(synth music)
(audience applause)
- Well, I want to thank you all for coming
and especially the people that came
from outside of Philadelphia that hovered over here.
Especially those of you that time-traveled
from other decades and times.
I'm Steve Klasko, I'm the CEO of
Stevie's Vinyl Emporium and Implantable Health Chips
in South Street in Philadelphia.
That's what I am today,
but for the past ten years,
I've been the Presidency of Thomas Jefferson University
and Jefferson University Hospital System,
that literally was one of the pioneers
along with several others
for what is now called the Leaders of the Optimistic Future
in Healthcare Revolution,
from 2015 to 2024.
So from those of you who are coming from another decade,
or for those of you who are here in the 2020s,
I'd like to talk a little bit
about how that journey happened,
and maybe give you a little bit of a personal story
about how it happened for me.
So first, one of the things that we did,
we got tired of whining,
and we decided let's just travel into the future.
Let's just think about what we want
and then create it.
For me, that started in 1977.
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 the TED you're thinking of
because TED didn't exist in 1977.
It was called Tomorrow's Education of Doctors.
It was everything different
than the technology that exists today.
It was a little slide show with a screen,
but they asked me to talk about
what the future of medicine looks like
from a medical student's point of view.
The other reason I remember it,
it was the first time I saw the Rolling Stones.
This is what they looked like back then.
I was a huge fan, but what I talked about
because I was a little nervous about the first talk,
I talked about, "Can you do anything about spiraling costs?
"Can you change the fevered service system
"so we're really rewarding volume,
"value and not volume,
"and can you measure outcomes?"
And I said, "My generation of docs is gonna solve this
"over the next four years.
"We are not going to be dealing with this
"even 20 years from now."
Well amazingly the docs said, "No."
And that didn't happen.
Now I was also a very different person back in 1977,
this is what I looked like. (applause and cheering)
Thank you, thank you.
That's called a leisure suit. (audience laughing)
And but for a brief interlude
where they tried to bring it back in 2019,
I think it's safe to say
it's out of the fashion lexicon forever,
but the car was a 1968 GTO which was,
and is, a very cool car. (audience light applause)
Thank you.
So there we went through really
what was what some people call the middle or dark ages,
the Managed Care Revolution,
which did not really manage anything.
It didn't really provide care,
it just promoted under utilization.
The Balanced Budget Amendment,
which didn't really balance the budget,
and didn't really amend anything.
And then the first iteration
of what has now been 17 iterations
of what was then called Obamacare.
So that bring us to 2014,
and why was 2014 important to me?
Well I was very proud and honored
to be inaugurated and selected
as the first president and CEO
of Thomas Jefferson University
and Health Systems combined.
It was also a big moment for me
because it was the second time I saw the Rolling Stones,
and this is what they looked like back in 2014.
And in my inauguration I was given a script,
and what I talked about in inauguration of 2014 is
"Hey, can we do anything about spiraling costs?
"Can we change the fevered service system?
"Do you think we can measure outcomes?"
So it was a bit of an aha moment for me,
I said, "Well, 37 years, that's a lot
for not to have much change."
This time though, the insurers and government said,
"We're really going to do it."
And really what people were actually predicting is,
because believe it or not even at 2014
the docs said, "I really don't want to take any risks.
"I think things are fine the way they are."
And you couldn't go a week
without people threatening the extinction
of academic health centers.
So I'm proud to say here in Philadelphia and Jefferson,
we said yes, and I'd love to talk to you a little bit
about what happened between 2014 and 2024.
So here we are in 2024, and by the way,
I don't know if any of you saw it
in your Facebook implantable glasses,
the Zombie Rock Tour, it was awesome.
It was awesome.
By the way, those Facebook implantable glasses,
can be bought at Stevie's Vinyl Records
and Implantable Devices.
This is, I thought the Rolling Stones,
the Rolling Stones rocked, (audience laughter)
they rocked the undead tour, right?
Who agrees with me? They rocked the undead tour.
Seven decades of great Rolling Stones,
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,
people saying that it's impossible to change healthcare.
And really the personal piece for me believe it or not
did not come from Admonities or Aristotle, or even somebody
from the University of Pennsylvania or Jefferson.
It came from a sneaker commercial.
It was an Adidas marketing campaign back in 2014
called the Impossible,
it said "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.
"Impossible is not a fact it's an opinion.
"Impossible is temporary, impossible is nothing."
So we decided, what the heck, let's do the impossible.
Because everybody know things were changing,
we weren't going to wait for a miracle.
And we said, "Let's do it."
Okay so, here it is, it's March 28, 2024,
now I apologize for those of you who come from this decade,
but I know some of you probably have time travel lag,
and I just want you to know where we're at today.
So it's March 28, 2024, President Jenna Bush
will be debating democratic nominee Chelsea Clinton,
in what a lot of people think will be a very tight race.
Harrison Ford has signed on
for one last Indiana Jones sequel.
Tentatively titled Indiana Jones: the Legend of Bingo Night,
we're all excited about that one.
And the Eagles are 2-0
and trying to win their first Superbowl
since the unprecedented four straight they won
from 2015 to 2018, the so-called Chip Championship Years.
(audience applause and cheering)
Of course, Governor Chip now has a very different job
than he had back then.
But more importantly, more importantly or as importantly,
Jefferson is celebrating it's 200th anniversary
as a state wide national,
and international hub of innovation,
with headquarters in Philadelphia
instead of just a Philadelphia academic medical center.
We've become a destination site
for innovation entrepreneurial health
with unprecedented economic development.
And our creative partnerships have allowed us
to become what the Wall Street Journal called
a thriving cluster on the verge of a chain reaction.
Which has helped make Philadelphia the epicenter
of the new healthcare.
Oh and by the way, I'm getting out of my DeLorean
to accept an award from the US News
and the Interplanetary Report, as most of you know,
in 2019 we found two other planets
with slightly disfunctional heath systems.
So they are now part of the ranking system
that the forward USNWR uses.
So how did we get there?
I'd like to, TEDx has asked me to talk about
three things that we did that were very different.
First of all we decided that we're going
to start to create docs of the future.
That it's ridiculous to have the same way
that we selected and educated physicians
that became autonomous, competitive, and hierarchical,
and that we actually were going to change the DNA
of healthcare literally one physician at a time.
You might now believe this,
but back in 2014 we still chose doctors based on
science GPAs, MedCaTs which were a multiple choice test,
and organic chemistry performance.
And somehow we were amazed that doctors weren't
more empathetic, commutative, and creative.
(audience laughter) As my kids would say, "Duh."
So we changed all that.
What we recognized is
that it used to be for those of you who came from the 70s,
and I think there are actually some,
I see some people from 2014,
I see some people from the 80s.
Go Journey, yeah.
I see some tie dye out there, some 60s and 70s, peace.
But we decided to transform admissions.
What we realized is that all the scientific data
is all on, what we called in 2014, iPhones and Androids,
but really what we needed
were really emotionally intelligent physicians.
So we now really select physicians based on
self-awareness, self-management,
and the ability to adapt,
social awareness and empathy,
relationship management, teamwork,
and the ability to really embrace change
instead of fighting it.
But not only that we totally changed the way
that we teach the physicians that we do accept.
Believe it or not back in 2014,
we used to spend two years really teaching them
scientific principles in large auditoriums,
classes that a lot of them didn't come to,
when we recognized that we could do all that,
have them learn that at two o'clock in the morning.
Now we spend most of our time
in what we call the Art of Attending.
Teaching them to really observe,
we started back in 2014, workshops designed
to sharpen observation skills of health students
by looking at art.
Very unusual partnership,
it was Thomas Jefferson University,
a contemporary art museum,
and an institute for an optimistic future in healthcare.
We took students and had them understand art.
So if you take this piece of art over here.
Medical students originally said,
"That's a woman, that's a snake, that's a family."
But when you start to look and say what is the story?
It starts to totally change the way
that they cared for patients.
And at the end of the day we went from silos
of full-time individuals
to folks who could deliver team-enabled and team-based care.
Doctors went from being captains of the ship
to being part of a team,
and they believe it or not worked closely
with multidisciplinary care and delivery teams.
Including doctors of nursing practice,
nurse practitioners, clinical pharmacists,
physician's assistants,
and at the Thomas Jefferson Institute
of Emerging Health Professions,
professions that didn't even exist in 2014.
Things like probability experts,
electronic health care ambassadors,
and telehealth professionals.
So we recognized that we need to evolve doctoring.
We also recognized that the patient experience
was really pretty lousy.
Back in 2014 you could actually do
anything you needed to do in travel,
anything you needed to do in shopping, on a device,
but could you get an appointment with a physician? No.
Could you interact with a doctor or nurse? No.
So we decided that healthcare needed in 2014,
to get into the E and I mode.
If you even look at how people viewed us from TV shows,
how many of you are here from the 70s?
There you go, okay.
So the big tip in the 70s was Marcus Welby.
Now here's what Marcus Welby was,
he was a family physician, he would get up in the morning,
he would go to the homeless shelter,
take care of people for free.
On the way home to lunch
a cow would be having trouble delivering a calf,
he'd deliver it.
He'd then go to his family medicine office in the afternoon,
and then at night he'd do lecithin ventricular neurosurgery.
We were gods, we could do everything,
that's how people viewed us.
In the 2010s this is what we had.
Anybody remember this guy? (audience laughter)
He was a drug addicted, sex addicted, really smart,
guy that couldn't communicate or see patients.
That's what people viewed us.
The number one TV show of 2023?
Was Doctor WHHO, stands for Watson Hybrid Hydro-Organo,
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, hilarity ensues.
By the way-- (audience laughs)
By the way the first season, the first season,
of Doctor WHHO is available
on Google Glass implantable chips,
available in Stevie's Vinyl Records and Implantable Chips
on South Street.
So we embrace, the other thing we embraced
was entrepreneurship.
We recognized that being academic and entrepreneurial
just were not mutually exclusive,
and we also recognized
that we had to enhance the consumer experience.
It really was lousy going to a physician.
This is what it looked like back in 2014.
(moaning) - What's wrong?
- I don't feel so good.
- Then you need to go to a doctor.
(sneezing)
- Mr. Stephenson?
- Stevenson.
- Do you have any allergies?
How would you describe your symptoms?
What is the general area of pain?
Does your family have a history of heart disease?
Does your family have a history of diabetes?
- And what seems to be the problem today, Mr. Stevenson?
- I'm feeling a little stuffed up.
I'm experiencing some--
- Doctor your three o'clock is early, your 2:45 is late,
from six and seven.
- Follow these instructions
and if it doesn't clear up in a week or two
come back and we'll do this all over again.
(moaning)
- I don't like going to the doctor.
- So in July of 2014,
we partnered with some great companies,
created an innovation driven ecosystem for healthcare.
And starting in 2015 patients in 48 states
could access doctors via Telemedicine.
- Well now you can see a doctor
without going to a doctor's office.
With the help of your smart phone or computer,
and American Well.
Signing up and setting up your health profile is easy,
it only takes a minute,
and once you're done it, it's stored safely and securely.
Then you can log in or use the app
to see doctors who're available,
and connect by video phone or chat.
- Hi Allen, I see you've been experiencing some congestion
and some nasal blockage.
How long as this been going on?
- During the visit,
the doctor can see your health information,
afterward you get a complete write-up
of everything the doctor says.
- Well it looks like acute sinusitis,
a sinus infection.
Now I wrote you a prescription to help with the congestion.
If things don't clear up in say, a week or so,
just send me a message.
I'll be right here.
- A few minutes later I've got my diagnosis,
and my instructions for treatment,
and my prescription is already waiting for me
at the pharmacy.
- Of course all that now is happens in your Google Glasses
which are available by the way
at Stevie's Vinyl Records and Implantable Health Chips.
We also recognize that information was everything.
As Yogi Berra would say,
"It 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 anecdote.
Evidence based medicine in 2024 was actually a novel idea.
And now we recognize that we can take things
from other industries.
So at Jefferson for example, in 2014,
we started the Center for Healthcare and Entrepreneurship
and Scientific Solutions.
We said it really doesn't make any sense that Nick Foles
has a better idea 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 modelling
and created a predictive analytics of mathematical modelling
to reduce uncertainty of medicine.
Believe it or not in 2014,
28% of people that went to the hospital in this country
got readmitted within 90 days.
Now through our mathematical modelling
we're able to see exactly what intervention
will keep people from coming back.
Not only that we've changed the way we do things.
In 2014, family medicine physicians
would actually be out of the hospital.
Hospitalists would never leave the hospital,
and then there was no real communication.
Now we have what's called extensivists.
Hospitalists that actually follow those patients for 90 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 and what you're getting back.
And 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 2014,
with decreasing NIH funding,
Penn, Jefferson, Temple, Drexel,
would all fight for NIH funds.
What we did, and one of the greatest things we did,
we created the Philadelphia Clinical Research Super Site.
Where we said really what's important
is to take all of our resources,
both in education and research,
and make Philadelphia an epicenter.
What did that do for us over the last 10 years?
Well were able to take the Nanotechnology University
of Pennsylvania and Molecular Genomics at Jefferson
and create the DNA vending machine.
For those of your from the 2010s,
it's sort of like a red box for your DNA.
We can now pick a drug for you,
instead of saying it's for 200 people that look like you,
we can take exactly the drug that fits your genome
and have it available for you.
We can also put your genome on a chip,
so that God forbid, if you need a new organ,
we can make that for you
based on work that's been done in Philadelphia.
And we finally decided to work with patients
to really make them shareholders in their health,
and this is what it means.
It means that in a community like Philadelphia,
if we're able to make you healthier
we do better as physicians, and you do better.
And we actually partnered with great companies
from again outside Philadelphia
to look at a different way
of making sure that everyone matters.
That we can look at not only drugs, but holistic remedies
to look at personalized performance game plans
integrating a proven system to drive health outcomes.
Whether it's mindset, or nutrition,
or movement, or recovery,
we were able to do many more things
that didn't require pharmaceuticals.
So that brings us to 2024, and as I said,
I'm here to accept our number one ranking
from the US News and Interplanetary Report
and what's really cool is
that some of the ranking parameters
didn't even exist in 2014,
and I'll give you an example
of a few of them on the academic side,
and a few of them on the clinical side.
On the academic side we actually, imagine this,
get ranked based on how our students do
at one year, three year, and five year.
We measure individual professional and personal happiness
at varying interval after graduation.
Because after all, that's why they came to our university.
And if we don't do really well,
then they actually get some of their money back.
We have a collaborative quotient,
academic entities are incentivized
to actually get over themselves and work well with others,
(audience laughter)
which would have been unheard of in 2014
when they were all cannibalizing each other.
And we have an entrepreneurial quotient,
institutions were awarded,
that invent and envision new ways of doing things
that generate alternate revenue
and develop new student opportunities.
But probably nothing's changed the most,
than health quotients.
I mean, it used to be back in 2014 and before,
that parameters were based
on reputational scores in the past.
Now it's based on what patients think.
For one, I'm really proud of that we a very high score
on is called the BUB Quotient.
It stands for the Believable Understandable Bill,
that we actually have enough respect for patients,
that we provide understandable bills
so they can understand what they got
and what they're paying for.
We have the Say What You Mean
and Mean What You Say quality parameter.
We actually take marketing professionals
to read all the billboards and the marketing we do,
and see if they have any semblance to reality
of what really happens in the hospital,
and you get points if there is some semblance to reality.
And then finally we have
the Through the Patient's Eyes factor.
And this is really exciting because what it is,
is every patient now in 2024,
is basically when they get in the hospital
given a Google Glasses,
and they basically can record
what's happening through their eyes.
How the doctors and nurses are treating them
and then we have CEOs of other hospitals
look at that video for a day
and grade on 1 to 10 how they'd like to spend a day
in that hospital.
And again that's a great parameter for us.
So a lot has happened since 2024,
and I'm really excited to be here,
we're about to accept an award
in the new convention center an casino
on the Schuylkill River.
(audience laughter)
And some things from the past really are good,
I'm going through my third mid-life crisis
because I'm 70 and I'm,
what happens is people live to 120,
so mid-life crises have changed.
And I'm proud to say this is what got myself,
I was able to retrofit (audience applause)
a GTO to hit the standards for hovercraft.
Excuse me for a second.
Google Glass out, could you get the GTO
to get ready to go to the convention center, great.
Thank you, listen I want to really thank you for being here,
I want to thank you for travelling in time and space,
and most importantly, stay healthy in Philadelphia.
Thank you very much. (audience applause)