Solving the Opioid Crisis through Crowdsourcing Contests: HHS’s Opioid Code-a-Thon
Why did the Department of Health and Human Services host a two-day Code-A-Thon focused on the opioid crisis? What role does crowdsourcing play in government agencies?
Every day more than 130 people die from opioid-related drug overdoses in the US; to combat this, the Department of Health and Human Services (HHS) officially signed a Public Health Emergency (October 2017) and sought out new ideas for how to address the epidemic .
HHS embraced open innovation and hosted a two-day Opioid Code-a-Thon in December 2017, bringing together more than 300 computer programmers, public health experts, data scientists, researchers, and innovators to develop data-driven solutions for one of three categories – Treatment, Usage, and Prevention – using a combination of federal, state, and private datasets that had never before been made public . Teams had 24 hours to prototype and develop solutions; 50 teams competed, with 9 selected for the final judging round, and three winners awarded $10,000 in prizes . See below for complete contest details and winners.
HHS Chief Technology Officer Bruce Greenstein emphasized the importance for crowdsourcing ideas via the Opioid Code-A-Thon because it enabled HHS to “multiply our combined skills and resources to combat the opioid epidemic… and create a community that will continue to use data and technology to develop new solutions” .
Government agencies have a history of embracing crowdsourcing to solve big problems, and incentivized open competition has become a standard tool for agencies to tackle a variety of technical, scientific, and creative issues. Agencies, like HHS, embrace challenges (crowdsourced idea competitions) because they generate “high-value solutions to complex problems through large-scale and diverse independent experimentation” . Challenges and prize competitions enable the government to establish ambitious goals and pay only for solutions, without having to preemptively predict which team or approach is likely to succeed. Most importantly, prize competitions attract teams outside the norm, increasing the number of solvers tackling a problem, helping to bring out-of-discipline perspectives, and identifying novel approaches without great risk or cost to taxpayer dollars.
To grow the number of participants in government-sponsored challenges (like the Opioid Code-a-Thon), the US supports Challenge.gov, a central repository website for agencies to post and manage crowdsourcing competitions . The US also has a variety of regulations which designate in which capacity federal agencies can host challenges (e.g., the American Innovation and Competitiveness Act of 2017 – currently under review as the American Innovation Act of 2018), as well as special contracting vehicles which support agencies launching, managing, and marketing prize competitions [6, 7]. In the future, US agencies will have to continually review and update these regulations and contracting vehicles to enable and incentivize open innovation, while also continue to grow promotion and attraction of the competitions so that diversity of thought continues.
One question I have for HHS (and other agencies) is how can agencies imbibe this culture of open innovation that is currently centered in one-time or one-off competitions more deeply into the day-to-day culture? The key takeaway from the Opioid Code-a-Thon was not the three winning ideas, but the data set developed for the competition. HHS was able to make public de-identified data from HHS, federal, state, and local government, as well as private industry, which enabled the teams to come up with ideas and new innovative solutions. Is it possible to make more information like this available and develop structures to promote innovative teaming inside and outside HHS more readily so this level of innovation can continue to spread?
We’ve already seen other organizations following the path of HHS’s Opioid Code-a-Thon and using this, and other, data sets to drive innovation and solutions. The University of California Institute for Prediction Technology announced their own Opioid West Hack-A-Thon+ (sponsored by HHS) to further develop new approaches to solving the opioid crisis . The FDA is currently hosting the “Innovation Challenge: Devices to Prevent and Treat Opioid Use Disorder” to increase the development of medical devices to support this space . Can HHS spread this information more broadly and make this a consistent activity?
Another question I have for HHS (and about crowdsourcing contests more broadly) is about the potential reach of the “open call” for solutions from teams. Most people in the US do not know about Challenge.gov or about these open innovation contests. How do we ensure that engagement in these competitions is not limited to interest groups or the traditional teams of researchers? How can we engage and attract broader networks of people with innovative ideas to contribute?
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HHS Opioid Code-a-Thon Overview (from the website):
Treatment Track: In addressing the opioid epidemic, HHS is focused on improving access to treatment and recovery services and promoting evidence-based approaches to reduce opioid overdoses, overdose-related mortality, and the prevalence of opioid use disorder.
- How can you help federal, state, and local stakeholders improve access to effective treatment and recovery services?
- Winner: The Visionist Inc. team came up with a program called Take Back America, to assess the unmet need in five states for takeback programs at pharmacies where unused or unneeded opioids can be returned, therefore taking a source of opioids out of circulation.
Usage Track: One of HHS’s key priorities in responding to the opioid epidemic is to strengthen its understanding of the epidemic through better public health data and reporting. A critical element of this understanding relates to knowing who is at risk for opioid misuse or abuse.
- How can you help federal, state, and local stakeholders identify at-risk populations and their underlying risk characteristics of opioid misuse or abuse?
- Winner: The Origami Innovations team, from New Haven, Connecticut, produced a model designed for real-time tracking of overdoses, allowing first responders and health authorities to be prepared for tracking events such as an outbreak of fentanyl overdoses in communities. This real time tracking would enable area hospitals and local health departments to allocate resources where they are most needed.
Prevention Track: HHS and public health officials across the country are committed to ensuring preventative resources and overdose-reversing drugs are made available to the public. To adequately supply and position resources, federal, state, and local stakeholders are faced with the complex challenge of predicting and identifying the supply of the full range of opioids contributing to the crisis.
- How can you help federal, state, and local stakeholders predict and analyze the supply and movement of legal and illicit opioids?
- Winner: The Opioid Prescriber Awareness Tool (OPAT) team borrowed from military aviation to create an instrument panel providing clinicians with a visual representation of their opioid prescribing patterns compared with those of their peers. The tool also informs the referral process and provides easy access to contact information for multi-modal pain and addiction treatment options in the prescriber’s area.
 “What Is The U.S. Opioid Epidemic?”. 2018. HHS.Gov. https://www.hhs.gov/opioids/about-the-epidemic/index.html.
 “HHS Opioid Code-A-Thon”. 2017. HHS.Gov. https://www.hhs.gov/challenges/code-a-thon/index.html.
 “HHS Announces The Winners Of The HHS Opioid Code-A-Thon”. 2017. HHS.Gov. https://www.hhs.gov/about/news/2017/12/08/hhs-announces-winners-hhs-opioid-code-thon.html.
 K. Boudreau and K. Lakhani. Using the crowd as an innovation partner. Harvard Business Review 91, no. 4 (April 2013): 61–69.
 “Challenge.Gov”. 2018. Ideascale. https://challenge.gov/a/buzz/challenge.
 “President Signs American Innovation And Competitiveness Act Into Law”. 2017. Committee On Science, Space, And Technology. https://science.house.gov/news/press-releases/president-signs-american-innovation-and-competitiveness-act-law.
 H.R.6756 – 115Th Congress (2017-2018): American Innovation Act Of 2018″. 2018. Congress.Gov. https://www.congress.gov/bill/115th-congress/house-bill/6756.
 Lab, HHS. 2017. “24 Hours To Change The Future Of Opioid Addiction – The HHS IDEA Lab”. Hhs.Gov. https://www.hhs.gov/idealab/2018/10/12/24-hours-to-change-the-future-of-opioid-addiction/.
 “FDA Innovation Challenge: Devices To Prevent And Treat Opioid Use Disorder”. 2018. Fda.Gov. https://www.fda.gov/aboutfda/centersoffices/officeofmedicalproductsandtobacco/cdrh/cdrhinnovation/ucm609082.htm.
Student comments on Solving the Opioid Crisis through Crowdsourcing Contests: HHS’s Opioid Code-a-Thon
You bring up an excellent point around the one off nature of these challenges and the need to bring it into day-to-day culture. In just two days, these three winning ideas and many others were developed in an attempt to combat one of the biggest public health crises in the U.S. By bringing together this diverse group of people, this crowd sourced challenge was able to create tangible actions to help solve this deadly problem. But why does this type of success have to happen so infrequently? Can we not change this model to focus on continuous process improvement? Instead of implementing deadlines and announcing winners, why not focus on providing incentives for all ideas judged worthy of being pursued? A sliding incentive scale can be implemented based on the quality of idea. People could also contribute by building off previous “winners” in attempt to further improve those ideas.
CMS actually uses a continuous crowd sourced approach for healthcare innovation (although I don’t think they’ve been very successful). I don’t think the CMS innovation center provides incentives but they allow anyone to submit their ideas for how to improve the health care system on a continuous basis. Maybe through combining some of these methods we can see some progress on these issues.
Really cool concept. Do you know if any of the businesses that were thought of continued on afterwards? Because this is a space that truly needs some innovative thinking and adjustments in order for it to truly help the sick and suffering in the addiction community.
Very interesting ideas, and such a fundamental problem for our healthcare system. I would argue that the U.S. government already has a framework for crowdsourcing solutions to problems like this – they do it all the time in military procurement as well as some civilian agencies. The military routinely puts out specifications for the function of the technology that it would like to procure and then solicits bids for many different approaches.
This structure is increasingly being applied to social problems like the opioid epidemic with something called a “social impact bond” where the government agrees to pay a fixed price for a given social outcome.
Interesting approach for addressing the opioid epidemic–at this point, I think any thought applied to the problem is helpful. But I always wonder, how often do solutions developed during a hack-a-thon actually come to fruition / market? I have a hard time believing that solutions developed over such a short time span can really address the complexity of such a tough issue. Is the HHS just paying lip service here, or do they really expect to make a dent in public health outcomes?
Truly fascinating use of crowdsourcing… I wish the fact that the government is using crowdsourcing in an attempt to solve major problems was more widely acknowledged and understood. As someone who has worked for the US Government for 12 years, I had never heard of challenge.gov until reading this! Much like the White House petitions website, I fear that knowledge of such a website is very limited, despite its great potential. Are major challenges our society faces losing out on potential solutions because of poor marketing?
I agree that the government and other agencies need to find a way to embed innovation within their day to day culture. Challenges like these are interesting and good publicity but don’t have the power to truly make a dent in the problem they are trying to tackle. Outsiders rarely have the perspective and understanding of the barriers at hand and therefore give solutions/recommendations that may be good in theory but aren’t practical. For instance, government programs require buy in and approval from multiple stakeholders and agencies. External innovators are rarely aware of these challenges. In reality, governments should hold challenges and elicit ideas on how to change their internal culture and practices. Transforming an agency from within is going to greater tangible impact than trying to find innovative solutions to one off problems.
Great topic! In most countries, government is in urgent need of innovation but their culture / systems do not really allow for innovation. I see tside’s point on these solutions not being actionable because if the limited time. I also understand tomchallenge’s point on these strategies not being sustainable but the government actually needing a change in culture. I think changing the culture and dynamics of government agencies, although necessary, is something that will take time. In my opinion, this type of code-a-thon initiatives would benefit of requiring each team to have at least one person that actually works in the government agency that is hosting the code-a-thon. This way, you increase the probability that the solutions provided are actionable and also the government agency can learn from the process to innovation and solution creation and communicate those findings to their day-to-day jobs in the government.
I really like the approach the government is taking to tackling such an important issue in our society. The opioid crisis is one that is affecting so many people in the United States and threatens to destabilize our country. The more hands on this issue we can have the better and bringing in different perspectives should lead to novel solutions. However, I share the same concern that many people have brought up in that I’m not sure that a hack-a-thon will necessarily bring the most long term solution to the problem, as the issue is extremely complex and adoption of an idea would take significant investment and time.
Super interesting! Thanks for bringing this topic up. I also think they should hold these events more often on a broader set of topics to encourage and drive innovation. One of my concerns is how they ensure they’re giving people the right amount of credit and exposure, particularly for people who don’t win but perhaps their idea was the foundation upon which someone else created or thought of something else.
This was a fascinating read! I agree with you about the need to embed this in the day-to-day culture to come up with implementable, long-term solutions. Crowdsourcing is an excellent way to tease out interdisciplinary ideas and skillsets, but I think HHS could find a way to bring more structured, continuous problem solving to it. Even having a team stick around to pilot an idea, see what works and doesn’t, apply some kaizen principles, and iterate for an improved version could go a long way. Incorporating opioid-addicted patients (willing to participate) into the process improvement stage could be valuable as well. Coders might think they have a solid grasp of the problem, but with limited knowledge about the sobering realities of the factors surrounding this health crisis, they may attach overly simplifying assumptions to their solutions.