When the pandemic hit, we needed both grassroots and industrial-strength data platforms to effectively respond to the crisis. I have written about scrappy, patient-led data innovation. Today I want to share a broader view, thanks to a conversation I recently had with Tim Paydos, Vice President & General Manager of IBM Government. (I’m proud to disclose that IBM is a client.)
Tim and I talked about how large organizations and governments play a role in, as he put it, “orchestrating the ecosystem” – pulling together existing teams and capabilities to respond to a challenge. One of the advantages of having a wide-ranging portfolio, whether you sit atop a government agency or multinational corporation, is to be able to bring together diverse talent and to repurpose existing tools. For example, IBM built their vaccine management network on top of an existing blockchain framework originally developed to track cargo shipping containers.
Tim and I talked about how digital reinvention and the importance of data has been discussed for many years at the federal level, but because of COVID, leaders recognized that they had to move quickly. This was no time for small-scale experimentation. As Tim put it, “Vaccine management is the data puzzle of our time.” He described the complex supply chain requiring the linkage of an object (one bottle of vaccine) to five or six individuals, depending on how many doses can be eked out of that one container. And, as he pointed out, “this is happening at a critical time in our society when it comes to trust in our institutions and in government.”
At full strength, IBM was able to assemble teams with expertise ranging from blockchain, cloud, supply-chain management, case management, design, human resources, equity and inclusion, telephony, and AI.
“IBM has been preparing for this, unknowingly, for years,” Tim said, pointing out that they invested in technology that, six years ago, sounded almost outlandishly futuristic, not knowing that these capabilities would be essential. His direction to the team was straightforward: “Whatever we bring to the clients has to work, right now, today, and it has be industrial strength and in production. It’s got to be tested and ready to go.”
I was particularly intrigued by the challenge of creating a platform that could be used in a wide range of settings, from rural to urban, from local to state to national. Staying close to the customer is a lesson that I brought to improving service delivery at the U.S. Department of Health and Human Services. I heard that ethos reflected in IBM’s strategy, too. They partnered with community-level organizations to better understand the local landscape, in terms of history, geography, and psychology, in order to effectively deliver vaccine.
Since I believe in the power of being a “nowist” rather than a futurist, I asked Tim for his observations about the current moment and what it could mean for longer-term trends. He talked about how quickly people realized that the pandemic presented a series of data challenges, but the speed of each stage took people by surprise. The rapid acceleration of capabilities across all industries was incredible to watch and, as Tim said, “These systems will scale down but they will not go away. Now we will be ready for the next national crisis, whether it’s wildfires, the next pandemic, or Godzilla.”
All the technical capabilities that data geeks have dreamed about have finally come of age, whether we are talking about access to tools at a national or an individual level. The pandemic pushed us forward, for better or for worse, and I’m personally grateful to know that these data systems are now in place.
Image: Close-up of doctor’s hands, vaccine, and arm, by Heather Hazzan, courtesy of the SELF x American Academy of Pediatrics Vaccine Photo Project: Medically accurate vaccination photography that anyone is welcome to use for free.
I wish there was a solution to vaccine distribution at the ground level. Here in NJ, access to vaccine depends wholly on internet connectivity and/or affiliation with either a person or institution of power. Too often, this excludes the most vulnerable most especially the elderly. I know may people who have been vaccinated and not one of them is older than me. They include a massage therapist (healthcare worker) as well as a work from home social media strategist and her family members (she’s works for a non-profit), and a college student.
But my 90 year old mother in law and my 80 year old neighbor remain unvaccinated.
Technology and blockchain are wonderful for managing the precious cargo. But if we don’t follow the vaccine all
the way through delivery, ensuring that the right (most vulnerable) people get vaccinated first, then the whole system fails.
Susannah, how can I persuade our local government to reconsider the distribution plan?
Natasha, I’m sorry to say that I’m hearing similar stories from all over. Did someone call vaccine delivery not only a “last mile” but also a “last inch” problem?
One of the questions that my conversation with Tim inspired, but we didn’t have time to dig into:
If the U.S. is a patchwork quilt of data & supply chain capabilities, where are seams coming apart most quickly?
Your question broadens the scope to public health capabilities and sadly we are seeing daily examples of our threadbare quilt. Here’s hoping we can get more vaccine into every community and make it easy for everyone to get their shots.
Now that my foolish Godzilla question on Twitter is out of the way :-/ …
I would love to see at least a partial list of the specific data challenges in this work. I’m sure it’s far beyond what I would anticipate, and it would be so great to understand.
There’s more to it than the design of the databases, of course – without coordination along the whole chain of supply and distribution, bits of vital info may not be present at point of need. Case in point: I personally am a “victim” (in the logistical sense) of a gross disconnect between VAMS (the disgraced $20M Deloitte vaccine mgmt contract) and my state government (N.H.). It’s no medical tragedy (as of today) but I signed on in the very first minute NH opened on 1/26 and registered within 15, then discovered the next day that the instructions I was then shown had been wrong, and the first available slot was March 5.
What strikes me is that it’s not like the need for a vaccine distribution system couldn’t be anticipated. I know the previous administration was opposed to federal coordination, and that’s a factor. But even if that had been run differently, I’m wondering what the data design challenges are.
I’m glad that a competent systems company like IBM is involved now! There are so many logic defects in VAMS that it’s clear that in the $20m project, nobody planned for testing of the whole system. Meanwhile we have stories like the Massachusetts programmer who built a better vaccine availability site for the state while on maternity leave https://www.macovidvaccines.com/ and Jeanne Pinder’s humble crowdsourced http://VaccineHunter.org. Perhaps such resources can be mashed up with / bolted onto IBM’s super-system for “last inch” help.
(btw, my 91 year old mom got her first dose yesterday – we’re so happy!)
Thanks, Dave, for the chance to use Godzilla GIFs on Twitter, for your insights and questions, and (most especially) for the great news that your mom got her first dose!
One of my favorite aspects of talking with Tim was the chance to hear how IBM brought together such a wide range of skill sets to address the wide range of challenges inherent to vaccine distribution. It reminded me of listening to HHS leaders draw together resources to respond to a crisis — smart people committed to solving a problem, with big levers to pull. I’m trying to think of a good image: “This is what we train for” can-do spirit of all the humans involved + that scene in The Iron Giant when he re-assembles.
The IBM site does a nice job of displaying each aspect of the vaccine management challenge but I don’t know that there’s one page or article that encompasses the full range. Maybe because they are still in the middle of deploying what they’ve built.