0:00:01.296,0:00:03.796
(synth music)

0:00:08.798,0:00:11.845
(audience applause)

0:00:11.845,0:00:13.291
- Well, I want to thank you all for coming

0:00:13.291,0:00:14.961
and especially the people that came

0:00:14.961,0:00:18.236
from outside of Philadelphia[br]that hovered over here.

0:00:18.236,0:00:20.548
Especially those of you that time-traveled

0:00:20.548,0:00:22.043
from other decades and times.

0:00:22.043,0:00:24.375
I'm Steve Klasko, I'm the CEO of

0:00:24.375,0:00:26.960
Stevie's Vinyl Emporium and[br]Implantable Health Chips

0:00:26.960,0:00:29.259
in South Street in Philadelphia.

0:00:29.259,0:00:30.816
That's what I am today,

0:00:30.816,0:00:32.990
but for the past ten years,

0:00:32.990,0:00:35.258
I've been the Presidency of[br]Thomas Jefferson University

0:00:35.258,0:00:37.718
and Jefferson University Hospital System,

0:00:37.718,0:00:40.467
that literally was one of the pioneers

0:00:40.467,0:00:41.714
along with several others

0:00:41.714,0:00:44.408
for what is now called the[br]Leaders of the Optimistic Future

0:00:44.408,0:00:46.224
in Healthcare Revolution,

0:00:46.224,0:00:48.265
from 2015 to 2024.

0:00:48.265,0:00:51.038
So from those of you who are[br]coming from another decade,

0:00:51.038,0:00:53.479
or for those of you who[br]are here in the 2020s,

0:00:53.479,0:00:54.817
I'd like to talk a little bit

0:00:54.817,0:00:56.296
about how that journey happened,

0:00:56.296,0:00:58.164
and maybe give you a little[br]bit of a personal story

0:00:58.164,0:00:59.933
about how it happened for me.

0:00:59.933,0:01:01.793
So first, one of the things that we did,

0:01:01.793,0:01:03.448
we got tired of whining,

0:01:03.448,0:01:05.337
and we decided let's just[br]travel into the future.

0:01:05.337,0:01:06.909
Let's just think about what we want

0:01:06.909,0:01:08.186
and then create it.

0:01:08.186,0:01:11.301
For me, that started in 1977.

0:01:11.301,0:01:12.670
Very important time for me,

0:01:12.670,0:01:14.785
I was a senior medical student.

0:01:14.785,0:01:17.857
It was important because I got[br]asked to give a talk for TED.

0:01:17.857,0:01:19.497
Now not the TED you're thinking of

0:01:19.497,0:01:21.727
because TED didn't exist in 1977.

0:01:21.727,0:01:24.170
It was called Tomorrow's[br]Education of Doctors.

0:01:24.170,0:01:25.601
It was everything different

0:01:25.601,0:01:27.112
than the technology that exists today.

0:01:27.112,0:01:29.082
It was a little slide show with a screen,

0:01:29.082,0:01:30.718
but they asked me to talk about

0:01:30.718,0:01:33.126
what the future of medicine looks like

0:01:33.126,0:01:35.191
from a medical student's point of view.

0:01:35.191,0:01:36.403
The other reason I remember it,

0:01:36.403,0:01:38.279
it was the first time I[br]saw the Rolling Stones.

0:01:38.279,0:01:39.928
This is what they looked like back then.

0:01:39.928,0:01:41.882
I was a huge fan, but what I talked about

0:01:41.882,0:01:44.075
because I was a little[br]nervous about the first talk,

0:01:44.075,0:01:46.670
I talked about, "Can you do[br]anything about spiraling costs?

0:01:46.670,0:01:49.225
"Can you change the fevered service system

0:01:49.225,0:01:50.766
"so we're really rewarding volume,

0:01:50.766,0:01:52.278
"value and not volume,

0:01:52.278,0:01:54.398
"and can you measure outcomes?"

0:01:54.398,0:01:57.879
And I said, "My generation[br]of docs is gonna solve this

0:01:57.879,0:01:59.531
"over the next four years.

0:01:59.531,0:02:01.627
"We are not going to be dealing with this

0:02:01.627,0:02:03.846
"even 20 years from now."

0:02:03.846,0:02:06.635
Well amazingly the docs said, "No."

0:02:06.635,0:02:07.926
And that didn't happen.

0:02:07.926,0:02:10.648
Now I was also a very[br]different person back in 1977,

0:02:10.648,0:02:14.256
this is what I looked like.[br](applause and cheering)

0:02:14.256,0:02:16.006
Thank you, thank you.

0:02:18.514,0:02:22.681
That's called a leisure suit.[br](audience laughing)

0:02:23.678,0:02:25.922
And but for a brief interlude

0:02:25.922,0:02:27.794
where they tried to bring it back in 2019,

0:02:27.794,0:02:29.023
I think it's safe to say

0:02:29.023,0:02:31.651
it's out of the fashion lexicon forever,

0:02:31.651,0:02:34.407
but the car was a 1968 GTO which was,

0:02:34.407,0:02:36.661
and is, a very cool car.[br](audience light applause)

0:02:36.661,0:02:38.210
Thank you.

0:02:38.210,0:02:39.737
So there we went through really

0:02:39.737,0:02:42.255
what was what some people[br]call the middle or dark ages,

0:02:42.255,0:02:43.772
the Managed Care Revolution,

0:02:43.772,0:02:45.805
which did not really manage anything.

0:02:45.805,0:02:47.308
It didn't really provide care,

0:02:47.308,0:02:49.080
it just promoted under utilization.

0:02:49.080,0:02:50.277
The Balanced Budget Amendment,

0:02:50.277,0:02:52.153
which didn't really balance the budget,

0:02:52.153,0:02:53.457
and didn't really amend anything.

0:02:53.457,0:02:54.687
And then the first iteration

0:02:54.687,0:02:56.639
of what has now been 17 iterations

0:02:56.639,0:02:58.841
of what was then called Obamacare.

0:02:58.841,0:03:00.555
So that bring us to 2014,

0:03:00.555,0:03:02.764
and why was 2014 important to me?

0:03:02.764,0:03:04.086
Well I was very proud and honored

0:03:04.086,0:03:05.911
to be inaugurated and selected

0:03:05.911,0:03:07.882
as the first president and CEO

0:03:07.882,0:03:10.052
of Thomas Jefferson University

0:03:10.052,0:03:11.801
and Health Systems combined.

0:03:11.801,0:03:13.198
It was also a big moment for me

0:03:13.198,0:03:15.248
because it was the second[br]time I saw the Rolling Stones,

0:03:15.248,0:03:18.916
and this is what they[br]looked like back in 2014.

0:03:18.916,0:03:21.533
And in my inauguration[br]I was given a script,

0:03:21.533,0:03:23.796
and what I talked about[br]in inauguration of 2014 is

0:03:23.796,0:03:25.423
"Hey, can we do anything[br]about spiraling costs?

0:03:25.423,0:03:27.880
"Can we change the fevered service system?

0:03:27.880,0:03:30.087
"Do you think we can measure outcomes?"

0:03:30.087,0:03:31.659
So it was a bit of an aha moment for me,

0:03:31.659,0:03:33.427
I said, "Well, 37 years, that's a lot

0:03:33.427,0:03:35.471
for not to have much change."

0:03:35.471,0:03:38.221
This time though, the[br]insurers and government said,

0:03:38.221,0:03:40.462
"We're really going to do it."

0:03:40.462,0:03:43.895
And really what people were[br]actually predicting is,

0:03:43.895,0:03:46.649
because believe it or not even at 2014

0:03:46.649,0:03:50.052
the docs said, "I really[br]don't want to take any risks.

0:03:50.052,0:03:52.429
"I think things are[br]fine the way they are."

0:03:52.429,0:03:53.814
And you couldn't go a week

0:03:53.814,0:03:55.737
without people threatening the extinction

0:03:55.737,0:03:57.737
of academic health centers.

0:03:57.737,0:04:00.790
So I'm proud to say here in[br]Philadelphia and Jefferson,

0:04:00.790,0:04:03.265
we said yes, and I'd love[br]to talk to you a little bit

0:04:03.265,0:04:06.695
about what happened between 2014 and 2024.

0:04:06.695,0:04:09.231
So here we are in 2024, and by the way,

0:04:09.231,0:04:11.138
I don't know if any of you saw it

0:04:11.138,0:04:13.782
in your Facebook implantable glasses,

0:04:13.782,0:04:16.463
the Zombie Rock Tour, it was awesome.

0:04:16.463,0:04:18.024
It was awesome.

0:04:18.024,0:04:20.524
By the way, those Facebook[br]implantable glasses,

0:04:20.524,0:04:22.600
can be bought at Stevie's Vinyl Records

0:04:22.600,0:04:24.200
and Implantable Devices.

0:04:24.200,0:04:27.497
This is, I thought the Rolling Stones,

0:04:27.497,0:04:30.532
the Rolling Stones rocked,[br](audience laughter)

0:04:30.532,0:04:32.484
they rocked the undead tour, right?

0:04:32.484,0:04:35.327
Who agrees with me? They[br]rocked the undead tour.

0:04:35.327,0:04:37.852
Seven decades of great Rolling Stones,

0:04:37.852,0:04:40.151
You talk about not[br]getting any satisfaction,

0:04:40.151,0:04:41.734
look at these guys.

0:04:43.122,0:04:45.547
But more importantly, more importantly,

0:04:45.547,0:04:46.901
what happened in Philadelphia,

0:04:46.901,0:04:48.696
what happened at Jefferson was,

0:04:48.696,0:04:50.861
that we took, we took that mode of,

0:04:50.861,0:04:53.905
people saying that it's[br]impossible to change healthcare.

0:04:53.905,0:04:56.218
And really the personal piece[br]for me believe it or not

0:04:56.218,0:04:59.484
did not come from Admonities[br]or Aristotle, or even somebody

0:04:59.484,0:05:01.427
from the University of[br]Pennsylvania or Jefferson.

0:05:01.427,0:05:03.394
It came from a sneaker commercial.

0:05:03.394,0:05:06.621
It was an Adidas marketing[br]campaign back in 2014

0:05:06.621,0:05:08.054
called the Impossible,

0:05:08.054,0:05:09.913
it said "Impossible is just a big word

0:05:09.913,0:05:11.677
"thrown around by small men and women

0:05:11.677,0:05:14.149
"who find it easier to live[br]the world they've been given

0:05:14.149,0:05:16.763
"rather than explore the[br]power they have to change it.

0:05:16.763,0:05:18.795
"Impossible is not a fact it's an opinion.

0:05:18.795,0:05:22.164
"Impossible is temporary,[br]impossible is nothing."

0:05:22.164,0:05:25.583
So we decided, what the heck,[br]let's do the impossible.

0:05:25.583,0:05:27.650
Because everybody know[br]things were changing,

0:05:27.650,0:05:29.961
we weren't going to wait for a miracle.

0:05:29.961,0:05:32.386
And we said, "Let's do it."

0:05:32.386,0:05:34.873
Okay so, here it is, it's March 28, 2024,

0:05:34.873,0:05:37.531
now I apologize for those of[br]you who come from this decade,

0:05:37.531,0:05:40.167
but I know some of you[br]probably have time travel lag,

0:05:40.167,0:05:42.478
and I just want you to[br]know where we're at today.

0:05:42.478,0:05:45.187
So it's March 28, 2024,[br]President Jenna Bush

0:05:45.187,0:05:47.785
will be debating democratic[br]nominee Chelsea Clinton,

0:05:47.785,0:05:50.511
in what a lot of people think[br]will be a very tight race.

0:05:50.511,0:05:52.053
Harrison Ford has signed on

0:05:52.053,0:05:54.451
for one last Indiana Jones sequel.

0:05:54.451,0:05:57.393
Tentatively titled Indiana[br]Jones: the Legend of Bingo Night,

0:05:57.393,0:05:59.408
we're all excited about that one.

0:05:59.408,0:06:00.710
And the Eagles are 2-0

0:06:00.710,0:06:02.630
and trying to win their first Superbowl

0:06:02.630,0:06:05.089
since the unprecedented[br]four straight they won

0:06:05.089,0:06:08.412
from 2015 to 2018, the so-called[br]Chip Championship Years.

0:06:08.412,0:06:12.228
(audience applause and cheering)

0:06:12.228,0:06:14.514
Of course, Governor Chip[br]now has a very different job

0:06:14.514,0:06:16.623
than he had back then.

0:06:16.623,0:06:19.267
But more importantly, more[br]importantly or as importantly,

0:06:19.267,0:06:22.008
Jefferson is celebrating[br]it's 200th anniversary

0:06:22.008,0:06:23.481
as a state wide national,

0:06:23.481,0:06:25.132
and international hub of innovation,

0:06:25.132,0:06:26.532
with headquarters in Philadelphia

0:06:26.532,0:06:28.642
instead of just a Philadelphia[br]academic medical center.

0:06:28.642,0:06:30.259
We've become a destination site

0:06:30.259,0:06:32.450
for innovation entrepreneurial health

0:06:32.450,0:06:34.702
with unprecedented economic development.

0:06:34.702,0:06:36.618
And our creative[br]partnerships have allowed us

0:06:36.618,0:06:39.131
to become what the Wall[br]Street Journal called

0:06:39.131,0:06:41.644
a thriving cluster on the[br]verge of a chain reaction.

0:06:41.644,0:06:43.739
Which has helped make[br]Philadelphia the epicenter

0:06:43.739,0:06:44.698
of the new healthcare.

0:06:44.698,0:06:46.964
Oh and by the way, I'm[br]getting out of my DeLorean

0:06:46.964,0:06:48.575
to accept an award from the US News

0:06:48.575,0:06:51.657
and the Interplanetary[br]Report, as most of you know,

0:06:51.657,0:06:53.804
in 2019 we found two other planets

0:06:53.804,0:06:55.739
with slightly disfunctional heath systems.

0:06:55.739,0:06:58.067
So they are now part of the ranking system

0:06:58.067,0:07:00.461
that the forward USNWR uses.

0:07:00.461,0:07:02.130
So how did we get there?

0:07:02.130,0:07:04.507
I'd like to, TEDx has[br]asked me to talk about

0:07:04.507,0:07:07.895
three things that we did[br]that were very different.

0:07:07.895,0:07:10.004
First of all we decided that we're going

0:07:10.004,0:07:11.578
to start to create docs of the future.

0:07:11.578,0:07:14.304
That it's ridiculous to have the same way

0:07:14.304,0:07:16.855
that we selected and educated physicians

0:07:16.855,0:07:19.705
that became autonomous,[br]competitive, and hierarchical,

0:07:19.705,0:07:21.650
and that we actually were[br]going to change the DNA

0:07:21.650,0:07:24.444
of healthcare literally[br]one physician at a time.

0:07:24.444,0:07:25.704
You might now believe this,

0:07:25.704,0:07:28.631
but back in 2014 we still[br]chose doctors based on

0:07:28.631,0:07:32.837
science GPAs, MedCaTs which[br]were a multiple choice test,

0:07:32.837,0:07:34.841
and organic chemistry performance.

0:07:34.841,0:07:37.026
And somehow we were amazed[br]that doctors weren't

0:07:37.026,0:07:38.932
more empathetic,[br]commutative, and creative.

0:07:38.932,0:07:42.223
(audience laughter)[br]As my kids would say, "Duh."

0:07:42.223,0:07:43.625
So we changed all that.

0:07:43.625,0:07:45.506
What we recognized is

0:07:45.506,0:07:49.233
that it used to be for those[br]of you who came from the 70s,

0:07:49.233,0:07:51.659
and I think there are actually some,

0:07:51.659,0:07:53.405
I see some people from 2014,

0:07:53.405,0:07:55.010
I see some people from the 80s.

0:07:55.010,0:07:56.427
Go Journey, yeah.

0:07:57.464,0:08:01.631
I see some tie dye out there,[br]some 60s and 70s, peace.

0:08:02.604,0:08:05.354
But we decided to transform admissions.

0:08:05.354,0:08:09.133
What we realized is that[br]all the scientific data

0:08:09.133,0:08:12.558
is all on, what we called in[br]2014, iPhones and Androids,

0:08:12.558,0:08:13.935
but really what we needed

0:08:13.935,0:08:15.885
were really emotionally[br]intelligent physicians.

0:08:15.885,0:08:18.780
So we now really select[br]physicians based on

0:08:18.780,0:08:20.727
self-awareness, self-management,

0:08:20.727,0:08:22.175
and the ability to adapt,

0:08:22.175,0:08:23.987
social awareness and empathy,

0:08:23.987,0:08:26.034
relationship management, teamwork,

0:08:26.034,0:08:28.411
and the ability to really embrace change

0:08:28.411,0:08:29.656
instead of fighting it.

0:08:29.656,0:08:32.206
But not only that we[br]totally changed the way

0:08:32.206,0:08:34.785
that we teach the physicians[br]that we do accept.

0:08:34.785,0:08:36.884
Believe it or not back in 2014,

0:08:36.884,0:08:39.967
we used to spend two[br]years really teaching them

0:08:39.967,0:08:42.820
scientific principles[br]in large auditoriums,

0:08:42.820,0:08:44.820
classes that a lot of them didn't come to,

0:08:44.820,0:08:46.595
when we recognized that[br]we could do all that,

0:08:46.595,0:08:48.517
have them learn that at[br]two o'clock in the morning.

0:08:48.517,0:08:50.112
Now we spend most of our time

0:08:50.112,0:08:52.296
in what we call the Art of Attending.

0:08:52.296,0:08:53.935
Teaching them to really observe,

0:08:53.935,0:08:56.952
we started back in[br]2014, workshops designed

0:08:56.952,0:08:59.691
to sharpen observation[br]skills of health students

0:08:59.691,0:09:01.252
by looking at art.

0:09:01.252,0:09:02.749
Very unusual partnership,

0:09:02.749,0:09:04.409
it was Thomas Jefferson University,

0:09:04.409,0:09:06.055
a contemporary art museum,

0:09:06.055,0:09:09.411
and an institute for an[br]optimistic future in healthcare.

0:09:09.411,0:09:12.619
We took students and[br]had them understand art.

0:09:12.619,0:09:15.799
So if you take this[br]piece of art over here.

0:09:15.799,0:09:17.148
Medical students originally said,

0:09:17.148,0:09:20.039
"That's a woman, that's a[br]snake, that's a family."

0:09:20.039,0:09:22.870
But when you start to look[br]and say what is the story?

0:09:22.870,0:09:24.681
It starts to totally change the way

0:09:24.681,0:09:26.804
that they cared for patients.

0:09:26.804,0:09:29.799
And at the end of the[br]day we went from silos

0:09:29.799,0:09:31.103
of full-time individuals

0:09:31.103,0:09:34.724
to folks who could deliver[br]team-enabled and team-based care.

0:09:34.724,0:09:36.978
Doctors went from being[br]captains of the ship

0:09:36.978,0:09:38.618
to being part of a team,

0:09:38.618,0:09:40.214
and they believe it or not worked closely

0:09:40.214,0:09:42.419
with multidisciplinary[br]care and delivery teams.

0:09:42.419,0:09:44.528
Including doctors of nursing practice,

0:09:44.528,0:09:46.612
nurse practitioners, clinical pharmacists,

0:09:46.612,0:09:48.055
physician's assistants,

0:09:48.055,0:09:49.803
and at the Thomas Jefferson Institute

0:09:49.803,0:09:51.099
of Emerging Health Professions,

0:09:51.099,0:09:54.279
professions that didn't[br]even exist in 2014.

0:09:54.279,0:09:56.751
Things like probability experts,

0:09:56.751,0:09:58.718
electronic health care ambassadors,

0:09:58.718,0:10:00.855
and telehealth professionals.

0:10:00.855,0:10:04.549
So we recognized that we[br]need to evolve doctoring.

0:10:04.549,0:10:07.843
We also recognized that[br]the patient experience

0:10:07.843,0:10:09.714
was really pretty lousy.

0:10:09.714,0:10:13.074
Back in 2014 you could actually do

0:10:13.074,0:10:15.292
anything you needed to do in travel,

0:10:15.292,0:10:18.140
anything you needed to do[br]in shopping, on a device,

0:10:18.140,0:10:20.761
but could you get an appointment[br]with a physician? No.

0:10:20.761,0:10:23.641
Could you interact with[br]a doctor or nurse? No.

0:10:23.641,0:10:26.756
So we decided that[br]healthcare needed in 2014,

0:10:26.756,0:10:28.426
to get into the E and I mode.

0:10:28.426,0:10:32.425
If you even look at how people[br]viewed us from TV shows,

0:10:32.425,0:10:34.883
how many of you are here from the 70s?

0:10:34.883,0:10:36.018
There you go, okay.

0:10:36.018,0:10:39.089
So the big tip in the[br]70s was Marcus Welby.

0:10:39.089,0:10:40.648
Now here's what Marcus Welby was,

0:10:40.648,0:10:43.623
he was a family physician, he[br]would get up in the morning,

0:10:43.623,0:10:45.140
he would go to the homeless shelter,

0:10:45.140,0:10:46.655
take care of people for free.

0:10:46.655,0:10:48.347
On the way home to lunch

0:10:48.347,0:10:50.304
a cow would be having[br]trouble delivering a calf,

0:10:50.304,0:10:51.561
he'd deliver it.

0:10:51.561,0:10:54.710
He'd then go to his family[br]medicine office in the afternoon,

0:10:54.710,0:10:57.226
and then at night he'd do[br]lecithin ventricular neurosurgery.

0:10:57.226,0:10:58.958
We were gods, we could do everything,

0:10:58.958,0:11:00.678
that's how people viewed us.

0:11:00.678,0:11:02.783
In the 2010s this is what we had.

0:11:02.783,0:11:06.216
Anybody remember this guy?[br](audience laughter)

0:11:06.216,0:11:09.364
He was a drug addicted,[br]sex addicted, really smart,

0:11:09.364,0:11:12.281
guy that couldn't[br]communicate or see patients.

0:11:12.281,0:11:14.501
That's what people viewed us.

0:11:14.501,0:11:17.201
The number one TV show of 2023?

0:11:17.201,0:11:21.368
Was Doctor WHHO, stands for[br]Watson Hybrid Hydro-Organo,

0:11:22.739,0:11:25.561
Doc, who basically fell in love

0:11:25.561,0:11:28.710
with his robotic-bionic counterpart

0:11:28.710,0:11:30.365
who does all the scientific stuff,

0:11:30.365,0:11:32.225
while he does the emotional stuff.

0:11:32.225,0:11:34.240
And as you can imagine, hilarity ensues.

0:11:34.240,0:11:37.057
By the way--[br](audience laughs)

0:11:37.057,0:11:40.544
By the way the first[br]season, the first season,

0:11:40.544,0:11:42.846
of Doctor WHHO is available

0:11:42.846,0:11:45.617
on Google Glass implantable chips,

0:11:45.617,0:11:49.220
available in Stevie's Vinyl[br]Records and Implantable Chips

0:11:49.220,0:11:51.309
on South Street.

0:11:51.309,0:11:54.048
So we embrace, the other thing we embraced

0:11:54.048,0:11:55.083
was entrepreneurship.

0:11:55.083,0:11:57.694
We recognized that being[br]academic and entrepreneurial

0:11:57.694,0:11:59.778
just were not mutually exclusive,

0:11:59.778,0:12:01.179
and we also recognized

0:12:01.179,0:12:04.285
that we had to enhance[br]the consumer experience.

0:12:04.285,0:12:06.956
It really was lousy going to a physician.

0:12:06.956,0:12:08.409
This is what it looked like back in 2014.

0:12:08.409,0:12:10.250
(moaning)[br]- What's wrong?

0:12:10.250,0:12:11.655
- I don't feel so good.

0:12:11.655,0:12:14.387
- Then you need to go to a doctor.

0:12:14.387,0:12:16.637
(sneezing)

0:12:20.959,0:12:22.228
- Mr. Stephenson?

0:12:22.228,0:12:23.228
- Stevenson.

0:12:24.392,0:12:26.013
- Do you have any allergies?

0:12:26.013,0:12:27.679
How would you describe your symptoms?

0:12:27.679,0:12:29.065
What is the general area of pain?

0:12:29.065,0:12:30.593
Does your family have a[br]history of heart disease?

0:12:30.593,0:12:32.481
Does your family have[br]a history of diabetes?

0:12:32.481,0:12:35.826
- And what seems to be the[br]problem today, Mr. Stevenson?

0:12:35.826,0:12:38.397
- I'm feeling a little stuffed up.

0:12:38.397,0:12:39.688
I'm experiencing some--

0:12:39.688,0:12:42.267
- Doctor your three o'clock[br]is early, your 2:45 is late,

0:12:42.267,0:12:43.414
from six and seven.

0:12:43.414,0:12:44.786
- Follow these instructions

0:12:44.786,0:12:46.204
and if it doesn't clear[br]up in a week or two

0:12:46.204,0:12:48.040
come back and we'll do[br]this all over again.

0:12:48.040,0:12:50.196
(moaning)

0:12:50.196,0:12:52.779
- I don't like going to the doctor.

0:12:52.779,0:12:54.933
- So in July of 2014,

0:12:54.933,0:12:57.000
we partnered with some great companies,

0:12:57.000,0:13:00.324
created an innovation driven[br]ecosystem for healthcare.

0:13:00.324,0:13:02.830
And starting in 2015 patients in 48 states

0:13:02.830,0:13:05.933
could access doctors via Telemedicine.

0:13:05.933,0:13:07.430
- Well now you can see a doctor

0:13:07.430,0:13:08.846
without going to a doctor's office.

0:13:08.846,0:13:10.296
With the help of your[br]smart phone or computer,

0:13:10.296,0:13:11.854
and American Well.

0:13:11.854,0:13:14.234
Signing up and setting up[br]your health profile is easy,

0:13:14.234,0:13:15.965
it only takes a minute,

0:13:15.965,0:13:18.484
and once you're done it, it's[br]stored safely and securely.

0:13:18.484,0:13:20.120
Then you can log in or use the app

0:13:20.120,0:13:21.690
to see doctors who're available,

0:13:21.690,0:13:24.881
and connect by video phone or chat.

0:13:24.881,0:13:28.949
- Hi Allen, I see you've been[br]experiencing some congestion

0:13:28.949,0:13:30.782
and some nasal blockage.

0:13:30.782,0:13:32.541
How long as this been going on?

0:13:32.541,0:13:33.722
- During the visit,

0:13:33.722,0:13:35.200
the doctor can see your[br]health information,

0:13:35.200,0:13:37.028
afterward you get a complete write-up

0:13:37.028,0:13:38.194
of everything the doctor says.

0:13:38.194,0:13:40.192
- Well it looks like acute sinusitis,

0:13:40.192,0:13:41.890
a sinus infection.

0:13:41.890,0:13:44.679
Now I wrote you a prescription[br]to help with the congestion.

0:13:44.679,0:13:47.168
If things don't clear[br]up in say, a week or so,

0:13:47.168,0:13:48.556
just send me a message.

0:13:48.556,0:13:49.782
I'll be right here.

0:13:49.782,0:13:51.725
- A few minutes later[br]I've got my diagnosis,

0:13:51.725,0:13:53.040
and my instructions for treatment,

0:13:53.040,0:13:54.662
and my prescription is[br]already waiting for me

0:13:54.662,0:13:55.724
at the pharmacy.

0:13:55.724,0:13:59.395
- Of course all that now is[br]happens in your Google Glasses

0:13:59.395,0:14:01.661
which are available by the way

0:14:01.661,0:14:05.624
at Stevie's Vinyl Records[br]and Implantable Health Chips.

0:14:05.624,0:14:09.281
We also recognize that[br]information was everything.

0:14:09.281,0:14:10.651
As Yogi Berra would say,

0:14:10.651,0:14:13.111
"It comes down to one word, big data."

0:14:13.111,0:14:16.519
And believe it or not, believe it or not,

0:14:16.519,0:14:19.913
we used to do everything based[br]on experience and anecdote.

0:14:19.913,0:14:24.080
Evidence based medicine in[br]2024 was actually a novel idea.

0:14:25.267,0:14:28.039
And now we recognize[br]that we can take things

0:14:28.039,0:14:29.160
from other industries.

0:14:29.160,0:14:31.677
So at Jefferson for example, in 2014,

0:14:31.677,0:14:33.768
we started the Center for[br]Healthcare and Entrepreneurship

0:14:33.768,0:14:35.297
and Scientific Solutions.

0:14:35.297,0:14:40.019
We said it really doesn't[br]make any sense that Nick Foles

0:14:40.019,0:14:43.043
has a better idea whether or[br]not a screen pass will work,

0:14:43.043,0:14:44.172
in the third quarter,

0:14:44.172,0:14:46.476
than I do of whether or not[br]a cancer drug will work.

0:14:46.476,0:14:47.641
So we took some of the best people

0:14:47.641,0:14:49.408
doing mathematical modelling

0:14:49.408,0:14:52.446
and created a predictive analytics[br]of mathematical modelling

0:14:52.446,0:14:54.463
to reduce uncertainty of medicine.

0:14:54.463,0:14:56.386
Believe it or not in 2014,

0:14:56.386,0:14:59.782
28% of people that went to[br]the hospital in this country

0:14:59.782,0:15:02.494
got readmitted within 90 days.

0:15:02.494,0:15:04.587
Now through our mathematical modelling

0:15:04.587,0:15:06.511
we're able to see[br]exactly what intervention

0:15:06.511,0:15:08.807
will keep people from coming back.

0:15:08.807,0:15:10.825
Not only that we've changed[br]the way we do things.

0:15:10.825,0:15:13.940
In 2014, family medicine physicians

0:15:13.940,0:15:15.955
would actually be out of the hospital.

0:15:15.955,0:15:18.303
Hospitalists would never[br]leave the hospital,

0:15:18.303,0:15:20.257
and then there was no real communication.

0:15:20.257,0:15:22.429
Now we have what's called extensivists.

0:15:22.429,0:15:25.545
Hospitalists that actually[br]follow those patients for 90 days

0:15:25.545,0:15:27.878
so they don't get readmitted.

0:15:27.878,0:15:29.937
We actually pay for performance now

0:15:29.937,0:15:32.036
because we can actually[br]measure performance.

0:15:32.036,0:15:35.074
And we can actually give[br]you predictable answers

0:15:35.074,0:15:38.460
as to what you're paying for[br]and what you're getting back.

0:15:38.460,0:15:40.173
And accountable care organizations

0:15:40.173,0:15:42.113
for the first time really are accountable

0:15:42.113,0:15:44.348
because we have math to back it up.

0:15:44.348,0:15:47.242
One of the great things that[br]happened in Philadelphia,

0:15:47.242,0:15:49.073
believe it or not again in 2014,

0:15:49.073,0:15:51.375
with decreasing NIH funding,

0:15:51.375,0:15:54.578
Penn, Jefferson, Temple, Drexel,

0:15:54.578,0:15:57.050
would all fight for NIH funds.

0:15:57.050,0:16:00.341
What we did, and one of[br]the greatest things we did,

0:16:00.341,0:16:02.796
we created the Philadelphia[br]Clinical Research Super Site.

0:16:02.796,0:16:04.606
Where we said really what's important

0:16:04.606,0:16:06.505
is to take all of our resources,

0:16:06.505,0:16:08.114
both in education and research,

0:16:08.114,0:16:10.004
and make Philadelphia an epicenter.

0:16:10.004,0:16:12.174
What did that do for us[br]over the last 10 years?

0:16:12.174,0:16:14.652
Well were able to take the[br]Nanotechnology University

0:16:14.652,0:16:17.757
of Pennsylvania and Molecular[br]Genomics at Jefferson

0:16:17.757,0:16:20.303
and create the DNA vending machine.

0:16:20.303,0:16:21.728
For those of your from the 2010s,

0:16:21.728,0:16:24.048
it's sort of like a red box for your DNA.

0:16:24.048,0:16:25.670
We can now pick a drug for you,

0:16:25.670,0:16:28.889
instead of saying it's for[br]200 people that look like you,

0:16:28.889,0:16:31.592
we can take exactly the[br]drug that fits your genome

0:16:31.592,0:16:33.246
and have it available for you.

0:16:33.246,0:16:35.171
We can also put your genome on a chip,

0:16:35.171,0:16:37.795
so that God forbid, if[br]you need a new organ,

0:16:37.795,0:16:39.028
we can make that for you

0:16:39.028,0:16:42.039
based on work that's been[br]done in Philadelphia.

0:16:42.039,0:16:44.677
And we finally decided[br]to work with patients

0:16:44.677,0:16:47.740
to really make them[br]shareholders in their health,

0:16:47.740,0:16:49.264
and this is what it means.

0:16:49.264,0:16:51.969
It means that in a[br]community like Philadelphia,

0:16:51.969,0:16:53.621
if we're able to make you healthier

0:16:53.621,0:16:56.413
we do better as physicians,[br]and you do better.

0:16:56.413,0:16:58.649
And we actually partnered[br]with great companies

0:16:58.649,0:17:00.562
from again outside Philadelphia

0:17:00.562,0:17:02.365
to look at a different way

0:17:02.365,0:17:04.724
of making sure that everyone matters.

0:17:04.724,0:17:08.429
That we can look at not only[br]drugs, but holistic remedies

0:17:08.429,0:17:11.734
to look at personalized[br]performance game plans

0:17:11.734,0:17:15.297
integrating a proven system[br]to drive health outcomes.

0:17:15.297,0:17:17.453
Whether it's mindset, or nutrition,

0:17:17.453,0:17:18.992
or movement, or recovery,

0:17:18.992,0:17:20.821
we were able to do many more things

0:17:20.821,0:17:23.119
that didn't require pharmaceuticals.

0:17:23.119,0:17:26.473
So that brings us to 2024, and as I said,

0:17:26.473,0:17:28.965
I'm here to accept our number one ranking

0:17:28.965,0:17:31.158
from the US News and Interplanetary Report

0:17:31.158,0:17:32.956
and what's really cool is

0:17:32.956,0:17:34.851
that some of the ranking parameters

0:17:34.851,0:17:36.469
didn't even exist in 2014,

0:17:36.469,0:17:37.666
and I'll give you an example

0:17:37.666,0:17:39.232
of a few of them on the academic side,

0:17:39.232,0:17:40.813
and a few of them on the clinical side.

0:17:40.813,0:17:44.074
On the academic side we[br]actually, imagine this,

0:17:44.074,0:17:46.540
get ranked based on how our students do

0:17:46.540,0:17:48.885
at one year, three year, and five year.

0:17:48.885,0:17:51.466
We measure individual professional[br]and personal happiness

0:17:51.466,0:17:54.310
at varying interval after graduation.

0:17:54.310,0:17:56.727
Because after all, that's why[br]they came to our university.

0:17:56.727,0:17:58.656
And if we don't do really well,

0:17:58.656,0:18:00.788
then they actually get[br]some of their money back.

0:18:00.788,0:18:02.737
We have a collaborative quotient,

0:18:02.737,0:18:04.851
academic entities are incentivized

0:18:04.851,0:18:06.784
to actually get over themselves[br]and work well with others,

0:18:06.784,0:18:08.675
(audience laughter)

0:18:08.675,0:18:11.684
which would have been unheard of in 2014

0:18:11.684,0:18:14.262
when they were all[br]cannibalizing each other.

0:18:14.262,0:18:16.330
And we have an entrepreneurial quotient,

0:18:16.330,0:18:17.877
institutions were awarded,

0:18:17.877,0:18:20.659
that invent and envision[br]new ways of doing things

0:18:20.659,0:18:22.108
that generate alternate revenue

0:18:22.108,0:18:24.152
and develop new student opportunities.

0:18:24.152,0:18:27.249
But probably nothing's changed the most,

0:18:27.249,0:18:28.813
than health quotients.

0:18:28.813,0:18:31.676
I mean, it used to be[br]back in 2014 and before,

0:18:31.676,0:18:32.958
that parameters were based

0:18:32.958,0:18:35.086
on reputational scores in the past.

0:18:35.086,0:18:36.921
Now it's based on what patients think.

0:18:36.921,0:18:39.434
For one, I'm really proud[br]of that we a very high score

0:18:39.434,0:18:41.498
on is called the BUB Quotient.

0:18:41.498,0:18:44.095
It stands for the Believable[br]Understandable Bill,

0:18:44.095,0:18:46.508
that we actually have[br]enough respect for patients,

0:18:46.508,0:18:48.505
that we provide understandable bills

0:18:48.505,0:18:50.443
so they can understand what they got

0:18:50.443,0:18:52.436
and what they're paying for.

0:18:52.436,0:18:53.950
We have the Say What You Mean

0:18:53.950,0:18:56.097
and Mean What You Say quality parameter.

0:18:56.097,0:18:57.776
We actually take marketing professionals

0:18:57.776,0:19:00.028
to read all the billboards[br]and the marketing we do,

0:19:00.028,0:19:02.292
and see if they have[br]any semblance to reality

0:19:02.292,0:19:04.202
of what really happens in the hospital,

0:19:04.202,0:19:06.983
and you get points if there[br]is some semblance to reality.

0:19:06.983,0:19:08.553
And then finally we have

0:19:08.553,0:19:10.301
the Through the Patient's Eyes factor.

0:19:10.301,0:19:12.284
And this is really exciting[br]because what it is,

0:19:12.284,0:19:14.475
is every patient now in 2024,

0:19:14.475,0:19:16.867
is basically when they get in the hospital

0:19:16.867,0:19:18.160
given a Google Glasses,

0:19:18.160,0:19:20.313
and they basically can record

0:19:20.313,0:19:23.358
what's happening through their eyes.

0:19:23.358,0:19:25.466
How the doctors and[br]nurses are treating them

0:19:25.466,0:19:27.655
and then we have CEOs of other hospitals

0:19:27.655,0:19:29.406
look at that video for a day

0:19:29.406,0:19:32.164
and grade on 1 to 10 how[br]they'd like to spend a day

0:19:32.164,0:19:33.298
in that hospital.

0:19:33.298,0:19:35.514
And again that's a great parameter for us.

0:19:35.514,0:19:38.545
So a lot has happened since 2024,

0:19:38.545,0:19:40.518
and I'm really excited to be here,

0:19:40.518,0:19:41.748
we're about to accept an award

0:19:41.748,0:19:43.413
in the new convention center an casino

0:19:43.413,0:19:44.596
on the Schuylkill River.

0:19:44.596,0:19:47.037
(audience laughter)

0:19:47.037,0:19:50.416
And some things from the[br]past really are good,

0:19:50.416,0:19:53.193
I'm going through my third mid-life crisis

0:19:53.193,0:19:55.140
because I'm 70 and I'm,

0:19:55.140,0:19:57.105
what happens is people live to 120,

0:19:57.105,0:19:58.846
so mid-life crises have changed.

0:19:58.846,0:20:00.635
And I'm proud to say[br]this is what got myself,

0:20:00.635,0:20:01.586
I was able to retrofit[br](audience applause)

0:20:01.586,0:20:05.147
a GTO to hit the standards for hovercraft.

0:20:05.147,0:20:07.220
Excuse me for a second.

0:20:07.220,0:20:09.579
Google Glass out, could you get the GTO

0:20:09.579,0:20:11.540
to get ready to go to the[br]convention center, great.

0:20:11.540,0:20:14.239
Thank you, listen I want to[br]really thank you for being here,

0:20:14.239,0:20:16.661
I want to thank you for[br]travelling in time and space,

0:20:16.661,0:20:19.749
and most importantly, stay[br]healthy in Philadelphia.

0:20:19.749,0:20:23.916
Thank you very much.[br](audience applause)