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Written by: Tinglong Dai, Johns Hopkins University School of Nursing

Published: 06 February 2021

 

The COVID-19 vaccine rollout has been a nightmare for many Americans as they struggle through multi-step registration and appointment systems.

The federal government had envisioned states using one national vaccine scheduling system, and it offered a contractor US$44 million to develop it. But that system turned out to be so poorly designed that all but nine states opted out before even trying to adopt it, even though it was being offered by the government for free.

The few states that do use the Vaccine Administration Management System, or VAMS, have reported random appointment cancellations and unreliable registrations. Some vaccinators have had to resort to creating records on paper because of system glitches, slowing down the pace of getting shots into people’s arms.

As troubled as the VAMS website may be, it is also a predictable result. We’ve seen this movie before.

HealthCare.gov, the federal healthcare exchange website that was launched to implement the Affordable Care Act, also known as Obamacare, cost taxpayers nearly $1 billion. When HealthCare.gov was launched on Oct. 1, 2013, only six people were able to sign up for health care on the first day. The Obama administration ended up having to enlist a team of engineers from Google, Amazon and Facebook to fix it.

The U.S. is among the most technologically advanced nations in the world, with some of the most powerful technology giants and the largest talent pool. So, why has the federal government repeatedly failed to deliver a functioning website essential to public health?

As an expert in health care operations management and contracting, I believe the complex federal contracting process bears much of the blame. The Biden administration has the power to fix it.

Three big problems with federal contracting

The U.S. government is the largest buyer on Earth. It spends more than half a trillion dollars a year procuring a wide range of goods and services from the private sector.

While private buyers may have their own rules governing purchasing, the U.S. government has to follow a set of procurement regulations. These regulations are known as the Federal Acquisition Regulations, or FAR, and they have been in place since 1983. The rules dictate all aspects of the federal purchasing process, including the contracting process for building websites such as HealthCare.gov and VAMS.

The Federal Acquisition Regulations were created to uphold the federal government and taxpayers’ interests through a uniform set of rules. Despite its good intention, this process has three key problems.

First, with thousands of clauses that are difficult to navigate, the Federal Acquisition Regulations have created a complicated and time-consuming contracting process, and many of those clauses are nearly impossible to implement in practice. That restricts the government to using a small group of vendors who are experienced in the game of contracting but are not necessarily the best choices for delivering products.

When the government announced the HealthCare.gov project, the tech giants that were eventually called in to fix it did not even participate in the bidding process, because the process favors past vendors such as CGI Federal, which specialized in federal contracting.

Second, in many cases, the complicated nature of the rules enables vendors to be selected without competition. In choosing a vendor for developing VAMS, the Centers for Disease Control and Prevention determined that Deloitte was the only contractor that met the project requirements. The reason: The CDC believed VAMS required GovConnect, which is Deloitte’s propriety platform. The GovConnect platform was launched in June 2020 and has had some problems. It is not clear why a vaccine rollout platform had to be built on GovConnect.

Third, the contracting process discourages communications and interactions between vendors and contracting officers. For websites like HealthCare.gov and VAMS that have many stakeholders, the needs of those stakeholders typically evolve during the development process. Companies such as Google, Amazon and Facebook use an “agile” method designed for changes during development. The current federal acquisition process naturally supports a traditional “waterfall” model that largely specifies all requirements at the beginning and allows little room for change.

Fixing the federal contracting process

How can the federal contracting process be fixed? Repealing the Federal Acquisition Regulations would likely cause chaos, but fixing it is doable. The executive branch of the U.S. government can modify the Federal Acquisition Regulations on its own, so it is up to the Biden administration to make changes.

Next, the federal contracting process must value results, not only the process itself or the vendors’ history of winning federal contracts. Deloitte and CGI Federal both continue to win federal contracts worth billions of dollars despite past failures.

VAMS has sparked far less public outcry than HealthCare.gov, but its failure is no less consequential, because a rapid vaccine rollout is the key to ending the ongoing COVID-19 pandemic. Deloitte spokesman Austin Price told Bloomberg News the company “continues to enhance the system based on feedback and priorities of VAMS users.”

The Obama administration started some reforms of the federal contracting system, particularly moving it away from the “waterfall” approach to allow more changes during development. The Biden administration could continue that work as it rethinks the tangle of federal contracting rules.

Unless it fixes the outdated federal contracting process, the U.S. will almost certainly repeat the same disaster again and again.

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Tinglong Dai, Associate Professor of Operations Management & Business Analytics, Johns Hopkins Carey Business School, Johns Hopkins University School of Nursing

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Written by: Preston Dyches

Published: 06 February 2021

What's Up for February? This month we follow the moon to three different points of interest in the winter sky.

First up, excitement about the red planet is building as NASA prepares to land its latest rover there, called Perseverance, on Feb. 18.

You'll find Mars high in the west after sunset all month long. It should be visible all evening, setting around, or soon after, midnight local time.

On the night of NASA's planned Mars landing, you'll find the half-full moon right next to the red planet. So go out and have a look with your own eyes – especially if you were one of the nearly 11 million people whose names traveled to Mars with Perseverance, etched into one of three microchips.

Staying with the moon in February, it next drifts through part of the sky that contains a familiar pattern of stars, also called an asterism. This is the Winter Circle, or Winter Hexagon – a ring of six bright stars that spans a very wide region of the sky.

The Winter Circle contains two other special groupings of stars: the constellation Orion, and another wintertime asterism, the Winter Triangle, made of the bright stars Sirius, Betelgeuse and Procyon.

Like their counterpart, the Summer Triangle, the Winter Circle and Winter Triangle are signposts of the season.

In the Northern Hemisphere, you'll see them rising in the east early in the evening during the time of long, cold nights, and setting in the west earlier and earlier as the season turns to spring.

Watch on Feb. 20 through 22, as the moon moves across the Winter Circle, growing a bit fuller each evening.

Finally, the moon continues on its journey, visiting the twins of Gemini. Unlike asterisms, Gemini is one of the 88 official constellations used by astronomers to help them describe the locations of objects in the sky. The two bright stars Castor and Pollux form the heads of the inseparable twins from Roman and Greek mythology for which the constellation is named.

On February evenings, Gemini is located high overhead in the south. On Feb. 23 the moon is just below Pollux.

NASA also has a history with Gemini, as it was the name of the human spaceflight program in the 1960s that tested technology and capabilities in preparation for the Apollo missions to the moon.

But while the constellation is pronounced "JEM-in-eye," not everyone knows the name of the NASA program was usually pronounced "JEM-ih-knee" within the space agency.

However you want to pronounce it is fine. Just make sure you go out and catch the moon's visit with Gemini on Feb. 23.

You can catch up on all of NASA's missions to explore the solar system and beyond at www.nasa.gov.

Preston Dyches works for NASA's Jet Propulsion Laboratory.

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Written by: Elizabeth Larson

Published: 05 February 2021

NORTH COAST, Calif. – An early Friday morning crash on Highway 20 in Mendocino County left one driver dead and another injured.

The wreck occurred at 6:50 a.m. on Highway 20 near Marina Drive east of Ukiah, according to the California Highway Patrol’s Friday morning report.

The CHP said a 56-year-old Potter Valley man died in the wreck, with a 23-year-old Clearlake Oaks man injured.

The names of the two drivers were not released in the Friday report.

The CHP said that the Potter Valley man was driving a 2006 Toyota westbound on Highway 20 just west of Marina Drive at an unknown speed while the Clearlake Oaks man was driving a 2014 Peterbilt towing a 2018 Landoll trailer eastbound at a stated speed of 55 miles per hour.

For an unknown reason, the CHP said the Toyota traveled in a southwesterly direction over the solid double yellow lines and collided with the left side of the Peterbilt.

After hitting the Peterbilt, the CHP report said the Toyota continued in a westerly direction. The front of the Toyota then hit the left side of the Landoll trailer and continued on, side-swiping the trailer’s left side.

Following the crash with the semi and trailer, the Toyota traveled, out of control, in a southerly direction over the south solid white line of Highway 20 and down the hillside, south of the highway, the report said.

The CHP said the Toyota came to rest on the south descending hillside of Highway 20.

The Toyota’s driver sustained fatal injuries as a result of the crash, the CHP said. The Peterbilt’s driver sustained moderate injuries.

Traffic control was in effect for about two hours at the crash scene, according to CHP reports.

The CHP said both men were wearing their seat belts.

The cause of the collision is still under investigation, with the CHP reporting that neither drugs nor alcohol are believed to be factors.

Email Elizabeth Larson at This email address is being protected from spambots. You need JavaScript enabled to view it.. Follow her on Twitter, @ERLarson, or Lake County News, @LakeCoNews.