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Disruptive Model for
the Future of Medicine
Clay Johnston, MD, PhD
Dean, Dell Medical School
Broken
Cost of
healthcare
Per person spending
Wells Fargo Insurance Services
US life
expectancy
Return
Investment
U.S. is the number
one spender on
healthcare
in the world
But only
34th in
health outcomes
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
3 Glaring Examples
3 No one
pays for
prevention
2 No one
reminds you to
take your meds
Hospital
gowns expose
your rear1
Broken healthcare
delivery system
Invested in the status quo
Doing more, rather than
doing better
Treating the sickest rather than
promoting health
Resistant to technology and other
approaches to enhance efficiency
Broken community
health system
MDs + tools
Care Settings
Community
Cause of death in
San Francisco women
(2003–2004)
1. HIV/AIDS
2. Drug overdose,
unintentional
3. Self-inflicted injuries,
all mechanisms
4. Breast cancer
5. Pancreas cancer
Cause of death in
San Francisco men
(2003–2004)
1. Violence/assault,
all mechanisms
2. Drug overdose,
unintentional
3. HIV/AIDS
4. Self-inflicted injuries, all
mechanisms
5. Alcohol use disorders
Broken
research system
Research
Care
Apply for grant
Apply for grant Get grant
Apply for grant Get grant
Important results
Apply for grant Get grant
Important resultsChange health
Dell Medical School:
Opportunity to start
from scratch
Photo: Christopher Sherman
Can we
create a better
ecosystem
for health
innovation?
Faster Innovation Cycles:
Lean Start-Up Model
Requirements
for an improved
health ecosystem
The product is value
value = quality/cost
The product is value
value = quality/cost
Value is measurable
The product is value
value = quality/cost
Value is measurable
Value is embraced by culture
Barriers to aligning incentives are minimized
Barriers to aligning incentives are minimized
Participants can be innovators
Barriers to aligning incentives are minimized
Participants can be innovators
Scaling is possible
Barriers to aligning incentives are minimized
Participants can be innovators
Scaling is possible
Innovation is built into the funding model
Focus on making
Austin a model
healthy city
What needs to
happen
Create funding streams based on
health value
New partnerships with self-insured businesses,
insurers, hospitals, local health districts and CMS
Requires orchestration of multiple
disjointed entities
Better data
Not just for prioritization, but also to assess
impact on an ongoing basis
New approaches to education
Physicians who are not just willing partners but
leaders in creating better systems
Community Hospitals & Doctors
Government / EmployersPeople
Academic Hospitals & DoctorsEntrepreneurs
Community Hospitals & Doctors
Government / EmployersPeople
Community Public Health Entities &
Nonprofits
Community Hospitals & Doctors
Government / EmployersPeople
Community Public Health Entities &
Nonprofits
Community Hospitals & Doctors
Government / EmployersPeople
Community Public Health Entities &
Nonprofits
Liberate
entrepreneurs

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Clay Johnston, Dell Medical School

Notas del editor

  1. Photos?
  2. Photos?
  3. Keep?
  4. Other solutions: -show last 2 yrs (not much growth) -increase in life expectancy vs. increase in spending -graph with two lines?
  5. ***Note the dots for visual queues Should we add a dot to include the header/intro slide?
  6. *Wall can be dynamic
  7. ?? Need clarity
  8. *Wall can be dynamic
  9. Photo?
  10. ???
  11. ???
  12. I’d like to see a symbol for entrepreneurs. These would start out next to the academia symbols but would then overwhelm them and all the other symbols.
  13. Photo?