Scaling Innovation Meaningfully for Population Health
Episode 497

Chris Gibbons MD, MPH, Board Member, Global Population Health Executive Thought Leader Forum at HP

Scaling Innovation Meaningfully for Population Health

Challenging norms and creating new visions of health and care delivery

This Podcast Series on Population Health is Brought to You by HP Population Health IT Solutions

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Scaling Innovation Meaningfully for Population Health

Episode 497

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Scaling Innovation Meaningfully for Population Health with Chris Gibbons MD, MPH, Board Member, Global Population Health Executive Thought Leader Forum at HP transcript powered by Sonix—the best automated transcription service in 2020. Easily convert your audio to text with Sonix.

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Saul Marquez:
Welcome back to the podcast, Saul Marquez here and on today’s episode of the Population Health series sponsored by HP, we are privileged to share the thoughts and passions of Dr. Chris Gibbons. He’s the Chief Health Innovation Advisor to the Federal Communications Commissions Connect to Health Task Force. He’s also the founder and CEO of the Greystone Group Digital Health Innovation Company and an adjunct Assistant Professor in the Department of Health Sciences and Informatics at Johns Hopkins. Previously, Dr. Gibbons was an associate director of the Johns Hopkins Urban Health Institute and then assistant professor of Medicine, Public Health and Health Informatics at Johns Hopkins University. He is a published author and international speaker who’s authored over 75 books, book chapters, research manuscripts, monographs and technical reports. Dr. Gibbons obtained his medical degree from the University of Alabama and then completed residency training in preventive medicine, basic Science Research Fellowship and a master’s of public health degree from Johns Hopkins. In today’s interview, we dive into health technology and population health that specifically explore the ideas of smart communities and how to best integrate technology to deploy population health strategies. I’m excited to share this interview with everybody. Hope you enjoy it. And again, appreciate the opportunity to do this alongside HP Population Health Solutions. So excited for you guys to listen. And here we go. Such a privilege to have Chris, Dr. Chris Gibbons here on the podcast today. Thanks so much for joining me.

Chris Gibbons:
Thank you for having me.

Saul Marquez:
So there’s so many interesting things happening in health care. Dr. Gibbons, you you cover such a broad, broad spectrum of things focused on digital health innovation, very honed into the patient and really looking at in, you know, public health. So we’re going to cover a lot of great things together. But before we do that today, I’d love to hear more about what inspires your work in health care.

Chris Gibbons:
Yeah, thanks for asking. It’s a really great question. You know, over the years, I have developed for myself a personal vision of what the future look like if I’m able to accomplish what I want to do. And my personal vision is really one of making a difference in health in my lifetime. And this is not to criticize anybody else. Some people skills scientists do work that they hope at some point in the future will make a difference. Sometimes it’s 100 years or more by adding to the body of science, and that’s great. It’s important. But I’ve chosen for myself a vision to make a difference in the lives of people in the area of health before I die. That’s what I really want to do. And quite frankly, not just for the rich and famous who have a lot of money and can get it, whatever they want it. But really for the middle class and for those that don’t have a lot of money and don’t have a lot of people helping them, if I can make a difference in their lives, particularly in their health. In my lifetime, that’s what gets me up every day and keeps me up at night.

Saul Marquez:
Wow, that’s powerful. And there’s nothing like a like a good timeline, right? And it’s important to be to be unrealistic sometimes to drive change. I mean, I’m not saying you’re unrealistic, but I’m saying is I your passion and your short timeline.

Chris Gibbons:
Yeah. You know, it is easy for some people to see something like that is unrealistic and I’ll be honest in the early days. I thought it was unrealistic. But over the years, I’ve I’ve learned so much. There are people who, like you may never have heard of before, like a guy named Tony Hansberry, who is a young African-American boy who at the age of 15, developed a new surgical procedure the surgeons are actually using today. At the age of 15, still in high school, and Kelvin Doe a young man born in Sierra Leone is abject poverty. The old country is a very poor country, and he’s short lived there. But he taught himself electronics. And then he used literally things that were thrown away, old electronics, radios, things that people no longer wanted were no longer even usable to create first a light bulb and then radio, a working radio and bringing electricity to his. And now, you know, he was identified and brought over to M.I.T., released these kids with so little accomplishing what most people would say is impossible. And I say to myself, if if they can do that, I’d been privileged to have, you know, what some might consider a world class education or work at some of the best health care institutions in the country or in the world. I ought to be able to accomplish something that maybe some people or maybe even myself think is impossible and I just believe that there were many other Tony Hansberrys and several Kelvin Does out there, and if they can be inspired and given opportunities with their health and others, they can change the world. And so every day I’m working to inspire and working to improve opportunities for health for everyone.

Saul Marquez:
I love it. I love it. And I and I am inspired right now just with your energy and your conviction. And, you know, like that quote says, it’s “unreasonable people are the ones that change the world”. And we need more of that. So I love that you’re here. So tell me about you and what you’re in your work, you know? How are you doing to add value to the ecosystem? You’re you’re an author, you’re a physician. You do so much. But tell me how exactly you believe this is your biggest contribution of your work and how how that’s impacted health.

Chris Gibbons:
Yeah, sure. Thanks. So health care, as we all know, has some really serious and intractable problems. I mean, we do some amazing things. We saved lives of millions of people every year. So health care does an amazingly wonderful things. At the same time, it has some serious problems. Those amazing things don’t reach everyone equally. There are many who cannot access those things virtually at all. We’re not often. And even for those who can access them, the system often doesn’t work well for them. You’ve probably heard, as I’ve heard, many of the leaders, particularly in the tech world, that are that are driving diving into health care. Now, people who like Huli, Google and Apple and other places talk about how they have had bad experiences with the health care system and they should be able they can afford anything. And so what? As I’ve looked at these problems from being on the inside, working in health care and realizing what everybody else is, realizing, that we are not making a lot of progress in fixing some of these large intractable problems. I got to the point where I said, you know what? Well, I think we need to apply the definition of insanity here. If we’re going to keep doing the same thing and expecting different results, we’re not going anywhere. And so I challenge myself to start looking at things differently and trying to come up with ideas and solutions and that perhaps others were overlooking, because at least in my view, most of the approaches that come from within the healthcare sector are only at best incremental improvements over what we’re doing and not really helping us get to where we need to go. So we had our company are thinking beyond traditional boundaries in the health sector. We’re challenging long held norms within healthcare. We’re learning from other sectors. That’s something that the health care system historically has not done. Healthcare sort of prides itself on teaching others, but being more complicated or more technical than other sectors. And so others have to learn from us. We don’t learn from them. We’re taking a very opposite approach. We think there’s a lot you can learn from other sectors and then apply to health care and overcome some challenges that others have experience. And so we’re learning from other sectors. We’re applying insights to health and we’re creating new visions of health and care delivery in a way to help us overcome these historic challenges and create opportunities for new advances in ways that, quite frankly, were not previously possible.

Saul Marquez:
This is fantastic. So as we think about what makes what you do different or better than what’s available, I love to take a dive into that and talk to us about that from the perspective of either you as a physician or with the company that you that you run.

Chris Gibbons:
You know they because they blend together. I mean, who I am and what I use at the company or kind of one in the same in large part, I think. So what makes us different than what’s out today? Maybe three or four things. I’d say one, we’re not afraid to fail. And in fact, over the years, we failed a lot. I failed personally. My company has failed in a few things. But I think if you’re not afraid to fail, you’re never going to accomplish anything that is significantly different than what we’ve been doing before. None of us have the ability to see the future. None of us have the ability to predict the future or know what’s going to work. So if we play it safe all the time, we’re never going to try something that might not work in the quest for something that will work better. And so we’re not afraid to fail and we use it as a learning point. I think it was Thomas Edison who said he tried to make a light bulb and fail 10000 times and the reporter asked him one day about that. So I didn’t fail. I just found 10000 ways in which it wouldn’t work. And he just kept going. And so we have that same attitude. I think second thing is we seek opportunities really in areas deemed worthless or impossible by others. I mean, that’s not to say that you can’t have other kinds of things, but I think at least in some of the areas where other people aren’t looking. There is gold to be found. There’s diamonds to be found. But because we believe it’s not there, we don’t look. And again, I go back to Tony Hansberry and add Kelvin Doe. Nobody’s going to look to Sierra Leone to come up with anything astounding for the world. Nobody thinks a 15 year old could do something that could change medical practice. Yet they both did. So, we tend to look in areas and in populations and in solutions that others are not typically working in. That’s another reason why we fail a lot. But when we succeed tends to be much bigger successes. I think third, we have a uniquely diverse, highly trained team of experts, all Johns Hopkins trained. Finally, we simply don’t give up. We’re just not going to. I just refuse to accept the notion that this can’t be improved or this can’t be changed or some people can’t do X or Y. We just simply won’t give up. And, you know, I think those things make this unique. And we’ve been able to accomplish some things using that formula and we’re proud of it.

Saul Marquez:
Now, that’s brilliant. So a lot of what we’ve discussed so far has been really around perspective, an and mindset and culture and values, right. that that drive your work. I’d love to just hone in a little bit on maybe and maybe some care points or particular areas that you guys are looking to influence or make a difference in. Would you care to touch on anything in there?

Chris Gibbons:
Yeah. So I can tell you some of the things that we have done. Maybe one or two things we’re doing and maybe we’re hoping to do in the future.

Saul Marquez:
Sounds great.

Chris Gibbons:
We have through the work that I have done personally through Hopkins were through the company. We really pushed science in general to new heights in how scientists look at the world around us in populations. Several years ago we published a paper that had a new concept in it that I saw. It was not going to go anywhere, it was going to get ridiculed, but it’s actually taken off. And that’s when we called it popular. And we were already visiting the role of computers and in technology to be prominent. And we said, you know what? I looked at other sectors in computer technology, absolutely revolutionized, revolutionized other sectors outside of the health care system. And I said there’s no reason to believe that it won’t do that in the health sector as well, not just in medical practice, but in public health and other worries. And I said, if we embrace this early, we might be able to create whole new ways of looking at things, of analyzing things. And we came up with this term popular mix as a fusion of population sciences, medicine and informatics and postulated that it’s relying heavily on to early, but enabling us to go to places where we couldn’t go before. And although we didn’t call it such it, we really believe we published several papers about it, the theoretic basis, etc etc. We believe it formed the foundation for a lot of what’s called precision medicine now a precision public health, even A.I. in health care. And there are many people at places like NIH and others who a lot of this as a as an advance. So we’ve pushed the sources of waste to new heights, as we’ve suggested here. We’ve pushed medical practice. One of the things that I did during my full-Time time at Johns Hopkins was to find a way to integrate what’s commonly known now as community health workers as an integrated part of a medical team. I wasn’t the first person to explore community health workers. I wasn’t the first person to even use them to help deliver care to patients. I think we were among the first to really integrate them into the medical care team at a tertiary academic medical center such as Johns Hopkins. And that was no small undertaking. And now that I’m no longer running that program, those programs and those workers are still going forward is still being utilized and expanding because the system because the outcomes of patients are being improved by it. And so we push medical practice beyond typically just looking at medical professionals and using them within the care team. We’ve pushed EMR design. Some of the early work we did in the company really said, hey, you actually can make these EMR is better, not because I say it’s better, but again, we went to the literature that most in health care were ignoring and didn’t know about. We went to the computer science and human factors and ergonomics literature and wrote reports, federal reports that are out there and available. Now it’s saying, hey, if you learn something about how to design computers from the guys who’ve been doing it for a while, you can design these things much better. And so we got a lot of interest in those those things. So those are some of the things that we’ve done in the past. Right now, we are working on something that we think is very exciting. Most people with whom the health care sector, who are thinking about and working in the space of innovation and trying to improve things are working from the perspective of trying to improve medical care or the practice or what doctors and nurses do terribly important. I’m all for it. I get it. I’m a doctor. So that’s important. However, again, sort of thinking the way I do, I think that the work that we’ve done leads us to believe that there are at least two other ways that technology could help us improve the health care sector beyond medical practice. And the more work that I do in this area, I’m beginning to believe and I think a growing number of people are also that these other areas, at least one of them, but maybe both of them are even the impact they could have or is even bigger than the impact you can have by changing what doctors do. And so those other two areas are the patient experience in healthcare. And the third one is the organization and delivery of health care aside from what two doctors do. So where is health care being delivered? When is it being delivered? How is it being delivered? I think in some ways is going to impact health care much more than the advances that we make with medical practice. And some of this is becoming obvious down in the early days when I started talking about this. It was harder for people to see. But now we’re seeing health care not just happen in clinics and in doctors’ offices and in hospitals, but we’re seeing that happening in retail stores like CVS and like Walgreens. And we’re hearing in Wal-Mart. Exactly. And we’re hearing Amazon just launching a totally virtual clinic. There is no brick and mortar anywhere. You’d never get sent to any brick and mortar anywhere. Now, in none of those cases are those companies changing what doctors do in terms of diagnosis and screening. But they are changing how it’s being delivered, where it’s happening, when it’s happening. And that is having a profound impact on what doctors do. And so we believe that this area is going to continue to expand in very significant ways. And one of the one of the ways that we can talk about later that I think it’s going to be extremely important to this is what we are calling smart care and smart cities and how they come together and impact the organization and delivery of care and ultimately what doctors do. And then ultimately, the last thing I’ll mention is in the future, we believe that our work will have some impact on not just the organization and delivery of care, not just the practice of care and patient experience, but even the financing of health care. And that’s been the holy grail Right.. That’s been the hardest thing to change in health care. And I’ll just say this. It is my belief that in the future it is possible, I don’t know for sure if it will happen, but I can see that we’re already moving in that direction and that some of the things that we do might contribute to that today. Health insurance is a primary way that most health care is paid for. I think that may well change. That may well change in the future. I’m not suggesting that health insurance will go away, entirely…

Saul Marquez:
Where would it shift to?

Chris Gibbons:
Well, I thought let me give you an example of what’s already happening. We don’t even have to talk about what I think. So since that day, medicine was boring back whenever that was until just about a couple of years or a year and a half ago, if you needed if you were having heart problems and needed a basic test that every cardiologist and many primary care doctors do to evaluate your heart, that’s the EKG, you had to go to a hospital or a doctor’s office or clinic of some kind. The technicians would put the 12 leaves on your on your body, on your chest, not your legs or thighs. They would turn the machine on. The strip would run. That strip would then be given to the doctor to read and evaluate. And you would be called back in or told right then what they found and go for it. The insurance company would be billed. The doctor would get a portion of that. The hospital gets a portion of that. The technician gets paid all that right. That was the only way you could get that done from the day medicine was born and that that was invented until recently. Today we have an Apple Watch that according to the FDA, not according to me. But according to the FDA can give you an EKG tracing that is equivalent. It’s an FDA approved EKG tracing through your Apple Watch simply by pressing the button. Anytime you want to. No insurance company involved at all, Apple is getting paid. That’s then that. And then the money right off the table of health care and putting it into the pockets of Apple already…

Saul Marquez:
In this particular situation. Dr. Gibbons, it’s very interesting. Sax, son of bars there for a second, because you mentioned a lot of really interesting things. A lot of really interesting ideas, areas of care that you guys are impacting. And in this particular example with EKG, they’re really not I guess they’re adding this value, but they’re not actually charging. Or are they or they’re just charging for the device, right?

Chris Gibbons:
You asked me how things are changing. Exactly. They’re not charging today, but they get paid when you buy the watch.

Saul Marquez:
Absolutely.

Chris Gibbons:
So they’re not getting paid for it, right? Oh, yes. So I’m saying new models of care lead to new opportunities for financing the care that’s delivered through the new models of care. And they don’t need insurance. They’re getting paid enough through window to help with the price point of the watch that justifies them doing it. Now, tomorrow, they may go to CMBS to say, hey, we need to be paid more for these E.K.G. That would be a bonus. Right. And it’s going to be hard to argue that that EKG is any different than the one that’s also FDA approved that we do in the doctor’s office. So I don’t know how health care is going to deal with that. And then and then if they do approve it, you do get paid. Does Apple get paid every time you press the button or once a day or how does that work? I don’t know. Big problem. They’ll have to deal with it. But the point is, Apple is getting paid for something that only physicians in the health care system used to do. And it’s not involving health insurance right now.

Saul Marquez:
That’s interesting. I love that perspective. And folks here listening to this and you’re like, wow, that’s actually a really good point. I feel the same way. So, Chris, you know, we think about I mean, even today, Right., like, I look at my cell phone and I forget what book it was. I think the book was called Bold, but they had a spreadsheet and there is a list of items, a camera, a calculator, a word processor, all these things. Right. And it says back in the day, if you bought all these things separately, it would be like, you know, something like five thousand dollars or even more. It was like fifty thousand dollars. And today it’s all on your phone. You know, it’s like. And so what what is the future? Software is eating healthcare. Is that what’s happening?

Chris Gibbons:
Well, there are a lot of people that are.. That that’s what’s going to happen. I think my position is that software and hardware with software is definitely going to change medicine. There’s no question about it. There’s no way to avoid it. Look at every other sector in which technology and software hardware has come into play. It’s absolutely revolutionized those industries. And the biggest thing has changed is the business models in those industries. And why do we think that’s not going to happen in health care? It’s actually, I think, ridiculous to think that it won’t. When we look at every other health, every other sector, and it has happened. So given that, I think at a minimum, it is at least worth our while to figure out, figure it out. So things will change? Yes, things will change. But you will still need people in the new world use. We don’t need doctors in the new world. They’ll just be doing different things. So the idea that all doctors will need to go away because a computer will do it, I don’t think is the right way of looking at who’s going to develop the algorithms for the A.I.. Who’s going to be overseeing things with that don’t fit in nicely into the algorithms that are there. There are many new opportunities and new jobs and new things that doctors, nurses and other medical professionals who used to do different things can do and will be needed to do so. It’ll be a change. But I don’t know that it will mean that we don’t need doctors anymore.

Saul Marquez:
Yeah, no, I totally agree with you. What would you say is is one of the biggest setbacks you’ve experienced then? What was the key learning out of that?

Chris Gibbons:
Yeah, I’ve had a lot of them. I think one is. So while I was there, the Urban Health Institute at Johns Hopkins for almost 15 years, and during that time I was reading some programs to develop and come up with new models of care to help people living in urban inner city. Obviously very poor as poverty, poor health outcomes. And at first I was both daunted and excited to take on this challenge. No one else that really did that. This was a new position. So no one else had formerly had a similar position like this. And I said, well, you know, we’ve got to start and go out and talk to people in the community and sort of get their perspectives. And as I began to do that, two things happened. One, at first there was excitement by many of the people that were in the community, were largely African-American. And if you can’t tell already, I’m African-American, too. So they were excited because usually if someone did come out to talk to them, it wasn’t an African-American Right.. And so they said, wow, this is great. This is great. So that’s all good. But the second part was, you know, I was there to do my best, to make a difference, to help fix it. And I had some ideas. Some of them were Right., some overall. What what some not all. Some of the people saw this as their opportunity to get back at the system that had been doing them wrong. And now they saw it as one of them there so that I would help them get back at the system that had done them wrong. But that wasn’t why I was there. That was not what I was going to do. And it’s not what I did. And so those same people that I was trying to help, some of them rejected me. And that was very hard for me because I said, wait a minute, I’m one of you, I’m trying to help you, but we can’t do things that we all know aren’t right. It won’t get us there. But that took me for a loop for a while. But I still was in that position. I still was committed to trying to figure out how to make a change. And so it helped me both mature and look at problems differently and look at and try to strategize how to overcome what seems to be intractable failure and or barriers that are not going to go. Now, I’ve got people fighting against me, the very people who I’m trying to help and in some cases have sought solutions where they’re rejecting them, not because they’re bad, but it’s because of me and I’m not doing what they want me to do. That was a very formative area of my life and helped me sort of think through and approach challenges and seeing things that other people couldn’t see and really has changed the rest of my career since then.

Saul Marquez:
Yeah. You know, when you get surprised with sort of one expectation, something different happens. How you react and what you do really makes a difference.

Chris Gibbons:
Yeah, absolutely. Absolutely.

Saul Marquez:
So as you think about today, Dr. Gibbons, what would you say is the most exciting thing that you’re working on? What are you most excited about?

Chris Gibbons:
Wow. Great question. There are a lot of things that excite me these days. I think the opportunity, the potential of technology and health care at a high level is something that excites me. But even within that even within that excitement, we have a potential challenge. If the benefits that we believe cannot be attributed to advances in technology are not evenly distributed in society, then we could have a situation where some parts of the population are benefiting more than the others or benefiting and the other part isn’t benefiting. And so that’s some of the same problems we have now will have and maybe even get bigger in this new world if we don’t find ways to enable everyone to benefit from what advances in technology have to offer. So the challenge is still before us. And so I’ve been thinking about this for a long time. And one of the ways that I think that we can address this problem, which I’m very excited about, is by a concept that’s been out there a little bit. But but by modifying it with a view and this is the notion of smart city. So a smart city, there’s many definitions for them all across the world. No unified sort of definition. But the things that sort of characterize them is that there is a notion that there would be a widespread availability of an broadband connections to all the residents who live in that area. It doesn’t have to just be a city. It can be a community, can be a rural area. It can be anywhere but that broadband internet is available to everyone in the area at that services then be delivered through those services could be government services. It could be all kinds of variety of things. Well, I think that that that’s a powerful concept. Now, I’ve looked at many of the smart cities proposals and things that are going on around the world. Most of them do not consider, yes, it’s relatively new. Don’t focus on health explicitly in any significant detail. There are a number that do mention wellness or health, but it’s very superficial, at least as best I can tell, in how they are attacking healthy focus on, you know, transportation pretty heavily. They focus on carbon footprint pretty heavily. They focus on delivering government services efficiently, pretty heavily lighting those kinds of things. But when it comes to health and health care, it’s much more superficial, at least in my view. But I think the potential not just for smart cities in those areas, but smart cities for health and through making is a term that we again, the model that we do call smart care is actually profound. If you take the model to be what it is that we will set up a situation where everybody has access to broadband in that live in the city. Then you have as a starting point, then you have just solved probably the single biggest barrier to some people benefiting from what technology has to offer because you can have a smartphone. But if you don’t have are able to afford or to connect to the Internet, that smartphone is a dumb phone. You can’t do anything for you. It’s not it’s really not the phone. That’s the innovation, the greatest innovation. It’s the broadband network that it connects to and the apps that flow over it, essentially. And that’s often the hardest part. Whether you’re talking about rural communities or you’re talking about inner city urban communities, they just can’t afford or don’t have access to a reliable broadband network. Now, as I’ve been all over this country and I’ve seen in low income rural and urban areas where kids, you know, education is going online now, you don’t turn in paper and pencil homework is submitted online. Well, there are kids that will stay on the bus just riding the bus until it’s night, nighttime. And the bus has to be part because that’s the only place they get Internet or sitting outside on the ground in front of their school because they can catch the Wi-Fi that’s coming out of the school to try to do their homework before it gets dark because they can’t afford it at home. So if you start with a smart cities foundation, that is i.e. getting broadband networks available to everyone, you’ve solved the single biggest problem right there. The next thing is then how do we get everybody connected to it? And how do we how do we deliver the services they need to improve their health? And so I think that a tremendous opportunity going forward is to bring health care into the smart cities arena in a very significant way – number one. And then start building services, not just medical care, clinical care services, but all the types of services that people may be to get healthy and stay well, social services. There’s a whole variety. And we have the opportunity we have the ability to do that. Right now, we are standing for the first time in the history of the world, probably where we can eliminate the problem of the hard to reach. We can reach just about everybody through technology. Even the poorest countries in the world have leapfrogged and now offer wireless technologies to most of their residents. So we can reach you. We just have to now figure out what to do with you in order to help you improve your health. And the answer again is not just going to go to a clinic. It’s going to be services that are going to be delivered 24/7 on demand at the point of need where ever that patient is. And that’s what we call smart care. We’ve got some work that we’re doing in this area. So this is the thing that’s exciting me now and we are working with the group to begin talking on working with a group to stand up the first smart care, smart city community, which is very, very exciting.

Saul Marquez:
That’s very exciting. And it goes back to that where, when and how that we start off the conversation with, right..

Chris Gibbons:
Yep.

Saul Marquez:
And Chris, it’s it’s I keep thinking about this. I mean, it doesn’t have to be difficult. I mean, a gigabit connection is 80 bucks a month. Why can’t you just prescribe it and have Medicare-Medicaid fund it? I mean, it’s nothing compared.

Chris Gibbons:
I think you’re hitting the nail right on the head there. Once you have a vision of what needs to happen, then you can think about ways to do it. And all of a sudden now there are a number of ways we could actually do this.

Saul Marquez:
Yeah

Chris Gibbons:
Right. But if you believe it’s not possible, you’re not even thinking about that. And that is one way it could be done. I can think of at least three or four others. But the point is, it’s not going to happen unless we begin to have the vision for it and start working towards it.

Chris Gibbons:
Love it. What a great conversation with Dr. Gibbons today. I know if you’re not thinking about the future, maybe you weren’t listening. It just hit the rewind button and you’ll be able to get some of the tidbits that we we touched on with Chris. Just incredible thought leader in the space. And it’s very exciting that to hear that physicians like him are working to improve access, build smarter communities and really help advance our health care system in our lifetime, not in the next lifetime. What’s your favorite book, Chris?

Chris Gibbons:
That’s a that’s a tough one. I got several. But I think with respect to this conversation, it’s probably the Innovator’s Dilemma by Clay Christensen that many people have read. And unfortunately, he died last week, which is a which is unfortunate. But that book is truly transformational in my life and undergirds all that I think about all that I do in health care now.

Saul Marquez:
What a great recommendation there. And Chris, this has just been an enlightening conversation. I appreciate the work that you do and and the difference that you’re making. Before we conclude, I love if you could just share a closing thought with the listeners and the best place that they could reach out to you if they want to continue the conversation.

Chris Gibbons:
Yeah, sure. You know, I heard a comment, a quote sometimes, and honestly, I’ve forgotten who said it. So I’m not trying to take any attribution from anybody, but it says that “everything is impossible until the first person does it”. And that’s what that’s what we’re trying to do. And we believe that a lot more is possible, particularly in those areas in health care. There have been and believed to be impossible. And come join us in the journey. Probably the easiest way to get in touch with me is through LinkedIn. I’m on LinkIn Chris Gibbons, MD, MPH And I’m also on Twitter, @mcgibbons. And those are probably the easiest ways to get in touch with.

Saul Marquez:
Outstanding. Dr. Gibbons, really appreciate your your insights and your leadership and looking forward to continuing the conversation another time.

Chris Gibbons:
Thanks so much. It’s been a pleasure.

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