Last week I got a parking ticket due to failing to use the SF parking meter system, but really it wasn't my fault. I was in a rush, I put my credit card in, I navigated through 5 screens and the last one said, "your meter expires in one hour, your card will be charged." What I missed was the teeny tiny letters in the bottom corner saying, "continue?" It needed a BIG HONKING BUTTON saying, "Press this or you will get a ticket" but it didn't, and so it cost me $72.
Covered Oregon just cost the taxpayer $250m (a little more than my parking fine) and didn't enroll a single insuree. Their problem was that the decade old Siebel CRM technology that Oracle tried to base it on, was a) old and b) wasn't suited to what they were trying to do with it. They're going to use healthcare.gov next time (which at least was fixed, eventually!).
What does this tell us? Getting both the core technology and the user experience right are equally crucial, and they have to be built in at the same time. Neither the SF Parking Service nor Covered Oregon and Oracle did that end to end (and both profited from it, but that's another story). In two weeks the HxRefactored conference is bringing together designers and developers, because in the new world of health care, we can't afford to get either end of the spectrum wrong. Please come join us.