Lessons learned from NIH online app

Being an innovator in government can be risky for your career, according to David Hale, project manager for the National Library of Medicine’s Pillbox online application that allows users to identify thousands of pills with visual images.

“Sometimes, I got a slap on the wrist,” Hale said at the Next Generation in Government Summit on July 28 in a presentation called “Gov 2.0 Ninja: Proven Tips on Implementing Gov 2.0 at your Agency.”

But the occasional reprimands did not discourage him from continuing on the project. “Fortunately, it’s pretty hard to get fired as a government employee,"  Hale said. "Why not just push the edge?”

The idea for Pillbox started with discussions between officials at the national library, the Veterans Affairs Department and the District of Columbia Poison Control Center. The participants agreed there was a need for an application to visually identify pills by substance and dose, a first for VA facilities.

NIH Pillbox prototype is easy to digest

While the project was still in the conceptual stage, Hale said he began expanding the idea and opening it to the public. Hales said he started Pillbox in a somewhat “stealthy” fashion by holding discussions on his own time with people outside government that included medical caregivers, patients and other potential customers, as well as with developers, programmers and innovation experts.

Hale also began tweeting about the project from his personal Twitter account (@lostonroute66) and attending Health 2.0 and other conferences. Hale also said he shared ideas with Todd Park, chief technology officer of the Health and Human Services Department, who was enthusiastic and encouraged him to continue.

It was not until a newspaper ran a story about the budding application that his supervisor became aware of the depth of his involvement, Hale said.

“I got a slap on the wrist,” Hale said. However, because the project had started to gain momentum and Park was supporting it, “I also got an ‘Atta boy!' After that, I got a little more leeway.”

When trying to work on an innovative project, it is hard to avoid getting discouraged when it might take months for certain actions to happen or requirements to be met, Hale said. Development work on Pillbox slowed down dramatically for nine months while compliance and regulatory requirements were met, he added.

The risk is that projects may lose valuable momentum if the focus is primarily on compliance, Hale said. Ideally, innovators have to strive to find a balance between pushing hard using unusual channels if necessary and being patient and staying within designated channels, he suggested.

“It’s a balance, but I have not yet found the balance,” he said.

Pillbox debuted in beta form in October 2009 and is still considered a research and development project. It also is available as an iPhone app. The national library, which is part of the National Institutes of Health, has spent about $30,000 developing Pillbox, not including staff time, while also taking advantage of a database of pill images developed in a $300,000 research program run by the Food and Drug Administration, Hale said. The two agencies collaborated under an interagency agreement.

Hale has continued to develop contacts with programmers and developers who contributed code and applications, sometimes for free in a spirit of friendly competition. The volunteers share their code at GitHub.com, which is an online public repository of code.

Hale has continued to hold discussions, tweet and attend conferences, and he said said interest in Pillbox has “gotten out of control” and volunteers have spontaneously added to the capabilities. For example, a college student working independently wrote the code for a voice-only version of Pillbox in just two weekends, at no charge.

Hale shared several other tips for “Gov 2.0 ninjas” wanting to advance innovation at their agencies:

• Spend time with your customers, ideally as a conversation rather than paying for a focus group. “If you pay someone, you can get bad information,” he said.
• Members of the public and end users will do the best job of explaining how an application will be used. “We, the government, are the experts in content. [Members of the public] are the experts in context,” Hale said.
• Get to know your agency’s mission statement, strategic plan and other strategic documents to help define and support your project goals. “Your agency’s mission provides great cover,” Hale said.
• Bring your managers along and share what you have learned. Align your project objectives with your managers’ objectives for achieving success in their positions.
• In a project’s first stages, you want to do things “small, fast and cheap,” Hale said. The prototype format and layout for Pillbox was drawn on a plain sheet of paper. The prototype was on Microsoft PowerPoint.