NOTES
Introduction
1. I’ve often spoken publicly of my illness and its impact on me. See Erin Goff, “New Intermountain Healthcare CEO Talks About How He Stays Healthy,” KSL, May 18, 2017, https://www.ksl.com/article/44295268/new-intermountain-healthcare-ceo-talks-about-how-he-stays-healthy; “Building the ‘Tesla’ of Health Systems: Where Marc Harrison Plans to Take Intermountain Next,” Advisory Board, June 6, 2017, https://www.advisory.com/blog/2017/06/marc-harrison-intermountain.
2. “Dr. A. Marc Harrison Named Upcoming CEO of Intermountain Healthcare,” Business Wire, May 20, 2016, https://www.businesswire.com/news/home/20160520005866/en/Dr.-A.-Marc-Harrison-Named-Upcoming-CEO-of-Intermountain-Healthcare.
3. “Q&A: Dr. Marc Harrison’s Transition from Abu Dhabi to Intermountain,” Modern Healthcare, October 29, 2016, https://www.modernhealthcare.com/article/20161029/MAGAZINE/310299957/q-a-dr-marc-harrison-s-transition-from-abu-dhabi-to-intermountain; “White House Recognizes Intermountain Healthcare and Syapse for Their Commitment to Precision Medicine,” press release, February 2016, syapse.com, https://syapse.com/news/press-releases/white-house-recognizes-intermountain-healthcare-and-syapse-for-their-commitment-to-precision-medicine.
4. Please see the “About Us” section of our website, intermountainhealthcare.org/ about/.
5. “FDA Approves BCMA-Targeted CAR T-Cell Therapy for Multiple Myeloma,” Cancer.gov, April 14, 2021, https://www.cancer.gov/news-events/cancer-currents-blog/2021/fda-ide-cel-car-t-multiple-myeloma.
Chapter 1
1. Brené Brown, Dare to Lead: Brave Work. Tough Conversations. Whole Hearts. (New York: Random House, 2018), 142.
2. John H. Noseworthy (former CEO of Mayo Clinic), interview with the author’s research team, October 13, 2021.
3. Courtney Tanner, “In Separate Rallies, Utahns Protest Mask Mandate and Demand In-Person Classes,” Salt Lake City Tribune, July 15, 2020, https://www.sltrib.com/news/education/2020/07/15/packed-meeting-utah/; Katie Karalis, “‘No More Masks’: Hundreds Attend Anti-mask Mandate Rally in St. George,” ABC4, updated September 14, 2020, https://www.abc4.com/news/top-stories/no-more-masks-hundreds-attend-anti-mask-mandate-rally-in-st-george/.
4. Tanner, “In Separate Rallies, Utahns Protest Mask Mandate and Demand In-Person Classes.”
5. “Utah Protest Says Mask Mandates Curtail Civil Liberties,” AP, August 6, 2020, https://apnews.com/article/virus-outbreak-utah-provo-ammon-bundy-infectious-diseases-4653e5ed676d1d5fffe38037c00d833a; Ivan Pereira, “Utah Public Hearing on Schools Dismissed After Angry Parents Pack Room Without Masks,” ABC News, July 16, 2020, https://abcnews.go.com/US/utah-public-hearing-schools-dismissed-angry-parents-pack/story?id=71825487.
6. Joshua Bote and K. Sophie Will, “Hundreds Turned out for Anti-mask Protest in Utah, Which Is Being Mocked as ‘A Straight Parody’ on Social Media,” USA Today, updated September 15, 2020, https://www.usatoday.com/story/news/nation/2020/09/14/st-george-utah-anti-mask-protest-social-media/5799567002/; Claire Lampen, “This Anti-Mask Rally Is Beyond Parody,” CUT, September 14, 2020, https://www.thecut.com/2020/09/viral-utah-anti-mask-rally-clip-feels-like-a-parody.html.
7. Bob Kerrey (former Nebraska governor and senator), interview with author, October 5, 2021.
8. Seraphine Kapsandoy (chief clinical information officer at Intermountain), interview with the author’s research team, October 20, 2021.
9. Please see the about section on our website: intermountainhealthcare.org.
10. For Utah, please see “Vaccinations in Utah,” https://coronavirus-dashboard.utah.gov/vaccines.html.
Chapter 2
1. “From Disney to Doctors: The Uncommon Path of a Patient Experience Leader,” Qualtrics, September 8, 2021, https://www.qualtrics.com/blog/patient-experience-path/.
2. I’m proud to say that in May 2022, Sue Robel became the president of our Canyons (Utah and Idaho) region.
3. David Epstein, Range: Why Generalists Triumph in a Specialized World (New York: Riverhead, 2019).
4. KLAS Research, “Kevan Mabbutt, Bringing the Disney Experience to Healthcare,” YouTube video, 32.20, November 3, 2021, https://www.youtube.com/watch?v=tGZ2COP125U.
5. “From Rep. John Lewis, Quotes in a Long Life of Activism,” Washington Post, July 18, 2020, https://www.washingtonpost.com/national/from-rep-john-lewis-quotes-in-a-long-life-of-activism/2020/07/18/7ee684d8-c8b0-11ea-a825-8722004e4150_story.html.
6. Orit Gadiesh (chairman of Bain & Company), interview with the author’s research team, November 29, 2021.
7. Gail Miller (chair of the Larry H. Miller Group of Companies and former owner of the Utah Jazz basketball team), interview with the author’s research team, November 8, 2021.
8. Denitza P. Blagev, et al., “On the Journey Toward Health Equity: Data, Culture Change, and the First Step,” NEJM Catalyst, 2, No.7 (July 2021), DOI: https://doi.org/10.1056/CAT.21.0118.
9. Kathleen E. McKee (assistant professor of neurology at Intermountain Healthcare and associate medical director, Intermountain Neurosciences Patient Experience & Research), interview with the author’s research team, October 6, 2021.
10. “Intermountain Healthcare Reaches Agreement to Acquire HealthCare Partners Nevada,” State of Reform, June 21, 2019, https://stateofreform.com/news/utah/2019/06/intermountain-healthcare-reaches-agreement-to-acquire-healthcare-partners-nevada/.
11. Dr. Paul Krakovitz, MD (region president of Intermountain Healthcare in Nevada), interview with the author’s research team, November 15, 2021.
Chapter 3
1. These datapoints all appear in “Intermountain 2017—Marc Harrison, MD Message to the Community,” YouTube video, 54.28, April 7, 2017, https://www.youtube.com/watch?v=EjufyYBO8KE; “Patient Safety Movement Ranks Intermountain in Top 3 for Eliminating Preventable Deaths,” St. George News, August 9, 2015, https://www.stgeorgeutah.com/news/archive/2015/08/09/patient-safety-movement-ranks-intermountain-in-top-3-eliminating-preventable-deaths/#.Ya7LUvHMKXg.
2. These datapoints all appear in “Intermountain 2017—Marc Harrison, MD Message to the Community”; “Patient Safety Movement Ranks Intermountain in Top 3 for Eliminating Preventable Deaths.”
3. These datapoints all appear in “Intermountain 2017—Marc Harrison, MD Message to the Community”; “Patient Safety Movement Ranks Intermountain in Top 3 for Eliminating Preventable Deaths.”
4. Dr. Shannon Phillips (chief medical officer for community-based care at Intermountain and president of Intermountain Medical Group), interview with the author’s research team, October 12, 2021.
5. Rob Allen (senior vice president and chief operating officer at Intermountain), interview with the author’s research team, October 5, 2021.
6. See, for instance, Brent C. James and Lucy A. Savitz, “How Intermountain Trimmed Health Care Costs Through Robust Quality Improvement Efforts,” Health Affairs 30, no. 6 (June 2011), doi: 10.1377/hlthaff.2011.0358. For a description of the general approach, please see “Lean Healthcare: 6 Methodologies for Improvement from Dr. Brent James,” Health Catalyst (executive report), accessed May 16, 2022, https://www.healthcatalyst.com/wp-content/uploads/2021/05/Lean-Healthcare-6-Methodologies-for-Improvement-from-Dr.-Brent-James.pdf.
7. A. Scott Anderson (chair emeritus of the board at Intermountain and president and CEO of Zions First National Bank), interview with the author’s research team, November 9, 2021.
8. Dr. Shannon Phillips (chief medical officer for community-based care at Intermountain and president of Intermountain Medical Group), interview with the author’s research team, October 12, 2021.
9. Dr. Mike Woodruff (emergency room physician and senior medical director for the Office of Patient Experience at Intermountain), interview with the author’s research team, December 2, 2021.
10. Dr. Mike Woodruff (emergency room physician and senior medical director for the Office of Patient Experience at Intermountain), interview with the author’s research team, December 2, 2021.
11. Data compiled by Intermountain from third-party healthcare data collection firms.
Chapter 4
1. Cara Camiolo Reddy, MD (associate chief medical officer, clinical shared services at Intermountain Healthcare), interview with the author’s research team, December 21, 2021.
2. Rob Allen (senior vice president and chief operating officer at Intermountain), interview with the author’s research team, October 5, 2021.
3. “Intermountain Restructuring: Overview of Forces Shaping Healthcare,” Intermountain Healthcare, accessed May 17, 2022, https://intermountainhealthcare.org/about/who-we-are/trustee-resource-center/newsletter/newsletter-archive/intermountain-restructuring-overview-of-forces-shaping-healthcare/.
4. “Intermountain Healthcare Announces New Clinical Structure,” Intermountain Healthcare, accessed May 17, 2022, https://intermountainhealthcare.org/about/who-we-are/trustee-resource-center/newsletter/newsletter-archive/intermountain-healthcare-announces-new-clinical-structure/.
5. I put it similarly in “Intermountain Restructuring: Overview of Forces Shaping Healthcare.”
6. Stephen Heidari-Robinson and Suzanne Heywood, “Getting Reorgs Right,” Harvard Business Review, November 2016, https://hbr.org/2016/11/getting-reorgs-right: “According to a McKinsey survey we conducted, more than 80% fail to deliver the hoped-for value in the time planned, and 10% cause real damage to the company. More important, they can be damned miserable experiences for employees. Research suggests that reorgs—and the uncertainty they provoke about the future—can cause greater stress and anxiety than layoffs, leading in about 60% of cases to noticeably reduced productivity.”
7. This paragraph incorporates language from an internal Intermountain presentation entitled “Intermountain Operating Model.”
8. General Stanley A. McChrystal (former commander of the Joint Special Operations Command), interview with the author’s research team, December 13, 2021. Also see Stanley A. McChrystal et al., Team of Teams: New Rules of Engagement for a Complex World (New York: Portfolio, 2015).
9. “Intermountain Restructuring: Overview of Forces Shaping Healthcare.”
10. “Intermountain Restructuring: Overview of Forces Shaping Healthcare.”
11. Rob Allen (senior vice president and chief operating officer at Intermountain), interview with the author’s research team, October 5, 2021.
12. Employee review of “Intermountain Healthcare,” posted on July 2, 2018: https://www.glassdoor.com/Reviews/Employee-Review-Intermountain-Healthcare-RVW21302586.htm.
13. Ben Lockhart, “Intermountain says it eliminated 396 positions in overhaul, but added 107 new jobs,” Deseret News, August 27, 2018, https://www.deseret.com/2018/8/27/20652124/intermountain-says-it-eliminated-396-positions-in-overhaul-but-added-107-new-jobs.
14. Matthew Piper, “Intermountain Healthcare Employees Brace for More Job Cuts as Utah’s Largest Employer Readies to ‘Adapt or Die,’” Deseret News, March 19, 2018, https://www.deseret.com/2018/3/19/20641954/intermountain-healthcare-employees-brace-for-more-job-cuts-as-utah-s-largest-employer-readies-to-ada#intermountain-medical-center-in-murray-is-pictured-on-thursday-march-15-2018.
15. John Commins, “Intermountain Healthcare to Cut 250 Admin Positions to Lower Care Costs for Patients,” Healthleaders, October 14, 2020, https://www.healthleadersmedia.com/strategy/intermountain-healthcare-cut-250-admin-positions-lower-care-costs-patients; “Intermountain Healthcare Emerges with a Stronger and Focused Brand,” HR Healthcare, accessed May 17, 2022, https://hrhealthcare.wbresearch.com/blog/intermountain-healthcare-emerges-from-restructuring-strategy-for-focused-brand.
16. Franz van Houten (CEO of Philips), interview with the author’s research team, December 16, 2021.
17. General Stanley A. McChrystal (former commander of the Joint Special Operations Command), interview with the author’s research team, December 13, 2021.
18. Ben Lockhart, “Intermountain Leaders Meet to Discuss Changes; Uncertainty Remains over Affected Jobs,” KSL, March 23, 2018, https://www.ksl.com/article/46286292/intermountain-leaders-meet-to-discuss-changes-uncertainty-remains-over-affected-jobs.
19. “Intermountain Healthcare Announces New Clinical Structure,” Intermountain Healthcare, accessed May 17, 2022, https://intermountainhealthcare.org/about/who-we-are/trustee-resource-center/newsletter/newsletter-archive/intermountain-healthcare-announces-new-clinical-structure/; “Intermountain’s Reorganization Is About Providing Better Care More Consistently and More Affordably,” LinkedIn, March 26, 2019, https://www.linkedin.com/pulse/intermountains-reorganization-providing-better-care-more-robert-allen?articleId=6513865692935258112.
20. Dr. Chad A. Spain (family medicine physician at Intermountain), interview with the author’s research team, November 5, 2021.
21. “Intermountain Announces New Company to Elevate Value-Based Care Capabilities,” Intermountain Healthcare, accessed May 17, 2022, https://intermountainhealthcare.org/about/who-we-are/trustee-resource-center/newsletter/newsletter-archive/intermountain-announces-new-company-to-elevate-value-based-care-capabilities/.
22. “Episode 33: Reimagining Primary Care,” Intermountain Healthcare Podcast, accessed May 17, 2022, https://intermountainhealthcare.org/about/podcasts/intermountain-podcast-episodes/ep-33/.
23. “Fact Sheet: Covid-19 Pandemic Results in Bankruptcies or Closures for Some Hospitals,” American Hospital Association, November 2020, 1, https://www.aha.org/system/files/media/file/2020/11/fact-sheet-covid-hospital-bankruptcies-1120.pdf.
24. Sue Robel (senior vice president of clinical operations and chief nursing executive at Intermountain), interview with the author’s research team, October 8, 2021.
Chapter 5
1. Erick Ridout and Marissa Ridout, “‘Every One of These Babies I’ve Taken Care of Is a Legacy,’” StoryCorps, accessed May 17, 2022, https://intermountainhealthcare.org/about/storycorps/erick-ridout-and-marissa-ridout/. This story also draws on a presentation Dr. Ridout gave to the American Academy of Pediatrics on October 10, 2021. Note that the patient’s name is spelled “Maci” in this presentation but is spelled “Macy” elsewhere.
2. Maria Castellucci, “Fewer Tests, Treatments for NICU Babies Reduces Infections, Cuts Costs,” Modern Healthcare, April 13, 2019, https://www.modernhealthcare.com/care-delivery/fewer-tests-treatments-nicu-babies-reduces-infections-cuts-costs.
3. Dr. R. Erick Ridout (neonatologist at Intermountain), interview with the author’s research team, November 11, 2021.
4. See Christopher Cheney, “How Intermountain Reduced NICU Infections, Pain, Blood Loss,” Health Leaders, April 16, 2019, https://www.healthleadersmedia.com/clinical-care/how-intermountain-reduced-nicu-infections-pain-blood-loss.
5. Castellucci, “Fewer Tests, Treatments for NICU Babies Reduces Infections, Cuts Costs.”
6. Ridout and Ridout, “‘Every One of These Babies I’ve Taken Care of Is a Legacy.’”
7. Marc Harrison and Thomas H. Lee, “Short-Term Loss, Long-Term Gain: Encouraging Bottom-up Ideas That Revise the Value Equation,” NEJM Catalyst, Innovations in Care Delivery, February 11, 2020, https://catalyst.nejm.org/doi/full/10.1056/CAT.20.0046.
8. “Intermountain Operating Model: A Guide for Caregivers and Leaders,” Intermountain Healthcare, 2021, p. 1.
9. Dr. Erick Ridout (neonatologist at Intermountain), interview with the author’s research team, November 11, 2021.
10. Guido Bergomi (executive director at Intermountain’s office of patient experience), interview with the author’s research team, December 17, 2021.
11. Mike Woodruff, MD (emergency room physician and senior medical director for the office of patient experience at Intermountain), interview with the author’s research team, December 2, 2021.
12. Wes Johnson (paralympic coach and founder of Balanced Art Multisport in Salt Lake City, Utah), interview with the author’s research team, December 14, 2021.
13. Orit Gadiesh (chairwoman of Bain & Company), interview with the author’s research team, November 29, 2021.
14. In 2019, for instance, we implemented over 54,000. See Matt Pollard and Namita Seth Mohta, “Implementing 54,000+ Ideas in a Culture of Continuous Improvement,” NEJM Catalyst, July 28, 2020, https://catalyst.nejm.org/doi/full/10.1056/CAT.20.0455.
15. Matt Pollard, MD (vice president of continuous improvement at Intermountain), interview with the author’s research team, November 1, 2021.
16. Pollard and Mohta, “Implementing 54,000+ Ideas in a Culture of Continuous Improvement.”
17. Ronald de Jong and Freek Vermeulen, “The Strategic Transformation of Royal Philips,” London Business School Case Study, June 2021, p. 1. See also Srikant M. Datar, Rajiv Lal, and Caitlin N. Bowler, “Royal Philips: Designing Toward Profound Change,” Harvard Business School Case Study 9-118-017, November 26, 2017.
18. Frans van Houten (CEO of Philips), interview with the author’s research team, December 16, 2021.
19. “Philips’ Revenue Worldwide from 2009 to 2021,” Statista, February 2022, https://www.statista.com/statistics/272107/philips-revenue-worldwide-since-2006/.
20. Matt Pollard, MD (vice president of continuous improvement at Intermountain), interview with the author’s research team, November 1, 2021.
21. Marc Harrison, “How a U.S. Health Care System Uses 15-Minute Huddles to Keep 23 Hospitals Aligned,” Harvard Business Review, November 29, 2018, https://hbr.org/2018/11/how-a-u-s-health-care-system-uses-15-minute-huddles-to-keep-23-hospitals-aligned.
22. “Critical Care Transport,” Cleveland Clinic (brochure), 2012, https://my.clevelandclinic.org/-/scassets/files/org/critical-care/critical-care-transport-brochure.pdf?la=en.
23. Matt Pollard, MD (vice president of continuous improvement at Intermountain), interview with the author’s research team, November 1, 2021.
Chapter 6
1. “Protecting Ghana’s Election: Instant Agility with Zipline’s Autonomous Delivery Network,” Zipline, February 2021, https://assets.ctfassets.net/pbn2i2zbvp41/3yrQaMNdJ1u1J2aSEucjzt/4412ea5d12896d15b7eb41a2212d0295/Zipline_Ghana_PPE_Global_Healthcare_Feb-2021.pdf.
2. Keller Rinaudo (founder and CEO of Zipline), interview with the author’s research team, January 23, 2022.
3. “Intermountain Healthcare and Zipline Partner,” Zipline, November 11, 2021, https://flyzipline.com/press/intermountain-healthcare-and-zipline-partner/.
4. Marc Harrison, “What One Health System Learned About Providing Digital Services in the Pandemic,” Harvard Business Review, December 11, 2020, https://hbr.org/2020/12/what-one-health-system-learned-about-providing-digital-services-in-the-pandemic.
5. “New Survey Shows Consumers Want Increased Access to Clinical Care at Home,” Intermountain Healthcare, December 2, 2021, https://intermountainhealthcare.org/news/2021/12/new-survey-shows-consumers-want-to-access-clinical-care-at-home/.
6. Mike Miliard, “Intermountain Expands Reach, Broadens Offerings of Hospital at Home program,” Healthcare IT News, August 6, 2021, https://www.healthcareitnews.com/news/intermountain-expands-reach-broadens-offerings-hospital-home-program.
7. “Intermountain Healthcare Opens New Hospital—Without a Building or Walls,” Intermountain Healthcare, February 28, 2018, https://intermountainhealthcare.org/news/2018/02/intermountain-healthcare-opens-new-hospital-without-a-building-or-walls/.
8. Brenda Reiss-Brennan, “Mental Health Integration: Normalizing Team Care,” Journal of Primary Care & Community Health, November 7, 2013, https://doi.org/10.1177/2150131913508983.
9. Brenda Reiss-Brennan et al., “Achieving Population Health Through Mental Health Integration and Team-Based Care,” Intermountain Healthcare (brochure), accessed May 23, 2022, https://www.jefferson.edu/content/dam/academic/population-health/hearst-health-prize/Intermountain-poster%20f.pdf.
10. In May 2022, we announced a partnership with General Catalyst to explore the creation of a “clicks and mortar” ecosystem for healthcare: “Intermountain Healthcare and General Catalyst to Collaborate on Innovation,” Global News Wire, May 9, 2022, https://www.globenewswire.com/news-release/2022/05/09/2438830/23694/en/Intermountain-Healthcare-and-General-Catalyst-to-Collaborate-on-Innovation.html.
11. Hemant Taneja (managing director of General Catalyst), interview with the author’s research team, January 5, 2022.
12. Jonathan Shieber, “Plume Is Building a Healthcare Service Specifically for the Transgender Community,” TechCrunch, June 18, 2020, https://techcrunch.com/2020/06/18/plume-is-building-a-healthcare-service-specifically-for-the-transgender-community/.
13. Dr. Derrick Haslem (oncologist at Intermountain), interview with the author’s research team, November 18, 2021.
14. Haslem, interview.
15. “Does Tele-oncology Work?” Intermountain Healthcare (podcast), https://intermountainhealthcare.org/about/podcasts/thanks-for-asking-podcast-episodes/2-ep-16/.
16. Derrick S. Haslem et al., “Using a Tele-oncology Service Provides a Direct Benefit to Patients and Caregivers in Rural Communities in the Intermountain West,” Journal of Clinical Oncology 38, no. 15 (2020), https://ascopubs.org/doi/abs/10.1200/JCO.2020.38.15_suppl.e14153?af=R.
17. “Does Tele-oncology Work?” Intermountain Healthcare (podcast).
18. Nickolas Mark (managing director of Intermountain Ventures), interview with the author’s research team, February 10, 2022.
19. “Intermountain Ventures Fund,” Intermountain Health, accessed May 23, 2022, https://intermountainhealthcare.org/about/transforming-healthcare/innovation/business-development/ventures/innovations-fund/; “Our partners see the potential to redefine what great healthcare can be,” Intermountain Ventures, accessed May 23, 2022, https://intermountainventures.com/portfolio/#undefined.
20. Mandy Roth, “6 Things You Can Learn About Innovation from Intermountain Ventures,” Health Leaders, November 26, 2019, https://www.healthleadersmedia.com/innovation/6-things-you-can-learn-about-innovation-intermountain-ventures.
21. Makenzie Holland, “Intermountain Ventures: A Look Inside a Healthcare Venture Fund,” TechTarget, March 27, 2019, https://searchhealthit.techtarget.com/feature/Intermountain-Ventures-A-look-inside-a-healthcare-venture-fund.
22. Roth, “6 Things You Can Learn About Innovation from Intermountain Ventures.”
23. “Alluceo,” Intermountain Healthcare, accessed May 24, 2022; Greg Slabodkin, “Intermountain Launches Company to Integrate Mental Health Services,” Health Data Management, March 12, 2018, https://www.healthdatamanagement.com/articles/intermountain-launches-company-to-integrate-mental-health-services.
24. Jasmine Pennic, “Intermountain to Deploy AI-Powered Digital Assistants Across Clinically Integrated Network,” HIT Consultant, October 6, 2020, https://hitconsultant.net/2020/10/06/intermountain-healthcare-notable-partnership/.
25. “My Health+,” Intermountain Healthcare, accessed May 24, 2022, https://intermountainhealthcare.org/patient-tools/my-health-plus/.
Chapter 7
1. Sydney Lupkin, “A Decade Marked by Outrage over Drug Prices,” NPR, December 31, 2019, https://www.npr.org/sections/health-shots/2019/12/31/792617538/a-decade-marked-by-outrage-over-drug-prices.
2. Michael R. Sisak and Jennifer Peltz, “Shkreli Ordered to Return $64M, Is Barred from Drug Industry,” AP, January 14, 2022, https://apnews.com/article/martin-shkreli-daraprim-profits-fb77aee9ed155f9a74204cfb13fc1130.
3. Zoe Thomas and Tim Swift, “Who Is Martin Shkreli—‘The Most Hated Man In America’?” BBC, August 4, 2017, https://www.bbc.com/news/world-us-canada-34331761.
4. Dan Liljenquist (chief strategy officer at Intermountain), interview with the author’s research team, November 12, 2021.
5. Civica Rx, “Not-for-Profit Generic Drug Company Officially Established, Attracts Interest of More Than 120 Health Organizations,” news release, September 6, 2018, https://civicarx.org/wp-content/uploads/2020/02/Civica_Rx_News_Release_9-4-18.f8fecc3d.pdf.
6. See, for example, Reed Abelson and Katie Thomas, “Fed up with Drug Companies, Hospitals Decide to Start Their Own,” New York Times, January 18, 2018, https://www.nytimes.com/2018/01/18/health/drug-prices-hospitals.html; Liljenquist, interview.
7. Liljenquist, interview.
8. Civica, internal presentation; Liljenquist, interview.
9. CivicaScript, “CivicaScript,” June 16, 2021, news release, https://civicarx.org/wp-content/uploads/2021/06/CivicaScript-FINAL_June.16.2021.pdf.
10. Adam Brandenburger and Barry Nalebuff, “The Rules of Co-opetition,” Harvard Business Review, January-February 2021, https://hbr.org/2021/01/the-rules-of-co-opetition; https://knowledge.insead.edu/strategy/managing-the-paradoxes-of-coopetition-10466; Joe DiVanna, “Coopetition in the New Economy,” Duke (corporate education), September 2020, https://www.dukece.com/insights/coopetition-in-the-new-economy/; Yunzhong Cheng, “What Is ‘Coopetition’ and How Can International Organizations Help?” World Economic Forum, May 6, 2021, https://www.weforum.org/agenda/2021/05/what-is-coopetition-and-how-can-international-organizations-help/.
11. “Northern Ohio Trauma System,” Annual Report (2010): 8, https://www.northernohiotraumasystem.com/media/1053/2010-annual-report.pdf.
12. “About NOTS,” Northern Ohio Trauma System, accessed May 24, 2022, https://www.northernohiotraumasystem.com/about-nots/.
13. “Cycle for Health UAE,” Cleveland Clinic Abu Dhabi, https://www.clevelandclinicabudhabi.ae/en/about-us/pages/cycle-for-health.aspx.
14. “Huntsman Cancer Institute and Intermountain Healthcare Launch Join Cancer Care Program for Adolescents and Young Adults,” Huntsman Cancer Institute, https://healthcare.utah.edu/huntsmancancerinstitute/news/2017/05/huntsman-cancer-institute-and0intermountain-healthcare-launch-aya.php.
15. Cornelia Ulrich, “Development, Implementation, and Evaluation of a Joint Research Funding Mechanism Addressing Cancer Control Needs of the State: The Utah Grand Challenges,” Huntsman Cancer Institute, https://drexel.edu/~/media/Files/medicine/drexel-pdfs/programs/program-elam/2020-leaders-forum/ELAM-leaders-forum-2020-Ulrich.ashx?la=en.
16. “ARUP and Intermountain Healthcare Collaborate to Meet COVID-19 Testing Needs,” ARUP and Intermountain Healthcare, March 31, 2020, https://www.aruplab.com/news/3-31-2020/arup-intermountain-collaborate-covid-19.
17. Intermountain Healthcare, “Medical Leaders from Utah’s Major Health Systems to Address Utah’s COVID Spike and Potential Impact on State’s Hospitals and Caregivers,” news release, July 6, 2021, https://intermountainhealthcare.org/news/2021/07/medical-leaders-from-utahs-major-health-systems-to-address-covid-spike-and-potential-impact-on-states-hospitals-and-caregivers/.
18. Becky Jacobs, “Utah Health Care Leaders Declare Systemic Racism a Public Health Crisis,” Salt Lake Tribune, January 12, 2021, https://www.sltrib.com/news/2021/01/13/utah-health-care-leaders/.
19. Kathy Wilets, “Intermountain Healthcare Partners with the University of Utah to Create Academic Program to Help Keep People Healthy,” University of Utah (Health), April 8, 2021, https://healthcare.utah.edu/publicaffairs/news/2021/04/intermountain-population-health.php.
20. Ginni Rometty (former CEO at IBM), interview with the author’s research team, January 19, 2022. In crafting this narrative, I also rely on Tony’s own account available at the following: “From Serving Coffee to Writing Code— How One IBMer Changed the Future of this Apprentice,” IBM (Careers blog), November 12, 2019, https://www.ibm.com/blogs/jobs/2019/11/12/from-serving-coffee-to-writing-code-how-one-ibmer-changed-the-future-of-this-apprentice/.
21. “From Serving Coffee to Writing Code—How One IBMer Changed the Future of This Apprentice,” IBM (Careers blog), November 12, 2019, https://www.ibm.com/blogs/jobs/2019/11/12/from-serving-coffee-to-writing-code-how-one-ibmer-changed-the-future-of-this-apprentice/.
22. Please explore the New Collar jobs and the apprenticeship program at https://www.ibm.com/us-en/employment/newcollar/.
23. Rometty, interview.
24. Rometty, interview.
25. Rometty, interview.
26. “P-Tech,” IBM, accessed May 24, 2022, https://www.ibm.org/initiatives/p-tech.
27. “Merck Executive Chairman Ken Frazier on Equity in Healthcare,” A Healthier Future (podcast), 35.00, https://podcasts.apple.com/us/podcast/a-healthier-future/id1612299596?i=1000557070365.
28. “Measurable actions. Immeasurable possibilities.” One Ten, accessed May 24, 2022, https://oneten.org/about/mission/.
29. Anuja Vaidya, “Graphite Health Launches with Plans to Create a Marketplace for Digital Tools,” MedCity News, October 5, 2021, https://medcitynews.com/2021/10/graphite-health-launches-with-plans-to-create-a-marketplace-for-digital-tools/.
30. Please see Larry Gabriel’s remarkable testimonial video: “Patient Stories,” Intermountain Healthcare, May 25, 2022, https://intermountainhealthcare.org/services/genomics/patients/patient-stories/.
31. “A Genetic Link to Vertigo? Discussion with Dr. David Jones,” January 13, 2022, https://hearinghealthmatters.org/thisweek/2022/genetics-vertigo-dizziness/; Dr. Lincoln Nadaud (oncologist at Intermountain and director of Precision Genomics), interview with the author’s research team, October 29, 2021.
32. Jonathan Byrnes and John Wass, “‘Showcase Projects’ Can Deepen Your Relationships with Profitable Customers,” Harvard Business Review, October 5, 2021, https://hbr.org/2021/10/showcase-projects-can-deepen-your-relationships-with-profitable-customers.
33. “In Business to Improve Lives,” TOMS Impact Report 2021, https://www.toms.com/us/impact/report.html.
Chapter 8
1. “Helping Our Clients and Communities Thrive,” 2011 KeyCorp Corporate Social Responsibility Report, https://www.key.com/kco/images/2011-CR-report-053018.pdf.
2. Jenna Goudreau, “From Secretary to CEO: Beth Mooney Makes Banking History,” Forbes, September 6, 2011, https://www.forbes.com/sites/jennagoudreau/2011/09/06/key-corp-ceo-beth-mooney-makes-banking-history-power-women/?sh=457cfd953e43.
3. Beth Mooney (former CEO of KeyCorp), interview with the author’s research team, January 12, 2022.
4. KeyCorp, “KeyCorp to Acquire First Niagara Financial Group,” PR Newswire, press release, October 30, 2015, https://www.prnewswire.com/news-releases/keycorp-to-acquire-first-niagara-financial-group-300169466.html.
5. “Key Bank,” Mergr, accessed May 25, 2022, https://mergr.com/keycorp.-acquisitions.
6. “KeyCorp Total Assets 2010-2022,” Macrotrends, accessed May 25, 2022, https://www.macrotrends.net/stocks/charts/KEY/keycorp/total-assets.
7. “KeyCorp—35 Year Stock Price History,” Macrotrends, accessed May 25, 2022, https://www.macrotrends.net/stocks/charts/KEY/keycorp/stock-price-history.
8. Michael E. Porter and Mark R. Kramer, “Creating Shared Value,” Harvard Business Review, January-February 2011, https://hbr.org/2011/01/the-big-idea-creating-shared-value.
9. “Intermountain to Acquire HealthCare Partners Nevada,” Intermountain Healthcare, accessed May 25, 2022, https://intermountainhealthcare.org/about/who-we-are/trustee-resource-center/newsletter/newsletter-archive/intermountain-to-acquire-healthcare-partners-nevada/.
10. “Intermountain Healthcare Reaches Agreement to Acquire HealthCare Partners Nevada,” Intermountain Healthcare, June 21, 2019, https://intermountainhealthcare.org/news/2019/06/intermountain-healthcare-reaches-agreement-to-acquire-healthcare-partners-nevada/.
11. Adriana Gardella, “Will Your Company Grow Itself to Death?” CBS News, April 19, 2010, https://www.cbsnews.com/news/will-your-company-grow-itself-to-death/.
12. Rob Allen (chief operating officer at Intermountain), interview with the author’s research team, January 18, 2022.
13. Marc Harrison, “Intermountain Healthcare Quarterly CEO Update 9/9/20,” YouTube video, 43.40, published September 20, 2020, https://www.youtube.com/watch?v=woqpr_YkllA&t=28s.
14. “3 Years at the Top: Moving Intermountain to Wellness and Value,” MAG.com, https://www.managedcaremag.com/archives/2019/9/3-years-top-moving-intermountain-wellness-and-value/.
15. Dan Liljenquist (chief strategy officer at Intermountain), interview with the author’s research team, January 26, 2022.
16. Bob Bradway (CEO at Amgen), interview with the author’s research team, January 21, 2022; “Mission and Values,” Amgen, accessed May 25, 2022, https://www.amgen.com/about/mission-and-values.
17. Amgen, “Amgen to Acquire Five Prime Therapeutics for $1.9 Billion in Cash,” press release, March 4, 2021, https://www.amgen.com/newsroom/press-releases/2021/03/amgen-to-acquire-five-prime-therapeutics-for-$1-9-billion-in-cash.
18. Liljenquist, interview.
19. Bradway, interview.
Chapter 9
1. Intermountain Healthcare, “Social Determinants of Health,” December 2020, 1, https://intermountainhealthcare.org/ckr-ext/Dcmnt?ncid=529732182.
2. Alliance for the Determinants of Health, “Update 2021,” https://alliancefordeterminantsofhealth.org/wp-content/uploads/2022/03/2021-Alliance-Report.pdf; Eli Kirshbaum, “United Way of Salt Lake Partners with Intermountain Healthcare to Address Social Determinants of Health,” November 23, 2020, https://stateofreform.com/news/2020/11/united-way-of-salt-lake-partners-with-intermountain-healthcare-to-address-social-determinants-of-health/.
3. Seth Southwick (assistant vice president of kidney services at Intermountain), and Nannette Berensen (vice president and chief operating officer of clinical shared services at Intermountain Healthcare), interview with the author’s research team, March 24, 2022.
4. Lauren Taylor, “Housing and Health: An Overview of the Literature,” HealthAffairs, June 7, 2018, https://www.healthaffairs.org/do/10.1377/hpb20180313.396577/.
5. Nick Fritz (director of impact investing at Intermountain), interview with the author’s research team, November 4, 2021.
6. Intermountain Healthcare, “Social Determinants of Health.”
7. Intermountain Healthcare, “Community Health Impact Report 2020,” 11–13 passim, https://intermountainhealthcare.org/-/media/files/community-benefit/community-health-impact-report-2020.pdf.
8. Intermountain Healthcare, “Intermountain Healthcare Sets Goal to Reduce Opioid Prescribing by 40 Percent,” August 22, 2017, https://intermountainhealthcare.org/news/2017/08/intermountain-healthcare-sets-goal-to-reduce-opioid-prescribing-by-40-percent/.
9. Mikelle Moore (chief community health officer at Intermountain), interview with the author’s research team, November 18, 2021.
10. United States Congress Joint Economic Committee, “The Epidemic Preceding the Pandemic: Will Utah’s Progress Hold?,” February 19, 2021, https://www.jec.senate.gov/public/index.cfm/republicans/2021/2/the-epidemic-preceding-the-pandemic.
11. Shannon Clegg (senior strategy consultant and neonatal intensive care nurse), interview with the author’s research team, February 17, 2022.
Chapter 10
1. I draw these comments from Intermountain’s internal Yammer social media site, as well as from responses to a survey we field to caregivers to gauge their experience on the job.
2. Intermountain’s internal Yammer site and responses to caregivers survey.
3. Katie Welkie (CEO of the Primary Children’s Hospital at Intermountain Healthcare), interview with the author’s research team, October 6, 2021.
4. Brad Gillman, “Building Healthy Eating Environments at Intermountain,” Intermountain Healthcare, January 27, 2017, https://intermountainhealthcare.org/blogs/topics/live-well/2017/01/building-healthy-eating-environments-at-intermountain/.
5. Intermountain’s internal Yammer site as well and responses to caregivers survey.
6. Heather Brace (chief people officer at Intermountain), interview with the author’s research team, October 6, 2021.
7. Mikelle Moore (chief community health officer at Intermountain), interview with the author’s research team, December 7, 2021.
8. Governor Spencer J. Cox, “Utah Covid-19 Briefing,” YouTube video, 1:06:44, https://www.youtube.com/watch?v=mhiRWp--Tc8.
9. Sean P. Means, “Intermountain’s CEO Makes a Plea to Utahns: Wear a Mask,” Salt Lake City Tribune, August 31, 2021, https://www.sltrib.com/news/2021/08/31/intermountains-ceo-makes/.
10. Intermountain Healthcare, “Intermountain Healthcare Is Closing 25 Community Pharmacies in August 2021,” accessed May 25, 2022, https://intermountainhealthcare.org/services/pharmacy/community-pharmacies/.
11. Scott D. Pierce, “Intermountain Is Closing 25 Retail Pharmacies and Looking for New Jobs for 250 Employees,” Salt Lake City Tribune, July 13, 2021, https://www.sltrib.com/news/2021/07/13/intermountain-is-closing/.
12. Todd B. Kashdan, The Art of Insubordination: How to Dissent & Defy Effectively (New York: Avery, 2022), 10 passim.
Chapter 11
1. “Suicide and Firearm Injury in Utah: Linking Data to Save Lives,” research report, Harvard T. H. Chan School of Public Health, October 2018, https://dsamh.utah.gov/pdf/suicide/Suicide%20and%20Firearm%20Injury%20in%20Utah%20-%20Final%20Report.pdf; you can find more recent data at “Gun Ownership by State,” World Population Review, 2022, https://worldpopulationreview.com/state-rankings/gun-ownership-by-state.
2. Morissa Henn (former community health director at Intermountain and current associate commissioner at New Hampshire’s Department of Health and Human Services), interview with the author’s research team, November 18, 2021.
3. Noah Leavitt, “Uncommon Ground,” Harvard Public Health: Magazine of the Harvard T. H. Chan School of Public Health (special report), Fall 2018, https://www.hsph.harvard.edu/magazine/magazine_article/uncommon-ground/.
4. Henn, interview.
5. For these details and others in this story, I rely on Leavitt, “Uncommon Ground.”
6. Leavitt, “Uncommon Ground.”
7. Leavitt, “Uncommon Ground.”
8. Henn, interview.
9. Surae Chinn, “Safe Storage of Guns to Prevent Suicides,” ABC4, updated August 23, 2019, https://www.abc4.com/sponsored/4pm-sponsored/safe-storage-of-guns-to-prevent-suicides/.
10. Katie McKellar, “Two Utah Gun Bills—Including ‘Lauren’s Law’—Stall, While 2 Others Advance to House Floor,” Deseret, February 20, 2019, https://www.deseret.com/2019/2/20/20666372/two-utah-gun-bills-including-lauren-s-law-stall-while-2-others-advance-to-house-floor; Bethany Rodgers, “Utahns Could Temporarily Give up Their Right to Buy Guns Under Bill Before State Lawmakers,” Salt Lake Tribune, February 17, 2021, https://www.sltrib.com/news/politics/2021/02/17/utahns-could-temporarily/.
11. Lindsay Woolman, “Intermountain Working to Prevent Suicides by Firearms,” Intermountain Healthcare, October 8, 2019, https://intermountainhealthcare.org/blogs/topics/transforming-healthcare/2019/10/preventing-suicides-by-firearms/.
12. Emma Johnson, “Blue Plate Diner in Salt Lake City Announces Closure,” ABC4, updated May 4, 2021, https://www.abc4.com/news/wasatch-front/blue-plate-diner-in-salt-lake-city-announces-closure/.
13. Of Intermountain’s caregivers, 75 percent had been fully vaccinated and 82 percent had received at least one dose.
14. Katie McKellar, “Utah Homeless Spending Is up by 600%, but the Problems ‘Continue to Grow.’ Here’s What an Audit Says Leaders Should Do,” Deseret, November 16, 2021, https://www.deseret.com/utah/2021/11/16/22785513/audit-utah-homelessness-spending-rose-but-problems-continue-to-grow-salt-lake-city-homeless; Gregory Scruggs, “Once a National Model, Utah Struggles with Homelessness,” Reuters, January 10, 2019, https://www.reuters.com/article/us-usa-homelessness-housing/once-a-national-model-utah-struggles-with-homelessness-idUSKCN1P41EQ.
15. Clark Ivory (chief executive officer of Ivory Homes), interview with the author’s research team, March 1, 2022.
16. Kem C. Gardner, “Utah Homeless Services,” University of Utah (Policy Institute), November 2020: 5 passim, https://gardner.utah.edu/wp-content/uploads/HomelessReport-Nov-2020.pdf?x71849.
17. Mike Leavitt (former Utah governor and US secretary of health and human services), interview with the author’s research team, December 1, 2021.
18. Bert Zimmerli (chief financial officer at Intermountain), interview with the author’s research team, January 26, 2022.