There has been a lot of talk in healthcare circles about the concept of “gamification,” a super-annoying made-up word that means turning health tasks into games so they are more engaging and people are more willing to do them. People and companies are coming up with all sorts of games for kids with asthma and diabetes to learn good medical compliance and for adults who need the extra incentive to do their exercise and comply with their chronic care regimens, among others. Michelle Obama even sponsored a big contest to foster the creation of games to sponsor healthy eating and virtually every large health insurance company is now offering various forms of incentive game and points programs for taking better care of oneself. You can get frequent flyer points for taking United Airlines and “personal rewards” points, that you can turn into cash, for being insured by United Healthcare.
We Americans just love our games and nothing sells like a healthy competition. Just witness the insanity of prime time television and you will see people attempting feats that they never would have done (losing hundreds of pounds, surviving extreme conditions, baring their souls in front of Simon Cowell) if it weren’t for the big juicy cash prize at the end of the rainbow. Vanna, can I buy a vowel?
So it was with this thought in my mind that I recently attended the X Prize Radical Benefit for Humanity (thanks, Qualcomm guys, for inviting me!). The event was a fund-raiser/auction for the X Prize Foundation, which describes itself as: “the leading nonprofit organization solving the world’s Grand Challenges by creating and managing large-scale, high profile, incentivized price competitions that stimulate investment in research and development with far more than the price itself. The organization motivates and inspires brilliant innovators from all disciplines to leverage their intellectual and financial capital for the benefit of humanity.”
The X Prize Foundation made its name in 2004 when it awarded its first $10 million prize to aerospace designer Burt Rutan and former MicroSoft leader Paul Allen for building and launching a spacecraft capable of carrying three people to 100 kilometers above the earth’s surface and then repeat the mission within two weeks. This was the first time in history that private sub-orbital space flight had been accomplished in any significant way without the intervention or funding of government. Interestingly, Dr. Peter Diamandis (Chair and CEO of the X Prize Foundation), founded the Ansari X Prize after being inspired by learning of the Orteig Prize, a $25,000 challenge sponsored by a rich NY hotelier in 1927. The winner of the Orteig Prize would be the first person to fly non-stop from New York to Paris. Winner: Charles Lindbergh. Spirit of St. Louis, come on down! I guess we Americans have been contest-motivated for a long time.
Today the X Prize has diversified to include not just space travel, but also environmental, energy and, most interesting to me, several life science challenges.
The X Prize benefit on October 19th in San Francisco was a very swank affair (we’re talking sequins, baby) filled with the San Francisco glitterati and me. Ali Velshi, Chief Business Reporter for CNN was the evening’s master of ceremonies, doing double duty with movie producer and entrepreneur James Cameron (turns out that, in fact, he IS king of the world). Cameron, an X Prize Trustee, said that “most of humanity’s challenges can be solved by small teams using new technologies,” and that we are entering a “new golden age of exploration” in which “ideas that could once only be done by government” can be realized by regular people given the right incentives. In fact, hanging prominently in the room where the various current and past X Prize challenges were displayed before the gala dinner began was a sign that really got my attention, “You are what you incentivize.”
That is a very interesting thought. It implies that it takes eye-popping financial incentives and somewhat dramatic gestures to spur real breakthrough innovation and that, conversely, without such incentives, profound innovation is unlikely. Let that settle in for a moment, as it is a slightly worrisome thought, at least to me. Considering the unbelievable amount of money that is already spent to spur research and development of new ideas through government, universities, industry and my own field, venture capital, it is interesting to think that it may take a game show approach to get truly profound innovation. Ladies and Gentlemen, come on down! You can be the next contestant on The Price is Right if you change the world for the better!
Those of us who have kids are constantly trying to stay “above” the bribery thing, hoping our kids will do what we tell them to do without a financial pay-off. Yet lets be honest, almost all of us succumb to the act of paying the little weasels in cash or TV time or whatever currency moves them to do things they should do just to make us happy (yeah, right). The idea behind the X Prize and many of these other cash-prize contests is, in some way, right up this alley. Yes, some innovation can and will happen on its own, but if you slap $10 million bucks on the table and a short list of seemingly impossible requirements, innovation will show up faster and better and with a cherry on top. Son of a bitch, it seems to work.
The X Prize event, which was really a lot of fun (and I had a table of great companions), got me thinking hard about the recent upsurge I have seen in challenges and prize competitions and the like in the healthcare field. Clearly the healthcare field is broken to the point of disaster and legions industry veterans have done little to fix that. It isn’t hard to understand that those who have always done things a certain way are somewhat hamstrung by the fact that they benefit greatly from keeping things the way they are, even if it does not serve the greater good. Their incentive, for better or for worse, is to keep the status quo even if it is everyone’s ultimate undoing.
Charging into the void has been a mounting series of cash-prize competitions sponsored by the government, private industry and a variety of nonprofit entities, including the X Prize Foundation. A couple of examples:
- The Office of the National Coordinator for Health Information Technology (ONC) within the Department of Health and Human Services (HHS) has committed nearly $5 million in U.S. government funds to its Investing in Innovation (i2) program, which was formed under the American Competes Reauthorization Act of 2010. The Act authorizes federal agencies to create challenges to further innovation and about 30 such challenges with prize money are in the works. The competitions focus on innovations that support widespread Health IT adoption and meaningful use, ONC’s and HHS’ programs and programmatic goals, and systems that improve quality, safety, and/or efficiency of health care. The I2 Program is being administered by Health 2.0, which also administers a number of similar healthcare IT prize programs for other organizations (fyi, I’m on the advisory board for the I2 Program). Notably, NASA and the Defense Department have formed challenges similar to ONC.
- Heritage Provider Network, a network of doctors and medical groups in California, is touting its answer to health-care innovation: a $3 million prize to the person who can derive an algorithm to can identify patients who will be admitted to a hospital within the next year, using historical claims data in order to prevent unnecessary re-admissions.
- The Center for the Integration of Medicine and Technology (CIMIT) has announced their Fourth Annual CIMIT Prize for Primary Healthcare, sponsored by the Gelfand Family Charitable Trust, a $400,000 competition for engineering students to help foster solutions that improve access to medical care, leverage the skill of caregivers, automate routine tasks, increase workflow efficiency, support patients managing chronic disease, increase compliance with care protocols, reduce medical error, or augment the physician-patient relationship.
- Back to the X Prize, they have some pretty amazing activities in process. Medco has sponsored the $10 million Archon Genomics prize that will be won by the team that can sequence 100 human genomes in then days for less than $10,000 per sample. Other prizes are actively in the works to incentivize dramatic advances in the field of predicting/treating Alzheimer’s (Biogen IDEC to sponsor) and to build a mobile diagnostic tool for consumers, ideally around a smart phone, that will be capable of accurately diagnosing at least 15 diseases without the intervention of a doctor (Qualcomm is working on this one). Qualcomm told me that their concept, to be named the Tricorder Challenge, is to make the consumer the CEO of their own healthcare. What a great concept. It is worth noting that a kid-oriented healthcare X Prize competitiongot a troop of 12-year old Girl Scouts $20,000 for inventing a biomedical device that allows children with disfigured hands to write with a pencil or pen just like their friends. You go girl scouts.
This is by no means a complete list of the prizes being offered for people who can come up with dramatic breakthroughs to advance a healthier healthcare system. If you can wrap a game around it and attach a nice cash prize, you too can spur innovation and engagement. And yes, while it makes me somewhat uneasy to think that it’s always the financial incentives that get people motivated to make a difference, I think it is rapidly becoming my final answer.
While not quite the same, I lived a recent example of this gamification (aack, I hate that word) thing; I got to serve as “the bachelorette” at San Diego Venture Group’s recent breakfast event, entitled The Dating Game: Who Can Best Transform Healthcare, where I got to ask questions of 3 entrepreneurs hidden behind a partition in order to determine which one got to win a “date” with me to pitch their business based on which idea had the most potential. Yeah, I know what you’re thinking: second prize is two dates with me. It was a really fun event with around 250 people in the audience, no doubt interested because we just love our game shows and the usual format for such events, a bunch of talking heads on a panel, is oh so yesterday. The only thing missing was the groovy Dating Game music. Note: if you are too young to remember the Dating Game then I do not want to hear from you.
Circling back to the X Prize benefit event, the presentation that really grabbed my attention was the one about the recently awarded Wendy Schmidt Oil Cleanup X Challenge. In this challenge, $1 million was up for grabs for the team able to build a new device capable of massively increasing (by at least 2x) the ability to extract oil from seawater after a spill.
While the third prize winner of this challenge was–and I swear this is true–a bunch of guys from a tattoo parlor that were able to just about hit that 2x mark with their invention, the big winner was Team Elastec, which is comprised of workers from an existing manufacturer of oil spill equipment. They were able to come up with a machine that performed at 4x the industry best, sucking up oil like breadsticks at an Olive Garden. That is pretty awesome, particularly given what happened in the oceans outside Louisiana and Mississippi earlier this year, but it made me wonder why these guys, who are already paid to do exactly the task of building oil clean-up equipment, hadn’t innovated to this level as part of their regular jobs. I find it fascinating that it took the X Prize, with its goal to do something the industry veterans thought impossible (hit that 2x improvement mark) in order to get this company to rise to and even blow out, the challenge. Shouldn’t they have been doing that anyway to keep their company ahead of the pack? What does this say about American corporate ingenuity?
I think it is this particular example that gave me the most pause in thinking about how much we love our games and need to have the gauntlet thrown down to take on the impossible. We are going to have to figure out how to put some of that drive into our regular every day culture to stay at the top of the innovation food chain. There isn’t always $10 million lying around to foster innovation and it worries me to think that every great breakthrough might have to have a contest attached to it. Another question I have, particularly as I have seen what has come out of some of the healthcare challenges that have already occurred, is whether they spur great businesses or just great technologies. Technology is often critical to the making of a great business, but it isn’t enough. There has to be a market willing to buy and a plan to execute. Virtually none of the healthcare challenges I have seen put any value on these latter issues.
Don’t get me wrong, I think that the philosophy behind the X Prize and other challenges is really intriguing: by challenging people to do what is believed impossible you make it possible. Certainly the results they and others like them have inspired would suggest they are on to something very real. It would just be great if that drive to reach unparalleled heights of innovation could come from within some of the time and not from the chance to beat out some other guy to get there. Competition can definitely be healthy, but it just feels odd to me to think that is the only way to get big things done. And if competition leads to great research, but not great opportunity to spread an idea far and wide through great business execution, it will be for naught. It would be great to see some of those business-related criteria wrapped into the judging mix.
Anyway, I think the best part of the X Prize benefit evening (other than the fact that I won 4 VIP tickets to see Wheel of Fortune being filmed—I swear this is true and God I love irony), was a poetry slam performance by Sekou Andrews and Steven Connell, who call themselves “motivational poets.” They sang/spoke/rapped with unbelievable enthusiasm and skill and got a standing ovation for their piece which was a story about a kid who was told it was impossible to fly so he climbs to the top of a jungle gym in the park and leaps off. Yeah, he gets a bit clobbered when he hits the ground, but the punch line was, “hey, I flew didn’t I?” Among the memorable lines from this awesome performance were, “It’s my world to change, I don’t need you to let me,” and an admonition to anyone who is told the words “you can’t” to respond with the words, “wanna bet?!” You gotta love that spirit, even if it does come in the form of a question, Jeopardy-style.
By the way, Sekou Andrews and Steven Connell are amazing and it’s worth watching something by them. The piece they did at the X Prize benefit this week isn’t yet online, but here is a sample of one of their shorter works called America Calls.