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Vote Newsday 11/4

Sarah Richardson: Crisis management is about how do you respond to the communities you're serving. And so when you think about the impact of policy on Telehealth and supporting interoperability those are things that I do believe transcend how you may feel about who is in office. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health. where we are dedicated to transforming healthcare, one connection at a time. Newstay discusses the breaking news in healthcare with industry experts

Bill Russell: Now, let's jump right in.

(Main) All right, it's Newsday, and this week we are going to have a special episode.

This is the Get Out the Vote episode, and it's Sarah, Drex, and I. Is this the first time the three of us, just the three of us, have been on a show? Except

Sarah Richardson: for

our attempt at live. Yes.

Bill Russell: Oh, that's right. We did live. We did that one episode of live. anyone who's wondering what happened to live, our schedules are so crazy.

Sarah Richardson: We do, and we've done two NFL episodes thus far as well. Man,

Bill Russell: NFL this year is, let's see, Seahawks and 49ers. How are we doing there? It's not

Sarah Richardson: great. It's not awesome.

Bill Russell: Oh man but Dodgers. Have to love what's going on with the Dodgers.

Sarah Richardson: Hopefully by the time this airs, It will be a new World Series champion for sure.

Bill Russell: You know what? I didn't even look. Who like won that game?

Sarah Richardson: As of today being October 29th, last night they won their third So they're going in tonight's game up three over the Yankees.

Unfortunately, that's where we're at. All right. Hey, we're going to try to talk about the election. main thing here, we're going to stay out of the hot topic political issues. We're going to talk about this from a health IT perspective. Perspective and what this means, for the most part, we all agree that, voting is so important.

And Sarah you were just talking about all the statistics and things about how important voting is, and I'm sure we will get into that. Regardless of which perspective you have and those kinds of things, by all means get out and vote tomorrow. In this election, there is a lot of, obviously there's the.

National campaign, which gets a lot of attention, but gosh, the ballot initiatives are just rolling in. And I don't know about you guys, but when those ballot initiatives roll in, I actually have to go do some studying because you can't get into the booth and try to read all those and figure them out.

But yeah, it would be hard to do in the booth. And there are a ton of initiatives in a lot of states that have been put on the ballot.

Sarah Richardson: California didn't have as much on the ballot this year. It was interesting. And so there were more local initiatives than there were state initiatives.

And you really have to dig in to Drexel's point. You have to reread that ballot three or four times to make sure that you're absorbing all the perspectives and what the longer term implications may be.

Bill Russell: Unfortunately chat GPT isn't up to date on these things, so I can't say, Hey, this is what I think, and this is what I believe.

So we're going to stick to topics security, data privacy, AI, interoperability, and those kinds of things. And then, feel free to go from there. Drex, I'm going to start with you in the whole cybersecurity area. This is one of those areas that is never going to be a hot button issue, the people who get elected and the people who are setting the policy around this, it's really important to get this right.

And I think it's is it Senator is it Warner? Senator Warner, yeah. Warner's been the most consistent voice, I think, in this space. What are you looking at with regard to cybersecurity in terms of Continuity of direction or whatever, as you're looking at this election.

I think there's still a fair amount of disagreement about exactly how that happens. Do we do the CPGs the cyber performance goals how do those get incentivized? Are they incentivized? We still have the challenges of the haves and have nots when it comes to health systems and hospitals and rural access.

Facilities but we clearly have a lot of work to do. We still have to get safer. We still have to get better at cyber security. And in the places where we're the most challenged, those are the places that probably need health care. the most. When those hospitals go down, often in rural areas, when those hospitals go down, it's a hundred miles to get to the next hospital, sometimes more.

Bill Russell: Is there still like federal funding? Is there an MU, a meaningful use is that talk still floating out there in the ether around maybe, Getting more funds to rural healthcare and that kind of stuff.

Drex DeFord: There is, there's conversations. There are initiatives that are on the books, obviously that have not been approved, that would provide funding especially to smaller organizations to help improve their cybersecurity program.

Obviously there are free programs that have been offered by some companies like Google and Microsoft. The challenge with a lot of those. All of those in a lot of ways are the same challenges we found with meaningful use is that there was money to get on the ride, but there's no money to stay on the ride.

So we, are given a lot of money. We're giving grant money to get things started, but the sustainability of it becomes becomes a challenge. And I think that's the part we're going to have to look at too. It's great to be able to install new tools and do new and different things to get a cybersecurity program up and running, but keeping it running is a whole different thing.

There is no finish line.

Bill Russell: Yeah, Sarah, I want to talk to you about advocacy. Because we've had some great 2 29 project meetings this year. And more and more I'm hearing these CIOs talk about advocacy. They're talking about not only on the federal level, but on the state level. And we get some funny stories of, you think you're gonna talk to a senator or a congressman, but you're sitting down with a 22 or 21-year-old recent college graduate and.

That's who you're sitting down with, and you're trying to explain to them the complexities of healthcare and the complexities of AI and the complexities of whatever. what do you tell organizations and healthcare leaders about advocacy and how to go about it?

And sometimes we joke about, hey, don't send the 23 year old MBA to the meeting because they may not understand the nuances of some of the conversations we're having in our events. And yet, I was also that person. And if I'm going to be with my senators or my legislators, and I'm a page for them as an example, and I'm 23 out of my MBA program, you want to tell those perspectives.

Make sure it's something you care a lot about. What do I care about? Women's health, aging populations, affordability, equity, and access. Five things. They all matter. They're all also intertwined. And to Drexel's point, if you have a cyber event and a local hospital goes down that's that rural access to the major hospitals, how are people getting to them?

And you saw what happened even after these most recent hurricanes, where people are cut off from all support and all capability. And I used to work for HCA. Huge advocacy and the fact that they had a thousand people take time off to go and help the Asheville community. Yes, they own the healthcare system there, but again, that's not uncommon for the type of effort that they do in other organizations.

We make sure people know about those topics and how to have an impact on them. And we talk about them in today and health IT constantly, about equity and access and affordability. And so that's our responsibility to make sure people know how and where to go find the outlets that are important to them.

Bill Russell: Sarah, as you were mentioning that I recalled that there was a and it will be In our email that goes out tomorrow, HCA Healthcare faces 350 million dollar hit from hurricane disruptions. Disaster recovery and essentially business continuity become really important issues.

we just finished the 229 project meeting and one of the rural healthcare CIOs was there and he was telling the story of how during the hurricane they were knocked out. And he's look, I don't care how you design your network. When you only have one carrier coming in, it's it's one backhoe, it's one, whatever, that's it.

They would send the truck in with the essentially to get on satellite and that kinda stuff. They said, yeah, we did. We had that agreement, we had that contract, and when the Verizon truck came in the city commandeered the truck because they took a higher priority than the hospital.

And I had never thought about that before. But if you are coordinating the entire city's response. It could potentially have a higher impact, and if Verizon only sends one truck because they have to send trucks in, 20 different directions you could end up being cut off. I want to hit on rural healthcare.

And see this. Hey, we believe that the medical record should be shared, and we believe that it should be in the patient's hands, and we believe more and more that we are going to be able to do more with data than we ever have before in terms of interoperability. And you see a direction that doesn't really get set.

Maybe it does get set at the presidential level. But it seems to, no matter what the course was, that whole century cures probably is going to set the in the years, regardless of . Who's in office. That was something he talked about a while ago. And I've also seen the various heads of healthcare IT for HHS, Seema Verma, and going all the way back sit on a panel and they essentially said the same thing.

how will this election impact that, do you think? I'll leave that as an open, whoever wants to try to answer that one.

That leads to initiatives here that expand the physician workforce and incentivizing professionals to serve in these regions, but also investments in telehealth. that we can maintain care during crises. Here we've got wildfires, we have the pandemic, we also have mudslides and earthquakes and whatever else happens.

And those, crisis management isn't about politics per se. Crisis management is about how do you respond to the communities you're serving. And so when you think about the impact of policy on Telehealth and supporting interoperability so that if you do have a visit in a rural area that's only being served in some cases by telemedicine physicians, how is that getting back into your core EHR and ability to make decisions?

Those are things that I do believe transcend how you may feel about who is in office.

Right now what we have is we have executive orders in place, but the executive orders are, the executive order that's in place is really, directing the various entities to to look at this from a transparency standpoint, from a data use standpoint and some other things that are really key, but the regulation of AI, the approach to regulating AI technologies in the next couple of years, this is going to be.

This is going to be big and it feels we saw this in the European Union, they are, they feel like they're getting out ahead of this. Can we get out ahead of this? Do we know where this should go? Drex I'm curious what your thoughts are around AI over the next couple of years and is it a federal thing where they're going to be coming down on this or what do you think it might look like?

Which as soon as the new executive can come in, the new executive comes in, those orders can be overturned or changed. So that's not really long lasting, consistent policy. So when we don't do executive orders, we pass laws. And the problem that we have with passing law is that we don't usually write laws that are created to be very agile over time.

Those are the challenges that I think the next administration, the next several administrations will face.

Bill Russell: Yeah, and it's changed so rapidly. Sarah, what do you say to an entrepreneur?

And you think about even the contract negotiations with labor unions or nursing associations, they're asking for the security to be included. And I had not thought [00:17:00] about application security as part of a CISO or a CIO's responsibility. AI has now introduced that additional level of awareness and need for us.

And so we're all learning and growing together. But when you bring these things into the mainstream, then you have to talk about them, because then they become part of the norm, and some of these, we don't necessarily know the unintended consequences that [00:18:00] Drex is talking about, but it harkens back to our HIPAA days where just the awareness of the intent made it something that was important.

a neutral conversation and a level of curiosity that everybody got better together.

Bill Russell: the elephant in the room is no one's going to vote on those issues we just talked about. At the end of the day it's, we've gotten to such a polarized political environment that people they're going to vote based on other topics.

But part of the reason we talk about those things is, it's there have been many times in our history where we've had presidents where people were like, oh, this is the end of the Republic as we know it, it's going to end right here. It's going to end. And

this goes all the way back to Adams and Jefferson Oh my gosh. It's a fledgling thing. And they're like, if you let Adams run this thing, it's never going to make it to year number 10. actually it used to be worse because there was no filter on the editorials and people could actually fake.

For bad some things, regardless of who gets elected, some things will move forward, some things will move backwards. It happens over and over again. It depends on your political opinion sometimes, whether you think that's a move forward or back. We've had some good conversations on this.

just want to close this out by saying this is a very difficult time. Vote. That's what we can do. One of the things that we want to see, I think all of us want to see is civility. One of the things we're recording this ahead of time, one of the things we are all worried about is a lack of civility post the election.

it's to the point now where we can almost barely have conversations about politics without, people getting very very upset. I'll let you guys have the last word. I just took a lot of the words, so Sarah, why don't you go? You can go first.

Sarah Richardson: I was going to say, I want to hear Drex last.

The next piece is, the most fundamental thing you can ever be is kind. And whatever form that takes for you, regardless of your beliefs or views, number one, go vote. And throughout all of this, be nice. Be kind to your neighbor, be kind to all the people who need you for so many reasons that aren't about how you feel about politics, because that level of civility is what makes us human.

Bill Russell: I appreciate that. Yeah.

Drex DeFord: Drex, last word? Yeah, I definitely second that. Just a couple of things I think to think about to statistically there are some really good studies that show that people in a presidential election year vote for president but don't necessarily vote all the way down ballot.

They may just mark the presidential ballot and drop it in the box. Do the research. Do the research on your competitors down ballot all the way down to your city council and make sure that you make a decision and vote. It's really important. Don't leave those spots blank. Voting means voting the full slate.

And a lot of that is created by foreign nationals who are very interested in disrupting our faith in our election process and our faith in our voting process and democratic procedures. Don't let that happen. When you see things and your first reaction to them is that there's that, I just can't believe that.

Then you probably shouldn't believe it. And you probably should look for additional sources before you get really upset, or before you go off and do your own thing on social media, make sure that you're double checking and that the information that you're seeing is real, because there's a lot of.

Literally fake news out there.

Just remind yourself that you love these people before the election. You love them after the election. You respect them for who they are, what they've done, and what they mean to you and your family before the election and after. close with this. I had a conversation with my parents and I asked them like, hey, do you know what party, and some of their older friends, do you know what party they were a part of?

And they're like I don't know, I think they voted Democrat they might have been Republican, I have no idea. Back when my parents, it was like, they were just our friends. They voted for who they voted for. It's somehow along the way we've gotten so aligned with with our politics that we think we can't talk to somebody who votes a different way.

And man I hope we can, that's the thing I hope we can get past is civility following. Hey, I want to thank you guys for doing this episode. We were all apprehensive coming into it and I appreciate you guys doing this.

Sarah Richardson: Always appreciate you. Thanks.

Thanks for listening. That's all for now