Innovating Across Highly-Regulated Industries and the Federal Government

When I joined the federal government as a Presidential Innovation Fellow (PIF), I expected to be working somewhere drastically different than industry. As a data science and software leader with experience spanning the full healthcare continuum, I was excited to be bringing my skills into a role of public service, where I would be working across health innovation teams in the U.S. Department of Veterans Affairs (VA). Now 18 months in, I’ve found more similarities than differences between highly-regulated companies and the federal government. In this blog, I share some of the parallels I’ve experienced, and lessons healthcare innovators can use to improve their work in any sector.

Image courtesy of the Institute for Education.

Government and large, highly-regulated companies share two important qualities. For each, I’ve used a data-driven and entrepreneurial mindset to co-create progress alongside fellow colleagues and public servants.

• Understand simultaneous workstreams and map work to real needs. It is common to find overlapping efforts across different departments. It is important to identify shared business goals and vision, and focus on collaboration over competition. After aligning on shared goals and visions, I sometimes find that combining work streams is the best path forward. Other times, based on our audience’s needs - whether that’s the company’s customers, the federal agency’s serving population, or the federal workforce - we can determine that distinct workstreams are valuable and define which workstreams own which priorities to serve those needs.
• Find process navigators, or become one. In both highly-regulated industries and the federal government, there are layers of known or unknown processes to get approval for execution. Some of the processes are well established, but they may not be well documented for people who aren’t close to the process execution. In this case, knowing the right person with domain knowledge helps speed up execution by simply following well-defined processes. For example, opening network connectivity between different systems at the VA is a well-established process; however, most staff outside of the networking divisions are not aware of it. With proper guidance and diligent efforts on prerequisites, one can follow the standard process to establish network connectivity within a week. However, there are also approval processes that may or may not govern the technical implementation of your work. You are often recommended to seek additional approval given the conservative work culture in highly-regulated industries and the federal government. For me, it is an important skill set to quickly figure out the scope of all additional approval processes, and identify if and where precedent can be set. It’s also important to build relationships with the people behind each process, because shared respect and understanding are essential not only for healthy work environments, but also to uncover the potential to streamline processes and achieve shared goals. Otherwise, your work may be stuck into an infinite loop of approval processes.

I’ve found that working in the federal government is also different in two important ways. Each difference has made me a stronger health innovator, and provided skills that I’ll carry with me for the rest of my career.

• People are very mission-driven in the federal government. Public servants’ focus on mission is truly exceptional. The VA has one of the most noble missions: “to fulfill President Lincoln’s promise ‘To care for him who shall have borne the battle, and for his widow, and his orphan’ by serving and honoring the men and women who are America’s Veterans.” Among all the VA employees who I have interacted with (~500 people), everyone has clear alignment between daily tasks and the general mission. Many if not most U.S. corporations have clear missions to bring value to society. Their market capitalization indirectly reflects the perceived value from the society point of view. However, many companies also suffer from short-term financial pressure, and this prevents many large companies from high-risk/high-reward activities organically. Working in the federal government, I’ve been able to focus on a different bottom line: a bottom line of better lives. By default, the scale of the federal government is massive (every person in our country, or in the case of the VA, every veteran). While fiscal responsibility is always a priority, it has been liberating to focus on mission.
• With mission in mind, understand that you don’t have to understand everything. For example, I joined government from corporate America, and business operations are unique in the federal government and are something I’m still learning about. One example is what budgets can be used, and why. One of my first projects at VA was a collaboration between the Veterans Health Administration (VHA) and the Department of Energy (DoE). I was scheduled for a work trip to DoE’s Oak Ridge National Laboratory to finalize project deliverables between November 21-22, 2019. However, the seven-week continuous resolution signed by the president only covered up to 11:59 p.m. on November 20, 2019 (continuous resolutions can prevent a government shutdown between budget approvals year over year). While a government shutdown was looming, my VA Office of Information and Technology (OIT) colleagues and I were not allowed to book travel on or after November 21. At the very last minute, on the morning of November 20, my VHA collaborator offered to sponsor my trip using a separate funding stream that was related to the collaboration but not subjected to the November 20 resolution deadline. I cannot claim I fully understand the accounting details behind this, and the surprises continue, but that’s okay. The most important thing I remind myself is: Focus on the mission and build a business case. Armed with strong data, customer insights, and roadmaps, my colleagues and I stay aligned on what’s most important, and get work done no matter what.

Drawing parallels between the federal government and highly-regulated companies helped me quickly figure out the lay of land while on-boarding to the PIF program. However, there are also unique aspects of the federal government, and one has to respect, adapt and leverage the differences in order to make a sustainable innovation legacy during the PIF tenure.

Are you passionate about technology as a tool to improve lives? Interested in using your expertise for public good? That’s what Presidential Innovation Fellows (PIF) is all about. Learn more about PIF on our website, and follow us on Twitter and LinkedIn to find the latest work from our Fellows.