The US opioid epidemic has rapidly evolved into one of the most significant national health crises in recent history. The US Department of Health and Human Services (HHS) estimates that opioid overdose contributed to over 49,000 deaths in 2017, a nearly 250% increase from 2010 (see figure 1)1. Positively, preliminary data from the US Centers for Disease Control and Prevention (CDC) suggest that opioid-related deaths have declined three percent from September 2017 to March 20182.
HHS: Open for Innovation
Despite the apparent slowing of opioid-related deaths, much work remains. In addition to the SUPPORT for Patients and Communities Act (signed into law in October 2018)3 and an extensive list of private-sector partnerships to help deliver solutions to address the opioid crisis4, HHS has announced a five-point strategy to combat the crisis (see figure 2)5. Given the unique challenges of the opioid crisis – including flight to illicit drugs as prescriptions are curtailed and significant under-diagnosis and underreporting of opioid use – HHS is looking to open innovation to help address the challenges ahead6.
Fortunately for HHS, it is not the first organization to apply open innovation outside of Wikipedia, iOS, or Linux. Chesbrough and Crowther (2006) find that while open innovation has historically been reserved for high-technology industries, firms in other industries are increasingly – and successfully – employing such approaches to solve their own business challenges7. Further, HHS is not the first government agency to consider innovation tournaments: in 2010, President Obama launched Challenge.gov, a federal prize competition platform that awarded more than $150 million from 2010 to 20158. If open innovation works for non-high-technology businesses and the Obama White House, why not HHS?
Code-a-Thons: Exploit, Don’t Explore
In December 2017, HHS held its first Opioid Code-a-Thon. The event was structured as an innovation tournament, with 50 teams competing for a $10,000 prize in each of the three challenge tracks: treatment, usage, and prevention.9 Examples of winning submissions include Telesphora (treatment), which allows real-time tracking of opioid overdoses, and Visionist (prevention), which introduced “Take Back America,” a live-updating map of pharmacies where patients can return unused opioids10,11.
What was HHS hoping to accomplish with the Code-a-Thon? King and Lakhani (2013) provide a helpful matrix to evaluate innovation approaches (see figure 3). HHS’s Code-a-Thon falls into the “innovation tournament” category, comprising externally-generated ideas that are internally selected.12 This categorization provides valuable insight into HHS’s goals for its open innovation initiative: while HHS is eager to source ideas from external partners, it wants to select ideas that fit with its existing 5-point strategy.
Put differently, HHS used the 2017 Code-a-Thon to exploit resources to move incrementally along the innovation landscape in the short term. It remains to be seen whether HHS’s medium-term goals include more exploitation (i.e., more products like Telesphora and Take Back America), a shift to exploration (larger, more transformational jumps), or some combination of the two.
Increasing the Role of Open Innovation
In the short term, HHS’s decision to leverage innovation tournaments to solve specific problems will continue to generate valuable new ideas to address the opioid crisis. Depending on the efficacy of the initial Hack-a-Thon ideas, HHS should continue to pursue such exploitative innovation tournaments where applicable. Better data (see figure 2) appears to be a natural area where HHS could expand its innovation efforts, potentially incorporating novel data sets such as cell phone geolocation data.
In the medium term, however, HHS should reevaluate its approach. Brendan Saloner, a professor at John Hopkins’ Bloomberg School of Public Health, appropriately notes that “we’re not going to code our way out of this problem”13. Saloner’s assertion recalls King and Lakhani’s matrix: innovation tournaments will spur new ideas, but only ideas that align with a pre-determined approach to addressing the opioid crisis. To harness the true power of open innovation, HHS should endeavor to create a community where ideas are both contributed and selected by external parties. This approach will enable those closest to the crisis – first responders, nurses, physicians, and others – to act on those ideas that they know will drive the greatest change, creating the possibility of exploration on the innovation landscape instead of just exploitation. While HHS undoubtedly incorporates perspectives from these on-the-ground stakeholders today, creating an open innovation environment that encourages open collaboration between idea generators and idea selectors will maximize the value of open innovation to combat the opioid crisis.
Questions for Further Discussion
Should HHS transition open innovation to address the opioid crisis from innovation tournaments to an open community with external idea generation and idea selection? Why or why not?
How does the high-stakes nature of the opioid crisis change the role that open innovation plays in addressing this unique challenge?
- National Institute on Drug Abuse. “National Overdose Deaths—Number of Deaths Involving Opioid Drugs,” https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates, accessed November 2018.
- Centers for Disease Control and Prevention. “Provisional Drug Overdose Death Counts,” https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm, accessed November 2018.
- SUPPORT for Patients and Communities Act, HR 6, 115th Cong. (October 24, 2018), https://www.congress.gov/bill/115th-congress/house-bill/6, accessed November 2028.
- The White House. “A Year of Historic Action to Combat the Opioid Crisis,” https://www.whitehouse.gov/articles/year-historic-action-combat-opioid-crisis/, accessed November 2018.
- US Department of Health and Human Services. “5-Point Strategy To Combat the Opioid Crisis,” https://www.hhs.gov/opioids/about-the-epidemic/hhs-response/index.html, accessed November 2018.
- Sarun Charumilind, MD et al., “Why we need bolder action to combat the opioid epidemic,” McKinsey & Company, September 2018, https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/why-we-need-bolder-action-to-combat-the-opioid-epidemic, accessed November 2018.
- Henry Chesbrough and Adrienne Kardon Crowther, “Beyond high tech: early adopters of open innovation in other industries,” R&D Management 36, 3 (2006): 229-236.
- The Obama White House. “Prizes and Challenges,” https://obamawhitehouse.archives.gov/administration/eop/sicp/initiatives/prizes-challenges, accessed November 2018.
- US Department of Health and Human Services. “HHS Opioid Code-a-Thon,” https://www.hhs.gov/challenges/code-a-thon/index.html, accessed November 2018.
- https://telesphora.com/, accessed November 2018.
- Visionist, Inc. “Take Back America,” http://takeback.labs.visionistinc.com/, accessed November 2018.
- Andrew King and Karim R. Lakhani, “Using Open Innovation to Identify the Best Ideas,” MIT Sloan Management Review 55, No. 1 (Fall 2013): 41-48.
- Issie Lapowsky, “Tech Alone Can’t Solve the Opioid Crisis,” Wired, December 21, 2017, https://www.wired.com/story/opioid-crisis-hackathon-tech-health-care-funding/, accessed November 2018.