As most people are well aware by now, there are a number of COVID vaccines out in the wild now, with roughly a million people every day getting a shot from one of them. That’s quite the accomplishment given that a year ago today, many people believed any sort of vaccine was likely impossible, to say nothing of getting one by the end of 2020. Thanks to a lot of hard work and the clearing of administrative roadblocks made possible by Operation Warp Speed, we have not one, not two, but actually four out there getting distributed.
While the development of so many new vaccines in so short a time is impressive, another daunting task is to actually manage all the data related to the distribution of those vaccines. Which groups should get it first? Who has had it and who still needs it? Who has had one shot and who has had two? What sort of side effects might arise after taking the shot? All of these are important data points to keep track of. The CDC in Atlanta recognized this and set about ensuring that a system was developed that would be capable of managing it all effectively. At least, that’s what they hoped would happen.
What actually happened is a debacle on par with the launch of HealthCare.gov. The CDC issued a no-bid contract to consulting firm Deloitte to develop the Vaccine Administration Management System (VAMS). $44 million dollars later and what the CDC got was not a stunning accomplishment in the world of software development but something that only those who remember Windows Vista could appreciate. Instead of seamlessly tracking appointments and available supplies and all the rest of it, VAMS randomly drops appointments, thinks you’re literally getting a needle in your arm when you aren’t even in the building, and randomly locks staff members out of the system. I don’t care who you are, that program is anything but a success.
While the CDC and Deloitte acknowledge that the system has a few bugs that need to be worked out, they point to user error as a cause. While that might technically be true in some cases, when your system does such a lousy job that a professional health director can’t figure it out after 24hrs of trying, that a 100 doses of vaccine got wasted because VAMS couldn’t keep track of them, and hordes of volunteers are needed to transfer information from paper to the actual system, the problem is in fact the system. Or to perhaps put it more succinctly, when the name of your super great software system becomes a curse word amongst healthcare staff, the system is definitely the issue.
It is so bad that many states are in fact reverting back to paper records because it’s more efficient. Others are going with a paid option rather than struggling with the ‘free’ VAMS system, or even using a patchwork of other systems such as Eventbrite – a system used to manage things like concerts – to keep track of appointments.
How on earth did this happen? How could we possibly have gotten here with a digital revolution going on around us? Part of the issue is that this was a no-bid contract. Anytime that happens, alarm bells should be going off. It usually means that there some backs getting scratched money going into accounts that has nothing to do with the actual contract. Another is that Deloitte is actually run by accountants, not software experts or healthcare professionals. They most likely outsourced it to whatever firm had the lowest bid, didn’t test it and then sent it off to the CDC knowing they would never be held accountable.
Some have pointed to Deloitte being a private enterprise as part of the issue. However, they really aren’t private. Given their obvious ties with the government and the fact they developed this product with no competition whatsoever, Deloitte is more like a quasi-Government agency akin to NASA. It is only a matter of time before a real private company, like TARTLE, which already has an efficient and easy to use system for sharing data worldwide, shows up and presents a solution that is workable and cost effective that will help save lives.
What’s your data worth? Sign up and join the TARTLE Marketplace with this link here.
While the development of so many new vaccines in so short a time is impressive, another daunting task is to actually manage all the data related to the distribution of those vaccines.
Speaker 1 (00:07):
Welcome to TARTLE Cast with your host, Alexander McCaig and Jason Rigby, where humanity steps into the future and source data defines the path.
Alexander McCaig (00:25):
Hey, welcome back to TARTLE Cast, a shout out to MIT Technology Review. They have some very, very good journal scientists. I don't even know what you would call them over there, but they do a phenomenal job with the articles they write.
Jason Rigby (00:39):
Yeah. It's technologyreview.com. We have it on the screen right here. You could get that sent to you. Well worth it. If you find technology interesting, then you should-
Alexander McCaig (00:51):
Subscribe to MIT Technology Review, Nature, and National Geographic and call it a day.
Jason Rigby (00:55):
Yes.
Jason Rigby (00:56):
How far where you from MIT?
Alexander McCaig (00:58):
Channel your info wars money back into this. I was right next to it.
Jason Rigby (01:03):
Oh yeah.
Alexander McCaig (01:04):
Yeah. Like I said before, I don't know if I brought this up before, but these have these talking trash cans. I'd be just walking around the campus and then this trash can would talk to me. I'm like, "Sorry."
Jason Rigby (01:14):
Speaking of talking trash cans, there was one that would go to MIT all the time. We want to get into conspiracy theories. Mr. Epstein.
Alexander McCaig (01:21):
Mr. Epstein.
Jason Rigby (01:22):
He was trying to grab scientists out there all the time. The massage.
Alexander McCaig (01:25):
Yeah. Everybody wants a good scientist.
Jason Rigby (01:28):
Yeah. Everyone loves the what's the latest and greatest. This article from MIT, What went wrong with America's $44 million vaccine data system?
Alexander McCaig (01:39):
I don't know what went wrong, Jason?
Jason Rigby (01:40):
I wanted to use this, this is really interesting. They use an example of one lady, Mary Ann Price. I want you to think also, and this was never taken into consideration in this program and we're going to get into this, VAMS, the Vaccine Administration Management System. And any healthcare workers that are out there that using this system, is putting their middle finger at us right now. That's how bad this system.
Alexander McCaig (02:01):
Really. It's this bad.
Jason Rigby (02:02):
Yes. They use an example of this one lady. Think of elderly people going on a computer, probably a desktop at their home, and then trying to sign up for, to get a vaccine that they need.
Alexander McCaig (02:15):
Okay. Is it a nightmare of a process?
Jason Rigby (02:17):
Oh dude. First time Mary Ann Price logged into her employer system to schedule a vaccine, she found an appointment three days later at a nearby Walgreen's pharmacy. Oh great.
Alexander McCaig (02:24):
Oh great. Three days.
Jason Rigby (02:25):
She woke up the next day to an email saying it had been canceled.
Alexander McCaig (02:27):
For what reason?
Jason Rigby (02:28):
She logged in again and found an opening that afternoon at the local surgical hospital. When I showed up, they said they wouldn't honor it. They were only doing their own staff. Price says but when she tried a third time to make an appointment, she was blocked from doing so, according to the system. She was already in the middle of getting a vaccine. Price is 70 and worked for the West Virginia State Senate. She's deemed an essential worker. The crazy part about this is there is study after study, there are our elderly here in America, one after the other stating this. There was a rollout, I think it was in Virginia. And I'll get into that, where they had 200 some vaccines available. When they're ready, they're like do we have 270 vaccines ready for people that are 70 and older? The system was so hard to log in only 20 some people... They had the hundred some vaccines, just sitting there.
Jason Rigby (03:23):
Why didn't anybody think of this? The majority of people that need a vaccine are 70 and older, especially in the first wave.
Alexander McCaig (03:31):
I'm going to bring this back to TARTLE, because that's what we do. What we realized, in short order for us, after going through some interviews with our users that we have now, and, we're in 115 countries, was that, how do you design a system that is only in English, right now, but translates in form, function, and text to people who don't have English as a first language. How do you do that? And how do you design it with simplicity that, regardless of age, Luddite or non Luddite, someone could come in here and use this system effectively and not become frustrated by it. How do you elevate accessibility onto a system on a global scale? And so this is one thing that we have focused on a lot, because there are so many systems out there that are trying to do good, but are so poorly designed and so poorly executed on. Does that make sense?
Jason Rigby (04:35):
It does. And this is the part that aggravates me is when we get into these government contracts. The US Center for Disease Control and Prevention's, this brand new $44 million website called VAMS, Vaccine Administration Management System, was built by a consulting firm and we're going to get into them. D-E-L-O-I-T-T-E, Deloitte.
Alexander McCaig (04:57):
Oh, Deloitte.
Jason Rigby (04:58):
Yeah, Deloitte.
Alexander McCaig (04:58):
They're huge. They're also a bunch of accountants.
Jason Rigby (05:03):
This is crazy. There's only a few states using this right now because it's so fucked up. So now, we've built this huge program that everybody's supposed to be using. Now what's happening is hospitals are either creating their own, they're using paper.
Alexander McCaig (05:18):
Because something that was supposed to be efficient and help people go through a process so that they could decrease the risk of receiving a virus is so terrible that it's forced the people who give the vaccine to de-evolve their processes back to pen and paper.
Jason Rigby (05:33):
Yes.
Alexander McCaig (05:33):
Great.
Jason Rigby (05:35):
Marshall Taylor, head of South Carolina's Health Department, said VAMS has become a cuss word.
Alexander McCaig (05:39):
VAM.
Jason Rigby (05:39):
Yeah, VAMS. This is the funny part. The system is notorious for randomly canceled appointments, which we saw from the one lady, unreliable registration and problems that lock staff out of the dashboard. The CDC acknowledged there are multiple flaws. They acknowledge, the CDC did, and that it's working to fix. This is all in the middle of a COVID vaccine mass. This is the question. In May, it gave the task to consulting company, Deloitte, a huge federal contract with the 60 million no bid contract, to manage.
Alexander McCaig (06:12):
It was just like, we're going to give it to you. Done.
Jason Rigby (06:15):
In December, Deloitte snagged another 28 million for the project, again, with no competition. The contract specifies that the work could go as high as 32 million leaving taxpayers with a bill between 44 and 48 million. I'm reading the article from MIT right now. This is not my opinion. They said this in the article. Why was Deloitte awarded the project on a no-bid basis?
Alexander McCaig (06:37):
Yeah, that's crap. Why was there no competition for someone to come in and build a bigger, better system? Just for whatever reason, why wasn't TARTLE allowed to come in and bid on this system, build it better. We could build a better than a bunch of accountants who probably outsourced all the labor to get it built. And they don't have a freaking clue on how to do anything right. And they were just like, "Well, how do we commoditize this to make a buck?"
Jason Rigby (07:01):
Obviously, they didn't do proper studies. How many people did they bring in and pay? 70 year olds to come in and say, "Hey, let's see how easy it is for you to sign up on a desktop? Or let's see how this works with the health worker on their mobile phone." There's problems with that too.
Alexander McCaig (07:20):
They built it and they said, "Deal with it."
Jason Rigby (07:21):
In reality, many states are choosing to pay other vendors rather than using VAMS for free.
Alexander McCaig (07:27):
Sure. I would.
Jason Rigby (07:28):
There are, in Florida, they're using Eventbrite.
Alexander McCaig (07:31):
They're using Eventbrite?
Jason Rigby (07:35):
That is for concerts and conferences.
Alexander McCaig (07:38):
Doesn't matter, it works. Here's where we're holding our vaccine concert. Sign up, come on in.
Jason Rigby (07:45):
Virginia, where many individual vaccination sites have already chosen to adopt alternatives, is moving from VAMS to a commercial system, PrepMod. After participating in a trial of VAMS, California also picked PrepMod, but clinics that have blamed the system for delays in their vaccine reporting. This is the crazy part. A lack of flexibility has become a block for many clinics trying to use the CDC system. This has led to confusion and difficulty in keeping patients properly informed.
Alexander McCaig (08:11):
Flexibility.
Jason Rigby (08:12):
Yes.
Alexander McCaig (08:13):
Our system is only designed for flexibility because if you're inflexible, you can't meet people where they are. How are you supposed to receive data or get an individual to go into your VAMS system and input any data if the system is inflexible to their own operation or how they do things?
Jason Rigby (08:29):
Check this out. This is crazy.
Alexander McCaig (08:30):
Check, check, check.
Jason Rigby (08:32):
Check, check. One hospital administrator, his last name is Pang, he said this. He spent three weeks trying to sign into VAMS, but he constantly ended up in the dashboard for patients instead of clinic administrators.
Alexander McCaig (08:42):
Love it.
Jason Rigby (08:42):
In the meantime, his staff was vaccinating hundreds of people a day and keeping track of their information on paper forms. Now get this Alex, the college set up a bank of volunteers to sit in a room and copy all the information into VAMS.
Alexander McCaig (08:56):
Can I ask you something? If this guy couldn't figure it out after 24 hours, as health care administrator, do not try for three weeks straight. Call them on the phone. I would be down at Deloitte's front door, grabbing the guy by his Oxford button down white shirt and be like, "People's lives depend on this and you've screwed up. Fix it."
Jason Rigby (09:19):
This is what he said. "A good system is easier to use than it is not to use."
Alexander McCaig (09:22):
Yeah.
Jason Rigby (09:22):
"If people are writing this on paper, there's something wrong." How are you going to do a hundred million shots in a hundred days and have someone enter it all in by hand?
Alexander McCaig (09:31):
Yeah, that's just absurd.
Jason Rigby (09:32):
This is the crazy part here. Listen to this. Courtney Rowe.
Alexander McCaig (09:36):
Who's that?
Jason Rigby (09:37):
Listen to Courtney Rowe. So Courtney Rowe, I want you to get her title in what she does and how important she is. Courtney Rowe is a pediatric urologist at Connecticut Children's Medical Center.
Alexander McCaig (09:47):
Okay, so she's dealing with kids and their urinary tracts. I don't know what a urologist does. They study pee?
Jason Rigby (09:54):
Yeah. Yeah. No, but I mean-
Alexander McCaig (09:56):
At Connecticut Children's Hospitals. Yeah.
Jason Rigby (09:57):
You know how elevated is she? Her job is important. She's assigned with the vaccines now. She has an education. If she's a urologist, she has a high education.
Alexander McCaig (10:12):
Yeah.
Jason Rigby (10:12):
She's a smart woman, right?
Alexander McCaig (10:13):
Yes.
Jason Rigby (10:15):
And she's very learned. This is what she says. She says, "I basically function as tech support for this program." So we took somebody that's put 12 years in college.
Alexander McCaig (10:26):
12, probably more. How many years of learning and you've turned them into a tech support specialist.
Jason Rigby (10:32):
With the children's doctor.
Alexander McCaig (10:33):
She's supposed to be taking care of kids. And you have her worried about a crap system that Deloitte put out there for 44 million.
Jason Rigby (10:42):
She said, "I am literally..." Because she has a heart, obviously. She's like, "These people can't sign up. So I'm going to help them sign up." So she's on the phone. Listen to this. "It won't work Internet Explorer. It only works in Chrome. The Next button is all the way down and to the right. So if you're on a cell phone, you literally can't see it. In the first round, people using VAMS mostly had advanced degrees. If you're 75 and someone asks you to log into VAMS, there is zero way it will happen without help."
Alexander McCaig (11:14):
Where's Deloitte? Did they say anything?
Jason Rigby (11:17):
No, no, no. They said they recognize there's a few bugs.
Alexander McCaig (11:22):
A few bugs?
Jason Rigby (11:22):
And then they said that they're happy to be a part of the process in helping vaccinate America.
Alexander McCaig (11:29):
I'll bet you are. You're happy to be a part of delaying the process of vaccinating America.
Jason Rigby (11:34):
The problem is you have non-native English speakers that are working with high risk essential workers because those are the ones-
Alexander McCaig (11:39):
What did we say about non-native English speakers?
Jason Rigby (11:42):
Yes.
Alexander McCaig (11:42):
And building systems that are accessible.
Jason Rigby (11:43):
Yes.
Alexander McCaig (11:45):
Okay, for data inclusion, to be inclusive and meet people where they are. Flexibility.
Jason Rigby (11:51):
Because a lot of non-native English speakers are working in these nursing homes and places like that. Black and Latino communities, they're having issues.
Alexander McCaig (12:04):
Commercials.
Jason Rigby (12:04):
Commercials, yeah. There are some real equity concerns. What happens when you go to a city and 20% of the population can't get the notices? I can't log in. Or can't figure it out. I mean, dude, I could go on and on and on. Listen to this part. This was seven pages. MIT. That's why I love the article.
Alexander McCaig (12:21):
They must have been ticked off.
Jason Rigby (12:26):
To some watchdogs, VAMS is the latest example of a broken system for building government technology. This is where I'm going to have you get into...
Alexander McCaig (12:33):
Come on, don't tee me up.
Jason Rigby (12:34):
Deloitte had a long history of making malfunctioning things for state and federal governments. Most recently, it was in the news for charging states, hundreds of millions of dollars for unemployment websites that did not work.
Alexander McCaig (12:45):
Oh my gosh.
Jason Rigby (12:47):
Think about this bro.
Alexander McCaig (12:47):
All right. Hold on a second.
Jason Rigby (12:49):
I'm getting ripped.
Alexander McCaig (12:50):
Here we go. Let's think about this, just in a logical sense. You've charged a state a hundred million dollars. Okay. Why doesn't the state just give a hundred million dollars to the people that don't have a job? Why would you give it to Deloitte for a system that doesn't even work?
Jason Rigby (13:01):
Yes.
Alexander McCaig (13:02):
Submit a piece of paper, we'll write you a check. And here's the thing. If they have failed so many times, who at Deloitte knows somebody in the government, that is getting them that shoe in for no bid contracts, to build systems. Data systems, that's what they are, they're data systems. And applications that lack accessibility and red line people that don't speak English from using that system altogether.
Jason Rigby (13:30):
Listen to this. Deloitte may be representative of broken system, but it's certainly not alone. CGI Federal is another one. For instance, it landed over 5.6 billion. Billion dollars.
Alexander McCaig (13:41):
Who's CGI?
Jason Rigby (13:42):
Federal IT contracts since getting fired after its disastrous development of the healthcare.gov website. Remember that with Obama and trying to sign up for healthcare and it was all fucked up?
Alexander McCaig (13:52):
CGI Federal?
Jason Rigby (13:53):
They got another 5.6 billion after they screwed up healthcare.gov.
Alexander McCaig (13:57):
That means, regardless of they screwed up, somebody got... Here's what happens. Somebody, who is at CGI Federal, got a cut and the person, from the government, who gave him the contract also got a cut.
Jason Rigby (14:11):
I want to know about this think tank. There's a think tank called New America. This is interesting. Hannah Shank, the director of strategy for public interest technology, this is what she said. This is very interesting. She said, "Nobody wants to hear about it because it sounds really complicated and boring. But, the more you unpeel the onion of why all government systems suck..." She used that word, which I thought was awesome. "The more you realize it's the procurement process."
Alexander McCaig (14:36):
Yeah, dude, listen. I used to be a consultant. But, the procurement processes are a nightmare. And you have to use 30 different systems to get yourself verified to bid on something. And then they end up just giving it to the person, whoever the hell they want to give it to.
Jason Rigby (14:49):
And we've talked about this before and this article addressed it. And I want you to speak to this, Alex. Listen to this. The healthcare software industry is enormous and exists largely because it's privatized. It's not standardized. There are a lot of free market inefficiencies and the country doesn't have a public health infrastructure. So there isn't really a drive to fix it. Now, this is where you want you to speak.
Alexander McCaig (15:08):
I'm going to talk about we're driving to fix it.
Jason Rigby (15:09):
You think about the industries that have been transformed by technology, someone said. How do we get a pizza to your house faster? That's a competitive advantage. That has not happened in American healthcare.
Alexander McCaig (15:21):
And so let's talk about how TARTLE is redefining American healthcare then. TARTLE is the only system anywhere in the globe. Anywhere, hands down. Only people that do it. Where you can go on and get your entire health record and share it directly with any other healthcare system or person outside of the healthcare system that you choose to share it with. Instantly. Go ahead, find that somewhere else.
Jason Rigby (15:51):
And when you get that data.
Alexander McCaig (15:52):
Oh, by the way, you get paid for it.
Jason Rigby (15:54):
Or you can donate it to climate stability.
Alexander McCaig (15:57):
Whatever.
Jason Rigby (15:57):
Human rights.
Alexander McCaig (15:59):
If you're talking about tech redefining... This is great, get a pizza somewhere. But, we're talking about people's lives here. If we can incentivize people to control their healthcare records and share them through their control efficiently, they're a system that is accessible and easy to use and flexible. And we appropriate a standard, a global standard, for the documentation of that health record so that it makes sense to you, the user, looking at your health care record. And to the people that ingest that into their systems within the healthcare system, you have a winning combination. And for you to look anywhere else or to rely on all these other things, they only made that comment from New America because they haven't been paying attention to what we've been doing. And it's only a short period of time before this all becomes fixed because a private enterprise, like ourselves, shows up and efficiently solves a problem that is directly related to the health and longevity of America's future.
Jason Rigby (16:59):
You're a hundred percent right. And the question that they ask, at the end of the article, was this. One of the doctors at Connecticut Children's Hospital said, "How much money was put into the science of making the vaccine? How much money is being put into the distribution? It doesn't matter that you made it, if you can't distribute it."
Alexander McCaig (17:18):
Who cares?
Jason Rigby (17:19):
I don't care how much money was put into it. It's not money, it's not going to solve the problem.
Alexander McCaig (17:23):
I'm glad you built the car. It doesn't have any wheels or an engine.
Jason Rigby (17:28):
Yes.
Alexander McCaig (17:30):
Simple as that. We can build things that look all shiny and nice and get paid for it. But, if it doesn't do something, you are of no benefit to anybody and you're, frankly, just being irresponsible with public funds.
Jason Rigby (17:47):
We don't have that.
Alexander McCaig (17:47):
We don't have that.
Jason Rigby (17:49):
In our government. We don't have no irresponsibility.
Alexander McCaig (17:51):
No. And you want to know something. We don't need to take on the public's... We don't have to offload our liability to the public to create something wonderful. We're willing to take that risk for ourselves because we know how important it is to deliver this. Because that is just one example of these data systems that fail over and over and over again. And somebody needed to fix it so that we can deliver that pizza within 10 minutes to the house.
Jason Rigby (18:19):
It should be as easy as that. We have people's lives that are depending on it in. You're taking somebody that is depending on the government to do something for them.
Alexander McCaig (18:30):
Yeah.
Jason Rigby (18:30):
They're putting their trust.
Alexander McCaig (18:31):
The person's being responsible. They're like, "I'm going to go use the system to get vaccinated."
Jason Rigby (18:35):
Right.
Alexander McCaig (18:36):
But, you're not meeting them with responsibility. What's with that?
Jason Rigby (18:41):
Yes.
Alexander McCaig (18:42):
Look at that imbalance.
Jason Rigby (18:43):
Yes.
Alexander McCaig (18:44):
We're asking people on TARTLE to be responsible and we meet them with that responsibility. There has to be some sort of equilibrium here.
Jason Rigby (18:51):
That's why we value, and we talk about this over and over again, transparency and data.
Alexander McCaig (18:56):
All the time. This is why we're so educational on it because different ages learn different ways. People interpret things in many different formats.
Jason Rigby (19:06):
100%.
Speaker 1 (19:15):
Thank you for listening to TARTLE Cast with your hosts, Alexander McCaig and Jason Rigby. Where humanity steps into the future and the source data defines the path. What's your data worth?
