WEBVTT 00:00:01.296 --> 00:00:03.796 (synth music) 00:00:08.798 --> 00:00:11.845 (audience applause) 00:00:11.845 --> 00:00:13.291 - Well, I want to thank you all for coming 00:00:13.291 --> 00:00:14.961 and especially the people that came 00:00:14.961 --> 00:00:18.236 from outside of Philadelphia that hovered over here. 00:00:18.236 --> 00:00:20.548 Especially those of you that time-traveled 00:00:20.548 --> 00:00:22.043 from other decades and times. 00:00:22.043 --> 00:00:24.375 I'm Steve Klasko, I'm the CEO of 00:00:24.375 --> 00:00:26.960 Stevie's Vinyl Emporium and Implantable Health Chips 00:00:26.960 --> 00:00:29.259 in South Street in Philadelphia. 00:00:29.259 --> 00:00:30.816 That's what I am today, 00:00:30.816 --> 00:00:32.990 but for the past ten years, 00:00:32.990 --> 00:00:35.258 I've been the Presidency of Thomas Jefferson University 00:00:35.258 --> 00:00:37.718 and Jefferson University Hospital System, 00:00:37.718 --> 00:00:40.467 that literally was one of the pioneers 00:00:40.467 --> 00:00:41.714 along with several others 00:00:41.714 --> 00:00:44.408 for what is now called the Leaders of the Optimistic Future 00:00:44.408 --> 00:00:46.224 in Healthcare Revolution, 00:00:46.224 --> 00:00:48.265 from 2015 to 2024. 00:00:48.265 --> 00:00:51.038 So from those of you who are coming from another decade, 00:00:51.038 --> 00:00:53.479 or for those of you who are here in the 2020s, 00:00:53.479 --> 00:00:54.817 I'd like to talk a little bit 00:00:54.817 --> 00:00:56.296 about how that journey happened, 00:00:56.296 --> 00:00:58.164 and maybe give you a little bit of a personal story 00:00:58.164 --> 00:00:59.933 about how it happened for me. 00:00:59.933 --> 00:01:01.793 So first, one of the things that we did, 00:01:01.793 --> 00:01:03.448 we got tired of whining, 00:01:03.448 --> 00:01:05.337 and we decided let's just travel into the future. 00:01:05.337 --> 00:01:06.909 Let's just think about what we want 00:01:06.909 --> 00:01:08.186 and then create it. 00:01:08.186 --> 00:01:11.301 For me, that started in 1977. 00:01:11.301 --> 00:01:12.670 Very important time for me, 00:01:12.670 --> 00:01:14.785 I was a senior medical student. 00:01:14.785 --> 00:01:17.857 It was important because I got asked to give a talk for TED. 00:01:17.857 --> 00:01:19.497 Now not the TED you're thinking of 00:01:19.497 --> 00:01:21.727 because TED didn't exist in 1977. 00:01:21.727 --> 00:01:24.170 It was called Tomorrow's Education of Doctors. 00:01:24.170 --> 00:01:25.601 It was everything different 00:01:25.601 --> 00:01:27.112 than the technology that exists today. 00:01:27.112 --> 00:01:29.082 It was a little slide show with a screen, 00:01:29.082 --> 00:01:30.718 but they asked me to talk about 00:01:30.718 --> 00:01:33.126 what the future of medicine looks like 00:01:33.126 --> 00:01:35.191 from a medical student's point of view. 00:01:35.191 --> 00:01:36.403 The other reason I remember it, 00:01:36.403 --> 00:01:38.279 it was the first time I saw the Rolling Stones. 00:01:38.279 --> 00:01:39.928 This is what they looked like back then. 00:01:39.928 --> 00:01:41.882 I was a huge fan, but what I talked about 00:01:41.882 --> 00:01:44.075 because I was a little nervous about the first talk, 00:01:44.075 --> 00:01:46.670 I talked about, "Can you do anything about spiraling costs? 00:01:46.670 --> 00:01:49.225 "Can you change the fevered service system 00:01:49.225 --> 00:01:50.766 "so we're really rewarding volume, 00:01:50.766 --> 00:01:52.278 "value and not volume, 00:01:52.278 --> 00:01:54.398 "and can you measure outcomes?" 00:01:54.398 --> 00:01:57.879 And I said, "My generation of docs is gonna solve this 00:01:57.879 --> 00:01:59.531 "over the next four years. 00:01:59.531 --> 00:02:01.627 "We are not going to be dealing with this 00:02:01.627 --> 00:02:03.846 "even 20 years from now." 00:02:03.846 --> 00:02:06.635 Well amazingly the docs said, "No." 00:02:06.635 --> 00:02:07.926 And that didn't happen. 00:02:07.926 --> 00:02:10.648 Now I was also a very different person back in 1977, 00:02:10.648 --> 00:02:14.256 this is what I looked like. (applause and cheering) 00:02:14.256 --> 00:02:16.006 Thank you, thank you. 00:02:18.514 --> 00:02:22.681 That's called a leisure suit. (audience laughing) 00:02:23.678 --> 00:02:25.922 And but for a brief interlude 00:02:25.922 --> 00:02:27.794 where they tried to bring it back in 2019, 00:02:27.794 --> 00:02:29.023 I think it's safe to say 00:02:29.023 --> 00:02:31.651 it's out of the fashion lexicon forever, 00:02:31.651 --> 00:02:34.407 but the car was a 1968 GTO which was, 00:02:34.407 --> 00:02:36.661 and is, a very cool car. (audience light applause) 00:02:36.661 --> 00:02:38.210 Thank you. 00:02:38.210 --> 00:02:39.737 So there we went through really 00:02:39.737 --> 00:02:42.255 what was what some people call the middle or dark ages, 00:02:42.255 --> 00:02:43.772 the Managed Care Revolution, 00:02:43.772 --> 00:02:45.805 which did not really manage anything. 00:02:45.805 --> 00:02:47.308 It didn't really provide care, 00:02:47.308 --> 00:02:49.080 it just promoted under utilization. 00:02:49.080 --> 00:02:50.277 The Balanced Budget Amendment, 00:02:50.277 --> 00:02:52.153 which didn't really balance the budget, 00:02:52.153 --> 00:02:53.457 and didn't really amend anything. 00:02:53.457 --> 00:02:54.687 And then the first iteration 00:02:54.687 --> 00:02:56.639 of what has now been 17 iterations 00:02:56.639 --> 00:02:58.841 of what was then called Obamacare. 00:02:58.841 --> 00:03:00.555 So that bring us to 2014, 00:03:00.555 --> 00:03:02.764 and why was 2014 important to me? 00:03:02.764 --> 00:03:04.086 Well I was very proud and honored 00:03:04.086 --> 00:03:05.911 to be inaugurated and selected 00:03:05.911 --> 00:03:07.882 as the first president and CEO 00:03:07.882 --> 00:03:10.052 of Thomas Jefferson University 00:03:10.052 --> 00:03:11.801 and Health Systems combined. 00:03:11.801 --> 00:03:13.198 It was also a big moment for me 00:03:13.198 --> 00:03:15.248 because it was the second time I saw the Rolling Stones, 00:03:15.248 --> 00:03:18.916 and this is what they looked like back in 2014. 00:03:18.916 --> 00:03:21.533 And in my inauguration I was given a script, 00:03:21.533 --> 00:03:23.796 and what I talked about in inauguration of 2014 is 00:03:23.796 --> 00:03:25.423 "Hey, can we do anything about spiraling costs? 00:03:25.423 --> 00:03:27.880 "Can we change the fevered service system? 00:03:27.880 --> 00:03:30.087 "Do you think we can measure outcomes?" 00:03:30.087 --> 00:03:31.659 So it was a bit of an aha moment for me, 00:03:31.659 --> 00:03:33.427 I said, "Well, 37 years, that's a lot 00:03:33.427 --> 00:03:35.471 for not to have much change." 00:03:35.471 --> 00:03:38.221 This time though, the insurers and government said, 00:03:38.221 --> 00:03:40.462 "We're really going to do it." 00:03:40.462 --> 00:03:43.895 And really what people were actually predicting is, 00:03:43.895 --> 00:03:46.649 because believe it or not even at 2014 00:03:46.649 --> 00:03:50.052 the docs said, "I really don't want to take any risks. 00:03:50.052 --> 00:03:52.429 "I think things are fine the way they are." 00:03:52.429 --> 00:03:53.814 And you couldn't go a week 00:03:53.814 --> 00:03:55.737 without people threatening the extinction 00:03:55.737 --> 00:03:57.737 of academic health centers. 00:03:57.737 --> 00:04:00.790 So I'm proud to say here in Philadelphia and Jefferson, 00:04:00.790 --> 00:04:03.265 we said yes, and I'd love to talk to you a little bit 00:04:03.265 --> 00:04:06.695 about what happened between 2014 and 2024. 00:04:06.695 --> 00:04:09.231 So here we are in 2024, and by the way, 00:04:09.231 --> 00:04:11.138 I don't know if any of you saw it 00:04:11.138 --> 00:04:13.782 in your Facebook implantable glasses, 00:04:13.782 --> 00:04:16.463 the Zombie Rock Tour, it was awesome. 00:04:16.463 --> 00:04:18.024 It was awesome. 00:04:18.024 --> 00:04:20.524 By the way, those Facebook implantable glasses, 00:04:20.524 --> 00:04:22.600 can be bought at Stevie's Vinyl Records 00:04:22.600 --> 00:04:24.200 and Implantable Devices. 00:04:24.200 --> 00:04:27.497 This is, I thought the Rolling Stones, 00:04:27.497 --> 00:04:30.532 the Rolling Stones rocked, (audience laughter) 00:04:30.532 --> 00:04:32.484 they rocked the undead tour, right? 00:04:32.484 --> 00:04:35.327 Who agrees with me? They rocked the undead tour. 00:04:35.327 --> 00:04:37.852 Seven decades of great Rolling Stones, 00:04:37.852 --> 00:04:40.151 You talk about not getting any satisfaction, 00:04:40.151 --> 00:04:41.734 look at these guys. 00:04:43.122 --> 00:04:45.547 But more importantly, more importantly, 00:04:45.547 --> 00:04:46.901 what happened in Philadelphia, 00:04:46.901 --> 00:04:48.696 what happened at Jefferson was, 00:04:48.696 --> 00:04:50.861 that we took, we took that mode of, 00:04:50.861 --> 00:04:53.905 people saying that it's impossible to change healthcare. 00:04:53.905 --> 00:04:56.218 And really the personal piece for me believe it or not 00:04:56.218 --> 00:04:59.484 did not come from Admonities or Aristotle, or even somebody 00:04:59.484 --> 00:05:01.427 from the University of Pennsylvania or Jefferson. 00:05:01.427 --> 00:05:03.394 It came from a sneaker commercial. 00:05:03.394 --> 00:05:06.621 It was an Adidas marketing campaign back in 2014 00:05:06.621 --> 00:05:08.054 called the Impossible, 00:05:08.054 --> 00:05:09.913 it said "Impossible is just a big word 00:05:09.913 --> 00:05:11.677 "thrown around by small men and women 00:05:11.677 --> 00:05:14.149 "who find it easier to live the world they've been given 00:05:14.149 --> 00:05:16.763 "rather than explore the power they have to change it. 00:05:16.763 --> 00:05:18.795 "Impossible is not a fact it's an opinion. 00:05:18.795 --> 00:05:22.164 "Impossible is temporary, impossible is nothing." 00:05:22.164 --> 00:05:25.583 So we decided, what the heck, let's do the impossible. 00:05:25.583 --> 00:05:27.650 Because everybody know things were changing, 00:05:27.650 --> 00:05:29.961 we weren't going to wait for a miracle. 00:05:29.961 --> 00:05:32.386 And we said, "Let's do it." 00:05:32.386 --> 00:05:34.873 Okay so, here it is, it's March 28, 2024, 00:05:34.873 --> 00:05:37.531 now I apologize for those of you who come from this decade, 00:05:37.531 --> 00:05:40.167 but I know some of you probably have time travel lag, 00:05:40.167 --> 00:05:42.478 and I just want you to know where we're at today. 00:05:42.478 --> 00:05:45.187 So it's March 28, 2024, President Jenna Bush 00:05:45.187 --> 00:05:47.785 will be debating democratic nominee Chelsea Clinton, 00:05:47.785 --> 00:05:50.511 in what a lot of people think will be a very tight race. 00:05:50.511 --> 00:05:52.053 Harrison Ford has signed on 00:05:52.053 --> 00:05:54.451 for one last Indiana Jones sequel. 00:05:54.451 --> 00:05:57.393 Tentatively titled Indiana Jones: the Legend of Bingo Night, 00:05:57.393 --> 00:05:59.408 we're all excited about that one. 00:05:59.408 --> 00:06:00.710 And the Eagles are 2-0 00:06:00.710 --> 00:06:02.630 and trying to win their first Superbowl 00:06:02.630 --> 00:06:05.089 since the unprecedented four straight they won 00:06:05.089 --> 00:06:08.412 from 2015 to 2018, the so-called Chip Championship Years. 00:06:08.412 --> 00:06:12.228 (audience applause and cheering) 00:06:12.228 --> 00:06:14.514 Of course, Governor Chip now has a very different job 00:06:14.514 --> 00:06:16.623 than he had back then. 00:06:16.623 --> 00:06:19.267 But more importantly, more importantly or as importantly, 00:06:19.267 --> 00:06:22.008 Jefferson is celebrating it's 200th anniversary 00:06:22.008 --> 00:06:23.481 as a state wide national, 00:06:23.481 --> 00:06:25.132 and international hub of innovation, 00:06:25.132 --> 00:06:26.532 with headquarters in Philadelphia 00:06:26.532 --> 00:06:28.642 instead of just a Philadelphia academic medical center. 00:06:28.642 --> 00:06:30.259 We've become a destination site 00:06:30.259 --> 00:06:32.450 for innovation entrepreneurial health 00:06:32.450 --> 00:06:34.702 with unprecedented economic development. 00:06:34.702 --> 00:06:36.618 And our creative partnerships have allowed us 00:06:36.618 --> 00:06:39.131 to become what the Wall Street Journal called 00:06:39.131 --> 00:06:41.644 a thriving cluster on the verge of a chain reaction. 00:06:41.644 --> 00:06:43.739 Which has helped make Philadelphia the epicenter 00:06:43.739 --> 00:06:44.698 of the new healthcare. 00:06:44.698 --> 00:06:46.964 Oh and by the way, I'm getting out of my DeLorean 00:06:46.964 --> 00:06:48.575 to accept an award from the US News 00:06:48.575 --> 00:06:51.657 and the Interplanetary Report, as most of you know, 00:06:51.657 --> 00:06:53.804 in 2019 we found two other planets 00:06:53.804 --> 00:06:55.739 with slightly disfunctional heath systems. 00:06:55.739 --> 00:06:58.067 So they are now part of the ranking system 00:06:58.067 --> 00:07:00.461 that the forward USNWR uses. 00:07:00.461 --> 00:07:02.130 So how did we get there? 00:07:02.130 --> 00:07:04.507 I'd like to, TEDx has asked me to talk about 00:07:04.507 --> 00:07:07.895 three things that we did that were very different. 00:07:07.895 --> 00:07:10.004 First of all we decided that we're going 00:07:10.004 --> 00:07:11.578 to start to create docs of the future. 00:07:11.578 --> 00:07:14.304 That it's ridiculous to have the same way 00:07:14.304 --> 00:07:16.855 that we selected and educated physicians 00:07:16.855 --> 00:07:19.705 that became autonomous, competitive, and hierarchical, 00:07:19.705 --> 00:07:21.650 and that we actually were going to change the DNA 00:07:21.650 --> 00:07:24.444 of healthcare literally one physician at a time. 00:07:24.444 --> 00:07:25.704 You might now believe this, 00:07:25.704 --> 00:07:28.631 but back in 2014 we still chose doctors based on 00:07:28.631 --> 00:07:32.837 science GPAs, MedCaTs which were a multiple choice test, 00:07:32.837 --> 00:07:34.841 and organic chemistry performance. 00:07:34.841 --> 00:07:37.026 And somehow we were amazed that doctors weren't 00:07:37.026 --> 00:07:38.932 more empathetic, commutative, and creative. 00:07:38.932 --> 00:07:42.223 (audience laughter) As my kids would say, "Duh." 00:07:42.223 --> 00:07:43.625 So we changed all that. 00:07:43.625 --> 00:07:45.506 What we recognized is 00:07:45.506 --> 00:07:49.233 that it used to be for those of you who came from the 70s, 00:07:49.233 --> 00:07:51.659 and I think there are actually some, 00:07:51.659 --> 00:07:53.405 I see some people from 2014, 00:07:53.405 --> 00:07:55.010 I see some people from the 80s. 00:07:55.010 --> 00:07:56.427 Go Journey, yeah. 00:07:57.464 --> 00:08:01.631 I see some tie dye out there, some 60s and 70s, peace. 00:08:02.604 --> 00:08:05.354 But we decided to transform admissions. 00:08:05.354 --> 00:08:09.133 What we realized is that all the scientific data 00:08:09.133 --> 00:08:12.558 is all on, what we called in 2014, iPhones and Androids, 00:08:12.558 --> 00:08:13.935 but really what we needed 00:08:13.935 --> 00:08:15.885 were really emotionally intelligent physicians. 00:08:15.885 --> 00:08:18.780 So we now really select physicians based on 00:08:18.780 --> 00:08:20.727 self-awareness, self-management, 00:08:20.727 --> 00:08:22.175 and the ability to adapt, 00:08:22.175 --> 00:08:23.987 social awareness and empathy, 00:08:23.987 --> 00:08:26.034 relationship management, teamwork, 00:08:26.034 --> 00:08:28.411 and the ability to really embrace change 00:08:28.411 --> 00:08:29.656 instead of fighting it. 00:08:29.656 --> 00:08:32.206 But not only that we totally changed the way 00:08:32.206 --> 00:08:34.785 that we teach the physicians that we do accept. 00:08:34.785 --> 00:08:36.884 Believe it or not back in 2014, 00:08:36.884 --> 00:08:39.967 we used to spend two years really teaching them 00:08:39.967 --> 00:08:42.820 scientific principles in large auditoriums, 00:08:42.820 --> 00:08:44.820 classes that a lot of them didn't come to, 00:08:44.820 --> 00:08:46.595 when we recognized that we could do all that, 00:08:46.595 --> 00:08:48.517 have them learn that at two o'clock in the morning. 00:08:48.517 --> 00:08:50.112 Now we spend most of our time 00:08:50.112 --> 00:08:52.296 in what we call the Art of Attending. 00:08:52.296 --> 00:08:53.935 Teaching them to really observe, 00:08:53.935 --> 00:08:56.952 we started back in 2014, workshops designed 00:08:56.952 --> 00:08:59.691 to sharpen observation skills of health students 00:08:59.691 --> 00:09:01.252 by looking at art. 00:09:01.252 --> 00:09:02.749 Very unusual partnership, 00:09:02.749 --> 00:09:04.409 it was Thomas Jefferson University, 00:09:04.409 --> 00:09:06.055 a contemporary art museum, 00:09:06.055 --> 00:09:09.411 and an institute for an optimistic future in healthcare. 00:09:09.411 --> 00:09:12.619 We took students and had them understand art. 00:09:12.619 --> 00:09:15.799 So if you take this piece of art over here. 00:09:15.799 --> 00:09:17.148 Medical students originally said, 00:09:17.148 --> 00:09:20.039 "That's a woman, that's a snake, that's a family." 00:09:20.039 --> 00:09:22.870 But when you start to look and say what is the story? 00:09:22.870 --> 00:09:24.681 It starts to totally change the way 00:09:24.681 --> 00:09:26.804 that they cared for patients. 00:09:26.804 --> 00:09:29.799 And at the end of the day we went from silos 00:09:29.799 --> 00:09:31.103 of full-time individuals 00:09:31.103 --> 00:09:34.724 to folks who could deliver team-enabled and team-based care. 00:09:34.724 --> 00:09:36.978 Doctors went from being captains of the ship 00:09:36.978 --> 00:09:38.618 to being part of a team, 00:09:38.618 --> 00:09:40.214 and they believe it or not worked closely 00:09:40.214 --> 00:09:42.419 with multidisciplinary care and delivery teams. 00:09:42.419 --> 00:09:44.528 Including doctors of nursing practice, 00:09:44.528 --> 00:09:46.612 nurse practitioners, clinical pharmacists, 00:09:46.612 --> 00:09:48.055 physician's assistants, 00:09:48.055 --> 00:09:49.803 and at the Thomas Jefferson Institute 00:09:49.803 --> 00:09:51.099 of Emerging Health Professions, 00:09:51.099 --> 00:09:54.279 professions that didn't even exist in 2014. 00:09:54.279 --> 00:09:56.751 Things like probability experts, 00:09:56.751 --> 00:09:58.718 electronic health care ambassadors, 00:09:58.718 --> 00:10:00.855 and telehealth professionals. 00:10:00.855 --> 00:10:04.549 So we recognized that we need to evolve doctoring. 00:10:04.549 --> 00:10:07.843 We also recognized that the patient experience 00:10:07.843 --> 00:10:09.714 was really pretty lousy. 00:10:09.714 --> 00:10:13.074 Back in 2014 you could actually do 00:10:13.074 --> 00:10:15.292 anything you needed to do in travel, 00:10:15.292 --> 00:10:18.140 anything you needed to do in shopping, on a device, 00:10:18.140 --> 00:10:20.761 but could you get an appointment with a physician? No. 00:10:20.761 --> 00:10:23.641 Could you interact with a doctor or nurse? No. 00:10:23.641 --> 00:10:26.756 So we decided that healthcare needed in 2014, 00:10:26.756 --> 00:10:28.426 to get into the E and I mode. 00:10:28.426 --> 00:10:32.425 If you even look at how people viewed us from TV shows, 00:10:32.425 --> 00:10:34.883 how many of you are here from the 70s? 00:10:34.883 --> 00:10:36.018 There you go, okay. 00:10:36.018 --> 00:10:39.089 So the big tip in the 70s was Marcus Welby. 00:10:39.089 --> 00:10:40.648 Now here's what Marcus Welby was, 00:10:40.648 --> 00:10:43.623 he was a family physician, he would get up in the morning, 00:10:43.623 --> 00:10:45.140 he would go to the homeless shelter, 00:10:45.140 --> 00:10:46.655 take care of people for free. 00:10:46.655 --> 00:10:48.347 On the way home to lunch 00:10:48.347 --> 00:10:50.304 a cow would be having trouble delivering a calf, 00:10:50.304 --> 00:10:51.561 he'd deliver it. 00:10:51.561 --> 00:10:54.710 He'd then go to his family medicine office in the afternoon, 00:10:54.710 --> 00:10:57.226 and then at night he'd do lecithin ventricular neurosurgery. 00:10:57.226 --> 00:10:58.958 We were gods, we could do everything, 00:10:58.958 --> 00:11:00.678 that's how people viewed us. 00:11:00.678 --> 00:11:02.783 In the 2010s this is what we had. 00:11:02.783 --> 00:11:06.216 Anybody remember this guy? (audience laughter) 00:11:06.216 --> 00:11:09.364 He was a drug addicted, sex addicted, really smart, 00:11:09.364 --> 00:11:12.281 guy that couldn't communicate or see patients. 00:11:12.281 --> 00:11:14.501 That's what people viewed us. 00:11:14.501 --> 00:11:17.201 The number one TV show of 2023? 00:11:17.201 --> 00:11:21.368 Was Doctor WHHO, stands for Watson Hybrid Hydro-Organo, 00:11:22.739 --> 00:11:25.561 Doc, who basically fell in love 00:11:25.561 --> 00:11:28.710 with his robotic-bionic counterpart 00:11:28.710 --> 00:11:30.365 who does all the scientific stuff, 00:11:30.365 --> 00:11:32.225 while he does the emotional stuff. 00:11:32.225 --> 00:11:34.240 And as you can imagine, hilarity ensues. 00:11:34.240 --> 00:11:37.057 By the way-- (audience laughs) 00:11:37.057 --> 00:11:40.544 By the way the first season, the first season, 00:11:40.544 --> 00:11:42.846 of Doctor WHHO is available 00:11:42.846 --> 00:11:45.617 on Google Glass implantable chips, 00:11:45.617 --> 00:11:49.220 available in Stevie's Vinyl Records and Implantable Chips 00:11:49.220 --> 00:11:51.309 on South Street. 00:11:51.309 --> 00:11:54.048 So we embrace, the other thing we embraced 00:11:54.048 --> 00:11:55.083 was entrepreneurship. 00:11:55.083 --> 00:11:57.694 We recognized that being academic and entrepreneurial 00:11:57.694 --> 00:11:59.778 just were not mutually exclusive, 00:11:59.778 --> 00:12:01.179 and we also recognized 00:12:01.179 --> 00:12:04.285 that we had to enhance the consumer experience. 00:12:04.285 --> 00:12:06.956 It really was lousy going to a physician. 00:12:06.956 --> 00:12:08.409 This is what it looked like back in 2014. 00:12:08.409 --> 00:12:10.250 (moaning) - What's wrong? 00:12:10.250 --> 00:12:11.655 - I don't feel so good. 00:12:11.655 --> 00:12:14.387 - Then you need to go to a doctor. 00:12:14.387 --> 00:12:16.637 (sneezing) 00:12:20.959 --> 00:12:22.228 - Mr. Stephenson? 00:12:22.228 --> 00:12:23.228 - Stevenson. 00:12:24.392 --> 00:12:26.013 - Do you have any allergies? 00:12:26.013 --> 00:12:27.679 How would you describe your symptoms? 00:12:27.679 --> 00:12:29.065 What is the general area of pain? 00:12:29.065 --> 00:12:30.593 Does your family have a history of heart disease? 00:12:30.593 --> 00:12:32.481 Does your family have a history of diabetes? 00:12:32.481 --> 00:12:35.826 - And what seems to be the problem today, Mr. Stevenson? 00:12:35.826 --> 00:12:38.397 - I'm feeling a little stuffed up. 00:12:38.397 --> 00:12:39.688 I'm experiencing some-- 00:12:39.688 --> 00:12:42.267 - Doctor your three o'clock is early, your 2:45 is late, 00:12:42.267 --> 00:12:43.414 from six and seven. 00:12:43.414 --> 00:12:44.786 - Follow these instructions 00:12:44.786 --> 00:12:46.204 and if it doesn't clear up in a week or two 00:12:46.204 --> 00:12:48.040 come back and we'll do this all over again. 00:12:48.040 --> 00:12:50.196 (moaning) 00:12:50.196 --> 00:12:52.779 - I don't like going to the doctor. 00:12:52.779 --> 00:12:54.933 - So in July of 2014, 00:12:54.933 --> 00:12:57.000 we partnered with some great companies, 00:12:57.000 --> 00:13:00.324 created an innovation driven ecosystem for healthcare. 00:13:00.324 --> 00:13:02.830 And starting in 2015 patients in 48 states 00:13:02.830 --> 00:13:05.933 could access doctors via Telemedicine. 00:13:05.933 --> 00:13:07.430 - Well now you can see a doctor 00:13:07.430 --> 00:13:08.846 without going to a doctor's office. 00:13:08.846 --> 00:13:10.296 With the help of your smart phone or computer, 00:13:10.296 --> 00:13:11.854 and American Well. 00:13:11.854 --> 00:13:14.234 Signing up and setting up your health profile is easy, 00:13:14.234 --> 00:13:15.965 it only takes a minute, 00:13:15.965 --> 00:13:18.484 and once you're done it, it's stored safely and securely. 00:13:18.484 --> 00:13:20.120 Then you can log in or use the app 00:13:20.120 --> 00:13:21.690 to see doctors who're available, 00:13:21.690 --> 00:13:24.881 and connect by video phone or chat. 00:13:24.881 --> 00:13:28.949 - Hi Allen, I see you've been experiencing some congestion 00:13:28.949 --> 00:13:30.782 and some nasal blockage. 00:13:30.782 --> 00:13:32.541 How long as this been going on? 00:13:32.541 --> 00:13:33.722 - During the visit, 00:13:33.722 --> 00:13:35.200 the doctor can see your health information, 00:13:35.200 --> 00:13:37.028 afterward you get a complete write-up 00:13:37.028 --> 00:13:38.194 of everything the doctor says. 00:13:38.194 --> 00:13:40.192 - Well it looks like acute sinusitis, 00:13:40.192 --> 00:13:41.890 a sinus infection. 00:13:41.890 --> 00:13:44.679 Now I wrote you a prescription to help with the congestion. 00:13:44.679 --> 00:13:47.168 If things don't clear up in say, a week or so, 00:13:47.168 --> 00:13:48.556 just send me a message. 00:13:48.556 --> 00:13:49.782 I'll be right here. 00:13:49.782 --> 00:13:51.725 - A few minutes later I've got my diagnosis, 00:13:51.725 --> 00:13:53.040 and my instructions for treatment, 00:13:53.040 --> 00:13:54.662 and my prescription is already waiting for me 00:13:54.662 --> 00:13:55.724 at the pharmacy. 00:13:55.724 --> 00:13:59.395 - Of course all that now is happens in your Google Glasses 00:13:59.395 --> 00:14:01.661 which are available by the way 00:14:01.661 --> 00:14:05.624 at Stevie's Vinyl Records and Implantable Health Chips. 00:14:05.624 --> 00:14:09.281 We also recognize that information was everything. 00:14:09.281 --> 00:14:10.651 As Yogi Berra would say, 00:14:10.651 --> 00:14:13.111 "It comes down to one word, big data." 00:14:13.111 --> 00:14:16.519 And believe it or not, believe it or not, 00:14:16.519 --> 00:14:19.913 we used to do everything based on experience and anecdote. 00:14:19.913 --> 00:14:24.080 Evidence based medicine in 2024 was actually a novel idea. 00:14:25.267 --> 00:14:28.039 And now we recognize that we can take things 00:14:28.039 --> 00:14:29.160 from other industries. 00:14:29.160 --> 00:14:31.677 So at Jefferson for example, in 2014, 00:14:31.677 --> 00:14:33.768 we started the Center for Healthcare and Entrepreneurship 00:14:33.768 --> 00:14:35.297 and Scientific Solutions. 00:14:35.297 --> 00:14:40.019 We said it really doesn't make any sense that Nick Foles 00:14:40.019 --> 00:14:43.043 has a better idea whether or not a screen pass will work, 00:14:43.043 --> 00:14:44.172 in the third quarter, 00:14:44.172 --> 00:14:46.476 than I do of whether or not a cancer drug will work. 00:14:46.476 --> 00:14:47.641 So we took some of the best people 00:14:47.641 --> 00:14:49.408 doing mathematical modelling 00:14:49.408 --> 00:14:52.446 and created a predictive analytics of mathematical modelling 00:14:52.446 --> 00:14:54.463 to reduce uncertainty of medicine. 00:14:54.463 --> 00:14:56.386 Believe it or not in 2014, 00:14:56.386 --> 00:14:59.782 28% of people that went to the hospital in this country 00:14:59.782 --> 00:15:02.494 got readmitted within 90 days. 00:15:02.494 --> 00:15:04.587 Now through our mathematical modelling 00:15:04.587 --> 00:15:06.511 we're able to see exactly what intervention 00:15:06.511 --> 00:15:08.807 will keep people from coming back. 00:15:08.807 --> 00:15:10.825 Not only that we've changed the way we do things. 00:15:10.825 --> 00:15:13.940 In 2014, family medicine physicians 00:15:13.940 --> 00:15:15.955 would actually be out of the hospital. 00:15:15.955 --> 00:15:18.303 Hospitalists would never leave the hospital, 00:15:18.303 --> 00:15:20.257 and then there was no real communication. 00:15:20.257 --> 00:15:22.429 Now we have what's called extensivists. 00:15:22.429 --> 00:15:25.545 Hospitalists that actually follow those patients for 90 days 00:15:25.545 --> 00:15:27.878 so they don't get readmitted. 00:15:27.878 --> 00:15:29.937 We actually pay for performance now 00:15:29.937 --> 00:15:32.036 because we can actually measure performance. 00:15:32.036 --> 00:15:35.074 And we can actually give you predictable answers 00:15:35.074 --> 00:15:38.460 as to what you're paying for and what you're getting back. 00:15:38.460 --> 00:15:40.173 And accountable care organizations 00:15:40.173 --> 00:15:42.113 for the first time really are accountable 00:15:42.113 --> 00:15:44.348 because we have math to back it up. 00:15:44.348 --> 00:15:47.242 One of the great things that happened in Philadelphia, 00:15:47.242 --> 00:15:49.073 believe it or not again in 2014, 00:15:49.073 --> 00:15:51.375 with decreasing NIH funding, 00:15:51.375 --> 00:15:54.578 Penn, Jefferson, Temple, Drexel, 00:15:54.578 --> 00:15:57.050 would all fight for NIH funds. 00:15:57.050 --> 00:16:00.341 What we did, and one of the greatest things we did, 00:16:00.341 --> 00:16:02.796 we created the Philadelphia Clinical Research Super Site. 00:16:02.796 --> 00:16:04.606 Where we said really what's important 00:16:04.606 --> 00:16:06.505 is to take all of our resources, 00:16:06.505 --> 00:16:08.114 both in education and research, 00:16:08.114 --> 00:16:10.004 and make Philadelphia an epicenter. 00:16:10.004 --> 00:16:12.174 What did that do for us over the last 10 years? 00:16:12.174 --> 00:16:14.652 Well were able to take the Nanotechnology University 00:16:14.652 --> 00:16:17.757 of Pennsylvania and Molecular Genomics at Jefferson 00:16:17.757 --> 00:16:20.303 and create the DNA vending machine. 00:16:20.303 --> 00:16:21.728 For those of your from the 2010s, 00:16:21.728 --> 00:16:24.048 it's sort of like a red box for your DNA. 00:16:24.048 --> 00:16:25.670 We can now pick a drug for you, 00:16:25.670 --> 00:16:28.889 instead of saying it's for 200 people that look like you, 00:16:28.889 --> 00:16:31.592 we can take exactly the drug that fits your genome 00:16:31.592 --> 00:16:33.246 and have it available for you. 00:16:33.246 --> 00:16:35.171 We can also put your genome on a chip, 00:16:35.171 --> 00:16:37.795 so that God forbid, if you need a new organ, 00:16:37.795 --> 00:16:39.028 we can make that for you 00:16:39.028 --> 00:16:42.039 based on work that's been done in Philadelphia. 00:16:42.039 --> 00:16:44.677 And we finally decided to work with patients 00:16:44.677 --> 00:16:47.740 to really make them shareholders in their health, 00:16:47.740 --> 00:16:49.264 and this is what it means. 00:16:49.264 --> 00:16:51.969 It means that in a community like Philadelphia, 00:16:51.969 --> 00:16:53.621 if we're able to make you healthier 00:16:53.621 --> 00:16:56.413 we do better as physicians, and you do better. 00:16:56.413 --> 00:16:58.649 And we actually partnered with great companies 00:16:58.649 --> 00:17:00.562 from again outside Philadelphia 00:17:00.562 --> 00:17:02.365 to look at a different way 00:17:02.365 --> 00:17:04.724 of making sure that everyone matters. 00:17:04.724 --> 00:17:08.429 That we can look at not only drugs, but holistic remedies 00:17:08.429 --> 00:17:11.734 to look at personalized performance game plans 00:17:11.734 --> 00:17:15.297 integrating a proven system to drive health outcomes. 00:17:15.297 --> 00:17:17.453 Whether it's mindset, or nutrition, 00:17:17.453 --> 00:17:18.992 or movement, or recovery, 00:17:18.992 --> 00:17:20.821 we were able to do many more things 00:17:20.821 --> 00:17:23.119 that didn't require pharmaceuticals. 00:17:23.119 --> 00:17:26.473 So that brings us to 2024, and as I said, 00:17:26.473 --> 00:17:28.965 I'm here to accept our number one ranking 00:17:28.965 --> 00:17:31.158 from the US News and Interplanetary Report 00:17:31.158 --> 00:17:32.956 and what's really cool is 00:17:32.956 --> 00:17:34.851 that some of the ranking parameters 00:17:34.851 --> 00:17:36.469 didn't even exist in 2014, 00:17:36.469 --> 00:17:37.666 and I'll give you an example 00:17:37.666 --> 00:17:39.232 of a few of them on the academic side, 00:17:39.232 --> 00:17:40.813 and a few of them on the clinical side. 00:17:40.813 --> 00:17:44.074 On the academic side we actually, imagine this, 00:17:44.074 --> 00:17:46.540 get ranked based on how our students do 00:17:46.540 --> 00:17:48.885 at one year, three year, and five year. 00:17:48.885 --> 00:17:51.466 We measure individual professional and personal happiness 00:17:51.466 --> 00:17:54.310 at varying interval after graduation. 00:17:54.310 --> 00:17:56.727 Because after all, that's why they came to our university. 00:17:56.727 --> 00:17:58.656 And if we don't do really well, 00:17:58.656 --> 00:18:00.788 then they actually get some of their money back. 00:18:00.788 --> 00:18:02.737 We have a collaborative quotient, 00:18:02.737 --> 00:18:04.851 academic entities are incentivized 00:18:04.851 --> 00:18:06.784 to actually get over themselves and work well with others, 00:18:06.784 --> 00:18:08.675 (audience laughter) 00:18:08.675 --> 00:18:11.684 which would have been unheard of in 2014 00:18:11.684 --> 00:18:14.262 when they were all cannibalizing each other. 00:18:14.262 --> 00:18:16.330 And we have an entrepreneurial quotient, 00:18:16.330 --> 00:18:17.877 institutions were awarded, 00:18:17.877 --> 00:18:20.659 that invent and envision new ways of doing things 00:18:20.659 --> 00:18:22.108 that generate alternate revenue 00:18:22.108 --> 00:18:24.152 and develop new student opportunities. 00:18:24.152 --> 00:18:27.249 But probably nothing's changed the most, 00:18:27.249 --> 00:18:28.813 than health quotients. 00:18:28.813 --> 00:18:31.676 I mean, it used to be back in 2014 and before, 00:18:31.676 --> 00:18:32.958 that parameters were based 00:18:32.958 --> 00:18:35.086 on reputational scores in the past. 00:18:35.086 --> 00:18:36.921 Now it's based on what patients think. 00:18:36.921 --> 00:18:39.434 For one, I'm really proud of that we a very high score 00:18:39.434 --> 00:18:41.498 on is called the BUB Quotient. 00:18:41.498 --> 00:18:44.095 It stands for the Believable Understandable Bill, 00:18:44.095 --> 00:18:46.508 that we actually have enough respect for patients, 00:18:46.508 --> 00:18:48.505 that we provide understandable bills 00:18:48.505 --> 00:18:50.443 so they can understand what they got 00:18:50.443 --> 00:18:52.436 and what they're paying for. 00:18:52.436 --> 00:18:53.950 We have the Say What You Mean 00:18:53.950 --> 00:18:56.097 and Mean What You Say quality parameter. 00:18:56.097 --> 00:18:57.776 We actually take marketing professionals 00:18:57.776 --> 00:19:00.028 to read all the billboards and the marketing we do, 00:19:00.028 --> 00:19:02.292 and see if they have any semblance to reality 00:19:02.292 --> 00:19:04.202 of what really happens in the hospital, 00:19:04.202 --> 00:19:06.983 and you get points if there is some semblance to reality. 00:19:06.983 --> 00:19:08.553 And then finally we have 00:19:08.553 --> 00:19:10.301 the Through the Patient's Eyes factor. 00:19:10.301 --> 00:19:12.284 And this is really exciting because what it is, 00:19:12.284 --> 00:19:14.475 is every patient now in 2024, 00:19:14.475 --> 00:19:16.867 is basically when they get in the hospital 00:19:16.867 --> 00:19:18.160 given a Google Glasses, 00:19:18.160 --> 00:19:20.313 and they basically can record 00:19:20.313 --> 00:19:23.358 what's happening through their eyes. 00:19:23.358 --> 00:19:25.466 How the doctors and nurses are treating them 00:19:25.466 --> 00:19:27.655 and then we have CEOs of other hospitals 00:19:27.655 --> 00:19:29.406 look at that video for a day 00:19:29.406 --> 00:19:32.164 and grade on 1 to 10 how they'd like to spend a day 00:19:32.164 --> 00:19:33.298 in that hospital. 00:19:33.298 --> 00:19:35.514 And again that's a great parameter for us. 00:19:35.514 --> 00:19:38.545 So a lot has happened since 2024, 00:19:38.545 --> 00:19:40.518 and I'm really excited to be here, 00:19:40.518 --> 00:19:41.748 we're about to accept an award 00:19:41.748 --> 00:19:43.413 in the new convention center an casino 00:19:43.413 --> 00:19:44.596 on the Schuylkill River. 00:19:44.596 --> 00:19:47.037 (audience laughter) 00:19:47.037 --> 00:19:50.416 And some things from the past really are good, 00:19:50.416 --> 00:19:53.193 I'm going through my third mid-life crisis 00:19:53.193 --> 00:19:55.140 because I'm 70 and I'm, 00:19:55.140 --> 00:19:57.105 what happens is people live to 120, 00:19:57.105 --> 00:19:58.846 so mid-life crises have changed. 00:19:58.846 --> 00:20:00.635 And I'm proud to say this is what got myself, 00:20:00.635 --> 00:20:01.586 I was able to retrofit (audience applause) 00:20:01.586 --> 00:20:05.147 a GTO to hit the standards for hovercraft. 00:20:05.147 --> 00:20:07.220 Excuse me for a second. 00:20:07.220 --> 00:20:09.579 Google Glass out, could you get the GTO 00:20:09.579 --> 00:20:11.540 to get ready to go to the convention center, great. 00:20:11.540 --> 00:20:14.239 Thank you, listen I want to really thank you for being here, 00:20:14.239 --> 00:20:16.661 I want to thank you for travelling in time and space, 00:20:16.661 --> 00:20:19.749 and most importantly, stay healthy in Philadelphia. 00:20:19.749 --> 00:20:23.916 Thank you very much. (audience applause)