…Despite all of the effort to create medical records that are portable and shareable, there is still no single continuous repository of patient data that can be used to adequately provide a reliable context for the treatment of patients and the projection of their outcomes. Most patients are all too familiar with the difficulty in getting healthcare records in a moment of need, such as an ER visit. And yet in the US half of all healthcare visits are to emergency Rooms.
As a part of my interview series with leaders in healthcare, I had the pleasure to interview Thomas Kouloppulos.
Thomas 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. His clients have included United Health Care, The Mayo Clinic, Cardinal Health and American Hospital Association. He is the author of 12 books, 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. For more information please visit: https://delphigroup.com/)
Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?
I have an insatiable appetite for doing things differently and disrupting the status quo. I realized early in my career that the best way to do that was by starting a company whose focus was on using leading edge technologies and to increase innovation and value creation. That has been Delphi Group’s mission for over 30 years and we’ve worked with some of the largest organizations in the world to do that.
Can you share the most interesting story that happened to you since you began leading your company?
Every entrepreneurial journey is littered with stories and anecdotes and I’ve had my fair share over the 30 years leading Delphi Group. One that is most memorable was when we made the Inc. 500 list of America’s fastest growing private companies. I had set that as a goal for the company at a time when it was I and my partner working out of my second bedroom.
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?
I like to say that the key to success is a willingness to make more mistakes than most people are willing to make and to forget them faster. The key to that is to learn quickly and move on. However, because of that, I honestly don’t keep a record of my mistakes. I don’t dwell on them once the lesson has been learned.
What do you think makes your company stand out? Can you share a story?
What makes us stand out has differed over time. If it hadn’t we wouldn’t be here 30 years later. At this point I’d like to think that it’s a long track record of successfully identifying key trends and helping our clients and the marketplace prepare for and deal with radical changes brought on by new technologies.
What advice would you give to other healthcare leaders to help their team to thrive?
Healthcare is not an industry for the faint of heart. Nearly every aspect of it, from the delivery of care, to the very raw human emotions that often accompany an illness, to the economics of healthcare involve hard and complex challenges that can only be handled by keeping in mind that the most important mission of every healthcare provider is the care and well-being of the patient. Once a leader loses sight of that they, and their organization, will get lost in the countless distractions that have little if any impact on the positive outcomes of patient care.
Ok, thank you for that. Let’s jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?
This is a complex question that isn’t easily answered in short form. I spend a fair amount of the book refuting many of the metrics used to position US healthcare in the way the Newsweek article did. Other studies have shown mixed results among the world’s largest and wealthiest countries. A 2019 report by the Peterson Center for Healthcare and the Kaiser Family Foundation measured a variety of factors in nine countries including the Netherlands, Germany, Australia, the UK, France, Sweden, Switzerland, Canada, and the US. Although the US lagged in some categories such as same-day access to a doctor or nurse (sixth), it was third for mortality rates from cancer, and below the nine-country average for thirty-day mortality following heart attacks and strokes.
One often overlooked data point, that’s worth pointing out, is that the US has one of the world’s best health care systems as evidenced by the simple fact 800,000 people come from around the world to US seek treatment from US healthcare providers ad pay full uninsured rates for that care. Ironically a similar number leave the US each year for medical tourism due to lower costs outside of the US.
Although the use of rankings provides important insights, it’s also important to keep in mind that the differences among the top ranked countries often amount to only a few people per hundred thousand. In other words, bridging these differences and bringing the US into a position of preeminence in healthcare is not something that is outside of our reach. That’s not to say that there isn’t more than ample room for improvement in many areas of the US healthcare systems.
The last point I make in the book may be the most critical. The coming global shift to a significantly older population will stress every healthcare system, regardless of its provider or payer structure, into financial ruin if we continue to do business as usual. Consider that, in the US alone, by 2030 every boomer will be over age 65 and one in five of every Americans will be of retirement age or older. By 2060 the 65 and older population will nearly double from 49 million today to 95 million. And yet the 55 and older population accounts for 56% of all healthcare spending. What all of this means is that by 2060 we could be spending as much on healthcare for those over 65 as we are for all of healthcare today. That demographic trend is nearly identical across every geography.
You are a “healthcare insider”. If you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.
- The Anonymous Patient. Despite all of the effort to create medical records that are portable and shareable, there is still no single continuous repository of patient data that can be used to adequately provide a reliable context for the treatment of patients and the projection of their outcomes. Most patients are all too familiar with the difficulty in getting healthcare records in a moment of need, such as an ER visit. And yet in the US half of all healthcare visits are to emergency Rooms.
- The Asymmetry Between Costs and Outcomes. A lack of visibility into the relationship between costs and outcomes of a healthcare procedure, treatment, or therapy prevents doctors from treating patients in a way that effectively balances cost and risk. Studies that look at the relationship between healthcare costs and outcomes find that there is no correlation between the two.
- The Primary Care Crisis. There is a growing shortage of primary care physicians. Half of all millennials do not have a PCP. Yet, a PCP reduces healthcare costs for the average patient by 30%.
- Drifting from the Core. Healthcare providers have been forced to take on the responsibility of many administrative aspects of care, such as documentation, coding, and the billing process, which detract them from their core competency of caring for the patient.
- The Aging of America. An aging demographic will multiply the consequences of all of the above culprits dramatically over the next two decades, ultimately making today’s healthcare models economically unsustainable.
Ok, its very nice to suggest changes, but what concrete steps would have to be done to actually manifest these changes? What can a) individuals, b) corporations, c) communities and d) leaders do to help?
First, we need a universal healthcare record that is standardized across providers and insurers and which is owned by the patient.
Second, we need to use data about patient care and population health to create predictive models which can track and correlate patient treatments with long term outcomes.
Third, we cannot possibly graduate enough doctors to bridge the lack of PCPs. What we can do is alleviate their administrative burden and provide them with tools to deal with ever increasing complexity of therapies and the aging of the population. For example telemedicine enhances and provides continuity for the patient doctor relationship. The use of wearables provides better access to tools for diagnosing conditions and monitoring therapies and the progress of disease.
Fourth, providers need to partner with HSPs (Healthcare Services Providers) in areas such as revenue cycle, data management, IT, and patient management in order to alleviate their administrative burden and increase their ability to innovate in both core and non-core areas.
Fifth, while there is nothing we can do to stop or slow the aging of the population, by doing the above we can create a sustainable healthcare system that will have greater capacity to manage the needs of an aging population with more complex health needs.
I’m interested in the interplay between the general healthcare system and the mental health system. Right now, we have two parallel tracks, mental/behavioral health and general health. What are your thoughts about this status quo? What would you suggest to improve this?
This comes back to the disjointed nature of healthcare. A typical 60 year old will have over 30 separate providers during his or her lifetime. Creating a universal healthcare record which the patient owns would make a significant difference in how providers interpret and treat conditions with an informed understanding of the entire patient.
How would you define an “excellent healthcare provider”?
When all is said and done, what every patient wants most is to be treated with care and respect which acknowledges their uniqueness as an individual and to have access to the best care available for their condition. While that may sound soft in the context of all the problems that plague healthcare, it is the goal to which every healthcare provider should strive.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
Success is not final. Failure is not fatal. It is the courage to continue that counts.
Are you working on any exciting new projects now? How do you think that will help people?
As we move into an increasingly digital world where the majority of our presence is online we will need to create new tools that allow us to engage and interact in a virtual space with tools and technologies that enhance and augment the human aspect of online experience. I’m currently working on two startups focused on that area.
What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?
Since I am always in the process of researching or writing a book ( this was number 12 in 24 years) I have the good fortune to always be in “student” mode. Ultimately, I’ve come to the conclusion that simply reading and absorbing is not enough. In order to truly better yourself you also create something from what you have learned. Information and ideas alone do not change the world. Creating and doing are what cause sustainable change.
You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂
We have unfortunately come to believe that US healthcare is unfixable and fundamentally flawed. As a result far too much time is spent vilifying the industry. While there is ample evidence that healthcare is in need of improvement, there is also ample evidence (as I point out in my book) that there are ways to not only fix healthcare but to make the US healthcare system a role model for the world as the globe transitions to an older population
How can our readers follow you online?
Thank you so much for these insights! This was so inspiring!