Participation and Collaboration
The term “Open Government” may at first conjure up the image of improved communication and transparency. Indeed, as outlined above, our Open Government work will look toward achieving new levels for those goals: more effectively communicating factual and helpful information to Americans; moving to make the Department’s unique data resources more easily available; and putting new emphasis on transparency and “sunshine” in our information and decision-making processes.
But to have maximum positive impact, the goal of Open Government must also look beyond these traditional areas. Building on a foundation of open information, we will also seek to take Open Government to the next level – expanding opportunities for public participation and collaboration in HHS activities, especially by engaging new information and communications technologies. Our Open Government work will break new ground in enabling the public to give feedback to HHS programs. We can help stakeholders contribute knowledge and experience that will help us do our jobs better, and we can support new kinds of collaborative teamwork that will deliver better results for our citizens. We will move forward toward new strategies, new tools and indeed a new culture of public participation and collaboration in HHS affairs.
In truth, HHS is a department built on the idea of collaboration. Hundreds of health and social service programs are brought together in this department with the goal of achieving synergistic progress across programmatic lines, especially toward the goal of serving Americans in need. Most of our divisions oversee programs that involve collaboration and partnership with the states and counties that actually administer our programs “on the street.” Much of our work is carried out through grant and contract programs in which we and our partners collaborate with local organizations. For example:
- In protecting the public health, the work of the Centers for Disease Control and Prevention and the Food and Drug Administration could not be carried out except as a complex network of state, local and professional resources.
- In conducting the world’s largest biomedical research enterprise, the great majority of research sponsored by the National Institutes of Health is for extramural research conducted throughout our country. These research programs are guided by policies developed with the advice of non-federal professionals and health advocacy organizations.
- In managing the nation’s largest health insurance programs, our Centers for Medicare & Medicaid Services are the de facto meeting and negotiating ground for every element of our nation’s health care system. And in delivering health coverage to millions of Americans, the success of these programs success depends on fostering two-way communications.
- In protecting our children, the programs of the Administration for Children and Families rely on collaboration with other federal departments, states, law enforcement agencies and volunteer organizations.
- The success of the Head Start program derives strongly from its collaborative nature. It was conceived as a collaboration, not only with the community organizations that run Head Start centers, but more importantly with Head Start parents themselves, who are integral to the program’s management and operations at the ground level.
- To reduce the impact of substance abuse and mental illness on America’s communities, the Substance Abuse and Mental Health Services Administration (SAMHSA) works closely with 60 states, tribes, and countless local communities in the development of their behavioral systems through strategic block grant investments, technical assistance, data collection, evaluation activities, and special safety net programs.
- In supporting health care providers and programs to improve access to quality and culturally competent health care services for people who are uninsured, isolated, and medically vulnerable, the work of the Health Resources and Services Administration (HRSA) is accomplished with continual engagement with the populations it serves.
Thus, as HHS looks toward new horizons of participation and collaboration, we have a strong foundation on which to build. But we are also at an inflection point, where new progress is both needed and feasible. On the one hand, program complexity has grown, and the links across programs that were envisioned in the creation of HHS need to be renewed and revived. At the same time, information and communications technologies offer new tools and opportunities to support new kinds of participation and collaboration.
New tools and new policies will enable us not only to rejuvenate the important areas of participation and collaboration that already exist, but also to achieve a new level of Open Government. We can better support our own employees in team-building and innovation. We can forge stronger and more supple ties with our traditional partners, both in and out of government. And we can provide new opportunities for every citizen to contribute toward better performance by our department as well as improved health and well-being for our fellow citizens.
HHS has a large number of activities that provide a means for citizen participation in agency activities such as planning, priority setting, or community involvement. In developing a composite of our current approaches for public participation, we began by asking: “How does my agency include public participation in agency matters, and what will it take to revise its current practices to increase opportunities for the public to participate in and provide feedback on the agency’s core mission activities?”
There are several mechanisms that are widely applied across HHS to engage public input. A key approach is the convening of meetings and public forums such as HHS federal advisory committees that are either agency specific, cross-agency, or interactive with multiple federal agencies. Federal advisory committees are created to advise the Department on a specific topic. By law, the membership must fairly represent diverse points of view. These committee activities draw upon subject matter experts to provide context for issues and facilitate engagement with the public to address barriers and opportunities on particular issues of importance. Committee meetings are convened by the government and, with limited exceptions, held in the public domain. The committees develop reports and other products that help provide input to the government on a wide range of health and human services issues.
Formal input into HHS agencies’ federal advisory committees represents an important opportunity to participate in policy and planning activities. Virtually all public meetings of these bodies include representation by public members and are open for individual formal comment submissions. Many of these bodies also provide opportunities to follow the proceedings via the web or by phone, enabling remote participation. HHS strongly encourages public participation in these meetings and provides here a resource to identify these committees of interest and resources about them. You can find out information about these committees and how to engage with them through this portal: http://www.hhs.gov/open/stayconnected/facdb/index.html.
Another approach is the development of networks with non-governmental, academic, state and regional government and other organizations to take on specific challenges. Other approaches to encourage participation are to work with the media to highlight focused activities such as health promotion, prevention, and emergency preparedness. These include special events that mark certain periods of time during the year for featuring a particular cause with press events, town hall meetings, webinars, and broadcasted events that aim to allow the public to observe and submit questions and comments to government representatives. Yet another approach that HHS uses is to develop agreements with organizations, such as universities, colleges, professional societies, and other non-governmental organizations, to facilitate community engagement activities.
Increasingly, HHS organizations are turning to electronic communications as a means to connect with the public. While the Internet has been a main pathway of communication to the public for many years through websites and databases, it is now being used to interact with the public. Information dissemination to the public has advanced using the Internet and mobile communication technologies, such as the use of rapid syndication feeds for broadly disseminated publishing of accurate health information to other websites and automated text messaging. These have been an important part of providing trusted and verifiable source information to the public, and in turn, provide the public with information that enables citizens to respond on important issues. Electronic technology is also being used to gain input from the public through new Web 2.0 technologies. Among the techniques and methods that are becoming popular in federal agencies are web dialogues, blogs with federal organization leaders, microblogging (such as Twitter), video connectivity through YouTube, idea generation tools that include rating and rankings of ideas by the public, on-line collaboration tools, and hosted jams that engage a wide array of participants in an on-line group discussion. In some cases, the public and experts are using web technology to develop documents through group writing efforts that enable more efficient and wider participation with knowledge in the specific activity.
A prominent case example at HHS with respect to intensive use of Internet technologies and approaches is the Centers for Disease Control and Prevention (CDC). CDC has used podcasts and RSS to cover topics from H1N1 to emergency preparedness to chronic disease. CDC podcasts have been accessed over 8.4 million times, and CDC RSS feeds have been consumed 31.4 million times. CDC has launched Health-e-Cards as another means of providing interactive media activities to help disseminate public health information. Since its launch, over 110,625 e-Cards have been sent and over 313,767 cards have been viewed from the site. CDC has also served as a pioneer in the use of virtual worlds to expand the reach of health messages. Whyville and Second Life have been used by CDC to promote vaccination campaigns, share information about CDC’s mission and goals, and provide access to streaming video, posters, and links to CDC website information. CDC has extended federal public health use of Web 2.0 technologies into social networking sites and microblogging (with 1,251,936 followers on Twitter). CDC’s development of widgets and web gadgets have led to over 55.4 million interactions, while buttons and badges have been a source of over 2.6 million click-throughs in 2009.
There are many other ways to participate and engage in HHS activities. We encourage participation by the public in a variety of ways – a sampling of these opportunities is provided in our “Get Involved” searchable resource http://www.hhs.gov/open/stayconnected/facdb/index.html. This resource allows the user to search by topic area or agency.
There are several common approaches to collaboration across HHS. There are a large number of interagency or collaboration agreements with other federal agencies and with non-federal partners. Many of these are targeted to specific activities such as implementing quality improvement methods, patient safety methods, evidence-based health care practices, facilitation of healthy behaviors, etc.
In developing a profile of HHS collaborations, the following was addressed in a survey of the organization: “How does your agency foster collaboration, and what approaches will your agency take to revise its current practices to further cooperation with other Federal and non-Federal government agencies, the public, and non-profit and private entities in fulfilling the agency’s core mission activities?”
Notable examples of collaboration are articulated by the National Institutes of Health’s (NIH) annual report on collaboration efforts with other agencies. As required by the Public Health Service (PHS) Act, NIH must provide the Secretary with a report including detailed information on all of its activities and collaborations with other HHS agencies. These include hundreds of collaborations in areas of health such as autism, HIV/AIDS, childhood vaccines, and dozens of other diseases, as well as collaborations on the creation of resources and infrastructure in the realms of IT architecture, unique databases and data collection and evaluation. NIH engages in major international collaborations to study and ameliorate or eliminate disease and has a formal program of public-private partnerships addressing major scientific discovery. For example, the Biomarkers Consortium, a unique public-private partnership that includes FDA, NIH, and major pharmaceutical companies, led by the Foundation for NIH, just announced the launch of a clinical trial, I-SPY2, to help screen promising new drugs being developed for women who have high risk, fast-growing breast cancers—women for whom an improvement over standard treatment could dramatically change the odds of survival.
At the FDA, there are many examples of collaboration with other agencies within HHS, other federal agencies, and with state, local and foreign governments. The FDA works closely with state and local public health departments to protect the nation’s food supply. Recent activities include the opening of a center, operating under the direction of Customs and Border Protection, to work with FDA and other agencies on matters relating to the safety of foods imported to the United States, to which FDA is providing on-site expertise. FDA collaborates with CDC, USDA, and state and local public health departments on surveillance, investigation, and response to outbreaks of food-borne and other enteric illnesses. Additionally, through the Food Emergency Response Network (FERN), FDA integrates federal, state, and local laboratories into a network that can respond to emergencies involving biological, chemical or radiological contamination of food.
FDA also collaborates extensively with foreign governments. In addition to establishing offices overseas, the FDA has a large number of formal agreements and arrangements with its counterparts in different countries, the European Commission, and the World Health Organization, which improve the effectiveness of FDA programs by providing mechanisms for sharing human, scientific, and investigational resources and knowledge and by promoting responsible international standards and regulations. In a new pilot program, the FDA combined resources with the European Union and Australia to conduct inspections of facilities in certain countries that manufacture the starting materials for many drugs that end up in the United States and other countries.
Current approaches to collaboration in HHS are also shown in a number of notable efforts at the Centers for Medicare and Medicaid Services (CMS). CMS increases collaboration through health care industry forums including town hall meetings, open door forums, federal advisory committees, and industry presentations. Business partner collaboration activities include meetings with associations, Medicaid and Medicare Part D user calls and quality alliances and initiatives. CMS also collaborates with other federal and governmental entities via departmental work groups, Medicare program operations, and through the Nationwide Health Information Network. CMS is also active in collaboration on a civil level with participation in human resources, labor relations and other administrative function bodies and panels.
The Centers for Disease Control and Prevention (CDC) have developed innovative approaches to collaboration with external partners. Two examples include PHGrid and HuGENet. PHGrid is a research and development activity that links multiple collaborators in the public, academic, and private sectors to help develop the capabilities of grid computing as they apply to public health. HUGENet is a linkage into a “network of networks” promoting the exchange of research findings in genetic research. This effort is also tied to similar networks in Australia, Europe, and across North America. This allows for scientists to collaborate and share genomic knowledge that can be used to prevent disease and improve health in all stages of life.
At the local level, HHS regional offices play an important role in collaboration. Across the country, the HHS regional offices serve as the gateway through which communities and individual citizens can interact with the Department. For example, the regional offices can play an important role in collaborating with local governments and communities in policy development and the implementation of new HHS programs. They also play a key role in providing and/or coordinating services for citizens, and often serve as the primary point-of-contact for citizen engagement with HHS.
For Open Government activities, HHS is participating in an array of federal-wide activities, some of which have formal communities of practice associated with them. HHS employees are widely engaged in work on ideation tools; competitions and challenges; data sharing; and best practices in use of new media and social networking platforms.
In an effort to enhance the ability for HHS employees to identify opportunities to participate in the Open Government initiative, an initial action plan has been developed. With the advancement of Internet tools and the use of other communication technology, HHS is testing, developing, and deploying an array of media, tools, and approaches to communicate with the public. Across HHS, agencies are exploring new approaches to foster participation by the public and promote collaboration across government and with non-governmental organizations. Looking forward in 2010, HHS will deploy a Strategic Plan for Participation and Collaboration, based on four core elements:
1. Founding an HHS “Community of Practice” for Participation and Collaboration
The first step toward progress is enhancing awareness and experience across HHS regarding the use of new technologies and approaches to enhance Open Government. Another aspect of importance in this plan is to provide new venues and opportunities for HHS employees, its partners, and the public to obtain experience and learn from others. To accomplish this, HHS is establishing a “Community of Practice” for Participation and Collaboration. This community of practice will enable HHS Open Government innovators to share experiences, policies, and tools, and will increase dissemination of best practices and knowledge throughout the HHS workforce. The community of practice will focus on activities being developed in actual ‘laboratories’ or other facilities that allow testing in developmental Internet spaces and evaluation of results. The community of practice approach will enable many new concepts and applications of technology to flourish in helping “connect” HHS with the public and its partners. HHS leadership has been engaged in a growing number of community forums helping promote HHS Open Government activities to foster greater participatory interest among organizations, state and regional governments, and individuals. We will continue to use public gatherings and a broad array of media to enhance knowledge about ways to participate.
2. Development of an HHS Workplace Menu of Innovative Tools for Participation and Collaboration
One of the first orders of business for the new HHS “Community of Practice” on Participation and Collaboration is developing a “menu” of tools and techniques would encourage participation and collaboration within and outside the HHS community. Within the department, several Operating Divisions have expressed interest in deploying an ideation tool to enhance internal operations and boost employee morale. The menu will list common tools and information resources available that agencies may wish to use in participation and collaboration activities. HHS employees and other members of the community of practice will use this menu to share their experiences and lessons learned from using the tools in the menu. Such a feedback mechanism will ensure that the menu and its content remain dynamic and relevant over time.
As part of the Open Government Plan, since the debut of the initial Plan on April 7, we have started an HHS Community of Practice centered on participation and collaboration activities (CoP). This CoP has been engaged in several projects with operating divisions across HHS, promoting collaboration with outside entities and agencies, as well as participation activities to generate greater employee and public participation. In order to foster knowledge transfer across the HHS operating divisions and different program managers that might want to emulate these programs, an intranet site was developed to house collateral material and discussion. In addition to providing a collaborative platform for discussion, this intranet site also serves as a gallery of innovative practices that are occurring across the Department.
Figure 1: Community of Practice Site
The Community of Practice features a new internal innovation consulting team, launched after the debut of our Open Government Plan on April 7, that works with the members to actively seek out and take down barriers to participation and collaboration activities. Several of the team’s new projects are highlighted below.
National Institutes of Health, Office of Technology Transfer (NIH/OTT)
NIH/OTT is interested in utilizing social media tools to better market intramural inventions from NIH and FDA labs to external partners and organizations. The innovation consulting team is working with NIH/OTT to utilize Web 2.0 tools and develop partnerships with industry trade associations. Furthermore, collaborative opportunities between the NIH Library and NIH/OTT using semantic search capabilities have been established to better catalogue the licensing and partnership opportunities available to outside organizations.
Centers for Medicare and Medicaid Services (CMS)
CMS is interested in utilizing an employee ideation tool to upgrade its suggestion box program and harness the knowledge of its employees to solve operational problems. The innovation consulting team is working with CMS to navigate issues associated with utilizing Web 2.0 tools and employee engagement. Currently the program is in the design phases while distilling the lessons from the Department of Veterans Affairs Innovation Program.
Substance Abuse and Mental Health Services Administration (SAMHSA)
SAMHSA is interested in utilizing an employee ideation tool. The innovation consulting team is working with SAMHSA to determine feasible technical solutions to embed an ideation tool within SAMHSA’s existing collaboration platform software. Currently SAMHSA is exploring free no-cost options that can be embedded into its collaborative platform.
Food and Drug Administration Center for Tobacco Products
The Center for Tobacco Products is interested in soliciting feedback from retailers on the best ways to engage the front-line workers in combating underage purchase of tobacco products. The innovation consulting team worked with the Center to establish an ideation site that reached out to retailers. This ideas submitted to the site are now under consideration as strategies to better fulfill the mission of the Center.
Prizes & Challenges
The Department is looking at methods to launch competitions/challenges across all of its operating divisions and staff divisions. The innovation consulting team is working with the new Prizes and Challenges subcommittee of the Innovation Council to gather best practices from other federal agencies that have run successful competitions and develop a framework by which all the entities within the Department of Health and Human Services can run competitions (see Section 3.0 below).
Menu of Tools
The HHS menu of tools will exist on a “platform” that Community of Practice (CoP) members use to collaborate with one another and discover best tools and practices that may inform and support their own participation and collaboration efforts. Unlike traditional top-down development, the development of the CoP platform will hinge on CoP member/user input that will drive the implementation and use of the HHS menu of tools. A pilot CoP platform will be launched, and pilot users are invited to contribute content to the platform and discuss ways to improve the functionality of the platform. The innovation consulting team is currently experimenting with two possible collaboration platforms (Platforms A and B), with a final platform to be selected in 4Q 2010:
Set up Platform A
April 7, 2010
Add preliminary content to Platform A
April 23, 2010 and ongoing
CoP users invited to contribute Platform A
Initial contributions - June 15, 2010
Set up Platform B
June 30, 2010
CoP users invited to contribute to Platform B
July 6, 2010
Final platform selected and formally launched across HHS
It is our goal to have at least 10 active participation and collaboration projects present and running on the Community of Practice collaboration platform by the end of 2010.
3. Prizes and Challenges to Enhance Open Government
The HHS Innovation Council has established a subcommittee in response to the Office of Management and Budget’s Guidance on the Use of Challenges and Prizes to Promote Open Government, issued on March 8, 2010.1 The subcommittee’s charge is as follows: recognizing that the uses of prizes and competitions serve to spur new ideas towards addressing agency missions, the subcommittee is tasked to identify opportunities for use of prizes and competitions across HHS; provide guidance to HHS agencies on their use; and provide recommendations to the Innovation Council on strategies to overcome barriers toward their use. The subcommittee began its work by conducting a review of agency authorities for conducting prizes and competitions with a particular focus on mechanisms for use of appropriated funding to support these activities. In addition, a limited survey was conducted for emerging prizes and competitions activities with an emphasis on community participation and collaboration with non-federal agencies. An initial effort of the subcommittee will emphasize identification of best practices from various agencies and non-governmental agencies, and development of a marketing and information sharing activities. Future directions may examine key HHS strategic initiatives that may host prizes and competitions, uses of Web 2.0 technologies for community engagement, and potentially address legislative needs to address authorizing language.
And as discussed previously, since the debut of our initial Open Government Plan, we have already executed two such challenges and launched a third:
- A competition for best visualization of community health data as part of the Sunlight Foundation’s Design for America competition -- see http://sunlightlabs.com/blog/2010/design-america-winners/ for results, announced at the end of May
- As part of our flagship Community Health Data Initiative, a challenge to innovators to develop applications using HHS’s community health data for debut at a Community Health Data Forum jointly hosted by HHS and the Institute of Medicine on June 2 – see http://www.hhs.gov/open/datasets/initiative_launch.html to view a webcast of the amazing results
- As another part of the Community Health Data Initiative, HHS has collaborated with Health 2.0, Sunlight Foundation, and others to launch a third challenge, the Health 2.0 2010 Developer Challenge (www.health2challenge.org), with resulting applications to be showcased at the Health 2.0 conference in San Francisco in October
4. Evaluation of HHS Participation and Collaboration Efforts
Evaluation of the effectiveness of current and planned participation and collaboration efforts will serve as an important component of HHS’s Open Government Plan. Evaluation efforts will be expected to inform near-term activities such as community of practice discussions and the development of the participation and collaboration tools menu, as well as future strategic planning efforts regarding the use of participation/collaboration activities across HHS.
The evaluation activities will focus on three broad components: 1) evaluation of the effectiveness of the methods/techniques utilized in a sampling of featured HHS participation and collaboration activities (we will aim to select a diverse sample of initiatives so that we can evaluate not only the technical tools and management approaches applied to the use of these tools, but also the settings or issues for which participation and collaboration issues are best suited); 2) stakeholder evaluations of the effectiveness of engagement approaches; and 3) an assessment of the effectiveness of the participation and collaboration methods/techniques in supporting agency priorities. With regards to this third component, the evaluation will pay close attention to the extent to which public inputs garnered through participation efforts have contributed to the HHS priorities, as well as any best practices with regards to the handling of and responding to public comments.
5. Addressing Barriers to Participation and Collaboration at HHS
HHS leadership has designated the promotion of innovation across HHS as major priority. In our approach to implementing new ways to work together, HHS has identified barriers that impede new methods of participation and collaboration and is now working to overcome them.
One area that has represented a barrier to participation and collaboration has been the lack of knowledge about what technology platforms and services can be used in the workplace and what privacy and security concerns and protections are involved. HHS is working to inform workers on how to utilize Web 2.0 technologies responsibly and safely and promote their use to promote participation and collaboration activities.
Another source of difficulty impacting working with the public was identified as restrictive policies related to the Paperwork Reduction Act of 1984. Currently, research activities to collect information from the public require many layers of project review to comply with management controls introduced as a consequence of the statute. Now, HHS is working with the Office of Management and Budget to eradicate unnecessary obstructive practices and bureaucracy that will enable more effective and efficient data collection.
An important consideration for the future of communication and deployment of advanced collaboration and participation tools is the informatics infrastructure and technical support in HHS. Being such a large organization, HHS has an array of decentralized information systems, and the interactions among users and movement of important data can be inhibited by lack of connectivity or technical support. HHS is studying options through the Chief Information Officer Council to optimize sharing of experiences and improving connections across information systems. New policies and technical infrastructure will be a target of HHS work in the future to ensure that technology can be used effectively in the workplace.
One of our key Open Government advances has been the development of a model approach for approaching participation and collaboration. The Community Health Data Initiative has pioneered methods which can be used in other areas across HHS and the government. These methods include new approaches with respect to sharing data and working with innovators outside the government. The development of a process to open up data sets within HHS, encouraging other organizations to make data available, encouraging tool development by private sector innovators, and fostering communications with new media are all methods of practice that can be used across HHS. To help promote the use of these methods, a “playbook” of policy actions and methods which are making CHDI successful will be developed and made widely available by October 2010.
2 Guidance on the Use of Challenges and Prizes to Promote Open Government. March 8, 2010. http://www.whitehouse.gov/omb/assets/memoranda_2010/m10-11.pdf
In looking to the future, HHS agencies are creating innovative new approaches to participation and collaboration. These approaches are engaging Web 2.0 technologies that include the following functional capabilities:
- Blogging, rating and ranking of ideas, policies, priorities
- Crowdsourcing to identify public opinion and preferences
- Group collaboration tools such as wikis, portals, and file-sharing services
- Idea generation tools
- Use of mobile technologies such as text messaging services
- On-line awards and competitions.
Described below are samples of planned HHS activities for 2010 that are engaging innovative new participation and collaboration mechanisms.
Delivery of Consumer Information on Patient Safety and Health
Product Safety Text-Message Pilot
FDA has launched a six-month pilot to assess the use of text messages as a channel for reaching healthcare professionals, patients, and other members of the public. Once participants subscribe to the pilot, they will receive real-time MedWatch text message alerts on topics of interest they select. The content of the text messages will consist of alerts that provide timely new safety information on human drugs, medical devices, vaccines and other biologics, dietary supplements, and cosmetics. The alerts contain actionable information that may affect both treatment and diagnostic choices for healthcare professional and patient. To assess impact and user experience, after six weeks have passed, and then four months, the participants will receive a text message with a link to a survey.
The Text4baby program
Text4baby is an innovative mobile information service designed to promote maternal and child health. Through Text4baby, pregnant women and new moms receive timely health information via free mobile/cell phone text messages. This service was made possible through a broad private-public partnership that includes government, businesses, professional organizations, academic institutions, and non-profit organizations. A comprehensive list of partners can be found at www.text4baby.org/partner/html. Federal agencies provided input on evidence-based scientific recommendations, health promotion and disease prevention programs, and community health resources available to medically underserved communities and vulnerable populations. Individuals who sign up for the service by texting BABY to 511411 (or BEBE for Spanish) receive three free SMS text messages each week timed to their due date or baby’s date of birth. The messages focus on topics critical to the health of moms and babies, including nutrition, seasonal flu prevention and treatment, mental health issues, risks of tobacco use, oral health, immunization schedules, and safe sleep. Text4baby messages also connect women to public clinics and support services for prenatal and infant care. Information provided to mothers through Text4baby can help them take care of their health and give their babies the best possible start in life.
Use of Social Media to Reduce Harm from Tobacco Products
The Food and Drug Administration is planning to increase use of social media tools including widgets, podcasts, YouTube, and other novel avenues to increase awareness of and compliance with the restrictions on advertising and access to cigarette and smokeless tobacco products by youth.
Expanding the Functionality of Personal Health Records
CDC is exploring the use of electronic Personal Health Records (PHR) as a way to 1) distribute health data to individuals who participate in the NHANES in-person survey and 2) deliver personalized CDC health information directly to consumers. A CDC pilot demonstrated that data collected through NHANES could be provided securely to individual participants through a PHR to augment or replace individual reports sent through the mail. Participants were able to control their personal health information and choose to share their data with others or retract that capability on demand. The pilot demonstrated that data could be linked to health information resources and that NHANES data can be coded using standard methods and populated into a Continuity of Care Record -- making it readable across PHRs and electronic medical records in doctors’ offices and hospitals. Additionally, CDC and Microsoft are investigating the potential use of Web 2.0 tools that allow users of Microsoft’s PHR platform, HealthVault, to have personally tailored CDC disease management and prevention resources delivered to their PHR to improve informed decision making about their current and future health needs.
User-Friendly Information Services for Health Care Delivery
Using Cell Phone Applications as an Effective Health Care Program Dissemination Tool
The Agency for Healthcare Research and Quality (AHRQ) will be assessing the effectiveness of cell phone applications to increase the dissemination and implementation of effective health care program products among underserved priority populations. This will help overcome mobility barriers and enable access to high value information by users without readily available computers.
Delivering Computerized Geography-based Inventories of Patient Care Services
The Indian Health Service delivers health care services via hundreds of patient care facilities scattered across 35 states. The type of on-site services offered varies significantly place-to-place. A computerized patient portal is being developed to help patients determine which services are available at the nearest site and locations and travel distances to other sites where needed services may be available.
Medical Research Connections and Collaborations for Patient Engagement
Advancing Diabetes Research through Crowdsourcing
Via a Harvard program being pursued in partnership with InnoCentive, HHS is learning about how crowdsourcing and social networking can be harnessed to advance diabetes research. This approach is helping to generate new research ideas to address complex challenges of living with diabetes and will yield new perspectives on how research is done.
Advancing Health of Women Study
A new resource for public engagement in medical research has been developed through a partnership with the Army of Women and the National Cancer Institute. Through the use of Web 2.0 tools for connectivity and collaboration, women -- with or without breast cancer – can sign up and respond to a series of periodic secure online questionnaires about their health, family health history, nutrition, and physician activity. This population of women and their data is then connected to the research community via the web. Women can add more information about their health over time, enabling more research questions to be tested. This new model of engagement has the potential to revolutionize how research studies are conducted.
Resources for Public Information Needs about Medical Research
Recently, the public was provided a new information resource by the National Institutes of Health (NIH) called the Research Portfolio On-line Reporting Tools (RePORTER) system, which provides summary information about all biomedical research projects and related activities from NIH and other HHS agencies. In addition to facilitating public participation, RePORTER also provides the basis for more effective collaboration between agencies. In addition to providing a central repository that spans several HHS Operating Divisions engaged in health-related research, RePORTER provides information on research funded by the Veteran's Administration. Components of the Department of Defense and other research agencies also have requested information on the system, increasing the potential for even broader collaboration and coordination.
Technology for Teamwork
Enabling Collaboration among HHS Employees through Enhanced Access to Information Technology
One of the recent advances implemented to help the HHS workforce collaborate across the department involves technical engineering and revisions of management policies that provide HHS employees with improved access to common software programs and tools. The diversity in the types of work at HHS, breadth of the mission, and geographically-dispersed workforce of HHS have over the years led to deployment of multiple information systems in HHS agencies, which created complications for workers who wished to access common software to work on common projects. This problem has now been solved. The net effect of this advance will allow project officers of a cross-agency team to work together via the intranet and overcome geographic, organizational, and resource boundaries that previously slowed progress and limited collaborative work.
Implementing New Electronic Collaboration Platforms for HHS Planning and Evaluation Activities
One of the many ways that new projects are developed and existing ones are improved is through the use of agency planning and evaluation activities. Across HHS, this often means that a broad array of experience and knowledge from across the organization and from the public is needed. Current approaches to planning and evaluation are limited by the lack of knowing where expertise, data, and information are located throughout the organization. The emergence of electronic technologies to support group document collaboration, expert locator services, crowd-sourcing, wiki functions, and other related activities have brought the potential for new efficiencies in government planning and evaluation. A recent survey conducted at HHS indicates that a small percentage of employees have work experience with these technologies, but are eager to learn more about how to use them to improve their work. The Office of the Assistant Secretary for Planning and Evaluation (ASPE) will be deploying and piloting several new collaboration tools. These will include a wiki tool for collaborative editing, a desktop tool for online conferencing, and an analysis of the organization's suitability for deployment of more comprehensive collaboration tool that would integrate a number of collaborative functions into a single platform. Based on lessons learned from the pilot deployments, ASPE will consider adopting these technologies organization-wide. Lessons learned from deployment in this atmosphere may provide useful lessons for broader deployment across HHS.
Better Healthcare through Better Information
Nationwide Health Information Network – Direct
A key component of the Nation’s emerging health information technology infrastructure is the Nationwide Health Information Network (NHIN) – a set of standards, policies, and services that enable the secure exchange of health information over the Internet. “NHIN Direct” is the latest development in the evolution of the NHIN. It’s an important effort to develop a “lightweight on-ramp” to the NHIN that will enable simple, direct exchanges of information between providers, labs, pharmacies, and consumers -- and which will be easy to adopt and implement. In a process that launched on March 1, NHIN Direct is being designed in close collaboration with the community of potential users, with the entire process taking place in the open, in public, on a NHIN Direct wikispace. NHIN Direct will then be implemented in real-world tests and deployments by members of the community – with HHS’s Office of the National Coordinator for Health Information Technology (ONC) playing a coordinating and convening role. The gist of the NHIN Direct strategy is to utilize a community-driven approach to ramp up and power NHIN Direct-powered health information exchange.
Gathering Public Input on the Rollout of Health Information Technology
In an effort to reach very diverse stakeholder groups, HHS’s Office of the National Coordinator for Health Information Technology (ONC) is communicating through a variety of mediums, including encouraging bi-directional communication in a blog format. ONC blog authors provide opinion regarding ONC events and offer a personal perspective on current agency events. Readers are encouraged to leave comments on the blog and are able to rank comments according to favorability, thus helping the ONC communication team identify trends in reader opinion. The ONC blog is syndicated and often re-published on external websites by members of the public.
Finding New Ideas – Innovation in the Work Place
Centers for Medicare and Medicaid Services Plans Electronic Suggestion Box
In a new approach to using employees’ experience and know-how to solve complex problems, CMS will be piloting a new electronic employee suggestion box, which will use crowdsourcing, rating and ranking capabilities to identify the best ideas and solutions. The pilot will provide a way for CMS employees to offer unbounded suggestions and ideas relevant to CMS programs and CMS as a place to work. CMS will also ask employees to submit their best ideas for improving specific program or administrative areas.
Substance Abuse and Mental Health Services Administration (SAMHSA) Innovative Employee Engagement Initiative: PeopleFirst
Open government concepts have been applied internally at SAMHSA to improve program management and measurement. SAMHSA has launched an innovative, employee-driven organizational development initiative titled “PeopleFirst.” Through a collaborative intranet space and virtual and physical suggestion boxes, employees submit ideas for improvements in both programmatic and administrative domains that are then further explored and worked on by the employees themselves. This multi-faceted initiative is leading to significant gains in operations, level of employee engagement, and overall workforce productivity.
Building a better future for the health and well-being of the nation benefits from getting everyone involved. Harnessing the power of participation and collaboration holds great potential to help us advance our mission. In the months and years ahead, HHS will continue to pursue innovative approaches to doing so, in the spirit of commonwealth and “all hands on deck.”