This article was originally published the The Health Care Blog (August 24, 2013) – http://www.bit.ly/open-letter-to-the-president
Dear Mr. President:
I served in your White House; to do so was among the highest honors of my life and an incomparable professional opportunity.
Since 2009, I’ve sought to return the favor by building on a decade as a journalist to write about the unsung innovation I saw happening beneath the public’s radar. (The federal government has never been great about describing its positive achievements, but this unintentional “humility” is worsened by too much media reliance on muckraking to generate cheap content.) The prize for some of your Administration’s improvements will be billions of dollars’ worth of process efficiency and an ability to retain social-good programs while slashing redundancy and phasing out archaic ways of doing business. All politics aside, I watched these mechanisms with my own wide eyes.
But if one is to deliver praise like I just did, then one must also be willing to highlight dangerous errors in the path ahead, especially when the potholes are avoidable. As a subject matter expert on emergency medical technologies, I have a patriotic duty to point out correctible overstatements and oversimplifications that, if left uncorrected, could undermine your Administration’s objective to bolster the public’s senses of safety, security and comfort—especially as it simultaneously emphasizes the danger of man-made and natural disasters.
On July 9, 2013, your White House sent out a “marketing” email entitled “President Obama’s Plan for Using Technology to Make Government Smarter.” The email contained the following three bullets:
- Increasing efficiency and saving money. CHECK: A worthy goal, and one that I had the chance to see put in action from the inside-out, as part of the project team that relaunched USAJOBS.gov—the so-called “face of federal hiring.” The White House email cited cost reductions of our $2.5 billion; that seems reasonable, considering how extensive an effort went into collapsing duplicative data silos and databases, and modernizing the federal government’s technical infrastructure. Vivek Kundra, the visionary former federal Chief Information Officer, should be a central figure in every conversation about government’s meaningful gravitation toward efficiency; he earned more credit than he gets (but that’s not why people work in government).
- Opening government data to fuel innovation and problem-solving: CHECK: The Administration claims that it is opening “huge amounts of government data to the American people, and putting it on the internet for free.” There are many ways in which this is true, ranging from Data.gov to the Blue Button Initiative, to a (relative) simplification of the grant-making process. (The latter is better than it was, but it still is eons from intuitive or fair.) Much controversy now swirls around actions that the government still keeps secret, but that cannot detract from the fact that a veritable cornucopia of information has been released, and it is indeed spurring creativity. Unfortunately, my own firm uncovered a challenging corollary problem that goes hand-in-hand with the release of oodles of data: at least some of those data are bad, faulty or incomplete, yet when we tried contacting the appropriate agency to close the gap and strive for accuracy, we were met with silence.
The last bullet in the White House’s email, however, does not deserve a “CHECK.” Rather, it is concerning and arguably more dangerous than whoever drafted the outreach piece likely realized. It also touches on something I know a bit about.
- Digitizing disaster recovery: According to the White House, “FEMA uses data analytics and internet/mobile apps to deliver better results in disaster areas.” It is possible that FEMA uses analytics and apps—that may well be the case. But do they “deliver better results in disaster areas”? No, they don’t, and therein lies a problem: to suggest that emergency responders should use popular technologies (like “apps” or even devices like iPad) to do their sacred work in the field puts both responders and the public at risk, for such suggestions fail to account for the vulnerabilities that those popular technologies present.
This is not a statement against the apps or the iPad; both have their place, but given their current physician and technical construction, that place is not in an ambulance or a fire vehicle. Technologies tempered for use during disaster require technical robustness and physical ruggedness beyond the bounds of an iPad’s current capabilities, regardless of what Los Angeles City Councilman Michael Bonin said. (In early July he suggested that the Los Angeles Fire Department should utilize iPads as a centerpiece of modernization. Very few people inside the industry agree.) As the old saying goes (here’s looking at you, Joe Friday), these are “just the facts”: To describe consumer-grade technologies as broadly insufficient for use during disasters is not to devalue those devices, but rather to recognize that high-stress situations require hardier equipment. Indeed, to called emergencies “special contexts” may be to understate reality’s harshness.
After all, the first and most obvious problem that practitioners on the ground face during disasters emergencies is the loss of communications capabilities. If the previous hyperlink seems a bit old, consider this one instead from 2013: “Oklahoma City Area Hit by Phone, Internet Outages After Tornado.” Or another piece I have written on this subject: “A Dangerous Distortion: Verizon’s Foray into Emergency Medical Services.” At the 2013 National Association of EMS Educators Conference, two medics from Oklahoma were perplexed and anxious when I mentioned Verizon’s advertisement showing that one of their largest regional EMS agencies supposedly uses real-time video in its ambulances. It is simply untrue. The EMS agency neither collects nor transmits video from an accident scene; and because it operates in the heart of Tornado Alley, to rely on video connections would be to burden it with unacceptable risk of reliance on network connections that are vulnerable to disruption by storms.
As a citizen-taxpayer, and a professional in the Fire-EMS technology arena, such overstatements both infuriate and dishearten me, because they make it seem as though emergency responders are doing less than they could be today. They also misconstrue the “manual” nature of so much of disaster response in the United States. Did you know that one of Silicon Valley’s famous “superangel” investors is creating an application tohelp police officers write tickets more efficiently…but that the police department lacks phones on which to operate the app?
Or how about this: Did you know that the San Francisco Bay Area is considering a social network for use ”during emergencies only.” This social network will rely on the internet…in earthquake country. Perhaps I take my experience in this regard for granted because I grew up in California, but do you know what happens to the Internet (or, say, cell phones) when an earthquake knocks down a tower, shuts down power to a tower, and scared citizens take to their phones to call loved ones all at the same time?
Cell circuits overload. Networks go away. Bye-bye social media app “for emergencies,” and we’re left feeling stranded. That’s an uncomfortable feeling that was captured with frightening intensity in the film “Live Free and Die Hard”: “What if you’re hurt and alone and you dial 9-1-1 and no one answers?”
But it gets worse: The emergency networks in and around San Francisco are among the least-sufficient in the country, despite that this region is considered the Mecca of technology innovation for Planet Earth.
There are glimmers of hope that the Bay Area Wireless Enhanced Broadband (BayWEB)—a network especially designed for first responders, which will operate exclusively of public communication channels—will go back onto the drawing board. But it could also be déjà vu all over again: just as a smartphone application for police officers won’t work if they don’t have smartphones, so too will a next-generation technology network failwhile “there have been about $206 million worth of citywide information technology upgrades requested by departments, but only $49 million is available,”per the San Francisco Examiner.
- Author’s Post-Script: The Examiner‘s figure was published just five days before the announcement of the potential re-invigoration of the BayWEB project. It is unclear whether the two groups have been in communication regarding resources.
Mr. President: You have challenged us – bolstered by circumstances such as extreme weather and tragic terrorism – to step into an era of innovation, a path begun as part of President Clinton’s “Bridge to the 21st Century,” and continued as part of your commitment to “Make Government Cool Again.” (That was part of my mandate when I arrived at your Office of Management & Budget in 2009.)
I know that “Digitizing Disaster Recovery” makes for an excellent sound bite, but if you see it as longer-term-beneficial, then we need to be implementing wise—not just so-called “smart”—technologies in a manner that befits their pertinence to America’s dire need for impactful emergency response infrastructure.
My opinions on what these technologies should be have been published elsewhere, but they start simply with a need for better information about modern technologies and how should they best be applied. They end with the disastrous effects of incumbency (anathema to progress), and the suggestion that we learn to buy based on usefulness, not just politics or price considerations (“low-bids”).
Medics, firefighters, and other emergency personnel do so much with so little; the public is scarcely aware of their willingness to go without, because the public-facing story is often skewed toward non sequiturs like pensions that have little to do with capabilities or courage. We can have substantive conversations about business and politics for sure, but first let’s get ready to respond to disasters and even everyday crises.
As the global model of public preparedness (for better and worse), we need a pipeline of tools that offer improvements beyond what is possible using “apps” that “digitize disaster response” and thereby tie us riskily to an ephemeral internet that may or may not persist when we need it most. Quick-fix solutions may score political points, but ultimately they do little more than clutter the faces of our digital devices.