Warren

Initially, there was such an issue of getting data. And in the early 2000s, it was getting simple data, which is much less of a problem now. Now it’s getting into the queue for Epic. And where is your project on the queue? And can you actually get the IT people to do it? And that’s when getting juice can help you. And even at one point for the later ones, we said, we’re going to work on the projects that you have listed as one of your quality measures for CMS. And they would like that. But that was less important than some of the hospital-based ones. But getting data, the kind of data problem, there’s always data problems. It’s just that they’ve gradually increased in scope as we’ve gone on.

Jeremy

Part of the dynamic may be slightly different from the higher ed environment. Warren and his group went to the payers’ health plans. It’s as if you guys in higher education go to the banks and say, hey, you’re funding these colleges. We want to make them better. Come give the money to us. I think is provocative. Warren, you might have been the only network that had a very clinical practice focus. It made natural sense to go to the plans. But I don’t know that many networks have done that.

Warren

We also had the Department of Public Health in both states and AHEC. And they were there at the beginning. They varied a lot in their financial investment, but the fact that they were all behind it was helpful at the beginning, because a lot of it is the activation energy to begin with. And then if it works well, the costs go down and the group has the desire to keep on doing it.

I think getting that public support across sectors is important. I can see some of the analogies to higher education, Dr. Bergquist, but how do you get that which was helpful for one health system to be used by other systems. The North Carolina Department of Health said that they’re in it and they’re helping with this training. That was helpful.

Mitch

I’m loving what I’m hearing. I particularly appreciate Warren coming back to the matter of social connection. This is critical. The sense of safety is absolutely necessary. Yeah, we have to have this critical mass, but really we have to have a culture of working together. It’s probable and likely that more sharing get done at lunch or at dinner or the coffee break or whatever. It is where people are socializing, where people are talking, where relationships are built. And I think that’s left out of so much literature. I think that may be where 70, 80% of the real innovation and the real transformation takes place. And I think we’ve lost that; but, Warren, I love that you keep coming back to that. I think that’s critical. My tagline when I was directing the ICU—which was really about running a team–was that culture eats strategy for lunch. And I still really believe that.