NIH Campus in Bethesda, MD.
At the National Institutes of Health (NIH), revolutionary ideas often come from unexpected directions — and can lead to startling innovations.
The Human Genome Project (HGP), The Visible Human Project (VHP), and the Unified Medical Language System (ULMS) are just three examples of what can happen when an organization — even a government organization — comes to embrace innovation as a core value. At NIH, innovation is not only central to the nature of its work, it has also become part of it’s DNA.
“Innovation is the engine that drives scientific achievement,” NIH Director Dr. Francis S. Collins, M.D., Ph.D. told Breaking Gov.
“As director of the National Institutes of Health, I’m proud to say that our mission — of ‘turning discoveries into health’ — is fueled by the innovative spirit that permeates this organization, from our people to our business practices to our research.”
It helps that NIH invests more than $30 billion annually in medical research. About 10% of that goes to projects that NIH’s nearly 6,000 scientists are performing.
More than 80% of it is awarded through almost 50,000 competitive grants to more than 300,000 researchers at more than 2,500 universities, medical schools, and other research institutions in every state and around the world.
Located in Bethesda, Md., NIH is comprised of 27 different components known as Institutes and Centers (ICs) that pursue their own specific research goals. Of those, 24 get funding directly from Congress and administrate their own budgets.
Innovation: Not Just Scientific Breakthroughs
When you ask innovators at NIH about innovation, you quickly learn there is much more to it than people often imagine.
For many, the letters “NIH” can conjure up a vision of a team of scientists working in high-tech labs on innovative solutions to cure cancer or map genes. But there is more to innovation than just scientific-breakthroughs.
Just as important as making discoveries is making the knowledge available to researchers and having policies and processes in place to encourage the transfer of knowledge.
“I like to think not only are we promoting and developing innovations for commercial and ultimately public health benefit, but we want to continue to be innovative in how we do that,” said Dr. Mark Rohrbaugh, director of the NIH Office of Technology Transfer. “So it’s also process innovation in terms of how we are managing things in government.”
The mission for the Office of Technology Transfer is to take the inventions made by the NIH and FDA scientists and manage those new innovative technologies in a way that moves them towards the private sector for commercial development and ultimately public benefit as new products and services, according to Dr. Rohrbaugh. Part of that mission also involves transferring research materials to further ongoing research.
The Culture of Innovation
“There are lots of stock answers about innovation and culture of innovation,” Dr. Donald A. Lindberg, M.D., director of the National Library of Medicine (NLM)http://www.nlm.nih.gov/ told Breaking Gov during a recent interview.
The mission of the National Library of Medicine is to acquire, organize and disseminate the biomedical knowledge of the world for the benefit of public health. But the accomplishing that–and doing so in innovative ways–begins by having a keen perspective for the role of people in the process.
“The truth is that people have to be respected as individuals, not just employees; have a sense of purpose of the entire organization, not just their division; not be afraid to fail; and recognize some of the things we do are inherently long term,” he said.
A prime example of a long-term project led by Dr. Lindberg is the Unified Medical Language System (UMLS).
“You have to tell a computer that heart and cardiac are the same thing,” Dr. Lindberg explained. “No one had done that before. We started this in 1984 knowing it was at least a 20 year job. Now we have a million concepts and in pretty wide use.”
Now, the UMLS links health information, medical terms, drug names, and billing codes across different computer systems. The software brings together many health and biomedical vocabularies and standards and enables interoperability between them.
One who thrives from and within NIH’s culture of innovation is Dr. Michael Ackerman, Ph.D. who led the Visible Human Project (VHP), a digital image library of anatomical cross-sections at 1 mm intervals representing the complete, normal adult male and female anatomy.
Dr. Ackerman was quick to point out that he works for some very good people that allow him to “follow his nose.”
“That’s what keeps me going. If I have a good idea that I can build the scientific, economic and political case for, then they are extremely supportive.”
“They did that with the Visible Human Project. When it started, it was a crazy idea,” he recounted. “You are going to study anatomy by creating digital images by finding a cadaver and cutting it up from head to toe? But it was an intriguing idea and I could make the case, not only to my management, but eventually to the Board of Regents, and they allowed it.”
Today, Visible Human Project data sets have been applied to a wide range of educational, diagnostic, treatment planning, virtual reality, artistic, mathematical, and industrial uses by nearly 2,000 licensees in 48 countries. Applications include data surgical simulators and iAnatomy, an iPhone and iPod touch app. Auto designers use the VHP to create virtual crash dummies when simulating crashes on computer.
Be Open To New Ideas
Innovation at NIH also come in the form of providing an enhanced service to an already existing product.
Take MedlinePlus Connect – the most frequently consulted scientific/medical database in the world–which grew from Medline Plus.
“MedlinePlus is a health information website geared towards everyday consumers,” explained Loren Frant, head of the Health Information Products Unit at NLM.
“So where MedlinePlus takes the whole internet and says ‘here’s the authoritative best stuff’,” Frant said, “MedlinePlus Connect drills it down one level further and says ‘here’s the thing from MedlinePlus that’s related to your specific health information need.’”
Dr. John J. McGowan, Ph.D. is Deputy Director for Science Management at the National Institute of Allergy and Infectious Diseases’ (NIAID). He is widely recognized for moving NIH into the digital age and improving the grants process at both the Institute and the NIH levels.
Dr. McGowan says he isn’t driven by buying sexy technology, “but how do you move organizations forward? That takes not just a technology approach, but a cultural change approach as well.”
One person who knows how is Dr. Yang Fann, Ph.D., director of the Intramural IT and Bioinformatics Program at the National Institute of Neurological Disorders and Stroke (NINDS).
He is one of those rare individuals — a scientist who is actually in charge of an IT program. Winner of the 2010 HHSInnovates Award, Dr. Fann led the development of two information management systems — POTS (Purchasing On-line Tracking System) and PTMS (Protocol Tracking and Management System) — that are now widely used by the NIH community.
“How the POTS evolved at NIH shows really remarkable things can happen in the government. And I think that’s part of the reason why we won the first Innovator’s award,” Dr. Fann noted. “It’s not because of the system automation. You can find lots of ways to do the same thing. But it is how you take a solution from one institute to the 27 institutes and get them to use the identical system without having to reinvent the wheel. So that is really remarkable. At least it is to me.”
Process Innovation Is Everywhere At NIH
Scientists tracking purchases on POTS are benefiting from the innovative work being done in the NIH Office of Acquisition Management and Policy.
That’s where procurement analyst Tish Best and her colleagues write the polices and craft language used in solicitations and contracting documents. Then through the Document Generation System (DGS), a web-based system used to generate contract and solicitation documents, they make them available to the entire NIH community. The DGS is primarily for negotiated contracts for R&D and support services.
“So it’s a win-win for all the institutes,” proclaimed Best. “We have our contracting documents standardized. They also allow the contracting community to have a baseline from which to start.”
At the National Center for Advancing Translational Sciences (NCATS), Lili Portilla, the director of the Office of Strategic Alliances, runs the Transfer Agreement Dashboard (TAD). TAD streamlines the transfer of NIH-developed research materials to the biomedical research community.
“If I can find an electronic way of capturing all this information and do it efficiently, then it lessens the paper burden and the transactional cost on the Tech Transfer Office and the Institute,” explained Portilla. “But what it also does is get the material in the hands of the Investigator in a more efficient manner so that they can go on with the research.”
Take Time To Think
For anyone who has already had a non-virtual colonoscopy, the work of Dr. Ronald Summers, M.D., Ph.D., Senior Investigator at Clinical Image Processing Service in the NIH Clinical Center is welcome news.
Dr. Summers pioneered the virtual colonoscopy. “What I’m trying to do is develop alternatives that that might be just as effective at preventing cancer of the colon, he said during a recent interview. In order to do that Dr. Summer sets aside the one precious commodity necessary for innovation – time to think.
“We have an internal newsletter called the NIH catalyst. There was an article about someone whose day was occupied by constant action. Responding to emails and always on the move and never having time to think and valuable having that time was,” he said. “There’s nothing better than taking time to think once in a while, and I actually do put on my schedule, I block out some time every week to have a chance to think and contemplate what I am doing. And that’s often when I come up with my best ideas.”
What all of these doctors, scientists, and specialist reaffirm about innovation is that you can plan for it; but it also it can come from unexpected sources.
At NIH, it’s clear that building and providing a culture to take advantage of both has yielded monumental accomplishments.
For those who work for and with NIH, innovation also about more than discoveries or breakthoughs; it starts with having an open mind to new ideas, processes and technology, then doing just what the NIH watchwords say — turn discovery into health.