ad-free
Channel / Source:
TEDx Talks
Published: 2014-11-17
Source: https://www.youtube.com/watch?v=esugL07XANg
I want to thank you all for coming in especially the people that came from outside of Philadelphia that hovered over here specially those you the time travel from other decades in times I'm Steve classico I'm the CEO Stevie's vinyl emporium implantable health tips and South Street Philadelphia that's what I am today but for the past ten years I've been the presidency of Thomas Jefferson university in
Jefferson university hospital system that literally I was one of the pioneers along with several others for what is now called the leaders of the optimistic future in healthcare revolution up from twenty fifteen twenty twenty four so for those of you are coming from another decade or for those of you who are here in the twenty twenties like to talk a little bit about how that journey
happen and maybe give a little bit of the personal story about how it happened for me so the first one of things that we did is we got tired of whining and we decided let's just problem the future think about what we want and then created for me that started in nineteen seventy seven very important time for me I was a senior medical student it was
important because I got asked to give a talk for Ted now not to take your thinking of because Ted didn't exist in nineteen seventy seven this call tomorrow's education of doctors it was everything different than the technology exists today was a little slide show with the screen but they asked me to talk about what the future of medicine looks like from a medical students point of
view the other reason I remember it was the first time I saw the rolling stones this is what they look like back then knows each fan but what I talked about this a little nervous about the first talk I talked about can you do anything about borrowing costs his change of fee for service system so we're really rewarding volume value enough volume they can you measure
outcomes and I said you know my generation of doc's is going to solve this over the next four years we are not going to be dealing with this even twenty years from now well amazingly the doc said no and that didn't know I was also a very different person back in nineteen seventy seven this is what I look like %HESITATION that's called a %HESITATION leisure suit
%HESITATION and good for a a brief interlude where they tried to bring it back in twenty nineteen I think it's safe to say it's out of the faction that's the con for ever but the car was in nineteen sixty eight TTL which was and is a very cool car thank you so that we went through really what was what some people call the middle or dark
ages the managed care revolution which are not really manage anything and then really provide care are just promoted under utilization the balanced budget amendment which didn't really balance the budget and didn't really meant anything and in the first iteration of what is now been seventeen iterations of what was then called obamacare separatist to twenty fourteen and what was twenty fourteen important me well very proud and
honored to be inaugurated in selected as the first president CEO of Thomas Jefferson university and health system combined it was also a big moment for me because it was the second time I saw the rolling stones this is what they look like back into one and in my inauguration I was given a script when I talked about a mine operation twenty fourteen Hey can we do
anything about borrowing costs who change the fee for service system do you think we can measure outcomes so the bitter low home loan for me as a well you know thirty seven years that's a that's a lot for not that much change this time though the insurers and government said you know we're really going to do it and really what people were were actually predicting is
because believe it or not even a twenty fourteen that said you know I really don't want to take any risk somehow I think things are fine the way a war and you couldn't go weak without people threatening the extinction of academic health centers so I'm proud to say here in Philadelphia at Jefferson we said yes and I'd love to talk to little bit about what happened
between twenty fourteen and twenty twenty four so here we are twenty twenty four and by the way I don't know if you if any you sought in your Facebook implantable glasses zombie rock tour it was awesome it was awesome by the way those Facebook implantable glasses can be bought at Stevie's vinyl records an implantable devices this is %HESITATION the I thought the the rolling stones the
voice goes wrong they rock the on that floor right now who agrees with me they rock the on that tour seven decades of great wrongs don't you talk about not getting any satisfaction look at these guys but more importantly more importantly what happened in Philadelphia what happened at Jefferson was that we took we took that mode of saying you know people said it's impossible to change
healthcare and really the personal peace for me believe it or not did not come from my mind to dis or Aristotle or even somebody from the university of Pennsylvania Jepsen it came from a sneaker commercial those are the dearest marketing campaign back in two thousand fourteen called the impossible to impossible is just a big word thrown around by small men and women who find it easier
to live the world they've been given rather than explore the power they have to change it possible is not a fact is an opinion impossible was temporary impossible is nothing so we decided what the heck let's do the impossible because everybody knew things were changing we weren't going away for a miracle there we said let's do it okay so here it is March twenty twenty twenty
four and I apologize to those of you come from this decade by know some of you probably have time travel lag and this would you know where we're at today so smart twenty twenty twenty four president Jenna bush will be debating democratic nominee Chelsea Clinton into it a lot of people think of you a very tight race Harrison Ford signed over one last in the I
don't see tenderly title Indiana Jones alleging the bingo night broadside about that one I need those are two ago and trying to win the first Superbowl since the unprecedented four straight there one for twenty fifteen twenty days the so called chip tentatively of course governor chip now has a very different job than he had that but more importantly more importantly resin flirt with Jefferson is celebrating
its two hundredth anniversary as a statewide national international hub of innovation with headquarters of Philadelphia instead of just the phone off the academic Medical Center we become a destination site for innovative entrepreneurial health with unprecedented economic development and are creative partnerships have allowed us to become what the Wall Street journal called a thriving cluster on the verge of a chain reaction just help make Philadelphia the
epicenter of the new health care owned by the way I'm getting out of my the worry to accept an award news news an interplanetary report they as most of you know in twenty nineteen we found two other planets with slightly dysfunctional health systems from there now part of the ranking system that the former U. S. and W. argues so so how do we get there I'd
like to ten X. is F. McCullough three things that we did that were very different first of all we decided that we're going to start to create dots in the future that it's ridiculous they have the same way that we selected an educated positions that became autonomous competitive in hierarchal and that we actually going to change the DNA of health care literally one position the time
you may not believe this but back in twenty fourteen we still chose doctors based on size GPAs Meg cats which were a multiple choice test and organic chemistry performance and somehow we're maze that doctors are more empathetic community of a grin as my kids say Noah so we changed all that what we recognized is that it used to be for those who came from the from
the seventies %HESITATION and I think they're a threesome see some people from twenty fourteen I see some people from the eighties go to go journey yet I see see some some tie dye at their sixties and seventies piece up but I'm but what we decide to transform admissions we thought realized is that all the scientific data is on one twenty four T. we called iPhones and
androids but really what we need and we're really emotional intelligence additions so we now really select positions based on self awareness self management and the ability to adapt social awareness and empathy relationship management team work and the ability to really embrace change instead of fighting but not only that we totally changed the way that we teach physicians that we do accept we are not back in
twenty fourteen we suspend two years released teaching them scientific principles in larger auditoriums classes that a lot of them didn't come to when we recognize we could do all that have been learned that at two o'clock in the morning now we spend most of our time what we call the art of attending teaching them to really observe we started back in twenty fourteen workshops designed to
sharpen observation skills of health students but by looking at art very unusual partnership it was Thomas Jefferson university a contemporary art is you meet museum and it institute for an optimistic future in healthcare we took students and had them understand art so if you take this this piece of our over here medical students really said well that's a woman that's a snake that's a family but
when you start to look and say well what is the story it start to totally change the way that they care for patients at the end of the day we went from silos of full time individuals the folks who could deliver team enabled and team based care doctors were from being captains of the ship to being part of a team and they believe it or not
work closely with multi disparate care delivery teams hooting doctors and nursing practice nurse practitioners clinical pharmacist positions assistance and at the Thomas Jefferson institute of emerging health professions professions that didn't even exist in twenty fourteen things like probability experts electronic health care ambassadors and tele health professionals so we recognized that we needed to evolve doctoring we also recognize patient experience was really pretty wealthy back in
twenty fourteen you could actually do anything you need to do and travel anything you need to do in shopping on a device but could you get a point with the position no could you interact with with a doctor or nurse no so we decided that health care needed in twenty fourteen to get into the E. N. I. mode if you even look at how people viewed
us from TV shows how many of you are here from the seventies there you go okay so look the big hit television show in the seventies Marcus Welby that here's a Marcus Welby was his family physician you get up in the morning he would go to the homeless shelter take care people for free on the way home to lunch account would be having trouble delivering a
Kathy deliver it he then go to his family medicine office in the afternoon and then I know you do left ventricular nor surgery we were gods we could do everything that's how people viewed us in the twenty ten this is what we had a lot remember this guy he was a drug addicted sex addicted really smart guy that couldn't communicator see patients that's what people viewed
us the number one TV show of twenty twenty three was doctor who stands for Watson hybrid hydro again no doc who basically fell in love with his robotic bionic counterpart who does all the scientific stuff while he does the emotional stuff and as you can imagine who rarity ensues by the way by the way the first season the first season of %HESITATION of doctor who is
available on on Google glass a implantable chips available at Stevie's %HESITATION vinyl records and implantable chips on South Street so we embraced the other U. embraces entrepreneurship we recognize the being academic an entrepreneurial just were not mutually exclusive and we also recognize that we have to enhance the consumer experience it really was lousy going to a position this is what it looked like back in twenty
one I don't feel so good when you need to go to a doctor %HESITATION are Stephens and even said do you have any allergies Blaisdell area hearts family have a history of diabetes learn what seems to be the problem today in feeling the little stuff lucky three o'clock it's early in it's like follow these instructions and there've been a witness to come back to miss all
of I don't like going to the doctor so ins in July of twenty fourteen we partner with some great companies creating innovation driven ecosystem for healthcare and starting twenty fifteen patients in forty eight states could access Jeff doctors via telemedicine well now you can see a doctor without going to a doctor's office with the help of your smartphone or computer in American well signing up in
setting up your health profile it only takes safely clearly then you can log on to use the app the doctors are available and connect by video phone I see here in CA just Basil no one is during the visit the doctor can see your health efforts afterward we get a complete right above everything the doctors well it looks like you his sons sign it I wrote
you a prescription to help congestion if things don't clear up in say a week or so right a few minutes later I got my diagnosis in mind structure and my prescription is already waiting for me at the pharmacy of course all that now happens in your Google glasses %HESITATION which are available by the way it's Stevie's vinyl records and implantable health tips we also recognize that
information was everything as yogi Berra would say comes down to one word big data and believe it or not believe it or not we used to do everything based on experience and anecdotes evidence based medicine twenty fourteen who was actually a novel idea and now we recognize that we can take things from other industries so a Jefferson for example in twenty fourteen we started the center
for health care entrepreneurship and scientific solutions we said you know it really doesn't make any sense that Nick Foles has a better idea of whether or not a screen pass will work in the third quarter than I do of whether or not a cancer drug will work so we took some of the best people doing mathematical modeling and create a predictive analytics and mathematical modeling to
reduce uncertainty medicine believe it or not twenty fourteen twenty eight percent of people that went to the hospital in this country got readmitted within ninety days now through our mathematical modeling were able to see exactly what intervention will keep people from coming back not only that we change the way we do things in twenty fourteen family medicine physicians would actually be out of the hospital hospital
list would never leave the hospital and then there was no real communication now we have what's called extensive this hospital was that actually follow those patients for ninety days so they don't get readmitted we actually pay for performance now because we can actually measure performance and we can actually give you predictable answers as to what you're paying for what you're getting back accountable care organizations for
the first time really are accountable because we have math to back it up one of the great things that happened in Philadelphia believe it or not again in twenty fourteen with decreasing NIH funding hand Jefferson temple Drexel would all flight for a nice funds what we did and one of the greatest things we do we trade the Philadelphia clinical research supersite we said really what's important