Tag: harper reed

Apr 23 2020

Names Matter: Exposure Alerting vs. Digital Contact Tracing

Most people, unless you work either for government or an infectious disease “organization” (non-profit, hospital, health care system) probably had not heard the phrase “contact tracing” until a month or so ago.

I now hear and see the phrase “contact tracing” everywhere.

About a month ago, as I started working on Covid-related stuff, the phrase came up regularly on the private side as a partial solution to the problem of “opening things back up.” It was often phrased as “it will be hard to open anything up until we have enough testing and contact tracing.”

For about a week, I couldn’t figure out why many of the people I was interacting with seemed to dismiss my ideas and concerns about contact tracing. Then, in a conversation, someone in government explained what the government’s historical view of contact tracing was, which is a well-defined and regularly executed completely manual process.

A giant lightbulb went off in my brain as I realized two things were happening. A bunch of people who were hearing the phrase “contact tracing” figured “yup – we’ve got that under control” (meaning they already had a manual contact tracing effort in place or about to be launched). The rest were thinking “the tech people want to automate and digitize the manual contact tracing activity – that’ll never work and it’ll create huge security and data privacy issues.”

So, I, along with everyone I am working with, started calling it “Digital Contact Tracing.” That helped some, especially as we described its relationship to Manual Contact Tracing. But, there was still too much explanation of Manual Contact Tracing vs. Digital Contact Tracing. And, confused continued to abound.

The phrase “Digital Contact Tracing” started evolving. The ACLU wrote a great white paper titled Principles for Technology-Assisted-Contact-Tracing which generated a clever acronym (TACT). I also saw the phrase “Digital Contact Tracing and Alerting” being used.

Yesterday, Harper Reed put up a short post titled Digital Contact Tracing and Alerting vs Exposure Alerting that lays out the history of the concept and renames it “Exposure Alerting.”

Exposure Alerting is the correct phrase for Digital Contact Tracing. It is clearly additive to Manual Contact Tracing (or simply Contact Tracing as most of the non-technical world refers to it.)

So, from here on out, I think we should call this activity Exposure Alerting. I think we would have saved a lot of time and energy if we had come up with the right name from the beginning. But, since this is going to be with us for a very long time, let’s start now.

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Oct 21 2013

How To Fix Obamacare

Now that our federal government is back at work and the short term debt ceiling thing is resolved, it should be no surprise that the news cycle is now obsessed with Obamacare and its flawed implementation. Over the weekend I must have seen a dozen articles about this online and in the NY Times, and then I woke up this morning to a bunch of new things about the Healthcare.gov site underlying tech, how screwed up it is, and what / how the Health and Human Services agency is going to do to fix it.

The punch line – a tech surge.

To ensure that we make swift progress, and that the consumer experience continues to improve, our team has called in additional help to solve some of the more complex technical issues we are encountering.

Our team is bringing in some of the best and brightest from both inside and outside government to scrub in with the team and help improve HealthCare.gov.  We’re also putting in place tools and processes to aggressively monitor and identify parts of HealthCare.gov where individuals are encountering errors or having difficulty using the site, so we can prioritize and fix them.  We are also defining new test processes to prevent new issues from cropping up as we improve the overall service and deploying fixes to the site during off-peak hours on a regular basis.

From my perspective, this is exactly the wrong thing to do. Many years ago I read Fredrick Brooks iconic book on software engineering – The Mythical Man-Month. One of his key messages is that adding additional software engineers to an already late project will just delay things more. I like to take a different approach – if a project is late, take people off the project, shrink the scope, and ship it faster.

I think rather than a tech surge, we should have a “tech retreat and reset.” There are four easy steps.

  • 1. Shut down everything including taking all the existing sites offline.
  • 2. Set a new launch date of July 14, 2014.
  • 3. Fire all of the contractors.
  • 4. Hire Harper Reed as CTO of Healthcare.gov, give him the ball and 100% of the budget, and let him run with it.

If Harper isn’t available, ask him for three names of people he’d put in charge of this. But put one person – a CTO – in charge. And let them hire a team – using all the budget for individual hires, not government contractors or consulting firms.

Hopefully the government owns all the software even though Healthcare.gov apparently violates open source licenses. Given that, the new CTO and his team can quickly triage what is useful and what isn’t. By taking the whole thing offline for nine months, you aren’t in the hell of trying to fix something while it’s completely broken. It’s still a fire drill, but you are no longer inside the building that is burning to the ground.

It’s 2013. We know a lot more about building complex software than we did in 1980. So we should stop using approaches from the 1980s, admit failure when it happens, and hit reset. Doing a “tech surge” will only end in more tears.

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