Tom Lawry may be best-known as a leading voice on AI in health care; after all, he’s written two very well-selling books on the topic, speaks all over the world on the subject, and in his most recent company-based gig helped lead Microsoft’s efforts in AI in health care and life sciences.

When his publisher asked him to write a third book on AI in health care – still a hot topic in publishing – Tom said he’d rather turn to a subject long on his mind: the state of health care in America and how to change the conversation on health policy to involve all citizens.

And if he can help to kick-off that conversation for mainstream people – then he knows, “the future is calling and it’s better than you think” – which is the tagline to book’s title, Health Care Nation.

 

 

 

 

 

 

 

 

I spent time discussing the book with Tom, now that book has been published. I wrote the foreword for the book, having read an early galley copy, so I was keen to catch up with Tom on this pivot in his publishing persona. We started with the premise of the book, which evolved as Tom had been traveling all over the world advising health care providers, business, and government agencies.

The pivot from AI to health policy

“I’ve had the opportunity to work around the world with health systems. I just came back from Australia and before that, was in Singapore. In all my travels I have never found a country or health system that say they have everything figured out” for their healthcare system.

But, Tom hastens to add that in the U.S., health care is more politicized that anywhere else in the world (to which I would add the UK’s National Health Service, based on my own experience working in that environment).

Rosa Parks and the Butterfly Effect of citizen engagement

I point to Chapter 16 in the middle of the book, a section titled “The Butterfly Effect Takes Flight.” It’s one of my favorite chapters in Health Care Nation as Tom connects the social movement dots starting with Margaret Mead (talking about “that small group of thoughtful, committed citizens that can change the world,”) to Edward Lorenz’s chaos theory – also known as “The Butterfly Effect.”

And then Tom calls on the role of civil rights hero Rosa Parks.

In fact, “the premise of the whole book,” Tom explains, “is that I wonder what Rosa Parks had for breakfast” the day she started a civil rights revolution.” Rosa actually didn’t try and start a revolution when she refused to give up her seat on the bus. But she was fed up with a system that ignored her needs.

With that one act, a Butterfly Effect was put in motion.

And that’s what Tom hopes can happen in the U.S. when fed up patients, families, physicians, nurses and health citizens all find their voices.

At the same time, one of biggest challenges for changing health care in America today is that, in Tom’s words, “we have to stop politicizing health. I want citizens to find their voices and express what’s important – not just my voice or any one voice but the collective wisdom of citizens to have the debate about the U.S. health care system and what people want from it.”

That led to the question, so what can a Health Care Nation book do to inspire these voices to become a collective flywheel in a Butterfly Effect?

The mentor-nuns who demonstrated values-driven leadership

“I’ve been many things in my career,” Tom reminded me, but always in and around health care.” In the earliest part of his career path, Tom was a young health executive at a 500-bed hospital that was part of a faith-based, Catholic health care system. Over 12 years, Tom ran hospitals in Catholic health groups and was inspired by his early mentors – who were Catholic nuns in control of running these hospitals. “In my early 20s, my mentors were these religious women who were the best at demonstrating values-driven leadership,” and that stuck, Tom confessed.

“I’ve always believed that health care was a noble cause, which is why I am in it.”

From hospital management to health-tech – which is not a panacea for health care transformation

After his hospital management journey, Tom joined the dot-com technology world and crossed over into business intelligence, then morphing into AI – and, “now I’m in the cool kid crowd instead of being a tech nerd,” he joked.

 

 

 

 

 

 

 

“When I think about it, AI has the ability to help transform the way health and how medicine works, and we are seeing that play out. But at the next level, even if all the promises of AI for health care applications come true, tech would make health care a little more effective and less wobbly a little longer, but fundamentally AI won’t fix the elements driving the U.S. health care system toward failure,” Tom cautions.

“Everyone in healthcare is trying their best to work within a system that has wacky financial incentives that were never designed to actually be a system,” Tom observed. He succinctly quoted the great broadcaster Walter Cronkite, who said that, “The American health care system is neither healthy, nor caring, nor a system.”

In updating Cronkite’s observation, Tom invokes the concept of “America’s largest escape room: we put our clinicians, executives, suppliers, and patients in an escape room with $4.7 trillion of cash, and folks can’t find their way out.”

Four pillars of prescription

“If you were Health Care King or Merlin the Health System Magician, what would you do?”

I asked Tom to “pick one” change that might kick off the flywheel that could improve U.S. health care for all citizens, for one Health Care Nation.

Not surprisingly, Tom just couldn’t pick “one,” but left me and us with four issues for which he hopes U.S. health citizens will find their collective voices:

First, do you believe health care should be a right to all health citizens in the U.S.? If so, what should the rights and responsibilities include?

Second, can we re-design U.S. healthcare away from a break-fix model to fund greater prevention up-stream, and prevent avoidable diseases for those health citizens?

Third, how can we finance health care to move away from cost-shifting into a more rational economic model, turning away from Whac-a-mole health care allocations? And,

Fourth, “can we move away from hospital-centered care to systems of health?” Tom asked. In this pillar, Tom is thinking about health care’s role in improving the environment, in bolstering peoples’ access to healthy food systems, and to enabling healthy communities.

“That, across these four questions, is to me the prescription going forward,” Tom recommended.

 

 

 

 

 

 

This is not your mother’s health care reform book

Tom laid out the roadmap for his book, chapter by chapter, asking questions at the end of each to inspire each of us to find our inner voices on a variety of health care system issues, from health care costs and financing to paying for prevention versus “the break-fix model” and food-as-medicine.

“Before I started writing Health Care Nation, I reviewed at least 50 books that had been written in past decade on topic of ‘health care reform,’” Tom explained. “You will not find me talking about health care reform – which has become a trigger phrase that immediately starts the political discourse that has marred constructive dialogue for the past couple of decades,” he believes.

Tom’s book is different, he says, first and foremost because he does not play a “blame game” in the 150+ pages of the publication. “The purpose of my books is not to blame any one stakeholder or organization in health care.” Instead, Tom’s intent is to identify the underlying factors that cause our health care system to under-perform, under-deliver, and over-cost.

“I believe that we are looking for a Rosa Parks moment for health care,” Tom envisions.

Health Care Nation is available on Amazon, Audible, and wherever you like to get your books. Let’s find our collective voice for health care citizenship.