HHS CTO Bryan Sivak on How Government Can Spur Healthcare Innovation

Xconomy National — 

It’s not every entrepreneur who even entertains the notion of moving from business to government. Bryan Sivak, though, has made the shift three times over. Sivak left his job at the company he helped create for a position in city government (as Chief Technology Officer for Washington, DC), then became Maryland’s Chief Innovation Officer, and is now doing federal time, so to speak, as CTO of the U.S. Department of Health and Human Services.

Sivak is the successor to Todd Park, the Boston-area entrepreneur who co-founded Athenahealth before joining HHS—and who is now serving as CTO of the United States and pushing “data jujitsu.” Park personally recruited Sivak to take his old job, in a pitch over coffee that began with “Actually, dude, hold on.” (More on this below.)

Sivak, who co-founded an enterprise software company—InQuira, acquired last year by Oracle—will be a keynote speaker at Xconomy’s upcoming Healthcare in Transition event the afternoon of December 10 here in Cambridge, MA. I caught up with him recently on the phone to ask him about his path to federal government—and what he is trying to do to help Uncle Sam, and HHS, become more innovative, a subject he will definitely take up on December 10.

On how—and why—he took his present job at HHS 

“I had promised myself my job in Maryland would be my last government job for a while–and that I would never go to the federal government because I was scared of the bureaucracy,” says Sivak.

The plan was to stay in the Maryland role until Gov. Martin O’Malley finished his term at the end of 2014. But earlier this year, Aneesh Chopra, the first CTO of the U.S., announced he was leaving and Park was picked to take over. Park and Sivak knew each other, and not long after Park took his new role, Sivak asked him to coffee, in hopes Maryland might be able to work with the feds around data sharing. But Park soon had a different type of sharing in mind. Recalls Sivak, “About halfway through the conversation, he just said, ‘Actually dude, hang on. I really want you to do my old job.’”

So what made him sign on after that promise to himself? “The scope of the problem, the complexity of the issues, and the potential for even small changes to have massive effects,” says Sivak. He started in July.

On his general approach to helping government be more innovative

“Bureaucracy in a lot of ways is a state of mind,” says Sivak. “There’s a lot of stuff that’s sort of enforced by custom rather than reason—and those things are ripe for challenging. We can really improve processes by asking why a lot. If the answer is because it is enshrined in law, ok fine, that’ll take longer to solve. But if it’s just because we’ve always done it that way, to me that’s a terrible answer.”

On his job at HHS

“There are a lot of people out there both inside the department and in the outside world who are passionate believers in their work. The first part of our job is to find those people. The second piece is to put them together, to connect them. We believe people are stronger when they’re working together, and frankly you’re going to need partners to make a change in this world. So we want to act as a matchmaker in a lot of ways.

“The third element really is environmental. We want to provide an environment—the tools, the resources, the processes—for people to succeed.” (Some specifics of this below.)

Some First Steps: Think Crowdfunding for Government Innovation

Sivak pointed to several ideas he is working on to try to spur more innovative approaches to healthcare—and how the government can help.

One is a program Sivak’s group is working on is to put together a collaboration network across the department, including organizations such as the Centers for Disease Control, the National Institutes of Health, and the FDA. Many people in these agencies “work on the same things but don’t really have the opportunity to talk that much,” says Sivak. “We’re trying to break down some of the silos and walls that exist.”

To do that, HHS recently launched a private internal collaboration tool, “which so far has seen good adoption and continued engagement,” Sivak says.

If people from around the government who are interested in healthcare can connect to each other more readily, Sivak thinks there is potential for a lot of new ideas to bubble forth. Nearly 90,000 people work for HHS alone, he says. “Thousands have great ideas, but not the full range of skills or resources to implement them. What if we did some sort of internal ‘conditional collaboration’ system, where people could post their ideas and then ask for what else they need?” Much like Kickstarter or other crowdfunding sites, these resource commitments would only get triggered if the projects hit their thresholds.

A related effort is underway to attract people outside government. A lot of HHS’s ideas center around the massive amounts of healthcare data the government has amassed. One of the data initiatives Sivak’s group is working on involves “democratizing access” to these data sets. “There is a massive amount of valuable information available,” he says. But right now only subject matter experts can access that information, “which necessarily limits the resources that can be brought to bear.”

“I think there’s a lot of things we can do to make our materials more accessible to a wider community, and that will help us to expand the universe of people that we’re talking to, which will theoretically lead to many more and better solutions,” he says.

One aspect of this effort is to find people who don’t necessarily have anything to do with healthcare. A variety of subject matter specialists know parts of the healthcare space inside out, but if his role is only to bring together experts, says Sivak, “I feel like we’re leaving out a large portion of the people that can actually help.” These might be designers, entrepreneurs, developers, and others. But by attracting them to the effort, and making government data more accessible, Sivak says the department could “hopefully get more eyes on the problem, which would lead to more and more creative solutions over time.”

An idea for helping those solutions come forward is to set up an external crowdfunding model of some sort. Sivak’s group is thinking about creating a website that has a few statements of need—something not uncommon for government contracts. “Then imagine that any number of people out there can create their own little crowdfunding pages for that particular thing,” he says. Whichever projects gets the most support from the public, HHS might help get off the ground by contributing some additional funding. But the core idea, he says: “We’re using the crowd to vet potential solutions to these problems.”