Disrupting Medicine: From House to
Cheesecake Factory
What Does the Title Have to Do
with Medicine?
en.wikipedia.org
stephbousquet.wordpress.com
Atul Gawande, MD
commonhealth.wbur.org
Big Med
Restaurant chains have managed to combine quality
control, cost control, and innovation. Can health care?
http://www.newyorker.com/gawande/August13,2012
May 26, 2011
Cowboys and Pit Crews
Posted by aTUL GAWANDE
June 4, 2012
Failure and Rescue
Posted by Atul Gawande
RESILIENCE
What is Health Care Reform?
Health Care Reform is Driven
by Need to Reduce Costs
Michael Leavitt,
Former DHHS Director
http://www.hhs.gov/secretary/dhhssec.html
8
functional-medicine.blogspot.com
Blue Ocean Strategy
Value Innovation
Costs
Value
Innovation
Buyer Value
What Would Billy Bean Say?
totalspeakers.com
How Can We Fix Healthcare?
masg.org.au
Bedrock Principles (The Plan)
• Leverage Nature (Law of the Few)
• Create Health Experiences (Leave on Your
Socks)
• Leverage the Blue Zone Experience (What
Your Grandmother Told You)
• Create and Apply Precision Medicine (The
Science)
• Create Health Instead of Disease (What I
Learned from the Navy Seals)
Leverage Nature (Law of the Few)
Systems Biology
• Emergent field that
aims at systems
understanding of
biological systems
– Systems view focuses at
understanding:
• The complexity of the
system
• The networks activated in
the system
• The control methods of
the system
• Key nodes in the system
www.sysbio.de/figs/sysbio8.gif
The Tipping Point and Social
Networks
www.flickr.com
17
Hotspotting
http://www.newyorker.com/reporting/2011/01/24/110124fa_fact_gawande
Pareto’s Law and Health Care
Costs
http://www.incentivedirect.com/the-8020-rule/
The True Utility of Concierge
Medicine (Focus on the Few)
tracykrulik.com
en.wikipedia.org
The Cost Conundrum:
June 1, 2009
What a Texas town can teach us
about health care
http://www.nytimes.com/interactive/2010/06/03/business/Dartmouth-maps.html?ref=business
Systems Engineering and the
Checklist Manifesto
Create Health Experiences
(Leave on Your Socks)
What Should the Healthcare
Experience Look Like?
Trusting – Longitudinal – Accessible and Cheap –
Positive and Fun – Empowering – Intuitive –
Compelling – Proactive - Preventive – Precise –
Personalized – Health and Wellness Focused
TODAY
Controlling – Health System and Physician
Centered - Fragmented – Complex – Expensive –
Difficult to Access – Disease-Centered – Imprecise
– Scary – Disempowering
Protocol
counterkicks.com
medicalexpo.com
We Seek an Experience as
Consumers
Russel Honorè Lesson
thetakeaway.org
culture.wnyc.org
Seeks to Create a
“Health” Care Experience
Leverage the Blue Zone
Experience
(What Your Grandmother Told You)
health.lifegoesstrong.com
journal.aarpinternational.org
Blue Zones
Create and Apply Precision
Medicine
(The Science)
ncowie.wordpress.com
brooklyn.cuny.edu
Genetics/Genomics
www.elecamino.dnadirect.com
gotosay.com
Epigenetics
sciblogs.co.nz/.../2010/08/epigenetics-400px.png
Introns and Organismal
Complexity
genomicenterprise.com
Identify Hubs
http://mcdb.colorado.edu/courses/3280/lectures/class16-2.html
41
Create Health Instead of Disease
(What I Learned from the Navy Seals)
Balance – The Secret to Health
The universal truth is that you must balance the
elements of yin and yang in all aspects of your life
to achieve happiness, harmony, and health.
www.crystalvaults.com
en.wikipedia.org
navy.mil
Behavior
Environment
Gene
More Reasons to Blame Your Parents for
Any Health Problems
virtualworld360.blogspot.com
Health is Resiliency and Reserve
•
•
•
•
•
•
Emotional
Behavioral
Social
Physical
Environmental
Genetic/Epigenetic
AGING IS THE PARADIGM
Positive Psychology
http://www.argn.com/2008/11/
www.superbetter.com
Elyssa
Eppel, PhD
umassmed.edu
Chromosome
immortalhumans.com
Elizabeth
Blackburn, PhD
workplacebullying.org
The Impact of Happiness
The Losada Ratio
thehappinesscoach.biz
www.exercise-to-a-healthier-life.com/
156 lbs
http://www.nytimes.com/
http://siakhenn.tripod.com/snoring.html
futurity.org
NEJM 2007 (357): 406-07
57
Ecosystems Rely on
Interconnected Networks
Create an Ecosystem
www.apple.com
Ecosystems Influence Behavior
dailymail.co.uk
Personal Ecosystem
Individual Network
Community Network
Social Network
Complex System
Bottom Line (The One Thing)
• Connect to purpose (true north)
• Exercise – optimal 150 min/week, at least
10,000 steps/day
• Eat wisely, more plant than animal-based diet
• Stay Socially Connected to friends and family
• Don’t Smoke
• Have fun, reduce stress
• Get Sleep
• Be Grateful
www.patheos.com