In today’s world—with more information, data, and devices than one can manage— healthcare institutions are collapsing under complexity. An evolutionary biologist and provocative new voice in the mold of Thomas Friedman, Malcolm Gladwell, and Jared Diamond, Costa helps such organizations find ways to quickly adapt to this high-failure environment in order to not only avoid extinction, but to thrive.
If Silicon Valley venture capitalists were trying to fix broken healthcare systems, they would invest in multiple solutions at once and expect most to fail. But they would take action. In nature, diversification ensures survival. In healthcare, too often there are big organizations that want to meet endlessly, hold focus groups, and then move tentatively, if at all, as they embark on singular solutions destined to fail at a glacial pace. Even the best brains can’t bet right all of the time. So successful venture capitalists—or health reformers—accept that they are working in a high-failure environment and they jump in to try to solve problems.
As health policy experts move forward, the key is to explore multiple solutions and measure results. Says Costa: “Having a million options is equivalent to having none. Complexity is the real issue we’re up against, and we are time impoverished.” In biology, change happens over millions of years. But our brains can’t keep up with the speed of change as a rush of data overwhelms us. So how do humans overcome a high error rate and the paralysis of too much complexity? Costa says the key is to use reason and take action—to go for failure fast.
Instrumental in introducing new technologies to General Electric, Apple, 3M, and other pioneering companies, Costa is the first thought leader to confront the ways in which the rapid pace of change in every aspect of our lives has outstripped our brain’s ability to cope. In her acclaimed book The Watchman’s Rattle: A Radical New Theory of Collapse, she explains how each individual has the ability to solve complex problems through a spontaneous intuitive flash of insight—a skill that we can harness to solve seemingly intractable problems. A former CEO and founder of one of the largest marketing firms in Silicon Valley (sold in 1997 to J. Walter Thompson), Costa developed an extensive track record of introducing new technologies. Her clients included industry giants such as Hewlett-Packard, Apple Computer, Oracle Corporation, Seibel Systems, 3M, Amdahl, and General Electric. Costa is known for marketing the world’s first computer-aided design and manufacturing systems (CAD/CAM), computer networking, and first multimedia microprocessors. She also pioneered the early markets for optical disks, Internet- based marketing, electronic engineering records retrieval, wireless keyboards, digital scanners, just-in-time inventory software, and a host of other innovations in use around the world today.
Rebecca Costa examines the complexity of the modern healthcare system and unravels, piece by piece, the reasons for the gridlock that has thwarted meaningful solutions. She presents an insightful, multifaceted approach to removing outdated economic models that prevent today’s healthcare providers from delivering the highest patient care at the lowest possible price to the greatest number of people.
Regina Holliday is a Washington, DC-based patient advocate and artist known for painting a series of murals depicting the need for clarity and transparency in medical records. This advocacy mission was inspired by her husband Frederick Allen Holliday II and his struggle to get appropriate care during 11 weeks of continuous hospitalization in five facilities. After his death from kidney cancer on June 17, 2009, she began “73 Cents,” a mural depicting her husband dying in darkness surrounded by inaccessible technological tools in a closed data loop. The title refers to the cost per page for medical records in the state of Maryland.
Holliday’s artwork became part of the national healthcare debate and was reported on in the mainstream press, as well as reviewed by such journals as BMJ and APA. She began an advocacy movement called “The Walking Gallery,” for which medical providers and advocates wear “patient story” paintings on the backs of business suits. She recently authored The Walking Wall: 73 Cents to the Walking Gallery.Backed by her own patient and caregiving experiences.
Regina Holliday travels the globe heralding her message of patient empowerment and inclusion in healthcare decision making. She fearlessly stands before officials and practitioners demanding a thoughtful dialog on the role patients play in their own healthcare.
David A. Kessler, MD, was the commissioner of the United States Food and Drug Administration (FDA) from November 1990 until March 1997, originally appointed by President Bush and reappointed by President Clinton. He has also served as the dean of the medical schools at Yale and the University of California, San Francisco and is currently a professor of pediatrics and epidemiology and biostatistics at UCSF.
As commissioner of the FDA, Dr. Kessler worked to speed up the approval of new drugs and placed high priority on getting promising therapies for serious and life-threatening diseases to patients as quickly as possible. He introduced changes in the device approval process to make it more efficient and ensure that it meets high standards. Under his direction, the FDA announced a number of new programs, including the regulation of the marketing and sale of tobacco products to children, nutrition labeling for food, user fees for drugs and biologics, preventive controls to improve food safety, measures to strengthen the nation’s blood supply, and the MEDWatch program for reporting adverse events and product problems. He emphasized strong law enforcement and created an Office of Criminal Investigation within the agency. According to The New York Times, Kessler “revitalized a beleaguered agency that had become mired in bureaucratic disarray.” The Los Angeles Times praised him for “restoring the Food and Drug Administration to what it was meant to be—an aggressive advocate for the public’s health.” And with his departure, The New York Daily News claimed that “the American people lost one of their most effective champions.”
Dr. Kessler has a wide range of experience in research, clinical medicine, education, administration, and the law. He is a 1973 magna cum laude, Phi Beta Kappa graduate of Amherst College. He received his JD degree in 1978 from The University of Chicago Law School, where he was a member of the Law Review, and his MD degree from Harvard Medical School in 1979. He did his internship and residency in pediatrics at Johns Hopkins Hospital and, in 1986, he earned an Advanced Professional Certificate from New York University Graduate School of BusinessAdministration.
From 1984 until his FDA appointment, he was the medical director of the hospital of the Albert Einstein College of Medicine in the Bronx, New York, where he held teaching appointments in the Department of Pediatrics and in the Department of Epidemiology and Social Medicine.
From 1986 until 1990, Dr. Kessler also taught food and drug law at the Columbia University School of Law in New York. He was a consultant to the United States Senate Labor and Human Resources Committee from1981 until 1984.
Dr. Kessler’s book A Question of Intent was published in January 2001. The Boston Globe called it “an intensely compelling account… a gripping tale of intrigue and high-stakes morality.” In addition, Dr. Kessler has published numerous articles in The New England Journal of Medicine, JAMA, and other major medical journals. He serves on the board of various organizations including the Elizabeth Glaser Pediatric AIDS Foundation, where he is chairman of the board, and the National Center for Addiction and Substance Abuse at Columbia University and Amherst College. He is a member of the Institute of Medicine and the recipient of the 2001 National Academy of Sciences Public Welfare Medal. His many honors have included the American Cancer Society’s Medal of Honor, the American Heart Association’s National Public Affairs Special Recognition Award, the American Federation for AIDS Research Sheldon W. Andelson Public Policy Achievement Award, the American Academy of Pediatrics Excellence in Public Service Award, the March of Dimes Franklin Delano Roosevelt Leadership Award, and the Jacobs Institute of Women’s Health Excellence in Women’s Health Award. In April 2008, Dr. Kessler was named the “2008 National Hero” by the School of Public Health at the University of California-Berkeley “for his leadership as the nation’s top drug regulator and his courage in challenging the US tobacco industry.”
Ken Segall is the author of the New York Times bestseller Insanely Simple: The Obsession That Drives Apple’s Success. As an advertising creative director, he worked closely with Steve Jobs for over 12 years spanning NeXT and Apple. Segall led the team that created Apple’s famous Think Different campaign and started Apple down the i-road by naming the iMac. He has also been a global creative director for other iconic brands, including IBM, BMW, Intel and Dell.
Currently, Segall does creative work, branding and product naming for major brands, and regularly blogs about technology and marketing.