Tom Peters Toward Healthcare Excellence Version'23January2006

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Tom Peters Toward Health(care)
Excellence!Version.23January2006
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Slides at tompeters.com
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Health(care) Seven Main Messages1.
Quality (Error reduction/ Evidence-based
Medicine)2. Healthcare vs. Health (Wellness
Prevention)3. Models of Excellence
available4. Life sciences (Singularity)5.
Dubai as global/unique/insanely great
Center of Excellence6. Avian flu7. Africa
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Manifesto(s)
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!!!!!!!!!!!!!Healthcare vs Health
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TPs Healing Wellness
Manifesto2006(1) Acute-care facilities are
killing fields. (WE KNOW WHAT TO DO.)(2)
Shift the community focus 90 degrees (not
180, but not 25) from fix it to prevent
it. (WE KNOW WHAT TO DO.)(3) There are three
primary aims for all this
Wellness-Healing-Health. (WE KNOW WHAT TO
DO.)(4) Im mad as hell and Im not going to
take it anymore. (I KNOW WHAT TO DO.)
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• 
  Toms Rant2006
• Hospital quality control, at least in the
  U.S.A., is a bad, bad joke Depending on whose
  stats you believe, hospitals kill 100,000 or so
  of us a yearand wound many times that number.
  Finally, they are getting around to dealing
  with the issue. Well, thanks. And what is it
  weve been buying for our Trillion or so bucks a
  year? The fix is eminently do-able which makes
  the condition even more intolerable. (Disgrace
  is far too kind a label for the condition.
  Whos to blame? Just about everybody, starting
  with the docs who consider oversight from anyone
  other than fellow clan members to be
  unacceptable.)
• 2. The systemtraining, docs, insurance
  incentives, culture, patients themselvesis
  hopelessly-mindlessly-insanely (as I see it)
  skewed toward fixing things (e.g. me) that are
  brokennot preventing the problem in the first
  place and providing the Maintenance Tools
  necessary for a healthy lifestyle. Sure,
  bio-medicine will soon allow us to understand and
  deal with individual genetic pre-dispositions.
  (And hooray!) But take it from this 63-year old,
  decades of physical and psychological self-abuse
  can literally be reversed in relatively short
  order by an encompassing approach to life that
  can only be described as a Passion for Wellness
  (and Well-being). Patientslike meare catching
  on in record numbers but the system is highly
  resistant. (Again, the doctors are among the
  biggest sinnersno surprise, following years of
  acculturation as the man-with-the-white-coat-who-
  will-now-miraculously-dispense-fix
  it-pills-and-surgical-incisions-for-you-the-unwash
  ed. (Come to think of it, maybe Ill start
  wearing a White Coat to my doctors officeafter
  all, I am the Professional-in-Charge when it
  comes to my Body Soul. Right?)

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BIGGEST DEAL OF ALL
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!!!!!!!!!!!!!Healthcare vs Health
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TP Recce 1Dubai Healthcare City to Dubai
Health CityCleveland Clinic and Canyon Ranch
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Quality COULD IT TRULY BE THIS AWFUL?
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When I climb Mount Rainier I face less risk of
death than Ill face on the operating table.
Don Berwick, Six Keys to Safer Hospitals A Set
of Simple Precautions Could Prevent 100,000
Needless Deaths Every Year, Newsweek (1212.2005)
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CDC 1998 90,000 killed and 2,000,000 injured
from hospital-caused drug errors infections
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HealthGrades/Denver 195,000 hospital deaths per
year in the U.S., 2000-2002 390 full
jumbos/747s in the drink per year.Comments
This should give you pause when you go to the
hospital. Dr. Kenneth Kizer, National Quality
Forum. There is little evidence that patient
safety has improved in the last five years. Dr.
Samantha CollierSource Boston Globe/07.27.04
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Welcome to the Homer Simpson Hospitala/k/a
The Killing Fields
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1,000,000 serious medication errors per year
illegible handwriting, misplaced decimal points,
and missed drug interactions and
allergies.Source Wall Street
Journal/Institute of Medicine
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YE GADS! New England Journal of Medicine/
Harvard Medical Practice Study 4 error rate (1
of 4 negligence). Subsequent investigations
around the country have confirmed the ubiquity of
error. In one small study of how clinicians
perform when patients have a sudden cardiac
arrest, 27 of 30 clinicians made an error in
using the defibrillator. Mistakes in
administering drugs (1995 study) average once
every hospital admission. Lucian Leape,
medicines leading expert on error, points out
that many other industrieswhether the task is
manufacturing semiconductors or serving customers
at the Ritz Carltonsimply wouldnt countenance
error rates like those in hospitals.
Complications, Atul Gawande
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RAND (1998) 50, appropriate preventive care.
60, recommended treatment, per medical studies,
for chronic conditions. 20 chronic care
treatment that is wrong. 30 acute care treatment
that is wrong.
19
Various studies 1 in 3, 1 in 5, 1 in 7, 1 in 20
patients harmed by treatment Demanding
Medical Excellence Doctors and Accountability
in the Information Age, Michael Millenson
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In a disturbing 1991 study, 110 nurses of
varying experience levels took a written test of
their ability to calculate medication doses.
Eight out of 10 made calculation mistakes at
least 10 of the time, while four out of 10
made mistakes 30 of the time.Demanding
Medical Excellence Doctors and Accountability
in the Information Age, Michael Millenson
21
20 not get prescriptions filled50
use meds inconsistentlySource Tom
Farley Deborah Cohen, Prescription for a
Healthy Nation
22
In health care, geography is destiny.Source
Dartmouth Medical School 1996 report
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Geography Is DestinyOften all one must do to
acquire a disease is to enter a country where a
disease is recognizedleaving the country will
either cure the malady or turn it into something
else. Blood pressure considered treatably high
in the United States might be considered normal
in England and the low blood pressure treated
with 85 drugs as well as hydrotherapy and spa
treatments in Germany would entitle its sufferer
to lower life insurance rates in the United
States. Lynn Payer, Medicine Culture
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Geography Is DestinyE.g. Ft. Myers 4X
Manhattanback surgery. Newark 2X New
Havenprostatectomy. Rapid City SD 34X Elyria
OHbreast-conserving surgery. VT, ME, IA 3X
differences in hysterectomy by age 70 8X
tonsillectomy 4X prostatectomy Breast cancer
screening 4X NE, FL, MI vs. SE, SW. (Source
various)
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A healthcare delivery system characterized by
idiosyncratic and often ill-informed judgments
mustbe restructured according to evidence-based
medical practice.Demanding Medical Excellence
Doctors and Accountability in the Information
Age, Michael Millenson
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Without being disrespectful, I consider the U.S.
healthcare delivery system the largest cottage
industry in the world. There are virtually no
performance measurements and no standards. Trying
to measure performance is the next revolution
in healthcare.Richard Huber, former CEO, Aetna
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Practice variation is not caused by bad or
ignorant doctors. Rather, it is a natural
consequence of a system that systematically
tracks neither its processes nor its outcomes,
preferring to presume that good facilities, good
intentions and good training lead automatically
to good results. Providers remain more
comfortable with the habits of a guild, where
each craftsman trusts his fellows, than with the
demands of the information age.Michael
Millenson, Demanding Medical Excellence
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As unsettling as the prevalence of inappropriate
care is the enormous amount of what can only be
called ignorant care. A surprising 85 of
everyday medical treatments have never been
scientifically validated. For instance, when
family practitioners in Washington State were
queried about treating a simple urinary tract
infection, 82 physicians came up with an
extraordinary 137 strategies.Demanding Medical
Excellence Doctors and Accountability in the
Information Age, Michael Millenson
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Most physicians believe that diagnosis cant be
reduced to a set of generalizationsto a
cookbook. How often does my intuition lead
me astray? The radical implication of the Swedish
study is that the individualized, intuitive
approach that lies at the center of modern
medicine is flawedit causes more mistakes than
it prevents. Atul Gawande, Complications
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Deep Blue Redux 2,240 EKGs 1,120 heart
attacks. Hans Ohlin (50 yr old chief of coronary
care, Univ of Lund/SW) 620. Lars Edenbrandts
software 738.Only this time it matters!
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Dr Larry Weed/POMR (problem-oriented medical
record)/Etc Its impossible to keep up with
the avalanche of knowledge. Therefore its
essential to use a valid diagnostic-decision aid
like Larrys Neil de Crescenzo, VP Global
Healthcare/IBM Consulting There is no other
profession that tries to operate in the fashion
we do. We go on hallucinating about what we can
do. Dr Charles Burger (using Weeds software
for 20 years)
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Probable parole violations Simple model (age,
of previous offenses, type of crime) beats M.D.
shrinks. 100 studies Statistical formulas gt
Human judgment. In virtually all cases,
statistical thinking equaled or surpassed human
judgment. Atul Gawande, Complications
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PARADOX Many, many formal case reviews failure
to systematically/ systemically/ statistically
look at and act on evidence.Source
Complications, Atul Gawande
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Genius Required?
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Leapfrog Group
CPOE/Computerized Physician Order
EntryICU staffing by trained
intensivistsEHR/Evidence-based Hospital
Referral
Source HealthLeaders
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The Benefits of FOCUSED EXCELLENCE
Shouldice/Hernia Repair 30-45 min, 1
recurrence. Avg 90 min, 10-15
recurrence.Source Complications, Atul Gawande
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About Time!100,000 Lives CampaignDon
Berwick/Institute for Healthcare Improvement
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Whats your name? Whens your birthday?
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Hospitals Pay Appropriate
Attention To Medical ErrorsYes .
1Aware and Trying Hard ... 8Aware But
Tepid Response 22No ... 25An
Inexcusable Tragedy .. 44Source 12.2005
Poll/tompeters.com
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Attention/ Being There Job One!
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You Your Calendar
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You must be the change you wish to see in the
world.Gandhi
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The Necessary IS/Web REVOLUTION
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We all live in Dell-WalMart-eBay-Google World!
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We almost all live in Dell-WalMart-eBay-Goog
le World!
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Some grocery stores have better technology than
our hospitals and clinics. Tommy Thompson, HHS
SecretarySource Special Report on technology
in healthcare, U.S. News World Report (07.04)
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Computerized Physician Order Entry/CPOE 5 of
U.S. hospitalssource HealthLeaders/06.02
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Henry Lowe, U. of Pitt. School of Medicine
Broadband, Internet-based, multimedia
electronic medical records
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Telemedicine E.g. HANC Home Assisted
Nursing CareBP, ECG, pulse, temp, etc
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Telemedicine Reduces days/1000 patients and
physician visits for the chronically
illDecreases costs of managing chronic
diseaseExpands service areas for
providersReduces travel costs to and from
medical ed seminarsSource Douglas Goldstein,
e-Healthcare
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Our entire facility is digital. No paper, no
film, no medical records. Nothing. And its all
integratedfrom the lab to X-ray to records to
physician order entry. Patients dont have to
wait for anything. The information from the
physicians office is in registration and vice
versa. The referring physician is immediately
sent an email telling him his patient has shown
up. Its wireless in-house. We have 800
notebook computers that are wireless. Physicians
can walk around with a computer thats
pre-programmed. If the physician wants, well go
out and wire their house so they can sit on the
couch and connect to the network. They can review
a chart from 100 miles away. David Veillette,
CEO, Indiana Heart Hospital (HealthLeaders/12.2002
)
52
Healthvs Healthcare
53
Healthvs Healthcare
54
Healthvs Healthcare
55
Healthvs Healthcare
56
Sanitary revolution mortality in major cities
down 55 between 1850 and 1915Source Tom
Farley Deborah Cohen, Prescription for a
Healthy Nation
57
Gwen former healthcare exec has wonderful
health insurance and an abundance of healthcare.
What Gwen does not have is health. And there is
nothing our health system can do to give it to
her. The battle cry is always health, but in
fact the struggle has always been over
healthcare. For all its inspiring, high-tech
cures, medicine is just not very effective at
curing our eras major killers. Medicine
doesnt do much chronic disease. When the
most common killers of our era are mostly
incurable and our preventive treatments pretty
feeble, you have to wonder about medical care as
a whole. There is a widely held view that
medical care contributes little to health. (John
Bunker/ Journal of the Royal College of
Physicians) Source Tom Farley Deborah Cohen,
Prescription for a Healthy Nation
58
Smoking, excess drinking, lack of exercise,
shitty diet 40 of deathsSource Tom Farley
Deborah Cohen, Prescription for a Healthy Nation
59
Our mistake is not that we value medical
carebut that we have misunderstood what it can
and cannot do.Source Tom Farley Deborah
Cohen, Prescription for a Healthy Nation
60
Curve ShiftingSource Tom Farley Deborah
Cohen, Prescription for a Healthy Nation
61
Bump into factor Extra-size portions, eat
more. Higher shelf space snacks, more
obesity. More liquor stores, more crime. High
vs low fat Japanese who emigrate to U.S. suffer
3X increase in heart disease.Source Tom Farley
Deborah Cohen, Prescription for a Healthy Nation
62
Context Change The Most Powerful Force (??)
Wastebaskets Japan v U.S. Christchurch NZ v
Sydney AUSBroken windows
63
10 Sardinians, Adventists, OkinawansDont
smoke. Put family first. Be active every day.
Keep socially engaged. Eat fruits, vegetables,
whole grains. Other nuts, red wine, pecorino
cheese, small portions.Source National
Geographic (National Institute on Aging),
November 2005
64
An estimated 60 to 90 percent of doctor visits
involve stress-related complaints.
Newsweek/09.27.2004
65
Wellness
66
The curative model narrowly focuses on the
goal of cure. From many quarters comes evidence
that the view of health should be expanded to
encompass mental, social and spiritual
well-being. Institute for the Future
67
Ontario To Split Health Ministry Headline/
Globe And Mail /06.05 (New ministry will focus on
Prevention/ Wellness/Eldercare)
68
Savior for the Sickvs. Partner for Good
Health Source NPR
69
Companies Step Up Wellness Efforts Rising
health costs provide incentive to promote
healthier employee lifestyles headline/USA
Today/08.05
70
Prevention Program At Dow Chemical Aims To Save
Money IBD/08.05
71
Sprint/Overland Park KS Slow elevators, distant
parking lots with infrequent buses, food court
as poorly placed as possible, etc.Source
New York Times
72
Toms Story
73
Obesity/-79(-36) BP (140-85 to 90-60) Blood
sugar (180-87) Blood chemistry (normal)
Cholesterol (140-58) Metabolic rate/RMR (250)
Mental state (dramatic improvement)
74
FixesDiet (eg small portions, slow
down)Extreme exercise!MeditationDietary
supplementsNo alcohol(Psychotropic meds/others
reduced)(No work reduction)
75
Aging reversal!!!!Why wasnt I informed
until age 59?
76
Determinants of HealthAccess to care
10Genetics 20Environment 20Health
Behaviors 50Source Institute for the Future
77
Planetree A Radical Model for New
Healthcare/Healing/Health/Wellness
Excellence It can be done!
78
It was the goal of the Planetree Unit to help
patients not only get well faster but also to
stay well longer. Putting Patients First,
Susan Frampton, Laura Gilpin, Patrick Charmel
79
Much of our current healthcare is about curing.
Curing is good. But healing is spiritual, and
healing is better, because we can heal many
people we cannot cure. Leland Kaiser,
Holistic HospitalsSource Putting Patients
First, Susan Frampton, Laura Gilpin, Patrick
Charmel
80
The Nine
Planetree Practices1. The Importance of Human
Interaction2. Informing and Empowering Diverse
Populations Consumer Health Libraries and
Patient Information3. Healing Partnerships The
importance of Including Friends and Family4.
Nutrition The Nurturing Aspect of Food5.
Spirituality Inner Resources for Healing6.
Human Touch The Essentials of Communicating
Caring Through Massage7. Healing Arts Nutrition
for the Soul8. Integrating Complementary and
Alternative Practices into Conventional
Care9. Healing Environments Architecture and
Design Conducive to HealthSource Putting
Patients First, Susan Frampton, Laura Gilpin,
Patrick Charmel
81
1. The Importance of Human Interaction
82
There is a misconception that supportive
interactions require more staff or more time and
are therefore more costly. Although labor costs
are a substantial part of any hospital budget,
the interactions themselves add nothing to the
budget. Kindness is free. Listening to patients
or answering their questions costs nothing. It
can be argued that negative interactionsalienatin
g patients, being non-responsive to their needs
or limiting their sense of controlcan be very
costly. Angry, frustrated or frightened
patients may be combative, withdrawn and less
cooperativerequiring far more time than it would
have taken to interact with them initially in a
positive way. Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
83
Press Ganey Assoc/1999 139,380 former patients
from 225 hospitals0 of top 15 factors
determining Patient Satisfaction referred to
patients health outcomePS directly related to
Staff InteractionPS directly correlated with ES
(Employee Satisfaction)Source Putting
Patients First, Susan Frampton, Laura Gilpin,
Patrick Charmel
84
Perhaps the simplest and most profound of all
human interactions is KINDNESS. But if it is so
simple, it is surprising how frequently it is
absent from our healthcare environments. Many
staff members report verbal abuse by
physicians, managers and coworkers. Putting
Patients First, Susan Frampton, Laura Gilpin,
Patrick Charmel
85
Planetree is about human beings caring for other
human beings. Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel (Ladies
and gentlemen serving ladies and gentlemen4S
credo)
86
2. Informing and Empowering Diverse Populations
Consumer Health Libraries and Patient
Information
87
Planetree Health Resources Center/1981Planetree
Classification SystemConsumer Health
LibrariansVolunteersClasses, lecturesHealth
FairsGriffins Mobile Health Resource
CenterOpen Chart PolicyPatient Progress
NotesCare Coordination Conferences (Est goals,
timetable, etc.)Source Putting Patients First,
Susan Frampton, Laura Gilpin, Patrick Charmel
88
3. Healing Partnerships The Importance of
Including Friends and Family
89
When hospital staff members are asked to list
the attributes of the perfect patient and
family, their response is usually a passive
patient with no family. Putting Patients First,
Susan Frampton, Laura Gilpin, Patrick Charmel
90
The Patient-Family ExperiencePatients are
stripped of control, their clothes are taken
away, they have little say over their schedule,
and they are deliberately separated from their
family and friends. Healthcare professionals
control all of the information about their
patients bodies and access to the people who can
answer questions and connect them with helpful
resources. Families are treated more as intruders
than loved ones. Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
91
Family members, close friends and significant
others can have a far greater impact on
patients experience of illness, and on their
long-term health and happiness, than any
healthcare professional. Through the Patients
Eyes
92
A 7-year follow-up of women diagnosed with
breast cancer showed that those who confided in
at least one person in the 3 months after surgery
had a 7-year survival rate of 72.4, as compared
to 56.3 for those who didnt have a
confidant.Institute for the Future
93
Institute of Medicine/ Crossing the Quality
ChasmRespect for preferencesInvolvement in
Decision MakingAccess to careCoordination of
careInformation and educationPhysical
comfortEmotional supportInvolvement of Friends
and FamilyContinuity of careSource Putting
Patients First, Susan Frampton, Laura Gilpin,
Patrick Charmel
94
Care Partner Programs (IDs, discount meals,
etc.)Unrestricted visits (Most Planetree
hospitals have eliminated visiting restrictions
altogether.) (ER at one hospital has a policy
of never separating the patient from the family,
and there is no limitation on how many family
members may be present.)Collaborative Care
ConferencesClinical Guidelines
DiscussionsFamily SpacesPet Visits (POP
Patients Own Pets)Source Putting Patients
First, Susan Frampton, Laura Gilpin, Patrick
Charmel
95
4. Nutrition The Nurturing Aspect of Food
96
Meals are central eventsvsThere, youre
fed. Irony Focus on nutrition has
reduced focus on food and serviceSource
Putting Patients First, Susan Frampton, Laura
Gilpin, Patrick Charmel
97
KitchenBeautiful cutlery, plates, etcChef
repSource Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
98
Aroma therapy (eg smell of baking
cookies)Source Putting Patients First,
Susan Frampton, Laura Gilpin, Patrick Charmel
99
5. Spirituality Inner Resources for Healing
100
Spirituality Meaning and Connectedness in
Life1. Connected to supportive and caring
group2. Sense of mastery and control3. Make
meaning out of disease/find meaning in
sufferingSource Putting Patients First,
Susan Frampton, Laura Gilpin, Patrick Charmel
101
6. Human Touch The Essentials of Communicating
Caring Through Massage
102
Massage is a powerful way to communicate
caring. Putting Patients First, Susan Frampton,
Laura Gilpin, Patrick Charmel
103
Mid-Columbia Medical Center/Center for Mind and
BodyMassage for every patient scheduled for
ambulatory surgery (Go into surgery with a good
attitude) Infant massageStaff massage (caring
for the caregivers)Healing environments
chemo!Source Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
104
7. Healing Arts Nutrition for the Soul
105
Planetree Environment conducive to
healingColor!Light!Brilliance!Form!Art!Mu
sic!Source Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
106
8. Integrating Complementary and Alternative
Practices into Conventional Care
107
Griffin IMC/Integrative Medicine
CenterMassageAcupunctureMeditationChiropracti
cNutritional supplementsAroma therapySource
Putting Patients First, Susan Frampton, Laura
Gilpin, Patrick Charmel
108
CAM (Complementary Alternative Medicine) 83M
in US (42)CAM visits 243M, greater than to PCP
(Primary Care Physician) (With min insurance
coverage)W-Educated-Hi incDont tell PCP
(40)And lt30 procedures used in conventional
medicine have undergone RCTs (randomized clinical
trials) Source Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
109
Conclusion Caring/Growth Experience
110
Care!Control!Connect! Engage!Grow!
De-stress!
111
9. Healing Environments Architecture and Design
Conduciveto Health
112
Planetree LookWoods and natural
materialsIndirect lightingHomelike
settingsGoals Welcome patients, friends and
family Value humans over technology .. Enable
patients to participate in their care Provide
flexibility to personalize the care of each
patient Encourage caregivers to be responsive
to patients Foster a connection to nature and
beautySource Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
113
Access to nurses stationHappen
tovsHappen withSource Putting Patients
First, Susan Frampton, Laura Gilpin, Patrick
Charmel
114
Learn more about Planetree/ The Planetree
Alliance www.planetree.org
115
Life Sciences Revo Rocks Our WorldComing soon
to a
116
On February 12, 2001, anyone with access to the
Internet Could suddenly look at a new atlas
One containing the whole human genome.
Source Juan Enriquez, As The Future Catches You
117
WE ARE BEGINNING TO ACQUIRE DIRECT AND
DELIBERATE CONTROL OVER THE EVOLUTION OF ALL
LIFE FORMS ON THE PLANET.Source Juan
Enriquez, As The Future Catches You
118
GRIN Genetics, Robotics (nanotech), Information,
NanotechSource Radical Evolution The Promise
and Peril of Enhancing Our Minds, Our Bodiesand
What It Means to Be Human, Joel Garreau
119
We face the biggest change in tens of thousands
of years in what it means to be human. In
just 20 years the boundary between fantasy and
reality will be rent asunder. (Rodney Brooks,
AIL/MIT) We are at an inflection point in
history. It is about the defining cultural,
social, and political issue of our age. It is
about human transformation. Source Radical
Evolution The Promise and Peril of Enhancing Our
Minds, Our Bodiesand What It Means to Be Human,
Joel Garreau
120
Ray Kurzweil Singularity
121
415-page doc, Department of Commerce/NSF
Converging Technologies for Increasing Human
Performance Source Radical Evolution The
Promise and Peril of Enhancing Our Minds, Our
Bodiesand What It Means to Be Human, Joel Garreau
122
Soldiers having no physical, physiological, or
cognitive limitations will be key to survival and
operational dominance in the future. Michael
Goldblatt, Director, Defense Sciences
Office/DARPASource Radical Evolution The
Promise and Peril of Enhancing Our Minds, Our
Bodiesand What It Means to Be Human, Joel Garreau
123
Singularity/Bionic Tom, circa 2006 Medtronic
pacemaker (heart micro-management)
psychotropics (mental micro-management) Google
(mind-extensionsmart-beyond-measure) Samsung
cell phone (instant-permanent planetary
connectedness) Orvis shirt (smart skin)
124
If you dont like change, youre going to
like irrelevance even less. General Eric
Shinseki, Chief of Staff. U. S. Army
125
H5N1
126
Kroll/SARS dont over-reactKroll/H5N
1 devastatingSource Newsweek/10.24.05
127
Health(care) Seven Main Messages1.
Quality (Error reduction/ Evidence-based
Medicine)2. Healthcare vs. Health (Wellness
Prevention)3. Models of Excellence
available4. Life sciences (Singularity)5.
Dubai as global/unique/insanely great
Center of Excellence6. Avian flu7. Africa
(Hats off to Bill Melinda Bono)