Mosaic is an art form about perspective. From far away, mosaics appear to be a single image. As you move closer, your perspective changes and you start to see small works of art that blend together to form a whole. Stand right in front, and you see individual glittering tiles that are seemingly unconnected from the others around it.
A mosaic is the best way I can think of to describe Lygeia Ricciardi’s origin story.
Ricciardi’s career has taken her from the halls of academia to the public sector to a Health IT startup. At first glance each of these roles do not appear to be connected, but shift your perspective and an impressive masterwork is revealed. Not only is the whole of Ricciardi’s story a work of art, but each individual chapter is a beautiful tale unto itself.
Ricciardi’s story starts as many artist’s stories do, as an apprentice toiling away in obscurity until a chance meeting led to a big break.
Tile 1 – Understanding Industry
After graduating from Wellesley College with degrees in History and Italian language, Ricciardi found a job writing case studies for Professor Richard Tedlow at the Harvard Business Review. Tedlow was a world-class teacher who was later recruited by Apple to teach their employees.
The case studies created by Ricciardi, were nothing like the ones published by companies to describe their work with customers. Harvard’s famous case studies are complex educational exercises where students use the material to develop plans, strategies and tactics to solve complex business problems.
Ricciardi enjoyed the work and was particularly drawn to case studies involving the impact of emerging technologies on businesses and society. At the time, one technology was dominating headlines – the Internet. In her case studies, Ricciardi posed questions that she was wrestling with herself: How is the Internet changing the world? What role should government play in shaping it?
To answer those questions, she interviewed Reed Hundt, who was the incoming Chairman of the Federal Communications Commission (FCC) at the time, and an active participant in Professor Tedlow’s classes. Tedlow and Hundt worked together on laying the groundwork for Hundt’s early days in his role at the FCC, with a lot of support from Ricciardi. Through the collaboration, Ricciardi got to know Hundt.
“Both Tedlow and Hundt had extremely high standards,” said Ricciardi. “Both were smart, thoughtful and mission oriented. They were terrific mentors and human beings and I learned so much from them. When my term at Harvard ended, Hundt offered me a job at the FCC. I didn’t really know what it would be, but I packed my bags and went for it.”
Tile 2 – Understanding Policy
It wasn’t long after joining the FCC that Ricciardi got involved with the development of the $2.65 billion Universal Service Internet subsidy for schools and rural hospitals which was a key element of the Telecommunications Act of 1996. Ricciardi worked on the healthcare aspect of the subsidy.
“The education side was much more defined and well understood,” explained Ricciardi. “The agency had a better handle on the challenges and the needs. Plus it was much higher profile and garnered a significantly larger portion of the subsidies. The healthcare side, however, needed a lot more work. It was exactly the sort of thing you could entrust to a young and relatively inexperienced staffer. We had to figure out how telecommunications and Internet subsidies would apply to rural healthcare and underserved urban areas.”
To help shape the program, Ricciardi and her colleagues at the FCC assembled an advisory group made up of early healthcare and technology mavericks including:
- Joseph Kvedar, MD – Vice President of Connected Health at Partners Healthcare
- Jay H. Sanders, MD, FACP, FACAAI, FATA – Then President and CEO of The Global Telemedicine Group, Professor at Johns Hopkins University School of Medicine and a founding board member of the American Telemedicine Association
- Mary Jo Deering, PhD, a leader at the Department of Health and Human Services who was an early proponent of patient engagement
These advisors helped to shape the Rural Health Care Telecommunications Program which provided up to $400 million a year in financial assistance to qualifying healthcare institutions for broadband Internet access. That program morphed into the Healthcare Connect Fund, which is still available today.
Tile 3 – Understanding Public + Private Partnership
After leaving the FCC, Ricciardi went back to school and earned her Masters Degree in Technology and Education from Harvard. Because the institution did not have a program that combined technology, education and health, she cobbled together her own version through the Harvard Graduate School of Education, the Kennedy School of Government, and the MIT Media Lab (where she apprenticed herself to Dr. Seymour Papert, a pioneer in artificial intelligence, technology and learning).
Following a brief stint with a tech startup gounded in Papert’s theories, Ricciardi was hired by the Markle Foundation and became part of their new healthcare team. That small team launched Markle’s Health Program which included the Connecting-for-Health collaborative of public and private sector health information technology leaders. The team’s work was used as foundational elements in what would later become the HITECH Act.
While at Markle, Ricciardi also managed a multi-million dollar portfolio of Health IT projects, including a telemedicine clinic where doctors from Harvard Medical School could lend their expertise to healthcare workers in rural Cambodia, and CHESS, an online community that supported underserved women with breast cancer.
Tile 4 – Understanding Consumer Empowerment
After several years at the Markle Foundation, Ricciardi left to start her own consulting practice focused on consumers and health IT. She was convinced that new technologies would play a role in empowering patients and changing healthcare. She wanted to be part of making that a reality.
After a few years of sowing the seeds of patient engagement with her consulting clients (primarily foundations and government agencies that were willing to invest in the idea), Ricciardi was persuaded to apply for a newly created role at the Office of the National Coordinator (ONC).
“In 2011, the ONC was in the throws of figuring out Meaningful Use – a multi-billion dollar program to digitize healthcare, which up until that point had been largely stuck in a paper-based environment,” recalled Ricciardi. “Honestly, I wasn’t sure I wanted to dive back into the government. The role, at first glance, felt like a bolt-on. The consumer piece didn’t seem like it was a big focus for the ONC. But I knew there was a big potential for consumers and patients to have a bigger role in their own health through the application of technology. Plus, there was a real opportunity to help shape and influence where the billions of incentive dollars were going. So, I decided to go for it.”
Ricciardi was uniquely qualified for the role. She had public sector experience, a successful track record of bringing diverse stakeholders together to solve complex problems, and a unique perspective that spanned healthcare providers, government, clinicians and, most importantly, patients. Ricciardi landed the role and for the next 5 years she championed the patient/consumer voice within the ONC.
It was not an easy job.
“At first, there was a lot of opposition to what I was doing,” admitted Ricciardi. “Some people were concerned about empowering patients. This was borne out of fear of change rather than anything specifically against patients. Lots of people were critical of the path I wanted to take. There were really some low lows.”
Three things kept Ricciardi pushing ahead.
First was her unshakable belief that the needs and opinions of patients were important to the ONC’s mission.
“I kept thinking,” stated Ricciardi. “How can we improve health in the US without considering the individuals we were trying to help? After all, health outcomes are dependent on the individual as much as it is on the healthcare provider.”
Second was a virtual community of healthcare change agents that Ricciardi had gotten to know through social media (predominantly Twitter). Together online, they explored ideas and grew the patient empowerment movement.
“There were these beacons of light and hope out there,” explained Ricciardi. “There was Regina Holliday @ReginaHolliday who would later create The Walking Gallery, Dave deBronkhart @ePatientDave, Tiffany Peterson @TiffanyandLupus and all the people from diverse positions in the industry, not just patients, who would often identify themselves by wearing Blue Buttons at healthcare conferences. Knowing these tireless advocates were out there fighting for the same change kept me going.”
Ricciardi was so impressed with the passion and determination of these early advocates that she actively looked for ways to involve them in ONC activities and events – especially in Washington. Her not-so-secret agenda was to expose as many people as possible to these patients’ perspectives. It all started with bringing Dave deBronkhart to DC.
While she was a consultant, Ricciardi had attended a Health2.0 conference in Boston and heard deBronkhart speak. At the time he had written an article for the Boston Globe that documented his experience (and frustration) with trying to use Google Health. He had tried to gain access to his health data, but was stymied by policies and technical challenges. When deBronkhart finally did get access, he found nothing worthwhile in his record. While in the audience, the lightbulb went off for Ricciardi: “I thought – whoa – we need more of THAT in Washington.”
“Lygeia thrust me into the spotlight,” said deBronkhark. “I had blogged about garbage in my medical record and wound up on the front page of the Boston Globe, a week before the Health 2.0 meets Ix conference. I was up in the ballroom’s balcony when I was asked to stand up to be acknowledged…and who was sitting right below me? Lygeia. Turns out she was on a mission from Deven McGraw who was the Director of the Health Privacy Project at the Center for Democracy and Technology to help define what a personal health record, PHR, should be. She went back and got me invited to my first DC policy meeting. You sure could say Lygeia changed my life – changed the whole trajectory of my life.”
Third was her internal collaborators at the ONC. One was Dr Farzad Mostashari @Farzad_MD – National Coordinator for Health Information Technology.
“I wasn’t even a year into my job at the ONC,” remembered Ricciardi. “I had been trying to convince Farzad to have more patient voices involved in the ONC and move our policies toward greater consumer engagement. Listening to me and other persuasive voices, he ‘got it’ and agreed. And then he pushed me to really charge ahead. He’s the one who suggested ‘Why don’t we organize a consumer-focused event at the start of Health IT Week here in Washington, involving high-level federal official, industry leaders and patients?’.”
“That was in July and by September we had pulled it off. That was unheard of in the government. We had the Secretary of Health speak, Kathleen Sebelius and the Surgeon General. Plus we had industry leaders from health systems, insurers, and retail pharmacies involved. It was exhausting but so rewarding.”
Judy Murphy, Chief Nursing Officer was a collaborator and mentor who helped Ricciardi navigate through tough situations at the ONC.
“Judy supported me professionally,” recalled Ricciardi. “We became friends.”
When asked, Murphy had this to say about Ricciardi: “Over the years I have witnessed the passion and dedication with which Lygeia motivates and inspires others – including her staff and peers while at ONC, her social media followers, as well as many others throughout the Health IT industry – to contribute to something bigger than themselves. She has worked tirelessly to integrate Consumer eHealth into the bigger picture of healthcare transformation through Health IT in a lasting way. I am so very proud to be her colleague and friend.”
Ricciardi’s time at the ONC verified and validated her conviction that many aspects of personal health were within the control of the individual rather than healthcare organizations. Her interactions with patients, policymakers, thought-leaders and healthcare executives convinced her that:
- What you eat
- Where you live
- How frequently you exercise
- Who you associate with
…could matter more than the facility where you received care. These realizations stuck with her after she left the ONC and continues to drive her in her current role at Carium.
Tile 5 – Building the Tools
As Chief Transformation Officer at Carium, a year-old startup founded by experienced business executives from the communications industry, Ricciardi heads the marketing team and provides leadership on go-to-market as well as product strategy.
Carium is building a software-based platform that guides people through their unique health journeys, and helps doctors as well as other caregivers to support them along the way. The company partners with healthcare providers and community-based organizations to overlay software on top of their brick and mortar services, and uses behavior change science to nudge people toward better health.
“Healthcare shouldn’t be as disjointed as it is right now,” emphasized Ricciardi. “It needs to work as a cohesive whole. Health depends on more than just hospitals, doctors and the traditional infrastructure. It is also influenced by everyday behaviors, the environment, social interactions, and genetics – so we need to take all of those factors into account. The best way to do that is to start with the individual and empower them to reach their own personal health goals, supported by others”
Achieving this vision will be challenging, but Ricciardi believes she and the team at Carium are up to the task.
Putting it all together
Ricciardi’s early work writing Harvard case studies gave her the opportunity to learn how to identify big picture trends. Her job at the FCC taught her how to put people and processes in place for a successful program. At the Markle Foundation she leaned into healthcare and figured out how to bring public as well as private organizations together. Her role at the ONC was a masterclass in how to leverage diverse resources to overcome resistance to new ideas.
In each of her roles Ricciardi mastered the ability to: gather people together, put the right people in the right place and maintain perspective while dealing with the challenges and minutiae of the daily grind.
Gathering. Placing. Perspective. These are the skills an expert mosaicist uses to craft beautiful works and the same skills that Ricciardi wields in the pursuit of her goal of empowering healthcare consumers.