Dr. Colletti and I had the great honor of being invited to travel to Claremont, California to receive the Drucker Prize on behalf of every person working to support the mission of ImproveCareNow. The ceremony was a small gathering in Peter Drucker’s modest home, which now serves as an archive of his work. I wanted to share my comments from the event.


“Being part of the health care system today is very challenging. Pressures in many ways have never been greater. Our health care outcomes are worse than many other developed countries. Thirty percent or more of physicians experience burn out. And the research system is inefficient. The average NIH clinical trial enrolls one patient/site/month. The costs of care are remarkably high. In this setting, well-meaning leaders have resorted to programs of cost reduction and centralized control.

It is an honor beyond words, for me to be able to speak with you today as a representative of the entire ImproveCareNow Community. As I was thinking about my remarks, it brought to mind Thomas Edison’s words – inspiration, perspiration and a third validation.

The inspiration for ImproveCareNow grew out of a transformative idea by a very humble but very bold man – Paul Miles. Paul is a general pediatrician who was VP for Quality at the American Board of Pediatrics. He led the Board’s efforts to develop what’s called maintenance of certification. The Board’s concept is that being Board certified should mean more than just passing a test. Physicians ought to be able to tell their patients, ‘here’s the outcome you can expect, based on the last 1000 patients like you that I saw.’  We’ve heard this concept stated differently by Dr. Colletti who likes to say that the care that a patient gets is not just dependent on how smart the physician is, or how much the physician cares; the care depends on the system that the physician works in.

So our team designed a system that would have three parts: the systematic collection of data and open sharing across sites; the sharing of knowledge across sites; and the development of technical tools that sites needed to do this work and continue improving. And ImproveCareNow was the prototype.

When we started ImproveCareNow, no one believed we could raise the rate of remission; that we could impact outcomes.  It was a leap of faith. So our emphasis was to focus on learning as fast as we could. Our aspiration is to be the best at getting better…and that requires a lot of perspiration.

It’s not intuitive that you could create a system built off the normal motivation that people have. We are always asked how ICN can “get physicians to change” and how we find these unusual patients who want to contribute. It has, to many, seemed like a very unusual idea. Some have called it impossible. But it’s not. We’re all motivated by a shared desire to produce the best outcomes we can for our patients and to live the healthiest lives possible.

The receipt of this award also raises the stakes for us. As improvers we always seek opportunities to get better. We learned a lot through the process of applying for this award. It helped us identify some areas where we need to focus our attention to continue to build a more effective and impactful model for the future.

The validation of receiving the Drucker Prize is important not so much for our work, but for advancing the idea that networks are a valid model for creating value in health care. Paul Miles believed that every child with a serious illness deserved to be cared for by a system like ImproveCareNow. We hope that this award will inspire others to devote the time and effort, to offer their best energies, and even to perspire a little bit, and to continue to build a better, more participatory model of health care. Health care in which everyone can be part of the solution."


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