The Future of Healthcare

I had the privilege of attending Fortune Brainstorm Health last week, an innovation conference working to bring together the best minds in Healthcare, Technology and Business to make a difference in healthcare.  The theme of this years conference was “Accelerating the Health Revolution.”  The topics were broad and thought provoking.  I found myself at the event wondering how I could do more on a day to day business to help.  Since the conference the question has only gotten louder in my mind.   In reflection, I think that the starting point is to write down my top observations after review of my notes.  Maybe this exercise will lead my somewhere…

  • There are amazing people who work in healthcare:  scientists, physicians, innovators and investors.  I met people brave enough to tackle life or death situations with a gusto every day that most of us don’t muster at our best moments.  People with an insatiable quest for learning.  These people provide me a great deal of hope for the future despite the rhetoric of politics.  
  • This conference reinforced my belief that healthcare is a fundamental human right.  You can often get lost in the public debate over healthcare finance, which is what most of the political conversations center around.  The media doesn’t help, covering the politics of healthcare, and grabbing on to often non-core issues.  This conference allowed me time to simplify it for myself.  All people deserve access to care.  In order to afford this as a country, investment must shift from treatment to prevention.  This will ultimately bend the cost curve.  That said, the reason to have health care for all isn’t economic, it is ethical.  
  • Despite what I said above, costs are a major problem.  As a nation, we over invest in late stage healthcare and under invest in prevention.  Dr. Sandro Galea, physician and currently Professor and Dean, School of Public Health at Boston University, made a compelling case for the investment in creating health versus treatment illness as our priority.  When ranked versus 17 peer countries, the US mortality rates are ranked #15 – 17 for all age groups under age 60 and we quickly rise to the lowest mortality rates in the world for over age 80.  We invest a large portion of our healthcare dollars into this treatment and it is what is incentivized by our healthcare payment system.  The alarming thing is that it doesn’t increase longevity.  
  • Healthcare is about so much more than clinical care.  We were joined at the conference by Mark Bertolini, CEO of Aetna.  He shared that  “Only 10% of life expectancy is driven by clinical care – 30% by genetic code, 20% by the social determinants of health, and 40% by lifestyle choices.”  Dr. Galea, who I mentioned above, spoke of this as well.  In follow up to his talk, I read a great piece he wrote last fall.  Within this article, you can also find the chart to support the mortality rate information I shared above.  Improving the health of our nation is as much about investments in our social infrastructure (e.g. education, clean water, public transportation, a living wage) as it is investment in medical advancements.  I feel incredibly lucky for the good fortune that my family has had.  
  • One of the best comments from the audience at the event was about hospitals and their role at the center of healthcare improvement. The quote was something like…”Isn’t it ironic that our healthcare system is hospital-centric? Particularly given that a trip to the hospital is the failure of care.” Prevention, prevention, prevention. Our role must be to influence behavior so that people do not reach the point of needing the hospital.  
  • Corporations have a critical role in improving healthcare.  It is the right thing to do to focus on employee health and wellness.  If moral responsibility doesn’t convince you, employees that are well – getting enough sleep, eating well, exercising regularly – are more productive. The power of top-down leadership to drive a culture of wellbeing for our employees will be the pressure our healthcare system needs to evolve. On a side note, I crossed paths again with a former leader of mine, Chip Bergh, who is now the CEO of Levi Strauss. I remember his dedication to well being 20 years ago, and it was amazing to see his continued commitment to wellness as a driver of employee engagement and productivity. 
  • Fertility issues are a health crisis. The awareness of the breadth of fertility issues is low, and there is still a stigma to discussing these challenges.  A world-renowned fertility physician, Dr. John Zhang spoke about a controversial procedure (the three-parent baby) that he led last year.  It was a fascinating discussion, which prompted me to talk with him on a break.  We had a great conversation about this awareness issue.  His point…there is a Breast Cancer Awareness month, an MS walk, a Lymphoma/Leukemia organization all of which are doing great work to raise awareness of their disease, and funds to help reach a cure.  Yet, fertility issues are still taboo, unfunded, and impact over 6 million women in the US alone.  Fertility issues are reported to be as stressful as dealing with cancer for a family. Solutions are expensive, and the path to the solution is complex. Long-term this is decreasing wellbeing, and increasing costs within our healthcare system.  
  • Our company (CHG Healthcare) has a critical role in helping physicians to perform at their best.  With all of the challenges in healthcare, physicians are working harder, showing signs of stress and burnout and more focused on administrative tasks than ever (less time on patient care).  I sat next to a surgeon who said that given all of the electronic charting that she has to do, she sees about 40% less patients per day now than she used to.  Helping physicians to be successful and delivering to their maximum contributions well help save lives. 
  • Technology and data will be a propelling force for change.  Amazing people are investing in amazing things.  We got two live demonstrations that were particularly impressive.  The first, a matchstick size device that slides under the skin currently in development from Intarcia.  This device, combined with chemical innovation that allows medicine to stay good at 104 degrees for up to three years, enables medicine to be dispensed into the body automatically for up to a year post implementation.  Imagine chronic disease treatment improvements via increased drug compliance if this could be installed once a year in a less than a one minute procedure.  The second was a partnership between Tricog Health and GE Healthcare to provide EKG support to rural Indian clinics via a connection to the cloud for immediate diagnosis.  Both of these were amazing innovations, but just the tip of the iceberg in terms of what could be.  
  • Genomics.  All I can say is wow.  This field is moving through years of progress in weeks and months.  To envision its role in the future is for people smarter than me.  Refer to the first point above. 
  • Finally, there are people in this world who are way braver than me. Two physicians, Dr. Nahid Bhadelia and Dr. Raj Panjabi discussed the Ebola breakout in 2014. They were both on the front lines of the disease in Africa.  Dr. Bhadelia spoke of the impact of global security decisions on their work on the ground. As a country, we were began acting with an “abundance of caution” and airlines stopping flying into this part of the world.  Although well intentioned, this created immediate supply issues for healthcare workers on the ground. At one point, she and her team were out of personal protective equipment and had to make the decision to either use tarps to cover themselves and go back to work, or to let more people die.  They went in with tarps.  The bravery that this requires is something that I cannot fathom. I leave this week with an even further appreciation of the difference healthcare providers make for patients every day.  

An amazing, thought-provoking event to say the least.  What do I do with it?  I don’t know.  What I do know is that we all have a role in the Future of Healthcare.  Whether as a consumer of care, the owner of our own personal health or as an activist for a cause, we are all leaders in this challenge.  That said, senior corporate executives have a unique role given their influence.  I will paraphrase (and adjust) a quote from Mark Bertolini:

“The role of a CEO (substitute any senior executive leader in my point of view) is the power to convene, and the power to set the agenda.”   – Mark Bertolini, Aetna

The Busy and The Quiet


There are very few times in my life that I am alone any more.  Especially, times where I am alone and not connected to someone or something via my phone.  This is one of those times (don’t be bothered by the being connected to my blog….that is a part of the relief).  The kids are off to a movie with Jon and I am due to a friends house in about an hour.  But, for these 45 minutes, I am alone.  No sounds around me in the house other than my fingers typing, and the hum of our house as the dishwasher runs and the laundry is in action.  

I realize in this moment how I have almost forgotten how to sit silently.  The things I should be doing race through my mind:  should I prep the food for dinner; is the laundry ready to fold; maybe I should squeeze a quick workout in; I haven’t called my best friends from high school/college in a long time and should take this minute to make that happen; I have been meaning to get back to the book I got half way through on vacation and now is the time; what could I start on to make this week go more smoothly.  So, I force myself to keep writing as a way to not relinquish this time to the constant to do list in my mind.  

When did this happen?  Was it the onset of kids that took all my quiet moments and turned them into times filled with things?  Was it my job progressing to the point where I don’t have time during the day to take a deep breath?  Did this set the precedent for “no deep breaths, ever”?  Maybe it is because our world is on at all times (email, text, Facebook, Instagram, Linkedin, etc.).  Maybe it is because Jon and I are productive people….and don’t want to let a minute not help us to progress something forward.  

In reflection, it is a choice.  I like to squeeze a lot into my life.  I enjoy the things with my family, and my job, and socializing as a part of our community.  I enjoy my friends, and the outdoors where we live and staying connected to friends from prior times in my life via phone, text, email.  I enjoy the busy.  

But, I also like the quiet.  The slight dripping I hear from the kitchen sink, the idea of a nap, being bored.  A weekend with no plans, the time to take a spur of the moment road trip.  The ability to answer my phone when my mom calls versus texting her I am in the middle of something.  The free brain space to dream about things that make me happy, without making a plan about them….simply imagining what could be.  

To live my life to the fullest, it takes the ability to do both of these things.  Not letting either the busy or the quiet dominate my time.  Being comfortable telling myself to redirect if I get too heavy on one side of the scale.  This is one of those moments.  I have been running too hard the last few months.  Not enough quiet, not enough writing, not enough open space.  It shows up in my health (sitting here with a cold), my kids (they show me my stress as if they are a mirror) and my temperament.  Time to redirect.  

Through the Eyes of a Child

What a great day.  One that helps me to envision what the next ten years may feel like (knock on wood our kids still like us for ten years).  We went to our first Broadway musical as a family.  It was a big kid thing, with Matthew turning five in a few weeks.

My loves got all dressed up, and we took off for an outing as a family date.  An awesome show, great company, and a day to reflect on how lucky that I am.  The most memorable part of the day was Matthew on my lap at the theater, clapping in earnest, yelling “Bravo” at the end of the first act.

Art through the eyes of a child.  He was in awe of the performance, and in reflection, I am in awe of him.  Sometimes you forget how amazing the things are that you get to live, until you see them through the eyes of a child.

Thank You Hillary…#ImWithHer

I find myself at a loss of words after this monumental week.

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Katharine was beyond excited to stay up to watch Hillary Clinton accept the presidential nomination.  As was I.  I found myself moved almost to tears by Chelsea’s introduction (however not comfortable Chelsea looked), by Hilary’s deliberate recognition of the power of the moment, by her humble acknowledgement of both her strengths (work horse) and her weaknesses (show horse), but most notably by Katharine’s excitement about the evening.

For her it was just about the experience, about learning and understanding how this election thing works, about being able to stay up late, about seeing daughter introduce her mother for something exciting, and about the fascination with the role of our President.  And, it was of course cool that it was a girl.  She asked me if I was ever going to have her introduce me for something like that.  She wondered if the whole world was like America.

For me it was about making history, about hard work, about perseverance, about striving for something despite all odds, and about creating opportunity for all of the little girls that  were watching.  And, it was of course because it was a girl.  I had hoped for this day for a long time.  It made me proud of America.

I know that my politics haven’t always lined up with Hillary, and I am certain that I don’t agree with everything that she is advocating for, but #ImWithHer because of the lesson that she can teach America and the world.  She is showing us that hard work, perseverance, dedication to a cause, and belief in equality can change the world.  She is helping all of the little girls see what they can be.

There Should Be More Girls

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Tonight when putting Katharine (6 1/2) to bed and talking about her day, she asked me an important and hard to answer question.  “Mom, why aren’t there more girls in my mountain biking camp?”  First of all, mountain biking camp!  I know, only in Park City does a 6 1/2 year old have a bike nicer than I did at age 25, and get to go to a camp to learn to ride trails that I only got brave enough to take on 15 years ago.

She proceeded to say, “Having more girls would be more fun.  Plus mom, we can do anything that boys can do.”  Proud mommy moment.  After a few minutes, I realized that I had never answered her question.  Why aren’t there more girls?  I proceeded to tell her that at my work, I often times am the only girl so I know how she feels.  I shared with her that it would be more fun if there were more of us (not stated to her…and more productive, and more diverse in opinions, and better for business).  I told her that the good news is that I work with a ton of girls.  In fact, at my company, there are more girls than boys (we are over 60% female).  She gave me a bright-eyed smile.  I told her that in my office there are actually about 600 girls.  She proceeded to ask me if there were only a few boys because that would be “cool”, to which I said nope, about 500.  She was pretty jazzed that at my work the girls outnumbered the boys.  We talked about it more and I told her that it was actually really great that there were all kinds of people at my work…boys, girls, young people, old people, white people, black people (I know in Utah!).  She thought that it would be “better if in her mountain biking class there could be all kinds of people too.”

But, I never answered her question.  Why aren’t there more girls?  I want to protect her from some of the truths that are probably behind that question.  Maybe more parents believe their boys should be mountain bikers than girls?  Maybe society teaches little girls to choose ballet camp instead (trust me Katharine wants to do that too, and Matthew has never asked).  I avoided the question, hoped to teach her that girls can do anything boys can do, and vice versa, and hoped that what she remembers is that having all kinds of people in all things makes everything better.

How to disconnect?

How do I find time to disconnect?  In todays  busy world of two kids, two jobs in our family, a fair amount of work travel, and  building and now moving into our new house this seems to be the thing I have the hardest time with.  There is the literal disconnecting, from either work or technology.  I have gotten better at the work physicial disconnect over time.  I am there at 8:30 and I leave by 5:30 almost without fail.  The mental and technology disconnects have been much harder for me.  In fact, the more I have time to think at work, the more time my brain stays engaged outside of my desk hours.  And technology, ugh, no good at this.

My technology diconnect used to be via reading a book headed to bed. Lately that hasn’t worked.  My book is on my iPad which is the source of most of my connections in the world (my work calendar, my email, the internet, Instagram, Facebook, Twitter, LinkedIn and this blog).  I find myself instead of taking  30 minutes to read my book that I get started reading and then remember the ten things that I had meant to do that day and I begin to tackle a few on the spot.  Is it just that the device is associated with productivity?  Anyone else have this problem?

I am considering starting to read real books again.  Honest-to-god printed books.  So, 2000’s of me.  My other solution is banning the iPad from my bedroom.  That seems not practical though.  It serves as my music, my alarm, my source of book, and a way to catch up on the news.  Maybe I am rationalizing, but this doesn’t seem practical.

The only solution that I have had recently is the gym.  Being there has helped to mentally disconnect. I go there and I am only focused on the physicial activity.  This is giving me at least one hour, three days a week of separation from my to-do list.  Not enough, but a start.

Please give me some advice if you are reading this.  All of us have this challenge in some way, especially with technology, and I am wondering how you all are tackling it out there.

Commitments: Take Time to Think

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Over the last month, and in particular the past two weeks, we have been in the midst of fall planning.  I tend to love this time of year, despite the fact it makes us really busy, because it causes us to step back from our day to day and assess how things are going and where we should go from here.  These reflection and assessment times are key elements to helping us propel our organization and our business to the next level.

After a tiring and inspiring two weeks, where I stepped away from my daily whirlwind for a full five days, whether it be for our executive retreat or my team’s leadership planning summit, I wonder out-loud (if that is what writing a blog is?) why I don’t do this more often? There is something ceremonious about the fall planning retreat, but truthfully I felt like we moved the needle on our organization more in the last few weeks that I may have all year.  So, why not do this more?  Why do we as business leaders see stepping away from the whirlwind as a luxury, or a bi-annual event, versus thinking of stepping back as more of the norm?

To be clear, I am not talking about having more “retreats” or big, off-site events, but instead I am advocating for creating more brain space in our schedules as leaders.  Time more regularly to think and reflect, to innovate and be creative.  This year, I have been working to create 90 minutes of unscheduled time on my calendar every single day.  This is really hard.  I have more than 100 people who want regular one-to-one meetings with me, as well as being a part of business reviews and accountability sessions with my team and others in the organization.  I am a part of at least two teams (mine and our executive team) whose team meetings alone take 10-12 hours a month out of my schedule, not to mention the working teams that break out of these groups to help to move key initiatives and projects forward.  How, amongst all of these pulls on my time, can I create more unscheduled time in my calendar?  And, since I am not used to having it, how will I prevent myself from losing it to distraction if it arrives?

With this pursuit, I have definitely improved my time dedication to assessment and reflection, but not near to where I would like it to be.  Here are a few things that I have learned that may help in this journey, or at least remind me in the future, as I am sure I will have times I forget.

  1. Have a plan or a goal.  I (and likely many business professionals) work better with a plan or a goal.  Whether it be 90 minutes a day of unscheduled time, or simply a bike ride a week, this helped me focus my energy and time effectively.
  2. Tell people about your goal.  Accountability is an amazing thing.  The more you socialize what you are doing, the more I have felt accountable to not just myself for this improvement exercise.
  3. Don’t be down on yourself.  Change is hard.  I failed more days this year than I have succeeded, but if I get down on myself for this, it defeats the purpose.  Being kind and forgivining to myself is hard, in fact, sometimes almost impossible.  The more accepting at my own misses, the better I am at improving.
  4. Get creative on solutions.  For me, unscheduled calendar time isn’t the only way to create time for reflection (despite the original goal).  Ensuring that I have time dedicated to other activities like riding my bike, working out, outside learning time, reading, community events has helped this journey.  During these times, although my mind is far from quiet, I think and reflect.  In fact, my best organizational structure idea in the last two years came while on my mountain bike riding “Flying Dog” trail in Park City, Utah.

I guess it would be fitting to close this blog post with a commitment.  In a life with a lot of things pulling at me – my adorable children, a desire to have quality time with Jon, my job, business travel on both sides of our family and a desire to stay healthy – it is easy to not keep up with this.  My commitment today is that I will keep trying, and not be frustrated with my progress or failures.

Girls Weekend: The First of Many (Let’s Hope)

I am one lucky momma.  This weekend I had the luxury of taking Katharine (my now 5 3/4 year old – that 3/4 is very important to her) for her first girls weekend.  I was coming off a very busy week at work (fall budgeting, executive retreat in Southern Utah).  The prompting of the girls weekend location (Seattle) was because I had a business committment there on Friday morning.  A few weeks ago, as we were planning for this busy week, I was lamenting being gone out of town from Jon and the kids for 4 of the 5 weeknights.  So, we decided it was a great time for the first of what will hopefully be many girls weekends (and boys weekends with Matthew and Jon) so Katharine joined me on my business trip.  Given the Seattle destination (Hilary – my sister – and her family live there), it also gave us a great excuse to see them and let our three girls play together.

As the week progressed, and I arrived home from my first business trip to the Executive Retreat at 8pm on Wednesday night having worked about 40-45 hours in three days, I was lamenting leaving again on Thursday even though it was both a work and fun trip.  I was just tired.  I unpacked and repacked that evening, snuggled Matthew and crashed, trying to keep the faith that I could do it.

So, Thursday at work, Jon brought Katharine down to drop her off and we headed to the airport.  My energy had picked up, and seeing her excitement helped me over the hump to leave again.  The smile on her face when she come running into my office and how tightly she held my hand as we walked through the airport will be two memories that I will never forget.

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After I got through my work commitment on Friday morning, I met Hilary and Katharine for a lunch date and we took on the town.  Katharine had three things on her list:  1)  Put her gum on the gum wall in Seattle; 2) See the fish fly at Pike’s Place Market; and 3) Get her nails done.  Despite only an afternoon, we did it. On my list:  A nap.  I didn’t get to mine, but the excitement of seeing Katharine take in the sites, sounds and smells of the city for the first time made it worth it.

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As we bombed around Seattle, I got lots of “I love you” squeezes on my hand and heard a lot of singing out of Katharine (she sings when she is happy).  And, I forgot that I was tired.  Life is busy, and often times the whirwind makes me not live in each moment.  On what was my most tiring work weeks in awhile, I am so happy that I didn’t allow being tired to take away from this priceless time with my little one.  Cheers to many more girls weekends little K.

Starting My 40th Year

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Yesterday, I turned 39.  Today, people asked me what it is like to begin my 40th year.  In all honesty, today felt a lot like yesterday with a little less fanfare, and for certain less cake.  As I begin to think about what this 40th year will be like, it has made me reflect on how far I have come in a decade.   Today, I am a confident (at least half of the time), humble (most all of the time), professional, mother and wife.  I like to believe that I have helped more people in my 30’s than I have hurt, unlike my 20’s, and that I will help even more in the next decade.

One of the most vivid memories I have of turning 30 was celebrating that I could say “I am in my 30’s” at work.  For some reason, I felt like being 30 would instantly give me the respect that I craved at work, and it would help my coworkers (mostly men, 15 – 20 years my senior) to respect me.  At 30, I had been working in a corporate setting for almost ten years.  I came out of college young into an amazing job, and continued taking on progressively more responsibility from Procter and Gamble to Pepsi.  In 2006, I was working as a Marketing Director for Mrs. Fields Cookies in Salt Lake City.

I was enjoying the work.  It was challenging, both intellectually and organizationally.  I continued to work hard and stay committed to success.  Despite my positive performance feedback, and my commitment to the company, and me asking for them, my bosses and co-workers wouldn’t give me larger assignments or the nod to lead stretch projects.  I truly believed that they didn’t respect all that I could deliver.

So, in my immature mind, turning 30 was the answer!  I somehow convinced myself that this milestone would bring me confidence and help them to recognize that I wasn’t a “little girl who just graduated from college.”  Wow – was I wrong.  Sure, for several months, I found a new confidence based on this belief, but I quickly realized that nothing changed around me.  I was still the same person the day after I turned 30 that I was the day before.  My work relationships were still the same work relationships.  My feeling of “lack of respect” still existed.  I felt like I didn’t get taken seriously for what I had to offer.  I decided to just put my head down and work harder than anyone around me.  My last ditch effort to earn the respect I felt that I deserved.

As I reflect now, I can see how foolish this all seemed.  What was my problem?  Why did I worry about what now seems so trivial?  I know today that this feeling of self-doubt had nothing to do with how my bosses and co-workers were treating me, but had everything to do with my own self confidence.  Instead of believing in myself, I looked outward for affirmation.

Almost a decade later, I believe that living through this challenge in my life shaped how I live today.  So, I am not celebrating the start of my 40th year nor lamenting it.  Today, I am a professional, a leader, an athlete, a wife and a mother.  I still struggle at times with a feeling of “lack of respect”, but I try hard to celebrate what I have accomplished myself versus looking for someone to affirm my contributions.  I try act with respect for myself and for others, and to be humble about what I know and what I don’t.  I work everyday to value each person on my team and in my life, knowing that each person brings a unique value.  As I lead people, I listen and try help people find their inner confidence and encourage them to respect themselves.

So with 39 in the rear view mirror, and 40 around the corner, I don’t start this 40th year with any grand hopes that being “in my forties” will change much.  What I am celebrating is that I have learned a lot in the last decade and hope to learn as much as I head toward the next one.

Commitments: Drive (Live) at a Safe and Healthy Speed

Life moves at a constant 80 mph in my world.  Occasionally, I ramp to 110 mph for a two to three day period (like the last week).  Sometimes, if I am lucky, there is a deceleration to 65, but it is for certain a temporary slowing just to get around an obstacle.  As soon as I clear the obstacle, back on the accelerator to get up to driving 80 in a 65 mph speed limit zone.

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I am always keeping tabs on just how much faster I can go than the speed limit before I get a speeding ticket.  In my almost 39 years of life, and 23 years of driving it seems like 10 mph over the limit is an easy “no ticket”, I think of it as a safe 75 mph.  When I drive by a sitting police officer on the highway at 80 mph, I am wondering, “will he pull out and ticket me” or “did I make it through this time.”

As I sit here today, after running at about 90-110 mph all week with work and life both on overdrive, I think of the irony of this analogy.  Maybe instead of worrying about whether I am going to get a speeding ticket, I should be thinking about what speed to drive (live) and not as much about whether “I made it through this time.”

Deep thoughts always lead to a commitment post.  Today, I am committing to choosing a more healthy speed for my life and not just letting life keep pushing the accelerator down for me.