US Digital Service's Mina Hsiang tells TechRepublic about helping save Healthcare.gov and learning to get everyone 'rowing in the same direction.'
Mina Hsiang was raised a tech head. She's the daughter of two math professors—her mom now actually teaches computer science—and she grew up fixing things, going to science and math clubs, and leading her school's science olympiad team.
"I always probably grew up more identifying as an engineer than as a woman," she said. "Not that that has to be a dichotomy but more so if you had asked me I would have been like 'Yeah, I hang out with the science kids and have a little bit of a hard time having other friends.'"
That's not a bad setup for someone who is a member of the US Digital Service at the White House, and a senior advisor to US CTO Megan Smith, on health data.
When it came time to go to college, her decision was between Brown and MIT. Brown meant a liberal arts education. MIT meant "hanging out with engineers all the time, forever." She opted for the latter and got a bachelor's of science in electrical engineering, and then later an MBA from Harvard.
Being interested in the intersection of people and technology, Hsiang focused on technology and international development. She joined the Clinton Foundation and spent a year living in Malawi where she worked on the country's infrastructure, including rural water and sanitation. It was a learning experience in terms of figuring out how people, technology, and government need to fit together.
When she got back, she returned to engineering and worked on building robotic prosthetics at Deka R&D before going to business school and then eventually ending up in the US Digital Service.
Healthcare.gov launched Oct. 1, 2013 and things did not go well. The site, which was supposed to handle 500,000 simultaneous users, according to the New York Times, struggled to support 500 at a time.
It was a mess, and the recurring question was "how did this happen?" While the "how" is always important, the reality was the US government had to fix it, and fast.
Toward the end of October, Hsiang got a call asking if she could mock up a front end for a queueing system for the front end of Healthcare.gov. And if she could come in on Monday.
Hsiang found herself part of the rescue team for Healthcare.gov.
She was initially put in charge of metrics. One of the challenges was figuring out what they could accurately communicate internally and externally in order to set expectations for how things were going. Those metrics were also important for internal debugging, she said.
Hsiang was responsible for collecting and maintaining their dashboard, and then segued into something more of a product manager. That meant figuring out how the user experience was tripping up users, and helping manage the software teams who were fixing those issues.
"There was a joke that I was like the chief curiosity officer," Hsiang said, because she'd wander around asking people a lot of questions about things like response times and how different pieces fit together.
"All of a sudden you start to put together a picture of the system and at that point you can validate what's really important," she said. "It's a super interesting job, but it's one of those things that doesn't happen as much when you are there from the beginning and design that all into it."
Hsiang actually left, for a while, and went to work at a large healthcare company build scale analytics systems for hospitals. As the US Digital Service was ramping up, she got recruited to come back.
"They started the ball rolling on US Digital Service to say 'how can we build a core of people who can be at the table early enough to prevent something like this from happening again,'" she said.
Now she leads multiple health initiatives focusing on health data and the systems that manage and move health data.
For example, there's the issue of veteran records.
"The President has said it's a pretty strong focus that we be able to provide a veteran with their records so that they don't have to go chase down all the pieces of it. So, as someone leaves the service, and goes to the VA, the record goes with them," she said.
Sometimes, that means addressing the challenges of two different agencies coming together to make something like that happen in terms of engineering and design.
Hsiang is also working on policy around health data.
Five years ago, there wasn't a lot of health data. Or rather, it existed in stacks of patient health records in paper form.
"You couldn't just walk in and query the system and be like, 'Ok, how many of your patients are on penicillin right now?'" she said. But now that between 70-90% of physicians are using electronic health records, the question broadens to how to find value in these massive amounts of data—and that means everything from the ability to move data, to using data internally to improve the way a hospital runs, for example.
That ties into her work as the lead on the Precision Medicine Initiative, which ultimately involved corralling a lot of health data, advancements like sequencing the human genome (for one), and using the healthcare system as a platform to push health forward.
But all of that goes back to a simple idea Hsiang has about enabling people to work together on a track that will eventually yield success.
"The extent to which helping everyone get aligned just by laying out a map that makes sense to people, and the extent to which that can turn things is incredibly valuable to see," she said
In her own words...
How do you unplug?
"I like to go outside. I go hiking and camping and ride my bicycle, and I like to go see my family. They live in upstate New York, Boston, and California."
Is there another profession you could try, what would it be?
"I have often said I would love to be one of those people on TV who gets to explain how things work. I want to be on Myth Busters, or Dirty Work, but where you're not doing dirty jobs, but explaining how factories work."
What do you read for fun?
"I like fiction. I also really like biographies. And historical books. I'm reading Doris Kearns Goodwin's biography of Roosevelt and Taft. It's interesting reading about how that relationship evolved. And interesting reading about what Washington was like back then. I just picked it up and was like 'I'm curious what are the similarities and what are the differences.'"
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