Bio: Tom Koulopoulos is Chairman and Founder of Delphi Group, a 30-year-old Boston-based think-tank that advises Fortune 500 companies and governments on future trends. He is the author of 12 books, including the newly published Reimagining Healthcare, founder and the former Executive Director of the Babson College Center for Business Innovation, an adjunct professor at Boston University, and a columnist for Inc.com.
Can you tell us a story about what brought you to this specific career path?
I’ve been an author for the past 25 years. While I’ve built and sold several businesses in that time the one thing that has been the most consistent aspect of my life is writing. Writing provides the opportunity to constantly learn and stretch my mind. That was certainly the case with this book since healthcare is such an incredibly convoluted industry.
Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?
When I started my first business with my partner Carl we both had day jobs and would work on our startup from 6pm to the early hours of the morning. One of our big treats, and splurges, was the once a week all you could eat pasta buffet at a local fast food establishment, Papa Ginos. It certainly wasn’t gourmet, but it was cheap! We’d load up on carbs to last us the next 8 hours. One night Carl asked to see the chef. Thinking something was wrong the cook came out of the kitchen somewhat sheepishly. Carl looked at him and said, in the most sincere and heartfelt way “I just want you to know that this is the finest pasta around! We come here every week and really look forward to it!” I don’t think that poor fellow had ever been thanked as sincerely, if ever at all. I asked Carl about it later and he told me that while the pasta may not have been all that great it was something we looked forward to every week and he just felt that poor bloke should know it. the lesson stuck with me. We all want to be acknowledged and thanked and we all have the power to do that.
Where do you see the future of healthcare?
I see a promising future in which world-class healthcare will be available to anyone on the planet. However, that can only happen if we reimagine the entire healthcare system. The challenge today isn’t the lack of technology or medical care, but rather the enormous administrative albatross that weighs down healthcare. That’s the premise of my book, Reimagining Healthcare, if we alleviate that burden and allow clinicians to focus on patient care healthcare becomes far more effective and affordable for everyone. And this is not just a US problem. Every healthcare system across the globe will collapse under the increasing weight of a quickly aging population with far more complex healthcare needs.
What advice do you have for working smarter, finding purpose and beating burnout?
There’s ample advice to be found about how to practice better self care and achieve work-life balance. Much of it is good and well-meaning but it ignores the fundamental challenge at times like these when many people are facing devastating conditions that are entirely out of their control. In a situation of that sort the single most important thing to do is to find a direction and commit to it. The direction itself is far less important than the simple fact that you have one. That will not only provide the motivation needed to ride out the storm but it may also provide a long-term change in direction that you may never have taken otherwise.
You write about ten culprits that are causing the disintegration of the healthcare system. What are they? Can you please explain a few of them in detail?
The Ten Culprits are cornerstone challenges that healthcare faces. To fix healthcare we need to acknowledge and address each of them. In general they fall it three buckets: Patients, Providers, and Payers. For example, One of the worst culprits is what I call the Anonymous Patient.
One of the most striking lessons learned from the COVID-19 pandemic is the importance of sharing data about patients and how ill-prepared we are as a nation to share patient data outside of very narrow silos. Ultimately there is no single owner of a patient’s health record. It is scattered about across many providers, clinics, doctors, and insurers.
This isn’t always the sort of data that we may associate with a patients health history. For example, implementing a travel history could prompt warning signs and even protective measures to limit the spread of many diseases. This has already been done in parts of Africa to contain pandemics and by the Taiwanees to track those under quarantine through the use of mobile phones. Using that data, clinicians can see where patients were, who they’ve been in contact with, and when they contracted the disease.
Another key culprit is the Asymmetry between Costs and Outcomes
COVID-19 has made it abundantly clear how intimately connected our economic well-being is to our physical well-being. What is critical to understand is that much of the economic hardship we are seeing on a large global canvas, due to Covid-19, has always been present in forms that are not as vividly portrayed in the day-to-day news cycle. Our inability to provide primary care, a single trusted source of data about a patient’s health history, and the information needed to conduct deep analytics for public health is why over 30% of healthcare costs are due to administrative burdens and why the higher cost of healthcare does not correlate better outcomes.
What do you feel are the issues that the COVID-19 pandemic has highlighted in the healthcare system?
In addition to the above examples, COVID-19 has shown us how incredibly effective and committed front line healthcare workers and yet how ill prepared our health system was to support them. While a pandemic surge would stress even the most efficient providers, what we have failed to appreciate is that COVID-19 is in many ways a glimpse into the sort of strain an aging population will have on healthcare.
You suggest as a course of action utilizing smartsourcing and Health Service Providers (HSPs). How is that different from outsourcing of administrative functions?
First off, the two can coexist. The difference is that an outsourcing partner works on aspects of the healthcare system that have little, if any, impact on the quality of care. For example, the hospital cafeteria, laundry service, or valet parking. A smartsourcing partner takes on activities that impact the care of patients directly. In addition, Health Service Providers (HSPs) have deep core competencies in healthcare systems that support the core operations of a hospital, such as billing, technology, and patient scheduling. Lastly, HSPs should have a vested economic interest in better healthcare outcomes.
Is anyone actually using the strategies you recommend in order to elevate the healthcare system and allow medical professionals to more effectively focus on patients?
Yes. And that’s what I found most encouraging. In my research for the book I came across a number of providers who are paving the way by taking on many of the Ten Culprits. For example, John Muir Health in Northern California has embarked on an Health Service Provider relationship with Optum, a division of United Healthcare. I profiled John Muir Health in the book because they exemplify the sort of leadership and vision needed to put healthcare on the right track.