“When you actually diagnose the process—and this is classic general management—the thing that made it slow didn’t make it more safe, it’s just because everyone is risk averse and afraid of failure,” said Ries, who addressed the team early in its efforts. “It goes slow because no one is taking responsibility for a process that is really bad and creates silos between people that are really dumb. These are supply chain and manufacturing ideas that have been [incorporated] into general management that worked really well in olden times.”
It wasn’t working for Kamen. At the TEDMED 2011 conference, he mocked the FDA’s intransigence in green-lighting an advanced prosthetic arm he had designed for veterans who had lost limbs in combat.18 His acerbic commentary illustrated the serious rift between the regulatory agency and the innovators under its watch and, in reality, thumb.
Fully aware of this division, and determined to engage rather than enrage experts in the field, Dr. Peggy Hamburg set out to redefine the relationship. The agency sent out a signal for Kamen and 19 other leaders of industry, academia, venture capital, and research—including embolectomy catheter inventor Dr. Thomas Fogarty and retired Medtronic CEO William Hawkins—to work with the best and brightest in the FDA’s Center for Devices and Radiological Health.19 They were tasked with designing a better process for regulators to evaluate the risks and benefits of approving medical devices, a process that was more mindful of the innovator’s perspective and could get patients faster access to safe, state-of-the-art products. The team targeted one ailment, end-stage renal disease (ESRD), which afflicts more than half a million Americans, and for which patients have few options other than dialysis or kidney transplant.20 The team then zeroed in on specific parts of the process that were counterproductive.
“What if we had the same examiner who reviewed the initial application also review the follow-up application?” Ries asked. “That examiner wouldn’t have to get up to speed—brand new—every time the new application came in. That’s pretty common sense, an obvious thing to do. But just having a commonsense idea is not enough. You’ve got to have a team that can pilot it, test it, and see if it will work. So the key parts are a cross functional team with a limited mandate, six months not just to write a report or come up with new ideas but to implement the new solution, iterate it, prove that it works.”
In April 2012, the FDA announced that three ESRD technologies had emerged from a competitive pool of 32 and would get the opportunity to earn regulatory approval through the new pathway. In announcing the selections, the Center for Devices and Radiological Health’s director, Dr. Jeff Shuren, highlighted the overwhelming response, arguing that it “demonstrates that there is a desire from developers of innovative technologies for earlier and more collaborative agency interaction.”21
To initiate its EIR program, USCIS would also turn to an agitator. Brad Feld, an early-stage investor and prolific blogger, had become exasperated when officers of two promising startups under his watch were forced to return to their home countries because they couldn’t secure visas. He shared their story on a blog, attracting the attention of other entrepreneurs, including Ries, who couldn’t understand why there was no visa category for an entrepreneur with American investors and employees. In lieu of that category, many entrepreneurs were at the mercy of visa examiners who didn’t understand how they operated. At the point of visa application, many startups had not hired many employees or generated much revenue. This confused traditional visa examiners, who would then ask odd and irrelevant questions, often before a denial. To give just one example, it’s been years since AOL required a compact disc to use its service. And yet, visa examiners were demanding proof of a warehouse, where software startups would store their CD inventory for shipping to customers.
As Feld’s idea of a “startup visa” became intertwined with, and paralyzed by, the broader debate on comprehensive immigration reform, the USCIS, with White House support, sought to accomplish something administratively within the existing law. It instituted an EIR program, to organize and educate a specialty unit of immigration officers to handle entrepreneur and startup nonimmigrant visa cases.22 The project also called for educating entrepreneurs about the available options, one of which they may have overlooked. For instance, the O-1 visa, which was reserved “for those with extraordinary ability,” had proven a successful channel for actors, athletes, musicians, directors, scientists, artists, businessmen, engineers, and others who could provide ample evidence of their unique and impressive abilities, attributes, awards, and accolades. It had even created some controversy, when visa evaluators took the term “model” to an extreme, awarding a visa to one of Hugh Hefner’s ex-girlfriends, a Playboy centerfold from Canada named Shera Berchard.23 If she was confident enough to assert and explain her “extraordinary ability,” why weren’t entrepreneurs?
Like the team at the FDA, the EIR team enlisted entrepreneurs familiar with the obstacles, including SoftLayer senior executive Paul Ford, to work alongside the USCIS personnel committed to removing or clearing them. “You get fresh thinking, you get a very low-cost way of trying to impact the situation because the people doing this are committed to try to find what’s not working and propose solutions, rather than take a partisan or political or hierarchical or structural view to the environment,” Feld said. “They’re short-timers, so they’re committed for a period of time to come do something, but they’re not here for career advancement, so they are going to speak their mind.”
Feld also believed that the presence of Ford and other outside entrepreneurs made the participants feel more comfortable to speak freely than if they had been working with government officials alone. In the spring of 2012, the team began building a prototype of an alternative application process for entrepreneurs and by fall had achieved a significant breakthrough: the launch of the Entrepreneurship Pathways web portal, designed to close the information gap between USCIS and those in the entrepreneurial community, by letting them know which visa may be most appropriate—including the O-1—for their situation.24 While the results of this exercise were not empirically conclusive at the time of an interview for this book, Feld did offer his anecdotal assessment “that there’s an increased number of people who I know have been able to get into the country and get valid visas who are entrepreneurs. I’ve definitely heard a decrease in the negative.”
One case study was unquestionably positive. Fabien Beckers was born in France, where he, as a physicist, tried unsuccessfully to build a company for seven years.25 Convinced of grander opportunity in America, he enrolled at Stanford University, graduated with a master’s in business and, with a partner, started Morpheus Medical Inc. to build cloud-based software for noninvasive diagnosis of cardiac defects in babies. His work visa, however, was set to expire on December 13, 2012, and, in attempting to extend his stay, he was denied an H1-B visa because he did not have an employer.
“It was hell,” he said.
With other options exhausted, he applied for the O-1 visa that the Entrepreneurship Pathways portal had included as one of the viable possibilities for someone with his “extraordinary ability.” One week prior to his deportation date, and likely aided by the education that visa examiners had received, he was approved. With Beckers’ status assured for at least the next three years, investors felt comfortable contributing to his cause, and he quickly secured nearly $2 million and hired four employees.
“It’s really, really amazing,” Beckers said. “We’re so happy now.”
Yet he was not satisfied. He became a visible proponent of the passage of the aforementioned startup visa, hoping to make it easier for others than it had been for him to contribute something meaningful in, and for, America.
Todd Park wasn’t satisfied either, even after inroads that the Entrepreneurs in Residence had made at the FDA and USCIS.
He had been the pioneer of the open data movement from his post as CTO of Health and Human Services, p
rior to becoming my successor as the nation’s Chief Technology Officer on March 9, 2012.26 That promotion positioned him to expand upon our attempts to alter the culture of the entire federal government. He would build toward the future by drawing from the past: the White House Fellows program that had endured since President Lyndon B. Johnson established it in 1964 to give promising Americans a chance to work inside government for a year. Park would give that time-honored program a more modern spin, integrating Eric Ries’ lean startup principles of lightning speed and limited scope.
In May 2012, Park proposed a Presidential Innovation Fellows program to bring together external and internal innovators to work for six months on what he deemed “game-changing projects.”27 With President Obama’s support, and leadership from John Berry at the Office of Personnel Management, Park selected 18 fellows from more than 700 applicants, to work on five projects. I have covered two (scaling Open Data and increasing the awareness of Blue Button personal health records) extensively in this book. The others were MyGov, to streamline communication between government and citizens by organizing the more than 1,200 government websites around people’s needs rather than around the bureaucracy; RFP-EZ, to create an easy online marketplace to better connect government and private sector technology firms during the request for proposal (RFP) process, allowing government to buy better technology at less expense; and the 20% Initiative, which aimed to transition international development assistance from cash to electronic payments to reduce fraud and theft and lower administrative costs.
Park didn’t force the projects, or the fellows, on the agencies. He wanted willing, eager partners who saw a need for outside assistance.28 He required that those agencies compete for the right to house—and pay for—the fellows, by submitting proposals and explaining how they would enable and empower the new personnel. He got the fellows going quickly, so quickly that it stunned even Ries; by the swearing-in ceremony, after only a few days together, some had already hit their first milestones. “The speed of it is so refreshing,” Ries said. “It’s refreshing for those of us who are frustrated with government, but it’s even more refreshing for the people in government. A lot of those people want to go faster; they want to be innovative, they want to do a good job. There’s this caricature of them that they’re lifetime bureaucrats who don’t care. That’s not true. I’m sure there are some of those people, but the ones I’ve met get excited about trying to serve their country.”
Ries credited Park for showing respect to those people, by not giving the newcomers too much license at their expense, and creating resistance or resentment.
“That would be a catastrophic failure, if we go get a bunch of people from the outside and we drop them like aliens on the lawn of the government, and they sort of tell the government what to do,” Park said. “That has been tried before, and that project would be flaming wreckage.”
Instead, Park used a Ries-inspired technique to assist the entrepreneurs in government who may have felt stifled by a general management environment: he gave them more like-minded help and, through a supportive structure, gave everyone permission to experiment and fail.
“What we said instead was ‘What are you trying to do? What kinds of capabilities and skills do you want to bring in from the outside to help you? OK, let’s form a team that has your best people on it, and bring in people from the outside that have the skills you want, and then have that new team execute in a lean startup mode to change the game, do more than either could do separately, and deliver successfully against that mission,’” Park said. “That recipe is working incredibly well.”
At times, it required adding a pinch of spice to the mix: entrepreneurs who, like Dean Kamen, may be somewhat skeptical of government. Clay Johnson hadn’t even voted prior to the 2004 Presidential election, when his mother’s breast cancer, and the corresponding hike in health care costs, led him to become the lead programmer of Democratic candidate Howard Dean’s website. After his subsequent technology firm, Blue State Digital, designed websites for the Democratic National Committee and then-Senator Barack Obama, he became the director of the nonprofit Sunlight Labs. In that capacity, he collaborated with the government on Data.gov, including the Apps for America contest that produced the aforementioned upgrades to the Federal Register website. Over the years, he came to conclude that government reform required more than just the noble goal of transparency.
“When you are dealing with government, there is always this question in the back of your head, Is this corruption or is this incompetence or is this inertia?” Johnson said. “And it could be one of those three things that is frustrating you inside of government. More than likely, most of the time, it’s not corruption, it’s not incompetence; it’s usually inertia, and inertia is just as much of a corrosive influence on the business of government as money or malfeasance.”
After leaving Sunlight Labs, he captured his frustration with the current political discourse in a book called The Information Diet, arguing that the public, taking a cue from its leaders, was arguing about the wrong things. “What the Republicans say is ‘We need to cut programs’ and the Democrats say, ‘Well, we need to raise revenues,’” Johnson said. “And it doesn’t make any sense. It’s as though America is a fat guy on the couch. And the Republicans are saying, ‘We’ve got to get him off the couch, the best way for him to get off the couch is for him to lose weight, the best way for him to lose weight is to cut off his legs.’ The Democrats are saying, ‘No, no, to get him off the couch, he needs more energy, and the best way for him to get more energy is for him to eat more,’ which is also not going to get him off the couch. We need to have conversations about how to get government to run better and work better.”
After completing the book, Johnson would receive another opportunity to actively participate in that conversation—to, as acquaintances challenged him, “do something about all of those things you’ve been complaining about.” One of those things had been the government’s procurement process, which had frustrated him again during a failed bid to provide website development services for Recovery.gov. He concluded that the government’s arcane restrictions and overreaching requirements caused it unnecessary expense, as it consistently paid more than the private sector for similar technology services. The White House agreed, which is why it made RFP-EZ one of the five initial Presidential Innovation Fellow projects, assigning Johnson, GovHub cofounder Adam Becker, and innovation designer Ed Wood to the Small Business Administration.
The team approached the project in lean startup fashion, with the intention of speeding up the interminable RFP process so that the product, service, or technology requested wasn’t out of date by the time it was received. It also sought to make the process less overwhelming to small-business bidders, who sometimes gave up because they didn’t speak the language of government, and less intimidating to program officers and contracting officers, who are sometimes scared to even post work for bidding because they don’t have time to do the necessary diligence on bulky proposals.
The RFP-EZ team identified one of the root causes of the problem: agencies had been asked to outline their needs in overly complex and clunky statements of work (SOWs), often from scratch or with little guidance, and in a language that neither they nor many vendors really understood. The result was fewer bidders, many incurring costs to interpret the statement and passing on those costs in higher prices. So, as its first deliverable, the team launched the SOW Composer, a way of creating simpler forms patterned after what the Internal Revenue Service has done with the 1040EZ for a subset of its filers.29 The SOW Composer is a template repository of simplified stock content for statements of work, all ready to be repurposed. The tool not only allows authorized government contracting officers to choose exactly what they want in the statements of work, by checking boxes and filling in blanks, it also offers tips on how to make sure the content developed is easily located and understood by small businesses. The tool elimi
nates repetition and leaves space for users to add their own requirements.
Then the team, in an open source manner, developed other tools, such as BidMaker, which helps small businesses create their bids; the Marketplace, where small businesses sort through opportunities and make their bids; and BidMonitor, which helps contracting officers swiftly sort through those bids, search databases with background about the bidding company, match the bid up to the statement of work, and use a drop-down menu (“price too high” or “irrelevant proposal”) to explain why they dismissed or awarded the bid.
In its initial pilot, RFP-EZ posted five website development and database contract requests on its new platform, four of them simultaneously posted on the traditional portal, FedBizOpps.gov.30 The bids received on the new RFP-EZ platform attracted 270 businesses that had never competed for government work. Not surprisingly, the bids were 30 percent lower on average.
Following his fellowship, Johnson returned to the private sector, but didn’t turn his back on the open government movement; with a seed grant from the Knight Foundation, he and Becker started a company called the Department of Better Technology to create a number of products, including Screendoor, based on the RFP-EZ software and designed “to make the process of procurement less painful—both for government and for business.”31
Johnson emerged from his government experience believing that the culture must change more, to reward innovation over compliance. He strongly advocates educating all government employees—especially newcomers—about the importance of innovation through open government and open data. He actually found some senior staffers to be more open to such alternative policies, perhaps because junior staffers are concerned about doing anything that might undermine their ascents.
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