1 00:00:11,691 --> 00:00:13,667 Well, I want to thank you all for coming, 2 00:00:13,667 --> 00:00:16,693 and especially the people that came from outside of Philadelphia 3 00:00:16,693 --> 00:00:18,408 that hovered over here; 4 00:00:18,408 --> 00:00:21,795 especially those of you that time-traveled from other decades and times. 5 00:00:21,795 --> 00:00:23,385 I'm Steve Klasko. 6 00:00:23,385 --> 00:00:26,653 I'm the CEO of Stevie's Vinyl Emporium and Implantable Health Chips 7 00:00:26,653 --> 00:00:28,180 in South Street in Philadelphia. 8 00:00:28,180 --> 00:00:29,254 (Laughter) 9 00:00:29,254 --> 00:00:30,900 That's what I am today. 10 00:00:30,900 --> 00:00:32,630 But for the past ten years, 11 00:00:32,630 --> 00:00:35,228 I've been the presidency of Thomas Jefferson University 12 00:00:35,228 --> 00:00:37,684 in Jefferson University Hospital System 13 00:00:37,684 --> 00:00:40,863 that literally was one of the pioneers along with several others 14 00:00:40,863 --> 00:00:44,296 for what is now called the leaders of the optimistic future 15 00:00:44,296 --> 00:00:48,177 in Healthcare Revolution from 2015 to 2024. 16 00:00:48,177 --> 00:00:50,745 So for those of you who are coming from another decade, 17 00:00:50,745 --> 00:00:52,903 or for those of you who are here in the 2020s, 18 00:00:52,903 --> 00:00:55,772 I'd like to talk a little bit about how that journey happened 19 00:00:55,772 --> 00:00:58,260 and maybe give you a little bit of the personal story 20 00:00:58,260 --> 00:00:59,712 about how it happened for me. 21 00:00:59,712 --> 00:01:02,849 So first one of the things that we did, is we got tired of whining, 22 00:01:02,849 --> 00:01:05,086 and we decided let's just travel to the future, 23 00:01:05,086 --> 00:01:07,608 think about what we want and then create it. 24 00:01:07,608 --> 00:01:10,469 For me, that started in 1977. 25 00:01:11,079 --> 00:01:14,440 Very important time for me, I was a senior medical student. 26 00:01:14,440 --> 00:01:17,714 It was important because I got asked to give a talk for TED. 27 00:01:17,714 --> 00:01:21,405 Now not the TED you're thinking of because TED didn't exist in 1977. 28 00:01:21,405 --> 00:01:23,819 It was called tomorrow's education of doctors. 29 00:01:23,819 --> 00:01:26,914 It was everything different than the technology that exists today. 30 00:01:26,914 --> 00:01:29,287 It was a little slideshow with a screen, 31 00:01:29,287 --> 00:01:32,765 but they asked me to talk about what the future of medicine looks like 32 00:01:32,765 --> 00:01:34,778 from a medical student's point of view. 33 00:01:34,778 --> 00:01:37,871 I remember it for it was the first time I saw the Rolling Stones - 34 00:01:37,871 --> 00:01:40,608 this is what they looked like back then; I was a huge fan. 35 00:01:40,608 --> 00:01:44,185 But what I talked about because I was a little nervous about the first talk, 36 00:01:44,185 --> 00:01:46,965 I talked about: Can you do anything about spiraling costs? 37 00:01:46,965 --> 00:01:49,001 Can you change the fee-for-service system, 38 00:01:49,001 --> 00:01:52,197 so we're really rewarding value and not volume? 39 00:01:52,197 --> 00:01:54,142 And can you measure outcomes? 40 00:01:54,142 --> 00:01:58,968 And I said my generation of docs is going to solve this over the next four years. 41 00:01:58,968 --> 00:02:03,262 We are not going to be dealing with this even 20 years from now. 42 00:02:03,917 --> 00:02:06,493 Well, amazingly the docs said, "No." 43 00:02:06,493 --> 00:02:07,692 And that didn't happen. 44 00:02:07,692 --> 00:02:10,290 Now I was also a very different person back in 1977. 45 00:02:10,290 --> 00:02:11,610 This is what I look like. 46 00:02:11,610 --> 00:02:14,130 (Applause) (Cheering) 47 00:02:14,130 --> 00:02:15,532 Thank you. 48 00:02:18,432 --> 00:02:20,928 That's called a leisure suit. 49 00:02:20,928 --> 00:02:23,358 (Laughter) 50 00:02:23,358 --> 00:02:27,418 But for a brief interlude where they tried to bring it back in 2019, 51 00:02:27,418 --> 00:02:31,254 I think it's safe to say it's out of the fashion lexicon forever, 52 00:02:31,254 --> 00:02:36,218 but the car was in 1968 GTO which was and is a very cool car. 53 00:02:36,218 --> 00:02:37,599 Thank you. 54 00:02:37,599 --> 00:02:40,505 So then we went through really what some people called 55 00:02:40,505 --> 00:02:41,992 the middle or dark ages, 56 00:02:41,992 --> 00:02:45,599 the Managed Care Revolution, which did not really manage anything. 57 00:02:45,599 --> 00:02:48,749 It didn't really provide care; it just promoted underutilization - 58 00:02:48,749 --> 00:02:50,193 the balanced budget amendment, 59 00:02:50,193 --> 00:02:53,290 which didn't balance the budget, and didn't really amend anything. 60 00:02:53,290 --> 00:02:56,287 And then the first iteration of what has now been 17 iterations 61 00:02:56,287 --> 00:02:58,405 of what was then called Obamacare. 62 00:02:58,405 --> 00:03:02,393 So that brings us to 2014, and why was 2014 important to me? 63 00:03:02,393 --> 00:03:05,891 Well, I was very proud and honored to be inaugurated and selected 64 00:03:05,891 --> 00:03:07,910 as the first president and CEO 65 00:03:07,910 --> 00:03:11,076 of Thomas Jefferson University and Health System combined. 66 00:03:11,076 --> 00:03:14,564 It was also a big moment for me because it was the second time I saw them. 67 00:03:14,564 --> 00:03:17,294 This is what the Rolling Stones looked like back in 2014. 68 00:03:17,294 --> 00:03:18,741 (Laughter) 69 00:03:18,741 --> 00:03:21,042 And in my inauguration I was given a script, 70 00:03:21,042 --> 00:03:23,590 and what I talked about my inauguration in 2014 is: 71 00:03:23,590 --> 00:03:25,847 "Hey, can we do anything about spiraling costs?" 72 00:03:25,847 --> 00:03:27,758 Can we change the fee-for-service? 73 00:03:27,758 --> 00:03:29,588 Do you think we can measure outcomes? 74 00:03:29,588 --> 00:03:31,609 That was a bit of an a-ha moment for me, 75 00:03:31,609 --> 00:03:35,256 I said, "Well, 37 years, that's a lot for not to have much change." 76 00:03:35,256 --> 00:03:38,456 This time though, the insurers and government said: 77 00:03:38,456 --> 00:03:40,754 "We're really going to do it." 78 00:03:40,754 --> 00:03:43,744 And really what people were actually predicting is - 79 00:03:43,744 --> 00:03:46,537 because believe it or not, even at 2014 80 00:03:46,537 --> 00:03:49,914 the docs said: "I really don't want to take any risks. 81 00:03:49,914 --> 00:03:51,945 I think things are fine the way they were." 82 00:03:51,945 --> 00:03:54,584 And you couldn't go a week without people 83 00:03:54,584 --> 00:03:57,470 threatening the extinction of academic health centers. 84 00:03:57,470 --> 00:04:01,235 So I'm proud to say here in Philadelphia and at Jefferson we said yes, 85 00:04:01,235 --> 00:04:06,293 and I'd love to talk to you a little bit about what happened between 2014 and 2024. 86 00:04:06,293 --> 00:04:08,837 So here we are in 2024, and by the way, 87 00:04:08,837 --> 00:04:13,329 I don't know if any of you saw it on your Facebook implantable glasses, 88 00:04:13,329 --> 00:04:16,127 the Zombie Rock Tour, it was awesome. 89 00:04:16,127 --> 00:04:17,668 It was awesome. 90 00:04:17,668 --> 00:04:20,310 By the way, those Facebook implantable glasses 91 00:04:20,310 --> 00:04:23,478 can be bought at Stevie's Vinyl Records and Implantable Devices. 92 00:04:23,478 --> 00:04:24,598 (Laughter) 93 00:04:25,358 --> 00:04:29,211 I thought the Rolling Stones, the Rolling Stones rocked, 94 00:04:29,211 --> 00:04:30,479 (Laughter) (Cheers) 95 00:04:30,479 --> 00:04:32,548 they rocked the undead tour, right? 96 00:04:32,548 --> 00:04:34,980 Who agrees with me? They rocked the undead tour. 97 00:04:34,980 --> 00:04:37,201 Seven decades of great Rolling Stones. 98 00:04:37,201 --> 00:04:39,438 You talk about not getting any satisfaction, 99 00:04:39,438 --> 00:04:40,708 look at these guys. 100 00:04:40,708 --> 00:04:42,538 (Laughter) 101 00:04:42,538 --> 00:04:44,875 But more importantly, more importantly, 102 00:04:44,875 --> 00:04:48,313 what happened in Philadelphia, what happened at Jefferson was, 103 00:04:48,313 --> 00:04:50,753 that we took that mode of saying - 104 00:04:50,753 --> 00:04:53,551 people said that it's impossible to change healthcare. 105 00:04:53,551 --> 00:04:56,177 And really the personal piece, for me believe it or not, 106 00:04:56,177 --> 00:04:58,275 didn't come from Maimonides or Aristotle, 107 00:04:58,275 --> 00:05:01,398 or even somebody from the University of Pennsylvania or Jefferson. 108 00:05:01,398 --> 00:05:03,284 It came from a sneaker commercial. 109 00:05:03,284 --> 00:05:07,780 It was an Adidas marketing campaign back in 2014 called the Impossible. 110 00:05:07,780 --> 00:05:11,789 It said "impossible" is just a big word thrown around by small men and women 111 00:05:11,789 --> 00:05:14,532 who find it easier to live the world they've been given 112 00:05:14,532 --> 00:05:17,026 rather than explore the power they have to change it. 113 00:05:17,026 --> 00:05:19,170 Impossible is not a fact; it's an opinion. 114 00:05:19,170 --> 00:05:21,470 Impossible is temporary; impossible is nothing. 115 00:05:22,100 --> 00:05:25,170 So we decided, "What the heck, let's do the impossible." 116 00:05:25,170 --> 00:05:27,241 Because everybody knew things were changing, 117 00:05:27,241 --> 00:05:30,019 we weren't going to wait for a miracle. 118 00:05:30,019 --> 00:05:32,108 And we said, "Let's do it." 119 00:05:32,108 --> 00:05:34,783 OK, so here it is, it's March 28th, 2024. 120 00:05:34,783 --> 00:05:37,594 Now I apologize for those of you who come from this decade, 121 00:05:37,594 --> 00:05:40,108 but I know some of you probably have time travel lag, 122 00:05:40,108 --> 00:05:42,410 and I just want you to know where we're at today. 123 00:05:42,410 --> 00:05:43,772 So it's March 28th, 2024, 124 00:05:43,772 --> 00:05:47,678 President Jenna Bush will be debating Democratic nominee Chelsea Clinton, 125 00:05:47,678 --> 00:05:50,495 in what a lot of people think will be a very tight race. 126 00:05:50,495 --> 00:05:53,402 Harrison Ford has signed up for one last Indiana Jones sequel, 127 00:05:53,402 --> 00:05:54,452 (Laughter) 128 00:05:54,452 --> 00:05:57,393 tentatively titled Indiana Jones: the Legend of Bingo Night, 129 00:05:57,393 --> 00:05:59,211 we're all excited about that one. 130 00:05:59,211 --> 00:06:02,206 And the Eagles are 2-0 and trying to win their first Super Bowl 131 00:06:02,206 --> 00:06:05,985 since the unprecedented fourth straight they won from 2015 to 2018, 132 00:06:05,985 --> 00:06:08,100 the so-called Chip Championship Years. 133 00:06:08,100 --> 00:06:10,830 (Applause) (Cheering) 134 00:06:11,703 --> 00:06:16,071 Of course, Governor Chip now has a very different job than he had back then. 135 00:06:16,071 --> 00:06:18,738 But more importantly or as importantly, 136 00:06:18,738 --> 00:06:21,563 Jefferson is celebrating its 200th anniversary 137 00:06:21,563 --> 00:06:24,486 as an international hub of innovation, 138 00:06:24,486 --> 00:06:26,108 with headquarters in Philadelphia, 139 00:06:26,108 --> 00:06:28,781 instead of just the Philadelphia academic medical center. 140 00:06:28,781 --> 00:06:32,160 We've become a destination site for innovative entrepreneurial health 141 00:06:32,160 --> 00:06:34,425 with unprecedented economic development, 142 00:06:34,425 --> 00:06:35,804 and our creative partnerships 143 00:06:35,804 --> 00:06:38,731 have allowed us to become what The Wall Street Journal called 144 00:06:38,731 --> 00:06:41,165 a thriving cluster on the verge of a chain reaction, 145 00:06:41,165 --> 00:06:44,528 which has helped make Philadelphia the epicenter of the new healthcare. 146 00:06:44,528 --> 00:06:46,548 By the way, I'm getting out of my DeLorean 147 00:06:46,548 --> 00:06:50,036 to accept an award from the US News and Interplanetary Report. 148 00:06:50,036 --> 00:06:53,481 As most of you know in 2019, we found two other planets 149 00:06:53,481 --> 00:06:55,581 with slightly dysfunctional health systems, 150 00:06:55,581 --> 00:06:59,980 so they are now part of the ranking system that the former USNWR used. 151 00:06:59,980 --> 00:07:02,809 So how did we get there? I'd like to ... 152 00:07:02,809 --> 00:07:05,575 TEDx has asked me to talk about three things that we did 153 00:07:05,575 --> 00:07:07,528 that were very different. 154 00:07:07,528 --> 00:07:11,351 First of all, we decided that we're going to start to create docs of the future, 155 00:07:11,351 --> 00:07:16,260 that it's ridiculous to have the same way that we selected and educated physicians 156 00:07:16,260 --> 00:07:19,230 that became autonomous, competitive, and hierarchical, 157 00:07:19,230 --> 00:07:22,313 and that we actually were going to change the DNA of healthcare 158 00:07:22,313 --> 00:07:23,993 literally one physician at a time. 159 00:07:23,993 --> 00:07:25,271 You may not believe this, 160 00:07:25,271 --> 00:07:30,317 but back in 2014, we still chose doctors based on science GPAs, MedCaTs, 161 00:07:30,317 --> 00:07:34,209 which were a multiple-choice test, and organic chemistry performance. 162 00:07:34,209 --> 00:07:37,221 And somehow we were amazed that doctors weren't more empathetic, 163 00:07:37,221 --> 00:07:38,769 communicative, and creative. 164 00:07:38,769 --> 00:07:40,609 As my kids would say, "Duh." 165 00:07:40,609 --> 00:07:42,333 (Laughter) (Applause) 166 00:07:42,333 --> 00:07:43,528 So we changed all that. 167 00:07:43,528 --> 00:07:48,655 What we recognized is that it used to be for those of you who came from the '70s - 168 00:07:48,985 --> 00:07:51,166 and I think there are actually some, 169 00:07:51,166 --> 00:07:54,393 I see some people from 2014, I see some people from the '80s. 170 00:07:54,393 --> 00:07:56,283 Go Journey, yeah. 171 00:07:56,283 --> 00:07:57,413 (Laughter) 172 00:07:57,413 --> 00:08:01,204 I see some tie-dye out there, some '60s and '70s. Peace! 173 00:08:01,564 --> 00:08:05,037 But we decided to transform admissions. 174 00:08:05,037 --> 00:08:08,686 What we realized is that all the scientific data 175 00:08:08,686 --> 00:08:12,143 is on what in 2014 we called iPhones and Androids, 176 00:08:12,143 --> 00:08:15,737 but really what we needed were emotionally intelligent physicians. 177 00:08:15,737 --> 00:08:20,341 So we now really select physicians based on self-awareness, self-management, 178 00:08:20,341 --> 00:08:23,565 and the ability to adapt, social awareness and empathy, 179 00:08:23,565 --> 00:08:25,702 relationship management, teamwork, 180 00:08:25,702 --> 00:08:29,113 and the ability to really embrace change instead of fighting it. 181 00:08:29,113 --> 00:08:30,419 But not only that, 182 00:08:30,419 --> 00:08:34,542 we totally changed the way that we teach the physicians that we do accept. 183 00:08:34,542 --> 00:08:36,383 Believe it or not back in 2014, 184 00:08:36,383 --> 00:08:40,925 we used to spend two years really teaching them scientific principles 185 00:08:40,925 --> 00:08:43,947 in large auditoriums, classes that a lot of them didn't come to, 186 00:08:43,947 --> 00:08:46,088 when we recognized that we could do all that, 187 00:08:46,088 --> 00:08:48,514 have them learn that at two o'clock in the morning. 188 00:08:48,514 --> 00:08:51,801 Now we spend most of our time in what we call the Art of Attending. 189 00:08:51,801 --> 00:08:55,431 Teaching them to really observe, we started back in 2014, 190 00:08:55,431 --> 00:08:59,001 workshops designed to sharpen observation skills of health students 191 00:08:59,001 --> 00:09:00,770 by looking at art. 192 00:09:00,770 --> 00:09:02,267 Very unusual partnership, 193 00:09:02,267 --> 00:09:06,084 it was Thomas Jefferson University, Contemporary Art Museum, 194 00:09:06,084 --> 00:09:08,919 an institute for an optimistic future in healthcare. 195 00:09:08,919 --> 00:09:12,572 We took students and had them understand art. 196 00:09:12,572 --> 00:09:14,983 So if you take this piece of art over here, 197 00:09:14,983 --> 00:09:16,831 medical students originally said, 198 00:09:16,831 --> 00:09:19,684 "Well, that's a woman; that's a snake; that's a family." 199 00:09:19,684 --> 00:09:22,499 But when you started to look and say, "What is the story?", 200 00:09:22,499 --> 00:09:26,270 it started to totally change the way that they cared for patients. 201 00:09:26,270 --> 00:09:30,530 And at the end of the day, we went from silos of full-time individuals 202 00:09:30,530 --> 00:09:34,419 to folks who could deliver team-enabled and team-based care. 203 00:09:34,419 --> 00:09:37,679 Doctors went from being captains of the ship to being part of a team, 204 00:09:37,679 --> 00:09:39,686 and they, believe it or not, work closely 205 00:09:39,686 --> 00:09:42,164 with multidisciplinary care-delivery teams, 206 00:09:42,164 --> 00:09:45,069 including doctors of nursing practice, nurse practitioners, 207 00:09:45,069 --> 00:09:47,584 clinical pharmacists, physician's assistants. 208 00:09:47,584 --> 00:09:50,887 and at the Thomas Jefferson Institute of Emerging Health Professions, 209 00:09:50,887 --> 00:09:53,934 professions that didn't even exist in 2014, 210 00:09:53,934 --> 00:09:58,115 things like probability experts, electronic health care ambassadors, 211 00:09:58,115 --> 00:10:00,196 and telehealth professionals. 212 00:10:00,196 --> 00:10:04,070 So we recognized that we needed to evolve doctoring. 213 00:10:04,070 --> 00:10:08,784 We also recognized that the patient experience was really pretty lousy. 214 00:10:09,374 --> 00:10:14,710 Back in 2014, you could actually do anything you needed to do in travel, 215 00:10:14,710 --> 00:10:17,567 anything you needed to do in shopping on a device, 216 00:10:17,567 --> 00:10:20,477 but could you get an appointment with a physician? No. 217 00:10:20,477 --> 00:10:23,278 Could you interact with a doctor or nurse? No. 218 00:10:23,278 --> 00:10:27,983 So we decided that healthcare needed in 2014 to get into the E&I mode. 219 00:10:27,983 --> 00:10:32,135 If you even look at how people viewed us from TV shows - 220 00:10:32,135 --> 00:10:35,333 how many of you are here from the '70s? There you go, okay. 221 00:10:35,333 --> 00:10:38,637 So the big tip television show in the '70s was Marcus Welby. 222 00:10:38,637 --> 00:10:40,233 Now here's what Marcus Welby was. 223 00:10:40,233 --> 00:10:41,679 He was a family physician. 224 00:10:41,679 --> 00:10:43,349 He would get up in the morning, 225 00:10:43,349 --> 00:10:46,538 he would go to the homeless shelter, take care of people for free. 226 00:10:46,538 --> 00:10:50,010 On the way home to lunch, a cow would be having trouble delivering a calf, 227 00:10:50,010 --> 00:10:51,236 he'd deliver it. 228 00:10:51,236 --> 00:10:54,326 He'd then go to his family medicine office in the afternoon, 229 00:10:54,326 --> 00:10:57,000 and then at night he'd do left ventricular neurosurgery. 230 00:10:57,000 --> 00:11:00,301 We were Gods, we could do everything, that's how people viewed us. 231 00:11:00,301 --> 00:11:03,591 In the 2010s this is what we had. Anybody remember this guy? 232 00:11:03,591 --> 00:11:05,741 (Laughter) 233 00:11:05,741 --> 00:11:09,538 He was a drug-addicted, sex-addicted, really smart guy 234 00:11:09,538 --> 00:11:12,219 that couldn't communicate or see patients. 235 00:11:12,219 --> 00:11:14,240 That's what people viewed us. 236 00:11:14,240 --> 00:11:17,591 The number one TV show of 2023? 237 00:11:17,591 --> 00:11:23,002 Was Doctor WHO, which stands for Watson Hybrid Organo Doc, 238 00:11:23,002 --> 00:11:28,349 who basically fell in love with his robotic-bionic counterpart 239 00:11:28,349 --> 00:11:31,791 who does all the scientific stuff while he does the emotional stuff. 240 00:11:31,791 --> 00:11:33,878 And as you can imagine, hilarity ensues. 241 00:11:33,878 --> 00:11:35,128 By the way ... 242 00:11:35,128 --> 00:11:36,757 (Laughter) 243 00:11:36,757 --> 00:11:41,610 By the way the first season of Doctor WHO 244 00:11:41,610 --> 00:11:45,195 is available on Google Glass implantable chips, 245 00:11:45,195 --> 00:11:50,269 available at Stevie's Vinyl Records and Implantable Chips on South Street. 246 00:11:50,269 --> 00:11:51,429 (Laughter) 247 00:11:51,429 --> 00:11:54,307 So the other thing we embraced was entrepreneurship. 248 00:11:54,307 --> 00:11:57,305 We recognized that being academic and entrepreneurial 249 00:11:57,305 --> 00:11:59,473 just were not mutually exclusive, 250 00:11:59,473 --> 00:12:03,867 and we also recognized that we had to enhance the consumer experience. 251 00:12:03,867 --> 00:12:06,623 It really was lousy going to a physician. 252 00:12:06,623 --> 00:12:08,584 This is what it looked like back in 2014. 253 00:12:08,914 --> 00:12:11,605 Female: What's wrong? Stevenson: I don't feel so good. 254 00:12:11,605 --> 00:12:13,535 F: Then you need to go to a doctor. 255 00:12:20,788 --> 00:12:24,022 Female nurse: Mr. Stephenson? S: Stevenson. 256 00:12:24,022 --> 00:12:25,553 FN: Do you have any allergies? 257 00:12:25,553 --> 00:12:29,005 How would you describe your symptoms? What is the general area of pain? 258 00:12:29,005 --> 00:12:32,417 Does your family have a history of heart disease or diabetes? 259 00:12:32,417 --> 00:12:36,059 Doctor: And what seems to be the problem today, Mr. Stevenson? 260 00:12:36,059 --> 00:12:39,342 S: I'm feeling a little stuffed up. I'm experiencing some ... 261 00:12:39,342 --> 00:12:42,926 FN: Doctor, your 3 o'clock is early, your 2:45 is late from 6 and 7. 262 00:12:42,926 --> 00:12:44,459 D: Follow these instructions; 263 00:12:44,459 --> 00:12:48,303 if it doesn't clear up in a week or two, come back; we'll do this all over again. 264 00:12:48,303 --> 00:12:49,687 (Moaning) 265 00:12:50,158 --> 00:12:52,572 S: I don't like going to a doctor. 266 00:12:52,572 --> 00:12:56,883 SK: So in July of 2014, we partnered with some great companies, 267 00:12:56,883 --> 00:13:00,077 created an innovation-driven ecosystem for healthcare. 268 00:13:00,077 --> 00:13:02,480 Starting in 2015, patients in 48 states 269 00:13:02,480 --> 00:13:05,550 could access Jefferson doctors via telemedicine. 270 00:13:05,550 --> 00:13:08,751 S: Well, now you can see a doctor without going to a doctor's office 271 00:13:08,751 --> 00:13:11,814 with the help of your smartphone, or computer, and American Well. 272 00:13:11,814 --> 00:13:14,368 Signing up and setting up your health profile is easy; 273 00:13:14,368 --> 00:13:15,474 it only takes a minute, 274 00:13:15,474 --> 00:13:18,265 and once you've done it, it's stored safely and securely. 275 00:13:18,265 --> 00:13:21,533 Then you can log in or use the App to see doctors who're available, 276 00:13:21,533 --> 00:13:23,624 and connect by video phone or chat. 277 00:13:25,060 --> 00:13:26,093 D: Hi Allen. 278 00:13:26,093 --> 00:13:30,443 I see you've been experiencing some congestion and some nasal blockage. 279 00:13:30,443 --> 00:13:32,104 How long has this been going on? 280 00:13:32,104 --> 00:13:35,109 S: During the visit, the doctor can see your health information, 281 00:13:35,109 --> 00:13:38,347 afterward, you get a complete write-up of everything the doctor says. 282 00:13:38,347 --> 00:13:41,506 D: It looks like acute sinusitis, a sinus infection. 283 00:13:41,506 --> 00:13:44,467 Now I wrote you a prescription to help with congestion. 284 00:13:44,467 --> 00:13:46,914 If things don't clear up in, say, a week or so, 285 00:13:46,914 --> 00:13:49,448 just send me a message, I'll be right here. 286 00:13:49,448 --> 00:13:53,045 S: A few mins later, I've got my diagnosis and my instructions for treatment 287 00:13:53,045 --> 00:13:56,071 and my prescription is already waiting for me at the pharmacy. 288 00:13:56,071 --> 00:13:59,933 SK: Of course, all that now happens in your Google Glasses 289 00:13:59,933 --> 00:14:01,625 which are available by the way 290 00:14:01,625 --> 00:14:05,083 at Stevie's Vinyl Records and Implantable Health Chips. 291 00:14:05,568 --> 00:14:09,145 We also recognized that information was everything. 292 00:14:09,145 --> 00:14:13,193 As Yogi Berra would say, it comes down to one word, big data. 293 00:14:13,193 --> 00:14:16,694 And believe it or not, believe it or not, 294 00:14:16,694 --> 00:14:19,709 we used to do everything based on experience and anecdote. 295 00:14:19,709 --> 00:14:24,815 Evidence-based medicine in 2014 was actually a novel idea. 296 00:14:24,815 --> 00:14:28,737 And now we recognize that we can take things from other industries. 297 00:14:28,737 --> 00:14:31,373 So at Jefferson, for example, in 2014, we started 298 00:14:31,373 --> 00:14:34,807 the Center for Healthcare, Entrepreneurship and Scientific Solutions. 299 00:14:34,807 --> 00:14:40,389 We said, "It really doesn't make any sense that Nick Foles has a better idea 300 00:14:40,389 --> 00:14:43,773 of whether or not a screen pass will work in the third quarter 301 00:14:43,773 --> 00:14:46,248 than I do of whether or not a cancer drug will work." 302 00:14:46,248 --> 00:14:49,409 So we took some of the best people doing mathematical modeling 303 00:14:49,409 --> 00:14:52,283 and created a predictive analytics and mathematical modeling 304 00:14:52,283 --> 00:14:54,200 to reduce uncertainty in medicine. 305 00:14:54,200 --> 00:14:59,766 Believe it or not, in 2014, 28% of people that went to the hospital in this country 306 00:14:59,766 --> 00:15:01,725 got readmitted within 90 days. 307 00:15:02,185 --> 00:15:04,020 Now, through our mathematical modeling 308 00:15:04,020 --> 00:15:06,484 we're able to see exactly what intervention 309 00:15:06,484 --> 00:15:08,101 will keep people from coming back. 310 00:15:08,101 --> 00:15:10,607 Not only that, we've changed the way we do things. 311 00:15:10,607 --> 00:15:15,412 In 2014, family medicine physicians would actually be out of the hospital. 312 00:15:15,412 --> 00:15:17,940 Hospitalists would never leave the hospital, 313 00:15:17,940 --> 00:15:20,179 and then there was no real communication. 314 00:15:20,179 --> 00:15:22,335 Now we have what's called extensiveness, 315 00:15:22,335 --> 00:15:25,515 hospitalists that actually follow those patients for 90 days 316 00:15:25,515 --> 00:15:27,585 so they don't get readmitted. 317 00:15:27,585 --> 00:15:29,502 We actually pay for performance now 318 00:15:29,502 --> 00:15:31,986 because we can actually measure performance. 319 00:15:31,986 --> 00:15:35,114 And we can actually give you predictable answers 320 00:15:35,114 --> 00:15:37,937 as to what you're paying for and what you're getting back. 321 00:15:37,937 --> 00:15:41,710 Accountable care organizations for the first time really are accountable 322 00:15:41,710 --> 00:15:43,742 because we have math to back it up. 323 00:15:44,292 --> 00:15:46,863 One of the great things that happened in Philadelphia, 324 00:15:46,863 --> 00:15:49,554 believe it or not, again in 2014, 325 00:15:49,554 --> 00:15:51,721 with decreasing NIH funding, 326 00:15:51,721 --> 00:15:57,325 Penn, Jefferson, Temple, Drexel, would all fight for NIH funds. 327 00:15:57,325 --> 00:15:59,989 What we did, and one of the greatest things we did, 328 00:15:59,989 --> 00:16:02,706 we created the Philadelphia Clinical Research Super Site 329 00:16:02,706 --> 00:16:06,272 where we said really what's important is to take all of our resources, 330 00:16:06,272 --> 00:16:09,459 both in education and research, and make Philadelphia an epicenter. 331 00:16:09,459 --> 00:16:11,798 What did that do for us over the last ten years? 332 00:16:11,798 --> 00:16:15,058 We were able to take the Nanotechnology University of Pennsylvania 333 00:16:15,058 --> 00:16:17,657 and Molecular Genomics at Jefferson 334 00:16:17,657 --> 00:16:19,884 and create the DNA vending machine. 335 00:16:19,884 --> 00:16:23,786 For those of you from the 2010s, it's sort of like a red box for your DNA. 336 00:16:23,786 --> 00:16:25,430 We can now pick a drug for you, 337 00:16:25,430 --> 00:16:28,767 and instead of saying it's for 200 people that look like you, 338 00:16:28,767 --> 00:16:31,557 we can take exactly the drug that fits your genome 339 00:16:31,557 --> 00:16:33,019 and have it available for you. 340 00:16:33,019 --> 00:16:35,212 We can also put your genome on a chip, 341 00:16:35,212 --> 00:16:36,402 so that God forbid, 342 00:16:36,402 --> 00:16:39,004 if you need a new organ, we can make that for you 343 00:16:39,004 --> 00:16:41,698 based on work that's been done in Philadelphia. 344 00:16:41,698 --> 00:16:44,677 And we finally decided to work with patients 345 00:16:44,677 --> 00:16:47,683 to really make them shareholders in their health, 346 00:16:47,683 --> 00:16:48,954 and this is what it means. 347 00:16:48,954 --> 00:16:51,160 It means that in a community like Philadelphia, 348 00:16:51,160 --> 00:16:53,067 if we're able to make you healthier, 349 00:16:53,767 --> 00:16:56,147 we do better as physicians; you do better. 350 00:16:56,147 --> 00:16:58,486 And we actually partnered with great companies 351 00:16:58,486 --> 00:17:00,362 from again outside Philadelphia 352 00:17:00,362 --> 00:17:04,152 to look at a different way of making sure that everyone matters, 353 00:17:04,152 --> 00:17:08,380 that we can look at not only drugs, but holistic remedies 354 00:17:08,380 --> 00:17:11,375 to look at personalized performance-gain plans 355 00:17:11,375 --> 00:17:14,883 integrating a proven system to drive health outcomes. 356 00:17:14,883 --> 00:17:18,620 Whether it's mindset, or nutrition, or movement, or recovery, 357 00:17:18,620 --> 00:17:22,860 we were able to do many more things that didn't require pharmaceuticals. 358 00:17:22,860 --> 00:17:25,726 So that brings us to 2024, and as I said, 359 00:17:25,726 --> 00:17:31,059 I'm here to accept our number one ranking from the US News and Interplanetary Report 360 00:17:31,059 --> 00:17:32,805 and what's really cool is 361 00:17:32,805 --> 00:17:35,708 that some of the ranking parameters didn't even exist in 2014, 362 00:17:35,708 --> 00:17:38,817 and I'll give you an example of a few of them on the academic side 363 00:17:38,817 --> 00:17:40,320 and also on the clinical side. 364 00:17:40,320 --> 00:17:43,652 On the academic side, we actually, imagine this, 365 00:17:43,652 --> 00:17:48,359 get ranked based on how our students do at one year, three year, or five year. 366 00:17:48,359 --> 00:17:51,692 We measure individuals' professional and personal happiness 367 00:17:51,692 --> 00:17:53,935 at varying intervals after graduation. 368 00:17:53,935 --> 00:17:56,661 Because after all, that's why they came to our university. 369 00:17:56,661 --> 00:17:58,249 And if we don't do really well, 370 00:17:58,249 --> 00:18:00,539 then they actually get some of their money back. 371 00:18:00,539 --> 00:18:02,256 We have a collaborative quotient. 372 00:18:02,256 --> 00:18:05,867 Academic entities are incentivized to actually get over themselves 373 00:18:05,867 --> 00:18:07,433 and work well with others, 374 00:18:07,433 --> 00:18:09,035 (Laughter) (Applause) 375 00:18:09,035 --> 00:18:11,410 which would have been unheard of in 2014 376 00:18:11,410 --> 00:18:13,987 when they were all cannibalizing each other. 377 00:18:13,987 --> 00:18:17,462 And we have an entrepreneurial quotient where institutions are rewarded 378 00:18:17,462 --> 00:18:20,360 that invent and envision new ways of doing things 379 00:18:20,360 --> 00:18:23,868 that generate alternate revenue and develop new student opportunities. 380 00:18:23,868 --> 00:18:28,479 But probably nothing's changed the most than health quotients. 381 00:18:28,479 --> 00:18:31,355 I mean, it used to be back in 2014 and before 382 00:18:31,355 --> 00:18:34,421 that parameters were based on the reputational score in the past. 383 00:18:34,421 --> 00:18:36,268 Now it's based on what patients think. 384 00:18:36,268 --> 00:18:39,203 The one I'm really proud of that we got a very high score on 385 00:18:39,203 --> 00:18:41,021 is called the BUB Quotient. 386 00:18:41,021 --> 00:18:43,861 It stands for the Believable Understandable Bill, 387 00:18:43,861 --> 00:18:46,216 that we actually have enough respect for patients 388 00:18:46,216 --> 00:18:48,484 that we provide understandable bills, 389 00:18:48,484 --> 00:18:52,183 so they can understand what they got and what they're paying for. 390 00:18:52,183 --> 00:18:55,494 We have the say-what-you-mean and mean-what-you-say quality parameter. 391 00:18:55,494 --> 00:18:58,669 We actually take marketing professionals to read all the billboards 392 00:18:58,669 --> 00:18:59,828 in the marketing we do, 393 00:18:59,828 --> 00:19:03,041 and see if they have any semblance to reality of what really happens 394 00:19:03,041 --> 00:19:03,999 in the hospital, 395 00:19:03,999 --> 00:19:06,737 and you get points if there is some semblance to reality. 396 00:19:06,737 --> 00:19:09,804 And then finally we have the through-the-patient-eyes factor. 397 00:19:09,804 --> 00:19:12,240 And this is really exciting because what it is, 398 00:19:12,240 --> 00:19:14,922 is every patient now, in 2024, 399 00:19:14,922 --> 00:19:18,420 basically when they get in the hospital is given a Google Glasses, 400 00:19:18,420 --> 00:19:22,807 and they basically can record what's happening through their eyes, 401 00:19:22,807 --> 00:19:25,267 how the doctors and nurses are treating them, 402 00:19:25,267 --> 00:19:28,915 and then we have CEOs of other hospitals look at that video for a day 403 00:19:28,915 --> 00:19:32,862 and grade on 1 to 10 whether they'd like to spend a day in that hospital. 404 00:19:32,862 --> 00:19:35,195 And again that's a great parameter for us. 405 00:19:35,195 --> 00:19:37,718 So a lot has happened since 2024, 406 00:19:37,718 --> 00:19:40,019 and I'm really excited to be here. 407 00:19:40,019 --> 00:19:43,203 We're about to accept an award in the new Convention Center & Casino 408 00:19:43,203 --> 00:19:44,609 on the Schuylkill River. 409 00:19:44,609 --> 00:19:46,304 (Laughter) 410 00:19:46,304 --> 00:19:49,894 And some things from the past really are good. 411 00:19:49,894 --> 00:19:52,760 I'm going through my third midlife crisis 412 00:19:52,760 --> 00:19:56,618 because I'm 70 and what happens is people live to 120, 413 00:19:56,618 --> 00:19:58,232 so midlife crises have changed. 414 00:19:58,232 --> 00:20:00,428 And I'm proud to say this is what I got myself, 415 00:20:00,428 --> 00:20:05,591 I was able to retrofit a GTO to hit the standards for a hovercraft. 416 00:20:05,941 --> 00:20:09,755 Excuse me for a second, Google Glass out, could you get the GTO to get ready 417 00:20:09,755 --> 00:20:12,080 to go to the Convention Center? Great. Thank you. 418 00:20:12,080 --> 00:20:14,430 Listen, I want to really thank you for being here, 419 00:20:14,430 --> 00:20:16,952 I want to thank you for traveling in time and space, 420 00:20:16,952 --> 00:20:19,557 and most importantly, stay healthy in Philadelphia. 421 00:20:19,557 --> 00:20:20,883 Thank you very much. 422 00:20:20,883 --> 00:20:22,886 (Applause) (Cheering)