---
id: "workshop:private-innovation-in-the-public-interest-turning-problems-into-opportunities-for-corporate-engagement"
type: "InnovateUS workshop"
title: "Private Innovation in the Public Interest: Turning Problems into Opportunities for Corporate Engagement"
url: "https://innovate-us.org/private-innovation-in-the-public-interest-turning-problems-into-opportunities-for-corporate-engagement"
date: "2024-09-18"
duration: "60 minutes"
language: "English"
instructors: ["Anita McGahan"]
recording: "https://www.youtube.com/watch?v=jthRNUiybx0"
transcript: "automatic, from the recording"
source: "InnovateUS (innovate-us.org)"
licence: "CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0/), as stated on innovate-us.org"
---

# Private Innovation in the Public Interest: Turning Problems into Opportunities for Corporate Engagement

InnovateUS workshop · 18 September 2024 · 60 minutes

Join us for a three-part series on private innovation in the public interest led by Anita McGahan, Senior Research Scientist at the Burnes Center for Social Change at Northeastern University. The series will delve into the opportunities, problems, triumphs, and disasters that can arise when the private sector engages with public agencies to pursue the public interest. In this 60-minute virtual workshop, participants will learn how to build alignment with the private sector, break down problems into actionable initiatives, and build the capabilities to align organizations and interests. The workshop will discuss how to achieve early wins and measure long-term outcomes with corporate engagement.

## Learning goals

- Learn about private innovation in the public interest in a three-part series that will delve into the opportunities, problems, triumphs, and disasters that can arise when the private sector engages with public agencies to pursue the public interest
- Learn how to build alignment with the private sector, break down problems into actionable initiatives, and build the capabilities to align organizations and interests
- Discuss how to achieve early wins and measure long-term outcomes with corporate engagement

## Speakers

- **Anita McGahan**, Senior Research Scientist, The Burnes Center for Social Change

Recording: https://www.youtube.com/watch?v=jthRNUiybx0

## Transcript

Automatic transcript of the recording: names and terms can be misheard, and the times can be a few seconds off. Each time links to that moment of the video. The transcript alone: https://innovate-us.org/private-innovation-in-the-public-interest-turning-problems-into-opportunities-for-corporate-engagement.txt (plain text) and https://innovate-us.org/private-innovation-in-the-public-interest-turning-problems-into-opportunities-for-corporate-engagement.json (every segment with its start and end second).

**Unknown speaker**

[0:01](https://youtu.be/jthRNUiybx0?t=1) And turn it over to you, Anita.

**Anita McGahan**

[0:04](https://youtu.be/jthRNUiybx0?t=4) Thank you, Hannah, and good luck on everything that you're doing and on all this incredible innovation that you've done here in this program. It's been a phenomenal success and all to your credit. So thank you for everything. Well, good. Well, welcome, everyone. I wanted to just introduce our session today by reminding you that our broad agenda is on getting important things done in the public sector. And this almost always means tapping private money and resources somehow for capabilities, for skills, for experimentation, for permission to fail. We almost always work in the context of collaboration across sectors. Last time when we were together, we talked about several different projects. We were thinking about public agencies trying to engage with private companies in a very specific way, which was in pursuit of innovation initiatives.

[1:05](https://youtu.be/jthRNUiybx0?t=65) We introduced a five-part approach and contextualized that with examples. We talked about a disaster here in Toronto and a triumph in Tulsa, Oklahoma, in implementing these five different stages of joint work. So first, coming up with a compelling aspiration. The second, doing stakeholder analysis and really thinking about who we're creating value for. The third piece was talking about achieving and demonstrating excellence. The fourth part was about getting the resources you need. And then, of course, the fifth part was trying to sustain the thing that you might have succeeded at. Our agenda for today is to work on the first elements of that cascade of approach. Today, we're going to take a deep dive in how to begin. How do you begin to try to take on an innovation agenda and get organized for that?

[2:05](https://youtu.be/jthRNUiybx0?t=125) Next time, we'll be thinking about how to sustain it. Our focus right now is going to be on how do we turn problems into opportunities? How do we actually get going on this? To get started, I wanted to ask you to answer a pop quiz question. Here's the pop quiz, and I'm hoping people will put their answers into the chat. The question I want you to answer is to name ten things that are in your space right now. Almost all of you are working in the public sector as public servants. Name ten things in your space right now that are provided by companies. Can you please just throw those into the chat that surround you? Hannah, you can participate in this. I've got cloud infrastructure for sure.

[3:05](https://youtu.be/jthRNUiybx0?t=185) Matthew, I would say the computer itself is probably produced by the private sector. Tawana has written water, flights. Andrea is probably on a plane. Water bottles, headphones, pens, notebooks, computers, computer monitors. Absolutely. There are so many things that you could never list them all. The stapler, the SaaS solution, the support. It's an unbelievable number of things, right? You are completely dependent on stuff that's provided by the private sector in your work. We've got furniture, glasses, the lamp, the phone, the frame, the cell service, pencils, mugs, laptops, money itself, water, electricity. The building that you're sitting in might be provided by a ______. It's too broad a question that I've asked. The engagement of the public sector with the private sector is pervasive.

[4:05](https://youtu.be/jthRNUiybx0?t=245) That's the point that I wanted to put before us. Let me get more specific. Can you put into the chat the name of a problem that you're working on right now that was caused by a company or at least in part by a company? For example, this morning, I was working on a project we're doing here in Toronto on transportation systems. We've outsourced the production of some equipment in the city of Toronto to a private contractor, and the quality of that equipment is not up to snuff. So now we've got this big problem, which is we don't have equipment that we need to actually work on and improve the light rail that we're trying to extend. That's a problem that was caused in the private sector. What about you? What about you? What are you working on that you could say you had a problem that was caused by, at least in part, by a failure of performance from the private sector, somebody in the private sector?

[5:07](https://youtu.be/jthRNUiybx0?t=307) A big berth of digger in Seattle. That's very similar to, you know, in its substance to the problem we're having here in Toronto with the equipment not working. What else? I bet you've got a lot of them. There are a lot of problems around us that were caused by companies. Stuff is too expensive. Stuff is too hard to get. Stuff is not available as widely as you need. Let's hear what you're working on. Problems that are caused, at least in part, by companies. Housing shortages. I'm going to cold call people if you don't write stuff in. It's the prerogative of a college professor.

[6:07](https://youtu.be/jthRNUiybx0?t=367) What about you, Hannah? Can you think of anything?

**Unknown speaker**

[6:11](https://youtu.be/jthRNUiybx0?t=371) Well, actually Innovate US serves to fill a spot that was kind of neglected by the private sector, which is training public professionals.

**Anita McGahan**

[6:19](https://youtu.be/jthRNUiybx0?t=379) Yeah. We've got apps that were built with flaws. We've got being priced out of housing. We've got traffic problems because of back-to-work orders. We've got network congestion and network traffic. Solutions not delivered on time. Not functioning properly. You get the point that I want to make, of course, which is that this idea of the public and private sectors being very separate is really not an accurate representation of the ways in which the private and public sector are interrelated. Almost any problem that you come up with has got elements of private sector in it because everything around us has got a public sector and private sector piece to it. I'm actually an employee of the public sector sitting here at the University of Toronto.

[7:21](https://youtu.be/jthRNUiybx0?t=441) This is a public university, and my paycheck comes from the provincial government of Ontario. But almost everything in my office here, as you can see, from the painting on the wall to the paint on the wall, to the shades on the windows, to the windows themselves, to the concrete in the building, were all made by private companies. And same thing about the way that I'm talking with you, the computer, the software, the Zoom links, the clothes that I'm wearing, the glasses that you see, all of these were made by private sector companies. And that's not even the half of it because the problems that I'm working on in my research all relate to getting either products to work better or services to be more effective or more widely available. So our problem is not so much figuring out what's relevant. Our problem is, as we think about innovation in the public sector to try to come up with solutions to important problems, is really trying to figure out how to pick problems where we can do work that will have impact that matters.

[8:39](https://youtu.be/jthRNUiybx0?t=519) So we need to make problems actionable. And what I want to put before you is that in order to do that effectively, you've got to have strong answers to all five of these questions, and the answers have to be aligned. So what I want to say to you is that this framework can help you make real progress on solving public problems. Real progress. But you can't skip some of the steps here and ultimately succeed. Here's the temptation that we all face in the public sector. It's to work on just these two parts of the problem. The first is to try to come up with some kind of compelling idea where there's a big potential for impact by working with someone in the private sector. And then the second temptation is to focus on trying to get resources and capabilities from the private sector that we need.

[9:46](https://youtu.be/jthRNUiybx0?t=586) So the focus, it tends to be on, our focus tends to be, let's focus on inspiration, sometimes desperately, sometimes very hopefully. And there's this kind of pervasive idea that companies have tons of money. And if we could just inspire people in the private sector, get access to the CEO of a company, find a team in the private sector that wants to solve a problem, they must have money that they can bring to solving a problem, if not money, then other kinds of resources. And what we end up with here is this idea that if we can just, you know, identify opportunity and make our case, we can get access to resources from the private sector and solve a problem. And what ends up happening is nothing. It's unbelievably common for initiatives to fall flat and for nothing to happen.

[10:53](https://youtu.be/jthRNUiybx0?t=653) And what we need instead is instead of inspiration and, you know, this kind of yearning for some sort of access to resources, we have to be more systematic and more strategic. We have to answer these questions in a systematic way. And I want to talk about these questions in context of an example that I've been working on in Malawi, which is a country in sub-Saharan Africa. It's an impoverished, low-income country. And I'm going to talk a little bit about how a group of private innovators developed an electronic medical records system that saved, that reduced the death rate from HIV in AIDS clinics in Malawi, which is one of the most HIV-positive countries in the world. It reduced those deaths by 28% within just a few years. And I can, I'm going to tell you a little bit more about that here.

[12:01](https://youtu.be/jthRNUiybx0?t=721) The way we got to that accomplishment in Malawi is by being very systematic about answering questions about who we're trying to create value for and how. So let me get into this in a little bit more detail. The compelling aspiration here is to improve the continuity of healthcare for the destitute poor in Malawi suffering from HIV by bringing them into clinics and making sure that people are taking their antiretroviral medication. Who we are creating value for, that question, you know, the immediate answer to that question that comes to mind is for the patients, but the focus of the effort that I'm going to outline for you in the next few minutes was really the doctors, the clinical staff, and the nurses in these HIV clinics that were so stretched, so strapped, so overworked, that they couldn't follow up and trace patients who had lapsed from care. They didn't have enough capacity to serve everyone. And by supporting the clinical staff and creating value for them, the patient care improved dramatically in the sense of providing people with access to this follow-up care.

[13:31](https://youtu.be/jthRNUiybx0?t=811) And the demonstration and achievement of excellence really was a technical matter of coming up with a world-class electronic medical record system that was tolerant to the bad electricity in the particular situation. Now, the challenge here is to actually achieve and demonstrate excellence for the people that you're trying to create value for, and then you've got to make sure the people you're creating value for can actually fulfill the aspiration, which in this case was to reduce AIDS deaths in Malawi. The people that worked on this were not talking day-to-day about their inspiring vision as a matter of course. What they were talking about is problem-solving for the doctors and clinical staff and problem-solving in a technical sense on the character of the EMR system.

[14:31](https://youtu.be/jthRNUiybx0?t=871) And that's this idea that you reduce the very large problem of HIV deaths in Malawi to a very specific problem, which is developing and implementing an electronic medical record system. That insight to reduce from the big picture to something very actionable is critical to the translation of something that's compelling as an aspiration into something concrete. create that you can accomplish in the time you have with the resources that are available. So, that's going to be a sort of central theme of this organizational message that I want to try to convey today. So, we're thinking about the compelling aspiration. We're thinking about who we're creating value for and how we're going to achieve and demonstrate excellence. We're thinking about doing that for constituents, both in the public and private sectors. And we have to think about the criteria of what constitutes excellence from the bottom up in these two sectors.

[15:40](https://youtu.be/jthRNUiybx0?t=940) Now, I've written a couple of words here that I want to just focus on in the context of my case study on Malawi, but I want to also sort of argue that the criteria here are going to be broadly relevant across the public and private sectors. So, in the public sector, excellence tends to reflect principles such as accountability at scale and treating people equally and being reliable. This stands in contrast to what constitutes excellence in many private sector organizations, such as Baobab Healthcare, which is the healthcare group that built the EMR system that I'll tell you about. What they cared about are things like being efficient and flexible and experimenting and trying stuff and technical excellence. And the broader sort of idea that in the public sector, accountability for what you do is a very important and salient kind of principle, that idea comes up time and again in the public sector.

[16:53](https://youtu.be/jthRNUiybx0?t=1013) And it really stands in contrast and in tension with the sort of techiness and flexibility and efficiency and return on investment style of accomplishment that characterizes the private sector. We saw this almost as a, it almost became a laughing matter in our Toronto case study last time, because the Toronto Sidewalk Labs personnel that were working on the lakefront renovations here in Toronto were so over the top in their commitment to, you know, sort of tech bro styles of work, you know, with flexibility and technological frontier data and analytics. And the City of Toronto was so, you know, so reduced to criteria of good process and accountability and treating everybody equally and so on, that these criteria for excellence almost became tactics in a weapon of competition between members of the different, you know, the different sides of what was supposed to be a public-private partnership, but turned into a public-private tussle here. And we, you know, I'm working with colleagues from the Bern Center on this initiative that Hannah mentioned called Private Innovation in the Public Interest, and interviewing really famous people, and our website is going to go live next week, and you're going to get a sneak preview of it if you're interested. You're going to get early access to it next week in our session. We've got these people talking about barriers to alignment and work across the public-private boundary, and they keep coming back to these differences in what constitutes excellence for each side here. And you'll, you know, you'll see that, and I'll point you

[18:55](https://youtu.be/jthRNUiybx0?t=1135) to that briefly next week when we give you access to this website, this tension between accountability and flexibility as people seek to start to work together here. We've got to find some way to get alignment here, and I'll show you in a second how that occurred in Malawi in a way that was very inspiring. It's not enough to think of this as public and private sector alignment either. You've got to think about specific individuals that are motivated to overcome boundary problems and work together to make this happen. So we don't have a monolithic Ministry of Health in Malawi that we're trying to work with. We have specific individuals that want to do this work because they are so dedicated to saving lives. And similarly, on the private side, we have specific individuals, including a very inspiring guy that I'm going to show you a video about in a second, who is very dedicated as a native Malawian to trying to work with frontier technologies to try to solve local problems. And it's that dedication of the individuals to each other that makes the progress possible. You're going to see engineers highlighted on the right-hand side. Who are we creating value for? The engineers are trying to figure out how to solve technical problems en route to implementing this electronic medical record system. They're going to be in a hierarchy. They've got to report to their bosses.

[20:31](https://youtu.be/jthRNUiybx0?t=1231) They've got to worry about justifying their salaries. So they have to worry about their productivity. They have to show their managers that they're doing worthwhile work. They have to show a path to success. The criteria on which they're judged are things like taking risks and developing prototypes and demonstrating a return on investment and showing leadership and being competitive in what they're doing. And that stands in contrast to their peers on the public side, doctors, nurses, and clinical staff that also have hierarchy, but they also have to deal with their patients. And they have to deal with criteria like the politics of investing in HIV clinics and their careers as civil servants and the quality of life of the people that they're seeking to serve and their own quality of life and the chronic problems that they have to be ready to address in their environments here. So what they're going to end up doing is scoping something that's actionable and realistic in the time they have. The innovation is going to start in the private sector. We're going to see how that works. It's very similar to what we talked about last time in Tulsa, Oklahoma, where the prototyping is in the private sector.

[21:56](https://youtu.be/jthRNUiybx0?t=1316) And then that basketball is going to go over to the public sector. Now the Ministry of Health has control over this electronics medical record system. So we'll see how that transfer occurs and how critical it is to get that right, that transfer of responsibility and accountability in this instance. There are other models as well. We'll talk about them briefly in just a minute, where, for example, the implementation takes place on the private side and then the software is implemented in the public domain, but then the ping pong ball goes back to the private side for service contracts, for example. That frequently happens in public and private collaboration. So you get a model of collaboration that involves transfer, but it also involves amplification of different kinds of responsibilities in the private sector, for example, in software over time. And it's actually pretty rare that you actually see a soup-to-nuts, beginning-to-end collaboration that involves a team that's constituted of the public and private sector together from the beginning to the end. So we're going to see much more common is transfers across the public-private boundary. And, you know, I have some more examples, excuse me, some more of examples for you, again, that we can talk about next time. But, you know, the basketball example is you prove something on the private side and then transfer control to the public sector. There are examples of transferring, actually, resourcing capabilities from the private sector to the public sector. PricewaterhouseCoopers, which is a very large accountancy, accounting firm in the United States that does commercial auditing and account management and consulting for large companies on their accounting software, they will actually transfer personnel into the United States Security and Exchange Commission

[24:00](https://youtu.be/jthRNUiybx0?t=1440) on secondments to get the personnel that ultimately will end up returning to the private sector familiar with SEC guidelines, protocols, investigative protocols, you know. And it's all welcome on the public side because the public side wants compliance from the private side. So this idea of borrowing personnel from one sector and placing them on the other side is an example of a kind of ping-pong process where there's a transfer over time. And we'll see how working together collaboratively to figure out what's possible and then how to get it done. It does occur in healthcare relatively frequently as physicians and doctors and administrative personnel from the public sector set up teams with, for example, hospital personnel or even pharmaceutical personnel to figure out what's possible and then how to get it done. So there are examples from all of these different models and there are more models as well on how governance across the public and private boundary works. But the first thing you've got to do is scope an important problem. So let me get you a little bit more background briefly on my Malawi example and then I'm going to stop talking and we can have a discussion about this. So let me stop here for a moment here. Hannah, is anything

**Unknown speaker**

[25:30](https://youtu.be/jthRNUiybx0?t=1530) coming up in the chat that I should address before I get into my example? No, go for it.

**Anita McGahan**

[25:36](https://youtu.be/jthRNUiybx0?t=1536) Can I go for it? If people have any questions they want to raise even at this stage or should I give

**Unknown speaker**

[25:40](https://youtu.be/jthRNUiybx0?t=1540) my little case study here first? Go ahead with your case study. I don't see any questions yet.

**Anita McGahan**

[25:46](https://youtu.be/jthRNUiybx0?t=1546) Okay. Thank you, Hannah. All right. So let me just give you a little bit of background on the HIV epidemic in Malawi. We've got 9.5% HIV positive population. It's a low-income country. Anti-retroviral treatment for HIV has been available at no cost to Malawians for I think almost 20 years now. There are about 700 clinics that provide HIV care across the country, 20 million people. The introduction of this new cocktail of medicines has been extremely, extremely powerfully effective in Malawi with something like a 40% decline in incidence of death just as a result of introducing these medicines. Because of inconsistent electricity and other demands on operating systems like the absence of computers and so on, record keeping in Malawi has been in a paper-based system.

[26:58](https://youtu.be/jthRNUiybx0?t=1618) And you can see here on the left-hand side this picture of a mother and child in for a clinical visit talking with clinic staff in the blue shirts. The clinical nurse is on the left-hand side. She's consulting with the mother and child here. And the administrative officer has gone and pulled the paper-based record for this mother-child and is holding it on their lap here. And you can see the pink papers here. What a typical course of care is, first you go through a diagnosis, of course, and then you get a prescription for 30 days of medicine. And you have to come back every month or so to get a renewed prescription. And every time you come back, your CD4 count, your viral load count is tested, your medicine is calibrated, and all of that is based on this paper record. It's all recorded in this paper record. So when you show up for your visit to get your renewed prescription, you're there for an hour, most of that time is taken up by somebody having to go find your record. And you can see a picture of the record storage on the upper right-hand corner here in these cubicles, and it's just a mess as you can see.

[28:27](https://youtu.be/jthRNUiybx0?t=1707) So the implementation here that led to this enormous impact in the availability and success of medicines was to put in an electronic medical record system, which is computer-based, that generated a health passport card. And you can see that health passport card on the right-hand side. It's got a barcode on it. And when you come into the clinic, there's a scanning of your barcode that brings your medical record up right away, and you get an immediate access. It really improves the productivity of the clinic in a way that gives you immediate access to your nurse, and your nurse may be available, you know, your whole appointment may be 15 minutes instead of an hour. And that, in that example, would quadruple the capacity of the clinic to see patients. So it's very important for clinical care. Let me show you a six-minute video that was made through a TED Talk of the process by which the electronic medical record system was developed.

**Unknown speaker**

[29:52](https://youtu.be/jthRNUiybx0?t=1792) Like every passionate software engineer out there, I closely follow technology companies in Silicon Valley. Kwa mnafanya mbia, piri mnashwe ya kama pea United Teams kwa Afrika. Nidhaa defasa mafuza xeavwa pretty much the same why soccer fans follow their teams in Europe. I read articles on tech blogs and listen to podcasts on my phone. But after I finish the article, but after I finish the article, rock my phone and unplug the headphones, I'm back in sub-Saharan Africa, where the landscape is not quite the same. We have long and frequent power outages, and a lot of patients visiting understaffed hospitals. Since the HIV epidemic, hospitals have been struggling to manage regular HIV treatment records for increasing volumes of patients. For such environments, importing technology systems developed elsewhere has not worked. But in 2006, I joined Baobab Health, a team that uses locally based engineers to develop suitable interventions that are addressing health care challenges in Malawi.

[31:01](https://youtu.be/jthRNUiybx0?t=1861) We designed an electronic health record system that is used by health care workers while seeing patients. And in the process, we realized that we not only had to design the software, we had to implement the infrastructure as well. We don't have enough medical staff to comprehensively examine every patient, so we embedded clinical guidelines within the software to guide nurses and clerks who assist with handling some of the workload. Everyone has a birth date, but not everyone knows their birth date. So we wrote algorithms to handle estimated birth dates as complete dates. How do we follow up patients living in slums with no street and house numbers? We used landmarks to approximate their physical addresses. Malawi had no IDs to uniquely identify patients, so we had to implement unique patient IDs to link patient records across clinics.

[32:02](https://youtu.be/jthRNUiybx0?t=1922) The IDs are printed as barcodes on labels that are stuck on personal health booklets kept by each patient. With this barcoded ID, a simple scan with a barcode reader quickly pulls up the patient's records. No need to rewrite their personal details on paper registers at every visit. And suddenly, queues became shorter. This meant patients, typically mothers with little children on their backs, had to spend less time waiting to be assisted. And if they lose their booklets, their records can still be pulled by searching with their names. Now, the way we pronounce and spell names varies tremendously. We freely mix R's and L's, English and vernacular versions of their names. Even Soundex, a standard method for grouping words by how similar they sound, was not good enough. So we had to modify it to help us link and match existing records.

[33:06](https://youtu.be/jthRNUiybx0?t=1986) Before the iPhone, software engineers developed for personal computers. But from our experience, we knew our power system is not reliable enough for personal computers. So we repurposed touchscreen point-of-sale terminals that are meant for retail shops to become clinical workstations. At the time, we imported internet appliances, called eye-openers, that were manufactured during the dot-com era by a failed US company. We modified their screens to add touch sensors and their power system to run from rechargeable batteries. When we started, we didn't find a reliable network to transmit data, especially from rural hospitals. So we built our own towers, created a wireless network and linked clinics in Nilongwe, Malawi's capital. With a team of engineers working within a hospital campus, we observed health care workers use the system, and iteratively built an information system that is now managing HIV records in all major public hospitals in Malawi.

[34:28](https://youtu.be/jthRNUiybx0?t=2068) These are hospitals serving over 2,000 HIV patients each clinic. Now, health care workers who used to spend days to tally and prepare quarterly reports are producing the same reports within minutes. And health care experts from all over the world are now coming to Malawi to learn how we did it. It is inspiring and fun to follow technology trends across the globe, but to make them work in low-resource environments, like public hospitals in sub-Saharan Africa, we have had to become jerks of all trade and build whole systems, including their infrastructure, from the ground up. Thank you.

**Anita McGahan**

[35:18](https://youtu.be/jthRNUiybx0?t=2118) OK, let me ask you a question here. What is motivating this guy, do you think? Why do you think this guy did this? So he's built cell phone towers. He's put in local internet connectivity. He's put in rechargeable lithium-ion batteries. He didn't even say where he got the money to do this. I imagine that he went and appealed to rich people to do that. He might have had parents who died of HIV and wants to improve his community. Absolutely, he improves care for Malawian citizens, but he doesn't talk about any of that at all here. What does he say his goal was? It was to put in this electronic medical record system, right?

[36:19](https://youtu.be/jthRNUiybx0?t=2179) That was what he says his goal was. But his underlying aspiration, the thing that he shared with the doctors was this kind of common commitment to trying to reduce congestion in these clinics so that more people could get care and so that we're also finding in our research that if you have a shorter time at the clinic, you're more likely to actually go. It's less daunting to go. We can identify a 28% reduction in deaths with the implementation of the electronic medical record system in a fully controlled and instrumented study. 28% reduction of deaths from only a managerial improvement here. But he doesn't talk about reduction in deaths in his talk. He talks about the technology here. And that reduction of the broad value of preservation of life to something specific that can be accomplished in a relatively short time frame that all the constituents understand is a critical opportunity to achieve something even bigger.

[37:36](https://youtu.be/jthRNUiybx0?t=2256) That's what we mean by compelling aspiration, okay? It's making something really concrete. And what's also characteristic of successful innovative partnerships is this emphasis on improving the workflow and improving the lives of the specific clinical staff that are actually trying to deliver this care. In other words, there's this compassion for the particular individuals that you could construe as part of the problem but are actually part of the solution. So just to give you another sense of that, I remember I was working with quite a famous public health doctor named Paul Farmer. Paul died just last year quite prematurely from a heart attack in Rwanda where he was doing work. He was a Boston-based physician and a tremendous leader.

[38:39](https://youtu.be/jthRNUiybx0?t=2319) And I remember at one point saying to him and to his colleagues that I wanted to implement an accounting system or something like that in one of the clinics. And he said to me, Anita, which patients shouldn't I treat while I'm implementing your accounting system? And that attitude of patients first, I can't stop to learn how to do an electronic medical record system or an accounting system. I have to treat my patient. I can't prioritize your wonky administrative stuff. I've got to do my big. I've got to as a private sector person in that example, or Jerry Johnson, the fellow who was just speaking in that TED Talk, they have to overcome that resistance. You have to pour enough effort and find enough collaboration on your side to overcome that resistance by demonstrating that if you just spend one day with me now learning how to use this system, you can solve many, many, you can save many, many days of lost productivity in the near future.

[39:50](https://youtu.be/jthRNUiybx0?t=2390) That work of creating value for local impact is the work of innovating at the public-private boundary here. And then excellence. This guy, Jerry, one of the reasons I love this guy, Jerry Johnson, so much is he's building a world-class system. You need electricity? I'm going to get you lithium ion batteries in a Tesla stack and put them in every single clinic to give you. I'm going to go get somebody to pay for that. I was talking about this case study not too long ago in Silicon Valley in a seminar that I gave in a tech company. And somebody raised his hand and said, I was the guy that ran the failed retail company that gave this guy, Jerry Johnson, the point-of-sale kiosk things, which were these silly little idiosyncratic customized retail point-of-sale things.

[40:56](https://youtu.be/jthRNUiybx0?t=2456) And Jerry Johnson retrofitted those with his collaborators with touchscreen technology and rolled them out. And now he's maintaining them. So this guy is going to just go to the mat to do what it takes to develop world-class systems and get it. This is what we're talking about as the work of actually doing a competitive interest. It's aligning a compelling aspiration with something very concrete that we can do right now, creating value for people who may not be receptive initially but who are critical to the actual delivery of the value, and then achieving and demonstrating excellence at a level that nobody would have anticipated as possible. And that's what Pi Squared is about.

[41:57](https://youtu.be/jthRNUiybx0?t=2517) That's what private innovation in the public interest is about, is helping us all get better at doing that. So let me stop there, Hannah, and I'm happy to answer any questions anybody has.

**Unknown speaker**

[42:08](https://youtu.be/jthRNUiybx0?t=2528) Thank you so much, Anita. Let me just take us off recording.

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Original page: https://innovate-us.org/private-innovation-in-the-public-interest-turning-problems-into-opportunities-for-corporate-engagement · Licence: CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0/), as stated on innovate-us.org