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Brainstorm Health: Jamie Dimon on Atul Gawande, Walmart Blockchain Patent, Diabetes Vaccine

June 22, 2018, 3:10 PM UTC

Word that surgeon and scribe Atul Gawande had been named the new CEO of the mystery health venture launched by JPMorgan Chase, Amazon, and Berkshire Hathaway was met with what seemed to be a thunderclap of applause on the Interwebs—and, yes, by me too. Gawande, who is retaining most of his other ho-hum day jobs—general and endocrine surgeon at Brigham and Women’s Hospital, feature writer for The New Yorker, Harvard professor, and think tank thinker—will start shaping this “independent,” Boston-based, not-explicitly-for-profit, corporate health venture in two and a half weeks. Which means we’ll probably have to wait another two and a half weeks (and then some) before we get the first clues as to what the new boss has in mind.

But Brainstorm Health readers, happily, don’t have to wait to get some inside skinny on why Gawande got the job—and what his initial marching orders are. What’s more, you can hear such news directly from one of the gents who hired him: JPMorgan Chase CEO Jamie Dimon.

Here’s what Dimon had to say about Gawande yesterday afternoon, when I inelegantly barged into an interview my colleagues were conducting with the influential Fortune 500 CEO on another important topic:

“We interviewed quite a few people. [Berkshire Hathaway investment manager] Todd Combs [who also sits on the board of JPMorgan Chase & Co., and who has been helping to lead the effort] did most of that. But I did some. Warren [Buffett] did some. And Gawande was kind of always at the forefront. We wanted to make sure we thought about everybody, and thought about the issues. And if you know Atul, you know he’s got a big brain and a big heart. He has a huge work ethic. He’s trustworthy. And obviously no one’s going to have [all the background you might] want for a position like that. But, basically, all we want to do is get going—get him involved in the process. Let him hire a team. Let the team start looking at what we all do, and then we want them to be creative in what they pluck out. We have a million ideas—and we’ve got ideas from all around the world. And we’re going to share some of that with him. But then we’re going to say, ‘Look, after all of this, figure out how you want to go about tackling this problem.’ Start with something that’s workable. And Jeff [Bezos] always gives the advice: Take out a piece, and just crack that one piece. And then crack another piece, and not try to boil the ocean all at once. And then, also, there may be a lot of things we simply test. So we’ve got a real long-term view. I think one of the competitive things here is that we hope to be doing this a long time. We’re not looking for immediate success. We think that would be a mistake. And Atul has done some of this on his own, by the way. He’s already fairly knowledgeable about some of the flaws in the health care system—and potential fixes.”

(Yes, that came out in one blisteringly quick, single-breath cascade.)

As Dimon says, Gawande’s knowledge about the flaws in, and potential fixes for, the health care system, runs deep. And all of it, importantly, derives from real-world experience, not a textbook.

At Ariadne Labs, the innovation center he cofounded in 2012 (which is jointly operated by the Brigham and the Harvard T.H. Chan School of Public Health), Gawande and his colleagues pioneered several hospital safety protocols that are now used around the world and which are credited with preventing an untold number of deaths. Some of these straightforward guidelines—which Gawande dubs “checklists”—are designed to systematically reduce, for instance, avoidable errors before, during, and after surgery. (Roughly half of all surgical complications are thought to be preventable, according to various studies.)

Another Ariadne checklist helps care givers eliminate much of the needless risk in childbirth. (Though rates of maternal mortality have dropped sharply over the past two decades, according to the World Health Organization, an estimated 830 women still die every day from preventable causes during pregnancy or childbirth.)

“We said at the outset that the degree of difficulty is high and success is going to require an expert’s knowledge, a beginner’s mind, and a long-term orientation,” declared Amazon CEO Jeff Bezos in the press statement announcing Gawande’s hire.

“Atul,” he said, “embodies all three.”

Enjoy the weekend, everyone.

Clifton Leaf, Editor in Chief, FORTUNE


Walmart just got a blockchain patent for medical records. Have you heard about this thing called "blockchain"? The digital ledger technology has enraptured businesses all across the spectrum, from food to banking to, of course, health care. And in an intriguing nexus of business and newfangled tech, Walmart has secured a patent for a blockchain-driven system that stores medical records and can be used by first responders to pull up the data in the case of an emergency. "According to the patent, first responders would scan the device to access an encrypted private key. They would decrypt that using the biometric identifier and, with a second public key, retrieve the victim’s records," reports Healthcare Dive. You might remember that Walmart is in early stage talks to potentially acquire health insurer Humana, a company with which it already has a substantial relationship. (Healthcare Dive)


Could we prevent type 1 diabetes? A (very) early stage study suggests that a common tuberculosis vaccine could help ward off the causes of type 1 diabetes, according to research published in the journal Nature. What's truly remarkable is the patient population the treatment was targeted at—people who had had the disease for years and even decades. "Nobody thought you could intervene with an immunotherapy in people 10, 20 years out. To have data showing durability for 8 years, without revaccination, is remarkable," said study lead Dr. Denise Faustman, director of the MGH Immunobiology Laboratory. (Fortune)

The trouble with flu vaccines. The Food and Drug Administration (FDA) is out with some pretty lukewarm reports about Flucelvax, a different kind of flu vaccine that involves growing the virus in animal cells rather than utilizing chicken eggs (as conventional jabs do). But the shots only had about 26.5% effectiveness and weren't exactly stellar at keeping people older than 65 (who are particularly susceptible to flu) out of the hospital, WTOP reports. This year was a rough one for flu vaccinations—a difficult enterprise to begin with given that scientists essentially have to guess which strains will dominate a given flu season.


"Food" aid in Puerto Rico. Puerto Rico has grappled with unimaginable troubles in the wake of Hurricane Maria. And, as NPR notes, the struggles spread to essential humanitarian efforts such as food aid—George Washington University researchers examining food at a FEMA distribution center in the area found that "11 of the 107 different food items in the warehouse were candy and chips, including M&Ms and Twizzlers." What's worse is that the fruits and veggies provided to survivors consistently exceeded recommended portions of sugar and salt. (NPR)


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Produced by Sy Mukherjee

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