Kevin Tabb on Beth Israel Lahey Health on how to get ahead of changes in healthcare

Harry talks with Kevin Tabb, MD, the CEO and president of Beth Israel Lahey Health, the product of Lahey Health’s merger this spring with Beth Israel Deaconess Medical Center (BIDMC) and several other hospitals in the Boston region. How does Dr. Tabb manage change inside a growing organization that—by his own admission—has to build and implement new tools, processes and the actionable data it needs to evolve beyond the fee-for-service era.

Dr. Tabb was CEO of BIDMC before the merger, and previously served as chief medical officer at Stanford Hospital & Clinics in Stanford, CA, as well as head of the clinical data service division at GE Healthcare IT. Raised in Berkeley, CA, he emigrated to Israel at the age of 18, served in the Israel Defense Forces, studied medicine at Hebrew University’s Hadassah Medical School, and served as a resident in internal medicine at Hadassah Hospital.

Tabb says the most significant challenge for healthcare leaders is “figuring out how to calibrate the pace of change,” in particular the gradual but accelerating change in business models from fee-for-service to outcomes-based global payments, and the shift toward “treating patients as people” and focusing on health rather than sickness. The big question, he says, is “How far ahead of the curve should we get, so that we’re ready for the significant changes to come, but not so far ahead that we’ve shot ourselves in the foot and can’t survive the interim period.”

The task requires “constant calibration” and “is more of an art than a science,” Tabb says. But three key tools can help healthcare organizations manage the transition, he says: good, actionable information; incentives (monetary or otherwise) that are aligned among parties; and defined toolkits for change (which could include, but should never be limited to, new technologies).

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Transcript

Harry Glorikian: Hello, I’m Harry Glorikian. And this is Moneyball Medicine. The show where we meet executives, entrepreneurs, physicians, and scientists using the power of data to reinvent healthcare from machine learning to genomics, to personalized medicine. We look at the biggest trends in patient care and healthcare management.

And we talked to people behind the trends to find out where data is making the biggest difference.

My next guest has said when the, the issue of the use of IT and healthcare comes up, we are frequently stymied by the fact that the solutions presented are very expensive and not particularly user-friendly for providers that use them and not even what patients are looking for. Many of the innovative IT solutions.

I hear about seem to be solutions looking for problems. Dr. Kevin Tabb is president and chief executive officer of Beth Israel, Lahey health, a pioneering integrated healthcare system offering a full continuum of healthcare services. Ranging from hospital to ambulatory, to urgent, to behavioral health care.

Before coming to Beth Israel, Lahey health. Dr. Tabb was chief medical officer at Stanford hospital and clinics in Stanford, California. There, he had broad, strategic and operational responsibilities, which included physician network strategy, clinical quality and patient scent safety initiatives, regulatory and medical staff affairs and graduate and continuing medical education. He was previously chief quality and medical information officer at Stanford prior to joining Stanford. Dr. Tab led the clinical data services division of GE healthcare IT.  Raised in Berkeley, California. Dr Tabb immigrated to Israel at the age of 18 and served in the Israel defense forces, the country’s military service.

He received his undergraduate degree from Hebrew university in Jerusalem and his MD from the Hebrew university Hadassah medical school. He completed his residency in internal medicine at Hadassah hospital. Dr. Tabb, welcome to the show.

Kevin Tabb: Thanks very much. It’s a pleasure to be here.

Harry Glorikian: What’s interesting because both of us are actually from California.

I was born and raised in San Francisco. You were raised in Berkeley, so.

Kevin Tabb: Right across the bay,

Harry Glorikian: Right across the bay. Um, big changes over there these days.

Kevin Tabb: There are, yeah, lots, lots of changes. It’s uh, you know, it’s interesting though, coming from, uh, Silicon Valley, um, and, and the San Francisco bay area, which is really the Mecca of, of IT coming to the greater Boston area, which is the Mecca of healthcare.

Harry Glorikian: Right.

Kevin Tabb: And we like to think of ourselves here in the greater Boston area as the Silicon Valley of healthcare.

Harry Glorikian: Yes I was, I was actually thinking about just the position of the two geographical locations. Um, as good as the bay area is, as you know, cause I’m originally from there is this is a different animal.

Kevin Tabb: It, it really is. Um, and, uh, you know, even I would say the cultures are different and yet you see a lot of people migrate from one coast to the other fascinating place to be fascinating time to be in healthcare

Harry Glorikian: Yeah.

Kevin Tabb:– In Massachusetts.

Harry Glorikian: Yeah. I think actually it’s between the hospital systems and then the universities creating these. What you may use eventually in your hospital system? I think that synergy is very interesting here

Kevin Tabb: It is. It’s a combination of, uh, the wealth of great healthcare institutions that exist in Massachusetts and the greater Boston area. The universities that are here with um, the constant flow of, uh, interesting people and new grads, uh, but also the concentration of biotech and increasingly healthcare data companies that are realizing that there’s a hotbed here, uh, that can be used, uh, to play in and to innovate ultimately.

Harry Glorikian: Interesting. So let’s jump to you-  you’ve gone from, if, you know, if I remember the history I heard in one of your last talks from actually writing code and, and being able to pull data from information systems to now being CEO and of, uh, of a large system and managing this merger, which is not a trivial exercise.

Um, how do you see, how did you see your role shift from being the data guy, knowing what to do, how to do it even almost how to, you know, writing the code itself too, this strategic role and, and, and mentor and guide her of this, of this entity.

Kevin Tabb: It’s a fascinating question because, um, I would absolutely agree with you that, um, my role and the role, uh, of a CEO is really different than any of the previous roles that I’ve played.

Uh you’re right. I’ve. I’ve had sort of an eclectic background. I’ve um, been a clinician, um, in another healthcare system in another country. Um, I’ve worked in small startups, electronic health records. I’ve worked in large companies and corporations in healthcare IT, uh, and then gone over to academic medicine, uh, on the west coast and on the east coast.

And those are all uh, different roles in different places. I, I would say that, um, I was most struck in coming to Boston and what was, uh, my role at the time, uh, CEO of Beth Israel Deaconess Medical Center, um, at, at how, how much of a change I needed to go through in terms of what I focused on, um, and had those discussions internally with my own team when I came to Boston.

Uh, uh, I had a conversation, uh, with the person who was the CIO of a Beth Israel Deaconess medical center at the time, uh, Dr. John Halamka who’s well-known in

Harry Glorikian: Yes

Kevin Tabb: healthcare circles. And one of the things that I talked to him about was the fact that, uh, I was not coming to this role to be a shadow CIO. We didn’t need, in fact, two CIO’s

Harry Glorikian: Yes

Kevin Tabb: At this place. Uh, he was doing and continues to do a phenomenal job. I needed to focus on other things. And I, as CEO focused on a small number of things, most of them strategic in nature. And my job is to frame the questions that need answering for my team, not to determine what the answers are. And that fundamentally is the difference between some of the roles that I’ve filled previously, where I needed to come up with the specific solution I needed to come up with a specific idea.

Now I believe I need to find the people who are better than I am at coming up with the best solutions to the problems that we have in front of us.

Harry Glorikian: But right now, healthcare is in, has been in the middle of a shift between fee for service and a value based environment. And so we’re, we, the phrase I’ve always heard is like, we’re almost two canoes, one foot in each canoe and sort of straddling the river.

Um, what are the sort of strategic items that you’ve had to paint a picture for everybody and then get everybody developing systems that get you there?

Kevin Tabb: Well, I think you’re right. We, we, all of us, um, I know in healthcare that we are in this strange interim period between, uh, in the midst of a, of a significant change.

Uh, in the business of healthcare, certainly, and in the way that we, even in the way that we deliver care, what you have referred to as a one foot on the bank and one foot in the canoe. And that’s a hard, a hard time to be in, but, but that’s the reality situation. I think that for many of us that are leaders in healthcare, if we had magic wands, we would waive it and move quickly to get all the way to the other end and sort of be in one system, but we don’t have those magic wands. And so we need to figure out how we live in that hybrid world right now. The most significant challenge, I think that, uh, any of us as leaders in healthcare face in this particular time is figuring out how to calibrate the pace of change.

And what I mean by that is we all know that change is coming and some of the changes already occurred, but there’s still a significant amount that will occur in the future. None of us as leaders want to wait until a change has hit us in the face. In other words, none of us want to be at a place where we are staring over the cliff already.

The wheels have come off, so to speak and then try to figure out how to, how to change, how to morph, uh, and be different. That’s that’s a terrible thing to do. You never want to do that? Okay. So we all know we need to get out ahead of it. The question is, how far ahead do you get of your current state? In other words, we exist in this world for instance, you talked about the issue of fee for service versus global payment and, um, and things are changing. And many of the patients that we take care of now are under some form of global payment and yet a significant portion of our revenue is a fee for service.

Harry Glorikian: Right?

Kevin Tabb: How do we get out ahead of the curve? And how far ahead of the curve should we get so that we are ready for the significant changes that comes, but not so far ahead that we’ve shot ourselves in the foot, uh, and can’t survive in that interim period. And that calibration of how far ahead to get is not, is not something, uh, that there is a checklist that can give you an answer about, it’s not something that I can plug into a spreadsheet and receive an answer on.

There’s an art to that. And, and, and I think we’re all constantly calibrating trying to get ahead. And yet. Uh, uh, make sure that we are, uh, that we survive and in fact, thrive in the environment that we live in now. It’s, I believe more of an art at this point than a science and one that in fact is not particularly unique to healthcare.

There are lots of industries that have been through change, and I think a lot that we can learn from others.

Harry Glorikian: Yeah, no, I was thinking about, you know, I mean, you have all your lessons probably from GE, especially where there’s a corporate, um, strategy of we’re going to have a skunkworks project. We’re going to give people 10, 15% of their time to sort of ideate on different things.

We’re going to come up with a unit that actually gets to experiment on things and let’s see how it works. And then we can integrate it back into the pack. I’m just, you have a unique background and I’m wondering if you were thinking about other parts of the country and other institutions, what would be some of the experiences that you might be willing to share with people?

Kevin Tabb: Well, I, it’s interesting because what you just described of, um, both skunkworks, but allowing people to, uh, come up with innovative designs and ideas is something that we do here. I think in an, in a really interesting way. And one that is, uh, different than many places that I’ve been.

And as we morph in changes as organization. So we’ve just been through a significant merger. We’ve gone from a, a smaller system, a healthcare organization that was a total of four hospitals with a little more than 2 billion in revenue now to one uh, that is, uh, almost three times that size, uh, in one fell swoop.

So 6 billion in revenue, um, uh, 13 hospitals, uh, 35,000 employees, a myriad of different, uh, um, IT, pieces. And, uh, one of the many issues that we’re facing is how do we uh, uh, go through this merger, which can at times be chaotic. Um, but how do we do that? Keep our eye on the ball, uh, focus and still maintain our legacy of innovation and entrepreneurship.

One of the things that I decided to do structurally is, um, to split the pieces out. So what I mean by that is typically. Uh, a healthcare CIO, uh, is, uh, got to deal with, uh, budgets, um, bandwidth, uh, delivering, uh, projects that have long been determined, uh, on time and on budget. Uh, and when smaller companies, new ideas come and approach healthcare CIOs.

The typical response is please go away.

Harry Glorikian: Yeah

Kevin Tabb: Don’t bother me. I’m- I’ve got to be focused. And, and I have a lot of sympathy for that having filled those roles and demanding that of my CIO.

Harry Glorikian: Right.

Kevin Tabb: Um, And yet that’s really a pretty disturbing answer if you think about it, because how are you going to get innovation? If the answer to innovative ideas is go away, don’t bother me.

Harry Glorikian: Right.

Kevin Tabb: And so, in fact, what I did was I split these roles out within our organization and I asked uh, John Halamka, who was the CIO, uh, to step into an innovation role.

Harry Glorikian: Right.

Kevin Tabb: And, uh, we have a CIO who focuses now on the day to day bread and butter running of the systems that we have, but we have somebody else whose job it is to say to new companies, to innovative ideas, please come bother me. Let’s play with this. We have a sandbox for it. Let’s try things out. Let’s try new things. And the hope there is that we are able to do both things at once as an organization, we are able to deliver on the focus that we need, uh, as, uh, as now a much larger entity, but we’re also, we don’t lose our ability to innovate, uh, and to entertain new ideas.

Harry Glorikian: Well, John’s job sounds like a dream job to be quite honest. It’s uh

Kevin Tabb: I th I think it is. I think that he’s having a good time.

Harry Glorikian: I think, I think anybody listening to this now is going to go bug their CEO and CC. I want that job.

Kevin Tabb: That’s right. That’s right.

Harry Glorikian: So you had mentioned earlier technology and, uh, the analogy of a three-legged stool.

And so I I’m, I’m always trying to look at it from a venture standpoint of where to put investment, how to invest, um, what will ride and inflection curve and provide value. Um, and you’ve got to look at it from changing behaviors and everything else. How do you look at technology versus the other pieces of the puzzle that, you know, need to be balanced to get implementation?

Kevin Tabb: Yeah, I’d say a couple of things. I think, uh, first of all, I want to start by saying that unfortunately, a lot of what I see and I’m approached, uh, on a weekly, if not daily basis with, uh, you know, interesting new ideas out there. A lot of what I see is, uh, you mentioned at the, at the beginning of this podcast is what I would call a solutions looking for problems.

And what I mean by that is that. Um, uh, people do come up frequently with, uh, innovative solutions for small things. Uh, the problem is that, uh, in healthcare, we live in a larger ecosystem and by simply solving a single point issue and not thinking about the end-to-end solutions.

Harry Glorikian: Right.

Kevin Tabb: Um, we ended up with bottlenecks somewhere else and therefore it’s not useful to me when I take a step back and think about what we really need, what I really need within our organization, as we go through uh, this really, this period of turmoil, this changing, uh, model, both for the business of healthcare and the way that we deliver healthcare. I really think about the fact that what we need to do is find ways to affect behavioral change and behavioral change means, uh, by clinicians, by people who run our healthcare systems, uh, and, and by patients.

And the question is what are those pieces that are going to be best at allowing us to affect and get that real change. Um, healthcare IT and IT in general, um, has, uh, has a role to play in affecting change, but it doesn’t exist in a vacuum and is certainly not the only thing that is needed when I think about, uh, where we get real change it’s when we have a number of different pieces at the same time. I think about at least three different pieces that are needed, the three pieces of a, the three legs of a stool, so to speak. And that includes, um, having good information, good, good data. That’s actually, uh, actionable. So, so it’s not just the data itself it’s making it into actionable information. That’s a real important piece, but it’s not enough in and of itself. So that’s one. Um, the second is, uh, that we need to align incentives. And by the way, when I say incentives, people immediately think that I’m talking about money, 

Harry Glorikian: Right? 

Kevin Tabb: And sometimes that’s the case, although that is not the only incentive that exists in a complex, uh, ecosystem like ours and, uh, and incentives are frequently misaligned, the things that are important to people.

Well, that’s what you should think about when you think about incentives. So an alignment of incentives is the second piece that’s really important to effect change. Uh, and, um, and the third piece is that we need to provide people with toolkits for change and by toolkits sometimes that’s an IT piece, but it’s not always an IT piece

Harry Glorikian: Right

Kevin Tabb: Sometimes it’s coming to consensus around what the right way to do something is. And what I find looking around the country and in my own experience at the, at the organizations that I’ve worked in overtime is that we most often implement one or two, but not all three of those pieces, and then scratch our heads as to why we’re not getting change.

So if you think about it for a minute, if all that we do is provide data to people. Uh, but we’ve not aligned incentives and we don’t help people with how they would make change, even if they know that they need to make that change. Then we should not be surprised that we don’t get the change that we’re looking for.

If all that we do and this frequently more and more frequently, what is occurring now is we are aligning incentives, providing payments or other things, but not helping people with how they would get that change and not providing them with actionable data. And so then we scratch our heads-

Harry Glorikian: Right

Kevin Tabb: Why we don’t do the change. And so you need all three of those pieces and it’s a rarity that I see, uh, that we have in place, all three of those pieces when we do that’s when we get change.

Harry Glorikian: It’s interesting. Cause I mean, it, those that three-legged stool has existed in say corporate strategy. And when you’re going to implement something and make a change or something forever.

Right. And it seems that because healthcare had not had a huge shift for so long that these are concepts that now need to be embedded within the healthcare system.

Kevin Tabb: They are, they’re not, uh, they’re obviously not simple. Otherwise, they would have been done already.

Harry Glorikian: Right. Right.

Kevin Tabb: Whereas in a simple corporate structure, uh, it’s pretty easy to come up with, uh, say a simple toolkit for these are the things that you need to do. That’s much more difficult to do in healthcare. And in fact, frequently find there’s no, we find that there’s no consensus among, 

Harry Glorikian: Right.

Kevin Tabb: Among, uh, experts on, on what that toolkit should be around, what really a high quality care is or how we would measure that or all of those things.

And so these are not simple things I would say though, that, um, the fact that we have not reached nirvana yet. The fact that we have not, we do not typically implement all of those pieces, has nothing to do with the fact that technology lags. In other words, we’re not behind in healthcare because, uh, uh, because of a lack of feature functionality, that’s not the issue.

The issue is there are many complex pieces to this puzzle that all need to be put in place at once.

Harry Glorikian: So we were talking about behavioral change and, and I, and I think about where value based care is sort of, hopefully for all of our sakes leading the system is sort of towards keeping people healthy as opposed to treating people when they’re sick, um, where the brunt of the cost ends up.

So if you’re, if you’re managing people or trying to keep them healthy, technology does start to play hopefully a larger role because nobody has a dashboard for themselves for the most part. And so whether I can monitor my diabetes better or whether I can, uh, see a heart issue faster or any one of these different variables.

Um, how do you see the impact of technology sort of outside of that traditional space? And when I say traditional space, I see, um, home use coming into play, uh, you know, CVS and Aetna and this merger. And so their motivation and the strategy and they need to implement. But you have got a large community-based structure that you’ve got to manage. And so how do you see that evolving into the future and how do you manage that revenue transition change? I would say,

Kevin Tabb: Well, w uh, uh, we’re definitely going to, it’s still in the process of figuring out how we build out an infrastructure that will allow us to deliver care in a really different way, but before we even determine what that IT infrastructure, it looks like, I think we need to, uh, agree on what the future, uh, focus of healthcare organizations needs to be. So if you take a step back and, and I’m frequently asked what keeps me up at night. Um, I’ll say, you know, I, I, I tell, uh, my own team, I’ve told them a number. I’ve, I’ve talked a number of times with him about the story, um, of Kodak.

Harry Glorikian: Yes

Kevin Tabb: And, um, you know, in fact, I was talking about this with my kids at dinner, uh, last year. And, uh, the interesting response I got from my kids was uh, who’s Kodak?

Harry Glorikian: Who’s Kodak? Yeah.

Kevin Tabb: And that’s sort of the point of the story, of course, Kodak still around, but you know, at one time Kodak was, uh, the only game in town.

Harry Glorikian: Right

Kevin Tabb: And when Sony came out with the digital camera, uh, the, uh, response at Kodak was not in fact to ignore it. They did uh, they did a, an analysis-

Harry Glorikian: Right

Kevin Tabb:  Of what was this a threat and, uh, what they looked at was okay. Does, uh, does Sony make film? Because we Kodak make all of our money off of film and of course Sony was making digital cameras.They didn’t make film. 

Harry Glorikian: Right 

Kevin Tabb: Well, does Sony make chemicals because they made a lot of their margin off of chemicals? Well, obviously they didn’t with a digital camera and they came to the conclusion. Uh, that the digital camera was not a threat to them. And obviously that was a mistake because the company, uh, uh, tanked, um, and now my kids are asking who Kodak is.

So what was the mistake they made? I think that the mistake they made was that they did not fully understand the business they were in. They thought that they were in the um, film or chemicals business, but in fact, one could say the truth is that they were in the images, business and images it turns out can be, uh, made in lots of different ways, including ways that they had not contemplated.

Harry Glorikian: Right.

Kevin Tabb: So how is that relevant to us as leaders in healthcare? I think it’s actually extraordinarily relevant because many hospital CEOs, healthcare systems CEOs, pr- provider leaders. Um, while we talk about, uh, uh, doing all of the right things. We’re extraordinarily dependent on our existing model and, uh, a, a simple description of the existing model is a heads in beds model.

Harry Glorikian: Right

Kevin Tabb: Meaning the more people that we have in our facilities, uh, the more, uh, that we’re reimbursed for, and that’s the structure that we live in. And so I think many healthcare leaders, uh, ultimately if you scratch the surface, would admit that really the business that they are in is what, uh, uh, some people have called the heads in beds business.

And I think that’s a tremendous mistake because we are not, in fact, in the heads of beds business we’re in the healthcare business and healthcare can be provided in lots of different ways and lots of different places and beds in hospitals is one place that health care can be provided, but it can be provided in many other places, some of which we’ve contemplated and some of which we’ve not.

So it can be provided in community hospitals, which are less expensive than academic medical centers, but it can also be provided in ambulatory settings, whether that’s things like urgent care sites or ambulatory surgery centers. But it also can be provided in physician offices and then take it a step further.

It can be provided in non-traditional places in a drug store, um, or a place like that. And then take it a step further and think about the fact that it can be provided in patient’s homes. And then take it even a step further and realize that when we talk about healthcare and talk about patients. Maybe we should think about patients as people and not just as patients.

And what I mean by that is most people do not spend their lives as patients, do not spend their lives sick. And so thinking about, uh, how do we not only help people deal with their disease, but how do we help people from getting sick in the first place? And that’s, these are all things that are intuitive to your average lay person.

But not so intuitive to those of us that are embedded in and invested in a system that has existed and worked in a certain way for more than a hundred years. And so what I say to our people is {inaudible}, we need to get away from that old model and realize we’re in the healthcare business, just like with images, for Kodak that can be done in lots of different ways, some of which we imagined.

And some of which we don’t, and we need to be ready to do that. Wherever and however it will be provided in the future.

Harry Glorikian: So as an ex-, can you give any examples of, um, programs and or technologies or combination thereof? I would imagine that is achieving that goal that you just laid out.

Kevin Tabb: Well, I think that there are a lot, there are a lot of attempts out there, some with varying levels of success

Harry Glorikian: Yup

Kevin Tabb:  To help us as a system, all of, all of us around the country as systems manage populations of health since that requires, uh, uh, gathering large amounts of information and making sure that that information is actionable, um, easier said than done the way that we have typically gathered information doesn’t lend itself to doing well, what we need to do. So the way that we gather, -have gathered information that we use to take action today is really in one of two ways, either through billing systems, uh, and or through insurance systems, claims-

Harry Glorikian: Yea

Kevin Tabb: Data and that’s what we use frequently because that’s where we have the most data.

Harry Glorikian: Right

Kevin Tabb: It just isn’t that deep. Or we use electronic health record data increasingly, and that’s better than using claims data but it too is far from perfect. And the reason that it’s far from perfect is we’ve developed these systems, even the clinical systems really we’ve optimized them, uh, for purposes of billing.

Harry Glorikian: Exactly.

Kevin Tabb: And not for purposes of taking care of people and, and, and {inaudible}, unless we are able to see that shift, we’re really going to struggle.

Harry Glorikian: That’s interesting. I mean, it’s, it’s interesting that you say that technology isn’t the whole answer, but there is such a large piece of technology embedded in the system that is, was not built for what you, for the, for where you’re going.

Kevin Tabb: Yeah.

Harry Glorikian: That it, that it in and of itself, I feel hinders you from being able to move faster.

I’m not saying it answers all the questions, but EHR’s  and the way they’re built today hinders the speed at which you could make that transition because it doesn’t give you the information you need.

Kevin Tabb: I think that, um, ultimately, uh, what we’re going to have to do is a little heretical in that we’re going to have to be able to move away from the extraordinarily rigid, structured data entry that we now use to date and have to do in order to get actionable 

 

Harry Glorikian: Right

Kevin Tabb: information and allow, uh, us to go back to the free form narrative. Now that we’re increasingly have natural language processing tools and other things that can then extract actionable information in that,I think we’ll get to really interesting things in a much more flexible fashion. We’re not there yet, and I’m not seeing great tools to allow us to do it. But many of us, uh, many of our organizations are working on projects that will allow us to do it. So we’re doing things like pulling out of large amounts of freeform narrative, the ability to predict which patients will actually show up for visits and which won’t.

Harry Glorikian: Right.

Kevin Tabb : Um, that is something that’s extraordinarily difficult to do. And yet we’re now already, uh, doing that in a pilot form and we’re able to predict somewhere along the lines upfront. Before the patient actually shows up or doesn’t in 60% of the no-shows, we can predict it upfront. And that’s through being able to sift through large amounts of unstructured data, more important than that is, is being able to do things like being able to predict preventable harm, preventable harm, for instance, in the intensive care unit.

Harry Glorikian: Yep

Kevin Tabb :  How can we upfront before that harm occurs? Predict which patients are at greatest risk for preventable harm and then do something about it. Uh, we’re still, I think there are a lot of people out there trying to solve these sorts of problems. Uh, and we’ll get there eventually, but we’re not there yet.

Harry Glorikian: Yeah. I mean, I feel, what I feel good about is I think in the past there was a much smaller set of people working on these problems. And I think since the shift to a value-based and more data-driven oriented, there are up. Larger number of people. So hopefully there’s a few more shots on more shots on goal than there were previously.

And it all, it also seems like there’s a different group of people shooting on this. In other words, it’s not just healthcare people, but there’s a bunch of IT guys that don’t know healthcare that are willing to take some incredibly crazy risks. And I’m not saying- most of them will fail miserably.

Kevin Tabb: Right.

Harry Glorikian: But there’s a lot, there’s a few that will come up with something that could be useful to assist them like yours.

Kevin Tabb: No, I, I think you’re right. And I think, um, uh, we’ve not seen the, the thing that will wholesale transform the way that we deliver care yet. Uh, but it will come and it will probably come from, uh, from some person or company that we’ve never heard of.

I highly doubt that it will be from one of the entrenched incumbents.

Harry Glorikian: Yes

Kevin Tabb: Um, and if we look at other industries, that’s frequently being the case, it’ll come out of the field, you’re right, that there are now a multitude of. People that are fascinated with the problems that we have and trying to come up with solutions and I’m anxious to see and test some of the things.

And you know, we here at Beth Israel, Lahey health are anxious to be part of that. Uh, to say to people, come, bother us. Let’s try some of these things together. And that’s the only way ultimately that we will affect significant change.

Harry Glorikian: I think we just doubled John’s, uh, uh, queue of, of activities that he needs to go after.

Kevin Tabb: There you go. 

Harry Glorikian: Um, is there any other words of wisdom that we, that you’d like to share with us before we-

Kevin Tabb: Yeah. I mean, I think again, um, uh, maybe to reiterate what I’ve said already, my own background, as, um, as a person who spent many years in healthcare, IT has left me somewhat jaded around, uh, the existing solutions and we’re and, uh, somewhat, um, uh, skeptical about the fact that IT will be the silver bullet to all of our, all of our problems. But it will certainly be a piece of it. And I am looking forward to us and others, uh, helping to make sure that that happens.

Harry Glorikian: Excellent. Well, thank you. Uh, and uh, hope to see you again sometime soon.

Kevin Tabb: Thank you very much. I appreciate it. Take care.

Harry Glorikian: And that’s it for this episode. If you enjoyed Moneyball medicine, please head over to iTunes to subscribe, rate. And leave a review. It is greatly appreciated. Hope you join us next time until then farewell.