Notes

Chapter 1

1. For the history of the founding of Cleveland Clinic, see John D. Clough, To Act as a Unit: The Story of the Cleveland Clinic (Cleveland: Cleveland Clinic Press, 2005).

2. Merritt Hawkins, Review of Physician Recruiting Incentives: An Overview of the Salaries, Bonuses, and Other Incentives Customarily Used to Recruit Physicians (2012), http://www.merritthawkins.com/uploadedFiles/MerrittHawkins/Pdf/mha2012incentivesurveyPDF.pdf.

3. Data derived from Centers for Medicare & Medicaid Services Case Mix Indices, as reported on the American Hospital Directory website, www.ahd.com.

4. U.S. Government Accounting Office, “Technology Transfer, Administration of the Bayh-Dole Act by Research Universities,” Report to Congressional Committees, May 7, 1978.

Chapter 2

1. Theodore Roosevelt, “Citizenship in a Republic” (address, l’Université Paris-Sorbonne, Paris, April 23, 1910), accessed March 30, 2015, http://www.theodore-roosevelt.com/trsorbonnespeech.html.

2. Biotech Industry Organization, The Economic Contributions of University/Nonprofit Inventions in the United States: 1996–2010 (2012), accessed March 26, 2015, https://www.bio.org/articles/economic-contribution-universitynonprofit-inventions-united-states-1996-2010.

3. Association of University Technology Managers (AUTM), U.S. Licensing Survey (2013), accessed May 25, 2015, http://www.autm.net/FY_2013_Licensing_Activity_Survey/15156.htm.

Chapter 3

1. Vilfredo Pareto (1848–1923), an Italian economist, published Cours d’économie politique in 1896, describing that 80 percent of the land in his native country was held by 20 percent of the population. His hypothesis came from noting that 20 percent of the pea pods in his garden produced 80 percent of the crop. “Pareto Principle,” Wikipedia, last modified April 7, 2015, accessed April 8, 2015, http://en.wikipedia.org/wiki/Pareto_principle.

2. The Global Healthcare Innovations Alliance is discussed in detail in Chapter 6.

3. Jeff Dyer, Hal Gregersen, and Clayton M. Christensen, The Innovator’s DNA: Mastering the Five Skills of Disruptive Innovators (Boston: Harvard Business Review Press, 2011).

4. Tom Kelley and Jonathan Littman, The Ten Faces of Innovation: IDEO’s Strategies for Defeating the Devil’s Advocate and Driving Creativity Throughout Your Organization (New York: Currency/Doubleday, 2005).

5. Dyer et al., 11.

6. Henry Doss, “Five Ways Incentives Kill Innovation,” Forbes, December 19, 2013.

7. Kristen Grabarz, “Want Tenure at Penn? Be Innovative,” The Daily Pennsylvanian, November 12, 2014.

8. Kelley and Littman, 75–77.

Chapter 4

1. The Global Healthcare Innovations Alliance is discussed thoroughly in Chapter 6.

2. For additional information on Cleveland Clinic’s institute structure, see Toby Cosgrove, The Cleveland Clinic Way (New York: McGraw-Hill, 2013), 38–44.

Chapter 5

1. Diana Furchtgott-Roth and Harold Furchtgott-Roth, Employment Effects of the New Excise Tax on the Medical Device Industry (Washington, D.C.: Advanced Medical Technology Association, July 2011), accessed September 9, 2015, http://advamed.org/res.download/290.

2. Paul N. van de Water, Excise Tax on Medical Devices Should Not Be Repealed (Washington, D.C.: Center on Budget and Policy Priorities, February 23, 2015), accessed September 9, 2015, http://www.cbpp.org/sites/default/files/atoms/files/2-14-12health.pdf.

3. Estimated Revenue Effects of Division I of H.R. 4, the “Jobs for America Act” (Washington, D.C.: Joint Committee on Taxation, Congress of the United States, September 17, 2014), Publication JCX-105-14, accessed September 9, 2015, www.jct.gov/publications.html?func=startdown&id=4672. The Joint Commission’s initial estimate in March 2010 overestimated the revenue raised by the tax.

4. Frank Papay, “The Challenges Facing Medical Device Companies,” in The Medical Innovation Playbook (Cleveland: Cleveland Clinic Innovations, 2013): 70–81.

5. James Manyika, Michael Chui, Brad Brown, Jacques Bughin, Richard Dobbs, Charles Roxburgh, and Angela Hung Byers, Big Data: The Next Frontier for Innovation, Competition, and Productivity (San Francisco: McKinsey Global Institute, 2011).

6. http://data.worldbank.org/indicator/SH.XPD.PCAP.

7. Frank Lichtenberg, Benefits and Costs of Newer Drugs: An Update (Cambridge, Massachusetts: National Bureau of Economic Research, June 2002), Working Paper 8996, accessed September 9, 2015, http://www.nber.org/papers/w8996.

8. Ibid.

9. Kevin M. Murphy and Robert H. Topel, “The Value of Health and Longevity,” Journal of Political Economy 114, no. 5 (2006): 871–904.

10. Ross DeVol, Armen Bedroussian, et al., An Unhealthy America: The Economic Burden of Chronic Disease—Charting a New Course to Save Lives and Increase Productivity and Economic Growth (Santa Monica, California: The Milken Institute, October 2007).

11. Isaac Ehrlich and Gary S. Becker, “Market Insurance, Self-Insurance, and Self-Protection,” Journal of Political Economy 80, no. 4 (July–August 1972): 623–648.

12. Darius Lakdawalla, Anup Malnani, and Julian Reif, The Insurance Value of Medical Innovation (Cambridge, Massachusetts: National Bureau of Economic Research, 2015), Working Paper 21015, accessed September 9, 2015, http://www.nber.org/papers/w21015.

Chapter 6

1. Peter Drucker, Innovation and Entrepreneurship: Practice and Principles (New York: Harper and Row, 1985). Excerpted in “The Discipline of Innovation,” Harvard Business Review 80, no. 8 (August 2002): 95–100, 102, 148. Drucker’s seven sources of innovation are unexpected occurrences, incongruities, process needs, industry and market changes, demographic changes, changes in perception, and new knowledge.

2. In addition to Drucker, I owe homage to the Hungarian author Frigyes Karinthy, from whose 1929 short story came the “six degrees of separation” concept. Frigyes Karinthy, Everything Is Different (Hungary: 1929).

3. Chad T. Wilson, Elliott S. Fisher, H. Gilbert Welch, Andrea E. Siewers, F. Lee Lucas, “U.S. Trends in CABG Hospital Volume: The Effect of Adding Cardiac Surgery Programs,” Health Affairs 26:1 (2007): 162–168.

4. “Our Values at Work,” International Business Machines Corporation, accessed February 19, 2015, http://www.ibm.com/ibm/values/us/.

5. Breast Cancer Facts & Figures 2013–2014 (Atlanta: American Cancer Society, 2014).

6. For further information, see http://www.medicalinnovationplaybook.com/.

Chapter 7

1. Donald Hebb was the first to suggest that the “efficiency” of a given neuron, in contributing to the firing of another, could increase as that cell is repeatedly involved in the activation of the second. Thus, the basic tenet of Hebbian learning in neural networks is that “units that fire together, wire together.” Donald O. Hebb, The Organization of Behavior (New York: Wiley, 1949). Cited in Yuko Munakata and Jason Pfaffly, “Hebbian Learning and Development,” Developmental Science 7:2 (2004): 141–48.

2. Jessica Leber, “Economist Proposes a $30-Billion Megafund for New Cancer Drugs: A Hedge Fund Manager Aims to Solve the Funding Problems Facing Early-Stage Biomedical Research,” MIT Technology Review, November 19, 2012. See also Jose-Maria Fernandez, Roger M. Stein, and Andrew W. Lo, “Commercializing Biomedical Research Through Securitization Techniques,” Nature Biotechnology 30 (September 30, 2012): 964–75.

Chapter 8

1. Frans Johansson, The Medici Effect: Breakthrough Insights at the Intersection of Ideas, Concepts, and Cultures (Boston: Harvard Business Review Press, 2004).

2. See Peter Relan, “90% of Incubators and Accelerators Will Fail and That’s Just Fine for America and the World,” Tech Crunch (blog), October 14, 2012, http://techcrunch.com/2012/10/14/90-of-incubators-and-accelerators-will-fail-and-why-thats-just-fine-for-america-and-the-world/. See also Tim Devaney and Tom Stein, “Startup Accelerator Fail: Most Graduates Go Nowhere,” Readwrite (blog), June 21, 2012, http://readwrite.com/2012/06/21/startup-accelerator-fail-most-graduates-go-nowhere and Eilene Zimmerman, “Assessing the Impact of Business Incubators,” in You’re the Boss: The Art of Running a Small Business (blog), New York Times, August 12, 2013, http://boss.blogs.nytimes.com/2013/08/12/assessing-the-impact-of-business-incubators/?_r=0.

3. Michael Porter, “Clusters and Competition: New Agendas for Companies, Governments, and Institutions,” Harvard Business School Working Paper, No. 98-080, March 1998.

4. Joe Andre, Ziona Austrian, and Matthew Hrubey, The Cleveland Health Tech Corridor: An Analysis of Economic Trends, 2000–2011 (Cleveland: Cleveland State University, Maxine Goodman Levin College of Urban Affairs, 2012).

5. Brie Zeltner, “Cleveland Clinic Worth $12.6 Billion to Ohio, Report Says,” Plain Dealer, April 30, 2015.

Chapter 9

1. For further reading on the venture philanthropist class, see Matthew Bishop and Michael Green, Philanthrocapitalism: How the Rich Can Save the World (New York: Bloomsbury Press, 2008); Joel L. Fleishman, The Foundation: A Great American Secret; How Private Wealth Is Changing the World (New York: Public Affairs, 2007); and Holden Thorp and Buck Goldstein, Engines of Innovation: The Entrepreneurial University in the Twenty-First Century (Chapel Hill: University of North Carolina Press, 2010).

2. Jamie Merrill, “Number of Global Billionaires Has Doubled Since the Financial Crisis,” The Independent, October 29, 2014, accessed online April 6, 2015, http://www.independent.co.uk/news/world/politics/number-of-global-billionaires-has-doubled-since-the-financial-crisis-9826345.html.

3. Bill Gates, “Who We Are,” Annual Letter 2009, January 2009, accessed April 6, 2015, http://www.gatesfoundation.org/who-we-are/resources-and-media/annual-letters-list/annual-letter-2009.

4. Steven Lawrence and Reina Mukai, Foundation Growth and Giving Estimates: Current Outlook (New York: The Foundation Center, 2010).

5. Stated in homage to Marshall McLuhan’s famous 1978 saying, “The medium is the message.”

Chapter 10

1. In addition to Cleveland Clinic, the Global Cardiovascular Innovation Center collaborators include Case Western Reserve University, Ohio State University, University of Cincinnati, University Hospitals Health System, and University of Toledo.

2. Jose-Maria Fernandez, Roger M. Stein, and Andrew W. Lo, “Commercializing Biomedical Research Through Securitization Techniques,” Nature Biotechnology 30 (September 30, 2012): 964–75.

3. “Where are they now?” excerpts, the Cleveland Clinic Innovations Top 10 Innovations from 2007–2015, can be found at http://innovations.clevelandclinic.org/Summit-(1)/Top-10-Innovations.aspx#.VTbQ7iFVhBc.