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May 29 2012

US CTO seeks to scale agile thinking and open data across federal government

In the 21st century, federal government must go mobile, putting government services and information at the fingertips of citizens, said United States Chief Technology Officer Todd Park in a recent wide-ranging interview. "That's the first digital government result, outcome, and objective that's desired."

To achieve that vision, Park and U.S. chief information officer Steven VanRoekel are working together to improve how government shares data, architects new digital services and collaborates across agencies to reduce costs and increase productivity through smarter use of information technology.

Park, who was chosen by President Obama to be the second CTO of the United States in March, has been (relatively) quiet over the course of his first two months on the job.

Last Wednesday, that changed. Park launched a new Presidential innovation Fellows program, in concert with VanRoekel's new digital government strategy, at TechCrunch's Disrupt conference in New York City. This was followed by another event for a government audience at the Interior Department headquarters in Washington, D.C. Last Friday, he presented his team's agenda to the President's Council of Advisors on Science and Technology.

"The way I think about the strategy is that you're really talking about three elements," said Park, in our interview. "First, it's going mobile, putting government services at the literal fingertips of the people in the same way that basically every other industry and sector has done. Second, it's being smarter about how we procure technology as we move government in this direction. Finally, it's liberating data. In the end, it's the idea of 'government as a platform.'"

"We're looking for a few good men and women"

In the context of the nation's new digital government strategy, Park announced the launch of five projects that this new class of Innovation Fellows will be entrusted with implementing: a broad Open Data Initiative, Blue Button for America, RFP-EZ, The 20% Campaign, and MyGov.

The idea of the Presidential Innovation Fellows Program, said Park, is to bring in people from outside government to work with innovators inside the government. These agile teams will work together within a six-month time frame to deliver results.

The fellowships are basically scaling up the idea of "entrepreneurs in residence," said Park. "It's a portfolio of five projects that, on top of the digital government strategy, will advance the implementation of it in a variety of ways."

The biggest challenge to bringing the five programs that the US CTO has proposed to successful completion is getting 15 talented men and women to join his team and implement them. There's reason for optimism. Park shared vie email that:

"... within 24 hours of TechCrunch Disrupt, 600 people had already registered via Whitehouse.gov to apply to be a Presidential Innovation Fellow, and another several hundred people had expressed interest in following and engaging in the five projects in some other capacity."

To put that in context, Code for America received 550 applications for 24 fellowships last year. That makes both of these fellowships more competitive than getting in to Harvard in 2012, which received 34,285 applications for its next freshman class. There appears to be considerable appetite for a different kind of public service that applies technology and data for the public good.

Park is enthusiastic about putting open government data to work on behalf of the American people, amplifying the vision that his predecessor, Aneesh Chopra, championed around the country for the past three years.

"The fellows are going to have an extraordinary opportunity to make government work better for their fellow citizens," said Park in our interview. "These projects leverage, substantiate and push forward the whole principle of liberating data. Liberate data."

"To me, one of the aspects of the strategy about which I am most excited, that sends my heart into overdrive, is the idea that going forward, the default state of government data shall be open and machine-readable," said Park. "I think that's just fantastic. You'll want to, of course, evolve the legacy data as fast as you can in that same direction. Setting that as 'this is how we are rolling going forward' — and this is where we expect data to ultimately go — is just terrific."

In the videos and interview that follow, Park talks more about his vision for each of the programs.

A federal government-wide Open Data Initiative

In the video below, Park discusses the Presidential Innovation Fellows program and introduces the first program, which focuses on open data:

Park: The Open Data Initiative is a program to seed and expand the work that we're doing to liberate government data as a platform. Encourage, on a voluntary basis, the liberation of data by corporations, as part of the national data platform, and to actively stimulate the development of new tools and services, and enhance existing tools and services, leveraging the data to help improve Americans' lives in very tangible ways, and create jobs for the future.

This leverages the Open Government Directive to say "look, the default going forward is open data." Also the directive to "API-ize" two high priority datasets and also, in targeted ways, go beyond that, and really push to get more data out there in, critically, machine-readable form, in APIs, and to educate the entrepreneur and innovators of the world that it's there through meetups, and hackathons, and challenges, and "Datapaloozas."

We're doubling down on the Health Data Initiative, we are also launching a much more high-profile Safety Data Initiative, which we kicked off last week. An Energy Data Initiative, which kicked off this week. An education data initiative, which we're kicking off soon, and an Impact Data Initiative, which is about liberating data with respect to inputs and outputs in the non-profit space.

We're also going to be exploring an initiative in the realm of personal finance, enabling Americans to access copies of their financial data from public sector agencies and private sector institutions. So, the format that we're going to be leveraging to execute these initiatives is cloned from the Health Data Initiative.

This will make new data available. It will also take the existing public data that is unusable to developers, i.e. in the form of PDFs, books or static websites, and turn it into liquid machine-readable, downloadable, accessible data via API. Then — because we're consistently hearing that 95% of the innovators and entrepreneurs who could turn our data into magic don't even know the data exists, let alone that it's available to them — engage the developer community and the entrepreneurial community with the data from the beginning. Let them know it's there, get their feedback, make it better.

Blue Button for America

Park: The idea is to develop an open source patient portal capability that will replace MyHealthyVet, which is the Veterans Administration's current patient portal. This will actually allow the Blue Button itself to iterate and evolve more rapidly, so that everY time you add more data to it, it won't require heart surgery. It will be a lot easier, and of course will be open source, so that anyone else who wants to use it can use it as well. On top of that, we're going to do a lot of "biz dev" in America to get the word out about Blue Button and encourage more and more holders of data in the private sector to adopt Blue Button. We're also going to work to help stimulate more tool development by entrepreneurs that can upload Blue Button data and make it useful in all kinds of ways for patients. That's Blue Button for America.

What is RFP-EZ?

Park: The objective is "buying smarter." The project that we're working ON with the Small Business Administration on is called "RFP-EZ."

Basically, it's the idea of setting up a streamlined process for the government to procure solutions from innovative, high-growth tech companies. As you know, most high-growth companies regard the government as way too difficult to sell to.

That A) deprives startups and high-growth companies from the government as a marketplace and, B) perhaps even more problematically, actually deprives the government of their solutions.

The hope here is, through the actions of the RFP-EZ team, to create a process and a prototype that the government can much more easily procure solutions from innovative private firms.

It A) opens up this emerging market called "the government" to high-tech startups and B) infects the government with more of their solutions, which are radically more, pound for pound, effective and cost efficient than a lot of the stuff that the government is currently procuring through conventional channels. That's RFP-EZ.

The 20% Campaign

Park: The 20% Campaign is a project that's being championed by USAID. It's an effort at USAID to, working with other government agencies, NGOs and companies, to catalog the movement of foreign assistance payments from cash to electronics. So, just for example, USAID pays its contractors electronically, obviously, but the contractor who, say, pays highway workers in Afghanistan or the way that police officers get paid in Afghanistan is actually principally via cash. Or has been. And that creates all kinds of waste issues, fraud, and abuse.

The idea is actually to move to electronic payment, including mobile payment — and this has the potential to significantly cut waste, fraud and abuse, to improve financial inclusion, to actually let people on phones, to enable them to access bank accounts set up for them. That leads to all kinds of good things, including safety: it's not ideal to be carrying around large amounts of cash in highly kinetic environments.

The Afghan National Police started paying certain contingents of police officers via mobile phones and mobile payments, as opposed to cash, and what happened is that the police officers started reporting an up to a 30% raise. Of course, their pay hadn't changed, but basically, when it was in cash, a bunch of it got lost. This is obviously a good thing, but it's even more important if you realize that when they were paid what they were paid in cash that they ultimately physically received, that was less than the Taliban in this province was actually paying people to join the Taliban — but the mobile payment, and that level of salary, was greater than the Taliban was paying. That's a critical difference.

It's basically taking foreign assistance payments through the last mile to mobile.

MyGov is the U.S. version of Gov.uk

Park: MyGov is an effort to rapidly prototype a citizen-centric system that allows Americans the information and resources of government that are right for them. Think of it as a personalized channel for Americans to be able to access information resources across government and get feedback from citizens about those information and resources.

How do you plan to scale what you learned while you were HHS CTO to the all of the federal government?

Park: Specifically, we're doing exactly the same thing we did with the Health Data Initiative, kicking off the initiatives with a "data jam" — an ideation workshop where we invite, just like with health data, 40 amazing tech and energy minds, tech and safety innovators, to a room — at the White House, in the case of the Safety Data Initiative, or at Stanford University, in the case of the Energy Initiative.

We walk into the room for several hours and say, "Here's a big pile of data. What would you do with this data?" And they invent 15 or 20 news classes of products or services of the future that we could build with the data. And then we challenge them to, at the end of the session, build prototypes or actual working products, that instantiates their ideas in 90 days, to be highlighted at a White House — hosted Safety Datapalooza, Energy Datapalooza, Education Datapalooza, Impact Datapalooza, etc.

We also take the intellectual capital from the workshops, publish it on the White House website, and publicize the opportunity around the country: Discover the data, come up with your own ideas, build prototypes, and throw your hat in the ring to showcase at a Datapalooza.

What happens at the Datapaloozas — our experience in health guides us — is that, first of all, the prototypes and working products inspire many more innovators to actually build new services, products and features, because the data suddenly becomes really concrete to them, in terms of how it could be used.

Secondly, it helps persuade additional folks in the government to liberate more data, making it available, making it machine-readable, as opposed to saying, "Look, I don't know what the upside is. I can only imagine downsides." What happened in health is, when they went to a Datapalooza, they actually saw that, if data is made available, then at no cost to you and no cost to taxpayers, other people who are very smart will build incredible things that actually enhance your mission. And so you should do the same.

As more data gets liberated, that then leads to more products and services getting built, which then inspires more data liberation, which then leads to more products and services getting built — so you have a virtual spiral, like what's happened in health.

The objective of each of these initiatives is not just to liberate data. Data by itself isn't helpful. You can't eat data. You can't pour data on a wound and heal it. You can't pour data on your house and make it more energy efficient. Data is only useful if it's applied to deliver benefit. The whole point of this exercise, the whole point of these kickoff efforts, is to catalyze the development of an ecosystem of data supply and data use to improve the lives of Americans in very tangible ways — and create jobs.

We have the developers and the suppliers of data actually talk to each other, create value for the American people, and then rinse, wash, repeat.

We're recruiting, to join the team of Presidential Innovation Fellows, entrepreneurs and developers from the outside to come in and help with this effort to liberate data, make it machine-readable, and get it out there to entrepreneurs and help catalyze development of this ecosystem.

We went to TechCrunch Disrupt for a reason: it's right smack dab center in the middle of people we want to recruit. We invite people to check out the projects on WhiteHouse.gov and, if you're interested in applying to be a fellow, indicate their interest. Even if they can't come to DC for 6-plus months to be a fellow, but they want to follow one of the projects or contribute or help in some way, we are inviting them express interest in that as well. For example, if you're an entrepreneur, and you're really interested in the education space, and learning about what data is available in education, you can check out the project, look at the data, and perhaps you can build something really good to show at the Education Datapalooza.

Is open data just about government data? What about smart disclosure?

Park: In the context of the Open Data Initiatives projects, it's not just about liberation of government health data: it's also about government catalyzing the release, on a voluntary basis, of private sector data.

Obviously, scaling Blue Button will extend the open data ecosystem. We're also doubling down on Green Button. I was just in California to host discussions around Green Button. Utilities representing 31 million households and businesses have now committed to make Green Button happen. Close to 10 million households and businesses already have access to Green Button data.

There's also a whole bunch of conversation happening about, at some point later this year, having the first utilities add the option of what we're calling "Green Button Connect." Right now, the Green Button is a download, where you go to a website, hit a green button and bam, you download your data. Green Button Connect is the ability for you to say as a consumer, "I authorize this third party to receive a continuous feed of my electricity usage data."

That creates massive additional opportunity for new products and services. That could go live later this year.

As part of the education data initiative, we are pursuing the launch and scale up of something called "My Data," which will have a red color button. (It will probably, ultimately, be called "Red Button.") This is the ability for students and their families to download an electronic copy of their student loan data, of their transcript data, of their academic assessment data.

That notion of people getting their own data, whether it's your health data, your education data, your finance data, your energy use data, that's an important part of these open data initiatives as well, with government helping to catalyze the release of that data to then feed the ecosystem.

How does open data specifically relate to the things that Americans care about, access to healthcare, reducing energy bills, giving their kids more educational opportunities, and job creation? Is this just about apps?

Park: In healthcare, for example, you'll see a growing array of examples that leverage data to create tangible benefit in many, many ways for Americans. Everything from helping me find the right doctor or hospital for my family to being notified of a clinical trial that could assist my profile and save my life, and the ability to get the latest and greatest information about how to manage my asthma and diabetes via government knowledge in the National Library of Medicine.

There is a whole shift in healthcare systems away from pay-for-volume of services to basically paying to get people healthy. It goes by lots of different names — accountable care organizations or episodic payment — but the fundamental common theme is that the doctors and hospitals increasingly will be paid to keep people healthy and to co-ordinate their care, and keep them out of the hospital, and out of the ER.

There's a whole fleet of companies and services that utilize data to help doctors and hospitals do that work, like utilize Medicare claims data to help identity segments of a patient population that are at real risk, and need to get to the ER or hospital soon. There are tools that help journalists identify easily public health issues, like healthcare outcomes disparities by race, gender and ethnicity. There are tools that help country commissioners and mayors understand what's going on in a community, from a health standpoint, and make better policy decisions, like showing them food desserts. There's just a whole fleet of rapidly growing services for consumers, for doctors, nurses, journalists, employers, public policy makers, that help them make decisions, help them deliver improved health and healthcare, and create jobs, all at the same time.

That's very exciting. If you look at all of those products and services — and a subset of them are the ones that self-identify to us, to actually be exhibited at the Health Datapaloozas. Look at the 20 healthcare apps that were at the first Datapalooza or the 50 that were at the second. This year, there are 230 companies that are being narrowed down to about a total of 100 that will be at the Datapalooza. They collectively serve millions of people today, either through brand new products and services or through new features on existing platforms. They help people in ways that we would never have thought of, let alone build.

The taxpayer dollars expended here were zero. We basically just took our data, made it available in machine-readable format, educated entrepreneurs that it was there, and they did the rest. Think about these other sectors, and think about what's possible in those sectors.

In education, through making the data that we've made available, you can imagine much better tools to help you shop for the college that will deliver the biggest bang for your buck and is the best fit for your situation.

We've actually made available a bunch of data about college outcomes and are making more data available in machine-readable form so it can feed college search tools much better. We are going to be enabling students to download machine-readable copies of their own financial aid application, student loan data and school records. That will really turbo charge "smart scholarship" and school search capabilities for those students. You can actually mash that up with college outcomes in a really powerful, personalized college and scholarship search engine that is enabled by your personal data plus machine-readable data. Tools that help kids and their parents pick the right college for their education and get the right financial aid, that's something government is going to facilitate.

In the energy space, there are apps and services that help you leverage your Green Button data and other data to really assess your electricity usage compared to that of others and get concrete tips on how you can actually save yourself money. We're already seeing very clever, very cool efforts to integrate gamification and social networking into that kind of app, to make it a lot more fun and engaging — and make yourself money.

One dataset that's particularly spectacular that we're making a lot more usable is the EnergyStar database. It's got 40,000 different appliances, everything from washing machines to servers that consumers and businesses use. We are creating a much, much easier to use public, downloadable NSTAR database. It's got really detailed information on the energy use profiles and performance of each of these 40,000 appliances and devices. Imagine that actually integrated into much smarter services.

On safety, the kinds of ideas that people are bringing together are awesome. They're everything from using publicly available safety data to plot the optimal route for your kid to walk home or for a first responder to travel through a city and get to a place most expeditiously.

There's this super awesome resource on Data.gov called the "Safer Products API," which is published by the Consumer Products Safety Commission (CPSC). Consumers send in safety reports to CPSC, but until March of last year, you had to FOIA [Freedom of Information Act] CPSC to get these. So what they've now done is actually publish an API which not only makes the entire database of these reports public, without you having to FOIA them, but also makes it available through an API.

One of the ideas that came up is that, when people buy products on eBay, Craiglist, etc, all the time, some huge percentage of Americans never get to know about a recall — a recall of a crib, a recall of a toy. And even when a company recalls new products, old products are in circulation. What if someone built the ability to integrate the recall data and attach it to all the stuff in the eBays and Craigslists of the world?

Former CIO Vivek Kundra often touted government recall apps based upon government data during his tenure. Is this API the same thing, shared again, or something new?

Park: I think the smartest thing the government can do with data like product recalls data is not build our own shopping sites, or our own product information sites: it's to get the information out there in machine-readable form, so that lots and lots of other platforms that have audiences with millions of people already, and who are really good at creating shopping experiences or product comparison experiences, get the data into their hands, so that they can integrate it seamlessly into what they do. I feel that that's really the core play that the government should be engaged in.

I don't know if the Safer Products API was included in the recall app. What I do know is that before 2011, you had to FOIA to get the data. I think that even if the government included it in some app the government built, that it's important for it to get used by lots and lots of other apps that have a collective audience that's massively greater than any app the government could itself build.

Another example of this is the Hospital Compare website. The Hospital Compare website has been around for a long time. Nobody knows about it. There was a survey done that found 94% of Americans didn't know that there was hospital quality data that was available, let alone that there was a hospital compare website. So, the notion of A) making the hospital care data downloadable and B), we actually deployed it a year and a half ago in API form at Medicare.gov.

That then makes the data much easier for lots of other platforms to incorporate it, that are far more likely than HospitalCompare.gov to be able to present the information in actionable forms for citizens. Even if we build our own apps, we have to get this data out to lots of other people that can help people with it. To do that, we have to make it machine-readable, we have to put it into RESTFUL APIs — or at least make it downloadable — and get the word out to entrepreneurs that it's something they can use.

This is a stunning arbitrage opportunity. Even if you take all this data and you "API-ize" it, it's not automatic that entrepreneurs are going to know it's there.

Let's assume that the hospital quality data is good — which it is — and that you build it, and put it into an API. If nobody knows about it, you've delivered no value to the American people. People don't care whether you API a bunch of data. What they care about is that when they need to find a hospital, like I did, for my baby, I can get that information.

The private sector, in the places where we have pushed the pedal to the medal on this, has just demonstrated the incredible ability to make this data a lot more relevant and help a lot more people with it than we could have by ourselves.

White House photo used on associated home and category pages: white house by dcJohn, on Flickr

April 01 2012

What is smart disclosure?

Citizens generate an enormous amount of economically valuable data through interactions with with companies and government. Earlier this year, a report from the World Economic Forum and McKinsey Consulting described the emergence of personal data as of a new asset class." The value created from such data does not , however, always go to the benefit of consumers, particularly when third parties collect it, separating people from their personal data.

The emergence of new technologies and government policies has provided an opportunity to both empower consumers and create new markets from "smarter disclosure" of this personal data. Smart disclosure is when a private company or government agency provides a person with periodic access to his or her own data in open formats that enable them to easily put the data to use. Specifically, smart disclosure refers to the timely release of data in standardized, machine readable formats in ways that enable consumers to make better decisions about finance, healthcare, energy or other contexts.

Smart disclosure is "a new tool that helps provide consumers with greater access to the information they need to make informed choices," wrote Cass Sunstein, the U.S. administrator of the White House Office of Information and Regulatory Affairs (OIRA), in a post on smart disclosure on the White House blog. Sunstein delivered a keynote address at the White House Summit on smart disclosure at the U.S. National Archives on Friday. He authored a memorandum providing  guidance on smart disclosure guidance from OIRA in September 2011.

Smart disclosure is part of the final United States National Action Plan for its participation in the Open Government Partnership." Speaking at the launch of the Open Government Partnership in New York City last September, the president specifically referred to the role of smart disclosure in the United States:

"We’ve developed new tools -- called 'smart disclosures' -- so that the data we make public can help people make health care choices, help small businesses innovate, and help scientists achieve new breakthroughs," said President Obama. "We’ve been promoting greater disclosure of government information, empowering citizens with new ways to participate in their democracy," said President Obama. "We are releasing more data in usable forms on health and safety and the environment, because information is power, and helping people make informed decisions and entrepreneurs turn data into new products, they create new jobs."

In the months since the announcement, the U.S. National Science and Technology Council established a smart disclosure task force dedicated to promoting better policies and implementation across government.

"In many contexts, the federal government uses disclosure as a way to ensure that consumers know what they are purchasing and are able to compare alternatives," wrote Sunstein at the White House blog. "Consider nutrition facts labels, the newly designed automobile fuel economy labels, and ChooseMyPlate.gov.  Modern technologies are giving rise to a series of new possibilities for promoting informed decisions."

Smart disclosure is a "case of the Administration asking agencies to focus on making available high value data (as distinct from traditional transparency and accountability data) for purposes other than decreasing corruption in government," wrote New York Law School professor Beth Noveck, the former U.S. deputy chief technology officer for open government, in an email. "It starts from the premise that consumers, when given access to information and useful decision tools built by third parties using that information, can self-regulate and stand on a more level playing field with companies who otherwise seek to obfuscate." The choice of Todd Park as United States CTO also sends a message about the importance of smart disclosure to the administration, she said.

The United Kingdom's “midata” smart disclosure initiative is an important smart disclosure case study outside of the United States. Progress there has come in large part because the UK has a privacy law that gives citizens the right to access their personal data held by private companies, unlike the United States. In the UK, however, companies have been complying with the law in a way that did not realize the real potential value of that right to data, which is to say that a citizen could request personal data and it would arrive the mail weeks later at a cost of a few dozen pounds. The UK government has launched a voluntary public-private partnership to enable companies to comply with the law by making the data available online in open formats. The recent introduction of the Consumer Privacy Bill of Rights from the White House and Privacy Report from the FTC suggests that such rights to personal data ownership might be negotiated, in principle, much as a right to credit reports have been in the past.

Four categories of smart disclosure

One of the most powerful versions of smart disclosure is when data on products or services (including pricing algorithms, quality, and features) is combined with personal data (like customer usage history, credit score, health, energy and education data) into "choice engines" (like search engines, interactive maps or mobile applications) that enable consumers to make better decisions in context, at the point of a buying or contractual decision. There are four broad categories where smart disclosure applies:

  1. When government releases data about products or services. For instance, when the Department of Health and Human Services releases hospital quality ratings, the Security and Exchange Commission releases public company financial filings in machine-readable formats at XBLR.SEC.gov, or the Department of Education puts data about more than 7,000 institutions online in a College Navigator for prospective students.
  2. When government releases personal data about a citizen. For instance, when the Department of Veterans Affairs gives veterans access to health records using at the "Blue Button" or the IRS provides citizens with online access to their electronic tax transcript. The work of BrightScope liberating financial advisor data and 401(k) data has been an early signal of how data drives the innovation economy.
  3. When a private company releases information about products or services in machine readable formats. Entrepreneurs can then use that data to empower consumers. For instance, both Billshrink.com and Hello Wallet may enhance consumer finance decisions.
  4. When a private company releases personal data about usage to a citizen. For instance, when a power utility company provides a household access to its energy usage data through the Green Button or when banks allowing customers to download their transaction histories in a machine readable format to use at Mint.com or similar services. As with the Blue Button for healthcare data and consumer finance, the White House asserts that providing energy consumers with secure access to information about energy usage will increase innovation in the sector and empower citizens with more information.

An expanding colorwheel of buttons

Should smart disclosure initiatives continue to gather steam, citizens could see “Blue Button”-like and "Green Button"-like solutions for every kind of data government or industry collects about citizens.  For example, the Department of Defense has military training and experience records. Social Security and the Internal Revenue Service have the historical financial history of citizens, such as earnings and income. The Department of Veterans Affairs and Centers for Medicare and Medicaid Services have personal health records.

More "Green Button"-like mechanisms could enable secure, private access to private industry collects about citizen services. The latter could includes mobile phone bills, credit card fees, mortgage disclosures, mutual fund fee and more, except where there are legal restrictions, as for national security reasons.

Earlier this year, influential venture capitalist Fred Wilson encouraged entrepreneurs and VCs to get behind open data. Writing on his widely read blog, Wilson urged developers to adopt the Green Button.

"This is the kind of innovation that gets me excited," Wilson wrote. "The Green Button is like OAuth for energy data. It is a simple standard that the utilities can implement on one side and web/mobile developers can implement on the other side. And the result is a ton of information sharing about energy consumption and in all likelihood energy savings that result from more informed consumers.

When citizens gain access to data and put it to work, they can tap it to make better choices about everything from finance to healthcare to real estate, much in the same way that Web applications like Hipmunk and Zillow let consumers make more informed decisions.

"I'm a big fan of simplicity and open standards to unleash a lot of innovation," wrote Wilson. "APIs and open data aren't always simple concepts for end users. Green Buttons and Blue Buttons are pretty simple concepts that most consumers will understand. I'm hoping we soon see Yellow Buttons, Red Buttons, Purple Buttons, and Orange Buttons too. Let's get behind these open data initiatives. Let's build them into our apps. And let's pressure our hospitals, utilities, and other institutions to support them."

The next generation of open data is personal data, wrote open government analyst David Eaves this month:

I would love to see the blue button and green button initiative spread to companies and jurisdictions outside the United States. There is no reason why for example there cannot be Blue Buttons on the Provincial Health Care website in Canada, or the UK. Nor is there any reason why provincial energy corporations like BC Hydro or Bullfrog Energy (there's a progressive company that would get this) couldn't implement the Green Button. Doing so would enable Canadian software developers to create applications that could use this data and help citizens and tap into the US market. Conversely, Canadian citizens could tap into applications created in the US.

The opportunity here is huge. Not only could this revolutionize citizens access to their own health and energy consumption data, it would reduce the costs of sharing health care records, which in turn could potentially create savings for the industry at large.

Data drives consumer finance innovation

Despite recent headlines about the Green Button and the household energy data market, the biggest US smart disclosure story of this type is currently consumer finance, where there is already significant private sector activity going on today.

For instance, if a consumer visits Billshrink.com, you can get personalized recommendations for a cheaper cell phone plan based on your calling history. Mint.com will make specific recommendations on how to save (and alternative products to use) based on an analysis of the accounts it is pulling data from. Hello Wallet is enabled by smart disclosure by banks and government data. The sector's success hints at the innovation that's possible when people get open, portable access to their personal data in a a consumer market of sufficient size and value to attract entrepreneurial activity.

Such innovation is enabled in part because entrepreneurs and developers can go directly to data aggregation intermediaries like Yodlee or CashEdge and license the data, meaning that they do not have to strike deals directly with each of the private companies or build their own screen scraping technology, although some do go it alone.

"How do people actually make decisions?  How can data help improve those decisions in complex markets?  Research questions like these in behavioral economics are priorities for both the Russell Sage Foundation and the Alfred P. Sloan Foundation," said Daniel Goroff, a Sloan Program Director, in an interview yesterday.  "That's why we are launching a 'Smart Disclosure Research and Demonstration Design Competition.'  If you have ideas and want to win a prize,  please send Innocentive.com a short essay.  Even if you are not in a position to carry out the work, we are especially interested in finding and funding projects that can help measure the costs and benefits of existing or novel 'choice engines.'" 

What is the future of smart disclosure?

This kind of vibrant innovation could spread to many other sectors, like energy, health, education, telecommunication, food and nutrition, if relevant data were liberated. The Green Button is an early signal in this area, with the potential to spread to 27 million households around the United States. The Blue Button, with over 800,000 current users, is spreading to private health plans like Aetna and Walgreens, with the potential to spread to 21 million users.

Despite an increasingly number of powerful tools that enable data journalists and scientists to interrogate data, many of even the most literate consumers do not look at data themselves, particularly if it is in machine-readable, as opposed to human-readable formats. Instead, they digest it from ratings agencies, consumer reports and guides to the best services or products in a given area. Increasingly, entrepreneurs are combining data with applications, algorithms and improved user interfaces to provide consumers with "choice engines."

As Tim O'Reilly outlined in his keynote speech yesterday, the future of smart disclosure includes more than quarterly data disclosure from the SEC or banks. If you're really lining up with the future, you have to think about real-time data and real-time data systems, he said. Tim outlined 10 key lessons his presentation, an annotated version of which is embedded below.

The Future of Smart Disclosure (pdf)
View more presentations from Tim O'Reilly

When released through smart disclosure, data resembles a classic "public good" in a broader economic sense. Disclosures of such open data in a useful format are currently under-produced by the marketplace, suggesting a potential role for government in the facilitation of its release. Generally, consumers do not have access to it today.

Well over a century ago, President Lincoln said that "the legitimate object of government is to do for the people what needs to be done, but which they cannot by individual effort do at all, or do so well, for themselves." The thesis behind smart disclosure in the 21st century is that when consumers have access to that personal data and the market creates new tools to put to work, citizens will be empowered make economic, education and lifestyle choices that enable to them to live healthier, wealthier, and -- in the most aspirational sense -- happier lives.

"Moving the government into the 21st century should be applauded," wrote Richard Thaler, an economics professor at the University of Chicago, in the New York Times last year. In a time when so many citizens are struggling with economic woes, unemployment and the high costs of energy, education and healthcare, better tools that help them invest and benefit from personal data are sorely needed..

February 13 2012

Open innovation works in the public sector, say federal CTOs

President Barack Obama named Aneesh Chopra as the nation’s first chief technology officer in April 2009. In the nearly three years since, he was a tireless, passionate advocate for applying technology to make government and society work better. If you're not familiar with the work of the nation's first CTO, make sure to read Nancy Scola's extended "exit interview" with Aneesh Chopra at the Atlantic. where he was clear about his role: "As an advisor to the president, I have three main responsibilities," he said: "To make sure he has the best information to make the right policy calls for the country, which is a question of my judgment."

On his last day at the White House, Chopra released an "open innovator's toolkit" that highlights twenty different case studies in how he, his staff and his fellow chief technology officers at federal agencies have been trying to stimulate innovation in government.

Chopra announced the toolkit last week at a forum on open innovation at the Center for American Progress in Washington. The forum was moderated by former Virginia congressman Tom Perriello, who currently serves as counselor for policy to the Center for American Progress and featured Todd Park, U.S. Department of Health and Human Services CTO, Peter Levin, senior advisor to the Veterans Affair Secretary and U.S. Department of Veterans Affairs CTO, and Chris Vein, deputy U.S. CTO for government innovation at the White House Office of Science and Technology Policy. Video of the event is embedded below:

An open innovator's toolkit

"Today, we are unveiling 20 specific techniques that are in of themselves interesting and useful -- but they speak to this broader movement of how we are shifting, in many ways, or expanding upon the traditional policy levers of government," said Chopra in his remarks on Wednesday. In the interview with the Atlantic and in last week's forum, Chopra laid out four pillars in the administration's approach to open innovation:

  • Moving beyond providing public sector data by request to publishing machine-readable open data by default
  • Engaging with the public not simply as a regulator but as "impatient convener"
  • Using prizes and competitions to achieve outcomes, not just procurements
  • Focusing on attracting talented people to government by allowing them to serve as “entrepreneurs-in-residence.”

"We are clearly moving to a world where you don't just get data by requesting it but it's the default setting to publish it," said Chopra. "We're moving to a world where we're acting beyond the role of regulator to one of 'impatient convening.' We are clearly moving to a world where we're not just investing through mechanisms like procurement and RFPs to one where where we're tapping into the expertise of the American people through challenges, prizes and competition. And we are changing the face of government, recruiting individuals who have more of an entrepreneur-in-residence feel than a traditional careerist position that has in it the expectation of a lifetime of service. "

"Entrepreneurs and innovators around the country are contributing to our greater good. In some cases, they're coming in for a tour of duty, as you'll hear from Todd and Peter. But in many others, they're coming in where they can and how they can because if we tap into the collective expertise of the American people we can actually overcome some of the most vexing challenges that today, when you read the newspaper and you watch Washington, you say, 'Gosh, do we have it in us' to get beyond the divisions and these challenges, not just at the federal government but across all level of the public sector."

Open innovation, applied

Applying open innovation "is a task we’ve seen deployed effectively across our nation’s most innovative companies," writes Chopra in the memorandum on open innovation that the White House released this week. "Procter & Gamble’s “Connect+Develop” strategy to source 50% of its innovations from the outside; Amazon’s “Just Do It” awards to celebrate innovative ideas from within; and Facebook’s “Development Platform” that generated an estimated 180,000 jobs in 2011 focused on growing the economy while returning benefits to Facebook in the process."

The examples that Chopra cited are "bonafide," said MIT principal research professor Andrew McAfee, via email. "Open innovation or crowdsourcing or whatever you want to call it is real, and is (slowly) making inroads into mainstream (i.e. non high-tech) corporate America. P&G is real. Innocentive is real. Kickstarter is real. Idea solicitations like the ones from Starbucks are real, and lead-user innovation is really real."

McAfee also shared the insight of Eric Von Hippel on innovation:

“What is changing,” is that it is getting easier for consumers to innovate, with the Internet and such tools, and it is becoming more visible for the same reason. Historically though the only person who had the incentive to publicize innovation was the producer. People build institutions around how a process works and the mass production era products were built by mass production companies, but they weren’t invented by them. When you create institutions like mass production companies you create the infrastructure to help and protect them such as heavy patent protection. Now though we see that innovation is distributed, open collaborative.”

In his remarks, Chopra hailed a crowdsourced approach to the design of DARPA's next-generation combat vehicle, where an idea from a U.S. immigrant led to a better outcome. "The techniques we’ve deployed along the way have empowered innovators, consumers, and policymakers at all levels to better use technology, data, and innovation," wrote Chopra in the memo.

"We’ve demonstrated that “open innovation,” the crowdsourcing of citizen expertise to enhance government innovation, delivers real results. Fundamentally, we believe that the American people, when equipped with the right tools, can solve many problems." To be fair, the "toolkit" in question amounts more to a list of links and case studies than a detailed manual or textbook, but people interested in innovating in government at the local, state and national level should find it useful.

The question now is whether the country and its citizens will be the "winners in the productivity revolutions of the future," posed Chopra, looking to the markets for mobile technology, healthcare and clean energy. In that context, Chopra said that "open data is an active ingredient" in job creation and economic development, citing existing examples. 6 million Californians can now download their energy data through the Green Button, said Chopra, with new Web apps like Watt Quiz providing better interfaces for citizens to make more informed consumption decision.

More than 76,000 Americans found places to get treatment or health services using iTriage, said Chopra, with open data spurring better healthcare decisions by a more informed mobile citizenry. He hailed the role of collaborative innovation in open government, with citing mobile healthcare app ginger.io.

Open government platforms

During his tenure as US CTO, Chopra was a proponent of open data, participatory platforms and one of the Obama administration's most prominent evangelists for the use of technology to make government more open and collaborative. Our September 2010 interview on his work is embedded below:

In his talk last Wednesday, Chopra highlighted two notable examples of open government. First, he described the "startup culture" at the Consumer Financial Protection Bureau, highlighting the process by which the new .gov agency designed a better mortgage disclosure form.

Second, Chopra cited two e-petitions to veto the Stop Online Piracy Act and Protect IP Act on the White House e-petition platform, We The People, as an important example of open government in actions. The e-petitions, which gathered more than 103,000 signatures, are proof that when citizens are given the opportunity to participate, they will, said Chopra. The White House response, which came at a historic moment in the week the Web changed Washington. "SOPA/PIPA is exactly what We the People was meant to do," Chopra told Nancy Scola.

Traditionally, Congress formally requests a Statement of Administration Policy, called a "SAP." Requests for SAPs come in all the time from Congress. We respond based on the dynamics of Washington, priorities and timelines. One would argue that a Washington-centric approach would have have been to await the request for a SAP and publish it, oftentimes when a major vote is happening. If you contrast that were SOPA/PIPA was, still in committee or just getting out of committee, and not yet on the floor, traditionally a White House would not issue a SAP that early. So the train we were on, the routine Washington line of business, we would have awaited the right time to issue a SAP, and done it at congressional request. It just wasn't time yet. The We the People process flipped upside-down to whom we are responsible for providing input. In gathering over a hundred thousand signatures, on SOPA/PIPA, the American people effectively demanded a SAP.

Innovation for healthcare and veterans

"I think people will embrace the open innovation approach because it works," said Todd Park at last week's forum, citing examples at Novartis, Aventis and Walgreens, amongst others. Park cited "Joy's Law," by Sun Microsystems computer science pioneer Bill Joy: "no matter who you are, you have to remember that most of the smart people don't work for you."

Part of making that work is opening up systems in a way that enables citizens, developers and industry to collaborate in creating solutions. "We're moving the culture away from proprietary, closed systems … into something that is modular, standards-based & open, said Peter Levin.

If you went to the Veterans Affairs website in 2009, you couldn't see where you were in the process, said Levin. One of the ways to solve that problem is to create a platform for people to talk to each other, he explained, which the VA was able to do that through its Facebook page.

That may be a "colossal policy change," in his view, but it had an important result: "the whole patronizing fear that if we open up dialogue, open up channels, you'll create a problem you can't undo - that's not true for us," he said.

If you want to rock and roll, emphasized Park, don't just have your own smart people work on a challenge. That's an approach that Aventis executives found success using in a data diabetes challenge. Walgreens will be installing "Health Guides" at its stores to act as a free "health concierge," said Park, as opposed to what they would have done normally. They launched a challenge and, in under three months, got 50 credible prototypes. Now, said Park, mHealthCoach is building Health Guides for Walgreens.

One of the most important observations Park made, however, may have been that there has been too much of a focus on apps created from open data, as opposed to data informing policy makers and care givers. If you want to revolutionize the healthcare industry, open data needs to be at the fingertips of the people who need it most, where then need it most, when they need it most.

For instance, at a recent conference, he said, "Aetna rolled out this innovation called a nurse." If you want to have data help people, built a better IT cockpit for that nurse that helps that person become more omniscient. Have the nurse talk over the telephone with a human who can be helped by the power of the open data in front of the healthcare worker.

Who will pick up the first federal CTO's baton?

Tim O'Reilly made a case for Chopra in April 2009, when the news of his selection leaked. Tim put the role of a federal CTO in the context of someone who provides "visionary leadership, to help a company (or in this case, a government) explore the transformative potential of new technology." In many respects, he delivered upon that goal during his tenure. The person who fills the role will need to provide similar leadership, and to do so in a difficult context, given economic and political headwinds that confront the White House.

As he turns the page towards the next chapter of his career -- one which sources cited by the Washington Post might lead him into politics in Virginia -- the open question now will be who President Obama will choose to be the next "T" in the White House Office of Science and Technology Policy, a role that remains undefined, in terms of Congressional action.

The administration made a strong choice in federal CIO Steven VanRoekel. Inside of government, Park or Levin are both strong candidates for the role, along with Andrew Blumenthal, CTO at the Bureau of Alcohol, Tobacco and Firearms. In the interim, Chris Vein, deputy chief technology office for public sector innovation, is carrying the open government innovation banner in the White House.

In this election year, who the administration chooses to pick up the baton from Chopra will be an important symbol of its commitment to harnessing technology on behalf of the American people. Given the need for open innovation to addressing the nation's grand challenges, from healthcare to energy to education, the person tapped to run this next leg will play an important role in the country's future.

Related:

September 20 2011

Liveblogging the Open Government Partnership (OGP) launch

Today, a historic Open Government Partnership launches in New York City. I'll be liveblogging it all day in the CoverItLive module below. You can watch the livestream of the event at Google YouTube channel. More information on the Open Government Partnership lauch page.

Open Government Partnership Launch

Historic global Open Government Partnership launches in New York City

Open government is about to assume a higher profile in foreign affairs. On July 12, 2011, the State Department hosted an historic gathering in Washington to announce the (OGP) with Brazil and six other nations. Today in New York City, this unprecedented global partnership will launch. Heads of state, representatives of civil society, members of the free press and technologists will convene at the New York offices of Google to hail the "Power of Open" around the world. In the afternoon, President Obama and the leaders of seven other countries will announce their national action plans and commitments to open government. I'll be liveblogging the event here on the Radar Gov 2.0 channel and tweeting out pictures to Tumblr and other social platforms. Virtual participants will be able to watch the launch at Google's YouTube channel at 9 AM EST.

Some 43 countries have now indicated their intent to join this international open government partnership, with the vast majority joining the founding eight members, led by Brazil and the United States. The formation of the OGP revisited the bilateral U.S.-Indian partnership on open government that was announced during President Obama's trip to India last November, although India subsequently withdrew from the OGP in July.

In her remarks on July 12 at the State Department, Secretary of State Clinton explicitly connected open government to economic activity. "We've also seen the correlation between openness in government and success in the economic sphere," said Clinton. "Countries committed to defending transparency and fighting corruption are often more attractive to entrepreneurs. And if you can create small- and medium-size businesses, you have a broader base for economic activity. At a time when global competition for trade and investment is fierce, openness is not just good for governance, it is also good for a sustainable growth in GDP."

In the week following Clinton's speech, I spoke with Mario Otero, Under Secretary of State for Democracy and Global Affairs at the United States State Department, about the Open Government Partnership and what it will mean. Our interview follows. You can also listen to an audio recording of our discussion, embedded above.

Can you explain how open government and a greater degrees of transparency or accountability are related to investment, economic output or activity?

"I think what the secretary said really summarizes well one aspect of what's economic growth and even economic development in a country, which is really how the rest of the world perceive it and how the rest of the world measures risk when you invest in a country," said Otero. "Clearly, if anyone looks at the components of country risk as you invest, issues that have to do with transparency and accountability are present within the factors that comprise that equation.

Otero explored other aspects of open government that arose in discussions at the forums at the State Department in July. "One was clearly that transparency will insure that resources are used for what they are meant to be used for in their totality, in part because you are seeing the transfer of funds and the use of funds, to make sure that some of that is not being set aside for other things or in some way taken out for corrupt reasons," she said. "That concept of being able to use a country's revenues in order to carry out a government's mandate and plan is again one way which the economic concept becomes important. Even if you're talking about health, if in fact you're providing improved health services to your population, you are improving their capacity to be productive citizens and to contribute to the economy. I mean, you can just go across the board."

"Another thing that came up that was very interesting, and it was actually brought up on Kenya, was the degree to which they themselves were not asking to collect information completely, but now that they are, how it is that they look at some of the items that they import into the country they they themselves could produced or could have. Just looking more carefully both at their balance of trade issues, recording all the information, giving emphasis to using data to make decisions, led, certainly the Kenyan participants, to give a couple of examples of how their imports had decreased in a couple of areas."

"These are different ways that open government can address directly the question that you are asking. I think we're going to come up with a lot more applications for open government that relate to reducing costs, said Otero. "As countries do this work more and more, we will see, especially when they are looking at the budget and the way the resources are allocated, that this will also, and the Secretary talked about this, conceivably have an impact on the tax revenue base of a country, because there are many citizens, either for excuse or otherwise, say 'well, why am I going to pay taxes if it's going to go into the pockets of some bureaucrat and it's really not going to bring about changes.' The minute you have more transparency and people begin to see how their taxes are being used, you then again increase the tax revenue that the country has available."

I brought up how the new city government in Chicago is thinking about data and the global movement towards open data, which Otero said is part of OGP. For city government under Mayor Emmanuel, open data is viewed as a means for government to understand its own operations, become more productive and deploy its resources more efficiently and effectively. The example of Chicago led Otero to highlight an aspect of the Open Government Partnership that's she found very interesting. "It is open to developed countries that have cities like Chicago, and developing countries, like a Kenya," said Otero.

"The point is that some of these tools for transparency can be used even by countries that one might think may not have the resources to be able to do that, or even the know how," she said. "In fact, it is available across the board and that is one of the characteristics of the Open Government Partnership, both recognizing that and ensuring that the leadership in this partnership from the outset is comprised of countries from the north or from the south. Again, showing examples of how you can do this in the south that are attainable to the countries that want to do that. It's very interesting that we can talk about Chicago and, say, Kisumu, Kenya in the same breath."

What concrete outcomes for open government around the world should citizens, advocates, entrepreneurs and technologists be looking for from this partnership?

"The partnership is really the first time that there is a multilateral platform to address these issues," said Otero. "The partnership could have focused on countries come in and present best practices and exchange ideas and then just go home," said Otero. "The partnership is really focused on first having countries participate that have already demonstrated interest in this area and have already put in place a number of specific things and the material laid out, if you will, the minimum standards that are being requested. What the partnership really looks for is to provide a mechanism by which the countries can each develop their own national plans on ways to expand what they're doing on transparency, accountability, and civic engagement, or to start new initiatives for them. That is really what is very different and important about this partnership, is that it is very action- and results-oriented."

When countries join the Open Government Partnership, they commit themselves to address one of several "grand challenges." "They can be anything from public service, addressing public integrity issues, for managing public resources," said Otero. "Using these challenges, they need to be able to create a plan. Now countries can, of course, choose what they will address. The partnership is not saying 'now all of you have to do the same thing.' It's very much based upon the way in which each country is assessing the specific ways it is interested in addressing. The Partnership is challenging countries to identify those areas of most interest to them, and then to be able to develop a plan that will allow them to make changes and have some real results come out of this. The broad vision for this effort is to really mobilize countries to do something very concrete and in the process develop their own capacity for doing it. Of course here, one can note that there will be some resources available to help countries do this work. That's really at the core of the work."

One clear difference that we see today from past decades is the reality of an increasingly wired citizenry. "The role of technology in doing all of this is very apparent to anyone that's been alive in the last decade," she said. "How countries are using technology, everything from using social media to creating their own websites to a variety of different things is really impressive and very innovative. So, of course, the private sector, if they've got any brains in their head, are seeing this as an important business opportunity."

"Whether you're creating new apps or working with directly with different governments, keeping your eyes open in this space, you also create different mechanisms, different technologies that can be of use to government. The bottom line is that the real effort here and the real outcome that would make the Open Government Partnership successful is signing up a significant number of countries that participate, and having those countries launch their own national plans and carry them out."

What were some of the platforms and technologies that have inspired you?

In Estonia they talk about creating a 'paperless government, Otero observed. "They really are creating 'e-governance,' as they call it, throughout, which is really quite amazing," she said. "In Iceland, it's very interesting that they're using social media to be able to have citizens participate in the redrafting of their constitution. They're using Facebook, and Twitter, and other things to just be able to communicate with the population.

Otero also pointed to the dynamic technology sector in Kenya, which launched an open government data platform this summer. Kenyans have advanced in technology more than any country in Africa, said Otero with the M-PESA system and the way that Kenyans can access information record data using mobile phones. "I think the Kenyan understand the importance of being able to use this data and some of the ideas that they put forth were more related to this area of saving resources and making some of the money available for other work. Otero also referenced open government work in Mexico, England, Honduras, Tanzania and Uganda.

India withdrew from the partnership, reportedly over concerns about a third party "audit" of its progress. Can you offer any more detail?

"It makes all the sense in the world to have independent experts who don't do an audit, which is a word that you used, but really assess, and look, and monitor the progress that's being made," said Otero. "They do this in a way to maintain that accountability, but also to make sure that you're not rating these countries or grading them or putting them in a category from 1 to 100 or whatever. That process is in place that was decided upon and all the countries believe that it adds vigor and rigor to this effort. I think, as you said, India has provided great value in this area of open government, of transparency, of accountability. They have done very important work, and they are strongly committed to the principles that are espoused by the Open Government Partnership. In fact, in the time that they worked directly, they really contributed a great deal. I think, right now, the government has indicated that they can't participate, and I think that the reason is precisely the one that you've laid out."

"I think that they will continue to follow the progress of the partnership. Many countries have bilateral relationships with India and continue to address these kinds of issue in a more bilateral way, because they have a great deal to contribute, both to this initiative and the overall work in transparency. I think, certainly, we completely respect their decision right now to watch this closely but not be part of it right now, and to continue doing their work internally. That's really the way that I understand their position."

Progress and setbacks toward open government

Over the summer and fall, analysis and information have steadily emerged about what this open government partnership will mean to open government in the United States and around the world. David Sasaki wondered if the OGP was "democracy building 2.0." Greg Michener echoed his analysis, wondering if the Brazil was fit to lead the OGP. Global Integrity explained its role in the OGP. Emma Smith questioned whether the Philippines is serious about open government.

In the U.S., OMB Watch posited that the OGP could drive U.S. commitments, particularly if, as John Wonderlich suggested at the Sunlight Foundation suggested, a U.S. national plan for open government was matched by subsequent follow through. The White House open government "status update" capped a historic week for open government in Washington, as the administration prepares to launch e-petitions. Quiet successes, however, have been matched with setbacks to open government in Washington over the past three years. The Obama administration now faces an uncertain future for funding for its Office of Management and Budget's open government initiatives after the U.S. Senate appropriations committee shortchanged the Electronic Government Fund by some $10 million dollars last week. With these proposed funding cuts the U.S. Congress is, as OMB Watch put, it "about to underfund the very tools that will tell them how federal money is being spent." When President Obama announces the U.S. National Plan for Open Government PDF) (embedded below), the implementation will have to be undertaken in that context.

The future of funding for open government platforms coming from the White House, however, now must be taken in the context of a much broader narrative that includes dozens of other countries and hundreds of millions of other citizens. Aleem Walji, writing at the World Bank, put the effort in the context of a broad move from "eGov to 'WeGov'. His analysis captures something important: whatever action the United States does or does not take in its own movements towards greater transparent, accountable or participatory government, there is a global movement towards transparency that is now changing the relationship of the governed to their governments. Unprecedented levels of connectivity and mobile devices have created new connections between citizens and information that lie outside of traditional methods of government command and control. The future of open government may well literally be in all of our hands.

This interview was condensed and edited. A full audio recording is embedded above.

September 16 2011

Putting innovation and tech to work against breast cancer

GE challengeIn April, Jeff Hammerbacher looked around Silicon Valley and made an observation to Businessweek that spread like wildfire: "The best minds of my generation are thinking about how to make people click ads," he said. "That sucks."

With the launch of General Electric's Healthymagination Cancer Challenge, the best and brightest technical minds have been called to work on something that matters: fight breast cancer.

The open innovation challenge was launched yesterday in New York City. GE and a number of venture capitalists are putting $100 million behind the challenge as part of GE's larger billion-dollar commitment to fund cancer-related R&D over the next five years.

Tim O'Reilly moderated two panels during the launch yesterday that highlighted some of the challenges and opportunities in the fight against breast cancer. Video of the event is embedded below.

[Disclosure: Tim O'Reilly will be one of the judges in GE's investment challenge.]

A moment of convergence

While the Internet is changing healthcare, what happens next is immensely important to everyone.

"I turned to healthcare partly because I saw an immense hunger among the developers that I work with to start working on stuff that matters," said O'Reilly at the launch.

O'Reilly noted the combination of medical data and data tools is enticing to developers. "As we've been hearing, there are new diagnostic technologies that are producing massive amounts of data," he said. "And of course, crunching data and extracting meaning is something that the big Silicon Valley companies have worked to perfect. We're at a moment of convergence and I'm fascinated by what is happening as these two worlds come together."

Bob Kocher of VenRock cited three reasons why "cancer won't know what happened when we've finished":

  1. New data — "We are great at making sense out of data and we're getting better every day," Kocher said.
  2. New demand — "Thank God screening will be available to all Americans," he said. "Hopefully, we will reach them where they are, with technologies that are more sensitive, more reliable, more pleasant, and making it more pervasive. We'll catch cancer at a point where we can absolutely take care of it."
  3. New economics — "Our health system economics are changing in ways that I think actually will foster much better treatment of patients, more reliably, with drugs that work better with fewer side effects," Kocher said.

What's required for innovation? Beth Comstock, senior VP and CMO at General Electric, said that a global survey by GE returned three simple truths for what's needed: collaboration, the role of the creative individual, and profit with a purpose. When it comes to the latter, "there's nothing more relevant than healthcare."

Applying that care to where it's needed most was a point of agreement for all of the panelists. "Open innovation in health doesn't matter if we can't get it to the patient and deliver it," said O'Reilly.

Atul Gawande has written about lowering medical costs by giving the neediest patients better care with a process called "hotspotting." Give the success of the approach in Camden, New Jersey, similar data-driven measures for providing healthcare in communities may be in our future.

Personalized medicine and molecular biology

Personalized medicine, driven by the ongoing discoveries in molecular biology, is "just what's next," said GE chairman and CEO Jeffrey Immelt. To take on the immense challenge that breast cancer presents, it will require systems thinking to address both outcomes and cost over time.

Immelt is not the only executive bullish on the potential of new technologies to help breast cancer patients. "We'll see more innovation in the next five years in cancer research and development than we saw in the last 50 years," said Ron Andrews, CEO of Clarient.

Innovation needs partnership to scale, however, said Sue Siegel a general partner at Mohr Davidow. The ideas submitted to the GE challenge need to be open and scalable to have the biggest impact, she noted.

Siegel posited that the road to a cure will be through molecular diagnostics. The challenge is that less than 1% of spending is on diagnostics, said Siegel, in the context of a healthcare industry that represents $2.6 trillion of the U.S. GDP — and yet most clinical decisions are based on diagnostics. In that context, diagnostic data appears to be a significantly undervalued resource.

"We need to value the diagnostic data as much as we do the therapies," said Risa Stack, a general partner at Kleiner Perkins Caufield & Byers. Stack said that they're thinking of a "diagnostics registry," a website that would enable people to know the different kinds of diagnostics available to patients.

"The time for personalized healthcare is now in oncology, said Greg Plowman, senior vice president for research at ImClone Systems, a subsidiary of Eli Lilly. "What's best for the patient is knowing that this drug is best for them," he said. According to Plowman, Eli Lilly is investing heavily in new diagnostics and looking for partnerships.

Susan Love of UCLA noted that screening for breast cancer, however, is still one size fits all. Breast cancer for young women is more aggressive and less likely to be picked up by traditional mechanisms, she said. "We need to focus on screening — not just personalized medicine at the end. Do it at the beginning."


Obstacles to innovation in healthcare

For entrepreneurs, there are always obstacles to building any company. It is, however, 100 times harder to be an entrepreneur inside health and wellness, said Steve Krein, co-founder of StartUp Health. "Everything is stacked against you," he said, from regulations to the patient feedback cycle.

Krein sees an "incredible amount" of people who are interested in the healthcare space but are frustrated by barriers. He emphasized that there are important opportunities for entrepreneurs to seize, particularly in the "gap" between the Internet and a doctor's visit, where they're left alone with a search box.

There are two things that take too long, said Kocher: regulations and reimbursement. In his view, the Food and Drug Administration needs to get involved earlier to help startups navigate the system.

In a larger sense, O'Reilly suggested the healthcare industry apply a lesson from Google's playbook. The search giant solved a problem that Sam Wannamaker famously articulated about advertising: he knew half of ads work but not which half. By applying data-driven approaches to healthcare, there might be huge potential to know more about what's working and create feedback loops that allow physicians and regulators to iterate quickly.

We now have the ability to move to much more real-time monitoring of what works, O'Reilly said, suggesting that "regulations need to move from a stack of paper to a set of processes for monitoring in real-time."

That could become particularly important if more health data was voluntarily introduced into the startup ecosystem through the Blue Button, a technical mechanism for enabling citizens to download their personal health information and take it with them. "Once patients have their own data, they're much more willing to share than the law will allow," said O'Reilly, but they "will tend to share if they think it will solve their health crisis."

As entrepreneurs consider how to innovate, O'Reilly said, it's important to recognize that the "change in business model is often as important as the change in technology."

A mobile revolution is coming to healthcare

After the forum, O'Reilly tweeted that healthcare is due for a "UI revolution." He cited a statistic that 1 in 5 physicians now owns an iPad and that by 2014, virtually all physicians are expected to have a tablet.

Over the past five years, said MedHelp CEO John de Souza during the launch event, monthly visitors to MedHelp.com have grown from 1 million to 12 million, and mobile visitors have grown from 3% to 30% of that traffic.

The "mobile phone is becoming a health hub," said Souza, with the ability to transmit and collect data. The two big impediments to growth are manual entry and data monitoring. Data needs to be automatically collected and sent on to someone else looking at data through tele-monitoring, where they can analyze it and inform a physician.

Krein cited the iPad as one of the most transformative technologies in healthcare because the simplified user experience has opened the door to different thinking. Krein said that when they opened up StartupAcademy and 125 entrepreneurs applied, half of them had some element of mobile health in the proposals that included the use of an iOS or Android device.


The future of healthcare is social

As reported elsewhere, social media is changing healthcare by connecting patients to information and, increasingly, each other.

As the panelists acknowledged, advocates have built huge communities and created seminal change both online and offline.

There is an opportunity for people to share actual outcomes, said O'Reilly. Given that people are using the Internet to share that information, it becomes a useful source for patients and physicians. "We do see people looking for answers in the Internet," he said. "The key thing in patient's education is teaching people how to ask better questions."

Love went beyond peer-to-peer healthcare: we can really educate the public not just about the treatment but about the research too, she said, including how to get it done and how to participate. "That's the only way to get the cause, not just the cure."

A personal challenge

I can't claim to be unbiased about breast cancer. Both my mother and grandmother have had it and survived. Through their experiences, I learned just how many other women are affected. Breast cancer statistics are stark: about 1 in 8 women in the United States will develop invasive breast cancer over the course of their lifetime. More than 200,000 new cases of breast cancer are detected every year in the U.S. alone. Globally, breast cancer is the number one cancer for women in both the developing world and developed world, according to the World Health Organization. Hundreds of thousands of those diagnosed die.

Nancy Brinkler, the founder of the Susan G. Komen Foundation, lost her sister to breast cancer at the age of 36. We've moved from a society where breast cancer couldn't be said on television to one where billions are invested worldwide, she noted at the launch.

"We don't have the knowledge of how to defeat it but do know more about the biology," Brinkler said. While relative survival rates have improved for those who have access to early screening and treatment, "where a woman lives or how many resources she has should never determine whether she lives." To move forward "will require a bridge between science and society."

If healthcare data and the energy of innovation can be harnessed to create earlier detection and targeted therapies, more women diagnosed with breast cancer will join the millions of survivors.

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