Innovation Ecosystem

The little blue engine that could

Pushing and pulling, Rhode Island seeks to propel the state’s economy into the 21st century, recognizing a more diverse marketplace, despite a health care delivery system in shambles and breaking apart

Photo by Richard Asinof

Ravi Kumar, center, president of Infosys, talks with reporters following the Nov. 27 announcement that the global company will be locating a new design and innovation hub in Providence, creating 500 new jobs, as Gov. Gina Raimondo, left, and CommerceRI Secretary, Stefan Pryor, right, listen.

By Richard Asinof
Posted 12/4/17
The decision by Infosys to locate its design and innovation hub in Providence, with the promise of 500 new jobs and possibly more, was one of a number of positive stories last week about efforts to rebuild Rhode Island’s economy. Infosys President Ravi Kumar heralded what he called “the age of convergence” in the design of “experience” in digital technologies. But, beneath the good news, there was an undertow of a health care system in shambles.
When will political leaders of all stripes embrace diversity as an economic asset for Rhode Island? What lessons can be learned by Rhode Island from Infosys and its system of training the next generation of technology workers, focused on hiring graduates in humanities and liberal arts because of their versatility? Where will all the workers filling the new jobs being created by Infosys and Virgin Pulse find a place to live without displacing current residents, given the tight housing market?
Do good silos make good neighbors? Daniel Behr, the executive director of the Office of Industry Engagement and Commercial Venturing at Brown University, recently spoke at MedMates After Hours to discuss his new approach to engagement with companies in the life sciences and medtech arena. But, when asked, Behr said he did not know what health equity zones or neighborhood health stations were; he said he was curious to find out more.
Two days later, Brown University President Christina Paxson and Sylvia Mathews Burwell, the former secretary of Health and Human Services and now president of American University, spoke about the legacy of the Affordable Care Act and the future of health care reform for an audience largely comprised of medical students at Brown. Left entirely out of the conversation, save for one question about the social determinants of health, was any discussion of different models of community health, not necessarily health care, that were not hospital-based.
That same evening, medical students attending the talk by Dr. Damon Tweedy, author of Black Man in a White Coat, as part of the 23rd annual Stanley D. Simon lecture, had a much more engaged conversation attuned to the dynamics of diversity and racism in medicine, once again something not addressed directly by either Paxson or Burwell. At the dinner following the talk, medical students who had not previously known about health equity zones in Rhode Island had an opportunity to learn about them from Ana Novais, the executive director of the R.I. Department of Health.
Perhaps, as Robert Frost’s neighbor suggested, good fences do make good neighbors. At the same time, good conversations make for engaged communities, breaking down silos.

PROVIDENCE – I think we can, I think we can. That was the apt theme of the week, in harmony with the social media campaign launched last week to promote reading in Rhode Island by sharing what your favorite book was when you were a child.

The theme could have easily been drawn from the story of The Little Engine That Could, as a small blue engine pulls a heavy train up and over the high mountain, repeating the phrase over and over: “I think I can, I think I can, I think I can,” huffing and puffing the objectified values of optimism, hard work and determination.

All week long, there were a series of impressive ribbon cuttings and announcements and conversations, many of them featuring Gov. Gina Raimondo, leading the charge of CommerceRI cavalry, with her lieutenant Stefan Pryor, beaming at her side.

On Monday morning, Nov. 27, Infosys announced plans to create a national design innovation hub in Providence, creating 500 new jobs, heralding what Infosys executives called “the age of convergence” in the design of experience in digital technologies. The median annual salary for the new jobs was said to be about $77,000.

The global company, headquartered in Bengaluru [formerly known as Bangalore], India, employs more than 198,000 worldwide, with a market capitalization of $34.59 billion as of Dec. 1, 2017, according to YCharts.

Infosys has pledged that it is committed to hiring some 10,000 American workers over the next two years. The new design and information hub in Providence is the third such investment in the U.S., with technology and innovation hubs also planned for Indianapolis, Ind., and Raleigh, N.C.

Unlike many technology companies, Infosys prefers to train its own workforce, following its own formula for success, hiring new graduates from local universities and community colleges with liberal arts and humanities backgrounds, Ravi Kumar, the president of Infosys, explained to more than 125 people attending the announcement who crowded into the Ship Room at the Providence Public Library, including a phalanx of news media. “Creating talent is our strength,” Kumar said.

The company was lured to consider Providence in part by a persistent effort by CommerceRI’s Lynn Rakowsky to connect with Kumar on his LinkedIn account, an effort that was, ah, initially ignored.

Infosys will receive $10 million in state incentives, including $8.5 million in Qualified Jobs tax credits and some $1.5 million in Rebuild RI tax credits and the First Wave Closing Fund incentives.

“It’s on us to make sure they fall in love with Rhode Island,” said Pryor, hinting at the prospects of more jobs to come with the Infosys public-private collaborative venture.

Pryor predicted that the results of the $10 million in incentives would translate into $18 million in net increased revenues from state taxes over 12 years. The creation of 500 new jobs will add more than $62 million to the state’s gross domestic product, according to Pryor.

On Tuesday, Nov. 28, with lots of fanfare, there was the opening of the new Virgin Pulse global headquarters in downtown Providence. The firm, formerly known as Shape Up, had been located in Framingham, Mass.

The move was accompanied by a 36-second video by billionaire owner Richard Branson, “Hello Providence,” posted on Dec. 1. [See link to video below.]

“Hello, Providence,” the video begins, with a close up of Branson talking. “Virgin Pulse is proud to make a new home in your vibrant city. As Virgin, we believe that healthy societies flourish in cities just like yours, cities which are diverse, cities which are accessible, affordable, social, and committed to the arts.”

Branson continued: “With your hip young culture and some of the world’s best universities, I cannot think of a better city for Virgin Pulse to thrive. We promise to be responsible neighbors; we look forward to bringing our fiercely fun employees and business to your city. Thanks very much. Cheers.”

[Branson had originally purchased ShapeUp, which had been located in Providence, and moved it to Massachusetts.]

On Wednesday, Nov. 29, there was the ribbon cutting ceremony at South Street Landing. It was followed by the announcement of new seasonal direct flights between Providence and Toronto by Air Canada from T. F. Green Airport beginning in May of 2018.

On Thursday, Nov. 30, there was the gala Christmas tree lighting ceremony at the State House, to launch a holiday season of good cheer. [However, a number of grinches were not happy about the dazzling display of blue lights.]

Details, details, details
In the aftermath of the Nov. 27 event announcing the decision by Infosys to create a design innovation hub in Providence, ConvergenceRI followed up with three questions to Infosys.

The questions sought to better understand the context if not the subtext behind the decision to locate in Providence.

The responses were from an unidentified Infosys spokesperson, relayed through the firm’s communications firm.

ConvergenceRI: How important was “diversity” as a factor in choosing Providence and Rhode Island as the site of the design innovation hub?
INFOSYS:
Infosys is hiring 10,000 American workers across the U.S. and we’re looking to help nurture the next generation of innovators for our increasingly digital future.

Rhode Island was particularly interesting because of the mix of talent from experienced designers, design architects, specialists in information design and technical experts, who can help accelerate digital transformation in New England and beyond.

Teams composed of people from diverse backgrounds offer richer perspectives, lending organizations such as ours a sense of dynamism and democracy. It is also a belief reinforced by Design Thinking.

ConvergenceRI: Could you describe in more detail what Ravi Kumar meant when he talked about the concept of “convergence” in digital technology?
INFOSYS:
A new generation of designers are going to be driven by both technology and creative.

Design has matured from a creative endeavor to solving major technological and social challenges. This will accelerate as designers address increasingly complex challenges, from autonomous cars to bioelectronics. Going forward, designers will be measured by advanced skills and experiences across five domains:

• Objects and artifacts
• Services and experiences
• Systems and platforms
• Security and privacy
• Strategy and vision

[The] industry research firm Gartner predicts by 2021, 40 percent of IT staff will be “versatilists,” who will hold multiple roles.

Design as a profession will evolve into a hybrid industry that is driven both by creative and technology, embracing new technologies and standards that continue to change.

New specialties will continuously emerge, such as user-interaction specialists and information architects.

ConvergenceRI: What kinds of housing connections, if any, will Infosys provide to new employees?
INFOSYS:
The jobs are aimed at local people in Rhode Island; we haven’t crossed a bridge on housing connections.

Across the great divide
It was surprising, then, if not shocking, to walk down the steps of the Providence Public Library with two other reporters following the Nov. 27 Infosys announcement and turn on the car radio and listen to a totally different description of what had just taken place at that event, from folks who had not attended the event, or listened to what Kumar, Raimondo, and Pryor had said, both in their presentations and in answering questions from the news media.

The talk show host, apparently following the lead of a number of Republican political operatives, attempted to falsely position the decision by Infosys to locate the new design and innovation hub in Providence as a result of tough talk by President Donald Trump on immigration, even though Kumar had denied that the Trump administration policies had anything to do the firm’s decision to come to Providence.

[At issue, it seemed, was the fact that Infosys had agreed in 2013 under the Obama administation to pay $34 million to settle a case with the U.S. Department of Justice over improper use of foreign workers. In May of 2017 Infosys had announced its plan to hire some 10,000 workers in the U.S., a project that Kumar said had been in the works for more than a year. However, the Infosys announcement in May had been preceded by Trump saying he was going to crackdown on abuse of guest visa programs, in which he named Infosys as an example. Was it coincidence, or cause and effect? Once again, Kumar denied that Trump had had any influence on the firm's decision.]

As reported by The Providence Journal’s Patrick Anderson, state Republican Party Chairman Brandon Bell acknowledged in a phone interview that he couldn’t point to any evidence that Infosys was acting on Trump’s comments, after claiming in a news release that Infosys was now locating jobs in American as a result of the efforts by Trump.

Former state Rep. Joseph Trillo, a potential candidate for the Republican nomination for governor, echoed Bell is saying that Trump was responsible for the good news.

House Minority Leader Patricia Morgan, another Republican candidate running for governor, voiced concern in an interview with Anderson that the state should not be “handing out money to foreign corporations.”

[There were not so much competing narratives, ConvergenceRI realized, but separate competing play lists, with folks happy to be in their own silo, listening through their own noise reduction headphones, regardless of the factual distortion.]

A dark undertow
But, despite all the good reasons for optimism for growing the Rhode Island economy, the events of the past week were also framed by the turmoil of darker forces, the undertow of entropy at work.

In a consent order issued by the R.I. Department of Health on Nov. 30 to Care New England, Memorial Hospital of Rhode Island in Pawtucket was effectively closed down because of concerns for the safety of patients because of a lack of staffing.

The consent order stipulated that between Dec. 1, 2017, and the date when the R.I. Department of Health issued its decisions on Care New England’s pending reverse Certificate of Need applications: “EMS services will no longer transport patients to Memorial Hospital; no new patients will be admitted at Memorial Hospital; and no surgeries will be performed.”

The reason: “The R.I. Department of Health has determined that Memorial does not currently have the staffing levels to safely administer care in these areas.” The agency cited that the hospital did not have a functioning Intensive Care Unit or any on-site gastrointestinal physicians or orthopedists. In addition, the contract with the group providing anesthesia services ended on Nov. 30.

In the meantime, Care New England was still required to maintain respiratory therapy, radiology, laboratory, pharmacy and MRI services, with appropriate staffing levels to support these services.

The projected costs for the Unified Health Infrastructure Project, or UHIP, rose to $491.7 million in the federal fiscal year 2018-2019, with $108 million of that total to be covered by state taxpayers, according to the latest documents filed by the state with the Centers for Medicare and Medicaid Services, as reported by WPRI.

“It’s been a big investment, but we think it’s going to drive, ultimately, a better customer experience for people who need benefits and a better experience for our workforce,” Courtney Hawkins, the director of the R.I. Department of Human Services, told WPRI.

However, Hawkins’ optimism about the future of UHIP was not shared by a number of care providers. As Michael Bigney, the administrator and co-owner of Home Health & Hospice Care of Nursing, told ConvergenceRI last month, his agency finally received long delayed approval to provide home health services for a client; however, that client had been dead for nine months.

The efforts to move toward bundled reimbursements for health care received a big setback on Nov. 30, when the Centers for Medicare and Medicaid Services, at the direction of Administrator Seema Verma, announced that it was rolling back mandatory bundled payment programs for hip and knee replacements covered by Medicare.

In addition, CMS also announced it was canceling hip fracture and cardiac bundled payment models that were scheduled become mandatory on Jan. 1, 2018.

The tax package passed by the U.S. Senate on Friday, Dec. 1, with its handwritten insertions to please lobbyists and the lack of scrutiny, promises to be disaster for the middle-class and threatens America’s long-term economic security, according to Sen. Jack Reed.

“It irresponsibly cuts benefits for students, seniors, working parents, and many others and is designed to put Medicare and Social Security on the chopping block,” Reed said, calling it a “stunning transfer of wealth from taxpayers to millionaires.”

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