The role of the federal agency CIO has been the subject of near-constant debate since the passage of the 1996 Clinger-Cohen Act. Congress intended the law to improve its management within the federal government by designating agency CIOs and giving them authority over and accountability for IT activities. In practice, the results have been mixed, with many agency CIOs struggling with limited executive buy-in and power.
Empowering agency CIOs is a key component of the 25-point federal IT reform plan released by former U.S. CIO Vivek Kundra. Late last year, U.S. Office of Management and Budget (OMB) Director Jacob Lew acted on one of the plan’s recommendations, releasing a memo that puts CIOs in charge of commodity IT purchasing for their agencies. And in May, the OMB released a shared services strategy, noting that agency CIOs will need to “innovate with less,” given the federal government’s current fiscal constraints and growing IT demands.
The new strategy points out that agency CIOs will be pressured to deliver solutions faster and for less money, develop future-ready business and technology architectures, and take advantage of evolving technologies to help agencies work more flexibly, efficiently and effectively.
With this in mind, we thought it appropriate to shine a spotlight on the activities of three of the federal government’s most innovative agency CIOs.
Frank Baitman has only been CIO of the U.S. Department of Health and Human Services (HHS) for a few months, but he brings a track record of innovation to the post, and according to former Federal CTO Aneesh Chopra, Baitman is “a guy who deserves watching.” Baitman was director of corporate strategy at IBM and helped establish the company’s Life Sciences Unit. He later served for two years as CIO of the Social Security Administration (SSA). He left the SSA in 2011 after a major reorganization and became “entrepreneur in residence” at the U.S. Food and Drug Administration (FDA) before joining the HHS as CIO in February.
Entrepreneur in Residence
“What I did at the FDA was a lot of fun,” he said. “The charge before us was, ‘What can you do to streamline the process for getting innovative medical devices to market?’” Medical devices are becoming increasingly important, Baitman said, but are somewhat under the radar because they are overshadowed by pharmaceuticals. To hasten the process of getting the devices approved, Baitman and four others ramped up the Innovation Pathway 2.0.
“I was one of five members of an entrepreneur-in-residence team selected to work on this.” Baitman said he came in with a strategy and IT background, and other team members brought a range of abilities. A retired general brought leadership skills that enabled the group to get into action quickly. The team had six months to show what it could do.
“One of the things that we did was stress test this Innovation Pathway 2.0,” Baitman said. “So we put out a challenge to a particular disease state, which is something novel for the FDA. We said, ‘There is a disease called ‘end-stage renal disease’ that is a huge and growing public health problem. … More and more people are on dialysis and the prognosis is not good. Fifty percent of Americans with end-stage renal disease die within five years.’”
The FDA asked innovators if there were any medical devices that they’d like to put on the Innovation Pathway. Although there wasn’t a prize or money associated with the initiative, the pathway provided a way for companies to collaborate with the FDA to get their devices into the marketplace more quickly than traditional processes.
“We had our fingers crossed that we would get more than one company coming forward, and we ended up getting 32,” Baitman said. “The FDA selected three inventions that are now on the Innovation Pathway, moving to market. Things like a wearable kidney — really fascinating stuff.”
Baitman said that among supporters of the project were Chopra and Todd Park, who replaced Chopra, as well as the FDA’s Jeff Shuren, head of the Center for Devices and Radiological Health.
Photo: Frank Baitman, CIO, U.S. Department of Health and Human Services
IT played a significant part, as the team needed tools to support a business process that hinged on communication and collaboration. Baitman said the team did a crash course in software development and in eight weeks built a secure online conference center that allows the FDA and device sponsors to interact.
“To make that happen, we went to the cloud. We partnered with Salesforce, and we built a solution that among other things provides really good tracking of information flow between the company and the FDA, and inspires collaboration among FDA reviewers and with their peers in industry. We saw a problem, we came up with a solution — which was Innovation Pathway 2.0 — we stress tested it with the challenge and then we built the tools to enable that new business process to function.”
Health and Human Services
Baitman came into the HHS — as CIO and deputy assistant secretary for IT — aware of the challenges facing him. The agency has a wide range of missions that support public health — from National Institutes of Health research, to FDA regulatory functions, to the Centers for Disease Control and Prevention’s (CDC) public health work, to direct care provided by the Indian Health Service. “One of the challenges is looking out across that enterprise and saying, ‘Where are there common needs so that we can get people working together?” he said.
Working collaboratively is clearly driven by the need to build in efficiencies and save money, but according to Baitman, that’s only the beginning. “Part of the reason for that collaboration is that we can move our mission forward more quickly by sharing information. And that’s where I’m hoping to make a difference.”
To start the process, said Baitman, “We set up a new IT governance process in the agency, and what makes this one a little different than what’s being done elsewhere is we’re looking across the breadth of the agency and asking, ‘Where can we pull people together who are likely to have shared interests?’”
That means consolidating more than a dozen HR systems into one with specialty domains. “It’s going to make the flow of information across the agency so much more streamlined. People are going to be able to see things in the same way and share that information with the same data fields across the agency.”
For example, he said, the FDA, National Institutes of Health and CDC are all focused on science and research. “We’re looking across those operating divisions that care about research to see if there are common things that you do — like sourcing, finding experts in a particular research field.”
The HHS is also taking a page from the FDA entrepreneur-in-residence program by looking for staff to partner with innovators outside the federal government. “You can’t just have internal people, because they’re part of the system and they need the knowledge, the insight and perspective of people who come from outside,” Baitman said. “And you can’t just have outside people, because they don’t understand the organization and how to get things done.” In six months to one year, the idea is “not to produce a slide deck but to actually make something happen.”
Health and IT
Baitman thinks IT is key to health care’s future. “It’s an entirely different way of treating people when that file isn’t locked away in a doctor’s office, but is something you carry around with you,” he said in reference to a mobile health IT project. While Baitman said he was still very new at the HHS, he thinks that mobility and use of the cloud will become essentials to effective health-care IT.
In addition, Baitman said the Affordable Care Act depends heavily on IT. “The health insurance exchanges, for example, are rooted in IT,” he said. “And we’re moving forward building those exchanges so Americans can get access to health insurance. Regardless of whether or not they get that insurance today from their employer or if they don’t have insurance, we want them to have access, and IT underlies so many of the things we hope to deliver.”
-- By Wayne Hanson