Give it Time
But we are not designing an iPad here, more like a set of incredibly boring plumbing that, like the plumbing in our houses, simply has to work, all the while adhering to an ocean of FIPS (Federal Information Processing Standards) designed by other committees and acts of Congress.
Could the Federal and state procurement processes that produced healthcare.gov be reformed? Sure, there is always room for improvement. But at the federal level, agencies have to deal with 435 cranky investors, each of which has way too much authority over the process without the requisite qualifications to design systems. I don't see a procurement process around that.
Let's all take a breath or two and give this some time. That was my takeaway from CHIME on this whole health insurance exchange mess. The CIOs gathered in Scottsdale, Arizona were indeed far from idle – serving up passionate ideas about how to fix electronic health records, how to move to value-based care, how to align IT goals with business goals.
I don't expect them, or healthcare systems, or even Silicon Valley, to fix the health insurance exchange rollout, and neither should anyone else.