The Cost Of Complexity: Lessons From Obamacare

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Lately it’s been hard to let a day go by without following the next intrigue on Obamacare. At this point, it’s probably fair to say there isn’t a living soul who considers the website a success. And while I’ll refrain from expressing a point of view on the legislation itself or on the details of project planning or technical competency, I did want to dig deeper to understand the nature of the "complexity" that has marred the heart of Obamacare—the exchange. After all, there are many technologically complex data exchanges that we depend on—airline traffic management, ticketing, loan offers on, the stock exchange, eBay, Paypal…the list goes on. 

So what can healthcare marketing learn from Obamacare? 

Complexity is defined scientifically as being proportionate to the interdependence between elements within a system. The human body is an example of this—taking away any one part has a systemic impact upon the remaining parts. As it turns out, the systems that the Obamacare exchange needs to depend on include information about income from the IRS, citizenship status from the Social Security Administration and Homeland Security, status checks for other government program enrollment including Veterans Affairs, DOD, state Medicaid, and numerous other agency databases that then plug into insurance company data interfaces to offer a price comparison.

This technologic complexity is but an expression of the underlying organizational fragmentation within our government. When we look at other seemingly complex technology platforms such as the stock market, air traffic control, loans, passport validation, etc, the thing that's different about these data-heavy, mission-critical systems is that they are serviced by distinct and independent data inputs and outputs with low interdependency. If any one node fails, all others do not. These systems look highly complex but in reality represent a high volume of unique and independent inputs and outputs of data. So what can healthcare marketing learn from these models?



CTOs beware: Over-engineering can mean under-delivery

The notion of simplicity in design and in scientific pursuit (such as the formation of hypotheses) was popularized by the principle best known as Occam’s Razor. So what did we know in the 13th century that we’ve forgotten in the 21st and how is this relevant to healthcare marketing? 

If we embrace the idea that simplicity means minimizing interdependence between systems, then many large pharmaceutical companies probably wouldn't pass the test. The technical complexity of digital marketing has elicited a broadly simplistic response from large organizations. Overarching technologic mandates that add complexity by increasing interdependence between multiple suborganizations at these companies feed a vicious cycle that spin inefficiently and thwart innovation.

There are many examples of mandates and processes put in place that do so—the use of content management for sites that don’t need it; registration requirements into an RM program well beyond the essential data fields; mandating that all programming be done in a specific language such as J2EE for all sites; the use of a singular infrastructure across the world for marketing programs; or multidimensional approval processes that result in overly long timelines to update copy on a website. 

Especially in a regulated industry, it is critical to simplify marketing technology and processes that allow program independence. Best practices are always relevant to a context and a simplistic mandate doesn’t typically lead to simplicity. The use of best-in-breed cloud-based platforms that support marketing to be nimble and innovation-oriented instead of monolithic, standardized, and over-engineered for posterity is just one example.  

There are two central principles that most technology leadership supporting marketing organizations should pay heed to. One, that marketing thrives upon change—so the supporting infrastructure must be set up for adaptation. And two, the cost of administering a system is inversely proportional to its value. A good example of this principle is exemplified by charities that have come under fire for a minuscule proportion of donations actually making their way to the intended purpose. In marketing technology, the build, buy, or rent decision must be filtered through this rationale.

Value in marketing is based on the unique expression of new ideas. If you don’t get in the way, you’re doing your job.

1 comment about "The Cost Of Complexity: Lessons From Obamacare".
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  1. Jull Sanders from MO Team, December 14, 2013 at 11:16 a.m.

    To my mind it's not only the technical problems with the site which caused so much ado about the Obamacare project. A lot of reasonable people tend to use the services of lender offering to people in need, in case some emergency sets in, than be insured. A lot of uncertainty and I would even say dishonesty is inside the program itself.

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