Dr Georges Benjamin: People, would you please give it up for my good friend and yours, Dr.
Reed Tuckson.
Dr. Reed Tuckson: Thank you.
Thank you.
It is an extraordinary honor to be in your presence, especially at this historical moment
in the life of our society and our civilization.
I want to applaud you for choosing to focus your extraordinary talents and energy on the
topic of this year’s annual meeting – Prevention and Wellness Across the Lifespan.
Extraordinary choice, and nothing more worthy than the best of your efforts.
Focusing on prevention and wellness across the lifespan implies some very fundamental
aspirations, an inclusiveness, an integration, and a comprehensiveness…You see what happens
when you get inclusion?
Every voice wants to be in.
An inclusiveness, an integration, and a comprehensiveness of organizing health engagement that is essential
for the challenges of today.
You understand the dimensions of the catastrophe that is before this country, this tsunami
of preventable chronic illness that is washing every day over the banks of a medical care
system that we already can’t afford.
This collision is extraordinary in its implications.
It is frightening for people, people who desire to live healthier and more fulfilling lives.
It is a disaster for the people who have to pay for medical care, whether it’s the small
business owners who’ve mortgaged their houses two and three times to be able to afford healthcare
for their employees, whether it is for big corporations, whether it is the people that
have to pay for it who are in government, whether it is small governments, local governments,
state governments, the federal government, and the American taxpayers – all of these
folks are extraordinarily at risk as long as the wave, this tidal wave of preventable
illness continues to come into a delivery system that we can't afford.
This challenge that you have accepted has some very specific requirements that must
be addressed if we are to scale these engagements – as they must – and if they are going
to manifest themselves in the lives of all of the people who share our time, our space,
and our communities.
In the few minutes that I have with you, let me quickly outline four of the key requirements
that I think are essential to achieve the vision of this meeting.
Number one: We require a new organizing vision for this work, a willingness to sustain that
vision even when it becomes uncomfortable for our own individual activities.
A holistic, longitudinal, continuous, integrated, and person-centric model of health and medical
care engagement must be our vision.
“Across the lifespan” implies that we will actually decide to integrate across the
continuum of prevention all the way through to medical care delivery, and do it in a manner
that focuses not only on the health organizations’ needs but focuses on the patients’ needs.
It means that we will have to start to look like other consumer-centric industries.
It means that we will have to reexamine our own institutional behavior.
It means that we will have to blow up outmoded, myopic silos and institution-centric thinking.
It means we need a new kind of visionary leadership that sees how you mobilize all the pieces
of the puzzle and leverage each of those pieces to address the needs of the individual over
the course of their lives through primary, secondary, and tertiary prevention.
Number two: Data and analytics are key to understanding and realizing this vision.
We are in the era in most of American industries of big data and the commiserate analytics
that are required to analyze big data assets.
Finally, in healthcare we are beginning to catch up, but we have a long way to go.
Without the data at the level of sophistication that others have, we will not be able to identify
individual risk, we will not be able to identify individual need, we will not be able to identify
or respond to individual preferences, cultural values, and ways of appearing in the world.
Without the data, we will not be able to target prevention and care delivery, we will not
be able to track individual health status longitudinally, and we will not be able, without
data, to engage the holistic team of people who must organize their competencies and assets
around the needs of the individual.
Traditionally, we have enjoyed the importance of robust immunization registries.
In my side of the world, we have traditionally been able to take good use of claims data,
pharmacy data, laboratory data – integrate those together to be able to understand the
needs of an individual, see where there are gaps in care, and then reach out to fill and
address those gaps.
There is something very exciting that is now happening though.
We are now in an era when we can take health information exchange data, electronic medical
record data, we can take data from biometry and people’s engagement with biometrical
devices, we can take data that comes from health risk assessments, we can take data
that comes from coaching engagement and care management engagement, and now there are a
group of people in America who are statistically skilled enough to put all of those data assets
together, to be able to make sense out of it, and tell a novel about Mrs. Jones.
This is fundamental if we are to make these visions that we have move to reality.
The challenge will be do we have the will and the skill to use our financial resources
wisely so that we can then invest across the care continuum in the technology infrastructure
necessary to make these data assets come alive?
Do we have the will and the skill to be able to aggregate and analyze and disseminate data
so that it reaches all the places it needs to reach?
The challenge is this: Do we have the ability to ensure that the individual’s data will
then flow with the person across settings of care and across the person’s lifetime?
Do we finally have the ability through every element in this care continuum to guarantee
that there will be trust and protection and security in the use of those assets?
I have lived my life under the shadow in too many times of the Tuskegee Syphilis Study
consequences as I have worked in the inner cities of DC, New York, Philadelphia, Los
Angeles, Chicago, and I will tell you that once you lose trust, it is very, very difficult
to get it back.
And so we must redouble our efforts – all of us, at every level of data – to make
sure that we never violate it because we need that data to do all the things that I have
described.
Requirement number three: The ability to successfully engage the person and the family and community
to actually take the necessary and appropriate steps for prevention and wellness across the
continuum.
Now, one of the good things about the data assets that I described is that you can analyze
all of that data to understand better who’s at risk for what, how do we need to fill those
gaps, how do we engage in