The VA’s First Chief Innovation Officer Aims to Speed Up the Delivery of Cost-Saving Services

The Veterans Affairs Department’s Innovation Center has been around for a little longer than a decade, but it’s undergoing a propulsive transformation prompted by the MISSION Act’s passage in 2018. And at the forefront of its revamp is Michael Akinyele, a first-time federal employee who serves as the center’s principal lead and the VA’s first-ever chief innovation officer.  

In a recent conversation with Nextgov, Akinyele opened up about the pain that sparked his passion for public service, the first cutting-edge pilot program his office is pursuing and his own aims to improve and accelerate health care delivery across the agency and beyond.  

“I think the desire to serve is typically triggered by either a traumatic event or a serious event, and so for me, it's fairly similar—the traumatic event being the loss of my father in 2014,” Akinyele explained. “Because his death was sort of related to what I will call the failures of our global health care system, I felt like part of my mission should be to try and do something about that.”

After leading management consulting teams supporting multinational corporations, Akinyele spent a short stint in philanthropy as a health care-focused venture development director at a multibillion-dollar private foundation. Hoping to harness even more value from his work after his father’s untimely death, he landed at the VA in August 2017, initially as a Senior Advisor in the Veterans Health Administration. In March 2018, he joined the Office of Enterprise Integration to lead the Innovation Center. 

In June 2018, the Maintaining Internal Systems and Strengthening Integrated Outside Networks, or MISSION Act passed, and in it, Section 152 required the creation of a center for innovation within the VA that’s specifically focused on modernizing care and payments. Prompted by the passage, the center’s insiders (and Akinyele, who helped develop the measures that would govern the subsequent change) shifted gears and now, they’re implementing Section 152 by producing new cost-saving approaches that also improve clinical outcomes. Further building on those efforts, Akinyele was appointed to the Senior Executive Service in November. In this capacity, he’s also responsible for scaling innovation across the agency, which he said involves identifying and developing new solutions that could transcend the VA and change care paths across the nation.

“The VA is where the cardiac pacemaker was created, and I think that is a solution that has scaled across health care,” Akinyele said, offering up an example of what “scaling enterprise innovation” really entails. “I would consider things like that.”

He views himself as a health care futurist and is particularly interested in speeding up efforts around modernization that will resonate across the landscape. “I consider myself very, very impatient with the transformation of health care to date, and really what I call the systemwide failure to actually bend the cost curve. I'm not coming at this with a naive perspective, I understand why things are the way they are, but it does make me very impatient to try and change it,” he said.

According to the inaugural innovation officer, VA is “more similar to a large business than it is to a traditional federal agency,” as it’s hyper-focused on direct-to-veteran service delivery. He said the agency’s health care administration is effectively a $90 billion business serving about 9 million enrolled veterans, and the agency also provides around $120 billion in benefits as a direct service to about 6 million people. Akinyele’s office is now identifying new models and approaches to delivering services and facilitating payments differently. 

“And we're just getting started,” he said. 

The MISSION Act authorizes up to $50 million to be spent at VA a year on pilot programs to test innovative service delivery models that could potentially improve the care veterans receive. On Jan.13 the House approved the center’s initial submission for a pilot program waiver and is waiting for the Senate to take action. Based on distributed ledger technology, or blockchain, this first pilot program aims to increase veterans’ access to dental services, as they currently only qualify for VA-provided dental services based on narrow criteria. The program will launch the creation of a system through which veterans could connect with community-based, pro bono, or discounted dental service providers, and those providers could, in turn, receive “utility tokens” for their work. The dental providers (and in an ideal future, all providers who may eventually opt-in once it’s expanded) could then “convert the tokens to cash” or use them for other services on the platform, perhaps from a different entity that’s also on it and offering veterans similarly discounted legal aid services. 

“That dentist has now purchased legal services by exchanging tokens earned on the platform—and potentially if we are able to measure the impact of the veteran receiving free care, we can hopefully take that and make it a justification to buy back tokens on that platform,” Akinyele said. “So it's very complicated and we're just at the early stages of figuring out how we would develop the platform working with industry. But that is the vision of using emerging technology within the context of health care innovation and within the context of one of our pilot programs.”

In Akinyele’s eyes, the center was ultimately established to drive the agency forward through cutting-edge pilot programs and its unique approach to innovation. He noted that while the role of chief innovation officer across government and industry “has fairly been nebulous,” every federal organization could benefit from instituting the function of an individual or team that's looking inwardly and proactively figuring out high probability approaches to truly solving systemic issues. Almost three years into his own time at a federal agency and two months into his role as chief innovation officer, Akinyele’s efforts continue to be driven by the passion—and frustrations—that inspired him to work at the VA in the first place. 

“Part of the tragedy of how my father ultimately passed was a tragedy of information breakdown,” he said. “Part of what we're developing, I think if it existed, it might have helped.”

Akinyele explained that his father was overseas at a conference when he suffered a tragic medical event, but health care providers there had no context of his medical history or records. They could not reach any of his doctors, and “at a very basic level,” they likely weren't able to accurately diagnose what was going on. “So if we get to a future state where platforms exist, that can get the right types of information and put it at the hands of care teams ... then maybe we start having a system where evidence is driving the actions people take to care for themselves and to care for others,” he said. “That's one element of passion.”

The other element, he said, is his incessant frustration with the pace of change across health care, and the fact that all the interconnected elements and stakeholders working across the system have made it traditionally very difficult to drive transformation. 

“And so, like I said, I didn't come into this with sort of a naive lens. But I still look at all of it with hope,” Akinyele said. “Hope that with enough time and effort, and a large enough coalition, we can start developing and implementing the type of change that can truly revolutionize how health care is practiced and delivered across the world.”

Editor's Note: This article was updated to clarify the length of Mr. Akinyele's service at the Veterans Affairs Department and the pilot program waiver's status in Congress.