Itís not all about science

Bill Snyder
Published: January, 2009

Bill Stead, M.D., leads a discussion in the Vanderbilt Innovation Center. The “scribing” on the white board was drawn by the center’s production manager, Kelly Adams.
Photo by Joe Howell
Bill Stead, M.D., does a lot of thinking about connections.

As director of Vanderbilt Medical Center’s Informatics Center , he’s in charge of managing an information technology infrastructure that supports Vanderbilt’s patient care, research and educational programs.

As chairman of the Vanderbilt Center for Better Health , he also oversees efforts designed to help transform the nation’s health care system and accelerate improvements in health care outcomes.

But although he describes himself as an optimist, Stead worries that the United States is “drifting towards … a whole series of national-scale crises,” not only in health care, but in education, infrastructure, energy and the environment.

“We’ve now had a decade of one bubble after another,” he explains. “We’re getting people who are experts at making money out of chaos … (but) I think as a society we’ve really lost our ability to do anything important.

“We did take on high performance computing as a challenge a number of years ago. We did take on the human genome. (But) I’m not aware that we’ve done anything since then that has been taken on as a national grand challenge.

“It’s not all about science. I believe it’s a much broader cultural problem.

“We should each feel responsible for the fact that (last fall) our children (were) sitting in gas lines a generation after we did. And we’ve done nothing about it.”

In health care, “historically we’ve been superb in discovering new things,” Stead continues. Yet Vanderbilt, for example, is located in a state that has among the nation’s worst health indicators in such areas as obesity, diabetes and low birth weight.

“Producing the best science and providing the best service isn’t enough,” he argues. “How do we actually get the benefit in terms of health in society? What is the transformative model that generates a major difference in results?”

Through an ambitious exercise called “Vision 2020,” Vanderbilt hopes to develop such a model – one that transforms clinical practice and professional education through the rapid and efficient application of fundamental discoveries.

“We’ve now got 40 years of people trying to fix this (health care) system from the outside,” Stead says. “I think we’ve actually got to fix this system from the inside.”

There is concern that such targeted, “translational” research diverts funds from basic research that can lead to paradigm-shifting discoveries.

Stead believes they are not mutually exclusive. In fact, he says, “we’ve got to come up with new approaches for supporting fundamental research.”

“What would have happened if we’d had the emergence of HIV in the ‘80s, and we hadn’t had the previous 20 years of basic virology research? Look at how fast we grabbed that.”

In today’s world, the Internet has become as important a driver of communication and collaboration as was the printing press nearly six centuries ago. Yet Stead worries that many Americans are “coming out of school with extraordinarily limited skills.”

And while it is true that the United States can benefit from lessons learned elsewhere, “I don’t think we can depend on other countries to give our people the skills to solve problems,” he says.

“We need to be working on the ideas we think are most important for the problems we have,” Stead says. “We need to be doing things to get other people to work on those problems … (to) create the connections between the problems and the ideas … in a way that make light bulbs go off.”

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