Dr. Stephen Klasko – Top Hospital CEO Talks COVID + Health Technology – Virtually Speaking Episode 1

New Speaker Interview Series from Chris Lee and CAL Entertainment.

Our first guest and interview couldn’t be more timely and relevant. Dr. Stephen Klasko is an advocate for a transformation in our systems of health care and higher education, and is the current President and CEO of Thomas Jefferson University and Jefferson Health, overseeing over 35,000 employees. He has led Jefferson to become one of the fastest-growing academic health centers, expanding from 3 to 14 hospitals and growing revenues from 2.2 Billion to over $6 Billion in 2019.

Dr. Klasko was named one of the “Most Creative People in Business” by Fast Company (ranking 21 out of 100 – and was the only physician on the list) for making large-scale healthcare personal. He was also ranked #2 of the 100 Most Influential People in Healthcare by Modern Healthcare in 2018. He was appointed as the first Distinguished Fellow at the Davos World Economic Forum, and in 2020 will co-chair the World Economic Forum board of stewards. Dr. Klasko is a bestselling author and has two much anticipated books coming out in 2020.

In the talk, Chris and Stephen cover the COVID pandemic and the coming vaccine (which his team is working on), opening back up society, disruption and the consumer revolution, and the future of healthcare – which isn’t just Telehealth (which he is a leader in), but rather, healthcare with no address, which he describes as Health Assurance at Home.

—

Watch the episode here

Listen to the podcast here

Dr. Stephen Klasko – Top Hospital CEO Talks COVID + Health Technology

Our guest is Dr. Stephen Klasko who\’s an advocate for transformation in our systems of healthcare and higher education. He’s the President and CEO of Thomas Jefferson University and Jefferson Health, overseeing over 35,000 employees. He has led Jefferson to become one of the fastest-growing academic health centers, expanding from 3 to 14 hospitals and growing revenues from $2.2 billion to $9.2 billion in 2020.

Dr. Klasko was named one of the most creative people in business by Fast Company for making large-scale healthcare personal. He also was ranked number 2 of the 100 most influential people in healthcare by Modern Healthcare in 2018. He was appointed as the First Distinguished Fellow at the Davos World Economic Forum. In 2020, he’ll co-chair the World Economic Forum Board of Stewards. He’s a multiple best-selling author and his latest title is Bless This Mess: A Picture Story of Healthcare in America. In 2020, he will publish two much-anticipated books. Please join me with Dr. Klasko.

—

Stephen, thank you for joining me on Virtually Speaking. How are you doing?

I’m doing great.

You\’re in Pennsylvania.

I\’m in my office at Thomas Jefferson University and Jefferson Health, which is a bit of the epicenter. We have 35,000 employees. We’re the second-largest employer in Philadelphia. We have fourteen hospitals. We’re the largest health system in the area and had, by far, the most COVID patients. They have a three-campus university. One campus is in Rome, Italy. Everything that could happen with the pandemic, I\’ve had the pleasure and honor of the only one.

What\’s going on with your hospital in Rome, Italy? That must have been a bad situation there for a minute.

It was. We\’ve been prepared for this in Philadelphia partly because of our colleagues in Italy. My number two person is the former mayor of Rome. He was in Italy when it hit the fan. We were able to talk to the folks there before most people could spell COVID. It sounds funny but they were willing to tell us everything they did wrong. It was a little bit like, “This is what not to do.” It\’s hard to talk about success in COVID. We had about 60 days of PPE on hand. We\’ve had, by far, the lowest number of employees that have been affected with COVID. We were the first in the city to do all masking. We have a design university so we created some reusable masks.

You have a design university as part of Jefferson University.

It was one of the cool things that we did. We merged a 195-year-old health science university with the number three fashion design university in the country and number seven in the world. What\’s cool about that is we created the first MD Master’s in Design. This fits into the whole post-COVID world. The whole key is going to be the design of the human experience. The human experience of accessing healthcare is lousy. For those of you who are my age, I always say we have Star Wars technology for individual patients in a Fred Flintstone healthcare delivery system. I\’m a high-risk obstetrician. The way that I treat an individual patient had changed a lot in the years when I had hair. The way patients access the system has hardly changed at all. They\’re still getting on the phone, listening to eleven options to get an appointment next Wednesday. In this pandemic, we have to be consumer-facing for a little bit and then we\’ll go back to our shell. Is this the Amazon moment? Is this the iPhone moment?

I heard it was fast-forwarding ten years in ten weeks. It’s what\’s going on here to get up to speed with technology.

It’s hard to say if that lasts because we have a fragmented system. I\’m a distinguished fellow of the World Economic Forum. I lead the Board of Stewards for the digital economy for Davos. One of the CEOs of a large finance company said, “Stephen, years ago, the two sectors that didn\’t get the consumer revolution were banking and healthcare.” He stopped and said, “Now, you\’re alone.” If you\’re my age, if we had this pandemic, everybody would have been talking about what we have to do on Fridays when everybody goes to the bank to deposit their checks. We would have had to have social distancing for the people going to get money and deposit their checks. Banking decided that they were going to move from 90% of the bank to 90% at home. We don\’t get up in the morning and say, “I’m going to telebank.” It wasn\’t one thing. We get all caught up in telehealth. That\’s not the key. We need to go from sick care to health assurance starting at home. That\’s what I hope will be the disruption.

What does that mean, sick care to health assurance at home?

What it means is we\’ve run a system based on hospitals telling patients how they should get treated. You\’re lucky to see me, the fact that you have to wait two weeks to see me, and come in for an appointment, wait for an hour with a lot of other sick people in the waiting room, and then come in and I will do a static thing of your data then give you my wisdom. We\’ve allowed that to happen. Insurers have said, “I’ve got even a better gig. I\’m the middle man. My whole gig is making sure that I can take as much money in and have to pay as little money out.” If you think about health policy in the past years, all we\’ve argued about is how to pay for a fundamentally broken, fragmented, expensive, inequitable, and occasionally unsafe healthcare delivery system, and hope the system will transform.

[bctt tweet=\”We have to recognize that there are things beyond medicine and surgery that work.\” username=\”calentertainmnt\”]

We have a book called UnHealthcare: A Manifesto for Health Assurance. Moving from a model of hospital-directed sick care to how you can make sure that you can thrive without help getting in the way. Chris, you don\’t view yourself as a patient. You view yourself as a person who would like to stay healthy. If you have a problem, you view yourself as a person that would like to be a patient for as little time as you can be. We view everybody as a disease and a patient. Your car, Chris, gets better care than you do. What I mean by that is, depending on what car you have, my car sends out signals while it\’s in the garage. When I wake up in the morning and I go to start it, it says, “Steve, while you were sleeping, I lost some air in my tire. Could you please fill up the air?”

We have this model where once a year or once every two years, you go to a doctor\’s office. Based on that day, at that time, we take your blood pressure, we take your pulse, we get the data, and we say, “Based on that one time, here\’s what you should do for the rest.” The book is cool because it\’s co-written with an individual named Hemant Taneja who\’s the managing principal for General Catalyst, the initial investor in Airbnb, Warby Parker, the healthcare company Livongo. If you think about Airbnb, it used to be if you want to build bigger and better hotels than Marriott, you have to build bigger and better hotels. Now you build no hotels and bring people together, Uber, Amazon, all those things. What we said is, “What is that in healthcare?”

What\’s that version?

The version of healthcare is that healthcare starts at home. You have continuous data.

That means you\’re wearing something that\’s monitoring you and it’s keeping track of your sugar levels, your blood pressure, and all that stuff.

The most successful health IPO in history was a company called Livongo with Hemant and we were involved also at Jefferson. It was pretty simple. Let me get this straight. Diabetics, you\’re going to pee in a cup and dip something in there. This is in 2020. You\’re going to call your doctor and send the results. This was using AI around diabetics at home. What this book starts out with is a Silicon Valley entrepreneur and a CEO of a 195-year-old academic medical center walk into a bar. What if you embedded virtually 270 engineers into a fourteen-hospital system? What if you embedded what\’s happening in healthcare out to Silicon Valley? Both are clueless about the other. That\’s what\’s exciting.

Did you guys do that? Are you guys embedding?

Yes. We have a joint venture where we have General Catalyst folks embedded at Jefferson and Jefferson folks embedded at General Catalyst. We\’ve done a company together called Commure, which is an app store for healthcare. It\’s an FHIR, which overcomes the interoperability problems with any of the other EMRs and you can build on that. What if you had an Accenture for digital transformation in healthcare where any health system or any company could go and say, “What I need is this and this.” We can create the digital things where we already had those digital apps to be able to do that. Our biggest success was creating a carbonized temp wearable, which became an IPO in a company called Ecofibre. Once you\’ll go to sleep at night, it will measure your respiratory rate, heart rate, etc. That\’s the beginning of that revolution.

If you\’re sleeping and you\’re dying, can it call the ambulance to come and bang down your door?

We\’ve got some work to get to that point but we\’re working with it and we have some contracts with some of the voice recognition pieces. If you\’re asthmatic and you wake up in the morning, you\’re wearing the Ecofibre wearable, you wake up in the morning and say, “Siri, play the daily podcast.” Siri would say, “Not so fast, Chris. Before I do that, your breathing was labored. The AQI is X. Take an extra inhaler.” That\’s the future that exists in every other part of your consumer life. Why shouldn\’t it exist in healthcare?

In the COVID world that we\’re in, what are you guys doing? You told me before that you guys were doing 3,000 patient visits at home with real physicians to keep them from having to go to the hospital. Where\’s that gone since then?

We\’re doing 4,000 telehealth visits a day. I\’ll put that in perspective. We had started one of the largest telehealth entities back in 2013 where people thought I was on drugs. It’s like, “Why the hell are you investing $50 million in telehealth?” We had unlimited supply with almost no demand. We’re doing 50 a day. The cool thing is that we have unlimited demand and then we\’re doing it even for other folks. The key is getting it away from telehealth. It amazes me when I hear some other hospital’s CSA, “I discovered telehealth.” It\’s not the telehealth thing. Getting back to the banking thing. If you made a mobile deposit and you went, “This is quick. I\’m going to telebank this morning.”

I\’m depositing my check and I\’ll have to go down and touch the ATM screen that maybe somebody with COVID touched.

You don\’t think about it. I get mad on those Sundays from 2:00 AM to 6:00 AM where Schwab or Wells Fargo are doing the maintenance on their website. What do you mean I can\’t do a mobile deposit until 6:00 AM? That\’s what healthcare should be. At 3:00 AM on Sunday, something shows up at my AI that there\’s somebody for me to talk to. Imagine if you had that same thing? What do you mean it\’s 3:00 AM and I have to wait until 6:00 AM to do my mobile deposit? As opposed to healthcare, I can\’t even call anybody until 9:00 AM and then maybe they\’ll give me an appointment two weeks from now when some human decides they\’ll do it.

You have real physicians who are doing these phone calls. Are they able to not only diagnose what the person is describing or showing them on video or describing on the phone but also prescribe prescriptions so that they can have them delivered to the house?

Health Technology: We need to go from sick care to health assurance, starting at home.

It’s 24/7 emergency medicine positions, all with your chart. Chris, if you were one of our patients, you would get on JeffConnect, “Chris, how are you doing? We know you have this and this. By the way, Chris,” let\’s say it\’s 2:00 in the morning, “you should be on this medication. The closest 24-hour CVS to your house is on this boulevard. I\’ve done the prescription, they\’ll have it ready for you in twenty minutes.” That exists. If we think you need to come in, we can say, “Don\’t come into the emergency room. There’s a close Jeff Urgent Care to you or we take care of it.” We\’ve even done things where we\’re starting to send some people home. Like Livongo, if they have hypertension, we send them home with blood pressure cups.

Think about congestive heart failure, ten readmissions. Believe it or not, in 2020 in the United States, the determinant for congestive heart failure patients that may need to be readmitted is they\’ve gained a lot of weight. Without going through all the physiology, if your heart is not working well, you would what we call third-spacing liquid. All of a sudden, you\’re gaining a lot of weight and get what\’s called edema. We start in places where people have to come into their doctor\’s office three times a week to get weighed. What we did was we gave all of our congestive heart failure patients weighing scales. We said, “You’ve got one job beyond not eating salty stuff and pizzas. Get on the scale once a day.” We have AI that determines if their body weight is increased by more than 7% and if it has, somebody will call them and say, “We\’d like you to come in.”

Are toilets going to tell us we\’re eating the wrong food or we have too much sugar in our diet?

A great philanthropist, a guy named Bernie Marcus, who was one of the founders of Home Depot has given Jefferson almost $50 million to create the first academic department of integrative health, global health, and nutritional sciences. The whole issue of what we like to call the neutral biome is the next big thing. It\’s much more than eat the right stuff. It\’s taking your genome and looking at, if you\’re 46, 46 years of what you\’ve eaten and have done to your bowel flora and fauna and guiding you to the best things. It\’s not the classic eat less. It might be different for you. You might need more carbs.

The key to turning integrative health, nutritional sciences, even things like yoga and mindfulness into a real academic pursuit, one of the clinical trials we now have approved by the FDA is high doses of IV vitamin C for COVID. It\’s been pretty successful in certain folks. We have to recognize that there are things beyond medicine and surgery that work. We have to look at how other countries and other places in the world take care of people.

You guys are working on a vaccine, is that right?

Yes. It\’s exciting. We have a mad scientist that runs our vaccine center named Matthias Schnell. It’s almost one of those typecast guys. Dr. Matthias Schnell had been one of the leaders in creating the Ebola vaccine. If you think about the COVID vaccine, it gets down to speed and safety. It\’s not a science fair experiment. It\’s not a creativity thing. We need to get it safe and speedy.

It seems like it’s also a competition between countries and between different people who want to be the first one in and that seems concerning as well. I know you are headed in another direction.

That\’s true. We took a different approach. A lot of people are saying, “We\’re going to do the first DNA vaccine.” The problem of that is that\’s not going to happen. It\’s a neat idea but it takes years to be the first. Is that going to be safe? There are 100 million rabies vaccines that are manufactured a year, especially in African countries. We took the rabies vaccine as the carrier because we know it\’s safe and then added the COVID protein on it. The beautiful thing about that is we don\’t have to worry it\’s safe. We know it\’s safe. If it\’s effective, we have 100 million that we could make. We\’re starting human trials. We have three drug companies that are invested in it already. We\’re pretty excited about it.

Pfizer said that in the fall, we could potentially have an emergency vaccine available.

That\’s about right. Because ours is based on the rabies vaccine, if it\’s effective, it could be a little earlier than that. It could be in the September and October range where we would get what\’s called compassionate use from the FDA. We\’re doing human trials on some clinical trial volunteers. That\’s already starting. The beautiful thing is our initial partner is in India and they have a lot of people. They have less restrictive clinical trials than we do. There’s a company in Philadelphia that gets 50 people in Philadelphia with all the regulations and stuff. In India, you can get 5,000 in one province pretty easily. We\’re excited. There\’s not going to be one. We think we have a shot at being one of the 6 or 7. If that\’s the case, that\’s a big deal for our vaccines center and a big deal for Matthias.

Do we want to have 6 or 7 though in this world that work? Don\’t we want to know which one is the best one and have everybody use it and make it all over the world and nobody makes a profit on it? How\’s that going to work?

There might be multiple ones that work because we\’re all coming in from a different thing. You want to get into whatever can be made the most. The chance is that one is going to be able to make two billion doses. If there are 6 or 7 and they\’ve all got partners, if somebody is partners with J&J and our partner is Merck, that\’s all good.

You guys are going to share information with each other, right?

Yes. That\’s not an issue.

[bctt tweet=\”At some point, we have to get back to human contact. Not everything has to be that way, but somethings do.\” username=\”calentertainmnt\”]

Are they all going to be pretty similar?

No. They\’re all attacking different parts. The way that vaccines work is you either go after the DNA of the virus or you trick the protein that the virus is on. One of the things I always wanted to create is the best of both worlds where we could be a top 25 academic medical center by traditional senses and doing the things that Dr. Schnell is doing but then be the place to work with Silicon Valley. I always kid around because there are a couple of groups. We’re in the group of the top 25 traditional academic medical centers. I get invited out every January. It\’s the Hopkins, all the ones that you know about, Mass General. We\’re in the group of the top 25 cool health systems and universities.

Design center.

With all the different things. That\’s out in San Francisco and Napa. We’re on that one. I always kid around that of the top 25 traditional ones, we might be toward that bottom tier. Of the top coolest ones, we might be toward that bottom tier. Here\’s what\’s cool, there\’s nobody even in the same stratosphere that goes to this meeting in January and that meeting in July. The fact that we can be top 25 in both is exciting.

You\’ve always been an innovator. Fast Company called you one of the most creative people in business.

That was the coolest award I\’ve ever gotten. Fast Company does the 100 most creative people in business. I was number 21, the only healthcare executive in the 100. Right ahead of me was Reese Witherspoon, which was cool in a way. We\’ve all seen Big Little Lies and Little Fires Everywhere so that\’s pretty cool. The great thing about that is because it was Fast Company. I\’ve gotten lots of different academic awards. I\’ve been Dean of three different medical schools. When that came out, my kids said, “Dad, you’re important.”

What was that based on? Why did they call you a creative innovator? What was it that you did? You took it from 3 to 14 hospitals.

In one year, we did six mergers of bringing us together. We started the largest telehealth piece and we merged with the number three fashion design university and created the wearable. Who the hell would have thought that you would take this conservative health science university and merged with one of the top fashion design universities? We did an MD Master’s in Design with Princeton University. It’s the whole concept of creative partnerships. My role in the World Economic Forum is looking at what creative partnerships will the fourth industrial revolution engender? The fourth industrial revolution is everything from robotics to AI, 5G, and some of the things we talked about. That’s what\’s exciting to me, bringing together entities.

If there\’s a health system out there that says, “We got killed by the pandemic. The insurance companies are killing me.” At Jefferson, we said, “All those things are true. That\’s the traditional healthcare ecosystem.” Chris, there\’s going to be $1 trillion spent on transforming healthcare. If you\’re running a hospital or a health system out there, why aren\’t you sharing in that? Why are you going to HIMSS or going to these different things and buying something from somebody? They need you. Almost every deal we make, we were co-developer, we get equity in it, etc.

It might be tough on this end, around revenue or insurers, but it\’s good on this end. It\’s a little bit like diversifying your portfolio. It\’s a $1 billion company. If all we\’re doing is getting heads in beds and doing hip replacements and something like the pandemic hits, you\’re hurt. If you\’re also there and have 10, 20 companies as we have that are transforming healthcare and a pandemic hits, you can do well in that post-COVID world. This part of my world is doing lousy. This part of my world is getting ready to do well.

When is the lousy part of the world going to start seeing the light at the end of the tunnel, the end of this thing? I heard that we\’re hoping for phase three in Los Angeles to be implemented. We\’re hearing it might be another 2 or 3 months.

There are a few problems, one is people are having come to terms. Nothing dramatic is going to happen between now and the vaccine. If you\’re a conservative person that doesn\’t want to get COVID, you should not go out of your house. That\’s the fact. The risk-benefit starts to change. Once the surges go down, the chances that if I’m with ten people, before, six of them were carrying COVID. Now, maybe only two of them are. That\’s where the risk-benefit gets together. That\’s what we\’re starting to see. Especially if you\’re younger and you\’re not high risk, you don\’t want to get COVID. The difference between saying, “I\’m not going to start the economy at all. I\’m not going to go to work. I\’m not going to do anything. I\’m not going to see my grandkids for a year.” Versus, “I got it when we were in the height of it.” Unless somebody tells me that there\’s something different, we\’re doing that with my family.

I have two grandkids that are coming down from Rhode Island to our shore house. They said, “Dad, why don\’t you come up and come back to the house on Sunday?” My guess is my wife won\’t do it because she\’s more conservative than I am. My guess is I will. They\’re more worried about me than I am about them because they\’re mostly young. It\’s a risk-benefit ratio. I\’m looking and seeing the chances that one family doesn\’t have it, they don\’t have any symptoms, I\’m willing to take that chance. If I\’m not willing to take that chance, then I\’m not going to do it on Labor Day either. I\’m not going to do it at Christmas probably. To me, that\’s where people are going to start making things. I know everybody criticizes everybody but it\’s a tough decision. It shouldn\’t be economy versus health. Where is the risk-benefit?

Here\’s the other piece of the risk. Everybody reading this, if they\’re a patient, the health system should be concentrating on. Every one of us has to start calling patients and say, “Go to your hospital and call your doctor and start to get care again.” There was an article that the hospitals are losing $60 billion a month. That\’s the financial side. Fifty-seven percent less heart disease-related. Thirty-eight percent less neurologic disease-related. Sixty-two percent less mammograms and breast screening.

Nobody wants to go to the hospital.

Health Technology: The neutral biome is the next big thing. It\’s literally taking your genome and looking at what you\’ve eaten and done to your bowel and guiding you to the best thing.

Here\’s the problem. You either have to decide that all those things weren\’t necessary, I don\’t think that\’s the case, or we\’re going to have a lot of heart attacks, diabetes, strokes, and breast cancers. If you take Jefferson, we have enough PPE. We feel 100% safe. We have fourteen hospitals and there\’s not one patient that came in for a non-COVID thing that has gotten COVID. You start to say, “In that risk-benefit thing, I\’m at much greater risk of not getting my mammogram. We can\’t do that at home. I’m at much greater risk if I have high blood pressure and not getting a stress echo.” We\’re having our doctors call every patient and say, “Chris, you\’ve got hypertension. Let me explain to you why it\’s safe to come in. Let me explain to you, more importantly, why it\’s not safe for you to not come in.”

The other thing that we haven\’t talked about is immunity. What\’s up with the immunity test? If I got an immunity test and I knew I carried the antibodies and I was immune, I might feel pretty comfortable with doing that, going places.

That\’s a cluster mess. There are 28 different immunity tests, antibody tests. There are people that test positive in some and negative in others. We also don\’t know for sure that if you have antibodies, you\’re immune.

When are we going to know that? You\’ve got to be immune for a few days at least.

Get back to what I said, Chris, it\’s risk-benefit where the antibody test makes sense. I have 35,000 employees. If I\’m thinking about who I want to bring back to work, I should antibody test all my employees. If I\’m going to bring back half of my employees, I\’d rather bring back the ones with positive antibodies. Is it perfect? No.

What about going to conferences? Are you going to speak at a conference with 1,000 people?

Yes. I\’ll be at the Forbes Napa Conference.

You\’re willing to do that?

Yes. I\’ll be at Meadowood.

Are you going to wear a mask on stage when you\’re speaking or you\’ll be far enough where you won\’t need a mask on stage?

Yes. They\’ll probably put it in a bigger room so people can be a little farther apart. We\’ll do masks. We\’ll do whatever is necessary. At some point, we have to get back to human contact. I don\’t think everything has to be that way but some things do.

Do most of the people in healthcare share that opinion with you? Is this all political that we have to get back to work? Does the healthcare community also believe in that? The beds are empty. There are not as many people coming in with COVID. Is this the peak? Is it behind us?

When you say healthcare people, it\’s like saying, “Do all white people think this?” At Jefferson, we feel comfortable that we can take care of patients for other things other than COVID. Our numbers are down. We have an incredible amount of PPE. We have an amazing safety team. There will be a press release that Aramark, the big food company, a global company, has chosen us as their safety partner to create something called EverSafe. We feel good about it.

The issue about what do health professionals think about going to conferences? Honestly, Chris, it\’s not healthcare professionals. It\’s individuals. We talked about the fact that I\’ve done six mergers in five years. If you went to a lot of healthcare professionals, they\’d say, “That\’s suicide. That\’s not going to work.” It\’s worked incredibly well. I\’m sure there are some people in my position saying, “I\’m not going to leave the house because I don\’t think it\’s safe.

My daughter has a PhD in public health. The public health’s view is when is it safe where nobody has a chance of being harmed? Stephen, you\’re somewhat high risk. What would be the safest thing for you to do of having no chance of getting COVID? The safest thing for me to do would be to never leave my house. I\’m not doing stupid stuff but I\’m going to the office every day. I\’m not going to the hospital but I\’ll go to the office. Most of the conferences have either been canceled or I\’ve canceled. The first one that I\’ve agreed to do is an invitation-only and a smaller conference.

[bctt tweet=\”By the time we have a vaccine, somewhere around 35% or 40% of the population has gotten it.\” username=\”calentertainmnt\”]

Everybody\’s going to get the immunity test, right?

Yes. We all will do. Anybody will test at that point. I have a couple of things. I\’m going to be willing to do that.

Some people are going to be willing to do it. It\’s your decision. What about cutting hair? What about racquetball? I play racquetball. My wife cuts hair.

My concession was I\’ve had my Italian barber come in every one week to every two weeks.

All you need to use is a clipper, like me. Do you have a guy who does that for you?

I do.

You could look like me and do it yourself.

I have John Romano who comes in every two weeks. He\’s been doing it since he\’s twelve. He comes from Sicily. I\’m afraid to tell him not to come.

He’ll get angry.

This is what I think isn\’t going to happen. When is the Yankee stadium going to open? That\’s not going to happen for a long time because you’ve got 20,000 random people.

What about playing? What about racquetball? What about going to the barber and sitting in a chair with all the other people in the salon?

I wouldn\’t go with all the people in the salon. I would go to a barber that I know is disinfecting stuff with the right stuff. I’d take that chance.

Are you going to fly?

I\’ll fly. Most of the planes have done the thing of getting rid of the middle seats or having one person in the first class and everybody wears a mask including the stewardess. That\’s okay. I\’ve talked to the American Airlines folks about what they\’re doing in disinfecting. They\’re using pretty much what we use in the hospitals. That\’s okay.

Last question about COVID, because we went on a COVID tangent, but it was obvious that we had to knowing what you do. What percentage of the population do you think yourself or have you heard has gotten it at some point? Most people, more than half, don\’t even know they got it. What\’s the percentage that you think it is that got it in this country?

Health Technology: The way that vaccines work is you either go after the DNA of the virus or you trick the protein that the virus is on.

By the time we have a vaccine, we\’ll have somewhere around 35% or 40% of the population has gotten it.

Those are people who were out there more in general than people who stayed at home.

In your state, they published some results that are somewhere between 10 to 15 times as many people had positive antibodies that thought they had COVID. I have a nephew in LA call me up with some symptoms. He’s big, strong, plays baseball, and the whole bit. He could be. He could not be. We worked out a telehealth visit. We got him tested and he had COVID. He felt shitty for 5 or 6 days. He stayed at home for two weeks. He got the antibody test. His sister had a baby. We said, “Even though you have a positive antibody, you probably should stay away from the baby because you’ve got COVID.” He\’s now out doing stuff. There\’s probably a whole bunch of people that have gotten it with either mild symptoms or even major symptoms.

It\’s going to be weird shifting your mind from, “I don\’t want to get it. I can\’t get it.” You\’re then getting the antibody test and you\’re thinking, “I hope I had it. I hope I’m immune.”

That\’s the whole Sweden and Switzerland thing. In Sweden and Switzerland, “We\’re not going to isolate anybody other than high-risk people.” They don\’t go out and party and kiss everybody. The public health term for that is herd immunity. Let\’s have as many people get it as possible that are low risk. When we let Steve Klasko out, there will be a few transmitters that he\’s got a little chance of getting it.

Final question and final thought, COVID is behind us. There\’s a vaccine or cure, one of the two, and the cure is pretty reliable at least. I know you\’ve written about this and talked about it. Do you think the post-COVID world is a pretty positive place? Do you think we\’re going to have a lot of new things in that world now that we need it?

I\’ll say two things. It\’s a positive place for places that are willing to think about what\’s going to be obvious years from now and do it today. It\’s a negative place that people think that they can live on their existing business structure. If you\’re a hospital or when you\’re thinking you\’re a hospital, you\’re dead. You\’re going to have to think of yourself as healthcare with no address. You want everybody that’s healthy to say, “I need the Jefferson app. I need the Apple app while I\’m healthy.” As opposed to only thinking about you when you\’re sick.

I worked at Apple, pre-iPhone. If you think about that world, it was Gateway, Dell, Windows, and HP. Apple had 3% of the computer market. If you ask people back in the early 2000s, “What do you think is going to happen, let\’s say, 10 or 15 years from now?” They’d say, “Dell is going to have even cooler laptops. Gateway will deliver them to your door because they were the customized ones. There\’ll be Windows 2020 and it will be great.” Steve Jobs took money from the old math of creating operating systems in the computers, which was the only thing the company did to this crazy new math of a digital lifestyle. If you remember, the first thing he put out was the 200 MP3 iPod. The Wall Street Journal was thinking that Steve is on crack or on drugs. He was able to uniquely see what was happening.

One of my mentors has been John Sculley. John was the guy that came from Pepsi because the board wanted Steve to act like a CEO. He goes to Steve and he says, “You’re Steve Jobs, it’s fine. We\’re a NASDAQ company. You’ve got to come up with a three-year strategic and business plan.” He showed him Pepsi\’s, it was a glossy thing with spreadsheets and whatever. “I\’ll give you three months. I\’ll bring in McKinsey. I\’ll bring in whoever you need but it\’s got to look like this.”

Steve calls them up about twelve hours later and says, “John, I have your three-year business and strategic plans. Come to my office.” It was on a blackboard. In my talks, it’s on a whiteboard and I show this, “Year one, we change. In year two, we change the industry. Year three, we change the world.” If you think about it, that\’s what he did. In year one, they changed from the old math of investing in computers and operating systems to new math of digital lifestyles. Changing the industry were things like the iPods and the iPads, iTunes, and the digital store. Changing the world, one could argue was iPhone. It democratized many things.

I’ve stolen that. We talked in terms of the old math and the new math, the old math is academic and clinical and the new math is innovation and strategic ventures. Changing the industry is what we started to do with healthcare with no address and telehealth and the wearables. The change in the world will be some of the things we\’re looking at with General Catalyst and others. We’re going after the social determinants of health.

The fact that underserved folks and minority communities had COVID at a 10 to 1 ratio as Caucasians in better communities. It\’s not because they had that predisposition, it’s because they have higher rates of obesity, diabetes, hypertension. That gets into the disrupting food deserts through drone delivery. That gets into some of the stuff around education and housing. Even though we\’re a hospital system, we\’re tackling head-on with digital transformation. To me, that worked for Apple. It\’s exactly how any healthcare CEO or insurance CEO should be thinking post-COVID.

It will be interesting to see what you guys do. You\’re a leader and you\’re amazing. I like the idea that you guys have the design school because you are going to be a leader in wearables, I imagine, because of that. That\’s going to be exciting as well.

It\’s been an interesting cultural thing to take all these fashion design people. Our keynote speaker was the guy that started Queer Eye for the Straight Guy, David Collins. He\’s on our advisory board. It\’s been great because having that creativity embedded into the health science university creates some interesting synergies.

Thank you very much, Stephen. This has been amazing. I appreciate your time. I hope everybody else did as well. I look forward to talking to you again soon. Have yourself a safe and well rest of the month. Hopefully, we\’ll be able to look back at this thing as a memory soon.

Health Technology: If you\’re a conservative person that doesn\’t want to get COVID, you should not go out of your house.

Thanks, Chris. I started my career as a DJ. I have one of the more popular Spotify COVID things.

You’re at the Big Hair, right?

I did own the Big Hair. Don\’t Stand So Close To Me. I Can\’t Get Next to You by The Temptations. Dancing With Myself is a good one or Radar Love. The best one is Roberta Flack’s The First Time Ever I Saw Your Face for people who fall in love when they’re with somebody with a mess. It\’s called Corona On by Stevie K the DJ.

Thank you, Stephen. Have a good one.

Important Links

• Stephen Klasko
• Bless This Mess: A Picture Story of Healthcare in America
• UnHealthcare: A Manifesto for Health Assurance

About Dr. Stephen Klasko

Dr. Stephen Klasko is a transformative leader and advocate for a revolution in our systems of healthcare and higher education. In 2020, Stephen published two books: “Un-Healthcare: From Sick Care to Health Assurance”, and “Patient No Longer: Why Healthcare Must Deliver the Care Experience that Consumers Want and Expect”. His best-selling 2018 book is titled, “Bless This Mess: A Picture Story of Healthcare in America”.

As President of Philadelphia-based Thomas Jefferson University and CEO of Jefferson Health he has steered since 2013 one of the nation’s fastest-growing academic health institutions based on his vision of re-imagining health care and higher education. His 2017 merger of Thomas Jefferson University with Philadelphia University creates a pre-eminent professional university that includes top-20 programs in fashion and design, coupled with the first design thinking curriculum in a medical school, and with the nation’s leading research on empathy.

His track record of success at creating and implementing programs that are shaping the future of health care earned him a place among Fast Company’s 100 Most Creative People in Business in 2018; and Ernst & Young’s Greater Philadelphia Entrepreneur of the Year in 2018. He is also ranked #2 on Modern Healthcare’s list of Most Influential People in Healthcare. For 2018-19 U.S.News & World Report has ranked Thomas Jefferson University Hospital among the nation’s best in 10 specialties, and Magee Rehabilitation Hospital – Jefferson Health 13th Best Hospital in the nation for physical rehabilitation. In 2018, Jefferson was invited to join the World Economic Forum.

Dr. Klasko is a nationally recognized advocate for healthcare transformation, having served as dean of two medical colleges, and leader of three academic health centers before becoming President and CEO at Jefferson. He is author of 1999’s The Phantom Stethoscope, 2016’s We Can Fix Healthcare in America, and editor in chief of the journal “Healthcare Transformation.”

Under his leadership, Jefferson Health has grown from three hospitals to 14 with revenues that grew from $2.2 billion to more than $5.1 billion, annualized, with more than 30,000 employees and 6,600 physicians/practitioners.. The new Jefferson focuses on managing the health of populations in southeastern Pennsylvania and southern New Jersey. Jefferson has the largest faculty-based telehealth network in the country, the NCI-designated Sidney Kimmel Cancer Center, and an outpatient footprint that is among the most technologically advanced in the region.

Love the show? Subscribe, rate, review, and share! https://slot22.silverline.dev/virtually-speaking/