Why CovidTests.gov won’t be the next HealthCare.gov

The White House has launched COVIDTests.gov, which the Biden administration says will enable every home in the U.S. to order 4 free at-⁠home COVID-⁠19 tests through the mail, starting on January 19th — with no shipping costs or credit card required. Ideally, the administration will also allow Americans to request the high-quality masks President Biden said the US government would distribute through COVIDTests.gov as well.

As with Vaccines.gov, there’s a tremendous amount riding on the Biden administration delivering on this news service. Hundreds of millions of Americans REALLY need this administration to deliver on sending free tests and masks to the people through the mail who ask for them right now. This will be a simple but profound interaction.

If the White House can pull it off, it could rebuild public trust during a profoundly uneasy time, delivering the tests and masks that — with vaccines — would enable us all to navigate out of the pandemic together.

If COVIDTests.gov were to be overwhelmed by demand, flooding attacks, automated fraud, or test distribution is botched by the U.S. Postal Service, public trust could erode further.

Last week, Politico reporter Ben Leonard reached out and asked a series of questions about whether the Biden administration would be able to deliver on a website to request rapid tests, raising concerns about whether this be a repeat of the Healthcare.gov debacle of almost a decade ago. The answers below lay out the case for why this White House is likely to succeed.

What were the key failures of healthcare.gov

The public and major media focused a lot on the technology angle because healthcare.gov is a website, and it’s true that technical and design decisions caused major problems at the relaunch, when the Department of Health and Human Services moved it from being a glossy brochure to being a marketplace for health insurance. Lack of beta testing. Hosting at that couldn’t scale to meet demand. Incomplete integration between federal agency systems. Artificial bottlenecks in the marketplace flow.

That all led to a crisis when Americans began trying to use the site, in no small part because Healthcare.gov wasn’t iteratively built or tested “in the open” using modern software development practices, with the people it was meant to serve. 

Much like the endemic IT failures that have bedeviled big state and federal projects for years, however, the fundamental problems stemmed from:

  1. Poor project management and oversight
  2. A government procurement system that builds and buys software like buildings and cars
  3. Outsourcing huge contracts to systems integrators and contractors 
  4. Challenges recruiting and retaining technologists who must be sitting at the table from the beginning of a complex project 

The team that rescued the site in the winter of 2013 was able to address many of these failures and then founded the U.S. Digital Service based upon these insights and the inspiration of Gov.uk in the United Kingdom. 

  1. How can the Biden administration avoid them this time around?

The White House can give the U.S. Digital Service and 18F (the software development organization inside of the General Services Administration which could be involved) – resources and cover to do their best work. (Ideally, they will “show their work” as they go, too.) That means strong product management, iterative development,regular check-ins, designers and technologists in government, and working with best-in-class technology partners who understand how to build and scale modern responsive websites. 

It’s also worth noting that building a website to request a COVID-19 test is not the same technical challenge as one that had to tie into the IRS to check eligibility for subsidies and complete a secure transaction. Failure would still be consequential, but the bar is much lower, as are the risks surrounding errors.

  1. What were the key issues with Trump’s promised national COVID-19 screening website? What lessons can be taken from it? 

Former President Trump was unfit to lead a coordinated national response to a pandemic and uninterested in building out the national testing infrastructure that showed his lies about the prevalence of a deadly airborne virus to be false.

This promised website was vaporware, not a serious project that can or should be compared to past or present .gov efforts. The Trump White House never built or delivered anything after the President engaged in misleading hyperbole in the Rose Garden.

Instead of convening technologists, designers, and project managers from relevant agencies and private sector in a Manhattan Project for testing or grand national challenge, however, Trump misled the public by claiming that Google was already working on it. There’s no “there there” to compare.

  1. Vaccines.gov seemed to roll out more smoothly. Why do you think that happened and what lessons can be drawn? 

I’d rack that up to:

  1. Competent leadership at the U.S. Digital Service involved from the outset in coordinating and managing the project, top-down cover from the Oval Office
  2. Subject matter expertise from the medical professionals who built VaccineFinder.org
  3. Deep technical expertise and capacity to deliver at scale from private sector companies involved
  4. All-out, mission-driven effort from many patriots inside and outside of government committed to connecting Americans with vaccines. A thread: https://twitter.com/digiphile/status/1388495731422543877 

We all would know a lot more about what worked and why if the Biden administration had narrated its work in the open, held a press conference about Vaccines.gov, and taken questions instead of giving the news to Bloomberg on background

  1. How big of a technical task do you think putting together this website will be? 

If the functionality of COVIDTests.gov is limited to someone requesting a test be delivered to a given address, I don’t think that’s a big task for US government in 2022, even under heavy demand. If the COVIDTests.gov needs to authenticate someone and create accounts to prevent fraud or abuse, that will be a bit harder.

My hope is that we’ll see a lightweight website that uses Login.gov and a shortcode — say, text your zipcode to GETTST – that will enable people to quickly and easily request tests from a smartphone – along with a package of better, medical grade masks for themselves and their children that President Biden announced today would be made available for free to all Americans.

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