Tom Peters’
Health(care)
Excellence!
Part I
Leaders in Healthcare/Dubai/22January2006
(Long Version)
Slides at …
tompeters.com
Part I: Healthcare “Manifesto”
Part II: Getting It Done!
Health(care): Seven Main Messages
1. Quality (Error reduction/
Evidence-based Medicine)
2. “Healthcare” vs. “Health” (Wellness +
Prevention)
3. “Models of Excellence” available
4. Life sciences (“Singularity”)
5. Dubai as global/unique/“insanely great”
“Center of Excellence”
6. Avian flu
7. Africa
Manifesto(s)
“Healthcare”
vs “Health”
TP’s Healing & Wellness Manifesto2006
(1) Acute-care facilities are “killing fields.”
(WE KNOW WHAT TO DO.)
(2) Shift the “community” focus 90 degrees
(not 180, but not 25) from “fix it” to
“prevent it.” (WE KNOW WHAT TO DO.)
(3) There are three primary aims for “all this”:
Wellness-Healing-Health. (WE KNOW
WHAT TO DO.)
(4) I’m mad as hell and I’m not going to take
it anymore. (I KNOW WHAT TO DO.)
Tom’s Rant2006
1. Hospital “quality control,” at least in the U.S.A., is a bad, bad joke:
Depending on whose stats you believe, hospitals kill 100,000 or so of us a
year—and wound many times that number. Finally, “they” are “getting around to”
dealing with the issue. Well, thanks. And what is it we’ve been buying for our Trillion or so
bucks a year? The fix is eminently do-able … which makes the condition even more
intolerable. (“Disgrace” is far too kind a label for the “condition.” Who’s to blame? Just about
everybody, starting with the docs who consider oversight from anyone other than fellow clan
members to be unacceptable.)
2.
The “system”—training, docs, insurance incentives, “culture,” “patients”
themselves—is hopelessly-mindlessly-insanely (as I see it) skewed toward
fixing things (e.g. me) that are broken—not preventing the problem in the
first place and providing the Maintenance Tools necessary for a healthy
lifestyle. Sure, bio-medicine will soon allow us to understand and deal with individual
genetic pre-dispositions. (And hooray!) But take it from this 63-year old, decades of physical
and psychological self-abuse can literally be reversed in relatively short order by an
encompassing approach to life that can only be described as a “Passion for Wellness (and
Well-being).” Patients—like me—are catching on in record numbers; but “the system” is
highly resistant. (Again, the doctors are among the biggest sinners—no surprise, following
years of acculturation as the “man-with-the-white-coat-who-will-now-miraculously-dispensefix it-pills-and-surgical-incisions-for-you-the-unwashed.” (Come to think of it, maybe I’ll start
wearing a White Coat to my doctor’s office—after all, I am the Professional-in-Charge when it
comes to my Body & Soul. Right?)
COULD IT
TRULY BE THIS
AWFUL?
“Quality”:
“When I climb Mount
Rainier I face less risk
of death than I’ll
face on the operating
table.” —Don Berwick, “Six Keys to Safer Hospitals:
A Set of Simple Precautions Could Prevent 100,000 Needless
Deaths Every Year,” Newsweek (1212.2005)
CDC 1998: 90,000 killed
and 2,000,000 injured
from hospital-caused
drug errors & infections
HealthGrades/Denver:
195,000
hospital deaths per year in the U.S., 2000-2002 =
390 full jumbos/747s in the drink per year.
Comments: “This should give you pause
when you go to the hospital.”
National Quality Forum
—Dr. Kenneth Kizer,
. “There is little evidence
that patient safety has improved in
the last five years.” —Dr. Samantha Collier
Source: Boston Globe/07.27.04
Welcome to the Homer Simpson Hospital
a/k/a
The Killing Fields
1,000,000
“serious
medication errors per year” …
“illegible handwriting, misplaced
decimal points, and missed drug
interactions and allergies.”
Source: Wall Street Journal/Institute of Medicine
YE GADS!
New England Journal of Medicine/
Harvard Medical Practice Study: 4% error rate (1 of 4
negligence). “Subsequent investigations around the
country have confirmed the ubiquity of error.” “In one
small study of how clinicians perform when patients
have a sudden cardiac arrest, 27 of 30 clinicians made
an error in using the defibrillator.” Mistakes in
administering drugs (1995 study) “average once every
hospital admission.” “Lucian Leape, medicine’s
leading expert on error, points out that many other
industries—whether the task is manufacturing
semiconductors or serving customers at the Ritz
Carlton—simply wouldn’t countenance error rates like
those in hospitals.” —Complications, Atul Gawande
RAND (1998): 50%,
appropriate
preventive care. 60%,
recommended treatment, per
medical studies, for chronic
conditions. 20% chronic care
treatment that is wrong. 30%
acute care treatment that is
wrong.
Various studies: 1 in 3,
1 in 5, 1 in 7, 1 in 20
patients “harmed by
treatment”
Demanding Medical Excellence: Doctors and Accountability
in the Information Age, Michael Millenson
“In a disturbing 1991 study, 110 nurses of
varying experience levels took a written
test of their ability to calculate medication
doses. Eight out of 10 made calculation
mistakes at least 10% of the time,
while four out of 10 made mistakes
30% of the time.”
Demanding Medical Excellence: Doctors and Accountability
in the Information Age, Michael Millenson
20%: not get
prescriptions filled
50%: use meds
inconsistently
Source: Tom Farley & Deborah Cohen, Prescription for a Healthy Nation
“In health care,
geography is
destiny.”
Source: Dartmouth Medical School 1996 report
Geography Is Destiny
“Often all one must do to acquire a
disease is to enter a country where a
disease is recognized—leaving the
country will either cure the malady or turn
it into something else. … Blood pressure
considered treatably high in the United States might
be considered normal in England; and the low blood
pressure treated with 85 drugs as well as
hydrotherapy and spa treatments in Germany would
entitle its sufferer to lower life insurance rates in the
United States.” – Lynn Payer, Medicine & Culture
Geography Is Destiny
E.g.: Ft. Myers 4X Manhattan—back
surgery. Newark 2X New Haven—
prostatectomy. Rapid City SD 34X Elyria
OH—breast-conserving surgery. VT, ME,
IA: 3X differences in hysterectomy by age
70; 8X tonsillectomy; 4X prostatectomy
Breast cancer screening: 4X NE, FL, MI
vs. SE, SW. (Source: various)
“A healthcare delivery system
characterized by idiosyncratic and
often ill-informed judgments must
be restructured according to
evidence-based
medical practice.”
Demanding Medical Excellence: Doctors and Accountability
in the Information Age, Michael Millenson
“Without being disrespectful, I
consider the U.S. healthcare delivery
system the largest cottage industry in
the world. There
are virtually no
performance measurements
and no standards. Trying to
measure performance … is the next
revolution in healthcare.”
Richard Huber, former CEO, Aetna
“Practice variation is not caused by ‘bad’ or ‘ignorant’
doctors. Rather, it is a natural consequence
of a system that systematically tracks
neither its processes nor its outcomes,
preferring to presume that good facilities,
good intentions and good training lead
automatically to good results. Providers
remain more comfortable with the habits of a guild,
where each craftsman trusts his fellows, than with the
demands of the information age.”
Michael Millenson, Demanding Medical Excellence
“As unsettling as the prevalence of inappropriate care
is the enormous amount of what can only be called
A surprising 85% of
everyday medical treatments
have never been scientifically
validated. … For instance, when family
ignorant care.
practitioners in Washington State were queried about
treating a simple urinary tract infection, 82 physicians
came up with an extraordinary 137 strategies.”
Demanding Medical Excellence: Doctors and Accountability
in the Information Age, Michael Millenson
“Most physicians believe that
diagnosis can’t be reduced to a set
of generalizations—to a ‘cookbook.’
… How often does my intuition lead
me astray? The radical implication of
the Swedish study is that the
individualized, intuitive approach that
lies at the center of modern medicine
is flawed—it causes more mistakes
than it prevents.” —Atul Gawande, Complications
Deep Blue Redux*: 2,240
EKGs
… 1,120 heart attacks.
Hans Ohlin
: 620.
Lars Edenbrandt’s
software: 738.
(50 yr old chief of coronary care, Univ of
Lund/SW)
*Only this time it matters!
Dr Larry Weed/POMR (“problem-oriented medical
record”)/Etc: “It’s impossible to keep up with
the avalanche of knowledge. Therefore it’s
essential to use a valid diagnostic-decision
aid like Larry’s” —Neil de Crescenzo, VP Global
Healthcare/IBM Consulting
“There is no other
profession that tries to operate in the fashion
we do. We go on hallucinating about what we
can do.” —Dr Charles Burger (using Weed’s software for 20 years)
Probable parole violations: Simple model (age, #
of previous offenses, type of crime) beats M.D.
shrinks.
100 studies: Statistical formulas > Human
“In virtually all cases,
statistical thinking equaled
or surpassed human
judgment.”—Atul Gawande, Complications
judgment.
PARADOX: Many, many
formal case reviews …
failure to systematically/
systemically/ statistically
look at and act on evidence.
Source: Complications, Atul Gawande
Genius
Required?
Leapfrog Group:
CPOE/Computerized Physician
Order Entry*
ICU staffing by trained
intensivists**
EHR/Evidence-based Hospital
Referral***
*Duh I: Welcome to the computer age.
**Duh II: How about using experts?
***Duh III: If you do stuff a lotta times, you tend to get/be better.
Source: HealthLeaders
The Benefits of …
FOCUSED EXCELLENCE
Shouldice/Hernia Repair:
30-45 min, 1% recurrence.
Avg: 90 min, 10%-15%
recurrence.
Source: Complications, Atul Gawande
Hospitals Pay Appropriate
Attention To Medical Errors
Yes ………………………………. 1%
Aware and Trying Hard ……... 8%
Aware But Tepid Response … 22%
No ………………………………... 25%
An Inexcusable Tragedy …….. 44%
Source: 12.2005 Poll/tompeters.com
About Time!
100,000 Lives
Campaign*
*Don Berwick/Institute for Healthcare Improvement
What’s your
name? When’s
your birthday?
The Necessary
IS/Web
REVOLUTION
We all live in
Dell-Wal*MarteBay-Google
World!
We [almost] all
live in
Dell-Wal*MarteBay-Google
World!
“Some grocery stores
have better
technology than our
hospitals and
clinics.” —Tommy Thompson, HHS
Secretary
Source: Special Report on technology in healthcare, U.S. News & World Report (07.04)
Computerized Physician Order
Entry/CPOE:
5%
hospitals
source: HealthLeaders/06.02
of U.S.
Henry Lowe, U. of Pitt. School of
“Broadband,
Internet-based,
‘multimedia’
electronic medical
records”
Medicine:
Telemedicine: E.g. …
HANC* [Home Assisted
Nursing Care]
*BP, ECG, pulse, temp
Telemedicine …
Reduces days/1000 patients and
physician visits for the chronically ill
Decreases costs of managing chronic
disease
Expands service areas for providers
Reduces travel costs to and from medical
ed seminars
Douglas Goldstein, e-Healthcare
“Our entire facility is digital. No paper, no film, no
medical records. Nothing. And it’s all integrated—from the lab to
X-ray to records to physician order entry. Patients don’t have to
wait for anything. The information from the physician’s office is
in registration and vice versa. The referring physician is
immediately sent an email telling him his patient has shown up.
… It’s wireless in-house. We have 800 notebook computers that
are wireless. Physicians can walk around with a computer that’s
pre-programmed. If the physician wants, we’ll go out and wire
their house so they can sit on the couch and connect to the
network. They can review a chart from 100 miles away.” —David
Veillette, CEO, Indiana Heart Hospital (HealthLeaders/12.2002)
Health
“Gwen has wonderful health insurance and an abundance of
healthcare. What Gwen does not have is health. And there is
nothing our health system can do to give it to her.” “The battle
cry is always health, but in fact the struggle has always been
over healthcare.” “For all its inspiring, high-tech cures,
medicine is just not very effective at curing our era’s major
killers.” “Medicine doesn’t do much [for] chronic disease.”
“When the most common killers of our era are mostly incurable
and our preventive treatments pretty feeble, you have to wonder
about medical care as a whole.” “There is a widely held view
that medical care contributes little to health.” (John Bunker/
Journal of the Royal College of Physicians)
Source: Tom Farley & Deborah Cohen, Prescription for a Healthy Nation
Part 1:
“The Leading
Causes of
Health”
Source: Tom Farley & Deborah Cohen, Prescription for a Healthy Nation
“Our mistake is not that we
value medical care—but that
we have misunderstood what it
can and cannot do.”
Source: Tom Farley & Deborah Cohen, Prescription for a Healthy Nation
Smoking, drinking,
exercise, diet: 40% of
deaths
Source: Tom Farley & Deborah Cohen, Prescription for a Healthy Nation
“Sanitary revolution”:
mortality in major cities
55%
down
between
1850 and 1915
Source: Tom Farley & Deborah Cohen, Prescription for a Healthy Nation
“Curve
Shifting”
Source: Tom Farley & Deborah Cohen,
Prescription for a Healthy Nation
Context Change:
The Most Powerful Force (??)
Wastebaskets: Japan v U.S.;
Christchurch NZ v
Sydney AUS*
*“Broken windows”
“Bump into factor”: Extra-size
portions, eat more. Higher %
shelf space snacks, more obesity.
More liquor stores, more crime.
High vs low fat: Japanese who
emigrate to U.S. suffer 3X increase
in heart disease.
Source: Tom Farley & Deborah Cohen, Prescription for a Healthy Nation
+10: Sardinians,
Adventists, Okinawans
Don’t smoke. Put family first. Be
active every day. Keep socially
engaged. Eat fruits, vegetables,
whole grains. [Other: nuts, red wine, pecorino
cheese, small portions.]
Source: National Geographic (National Institute on Aging), November 2005
Wellness
“The ‘curative model’ narrowly
focuses on the goal of cure. …
From many quarters comes
evidence that the view of health
should be expanded to
encompass mental, social and
spiritual well-being.”
Institute for the Future
“An estimated 60 to 90
percent of doctor visits
involve stress-related
complaints.” —Newsweek/09.27.2004
“Ontario To Split Health
Ministry” —Headline/
Globe And Mail /06.05 (New ministry
will focus on Prevention/
Wellness/Eldercare)
“Savior for the Sick”
vs.
“Partner for Good
Health”
Source: NPR
“Companies Step Up
Wellness Efforts: Rising
health costs provide
incentive to promote
healthier employee
lifestyles” —headline/USA Today/08.05
“Prevention Program
At Dow Chemical
Aims To Save
Money”
—IBD/08.05
Sprint/Overland Park KS: Slow
elevators, distant parking lots
with infrequent buses, “food
court” as “poorly” placed
as possible, etc.
Source: New York Times
Tom’s Story
Obese/-79(-36); BP (140-85
to 90-60); Blood sugar (18087); Blood chemistry
(normal); Cholesterol (14058); Metabolic rate/RMR
(+250); Mental state
(dramatic improvement)
Aging
reversal!!!!*
*Why wasn’t I “informed”
until age 59?
“Fixes”
Diet
Extreme exercise
Meditation
Supplements
Teetotaler
(Meds)
Determinants of Health
Access to care: 10%
Genetics: 20%
Environment: 20%
Health Behaviors: 50%
Source: Institute for the Future
Planetree:
A Radical Model for New
Healthcare/Healing/Health/
Wellness Excellence
“It was the goal of the
Planetree Unit to help
patients not only get
well faster but also to
stay well longer.”
—Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
“Much of our current
healthcare is about curing.
Curing is good. But healing
is spiritual, and healing is
better, because we can heal
many people we cannot
cure.” —Leland Kaiser, “Holistic Hospitals”
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
The Nine Planetree Practices
1. The Importance of Human Interaction
2. Informing and Empowering Diverse Populations: Consumer
Health Libraries and Patient Information
3. Healing Partnerships: The importance of Including Friends
and Family
4. Nutrition: The Nurturing Aspect of Food
5. Spirituality: Inner Resources for Healing
6. Human Touch: The Essentials of Communicating
Caring Through Massage
7. Healing Arts: Nutrition for the Soul
8. Integrating Complementary and Alternative Practices
into Conventional Care
9. Healing Environments: Architecture and Design Conducive
to Health
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
1. The Importance of
Human Interaction
“There is a misconception that supportive interactions require
more staff or more time and are therefore more costly. Although
labor costs are a substantial part of any hospital budget, the
interactions themselves add nothing to the budget.
Kindness is free.
Listening to
patients or answering their questions costs nothing. It can be
argued that negative interactions—alienating patients, being
non-responsive to their needs or limiting their sense of
control—can be very costly. … Angry, frustrated or frightened
patients may be combative, withdrawn and less cooperative—
requiring far more time than it would have taken to interact with
them initially in a positive way.” —Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
Press Ganey Assoc/1999: 139,380 former patients
from 225 hospitals
0 of top 15 factors determining Patient Satisfaction
referred to patient’s health outcome
PS directly related to Staff Interaction
PS directly correlated with ES (Employee Satisfaction)
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
“Perhaps the simplest and most profound
of all human interactions is KINDNESS. …
But if it is so simple, it is surprising how
frequently it is absent from our healthcare
environments. … Many staff members
report verbal
‘abuse’ by physicians,
managers and coworkers.” —Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
“Planetree is about
human beings
caring for other
human beings.” —Putting
Patients First, Susan Frampton, Laura Gilpin, Patrick
Charmel (“Ladies and gentlemen serving ladies and
gentlemen”—4S credo)
2. Informing and
Empowering Diverse
Populations: Consumer
Health Libraries and
Patient Information
Planetree Health Resources Center/1981
Planetree Classification System
Consumer Health Librarians
Volunteers
Classes, lectures
Health Fairs
Griffin’s Mobile Health Resource Center
Open Chart Policy
Patient Progress Notes
Care Coordination Conferences (Est goals, timetable,
etc.)
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
3. Healing
Partnerships: The
Importance of
Including
Friends and Family
“When hospital staff members are
asked to list the attributes of the
‘perfect patient and family,’ their
response is usually a passive patient
with no family.”
—Putting Patients First, Susan Frampton, Laura
Gilpin, Patrick Charmel
The Patient-Family Experience
“Patients are stripped of control, their clothes are
taken away, they have little say over their schedule,
and they are deliberately separated from their family
and friends. Healthcare professionals control all of the
information about their patients’ bodies and access to
the people who can answer questions and connect them
with helpful resources. Families are treated more as
intruders than loved ones.”
—Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
“Family members, close friends
and ‘significant others’ can
have a far greater impact on
patients’ experience of illness,
and on their long-term health
and happiness, than any
healthcare professional.” —Through
the Patient’s Eyes
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
“A 7-year follow-up of women
diagnosed with breast cancer
showed that those who confided
in at least one person in the 3
months after surgery had a 7-year
survival rate of 72.4%, as
compared to 56.3% for those who
didn’t have a confidant.”
Institute for the Future
Institute of Medicine/ “Crossing the Quality Chasm”
Respect for preferences
Involvement in Decision Making
Access to care
Coordination of care
Information and education
Physical comfort
Emotional support
Involvement of Friends and Family
Continuity of care
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
Care Partner Programs (IDs, discount meals, etc.)
Unrestricted visits (“Most Planetree hospitals have eliminated
visiting restrictions altogether.”) (ER at one hospital “has a policy of never
separating the patient from the family, and there is no limitation on how many
family members may be present.”)
Collaborative Care Conferences
Clinical Guidelines Discussions
Family Spaces
Pet Visits (POP: Patients’ Own Pets)
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
4. Nutrition: The
Nurturing Aspect
of Food
Meals are central events
vs
“There, you’re fed.” *
*Irony: Focus on “nutrition” has reduced focus on “food” and “service”
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
Kitchen
Beautiful cutlery, plates, etc
Chef rep
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
“Aroma therapy” (e.g., “smell
of baking cookies”)
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
5. Spirituality: Inner
Resources for Healing
Spirituality: Meaning and Connectedness in Life
1. Connected to supportive and caring group
2. Sense of mastery and control
3. Make meaning out of disease/find meaning in
suffering
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
6. Human Touch:
The Essentials of
Communicating
Caring Through
Massage
“Massage is a
powerful way to
communicate
caring.”
—Putting Patients First, Susan Frampton,
Laura Gilpin, Patrick Charmel
Mid-Columbia Medical Center/Center for Mind and Body
Massage for every patient scheduled for ambulatory
surgery (“Go into surgery with a good attitude”)
Infant massage
Staff massage (“caring for the caregivers”)
Healing environments: chemo!
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
7. Healing Arts:
Nutrition for the Soul
Planetree: “Environment conducive to healing”
Color!
Light!
Brilliance!
Form!
Art!
Music!
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
8. Integrating
Complementary and
Alternative Practices
into Conventional Care
Griffin IMC/Integrative Medicine Center
Massage
Acupuncture
Meditation
Chiropractic
Nutritional supplements
Aroma therapy
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
CAM (Complementary & Alternative Medicine):
83M in US (42%)
CAM visits 243M, greater than to PCP (Primary Care
Physician) (With min insurance coverage)
W-Educated-Hi inc
Don’t tell PCP (40%)
And: <30% procedures used in conventional medicine
have undergone RCTs (randomized clinical trials)
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
9. Healing Environments:
Architecture and
Design Conducive
to Health
“Planetree Look”
Woods and natural materials
Indirect lighting
Homelike settings
Goals: Welcome patients, friends and family … Value
humans over technology .. Enable patients to
participate in their care … Provide flexibility to
personalize the care of each patient … Encourage
caregivers to be responsive to patients … Foster a
connection to nature and beauty
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
Access to nurses station:
“Happen to”
vs
“Happen with”
Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel
Conclusion:
Caring/Growth
“Experience”
Care!
Control!
Connect!
Engage!
Grow!
De-stress!
Learn more about Planetree/
The Planetree Alliance:
www.planetree.org
Life
Sciences
“On February 12, 2001, anyone with access to
the Internet …
Could suddenly look at a new atlas …
One containing
the whole human
genome.”
Source: Juan Enriquez, As The Future Catches You
“WE ARE BEGINNING TO
ACQUIRE … DIRECT AND
DELIBERATE CONTROL …
OVER THE EVOLUTION
OF ALL LIFE FORMS …
ON THE PLANET.”
Source: Juan Enriquez, As The Future Catches You
“In a couple of decades the world’s dominant language became
… strings of ones and zeroes.
Your world … and your language …
THE DOMINANT
LANGUAGE … AND
ECONOMIC DRIVER … OF
THIS CENTURY … IS GOING
TO BE … GENETICS.”
are about to change again.
Source: Juan Enriquez, As The Future Catches You
“We face the biggest change in tens of
thousands of years in what it means to
be human.” … “In just 20 years the
boundary between fantasy and reality
will be rent asunder.” (Rodney Brooks, AIL/MIT) …
“We are at an inflection point in history.” …
“It is about the defining cultural, social,
and political issue of our age. It is about
human transformation.”
Source: Radical Evolution: The Promise and Peril of Enhancing Our Minds,
Our Bodies—and What It Means to Be Human, Joel Garreau
GRIN: Genetics,
Robotics (nanotech),
Information, Nanotech
Source: Radical Evolution: The Promise and Peril of Enhancing Our
Minds, Our Bodies—and What It Means to Be Human, Joel Garreau
Ray Kurzweil:
“Singularity”
415-page doc, Department of
Commerce/NSF: Converging
Technologies for Increasing
Human Performance
Source: Radical Evolution: The Promise and Peril of Enhancing Our Minds,
Our Bodies—and What It Means to Be Human, Joel Garreau
“Soldiers having no
physical, physiological, or
cognitive limitations will
be key to survival and
operational dominance in
the future.” —Michael Goldblatt, Director,
Defense Sciences Office/DARPA
Source: Radical Evolution: The Promise and Peril of Enhancing Our Minds,
Our Bodies—and What It Means to Be Human, Joel Garreau
“Singularity”/“Bionic Tom,” circa
2006: Medtronic pacemaker (heart micromanagement) ; psychotropics (mental micromanagement) ; Google (mind-extension—smartbeyond-measure) ; Samsung cell phone
(instant-permanent planetary connectedness) ;
Orvis shirt (“smart skin”)
H5N1
Kroll/SARS: “don’t
over-react”
Kroll/H5N1:
Source: Newsweek/10.24.05
“devastating”
Health(care): Seven Main Messages
1. Quality (Error reduction/
Evidence-based Medicine)
2. “Healthcare” vs. “Health” (Wellness +
Prevention)
3. “Models of Excellence” available
4. Life sciences (“Singularity”)
5. Dubai as global/unique/“insanely great”
“Center of Excellence”
6. Avian flu
7. Africa
(Hats off to Bill & Melinda & Bono)