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Smart Government: An Oxymoron no More?

In the United States, there have been many conversations in the past 10 years about the role of government in our lives. We have had many opportunities to see the blessings and failings of an active government.

During the financial recession, government stepped in to save an automotive industry that is thriving and profitable today. It’s hard to imagine the impact in jobs and on our economy if two of the big three auto companies were allowed to fail. Certainly, there was a world market ready to step in and fill the vacuum with their products and services.

There have also been cases where the government’s actions have been judged as negative – as being the wrong solution to a problem that we have, and certainly time has shown us that those policies and decisions are in no short supply.

I would like to look at two trends for your consideration - that of government as an innovator and that of government as a catalyst for change. Breakthrough Technologies has been fortunate to have a seat at this table, and there are a lot of good things happening that I think can get overlooked in the cacophony of our political environment.

Government as an Innovator

I was at a Health Care Conference about four years ago, called Health 2.0.  It was in Silicon Valley, and I remember it well. There was the usual crowd of innovative startups – groups pushing telemedicine here, personalized health there, trying to solve problems in their respective silos that startups can solve in a very complicated, interconnected and highly regulated domain.

And then there was a session that featured the CTO of a government organization. This organization was the Veteran’s Administration. Now the VA is often vilified in the press, as providing medical services to veterans is an easy target, when they often struggle with the highly distributed nature of their customers and a lack of sustaining funding for service men and women who fought in a conflict 30 or 40 years ago. Reading that a vet had to wait 60 days for an appointment always sells papers and feels like cutting edge journalism. But let’s face it, they’re an easy target.

So at this presentation, the CTO revealed something so simple and awesome it totally blew me away. Many health care organizations have been working on a problem that has plagued health care for decades. That of portability. Why is it that my health records can’t travel with me to another state, to another insurer, to another hospital or doctor? Standards have been erected, privacy statutes enacted, but still a visit to the hospital requires the nurse to spend 40 minutes doing data entry on the medications you currently use, instead of assessing the patient or actually delivering health care services.

So here, then was the answer. Was it a deep government standard? Was it a report on the state of the industry that had been compiled over three years? Was it a task force assembled at the regional level?

No. It was none of these things. It was a big blue button:

When the VA customer pressed the big blue button, something miraculous happened. Every medical record in the VA system was downloaded to the user’s hard drive. That’s it. Simple, efficient, and extraordinary.

What happened next was a small explosion of open source tools that allowed users to display their data on their computer, ways to parse the data that allowed medical providers to glean relevant information from it, etc.

By making the data available in an open standard (XML) the government agency that is sometimes the poster child for bureaucracy and non-responsiveness did an end-run around every private health care company on the planet.

A feature that, years later, still has not been successfully duplicated on the private market.

Follow my blog for part two, which will be a discussion on government as an agent of change.

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