Jumpstarting Innovation at HHS: Ignite Launches its Sixth Round with a 3 Day Design Sprint

HHS bootcamp

Teams selected into the HHS Ignite Accelerator learn and apply core design and entrepreneurial principles taught by our partners from the University of Maryland.

The sixth round of HHS Ignite has now officially taken off!

Last week, 13 teams descended on the Hubert Humphrey Building to jumpstart projects addressing important problems or opportunities that affect how the Department ensures the health and well-being of Americans. They are starting their journey in Ignite, the Department’s internal innovation startup program for staff that want to improve the way their program, office, or agency works. Over the next three months, the sixth cohort of Ignite teams will run the gamut of HHS’ broad mission, from improving medical device review, to easing research grant applications processes, to spreading opioid abuse education and interventions, and on and on along other key mandates.

Despite running five rounds of the Ignite program, and already having seen 71 distinct sets of opportunities, personalities and approaches, it is still refreshing and pleasantly surprising to see most teams either wholeheartedly, or at least cautiously, adopt the entrepreneurial mindset and methods taught by our teaching partners from University of Maryland Academy for Innovation and Entrepreneurship. Over the three-day-long design sprint, or Boot Camp as we call it, teams learned and applied core design and entrepreneurial principles such as developing empathy through unstructured interviews, synthesis through tools such as journey maps, and ideation and testing through sketches and prototyping. They also gained key aspects of the Lean Startup framework, which guides them through identification of key stakeholders and development and testing of hypotheses surrounding their needs.

Jonathan Bush

Jonathan Bush, Chairman, CEO, and Co-Founder of athenahealth, presents to teams at the Boot Camp.

 

Continuing our legacy of having powerful guest speakers for Boot Camp, we presented Jonathan Bush, the Chairman, CEO, and co-founder of athenahealth. Jonathan shared important insight into the entrepreneurial thought that initially steered athenahealth’s early strategy and how it stumbled onto its ultimate business model of automating inefficient and repetitive processing of federal health care paper forms. His talk moved to focus on the ways that federal or state government contributes to administrative requirements on providers. And while not everyone in the audience necessarily agreed with his every view, Jonathan’s fiery presentation was instructive (and generous) in exposing his honest frustrations, providing valuable insight on how industry might view the demands of working with government.

Fortunately, one of our teams in this cohort just happens to be addressing an opportunity that intends to reduce those very burdens on physicians as they interact with the single largest payer in our healthcare system, the Centers for Medicare and Medicaid Services (CMS). The intrepid group, led by CMS’ Jon Langmead, is seeking ways to incorporate a variety of physician feedback into policies and/or communications that directly addresses their needs and pains. CMS will actively assess the  means and types of data they are receiving, synthesize the data into useful information, and, create actionable information to better serve providers.

Like the CMS team, Ignite teams expose their passion for making government operate more effectively and efficiently; they are addressing an opportunity with far-reaching potential and should be lauded for the efforts they will put forth as they navigate a complex system in order to make difficult but important change. Over the next three months, teams will be tasked with learning more than they care to about all the players in their ecosystem, where there is common ground, and what kinds of solutions will satisfy which needs and motivations that they uncover along the way. By the end of the Ignite journey, we hope but don’t expect every Ignite team to discover the ultimate solution to their challenge; however, what they learn along the way is most important; the value Ignite teams create almost always comes in unexpected ways, just as it did for Jonathan and athenahealth.

Spring 2017 Ignite: Selecting the Teams

We have selected the 6th Round of teams into the HHS Ignite Accelerator, the Department’s internal innovation startup program for staff who want to improve the way their program, office, or agency works.

This round we accepted a total of 108 proposals; from that pool of proposals we have selected our final 13 accepted teams. This post is meant to illustrate the selection process.

This post builds off previous explanations of the Ignite selection. Here are the links to our methodologies for Spring 2016, Winter 2015, and Summer 2015.

We received 108 proposals

Each team that submitted project idea identified a project lead, and we asked for that person’s Agency (or as we call it here in HHS, that person’s Operational Division [OpDiv]). Below, we breakdown the 108 proposals by OpDiv.

  • ACF = 5
  • AHRQ = 2
  • CDC = 12
  • CMS = 4
  • FDA = 19
  • HRSA = 15
  • IHS = 9
  • NIH = 27
  • OS = 15

A couple of notes:

  • Previous Rounds saw submission numbers of 82, 65, 72, 74, and 42, respectively.
  • There were applications from nearly every OpDiv.

These 108 proposals were scored by 20 Reviewers

The reviewers were comprised of previous Ignite team members and close collaborators on past projects from the Office of the Chief Technology Officer.

  • Amy Wiatr-Rodriguez, ACF
  • Dan Stowell, CDC
  • Leigh Willis, CDC
  • Jennifer Tyrawski, CDC
  • Carin Kosmoski, CDC
  • Roselie Bright, FDA
  • Bethany Applebaum, HRSA
  • Dan Elbert, HRSA
  • Paul Lotterer, HRSA
  • Vinay Pai, NIH
  • Nick Webber, NIH
  • Malini Sekhar, OS
  • Dan Duplantier, OS
  • Katerina Horska, OS
  • Damon Davis, OS
  • Mark Naggar, OS
  • Bonny Harbinger, OS
  • Kate Appel, OS
  • Kevin McTigue, OS
  • Will Yang, OS

Each proposal was scored 3 times

We worked with 20 reviewers, separated them into 7 panels, and then distributed the 108 proposals across the panels. Thus, each proposal was scored roughly 3 times. We used the average of the 3 scores to make a finals score that we used in our analysis.

Each reviewer received standardized guidance for scoring proposals. Naturally, there was some variation in each reviewer’s scores – some harsher, some lesser. Thus, we used Z-scores to normalize the scores. See more about that below in the section called: “There Were Three Ways A Project Idea Could Advance”

We asked each individual to self-identify if they should recuse themselves. There were no identified conflicts and no recusals.

Each proposal was scored based upon defined criteria

Each proposal was scored on a 0-100 range based upon our communicated criteria:

  • The project’s alignment to the Office, Agency mission [20 points]
  • The proposal’s explanation of the process, product, or system to be addressed. [60 points]
  • How well the proposed solution aligns with the communicated problem. [20 points]

Beyond the scoring rubric, reviewers were asked on a binary scale: do you think this proposal should be considered to become a finalist? Each Reviewer was also asked to provide brief comments on the proposal that help justify their score.

There were three ways a project idea could advance

The following were ways in which a proposal was able to advance:

  • The top z-scores overall
  • Review Panel unanimously votes to advance it
  • Wildcards picked by IDEA Lab staff

Z-scores are used as a way to control differences in reviewer scoring. For instance, out of a score of 100, reviewers on Panel A might score teams on average 70, whereas reviewers on Panel B might score teams on average 85. In this case we see that Panel A is harsher, whereas Panel B is less harsh. Now, the raw scores are different, but they both happen to say the same thing – average. Thus, the Z-score accounts for that variation. Here’s the wikipedia article on z-scores if you’d like to learn more.

While we rely on statistical methods, we also recognize that the process shouldn’t be left to math alone. Thus, we have a wildcard slot. Wildcards were picked by Kevin McTigue and Will Yang – the HHS Ignite Program Leads. We combed through every proposal, rigorously analyzing and fervently debating proposals that we felt were eligible for the wildcard category.

We interviewed 34 project ideas for Ignite

During this stage, we further identified applicants through 25 minute conversations. The applicants were given an opportunity to pitch the Program Directors for 5 minutes and converse for 20 minutes on their problem identified, solution, background for solving the problem, team background, and general clarity of direction.

We selected 13 project ideas for Ignite

We selected 13 teams for the Spring 2017 Ignite Accelerator. This was the most difficult selection process yet, and we are excited to see those who are willing to test new ideas. We wish we could have accepted more teams, and hope to do so in the future. To all those who submitted proposals, keep pressing on and innovating to better serve the American people.

 

Welcoming the Newest Teams to the Spring 2017 Ignite Accelerator

What if your ideas had the potential to transform how HHS delivers on its mission? What if you had the support and guidance to explore and test that idea?

During the Fall of 2016, we posed these questions to employees at the Department of Health and Human Services and solicited proposals for the HHS Ignite Accelerator Program, our 3-month internal innovation startup program for staff within the Department that want to improve the way their program, office, or agency works.

We received a record 108 applications. We thank those that boldly applied to Ignite.  This was the most competitive selection process yet, due to the sheer number and quality of proposals.

Today, after careful selection, we are delighted to announce the 13 teams invited to join the Spring 2017 Ignite Accelerator:

  • Building Communities of Practice to Unify OA Processes and Communications. Led by Lila Lee at ACF.
  • Enabling the CMS Physician Engagement and Burden Reduction Initiative through Improved Data Systems. Led by Jon Langmead at CMS.
  • Learning from Past Actions through Sentinel Event Review. Led by Cara Altimus at FDA.
  • Unique Device Identifier App. Led by Heather Valadez at FDA.
  • Improving Health Outcomes by Increasing Coordination of HHS’ Investments in Training & Technical Assistance (TTA) for Health and Human Service Organizations. Led by Robert McKenna at HRSA.
  • Convert Audiology Services to Paperless. Led by Jennifer Imboden at IHS.
  • A Virtual Partnering Platform to Advance NIH-funded Biomedical Technologies to the Marketplace. Led by Gary Robinson at NIH.
  • NLP-based Portfolio Analysis. Led by Bishen Singh at NIH.
  • Your Healthiest Self: NIH Research for Living Well. Led by Tianna Hicklin at NIH.
  • Enhancing Scientific Peer Review Using an Integrated Electronic Approach. Led by J. Bruce Sundstrom at NIH.
  • Bridge DC. Led by Joel Adu-Brimpong at NIH.
  • Community Opioid Consultation Toolkit. Led by Chad Edinger at OS.
  • Pilot for Establishing Infrastructure for Publicly Released Research Data. Led by Daniel Janes at OS.

Over the course of three months, teams will hypothesize, formulate problem statements, and scope solution-sets to turn their ideas into minimally viable products.

For those unfamiliar with the program, the Ignite Accelerator Program will teach selected teams entrepreneurial methodologies, provide access to a new network of fellow innovators, provide coaching from mentors, and ultimately push participants slightly out of their comfort zone as they explore problems and transform their ideas into solutions. And starting in January, the selected teams will be attending a Boot Camp to kick-start their 3 month journey.

Stay tuned, and please join me in congratulating these teams!

Help Shape New Directions in Open Science: Vote for Your Favorite Innovation!

a globe of a word cloud related to open science

In the spirit of open science – a movement to make data and other information from scientific research available to everyone — the National Institutes of Health invites you to cast your vote and help us decide which of the projects competing for the Open Science Prize are the most innovative and most likely to have the greatest impact. Your vote plays a critical role in determining the three finalists for the ultimate selection of a grand prize winner of $230,000.00

In this competition, six finalist teams, composed of at least one U.S.-based and one international researcher, are using open data to improve human health. Open data refers to publicly-accessible data that is available for re-use by anyone.

While science is truly a global endeavor, often involving teams of scientists at institutions in different nations, funding for scientific research is typically tied to the country of origin. To overcome this, the National Institutes of Health and the UK-based Wellcome Trust, with additional funding from the Howard Hughes Medical Institute, have jointly created the Open Science Prize, an innovative effort showing how funding agencies can collaborate internationally.

The goal of this Prize is to stimulate the development of novel and ground-breaking tools and platforms to enable the reuse and repurposing of open digital research objects relevant to biomedical or health applications.  A Prize model is necessary to help accelerate the field of open biomedical research beyond what current funding mechanisms can achieve.  We also hope to demonstrate the huge potential value of Open Science approaches, and to generate excitement, momentum and further investment in the field.

The prize was first announced in 2015 and we invited solvers around the world to submit their ideas.  Out of a pool of 96 applicant teams, six finalists were selected and provided $80,000 to develop their ideas into prototypes.

Vote today! You can play a part in shaping the future of biomedical research. To vote, go to www.OpenSciencePrize.org, review the projects listed there (and also described below), and choose the three you would like to see advance to the final round of competition. Voting is open from December 1, 2016 until January 6, 2017 at 11:59 p.m. PST.  The 3 prototypes receiving the highest number of public votes will advance to a final round of review by a panel of science experts and judges from the National Institutes of Health and the Wellcome Trust  A single, grand prize winning team will receive an award of $230,000 jointly funded by the collaborators will be announced in March 2017.

You can learn more about each of the six finalist projects below (listed in no particular order):

Open Neuroimaging Laboratory: Advancing brain research by enabling collaborative annotation, discovery and analysis of brain imaging data

There is a massive volume of brain imaging data available on the internet, capturing different types of information such as brain anatomy, connectivity and function. This data represents an incredible effort of funding, data collection, processing and the goodwill of thousands of participants.  The development of a web-based application called BrainBox enables distributed collaboration around annotation, discovery and analysis of publicly available brain imaging data, generating insight on critical societal challenges such as mental disorders, but also on the structure of our cognition.  Collaborators can send information, make comments, and highlight particular locations on the images, and access can be restricted to allow collaborators to view the images without modifying them – using a functionality similar to Google Docs.

Open AQ: Providing real-time information on poor air quality by combining data from across the globe

Poor air quality is responsible for one out of eight deaths across the world, but the most polluted places in the world are not well-researched, hindering scientific progress. Accessible and timely air quality data is critical to advancing the scientific fight against air pollution and is essential for health research.  The OpenAQ platform collects data every 10 minutes and allows users to view stored data and compare locations.  To date, the OpenAQ community has collected 32,929,735 air quality measurements from 4,569 locations in 41 countries.  Data are aggregated from 55 government level and research-grade sources.

Real-Time Evolutionary Tracking for Pathogen Surveillance and Epidemiological Investigation:  Permitting analysis of emerging epidemics such as Ebola, MERS-CoV and Zika

The Nextstrain project is an app for tracking pathogen evolution in real time, critical in this era of high mobility. Contact tracing is the main way to fight a virus without a vaccine; sequencing the genomes of viruses such as Ebola can determine the shared mutations and phylogeny of each strain, allowing field epidemiologists a more nuanced way to trace contact. To facilitate treatment of active outbreaks of pathogens such as Zika, Nextstrain is able to show molecular epidemiology within days. It also is intended to be scalable and easy to interpret for teams on the ground. The project uses an online visualization platform where the outputs of statistical analyses can be used by public health officials for epidemiological insights within days of samples being taken from patients.

OpenTrialsFDA: Enabling better access to drug approval packages submitted to and made available by the Food and Drug Administration

The OpenTrialsFDA app makes clinical trials data from the U.S. Food and Drug Administration (FDA) easier to find by making the contents of the drug approval packages publically available.  These review packages often contain information on clinical trials that have never been published in academic journals.  OpenTrialsFDA allows users to see the raw results of a study, such as unpublished data or data that seem more significant than they really are, in a way that is much more user-friendly and easier to navigate than the Drugs@FDA database of publicly available documents.

Fruit Fly Brain Observatory: Allowing researchers to better conduct modeling of mental and neurological diseases by connecting data related to the fly brain

Understanding human brain function and disease is arguably the biggest challenge in neuroscience. To help address this challenge, researchers turn to smaller but sufficiently complex brains from other organisms. The Fruit Fly Brain Observatory allows data from fruit fly brain scans to be used as models for investigating human neurological and psychological disorders. The Fruit Fly Brain Observatory also has integrated healthy and diseased models of the human brain for study. Using computational disease models, researchers can make targeted modifications that are difficult to perform in vivo with current genetic techniques. The platform is modular, so it will be extendable to mice, zebrafish, and other experimental animals. These capabilities have the potential to significantly accelerate the development of powerful new ways to predict the effects of pharmaceuticals upon neural circuit functions.

MyGene2: Accelerating Gene Discovery with Radically Open Data Sharing

Approximately 350 million people worldwide and over 30 million Americans have a rare disease. Most of these rare diseases are so-called Mendelian conditions, which means that mutation(s) in a single gene can cause disease.  Examples of such diseases are include sickle-cell anemia, Tay-Sachs disease, cystic fibrosis and xeroderma pigmentosa. Over 7,000 Mendelian conditions have been described, but to date, scientists have only linked half of those conditions to a specific gene. Consequently, close to 70 percent of families who undergo clinical testing lack a diagnosis.  MyGene2 is a website that makes it easy and free for families with Mendelian conditions to share health and genetic information with other families, clinicians and researchers worldwide in order to make a match.

 

Developers: Help Us Stop Fraud, Waste, and Abuse in Government Health Care Spending

Each year, the government pays over a trillion dollars for health care through the Medicare and Medicaid programs. For perspective, the federal government spends more each year on health care through these two programs than it does on space exploration, education, international aid and all branches of the military combined.

The estimates for 2014 show that more than $77 billion was spent on “improper payments” within Medicare and Medicaid. Spending in this category can include fraud, but can also be coding errors or other mistakes by providers and institutions. To protect these programs and those who depend upon them, it is important to detect and stop the misuse of taxpayer funds.

One of the key agencies involved in this work is the Office of Inspector General (OIG) at the Department of Health and Human Services. One of the core missions at OIG is to protect the integrity of Medicare and Medicaid as well as the health and welfare of program beneficiaries. Statistical sampling plays a critical role in these efforts. In fact, effective oversight would be nearly impossible without statistics, which OIG and many other private and public oversight groups leverage heavily.

OIG provides a tool to help implement statistical sampling in the health care setting; however, the current version of the tool will be impractical to keep up to date in the future, and its layout can be difficult to navigate and understand. That’s why we are running a $28,000 prize competition to help design a new version of the software.  As a solver, you will be involved in creating a tool that will better protect our health care system from fraud, waste, and abuse.  

The Current Tool Needs Refreshing – How Sampling Works Now

To oversee health care spending, the government relies on a web of federal, state, and private groups who strive to ensure that limited government dollars go to those who need the money most. For example, over a recent six month period OIG reported expected recoveries of more than $2.77 billion dollars. This total includes nearly $554.7 million from audits and $2.22 billion from civil and criminal investigations.

Agencies with limited resources must provide oversight of providers with thousands – often tens of thousands – of claims.  A cost efficient approach is to take a statistical sample of claims from a provider and then use the results of the sample to calculate a conservative estimate of any improper payments. When the government uses statistical sampling, it is able to recover the full amount of the estimated improper payment without having to spend tens of thousands of hours reviewing all of the claims (for an example see the following report).

The current sampling tool, RAT-STATS, was created more than 35 years ago to fulfill the need for a simple software solution that develops valid statistical samples and estimates in the health care setting for individuals without technical backgrounds. Since then, RAT-STATS has enabled the government to recover billions of dollars in health care related overpayments. That said, however, the software hasn’t received a major refresh in over 15 years and we are looking to the public to help with the next update.

While the current version of the sampling tool is well validated and produces statistically sound results, its user interface can be difficult to navigate (you can see the software itself here) and the underlying code makes the software impractical to update moving forward.  In addition, the current version of the software does not meet federal requirements for accessibility. As a result, we will not be able to continue supporting the software in the long term unless it is replaced with a new version!

A Call for New Solutions

The health care community needs a new, modern version of the software that is easy to use and can be extended in a cost-effective manner. Given the importance of sampling, it is no surprise that there is a demand among oversight agencies for a tool able to produce robust samples that can hold up in court.

To aid in the development of a new package to meet this need, we have posed a challenge to the public: create the foundation for the next version of RAT-STATS.  We are looking for a new design that is easy to use, meets the government requirements for accessibility, and can grow over time to account for advances within the field of statistics. The new design does not need to replicate the entire RAT-STATS package, just four select functions.

The individual or group who wins the challenge will receive $28,000 and will have the recognition of creating a critically important oversight tool in what is projected to become the single largest area of government spending in the country.

To learn more or get involved today, visit the official challenge website.

***

This prize competition was supported and developed through support from HHS Competes – an open innovation program to implement the COMPETES Act and other legal authorities. The program enables HHS and its Divisions to source solutions to tough problems beyond the typical contractor or grantee, to talented individuals and small companies all across the country.

An Open Letter to HHS Innovators: We Want to Hear Your Ideas for Change Today

Fellow HHS Innovators —

The sixth round of the HHS Ignite Accelerator starts in Spring 2017, which means we are now accepting your ideas about how to solve problems at HHS that you care about.

Personally, it is beyond exciting to see new ideas spring forth from our colleagues across the Department.

By applying to Ignite, you are putting forth yourself and ideas for how HHS might better deliver on its very important objectives. As we head into administrative transition, it’s also an opportune time to show incoming leaders and staff that they are joining an organization that has engaged problem-solvers — pragmatic people who want to do the right thing for the American Citizen, for their HHS colleagues, and for the cause of Health and Science across the globe.

What we’ve experienced through our three years, five rounds, and 71 project teams that have joined the Ignite Accelerator is that the spirit of innovation is alive and well amongst our ranks, but, in order to thrive, still needs: cover from a risk-averse culture; coaching and methodology that ensures sound solutions and strategy; access to a diverse network for advice and encouragement; and access to HHS senior leaders for feedback and further support.

The next round of Ignite promises to be full of wonderful teams and will feature a couple of new wrinkles. After each round of Ignite, we speak with newly minted Ignite graduates and ask for candid feedback about the Program. Based on that feedback, this round, we are further customizing our instruction and support to better support teams. We’ll be matching coaching based on where in the project life-cycle and risk spectrum our teams find themselves. To support further this, we anticipate selecting around 10 teams this round. Although we were able and fortunate to support more teams previously, we are scaling down for a customized approach this round.

We are ecstatic to begin the next round of the Ignite Accelerator because we get to watch as passionate colleagues reject the status quo, realize amazing possibilities and create impactful opportunities; we get to witness their gradual realization that the selflessness and idealism that brought them to a career in government might yet yield the fundamental rewards they had been seeking all along. And when we are met with heartfelt thanks, we know we are doing the right thing, too.

On behalf of your friends at the IDEA Lab, thank you for your courage and for sharing a spirit of adventure, idealism, and generosity as we enter our next phase together.

Will Yang

Program Director, HHS Ignite Program

Government as a Platform for Progress: HHS’s Open Government Plan

One of the first actions President Obama took after taking office was to direct federal agencies to find new ways to increase transparency, collaboration and public engagement. Since then, one of our top priorities at HHS has been to make our Department more open and accountable to the people we serve.

With the publication of our fourth HHS Open Government Plan, we’re building on our past performance in making government more transparent to the public and engaging in new ways of collaborating and partnering with our stakeholders.

All across HHS, we’ve been working to identify projects, policies and perspectives that will be our focus over the next two years for continued progress.  In our latest plan, you’ll see that we’re finding new ways to connect with stakeholder organizations and the public to identify new opportunities to improve our performance.

We’re seeking new approaches to connect with underserved communities to share ways HHS can help them have the building blocks for healthy and productive lives. Many of these efforts come in the form of making data and information products available to the public.

Over the past eight years, our team at HHS has made available to the public nearly 3,000 datasets that enable the public and private development of technology applications and services that improve our ability to deliver on our mission. These resources are proving to be important ingredients for improving the quality of America’s health care delivery system, enhancing the safety of our food supply, increasing program effectiveness in support of early child development and families in need, and developing new approaches to preventing disease.

In our plan, we highlight the strategies we’re undertaking to implement new legislation that aims to improve transparency in the reporting of financial data for information technology programs, and how we are strengthening our response to the public through Freedom of Information Act requests.

In our plan we also highlight several new cross-cutting flagship initiatives that underscore the key strategies that we’re undertaking with high impact values for our mission. These initiatives, among others, include:

  • Enhancing the ways we shape the future of biomedical research through the Precision Medicine Initiative, and recruiting 1 million or more participants to improve our ability to prevent and treat disease based on individual differences in lifestyle, environment and genetics.
  • Promoting the Open Payments initiative, which publishes data on the financial relationships between the health care industry and health care providers.
  • Speeding the delivery of health data to Medicare beneficiaries, using new applications and data services.
  • Undertaking strategic new projects to improve our block grant programs supporting children and families.
  • Creating a public comment database for the Physical Activity Guidelines update process. The database, open for comment for the next two years, will play a role in the development of the Physical Activity Guidelines for Americans.

We’re eager to share our plan with you.  We encourage you to review the broad array of ways we’re working to improve our service to the public. And we invite you to make your voice heard and engage with us at http://www.hhs.gov/open. Working together, we know we can be even more successful at making government processes more open at HHS.


This blog is a cross-post from the HHS.gov Blog.

Health care needs a jolt of innovation. Here’s how we’re approaching it at HHS.

Image of markers and a graphic that reads - Make Things

Credit: Juhan Sonin and Involution Studios

The Chief Technology Officer at the U.S. Department of Health and Human Services (HHS) is, in a lot of ways, the chief innovation officer. My team brings a can-do, creative spirit to HHS that a lot of people associate with startup companies.

What I can tell you now that I’ve been in the job for over a year is this: the passion, tenacity, and creativity that we associate with entrepreneurs can be found in government agencies. It can also be found in communities of people living with rare, life-changing, or chronic health conditions. The fire in the belly burns just as strongly among patients and caregivers as it does among startup founders.

When I arrived at HHS last year, I brought with me the spirit of the empowered patient movement.

I had spent 15 years doing fieldwork in online patient and caregiver communities, tracking a pattern of people who used the internet to network, to join together and demand access to their own data. They showed all of us the point of technology in health care.

In working with communities of people living with rare and life-changing diagnoses, like Moebius syndrome, I began to see a new pattern: people sharing their designs and modifications of physical objects. Ways to feed a baby born with full facial paralysis, for example, or modifications for people with low dexterity.

So, as the Chief Technology Officer, I decided to expand my office’s definition of technology to include medical and assistive device innovation. I’ve spent the last year exploring the intersection between the Maker movement and health care.

Here are the forces I see at work in the landscape:

  1. Industrial-strength manufacturing tools are becoming cheaper, easier to use, and more widely available.
  2. Access to new manufacturing capabilities, such as rapid prototyping using 3D printers, creates new opportunities for individuals and small businesses.
  3. New funding mechanisms and opportunities, such as crowdfunding, incubators, and accelerators, enable new entrants.
  4. Social media enables inventors to share their ideas with potential users for design feedback, funding, and distribution.
  5. A return to craft and “making” as a mainstream activity gives people the skills and creative confidence to demystify devices and solve their own problems.

What could happen to boost – or mute – the impact of each of those forces?

What might we learn if we push open design principles and tools out to the edges of the network, where humanity lives, where unexpected discoveries happen, where engineers meet artists?

What will happen when everyone has access to the tools and information they need to solve their own problems — and share their ideas with others?

We must walk together toward solutions, toward the possibility of sustaining health, toward new or improved medical and assistive devices.

We must keep trying – and talking with each other – making things with our hands and solving problems, sharing ideas and data.

This is the alchemy of technology.


You can watch my recent keynote from the 2016 Stanford MedicineX Conference here and learn more about my work in exploring the intersections of the Maker Movement and health care here

This blog is a cross-post from LinkedIn.

Seeking Public Input on the HHS Open Government Plan for 2016–2018

graphic of two icons and message bubbles

One of the roles that the IDEA Lab and the Office of the Chief Technology Officer perform to serve the U.S. Department of Health and Human Services (HHS) community, our stakeholders, and the public, is that of a ‘virtual village square’ to promote engagement of new ideas about how we do the people’s business. Nearly eight years ago, President Obama emphasized the virtues of opening up government to and of the people through his Open Government Directive.

The core factors he emphasized among federal agencies were the commitment to transparency of government business practices; collaboration among partners in service to the mission; and participation by the public with a voice of action in how their government functions. Each of these factors invoked the need for innovative practices, design of new processes, and adaption of new technologies such as social media to bring our agencies closer to those we serve. Every two years, we’ve worked across all corners of HHS to coordinate our strategies for making government more open. Earlier this summer, we called out for your ideas on getting our plan started. Today, we’re back in the village square to engage you once again and invite you into our open government plan.

In 2009, HHS published its first version of its Open Government plan and now I’m pleased to put forth the Version 4.0 edition in draft form, for public comment. I often hear that federal government agencies are too complex to navigate and that “my idea” doesn’t have a chance of finding a receptive ear or eye. One important lesson I’ve learned from my experiences at HHS is that there are many initiatives that started with that very thing – an idea. Sometimes it’s a person with key knowledge or understanding of a problem that is the perfect fit for what we want on our team to solve that problem. I’ve often heard comments from our team that we can never predict where the best solution is likely to come from.  All to say, your ideas and comments matter to us so we hope you will share them.

In our Version 4.0 plan, we address new areas of open government development including how we are making data available on our information technology and services acquisitions in response to new laws, details around our open source digital code products and services, program achievements and plans for expanding open innovation and crowdsourcing. Consistent with our past traditions, we’re featuring seven new cross-cutting initiatives as our ‘flagships’ that bring new ways of connecting government with the public to the fore.

We invite you to provide us your comments on each section of our plan here. Comments will be accepted until Friday, September 9, 2016. Later this fall we will publish our final plan for the next two years as we continue our open government efforts.