Brooks Jackson says he is taking the helm at the University of Minnesota's Academic Health Center at a time of great ferment in American medicine.

"Health care in general is undergoing significant change," he said. It's too expensive, makes too many mistakes, and its inefficiencies compound both of those problems, he said.

Jackson, a Johns Hopkins University pathologist and administrator with an international reputation in HIV research, shared his ideas in a 30 minute conversation with the Star Tribune last week. His comments follow, edited for clarity and space.

In the past, Jackson said, health care focused on treating diseases more than preventing them. It was built on clinics, hospitals and fee-for-service reimbursements — with care rendered largely by specialists. The Affordable Care Act, also known as Obamacare, will shift medical practice toward outpatient care and preventive medicine — a good development, he said.

Health reform will, however, require different training methods that bring together doctors, nurses, pharmacists, dentists, public health workers and others to coordinate care. The idea, he said, isn't to have an expensive team treating every patient. It's coordinating expertise to reduce costly errors, catch disease early, and get the best care at the lowest cost. Technology, he added, will play a major role as medical records are computerized and physicians can share expertise across digital networks.

In Jackson's view, these changes already are underway at the U. Its new Clinical and Translational Science Institute will help drive basic scientific findings into the clinic and patient care. And the new Biomedical Discovery District has faculty excited about state-of-the-art labs that can lead to groundbreaking discoveries.

Jackson noted that the U, which was a pioneer in HIV research, still has an excellent reputation worldwide for HIV-AIDS and stem cell therapies and high-tech imaging. It has money set aside to recruit some academic stars for department chairs. And the school's national renown for primary care training will help it capitalize on the Affordable Care Act. Johns Hopkins doesn't even have a primary care specialty, he said, "so we're struggling with this a little bit more than Minnesota."

The cost of attending medical school must be controlled to keep from losing top students. One option, he said, is to shorten the duration of medical school and residency programs.

"I went to a three-year medical school, not a four-year medical school," he said. "You know, I think I've done OK."