals and insurance companies. This significantly affects buying decisions and configuration of health plan offerings. These are complicated products and significant monetary purchases thereby nearly mandating the need for access to large amounts of information and the ability to make comparisons prior to purchase.

Creating a MVP, a website whose sole focus was to prove the hypothesis and be accessible by the main stakeholders - consumers and insurers - could have went a long way in iterative learning and measurement of what needed to be provided in terms of information, features and user experience in presenting insurance plan options from multiple insurers in order to properly choose an appropriate insurance plan.

In addition to basic usability the government could have been provided with invaluable information regarding which provisions of the Affordable Care Act are most important to consumers when purchasing insurance and for insurance companies who could have utilized information to create and refine product offerings and compete more effectively in the marketplace – driving more value.

In my view, the Healthcare Plan purchasing process is similar to purchasing a car. Cars are large purchases and have many features. We use car configuration applications as a tool to choose a brand, a model and add options. When you have found the correct combination of configuration and affordability you “checkout”, enter the approval and income verification process, get approved, and buy the car – this was the intention but it wasn’t ground in a methodology as it would have been if approached from a Lean Startup mentality.

Build, Measure, Learn

Creation of an MVP - “build” - in conjunction with an agile development approach could have quickly brought clarity, with continuous feedback - “measure” - and implementationof refinements - “learn” -from end-to-end within the first 3 - 6 months of the passage of Obamacare at an insignificant cost. This would have brought tremendous value to formulate design and system architecture prior to the hiring of government contractors. The Health and Human Services Department would have been able to deliver a vetted product and rock solid kick-off document outlining usability, feature and architecture requirements to appointed government contractors.

The timeline to build healthcare.gov was 3 years. Awards for development of healthcare.gov were given to approximately 6 different companies. Let’s estimate there were a total of 100 developers and product managers. Needless to say this obviates the need for a strong lead contractor, project management team and supporting software tools to coordinate all these vendors. Most of the articles I have read refer to: the complexity of the software, data integration from various information sources for verification / validation of consumers and load factors were very high.

I am here to tell you that 6+ companies and 100 team members for 3 years is overkill for a project of this size. Doing some quick math – online reporting estimates the cost anywhere between $175 to $300 million that is approximately $1.75 to $3 million per team member and 480,000 man hours. Reasonable cost? I think not. In fact, the number of disparate vendors, subcontractors and respective development teams severely hindered the successful build-out of healthcare.gov. I don’t believe that the building of healthcare.gov was much more difficult than development of a software product resembling, for example, Dell’s online store.

#2 Agile development


I don’t want to second guess the award process so let’s assume that all of these vendors were necessary. What was the project management and development methodology? Apparently the waterfall approach (vendors working autonomously coding to a predefined specification) – each vendor built features in a vacuum until completed, unaware if it would play nice with the other kids (codebases) and was not tested as a whole unit until the final days before roll-out.

Build, iterate and test again and again

I would have recommended Agile Development as an effective method for building the healthcare.gov website. Most of the opinion articles I have read diametrically oppose this view pointing to the complexity and scale of building healthcare.gov but as I have pointed out earlier I don’t share that view. This is how I would have set up the process. Set up 3 teams: Client user interface, Integration and Backend. Each team consists of a product owner/s and 8 -10 developers and a chief product manager to coordinate the 3 teams. The Agile process would work like this.

  • Software is built in sprints with predefined short-term goals. Each product owner has a backlog (work list) with tasks sorted in priority order. There is also a chief product owner with a master backlog with tasks sorted in priority order for the 3 teams.
  • With this process the highest priority tasks are addressed first and any contributor (team, departments, or other organizations) can contribute to the process, managed using Kanban principle – typically meaning one task per person per team.
  • When tasks are completed, the contributor pulls in on-demand resources to build test and release the new code.
  • Merge the code into a final staging area i.e. Github so that the software could be assembled and released at any time.
  • Using this process at a minimum would have allowed for a well tested, highly functional product even though every feature may not have been included initially.

A perfect example of what I am speaking about which demonstrates the key principle of Lean startup methodology – initially deliver what is only absolutely necessary. An article from Nov. 8 CBS evening news S.F. programmers build alternative to HealthCare.gov http://www.cbsnews.com/8301-18563_162-57611592/s.f-programmers-build-alternative-to-healthcare.gov/ and visit http://healthsherpa.com. Essentially in two weeks they created a much more effective way of evaluating exchange plans by zip code to help users make a better decision.

 So what would the Lean and Agile approach have that gotten the Obama administration?    

A Minimum Viable Productthat delivers only what is absolutely necessary rapidly. In this case, a usable system that allows consumers to access, evaluate and select a proper plan and then purchase insurance.  The most important point is that there is a minimum viable product that works from Day 1.

Agility - the ability to measure, learn and add features progressively.  There isn’t a hard rollout date – the system works in its current form.  As the product owner (Federal government and Health and Human Services) measure and receive feedback, features and functionality are added progressively to build a more robust system to better support users.  The Agile development teams and workflows are in place to support continuous improvement.

Low burn rates save on time and cost.  The launch of healthcare.gov using the proper methodology could have been in the hands of consumers well in advance of the Oct. 1 deadline and at a total lower cost.  I am generously estimating $30 – 40 million for a similar technology solution, an order of magnitude less than the current cost.

So the sophisticated, highly automated HealthCare.gov website with a feature set that should rival the most popular software services is barely operable as of this writing and the ripple effects of not releasing early and often could have dire consequences on the Obama administrations new business line. No users, no business.  The window of opportunity is closing and its competitors – Republicans – I am sure will be attempting to propose a pivot to a new business model.

Not very sexy - it looks like Healthcare.gov lost the MVP.

Who We Are

Founded in 2001, EGO7 is a US based consulting and technology services boutique with a focus on mobile and web strategies headquartered in New York, NY. We provide strategic consulting, rapid prototyping and UI/UX design, production services and recruitment. All of our services are available on an al-carte' basis - as needed.

Making a difference one client at a time

We leverage over 12 years of web & mobile consulting and development experience to create strategic advantage, improve business processes, leverage technology innovation and enhance organizational performance for our clients.

EGO7 works with firms who think outside of the box in all aspects of their business. We roll our sleeves up and engage our customers in a 'collaborative' way. Working with EGO7 is like having a great colleague. We're personal, getting to know you and forming solutions for your situation.

Our consultants are equipped to deliver exceptional service every time. EGO7 is committed to delivering results within demanding times & deadlines at a competitive cost.

What We Do

Our consulting approach and our success is guided by a simple truth. Businesses must produce the best possible result at the best possible cost on a daily basis. That's how we define value.

We strive to deliver that value for our clients' every day. Our deeply experienced staff, get personally invested in your success and work collaboratively with you - acting as your partners. We bring the best combination of resources together that will provide that value and support to our clients’ particular needs.

Ego7 fosters an entrepreneurial spirit and a mindset to challenge conventional thinking and ways of working. As such, we have built our core competency by providing innovative consulting noted for intelligent problem solving which is practically applied through a combination of third-party technologies and custom development provided by our functional support teams.

As we cultivate trusted working relationships our clients view us as a partner and an integral extension of their business. Our experienced staff makes communication and collaboration a driver of performance as we believe optimized solutions can only come from working hands-on with people, processes, and systems.

Services Offered



EGO7 is always eager to work with our clients to participate in the fashioning of their web and mobile strategies. Our consultants have a deep knowledge base our clients can tap into: we examine current methodologies, evaluate and analyze business process requirements from a technical perspective, recommend and implement solutions, and evaluate results.

We can help determine an approach, establish objectives, identify weaknesses, recommend creative tactics and facilitate proper measurement of goals or simply a different way of looking at a challenge.

Our areas of expertise relate to:

Spend a dollar get back 2

Consulting our clients is a highly particular and personalized process with the goal of identifying key success factors. At EGO7 we believe an integrated and collaborative approach achieves the best results for our customers and as such our strategic planning services include the following:

Rapid Prototyping & UI/UX


We can assist business side managers in effectively communicating and rapidly delivering business-side requirements for their initiatives thereby working more effectively with project managers and technical teams.

We can help you with:

Our experience and with the use of powerful software tools our consultants can produce comprehensive prototypes to deliver to technologists. 

You can benefit by:

Software Development


EGO7 understands that sometimes it is difficult to connect with the right resource at the right time, we have faced that challenge. We want you to continue to succeed and our in-house staff can help you when you need it.

One of EGO7's strengths is our exclusive talent pool that is deeply committed to engineering solutions that serve the unique needs of each client, anything from A to Z that contributes to making your projects a success. Our team works closely with the business side, internal technology resources or external partners to support their initiatives or perhaps devise creative ways to implementing technology.

Businesses are assured a seamless and efficient project process. Our experienced development team uses industry standard technologies to efficiently deliver stable, secure, high performance solutions that deploy to any OS/Browser environment quickly and efficiently.

Contact us to discover how we can take your most critical initiatives and make them a functional reality.

Broad technical expertise with a business mindset

Ego7 provides in-depth experience and expertise in legacy application development, release management, and maintenance. We understand that applications are the key point of any organization. Ego7 offers VALUE ADD services for both internal and external facing client applications. Our resources come equipped with proven project management techniques, application development methodologies, and release / change management principles. Whether it is a single resource requirement or staffing up a complete project team, our capabilities help companies drive efficiencies and productivity improvements and reduce process/cycle times.

Custom Application Development, Enhancement/Release, Third-party technology integration and Migration Services for:



Some of our clients are simply looking for qualified and talented technical personnel to work within their organization and we always try to provide our clients what they need. We possess an extremely talented pool of technical personnel with varied industry experience and excellent behavioral skills. From this pool, we offer contracting offerings to strengthen the developmental efforts of clients across a broad spectrum of platforms, applications and developmental tools. Depending upon the skill requirements of clients, services of suitable engineers can be made available on a Time & Material Basis.

We know talent when we see it

Ego7 deploys a systematic approach to attracting and recruiting the best talent. We believe that our client simply deserve the best and with this belief as the focal point we have structured our Key Quality Controls towards successfully attracting and recruiting the right talent for our client needs.

The key quality control aspects are:




How We Do It

You can utilize as much or as little of our services as is necessary. We don't need to own the whole process. Whether you require rapid prototyping, needs analysis or product evaluation, we deliver specific services based on necessity.

  • Our Value
  • How We Do It
  • How It Happens

Featured Case Studies

Free Consultation

You are under no obligation to make a commitment to us. Our consultants will discuss your needs, provide a high-level evaluation, define tasks and set an approximate scope of work. You will receive a document of this analysis to you free of charge. Please contact us in order to get started.

Interested in:

Thank You

Your information has been successfully submited and you will be hearing from us shortly.