Centricity™ LIVE 2015: Dr. Atul Gawande Advocates a “Systems Approach” to Solve Healthcare’s Challenges


Update from today’s keynote speaker at Centricity LIVE in Orlando, FL

Today, Centricity LIVE 2015 kicked off with over 1,700 gathered together in a darkened room. Anticipation was high as energetic music blasted over the buzz of conversation and coffee. But the real energy boost came from hearing Dr. Atul Gawande address the room as the morning’s keynote speaker.

As anyone who has read his bestselling books including, The Checklist Manifesto or Being Mortal, knew, we were poised to hear a thoughtful, passionate, and pragmatic talk about the state of healthcare. And, as expected, Dr. Gawande delivered his trademark mix of humor, empathy, and lots (and lots) of enlightening data.

While there was much to take away from his excellent discussion, the theme that stuck with me was the argument that the next century of medicine must be the “century of systems.” Let me try to explain, although surely not as eloquently, his argument.

As we all know, and Dr. Gawande demonstrated with a chart of mortality rates over the past 200 years, modern medicine has made amazing strides in a remarkably short amount of time. Scientists, doctors and researchers have done an amazing job of breaking down every morbidity, condition and symptom into its smallest pieces – down to smallest genes, molecules and neutrons. This has led to leapfrog discoveries about how disease and the human body work. This staggering progress can be summarized by a colleague of Dr. Gawande’ s who has called the last century of medicine, the “century of the molecule.”

But, Dr. Gawande argued that what we need now is to take that detailed molecular-level knowledge of medicine and rebuild it into insights about how those discrete pieces work together as components of much larger and infinitely complex systems. We need to enter “the century of the system.”

He used a practical example – or “thought experiment” as he called it – to underscore this point. Imagine if you sat down to design the best car in the world. Many would say you need a Ferrari engine, a McLaren carbon fiber body, and brakes from a Bugatti. But what would you end up with? Gawande said, “An expensive pile of junk that goes nowhere.”

In medicine, however, we had done just that. The brightest minds of our industry have spent countless hours and dollars researching and designing the best devices, the best machines and the best software. We have made great and important strides, clearly. But now the challenge is to bring them together into the best system – the one that delivers the best care at the best cost.

Unfortunately it’s easier said than done. Gawande talked about how modern day health systems are more often designed to stymie rather than support a “systems approach.” Using his own mother’s recent knee replacement surgery as an example, he explained how different departments, sub-specialists and care givers can make the process of care more disjointed than ever. In fact, he counted 62 different people who cared for his mother during her three day hospital stay. 62! That’s 10 more players than an NFL team traipsing in and out of just one patient’s room in just 72 hours.

The fact is that the “century of the molecule” description also applies to healthcare IT. Innumerable vendors have spent unfathomable R&D dollars developing the best EMRs, the best surgical devices and the best PACS. But the real magic does not come from any one piece of software, but rather from integrating these disparate tools into a system that’s truly seamless, patient-centered and supports – rather than inhibits – workflows.

While it can sometimes be hard to see how our work connects to the greater good, I’m thrilled to be working for GE Healthcare and focused on imaging. I truly believe that taking an enterprise-wide approach to standards-based, interoperable imaging can be a part of building these systems that Gawande spoke of. It will be exciting to see how GE Healthcare and our clients – including the thousands here in Orlando for Centricity LIVE – will be the architects of the next “century of systems.”


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