David Blumenthal: 'Broken' IT procurement process key to HealthCare.gov mess

The federal IT procurement process is a complex mess in need of a major overhaul, according to David Blumenthal, former National Coordinator for Health IT.

In an analysis published this week in the Huffington Post, Blumenthal (right), who now serves as president of The Commonwealth Fund, talked about his experiences navigating through the procurement process in order to push implementation of the HITECH Act. He then compared that to similar work he performed as Chief Health Information and Innovation Officer at Boston-based Partners HealthCare after leaving the government.

As National Coordinator for Health IT, Blumenthal said that request for proposals oftentimes were sent to independent contracting offices other than those in the U.S. Department of Health & Human Services. While the officials dealing with such RFPs were familiar with federal procurement procedure, he said, many times they were lacked familiarity with ONC's work.

Additionally, Blumenthal said, once a company was picked, it was difficult to get out of a contract--even if work performed was unsatisfactory--without "months of litigation."

At Partners, meanwhile, Blumenthal said he oversaw a rigorous process for selecting a new electronic health record system that involved multiple interviews, assessments and a "line-by-line" review of contracts.

"The [Partners] experience was very different," Blumenthal said. "The Partners' procurement process may not be perfect, but the federal process is clearly broken."

Blumenthal added that while he was not familiar with the intricacies of the procurement process behind the launch of HealthCare.gov, he doubts it was "up to the task of managing the subtle, technologically complex and unprecedented challenge of putting together a consumer-friendly website that would seamlessly connect multiple legacy state and federal databases that were never designed to work together."

HealthCare.gov continues to be a thorn in the side of the Obama administration, with reports now indicating that it's unlikely the White House will fix all of the site's problems by the end of this month, as the administration previously projected.

Some IT experts, like Tom Lee, director of Sunlight Labs, the research arm of the Sunlight Foundation transparency advocacy group, believe the procurement process is to blame for the rollout's struggles.

"The episode is all too typical of how government creates IT services," Lee said in October. "The procurement process tends to select firms that are good at navigating the procurement process, not providing good IT services for the dollar."

To learn more:
- read Blumenthal's post

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