From data to impact: The future of public health innovation

Insights from Washington DC

  • Is Innovation always just about “the next new thing?”
  • How can public health innovators avoid old stumbling blocks of governmental rigidity or academic detachment in their pursuit of real-world solutions?
  • At a time of tremendous political, sociological, and technological change, how might we seek to redefine our relationship with our work and our careers?

Last week’s panel on Civic Innovation and Social Impact at the George Washington University’s Milken School of Public Health featured a room of diverse leaders, students, and innovators discussing the above issues and more.

The panel was led by the school’s associate dean, Dr. Pierre Vigilance, and was co-convened by Onboard Health, a career hub for public health innovators and The Lab@DC, a data-driven civic innovation hub here in the nation’s district. The speakers included: Eric Letsinger, Enrique Martinez, Veronica Vela, Samson Williams, and David Yokum.

The panelists shared their stories, perspectives, and many types of insights over the course of numerous questions about their work in the trenches of public health innovation.

On challenges, upsides, and what’s next in public health innovation

“The real world is infinitely more creative when it comes to causing new problems.”
David Yokum spoke about the non-linear path that innovation tends to take, which differs dramatically from the confines of budgets, data silos, departmental goals, and short-term project management of working in the real world. Sometimes it helps to zoom out from any particular problem and take in the bigger picture. David’s most memorable anecdote: To address the challenge of managing rats, his team studies many things, including how restaurants dispose of their garbage.

“The potential in the civil sector is immense, and it hasn’t really been tapped yet.” 
Enrique Martinez, a design thinker-turned health sector innovator, contrasted the dynamic, evolving problems that the public sector faces, with the narrow approach that’s typically used to address them. It’s easy to understand how working in a “culture of results” can compromise people’s willingness to take risks and experiment. That’s why one of Enrique’s endeavors with his public sector colleagues is a simple one: teaching people to draw, in order help them tap into creativity, self-expression, communication, and originality.

“There’s a distance between the status quo approach and applying common sense.” 
Eric Letsinger spoke freely on the numerous, obvious opportunities for innovation in every corner of our country. In one eyebrow-raising, forehead-slapping example, Eric shared a story about a kid named Ernie from Baltimore who has asthma. He lives in an apartment with moldy carpets; when his latest asthma attack sends him to the emergency department, the doctors there already know him from his previous five visits, but they can’t do anything besides prescribe another inhaler because ripping out carpets is unfunded by CMS. Eric’s company develops and measures the impact of privately funded solutions for such scenarios, where applying an intuitive solution to an existing evidence base can create a double or triple bottom line.

“People in public health don’t talk about blockchain and cryptocurrency, because they don’t know about it.”
Samson Williams commented on healthcare’s seemingly self-imposed distance from the innovations happening in finance and technology. Samson offered up some examples of emerging healthcare uses of the blockchain, such as sharing patient data securely or fighting cybersecurity threats. Yet these developments, though early, remain far removed from classrooms and public health agency offices alike. Perhaps the biggest tech issue that candidates need to understand better to optimize their own job prospects and opportunities for innovation in the short-term? Automation and the rise of artificial intelligence, a trend that is redefining both the employment landscape and the possibilities for mass-scale population health initiatives.

The VA Patient Experience Journey Map

“Public health needs to teach practice, and do a better job of integrating practice into the curriculum.” 
Veronica Vela highlighted the disconnect between theory and action in both the training and practice of healthcare professionals. To improve the patient experience for US Army veterans, Veronica has been leading a project that involved traveling to facilities in nine cities, interviewing nearly a hundred patients, and developing a journey map that captures those learnings. She did a wonderful job of illustrating the tension between doing what you are trained to do, and meeting the needs of the people you are serving. Next up: Her team is scaling and adapting those learnings to hundreds of VA facilities around the country, demonstrating how innovation is best thought of as an ongoing process, rather than a one-time undertaking.

What skills do the workforces of tomorrow need to develop to be successful?

The discussion moved on to more practical aspects of working in a field in which we’re almost required to think of people as objects to leverage, persuade, or study — all while maintaining a human-centered approach to collaboration, design, and research.

Empathy
People in different organizations and sectors tend to speak different languages. There are plenty of smart people, especially in a city like DC, but to be able to negotiate with someone who speaks and thinks differently for an eight month project, empathy is key. It’s more important to be able to listen and understand — to want to understand — where other people are coming from.

Humility
Eric encouraged students to “move your technical expertise to the back of your mind.” In academic research, it’s easy to wind up shopping around for the right community to study, but people are smart, and they’ll figure out that you’re not there to solve their problem — you’re there to solve your problem. Enrique added wanting to know that we’re making a difference can easily develop into narcissism.

“Stew in the Problem”
Pierre shared this credo, explaining that when we’re given an hour to work on a problem, it’s usually better to spend 50 minutes, not just five, before jumping into figuring out the solution. At a time when challenges seem to expand in scope and complexity even as the resources to solve them stay the same (or shrink), ‘measure twice, cut once’ is an important habit to build.

“There are people behind the numbers”
Data is the new currency, the critical resource that can help uncover solutions, garner budgets, and connect public health to the outside world. But in embracing trends of technology and data sciences, it becomes all too easy to overlook the experiences (often adverse) that put a human being into a column in a spreadsheet or database. Just as public health research involves converting people’s stories and problems into hard data, it’s critical to maintain those stories’ power alongside the data, and even to learn some reverse engineering to uncover hidden stories that live inside and behind the data.

Life advice, cocktail hour…then back to work

The career advice soon expanded into a more general discussion around lifestyle design to balance success and happiness. Samson encouraged students to “know your number” — figure out the salary or hourly rate that you can live with, so that you can move quickly when the right opportunity arises.

Similarly, David, ever the data-scientist, shared the concept of a “moment-to-moment” happiness index; research has shown that above a certain salary, most peoples’ happiness tends to level off, rendering it an ineffective tool for measuring progress in your career. Focusing on the work, people, and projects that let you lose yourself in moment-to-moment fulfillment is certainly tougher to do, especially earlier in your career, but much more rewarding over the long term. Enrique pointed to the period of the career advancement curve where people tend to start feeling bored or stuck — before interest doubles or triples in intensity, and the dedication to craft and detail consume you whole (think Jiro Dreams of Sushi.)

As the panel session wrapped up and the discussion meandered into happy hour conversations, we had the opportunity to meet a diverse group of folks and learn about public health from the numerous trenches of academia and public sector work. Several students brought up their interest in understanding how to forge a career beyond traditional public health roles; one young man had become a grants expert to help pay for school while developing a real-world skillset, another young woman had left “the bubble of Silicon Valley” to understand the diverse cultural dynamics across the country more thoroughly.

We were inspired by stories from a nutrition expert looking at consumer innovation models like Blue Apron, and from a woman who had turned to puppets (puppets!) to engage young girls in African-American communities plagued by diabetes. More than one former government employee shared stories of frustration and limitations they faced in the public sector, before they tapped into the passion that drove them into the next chapter of their careers, whether that was working directly with patients, or exploiting new techniques in technology, finance, or storytelling to overcome those previous roadblocks.

Living in Washington DC, there are constant reminders of the tremendous political and social challenges we face in our day-to-day work trying to make things better for people who need help. Ultimately, it doesn’t matter whether “innovation” means adapting new technology, tools, and techniques to tackle complex problems, or simply going old-school analog with a pencil, paper, or puppets. Progress in our field will always be driven by our ability to forge authentic connections with other people on an ongoing basis, whether they are co-workers, mentors, patients, or other members of the community.