WEBVTT

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Well, I want to thank you all for coming,

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and especially the people
that came from outside of Philadelphia

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that hovered over here;

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especially those of you that time-traveled
from other decades and times.

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I'm Steve Klasko.

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I'm the CEO of Stevie's Vinyl Emporium
and Implantable Health Chips

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in South Street in Philadelphia.

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(Laughter)

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That's what I am today.

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But for the past ten years,

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I've been the presidency
of Thomas Jefferson University

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in Jefferson University Hospital System

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that literally was one of the pioneers
along with several others

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for what is now called
the leaders of the optimistic future

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in Healthcare Revolution
from 2015 to 2024.

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So for those of you
who are coming from another decade,

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or for those of you
who are here in the 2020s,

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I'd like to talk a little bit
about how that journey happened

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and maybe give you
a little bit of the personal story

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about how it happened for me.

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So first one of the things that we did,
is we got tired of whining,

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and we decided
let's just travel to the future,

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think about what we want
and then create it.

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For me, that started in 1977.

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Very important time for me,
I was a senior medical student.

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It was important because I got asked
to give a talk for TED.

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Now not the TED you're thinking of
because TED didn't exist in 1977.

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It was called tomorrow's
education of doctors.

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It was everything different
than the technology that exists today.

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It was a little slideshow with a screen,

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but they asked me to talk about
what the future of medicine looks like

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from a medical student's point of view.

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I remember it for it was the first time
I saw the Rolling Stones -

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this is what they looked like
back then; I was a huge fan.

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But what I talked about because I
was a little nervous about the first talk,

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I talked about: Can you do anything
about spiraling costs?

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Can you change the fee-for-service system,


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so we're really rewarding
value and not volume?

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And can you measure outcomes?

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And I said my generation of docs is going
to solve this over the next four years.

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We are not going to be dealing with this
even 20 years from now.

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Well, amazingly the docs said, "No."

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And that didn't happen.

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Now I was also a very different
person back in 1977.

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This is what I look like.

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(Applause) (Cheering)

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Thank you.

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That's called a leisure suit.

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(Laughter)

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But for a brief interlude
where they tried to bring it back in 2019,

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I think it's safe to say
it's out of the fashion lexicon forever,

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but the car was in 1968 GTO
which was and is a very cool car.

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Thank you.

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So then we went through really
what some people called

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the middle or dark ages,

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the Managed Care Revolution,
which did not really manage anything.

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It didn't really provide care;
it just promoted underutilization -

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the balanced budget amendment,

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which didn't balance the budget,
and didn't really amend anything.

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And then the first iteration
of what has now been 17 iterations

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of what was then called Obamacare.

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So that brings us to 2014,
and why was 2014 important to me?

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Well, I was very proud and honored
to be inaugurated and selected

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as the first president and CEO

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of Thomas Jefferson University
and Health System combined.

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It was also a big moment for me
because it was the second time I saw them.

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This is what the Rolling Stones
looked like back in 2014.

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(Laughter)

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And in my inauguration
I was given a script,

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and what I talked about
my inauguration in 2014 is:

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"Hey, can we do anything
about spiraling costs?"

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Can we change the fee-for-service?

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Do you think we can measure outcomes?

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That was a bit of an a-ha moment for me,

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I said, "Well, 37 years, that's a lot
for not to have much change."

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This time though, the insurers
and government said:

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"We're really going to do it."

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And really what people
were actually predicting is -

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because believe it or not, even at 2014

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the docs said: "I really don't
want to take any risks.

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I think things are fine
the way they were."

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And you couldn't go a week
without people

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threatening the extinction
of academic health centers.

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So I'm proud to say here in Philadelphia
and at Jefferson we said yes,

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and I'd love to talk to you a little bit
about what happened between 2014 and 2024.

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So here we are in 2024, and by the way,

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I don't know if any of you saw it
on your Facebook implantable glasses,

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the Zombie Rock Tour, it was awesome.

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It was awesome.

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By the way, those Facebook
implantable glasses

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can be bought at Stevie's Vinyl Records
and Implantable Devices.

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(Laughter)

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I thought the Rolling Stones,
the Rolling Stones rocked,

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(Laughter) (Cheers)

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they rocked the undead tour, right?

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Who agrees with me?
They rocked the undead tour.

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Seven decades of great Rolling Stones.

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You talk about
not getting any satisfaction,

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look at these guys.

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(Laughter)

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But more importantly, more importantly,

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what happened in Philadelphia,
what happened at Jefferson was,

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that we took that mode of saying -

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people said that it's impossible
to change healthcare.

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And really the personal piece,
for me believe it or not,

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didn't come from Maimonides or Aristotle,

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or even somebody from the University
of Pennsylvania or Jefferson.

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It came from a sneaker commercial.

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It was an Adidas marketing campaign
back in 2014 called the Impossible.

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It said "impossible" is just a big word
thrown around by small men and women

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who find it easier to live the world
they've been given

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rather than explore the power
they have to change it.

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Impossible is not a fact; it's an opinion.

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Impossible is temporary;
impossible is nothing.

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So we decided, "What the heck,
let's do the impossible."

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Because everybody knew
things were changing,

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we weren't going to wait for a miracle.

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And we said, "Let's do it."

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OK, so here it is, it's March 28th, 2024.

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Now I apologize for those of you
who come from this decade,

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but I know some of you
probably have time travel lag,

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and I just want you to know
where we're at today.

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So it's March 28th, 2024,

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President Jenna Bush will be debating
Democratic nominee Chelsea Clinton,

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in what a lot of people think
will be a very tight race.

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Harrison Ford has signed up
for one last Indiana Jones sequel,

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(Laughter)

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tentatively titled Indiana Jones:
the Legend of Bingo Night,

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we're all excited about that one.

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And the Eagles are 2-0
and trying to win their first Super Bowl

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since the unprecedented fourth straight
they won from 2015 to 2018,

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the so-called Chip Championship Years.

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(Applause) (Cheering)

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Of course, Governor Chip now has a very
different job than he had back then.

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But more importantly or as importantly,

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Jefferson is celebrating
its 200th anniversary

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as an international hub of innovation,

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with headquarters in Philadelphia,

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instead of just the Philadelphia
academic medical center.

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We've become a destination site
for innovative entrepreneurial health

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with unprecedented economic development,

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and our creative partnerships

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have allowed us to become
what The Wall Street Journal called

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a thriving cluster on the verge
of a chain reaction,

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which has helped make Philadelphia
the epicenter of the new healthcare.

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By the way, I'm getting out of my DeLorean

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to accept an award from the US News
and Interplanetary Report.

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As most of you know in 2019,
we found two other planets

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with slightly dysfunctional
health systems,

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so they are now part of the ranking system
that the former USNWR used.

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So how did we get there? I'd like to ...

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TEDx has asked me to talk
about three things that we did

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that were very different.

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First of all, we decided that we're going
to start to create docs of the future,

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that it's ridiculous to have the same way
that we selected and educated physicians

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that became autonomous,
competitive, and hierarchical,

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and that we actually were going
to change the DNA of healthcare

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literally one physician at a time.

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You may not believe this,

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but back in 2014, we still chose doctors
based on science GPAs, MedCaTs,

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which were a multiple-choice test,
and organic chemistry performance.

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And somehow we were amazed
that doctors weren't more empathetic,

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communicative, and creative.

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As my kids would say, "Duh."

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(Laughter) (Applause)

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So we changed all that.

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What we recognized is that it used to be
for those of you who came from the '70s -

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and I think there are actually some,

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I see some people from 2014,
I see some people from the '80s.

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Go Journey, yeah.

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(Laughter)

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I see some tie-dye out there,
some '60s and '70s. Peace!

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But we decided to transform admissions.

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What we realized is
that all the scientific data

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is on what in 2014 we called
iPhones and Androids,

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but really what we needed
were emotionally intelligent physicians.

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So we now really select physicians
based on self-awareness, self-management,

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and the ability to adapt,
social awareness and empathy,

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relationship management, teamwork,

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and the ability to really embrace change
instead of fighting it.

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But not only that,

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we totally changed the way that we teach
the physicians that we do accept.

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Believe it or not back in 2014,

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we used to spend two years
really teaching them scientific principles

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in large auditoriums,
classes that a lot of them didn't come to,

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when we recognized
that we could do all that,

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have them learn that
at two o'clock in the morning.

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Now we spend most of our time
in what we call the Art of Attending.

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Teaching them to really observe,
we started back in 2014,

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workshops designed to sharpen
observation skills of health students

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by looking at art.

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Very unusual partnership,

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it was Thomas Jefferson University,
Contemporary Art Museum,

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an institute for an optimistic
future in healthcare.

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We took students
and had them understand art.

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So if you take
this piece of art over here,

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medical students originally said,

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"Well, that's a woman;
that's a snake; that's a family."

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But when you started to look
and say, "What is the story?",

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it started to totally change the way
that they cared for patients.

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And at the end of the day, we went
from silos of full-time individuals

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to folks who could deliver
team-enabled and team-based care.

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Doctors went from being captains
of the ship to being part of a team,

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and they, believe it or not, work closely

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with multidisciplinary
care-delivery teams,

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including doctors of nursing practice,
nurse practitioners,

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clinical pharmacists,
physician's assistants.

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and at the Thomas Jefferson Institute
of Emerging Health Professions,

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professions that didn't
even exist in 2014,

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things like probability experts,
electronic health care ambassadors,

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and telehealth professionals.

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So we recognized that we needed
to evolve doctoring.

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We also recognized that the patient
experience was really pretty lousy.

00:10:09.374 --> 00:10:14.710
Back in 2014, you could actually
do anything you needed to do in travel,

00:10:14.710 --> 00:10:17.567
anything you needed
to do in shopping on a device,

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but could you get an appointment
with a physician? No.

00:10:20.477 --> 00:10:23.278
Could you interact
with a doctor or nurse? No.

00:10:23.278 --> 00:10:27.983
So we decided that healthcare needed
in 2014 to get into the E&I mode.

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If you even look at how people
viewed us from TV shows -

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how many of you are here from the '70s?
There you go, okay.

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So the big tip television show
in the '70s was Marcus Welby.

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Now here's what Marcus Welby was.

00:10:40.233 --> 00:10:41.679
He was a family physician.

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He would get up in the morning,

00:10:43.349 --> 00:10:46.538
he would go to the homeless shelter,
take care of people for free.

00:10:46.538 --> 00:10:50.010
On the way home to lunch, a cow would
be having trouble delivering a calf,

00:10:50.010 --> 00:10:51.236
he'd deliver it.

00:10:51.236 --> 00:10:54.326
He'd then go to his family medicine
office in the afternoon,

00:10:54.326 --> 00:10:57.000
and then at night he'd do
left ventricular neurosurgery.

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We were Gods, we could do everything,
that's how people viewed us.

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In the 2010s this is what we had.
Anybody remember this guy?

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(Laughter)

00:11:05.741 --> 00:11:09.538
He was a drug-addicted,
sex-addicted, really smart guy

00:11:09.538 --> 00:11:12.219
that couldn't communicate or see patients.

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That's what people viewed us.

00:11:14.240 --> 00:11:17.591
The number one TV show of 2023?

00:11:17.591 --> 00:11:23.002
Was Doctor WHO, which
stands for Watson Hybrid Organo Doc,

00:11:23.002 --> 00:11:28.349
who basically fell in love
with his robotic-bionic counterpart

00:11:28.349 --> 00:11:31.791
who does all the scientific stuff
while he does the emotional stuff.

00:11:31.791 --> 00:11:33.878
And as you can imagine, hilarity ensues.

00:11:33.878 --> 00:11:35.128
By the way ...

00:11:35.128 --> 00:11:36.757
(Laughter)

00:11:36.757 --> 00:11:41.610
By the way the first season of Doctor WHO

00:11:41.610 --> 00:11:45.195
is available on Google Glass
implantable chips,

00:11:45.195 --> 00:11:50.269
available at Stevie's Vinyl Records
and Implantable Chips on South Street.

00:11:50.269 --> 00:11:51.429
(Laughter)

00:11:51.429 --> 00:11:54.307
So the other thing we embraced
was entrepreneurship.

00:11:54.307 --> 00:11:57.305
We recognized that being academic
and entrepreneurial

00:11:57.305 --> 00:11:59.473
just were not mutually exclusive,

00:11:59.473 --> 00:12:03.867
and we also recognized that we had
to enhance the consumer experience.

00:12:03.867 --> 00:12:06.623
It really was lousy going to a physician.

00:12:06.623 --> 00:12:08.584
This is what it looked like back in 2014.

00:12:08.914 --> 00:12:11.605
Female: What's wrong?
Stevenson: I don't feel so good.

00:12:11.605 --> 00:12:13.535
F: Then you need to go to a doctor.

00:12:20.788 --> 00:12:24.022
Female nurse: Mr. Stephenson?
S: Stevenson.

00:12:24.022 --> 00:12:25.553
FN: Do you have any allergies?

00:12:25.553 --> 00:12:29.005
How would you describe your symptoms?
What is the general area of pain?

00:12:29.005 --> 00:12:32.417
Does your family have a history
of heart disease or diabetes?

00:12:32.417 --> 00:12:36.059
Doctor: And what seems
to be the problem today, Mr. Stevenson?

00:12:36.059 --> 00:12:39.342
S: I'm feeling a little stuffed up.
I'm experiencing some ...

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.

00:12:42.926 --> 00:12:44.459
D: Follow these instructions;

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.

00:12:48.303 --> 00:12:49.687
(Moaning)

00:12:50.158 --> 00:12:52.572
S: I don't like going to a doctor.

00:12:52.572 --> 00:12:56.883
SK: So in July of 2014, we partnered
with some great companies,

00:12:56.883 --> 00:13:00.077
created an innovation-driven
ecosystem for healthcare.

00:13:00.077 --> 00:13:02.480
Starting in 2015, patients in 48 states

00:13:02.480 --> 00:13:05.550
could access Jefferson doctors
via telemedicine.

00:13:05.550 --> 00:13:08.751
S: Well, now you can see a doctor
without going to a doctor's office

00:13:08.751 --> 00:13:11.814
with the help of your smartphone,
or computer, and American Well.

00:13:11.814 --> 00:13:14.368
Signing up and setting up
your health profile is easy;

00:13:14.368 --> 00:13:15.474
it only takes a minute,

00:13:15.474 --> 00:13:18.265
and once you've done it,
it's stored safely and securely.

00:13:18.265 --> 00:13:21.533
Then you can log in or use the App
to see doctors who're available,

00:13:21.533 --> 00:13:23.624
and connect by video phone or chat.

00:13:25.060 --> 00:13:26.093
D: Hi Allen.

00:13:26.093 --> 00:13:30.443
I see you've been experiencing
some congestion and some nasal blockage.

00:13:30.443 --> 00:13:32.104
How long has this been going on?

00:13:32.104 --> 00:13:35.109
S: During the visit, the doctor
can see your health information,

00:13:35.109 --> 00:13:38.347
afterward, you get a complete
write-up of everything the doctor says.

00:13:38.347 --> 00:13:41.506
D: It looks like acute sinusitis,
a sinus infection.

00:13:41.506 --> 00:13:44.467
Now I wrote you a prescription
to help with congestion.

00:13:44.467 --> 00:13:46.914
If things don't clear up
in, say, a week or so,

00:13:46.914 --> 00:13:49.448
just send me a message,
I'll be right here.

00:13:49.448 --> 00:13:53.045
S: A few mins later, I've got my diagnosis
and my instructions for treatment

00:13:53.045 --> 00:13:56.071
and my prescription is already
waiting for me at the pharmacy.

00:13:56.071 --> 00:13:59.933
SK: Of course, all that now happens
in your Google Glasses

00:13:59.933 --> 00:14:01.625
which are available by the way


00:14:01.625 --> 00:14:05.083
at Stevie's Vinyl Records
and Implantable Health Chips.

00:14:05.568 --> 00:14:09.145
We also recognized
that information was everything.

00:14:09.145 --> 00:14:13.193
As Yogi Berra would say,
it comes down to one word, big data.

00:14:13.193 --> 00:14:16.694
And believe it or not, believe it or not,

00:14:16.694 --> 00:14:19.709
we used to do everything
based on experience and anecdote.

00:14:19.709 --> 00:14:24.815
Evidence-based medicine in 2014
was actually a novel idea.

00:14:24.815 --> 00:14:28.737
And now we recognize that we can
take things from other industries.

00:14:28.737 --> 00:14:31.373
So at Jefferson, for example,
in 2014, we started

00:14:31.373 --> 00:14:34.807
the Center for Healthcare,
Entrepreneurship and Scientific Solutions.

00:14:34.807 --> 00:14:40.389
We said, "It really doesn't make any sense
that Nick Foles has a better idea

00:14:40.389 --> 00:14:43.773
of whether or not a screen pass
will work in the third quarter

00:14:43.773 --> 00:14:46.248
than I do of whether or not
a cancer drug will work."

00:14:46.248 --> 00:14:49.409
So we took some of the best people
doing mathematical modeling

00:14:49.409 --> 00:14:52.283
and created a predictive analytics
and mathematical modeling

00:14:52.283 --> 00:14:54.200
to reduce uncertainty in medicine.

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

00:14:59.766 --> 00:15:01.725
got readmitted within 90 days.

00:15:02.185 --> 00:15:04.020
Now, through our mathematical modeling

00:15:04.020 --> 00:15:06.484
we're able to see exactly
what intervention

00:15:06.484 --> 00:15:08.101
will keep people from coming back.

00:15:08.101 --> 00:15:10.607
Not only that, we've changed
the way we do things.

00:15:10.607 --> 00:15:15.412
In 2014, family medicine physicians
would actually be out of the hospital.

00:15:15.412 --> 00:15:17.940
Hospitalists would never
leave the hospital,

00:15:17.940 --> 00:15:20.179
and then there was no real communication.

00:15:20.179 --> 00:15:22.335
Now we have what's called extensiveness,

00:15:22.335 --> 00:15:25.515
hospitalists that actually
follow those patients for 90 days

00:15:25.515 --> 00:15:27.585
so they don't get readmitted.

00:15:27.585 --> 00:15:29.502
We actually pay for performance now

00:15:29.502 --> 00:15:31.986
because we can actually
measure performance.

00:15:31.986 --> 00:15:35.114
And we can actually
give you predictable answers

00:15:35.114 --> 00:15:37.937
as to what you're paying for
and what you're getting back.

00:15:37.937 --> 00:15:41.710
Accountable care organizations
for the first time really are accountable

00:15:41.710 --> 00:15:43.742
because we have math to back it up.

00:15:44.292 --> 00:15:46.863
One of the great things
that happened in Philadelphia,

00:15:46.863 --> 00:15:49.554
believe it or not, again in 2014,

00:15:49.554 --> 00:15:51.721
with decreasing NIH funding,

00:15:51.721 --> 00:15:57.325
Penn, Jefferson, Temple, Drexel,
would all fight for NIH funds.

00:15:57.325 --> 00:15:59.989
What we did, and one
of the greatest things we did,

00:15:59.989 --> 00:16:02.706
we created the Philadelphia
Clinical Research Super Site

00:16:02.706 --> 00:16:06.272
where we said really what's important
is to take all of our resources,

00:16:06.272 --> 00:16:09.459
both in education and research,
and make Philadelphia an epicenter.

00:16:09.459 --> 00:16:11.798
What did that do for us
over the last ten years?

00:16:11.798 --> 00:16:15.058
We were able to take the
Nanotechnology University of Pennsylvania

00:16:15.058 --> 00:16:17.657
and Molecular Genomics at Jefferson

00:16:17.657 --> 00:16:19.884
and create the DNA vending machine.

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.

00:16:23.786 --> 00:16:25.430
We can now pick a drug for you,

00:16:25.430 --> 00:16:28.767
and instead of saying it's
for 200 people that look like you,

00:16:28.767 --> 00:16:31.557
we can take exactly
the drug that fits your genome

00:16:31.557 --> 00:16:33.019
and have it available for you.

00:16:33.019 --> 00:16:35.212
We can also put your genome on a chip,

00:16:35.212 --> 00:16:36.402
so that God forbid,

00:16:36.402 --> 00:16:39.004
if you need a new organ,
we can make that for you

00:16:39.004 --> 00:16:41.698
based on work that's been done
in Philadelphia.

00:16:41.698 --> 00:16:44.677
And we finally decided
to work with patients

00:16:44.677 --> 00:16:47.683
to really make them
shareholders in their health,

00:16:47.683 --> 00:16:48.954
and this is what it means.

00:16:48.954 --> 00:16:51.160
It means that in a community
like Philadelphia,

00:16:51.160 --> 00:16:53.067
if we're able to make you healthier,

00:16:53.767 --> 00:16:56.147
we do better as physicians; you do better.

00:16:56.147 --> 00:16:58.486
And we actually partnered
with great companies

00:16:58.486 --> 00:17:00.362
from again outside Philadelphia

00:17:00.362 --> 00:17:04.152
to look at a different way
of making sure that everyone matters,

00:17:04.152 --> 00:17:08.380
that we can look at not only drugs,
but holistic remedies

00:17:08.380 --> 00:17:11.375
to look at personalized
performance-gain plans

00:17:11.375 --> 00:17:14.883
integrating a proven system
to drive health outcomes.

00:17:14.883 --> 00:17:18.620
Whether it's mindset, or nutrition,
or movement, or recovery,

00:17:18.620 --> 00:17:22.860
we were able to do many more things
that didn't require pharmaceuticals.

00:17:22.860 --> 00:17:25.726
So that brings us to 2024, and as I said,

00:17:25.726 --> 00:17:31.059
I'm here to accept our number one ranking
from the US News and Interplanetary Report

00:17:31.059 --> 00:17:32.805
and what's really cool is

00:17:32.805 --> 00:17:35.708
that some of the ranking parameters
didn't even exist in 2014,

00:17:35.708 --> 00:17:38.817
and I'll give you an example
of a few of them on the academic side

00:17:38.817 --> 00:17:40.320
and also on the clinical side.

00:17:40.320 --> 00:17:43.652
On the academic side,
we actually, imagine this,

00:17:43.652 --> 00:17:48.359
get ranked based on how our students do
at one year, three year, or five year.

00:17:48.359 --> 00:17:51.692
We measure individuals' professional
and personal happiness

00:17:51.692 --> 00:17:53.935
at varying intervals after graduation.

00:17:53.935 --> 00:17:56.661
Because after all, that's why
they came to our university.

00:17:56.661 --> 00:17:58.249
And if we don't do really well,

00:17:58.249 --> 00:18:00.539
then they actually
get some of their money back.

00:18:00.539 --> 00:18:02.256
We have a collaborative quotient.

00:18:02.256 --> 00:18:05.867
Academic entities are incentivized
to actually get over themselves

00:18:05.867 --> 00:18:07.433
and work well with others,

00:18:07.433 --> 00:18:09.035
(Laughter) (Applause)

00:18:09.035 --> 00:18:11.410
which would have been unheard of in 2014

00:18:11.410 --> 00:18:13.987
when they were all
cannibalizing each other.

00:18:13.987 --> 00:18:17.462
And we have an entrepreneurial quotient
where institutions are rewarded

00:18:17.462 --> 00:18:20.360
that invent and envision
new ways of doing things

00:18:20.360 --> 00:18:23.868
that generate alternate revenue
and develop new student opportunities.

00:18:23.868 --> 00:18:28.479
But probably nothing's changed
the most than health quotients.

00:18:28.479 --> 00:18:31.355
I mean, it used to be back
in 2014 and before

00:18:31.355 --> 00:18:34.421
that parameters were based
on the reputational score in the past.

00:18:34.421 --> 00:18:36.268
Now it's based on what patients think.

00:18:36.268 --> 00:18:39.203
The one I'm really proud of
that we got a very high score on

00:18:39.203 --> 00:18:41.021
is called the BUB Quotient.

00:18:41.021 --> 00:18:43.861
It stands for the
Believable Understandable Bill,

00:18:43.861 --> 00:18:46.216
that we actually have enough
respect for patients

00:18:46.216 --> 00:18:48.484
that we provide understandable bills,

00:18:48.484 --> 00:18:52.183
so they can understand
what they got and what they're paying for.

00:18:52.183 --> 00:18:55.494
We have the say-what-you-mean
and mean-what-you-say quality parameter.

00:18:55.494 --> 00:18:58.669
We actually take marketing professionals
to read all the billboards

00:18:58.669 --> 00:18:59.828
in the marketing we do,

00:18:59.828 --> 00:19:03.041
and see if they have any semblance
to reality of what really happens

00:19:03.041 --> 00:19:03.999
in the hospital,

00:19:03.999 --> 00:19:06.737
and you get points
if there is some semblance to reality.

00:19:06.737 --> 00:19:09.804
And then finally we have
the through-the-patient-eyes factor.

00:19:09.804 --> 00:19:12.240
And this is really exciting
because what it is,

00:19:12.240 --> 00:19:14.922
is every patient now, in 2024,

00:19:14.922 --> 00:19:18.420
basically when they get in the hospital
is given a Google Glasses,

00:19:18.420 --> 00:19:22.807
and they basically can record
what's happening through their eyes,

00:19:22.807 --> 00:19:25.267
how the doctors and nurses
are treating them,

00:19:25.267 --> 00:19:28.915
and then we have CEOs of other hospitals
look at that video for a day

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.

00:19:32.862 --> 00:19:35.195
And again that's a great parameter for us.

00:19:35.195 --> 00:19:37.718
So a lot has happened since 2024,

00:19:37.718 --> 00:19:40.019
and I'm really excited to be here.

00:19:40.019 --> 00:19:43.203
We're about to accept an award
in the new Convention Center & Casino

00:19:43.203 --> 00:19:44.609
on the Schuylkill River.

00:19:44.609 --> 00:19:46.304
(Laughter)

00:19:46.304 --> 00:19:49.894
And some things
from the past really are good.

00:19:49.894 --> 00:19:52.760
I'm going through my third midlife crisis

00:19:52.760 --> 00:19:56.618
because I'm 70 and what happens
is people live to 120,

00:19:56.618 --> 00:19:58.232
so midlife crises have changed.

00:19:58.232 --> 00:20:00.428
And I'm proud to say
this is what I got myself,

00:20:00.428 --> 00:20:05.591
I was able to retrofit a GTO
to hit the standards for a hovercraft.

00:20:05.941 --> 00:20:09.755
Excuse me for a second, Google Glass out,
could you get the GTO to get ready

00:20:09.755 --> 00:20:12.080
to go to the Convention Center?
Great. Thank you.

00:20:12.080 --> 00:20:14.430
Listen, I want to really
thank you for being here,

00:20:14.430 --> 00:20:16.952
I want to thank you
for traveling in time and space,

00:20:16.952 --> 00:20:19.557
and most importantly,
stay healthy in Philadelphia.

00:20:19.557 --> 00:20:20.883
Thank you very much.

00:20:20.883 --> 00:20:22.886
(Applause) (Cheering)