The Innovation Advisors Program

January 26, 2012 at 9:35 AM Leave a comment

As some of you may know, I was chosen to be an Innovation Advisor for the Center for Medicare and Medicaid Innovation in December of 2011.  Since then, many have asked what that means.  I have been telling people that what I know is what’s in the press release.   I have since been to the kickoff meeting in Baltimore and know a little bit more.   Here’s what it’s like.

The first thing that struck me is the people are both unassuming and wicked smart.  I felt like a slacker because I sleep several hours each night.  Eating lunch, riding on the bus, taking a coffee break–you start up a conversation and you get into areas that you usually can find only about three people to talk with you about in the country.  You quickly realize there are at least four.   I made an offhand remark about complex adaptive systems, and the woman next to me said, “I teach that at a major university.”  Wicked smart.  All of them.

Next is that the program is moderately unstructured, in the way Zen is unstructured.  It is experiential and relational, but with metrics and outcomes.  I think this is intended to engage both the limbic system and the cortex, i.e., the emotional and the rational brain, and like many Zen things, it’s mildly unsettling.  Almost all of us have been quite goal-directed in life, and the lack of clear proximal anticipated outcomes is unnerving for many of us.  Despite that, the mere sensation of being with one’s own people makes up for a lot of discomfort, and I think if you polled us privately about giving up our spots now, we’d all say no, or no way.   I think it’s been a common experience for many of us that we are simultaneously attract to and frustrated by the same work.  No different here.

I tried to connect this to a mental model, to access heuristics that would help me anticipate the feel of the experience.  (Zen will tell you not to do this, but old habits die hard.)  What popped to mind would be what I imagine a Silicon Valley incubator looked like in the 90s, without the ridiculous amounts of money and foosball tables.   Bright people, coming out of organizations that are doing start up work, collaborating to find the idea fragment collisions that create new value.   (For more on idea fragments, see Steven Johnson’s Where Good Ideas Come From.)  In general, this is a low yield, high risk, high reward proposition.  Most pitches to venture capital don’t get funded.  But ten in a hundred are good enough to test, and one in a hundred/thousand changes markets.  But that’s the cost of finding the game changer.

You might wonder what any of this is doing in the federal government, and particularly in a rule-bound agency like CMS.   In fact, the tension between regulatory constraints and the creation of safe space for the failure inherent in experimentation is the key dynamic tension in the existence of CMMI.   The acceptance of that tension is also a Zen exercise, and a worthy meditation for all of us involved in this project.

All things considered, I look forward to the journey.  One of my life’s great pleasures is learning new things from people I like and respect, and CMMI was kind enough to introduce me to 72 new friends who fit that description.  For that, I am truly honored and humbled.  And despite my Zen meditiations to remain in the moment, I can’t wait to see what happens next.  Stay tuned.

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Let the games begin… The amazing clarifying effect of being out of money

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