0:00:11.691,0:00:13.667
Well, I want to thank you all for coming,

0:00:13.667,0:00:16.693
and especially the people[br]that came from outside of Philadelphia

0:00:16.693,0:00:18.408
that hovered over here;

0:00:18.408,0:00:21.795
especially those of you that time-traveled[br]from other decades and times.

0:00:21.795,0:00:23.385
I'm Steve Klasko.

0:00:23.385,0:00:26.653
I'm the CEO of Stevie's Vinyl Emporium[br]and Implantable Health Chips

0:00:26.653,0:00:28.180
in South Street in Philadelphia.

0:00:28.180,0:00:29.254
(Laughter)

0:00:29.254,0:00:30.900
That's what I am today.

0:00:30.900,0:00:32.630
But for the past ten years,

0:00:32.630,0:00:35.228
I've been the presidency[br]of Thomas Jefferson University

0:00:35.228,0:00:37.684
in Jefferson University Hospital System

0:00:37.684,0:00:40.863
that literally was one of the pioneers[br]along with several others

0:00:40.863,0:00:44.296
for what is now called[br]the leaders of the optimistic future

0:00:44.296,0:00:48.177
in Healthcare Revolution[br]from 2015 to 2024.

0:00:48.177,0:00:50.745
So for those of you[br]who are coming from another decade,

0:00:50.745,0:00:52.903
or for those of you[br]who are here in the 2020s,

0:00:52.903,0:00:55.772
I'd like to talk a little bit[br]about how that journey happened

0:00:55.772,0:00:58.260
and maybe give you[br]a little bit of the personal story

0:00:58.260,0:00:59.712
about how it happened for me.

0:00:59.712,0:01:02.849
So first one of the things that we did,[br]is we got tired of whining,

0:01:02.849,0:01:05.086
and we decided[br]let's just travel to the future,

0:01:05.086,0:01:07.608
think about what we want[br]and then create it.

0:01:07.608,0:01:10.469
For me, that started in 1977.

0:01:11.079,0:01:14.440
Very important time for me,[br]I was a senior medical student.

0:01:14.440,0:01:17.714
It was important because I got asked[br]to give a talk for TED.

0:01:17.714,0:01:21.405
Now not the TED you're thinking of[br]because TED didn't exist in 1977.

0:01:21.405,0:01:23.819
It was called tomorrow's[br]education of doctors.

0:01:23.819,0:01:26.914
It was everything different[br]than the technology that exists today.

0:01:26.914,0:01:29.287
It was a little slideshow with a screen,

0:01:29.287,0:01:32.765
but they asked me to talk about[br]what the future of medicine looks like

0:01:32.765,0:01:34.778
from a medical student's point of view.

0:01:34.778,0:01:37.871
I remember it for it was the first time[br]I saw the Rolling Stones -

0:01:37.871,0:01:40.608
this is what they looked like[br]back then; I was a huge fan.

0:01:40.608,0:01:44.185
But what I talked about because I[br]was a little nervous about the first talk,

0:01:44.185,0:01:46.965
I talked about: Can you do anything[br]about spiraling costs?

0:01:46.965,0:01:49.001
Can you change the fee-for-service system,[br]

0:01:49.001,0:01:52.197
so we're really rewarding[br]value and not volume?

0:01:52.197,0:01:54.142
And can you measure outcomes?

0:01:54.142,0:01:58.968
And I said my generation of docs is going[br]to solve this over the next four years.

0:01:58.968,0:02:03.262
We are not going to be dealing with this[br]even 20 years from now.

0:02:03.917,0:02:06.493
Well, amazingly the docs said, "No."

0:02:06.493,0:02:07.692
And that didn't happen.

0:02:07.692,0:02:10.290
Now I was also a very different[br]person back in 1977.

0:02:10.290,0:02:11.610
This is what I look like.

0:02:11.610,0:02:14.130
(Applause) (Cheering)

0:02:14.130,0:02:15.532
Thank you.

0:02:18.432,0:02:20.928
That's called a leisure suit.

0:02:20.928,0:02:23.358
(Laughter)

0:02:23.358,0:02:27.418
But for a brief interlude[br]where they tried to bring it back in 2019,

0:02:27.418,0:02:31.254
I think it's safe to say[br]it's out of the fashion lexicon forever,

0:02:31.254,0:02:36.218
but the car was in 1968 GTO[br]which was and is a very cool car.

0:02:36.218,0:02:37.599
Thank you.

0:02:37.599,0:02:40.505
So then we went through really[br]what some people called

0:02:40.505,0:02:41.992
the middle or dark ages,

0:02:41.992,0:02:45.599
the Managed Care Revolution,[br]which did not really manage anything.

0:02:45.599,0:02:48.749
It didn't really provide care;[br]it just promoted underutilization -

0:02:48.749,0:02:50.193
the balanced budget amendment,

0:02:50.193,0:02:53.290
which didn't balance the budget,[br]and didn't really amend anything.

0:02:53.290,0:02:56.287
And then the first iteration[br]of what has now been 17 iterations

0:02:56.287,0:02:58.405
of what was then called Obamacare.

0:02:58.405,0:03:02.393
So that brings us to 2014,[br]and why was 2014 important to me?

0:03:02.393,0:03:05.891
Well, I was very proud and honored[br]to be inaugurated and selected

0:03:05.891,0:03:07.910
as the first president and CEO

0:03:07.910,0:03:11.076
of Thomas Jefferson University[br]and Health System combined.

0:03:11.076,0:03:14.564
It was also a big moment for me[br]because it was the second time I saw them.

0:03:14.564,0:03:17.294
This is what the Rolling Stones[br]looked like back in 2014.

0:03:17.294,0:03:18.741
(Laughter)

0:03:18.741,0:03:21.042
And in my inauguration[br]I was given a script,

0:03:21.042,0:03:23.590
and what I talked about[br]my inauguration in 2014 is:

0:03:23.590,0:03:25.847
"Hey, can we do anything[br]about spiraling costs?"

0:03:25.847,0:03:27.758
Can we change the fee-for-service?

0:03:27.758,0:03:29.588
Do you think we can measure outcomes?

0:03:29.588,0:03:31.609
That was a bit of an a-ha moment for me,

0:03:31.609,0:03:35.256
I said, "Well, 37 years, that's a lot[br]for not to have much change."

0:03:35.256,0:03:38.456
This time though, the insurers[br]and government said:

0:03:38.456,0:03:40.754
"We're really going to do it."

0:03:40.754,0:03:43.744
And really what people[br]were actually predicting is -

0:03:43.744,0:03:46.537
because believe it or not, even at 2014

0:03:46.537,0:03:49.914
the docs said: "I really don't[br]want to take any risks.

0:03:49.914,0:03:51.945
I think things are fine[br]the way they were."

0:03:51.945,0:03:54.584
And you couldn't go a week[br]without people

0:03:54.584,0:03:57.470
threatening the extinction[br]of academic health centers.

0:03:57.470,0:04:01.235
So I'm proud to say here in Philadelphia[br]and at Jefferson we said yes,

0:04:01.235,0:04:06.293
and I'd love to talk to you a little bit[br]about what happened between 2014 and 2024.

0:04:06.293,0:04:08.837
So here we are in 2024, and by the way,

0:04:08.837,0:04:13.329
I don't know if any of you saw it[br]on your Facebook implantable glasses,

0:04:13.329,0:04:16.127
the Zombie Rock Tour, it was awesome.

0:04:16.127,0:04:17.668
It was awesome.

0:04:17.668,0:04:20.310
By the way, those Facebook[br]implantable glasses

0:04:20.310,0:04:23.478
can be bought at Stevie's Vinyl Records[br]and Implantable Devices.

0:04:23.478,0:04:24.598
(Laughter)

0:04:25.358,0:04:29.211
I thought the Rolling Stones,[br]the Rolling Stones rocked,

0:04:29.211,0:04:30.479
(Laughter) (Cheers)

0:04:30.479,0:04:32.548
they rocked the undead tour, right?

0:04:32.548,0:04:34.980
Who agrees with me?[br]They rocked the undead tour.

0:04:34.980,0:04:37.201
Seven decades of great Rolling Stones.

0:04:37.201,0:04:39.438
You talk about[br]not getting any satisfaction,

0:04:39.438,0:04:40.708
look at these guys.

0:04:40.708,0:04:42.538
(Laughter)

0:04:42.538,0:04:44.875
But more importantly, more importantly,

0:04:44.875,0:04:48.313
what happened in Philadelphia,[br]what happened at Jefferson was,

0:04:48.313,0:04:50.753
that we took that mode of saying -

0:04:50.753,0:04:53.551
people said that it's impossible[br]to change healthcare.

0:04:53.551,0:04:56.177
And really the personal piece,[br]for me believe it or not,

0:04:56.177,0:04:58.275
didn't come from Maimonides or Aristotle,

0:04:58.275,0:05:01.398
or even somebody from the University[br]of Pennsylvania or Jefferson.

0:05:01.398,0:05:03.284
It came from a sneaker commercial.

0:05:03.284,0:05:07.780
It was an Adidas marketing campaign[br]back in 2014 called the Impossible.

0:05:07.780,0:05:11.789
It said "impossible" is just a big word[br]thrown around by small men and women

0:05:11.789,0:05:14.532
who find it easier to live the world[br]they've been given

0:05:14.532,0:05:17.026
rather than explore the power[br]they have to change it.

0:05:17.026,0:05:19.170
Impossible is not a fact; it's an opinion.

0:05:19.170,0:05:21.470
Impossible is temporary;[br]impossible is nothing.

0:05:22.100,0:05:25.170
So we decided, "What the heck,[br]let's do the impossible."

0:05:25.170,0:05:27.241
Because everybody knew[br]things were changing,

0:05:27.241,0:05:30.019
we weren't going to wait for a miracle.

0:05:30.019,0:05:32.108
And we said, "Let's do it."

0:05:32.108,0:05:34.783
OK, so here it is, it's March 28th, 2024.

0:05:34.783,0:05:37.594
Now I apologize for those of you[br]who come from this decade,

0:05:37.594,0:05:40.108
but I know some of you[br]probably have time travel lag,

0:05:40.108,0:05:42.410
and I just want you to know[br]where we're at today.

0:05:42.410,0:05:43.772
So it's March 28th, 2024,

0:05:43.772,0:05:47.678
President Jenna Bush will be debating[br]Democratic nominee Chelsea Clinton,

0:05:47.678,0:05:50.495
in what a lot of people think[br]will be a very tight race.

0:05:50.495,0:05:53.402
Harrison Ford has signed up[br]for one last Indiana Jones sequel,

0:05:53.402,0:05:54.452
(Laughter)

0:05:54.452,0:05:57.393
tentatively titled Indiana Jones:[br]the Legend of Bingo Night,

0:05:57.393,0:05:59.211
we're all excited about that one.

0:05:59.211,0:06:02.206
And the Eagles are 2-0[br]and trying to win their first Super Bowl

0:06:02.206,0:06:05.985
since the unprecedented fourth straight[br]they won from 2015 to 2018,

0:06:05.985,0:06:08.100
the so-called Chip Championship Years.

0:06:08.100,0:06:10.830
(Applause) (Cheering)

0:06:11.703,0:06:16.071
Of course, Governor Chip now has a very[br]different job than he had back then.

0:06:16.071,0:06:18.738
But more importantly or as importantly,

0:06:18.738,0:06:21.563
Jefferson is celebrating[br]its 200th anniversary

0:06:21.563,0:06:24.486
as an international hub of innovation,

0:06:24.486,0:06:26.108
with headquarters in Philadelphia,

0:06:26.108,0:06:28.781
instead of just the Philadelphia[br]academic medical center.

0:06:28.781,0:06:32.160
We've become a destination site[br]for innovative entrepreneurial health

0:06:32.160,0:06:34.425
with unprecedented economic development,

0:06:34.425,0:06:35.804
and our creative partnerships

0:06:35.804,0:06:38.731
have allowed us to become[br]what The Wall Street Journal called

0:06:38.731,0:06:41.165
a thriving cluster on the verge[br]of a chain reaction,

0:06:41.165,0:06:44.528
which has helped make Philadelphia[br]the epicenter of the new healthcare.

0:06:44.528,0:06:46.548
By the way, I'm getting out of my DeLorean

0:06:46.548,0:06:50.036
to accept an award from the US News[br]and Interplanetary Report.

0:06:50.036,0:06:53.481
As most of you know in 2019,[br]we found two other planets

0:06:53.481,0:06:55.581
with slightly dysfunctional[br]health systems,

0:06:55.581,0:06:59.980
so they are now part of the ranking system[br]that the former USNWR used.

0:06:59.980,0:07:02.809
So how did we get there? I'd like to ...

0:07:02.809,0:07:05.575
TEDx has asked me to talk[br]about three things that we did

0:07:05.575,0:07:07.528
that were very different.

0:07:07.528,0:07:11.351
First of all, we decided that we're going[br]to start to create docs of the future,

0:07:11.351,0:07:16.260
that it's ridiculous to have the same way[br]that we selected and educated physicians

0:07:16.260,0:07:19.230
that became autonomous,[br]competitive, and hierarchical,

0:07:19.230,0:07:22.313
and that we actually were going[br]to change the DNA of healthcare

0:07:22.313,0:07:23.993
literally one physician at a time.

0:07:23.993,0:07:25.271
You may not believe this,

0:07:25.271,0:07:30.317
but back in 2014, we still chose doctors[br]based on science GPAs, MedCaTs,

0:07:30.317,0:07:34.209
which were a multiple-choice test,[br]and organic chemistry performance.

0:07:34.209,0:07:37.221
And somehow we were amazed[br]that doctors weren't more empathetic,

0:07:37.221,0:07:38.769
communicative, and creative.

0:07:38.769,0:07:40.609
As my kids would say, "Duh."

0:07:40.609,0:07:42.333
(Laughter) (Applause)

0:07:42.333,0:07:43.528
So we changed all that.

0:07:43.528,0:07:48.655
What we recognized is that it used to be[br]for those of you who came from the '70s -

0:07:48.985,0:07:51.166
and I think there are actually some,

0:07:51.166,0:07:54.393
I see some people from 2014,[br]I see some people from the '80s.

0:07:54.393,0:07:56.283
Go Journey, yeah.

0:07:56.283,0:07:57.413
(Laughter)

0:07:57.413,0:08:01.204
I see some tie-dye out there,[br]some '60s and '70s. Peace!

0:08:01.564,0:08:05.037
But we decided to transform admissions.

0:08:05.037,0:08:08.686
What we realized is[br]that all the scientific data

0:08:08.686,0:08:12.143
is on what in 2014 we called[br]iPhones and Androids,

0:08:12.143,0:08:15.737
but really what we needed[br]were emotionally intelligent physicians.

0:08:15.737,0:08:20.341
So we now really select physicians[br]based on self-awareness, self-management,

0:08:20.341,0:08:23.565
and the ability to adapt,[br]social awareness and empathy,

0:08:23.565,0:08:25.702
relationship management, teamwork,

0:08:25.702,0:08:29.113
and the ability to really embrace change[br]instead of fighting it.

0:08:29.113,0:08:30.419
But not only that,

0:08:30.419,0:08:34.542
we totally changed the way that we teach[br]the physicians that we do accept.

0:08:34.542,0:08:36.383
Believe it or not back in 2014,

0:08:36.383,0:08:40.925
we used to spend two years[br]really teaching them scientific principles

0:08:40.925,0:08:43.947
in large auditoriums,[br]classes that a lot of them didn't come to,

0:08:43.947,0:08:46.088
when we recognized[br]that we could do all that,

0:08:46.088,0:08:48.514
have them learn that[br]at two o'clock in the morning.

0:08:48.514,0:08:51.801
Now we spend most of our time[br]in what we call the Art of Attending.

0:08:51.801,0:08:55.431
Teaching them to really observe,[br]we started back in 2014,

0:08:55.431,0:08:59.001
workshops designed to sharpen[br]observation skills of health students

0:08:59.001,0:09:00.770
by looking at art.

0:09:00.770,0:09:02.267
Very unusual partnership,

0:09:02.267,0:09:06.084
it was Thomas Jefferson University,[br]Contemporary Art Museum,

0:09:06.084,0:09:08.919
an institute for an optimistic[br]future in healthcare.

0:09:08.919,0:09:12.572
We took students[br]and had them understand art.

0:09:12.572,0:09:14.983
So if you take[br]this piece of art over here,

0:09:14.983,0:09:16.831
medical students originally said,

0:09:16.831,0:09:19.684
"Well, that's a woman;[br]that's a snake; that's a family."

0:09:19.684,0:09:22.499
But when you started to look[br]and say, "What is the story?",

0:09:22.499,0:09:26.270
it started to totally change the way[br]that they cared for patients.

0:09:26.270,0:09:30.530
And at the end of the day, we went[br]from silos of full-time individuals

0:09:30.530,0:09:34.419
to folks who could deliver[br]team-enabled and team-based care.

0:09:34.419,0:09:37.679
Doctors went from being captains[br]of the ship to being part of a team,

0:09:37.679,0:09:39.686
and they, believe it or not, work closely

0:09:39.686,0:09:42.164
with multidisciplinary[br]care-delivery teams,

0:09:42.164,0:09:45.069
including doctors of nursing practice,[br]nurse practitioners,

0:09:45.069,0:09:47.584
clinical pharmacists,[br]physician's assistants.

0:09:47.584,0:09:50.887
and at the Thomas Jefferson Institute[br]of Emerging Health Professions,

0:09:50.887,0:09:53.934
professions that didn't[br]even exist in 2014,

0:09:53.934,0:09:58.115
things like probability experts,[br]electronic health care ambassadors,

0:09:58.115,0:10:00.196
and telehealth professionals.

0:10:00.196,0:10:04.070
So we recognized that we needed[br]to evolve doctoring.

0:10:04.070,0:10:08.784
We also recognized that the patient[br]experience was really pretty lousy.

0:10:09.374,0:10:14.710
Back in 2014, you could actually[br]do anything you needed to do in travel,

0:10:14.710,0:10:17.567
anything you needed[br]to do in shopping on a device,

0:10:17.567,0:10:20.477
but could you get an appointment[br]with a physician? No.

0:10:20.477,0:10:23.278
Could you interact[br]with a doctor or nurse? No.

0:10:23.278,0:10:27.983
So we decided that healthcare needed[br]in 2014 to get into the E&I mode.

0:10:27.983,0:10:32.135
If you even look at how people[br]viewed us from TV shows -

0:10:32.135,0:10:35.333
how many of you are here from the '70s?[br]There you go, okay.

0:10:35.333,0:10:38.637
So the big tip television show[br]in the '70s was Marcus Welby.

0:10:38.637,0:10:40.233
Now here's what Marcus Welby was.

0:10:40.233,0:10:41.679
He was a family physician.

0:10:41.679,0:10:43.349
He would get up in the morning,

0:10:43.349,0:10:46.538
he would go to the homeless shelter,[br]take care of people for free.

0:10:46.538,0:10:50.010
On the way home to lunch, a cow would[br]be having trouble delivering a calf,

0:10:50.010,0:10:51.236
he'd deliver it.

0:10:51.236,0:10:54.326
He'd then go to his family medicine[br]office in the afternoon,

0:10:54.326,0:10:57.000
and then at night he'd do[br]left ventricular neurosurgery.

0:10:57.000,0:11:00.301
We were Gods, we could do everything,[br]that's how people viewed us.

0:11:00.301,0:11:03.591
In the 2010s this is what we had.[br]Anybody remember this guy?

0:11:03.591,0:11:05.741
(Laughter)

0:11:05.741,0:11:09.538
He was a drug-addicted,[br]sex-addicted, really smart guy

0:11:09.538,0:11:12.219
that couldn't communicate or see patients.

0:11:12.219,0:11:14.240
That's what people viewed us.

0:11:14.240,0:11:17.591
The number one TV show of 2023?

0:11:17.591,0:11:23.002
Was Doctor WHO, which[br]stands for Watson Hybrid Organo Doc,

0:11:23.002,0:11:28.349
who basically fell in love[br]with his robotic-bionic counterpart

0:11:28.349,0:11:31.791
who does all the scientific stuff[br]while he does the emotional stuff.

0:11:31.791,0:11:33.878
And as you can imagine, hilarity ensues.

0:11:33.878,0:11:35.128
By the way ...

0:11:35.128,0:11:36.757
(Laughter)

0:11:36.757,0:11:41.610
By the way the first season of Doctor WHO

0:11:41.610,0:11:45.195
is available on Google Glass[br]implantable chips,

0:11:45.195,0:11:50.269
available at Stevie's Vinyl Records[br]and Implantable Chips on South Street.

0:11:50.269,0:11:51.429
(Laughter)

0:11:51.429,0:11:54.307
So the other thing we embraced[br]was entrepreneurship.

0:11:54.307,0:11:57.305
We recognized that being academic[br]and entrepreneurial

0:11:57.305,0:11:59.473
just were not mutually exclusive,

0:11:59.473,0:12:03.867
and we also recognized that we had[br]to enhance the consumer experience.

0:12:03.867,0:12:06.623
It really was lousy going to a physician.

0:12:06.623,0:12:08.584
This is what it looked like back in 2014.

0:12:08.914,0:12:11.605
Female: What's wrong?[br]Stevenson: I don't feel so good.

0:12:11.605,0:12:13.535
F: Then you need to go to a doctor.

0:12:20.788,0:12:24.022
Female nurse: Mr. Stephenson?[br]S: Stevenson.

0:12:24.022,0:12:25.553
FN: Do you have any allergies?

0:12:25.553,0:12:29.005
How would you describe your symptoms?[br]What is the general area of pain?

0:12:29.005,0:12:32.417
Does your family have a history[br]of heart disease or diabetes?

0:12:32.417,0:12:36.059
Doctor: And what seems[br]to be the problem today, Mr. Stevenson?

0:12:36.059,0:12:39.342
S: I'm feeling a little stuffed up.[br]I'm experiencing some ...

0:12:39.342,0:12:42.926
FN: Doctor, your 3 o'clock is early,[br]your 2:45 is late from 6 and 7.

0:12:42.926,0:12:44.459
D: Follow these instructions;

0:12:44.459,0:12:48.303
if it doesn't clear up in a week or two,[br]come back; we'll do this all over again.

0:12:48.303,0:12:49.687
(Moaning)

0:12:50.158,0:12:52.572
S: I don't like going to a doctor.

0:12:52.572,0:12:56.883
SK: So in July of 2014, we partnered[br]with some great companies,

0:12:56.883,0:13:00.077
created an innovation-driven[br]ecosystem for healthcare.

0:13:00.077,0:13:02.480
Starting in 2015, patients in 48 states

0:13:02.480,0:13:05.550
could access Jefferson doctors[br]via telemedicine.

0:13:05.550,0:13:08.751
S: Well, now you can see a doctor[br]without going to a doctor's office

0:13:08.751,0:13:11.814
with the help of your smartphone,[br]or computer, and American Well.

0:13:11.814,0:13:14.368
Signing up and setting up[br]your health profile is easy;

0:13:14.368,0:13:15.474
it only takes a minute,

0:13:15.474,0:13:18.265
and once you've done it,[br]it's stored safely and securely.

0:13:18.265,0:13:21.533
Then you can log in or use the App[br]to see doctors who're available,

0:13:21.533,0:13:23.624
and connect by video phone or chat.

0:13:25.060,0:13:26.093
D: Hi Allen.

0:13:26.093,0:13:30.443
I see you've been experiencing[br]some congestion and some nasal blockage.

0:13:30.443,0:13:32.104
How long has this been going on?

0:13:32.104,0:13:35.109
S: During the visit, the doctor[br]can see your health information,

0:13:35.109,0:13:38.347
afterward, you get a complete[br]write-up of everything the doctor says.

0:13:38.347,0:13:41.506
D: It looks like acute sinusitis,[br]a sinus infection.

0:13:41.506,0:13:44.467
Now I wrote you a prescription[br]to help with congestion.

0:13:44.467,0:13:46.914
If things don't clear up[br]in, say, a week or so,

0:13:46.914,0:13:49.448
just send me a message,[br]I'll be right here.

0:13:49.448,0:13:53.045
S: A few mins later, I've got my diagnosis[br]and my instructions for treatment

0:13:53.045,0:13:56.071
and my prescription is already[br]waiting for me at the pharmacy.

0:13:56.071,0:13:59.933
SK: Of course, all that now happens[br]in your Google Glasses

0:13:59.933,0:14:01.625
which are available by the way[br]

0:14:01.625,0:14:05.083
at Stevie's Vinyl Records[br]and Implantable Health Chips.

0:14:05.568,0:14:09.145
We also recognized[br]that information was everything.

0:14:09.145,0:14:13.193
As Yogi Berra would say,[br]it comes down to one word, big data.

0:14:13.193,0:14:16.694
And believe it or not, believe it or not,

0:14:16.694,0:14:19.709
we used to do everything[br]based on experience and anecdote.

0:14:19.709,0:14:24.815
Evidence-based medicine in 2014[br]was actually a novel idea.

0:14:24.815,0:14:28.737
And now we recognize that we can[br]take things from other industries.

0:14:28.737,0:14:31.373
So at Jefferson, for example,[br]in 2014, we started

0:14:31.373,0:14:34.807
the Center for Healthcare,[br]Entrepreneurship and Scientific Solutions.

0:14:34.807,0:14:40.389
We said, "It really doesn't make any sense[br]that Nick Foles has a better idea

0:14:40.389,0:14:43.773
of whether or not a screen pass[br]will work in the third quarter

0:14:43.773,0:14:46.248
than I do of whether or not[br]a cancer drug will work."

0:14:46.248,0:14:49.409
So we took some of the best people[br]doing mathematical modeling

0:14:49.409,0:14:52.283
and created a predictive analytics[br]and mathematical modeling

0:14:52.283,0:14:54.200
to reduce uncertainty in medicine.

0:14:54.200,0:14:59.766
Believe it or not, in 2014, 28% of people[br]that went to the hospital in this country

0:14:59.766,0:15:01.725
got readmitted within 90 days.

0:15:02.185,0:15:04.020
Now, through our mathematical modeling

0:15:04.020,0:15:06.484
we're able to see exactly[br]what intervention

0:15:06.484,0:15:08.101
will keep people from coming back.

0:15:08.101,0:15:10.607
Not only that, we've changed[br]the way we do things.

0:15:10.607,0:15:15.412
In 2014, family medicine physicians[br]would actually be out of the hospital.

0:15:15.412,0:15:17.940
Hospitalists would never[br]leave the hospital,

0:15:17.940,0:15:20.179
and then there was no real communication.

0:15:20.179,0:15:22.335
Now we have what's called extensiveness,

0:15:22.335,0:15:25.515
hospitalists that actually[br]follow those patients for 90 days

0:15:25.515,0:15:27.585
so they don't get readmitted.

0:15:27.585,0:15:29.502
We actually pay for performance now

0:15:29.502,0:15:31.986
because we can actually[br]measure performance.

0:15:31.986,0:15:35.114
And we can actually[br]give you predictable answers

0:15:35.114,0:15:37.937
as to what you're paying for[br]and what you're getting back.

0:15:37.937,0:15:41.710
Accountable care organizations[br]for the first time really are accountable

0:15:41.710,0:15:43.742
because we have math to back it up.

0:15:44.292,0:15:46.863
One of the great things[br]that happened in Philadelphia,

0:15:46.863,0:15:49.554
believe it or not, again in 2014,

0:15:49.554,0:15:51.721
with decreasing NIH funding,

0:15:51.721,0:15:57.325
Penn, Jefferson, Temple, Drexel,[br]would all fight for NIH funds.

0:15:57.325,0:15:59.989
What we did, and one[br]of the greatest things we did,

0:15:59.989,0:16:02.706
we created the Philadelphia[br]Clinical Research Super Site

0:16:02.706,0:16:06.272
where we said really what's important[br]is to take all of our resources,

0:16:06.272,0:16:09.459
both in education and research,[br]and make Philadelphia an epicenter.

0:16:09.459,0:16:11.798
What did that do for us[br]over the last ten years?

0:16:11.798,0:16:15.058
We were able to take the[br]Nanotechnology University of Pennsylvania

0:16:15.058,0:16:17.657
and Molecular Genomics at Jefferson

0:16:17.657,0:16:19.884
and create the DNA vending machine.

0:16:19.884,0:16:23.786
For those of you from the 2010s,[br]it's sort of like a red box for your DNA.

0:16:23.786,0:16:25.430
We can now pick a drug for you,

0:16:25.430,0:16:28.767
and instead of saying it's[br]for 200 people that look like you,

0:16:28.767,0:16:31.557
we can take exactly[br]the drug that fits your genome

0:16:31.557,0:16:33.019
and have it available for you.

0:16:33.019,0:16:35.212
We can also put your genome on a chip,

0:16:35.212,0:16:36.402
so that God forbid,

0:16:36.402,0:16:39.004
if you need a new organ,[br]we can make that for you

0:16:39.004,0:16:41.698
based on work that's been done[br]in Philadelphia.

0:16:41.698,0:16:44.677
And we finally decided[br]to work with patients

0:16:44.677,0:16:47.683
to really make them[br]shareholders in their health,

0:16:47.683,0:16:48.954
and this is what it means.

0:16:48.954,0:16:51.160
It means that in a community[br]like Philadelphia,

0:16:51.160,0:16:53.067
if we're able to make you healthier,

0:16:53.767,0:16:56.147
we do better as physicians; you do better.

0:16:56.147,0:16:58.486
And we actually partnered[br]with great companies

0:16:58.486,0:17:00.362
from again outside Philadelphia

0:17:00.362,0:17:04.152
to look at a different way[br]of making sure that everyone matters,

0:17:04.152,0:17:08.380
that we can look at not only drugs,[br]but holistic remedies

0:17:08.380,0:17:11.375
to look at personalized[br]performance-gain plans

0:17:11.375,0:17:14.883
integrating a proven system[br]to drive health outcomes.

0:17:14.883,0:17:18.620
Whether it's mindset, or nutrition,[br]or movement, or recovery,

0:17:18.620,0:17:22.860
we were able to do many more things[br]that didn't require pharmaceuticals.

0:17:22.860,0:17:25.726
So that brings us to 2024, and as I said,

0:17:25.726,0:17:31.059
I'm here to accept our number one ranking[br]from the US News and Interplanetary Report

0:17:31.059,0:17:32.805
and what's really cool is

0:17:32.805,0:17:35.708
that some of the ranking parameters[br]didn't even exist in 2014,

0:17:35.708,0:17:38.817
and I'll give you an example[br]of a few of them on the academic side

0:17:38.817,0:17:40.320
and also on the clinical side.

0:17:40.320,0:17:43.652
On the academic side,[br]we actually, imagine this,

0:17:43.652,0:17:48.359
get ranked based on how our students do[br]at one year, three year, or five year.

0:17:48.359,0:17:51.692
We measure individuals' professional[br]and personal happiness

0:17:51.692,0:17:53.935
at varying intervals after graduation.

0:17:53.935,0:17:56.661
Because after all, that's why[br]they came to our university.

0:17:56.661,0:17:58.249
And if we don't do really well,

0:17:58.249,0:18:00.539
then they actually[br]get some of their money back.

0:18:00.539,0:18:02.256
We have a collaborative quotient.

0:18:02.256,0:18:05.867
Academic entities are incentivized[br]to actually get over themselves

0:18:05.867,0:18:07.433
and work well with others,

0:18:07.433,0:18:09.035
(Laughter) (Applause)

0:18:09.035,0:18:11.410
which would have been unheard of in 2014

0:18:11.410,0:18:13.987
when they were all[br]cannibalizing each other.

0:18:13.987,0:18:17.462
And we have an entrepreneurial quotient[br]where institutions are rewarded

0:18:17.462,0:18:20.360
that invent and envision[br]new ways of doing things

0:18:20.360,0:18:23.868
that generate alternate revenue[br]and develop new student opportunities.

0:18:23.868,0:18:28.479
But probably nothing's changed[br]the most than health quotients.

0:18:28.479,0:18:31.355
I mean, it used to be back[br]in 2014 and before

0:18:31.355,0:18:34.421
that parameters were based[br]on the reputational score in the past.

0:18:34.421,0:18:36.268
Now it's based on what patients think.

0:18:36.268,0:18:39.203
The one I'm really proud of[br]that we got a very high score on

0:18:39.203,0:18:41.021
is called the BUB Quotient.

0:18:41.021,0:18:43.861
It stands for the[br]Believable Understandable Bill,

0:18:43.861,0:18:46.216
that we actually have enough[br]respect for patients

0:18:46.216,0:18:48.484
that we provide understandable bills,

0:18:48.484,0:18:52.183
so they can understand[br]what they got and what they're paying for.

0:18:52.183,0:18:55.494
We have the say-what-you-mean[br]and mean-what-you-say quality parameter.

0:18:55.494,0:18:58.669
We actually take marketing professionals[br]to read all the billboards

0:18:58.669,0:18:59.828
in the marketing we do,

0:18:59.828,0:19:03.041
and see if they have any semblance[br]to reality of what really happens

0:19:03.041,0:19:03.999
in the hospital,

0:19:03.999,0:19:06.737
and you get points[br]if there is some semblance to reality.

0:19:06.737,0:19:09.804
And then finally we have[br]the through-the-patient-eyes factor.

0:19:09.804,0:19:12.240
And this is really exciting[br]because what it is,

0:19:12.240,0:19:14.922
is every patient now, in 2024,

0:19:14.922,0:19:18.420
basically when they get in the hospital[br]is given a Google Glasses,

0:19:18.420,0:19:22.807
and they basically can record[br]what's happening through their eyes,

0:19:22.807,0:19:25.267
how the doctors and nurses[br]are treating them,

0:19:25.267,0:19:28.915
and then we have CEOs of other hospitals[br]look at that video for a day

0:19:28.915,0:19:32.862
and grade on 1 to 10 whether they'd like[br]to spend a day in that hospital.

0:19:32.862,0:19:35.195
And again that's a great parameter for us.

0:19:35.195,0:19:37.718
So a lot has happened since 2024,

0:19:37.718,0:19:40.019
and I'm really excited to be here.

0:19:40.019,0:19:43.203
We're about to accept an award[br]in the new Convention Center & Casino

0:19:43.203,0:19:44.609
on the Schuylkill River.

0:19:44.609,0:19:46.304
(Laughter)

0:19:46.304,0:19:49.894
And some things[br]from the past really are good.

0:19:49.894,0:19:52.760
I'm going through my third midlife crisis

0:19:52.760,0:19:56.618
because I'm 70 and what happens[br]is people live to 120,

0:19:56.618,0:19:58.232
so midlife crises have changed.

0:19:58.232,0:20:00.428
And I'm proud to say[br]this is what I got myself,

0:20:00.428,0:20:05.591
I was able to retrofit a GTO[br]to hit the standards for a hovercraft.

0:20:05.941,0:20:09.755
Excuse me for a second, Google Glass out,[br]could you get the GTO to get ready

0:20:09.755,0:20:12.080
to go to the Convention Center?[br]Great. Thank you.

0:20:12.080,0:20:14.430
Listen, I want to really[br]thank you for being here,

0:20:14.430,0:20:16.952
I want to thank you[br]for traveling in time and space,

0:20:16.952,0:20:19.557
and most importantly,[br]stay healthy in Philadelphia.

0:20:19.557,0:20:20.883
Thank you very much.

0:20:20.883,0:20:22.886
(Applause) (Cheering)