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 Welcome to this weekend in Health it. It's Tuesday Newsday where we look at the news which will impact health it. Today we're gonna look at the United States of Care's City level C Ovid 19 Rapid Response Playbook, and I'm gonna entertain a little post C Ovid 19 healthcare discussion if you'll allow me.

The opportunity to do that. My name is Bill Russell Healthcare, CIO coach, creator of this week in Health. It a set of podcast videos and collaboration events dedicated to developing the next generation of health leaders. Shout out to our channel sponsors, Galen Healthcare, VMware, Starbridge Advisors, pro Talent Advisors series, healthcare and Health lyrics, whose investment in this week in health, it make our mission to amplify great thinking to propel healthcare forward a reality.

This episode and every episode since we started the C Ovid 19 series has been sponsored by Sirius Healthcare. They reached out to me to see how we might partner during this time, and that is how we've been able to support producing daily shows. Special thanks to Sirius for supporting the show's efforts during the crisis.

As I said, it's Tuesday Newsday. Gosh, there's always so much to talk about. I'm gonna try to keep it to 20 minutes. Uh, we have the, uh, playbook, the Covid 19 city level, uh, rapid response from, uh, United States of Care. I'll get to that in a minute. Um, but if you'll allow me, I'd like to do a little post c Ovid 19 Healthcare World, uh, discussion.

And, uh, how I'm gonna start this is I'm gonna talk about the field reports. Here's what we've learned. We've learned, you know, telehealth work from home have just exploded, right? So supply and demand and regulatory all came together to blow the doors off of telehealth. Uh, it used to be hard to get physicians to, to really listen to the discussion, uh, because, you know, workflow was so hard.

I mean, they had to do, uh. Uh, in-person visits, they had to do televisits. They, you know, they had to do, uh, messaging through the portal and it was just, it was too convoluted, too much. Uh, the reimbursement also didn't support it. Uh, then the offices emptied, reimbursement changed and the physicians had time on their hands and they then knocked on our door and said, make this happen.

And so that changed everything in a matter of weeks. Um. But that's not the only area where we saw really tele take off. And I, I'm gonna use the word broadly here and just talk about the area where video really has taken off in the last couple of weeks. Uh, family, families, uh, visiting with their, uh, sick patients with their family members in the hospital, uh, via Televisits.

Has been, uh, uh, one of the things we've done, video used in the care of non covid chronic patients as well as, uh, IoT devices and other devices. Uh, video used to minimize the amount of times that clinicians have to go into the room. Video has been used for huddles for our teams. It's been used for collaboration, uh, with, with our work from home staff.

So you see, we have gotten really good at using video over the last six to eight weeks. Um, so that's one of the things we're learning from these. Yeah, 37 some odd interviews I've done right now from the front lines. A couple other things. Uh, new venues drive-through testing, which stood up in most communities, uh, converted whole hospitals.

The conversation about the hospital for special surgery, uh, changing almost overnight into a covid hospital was just incredible. That's a conversation from Friday and uh, I highly recommend listening to it. Um. We've converted stadiums and parks to field hospitals, mobile units became covid screening units.

So all sorts of new venues, uh, were rethought in a very rapid time, uh, timeframe. Uh, community engagement, chatbots received wide adoption. Uh, chatbots were sort of inching along in our industry. And then all of a sudden, everyone was saying, I need a chat bot on my, uh, website. So, . Um, very interesting to see how that has been.

Uh, just wide adoption implemented very rapidly. Uh, call centers were radically changed to provide outbound information, but not only that, the call centers themselves were just completely dissected and rebuilt as remote units, right. So we used to have, I mean, if you've ever been into a call center, you know it's impossible to practice social distancing in a call center.

So, you know, we took our phone systems, we moved people outta their homes. And, uh, we're getting those, the, the same level of service with people working from their homes. Uh, very, uh, interesting. So that's some of the stuff we've heard. Uh, reporting data governance. Data governance is something that moves at a glacial pace in healthcare and we now have it clicking on an hourly pace in some health systems.

Very amazing work. Our reporting moved, uh. Very rapidly as well to create tracking metrics, new screens. Uh, we track constrained resources and other things. Data science took on a new level, uh, during the pandemic. Uh, finally, you know, work from home. I gotta come back to this work from home, uh, at, at this scale for this industry, was just never really thought possible before.

And now we're doing it. And, uh, you know, the, we we're, we're learning a lot. From it. Uh, I'm gonna get that, get to that in a minute. Uh, we thought through succession plans, maybe some of us for the first time huddles are, have become really much more effective communication tools. Communication from top to bottom has really been thought through.

We've stood up these command centers and the communication is probably more clear. Then, uh, at any time within our history in recent history anyway, uh, and, and the, the just the crazy back and forth went away, we became very focused, um, focused on the best care for our community. No one left behind, let's get it done.

That level of focus provided the much needed clarity that, that really enabled us to move this fast. So, you know, what does post covid 19 look like for healthcare and health? It, um. Now I realize this might be a little premature. This is not, might be, this is premature to have this conversation, but as a leader, I.

Um, I think it's important to be, to be banging some of these ideas around within your head, even back and forth amongst your leadership team. I've heard of organizations actually setting a, a, a, uh, work group up of people that are considering what post covid I. It's going to look like. And I, I recommend that as well.

So in that spirit, not to be insensitive, uh, 'cause I'm not going to, I'm not trying to be insensitive, but to just start throw out questions that are, that are rolling around in my head that I wanted to capture, and I'm gonna use this venue to capture it. Uh, I'm just gonna throw them out to you. I wanted to get the conversation started.

If you want to have a conversation with me, shoot me a note bill at this week in health it.com if you wanna discuss it further on the air or even off the air. . More than happy to do that. So here's some of the questions I'm considering. Lemme check my time real quick. Okay man, I, that was a long setup for that.

So here's some questions that are rolling around in my head. What's gonna remain from a post covid world, from a national level? Were there, were there be a greater demand for public health? Obviously there's going to be, uh, but at what level? Where, where . You know, what are gonna be the demands on the health systems?

What about research? Is research gonna become more tightly linked to the, to the, uh, medical record? And where's that link gonna happen? Is it gonna happen at the EHR? Is it gonna happen at the individual health systems? Um, what about pandemic prep? Are we gonna be asked to do that at a, uh, city level, at a state level?

At a national level, are we gonna have to prepare plans in conjunction with the other health systems in our, uh, region? Who's gonna coordinate that? Um, you know, what kind of work is going to be required? That's at the national level. You know, what's our president going to do? What are, what are the executive orders that are gonna stay in place?

What aren't going to stay in place? But even as important at this point is what, what is, what are, what are our governors gonna do? . Right. You know, never let a good disaster go to waste. We've heard people say that, and I think you're gonna see governor responses be all over the board, depending on, you know, how they think the government should play a role in this, uh, moving forward.

I, I was ACIO in California and I can almost guarantee that the work that is gonna be required from California Health Systems from the governor is going to probably be, uh, more labor intensive than what you're gonna get from the federal level. Just my 2 cents. I'm sorry, I, I just wanna throw out the questions.

I don't, I don't want to be answering this stuff, but, uh, what about interoperability, you know, is what about it? How about a national, how about national data models? Do you think that's gonna be a thing, uh, in order to, to be able to respond to these things faster? Uh, perhaps genetic testing on a national scale?

Do you think that'll be a thing? Uh, what about within your system, work from home? Is it here to stay? How, how, how was it for you? I mean, did you experience productivity? Uh, drop like we anticipated we would feel, or did productivity pretty much hold true to what, what, uh, what it's been in the past? And if it did hold true, are we gonna bring everybody back into the, into the health system?

Are we gonna put them back into expensive real estate, uh, just to, uh, you know, get everybody back into the same room? Uh, what, uh, which of the tele strategies you think are gonna stick? This is the, uh, million dollar question. How much of the funding will remain for telehealth? And if, if it does remain, you know, what are we gonna do?

You know, HIPAA's probably gonna be coming back. , you know, they ease those restrictions. Uh, does that mean that Zoom is out? Do we have to put something more sustainable in place? Are we ready to put something more sustainable in place? Um, you know, what about physicians practicing across state lines? Do you think that's gonna, uh, stick or do you think that's gonna snap back?

Uh. You know, how did your, just getting to it a little bit, how did your infrastructure and operations really scale? Not the stuff that you're telling people, not the stuff that sometimes we hear on the podcast, but the stuff that, you know, you talk about in your office behind closed doors, it couldn't have all scaled.

I. I've been in the chair. I understand. I've been in those meetings. Right? We have legacy environments, we have a lot of applications, we have a lot of data silos. Uh, we have some latency issues. Well, what scaled, what didn't scale and does that change your strategy moving forward? Are you looking at more application rationalization moving forward?

Um. You know, I'm curious about your EHR strategy. How did your EHR strategy hold up during this? You know, did you do, do you need your hosted EHR to be closer to you? Was it too far away? Was there, was there too much latency, uh, in response as you scaled it up so rapidly? Maybe some of you, you know, do you need your EHR to be hosted, period?

Maybe you, you have it, uh, in-house and it didn't scale real well, or maybe you had it in-house and it scaled perfectly. I, you know, just some of the questions I'm, I'm curious about, uh, you know, did your work from home scale securely, keyword being securely, or did it just scale? Um. You know, did you just throw security to the wind and say, we've gotta do this, let's get this scaled up.

And uh, and now you're sort of looking at it going, well, we, we cut some corners there. Uh, let's talk about the competitive landscape. These, again, these are just questions that are bouncing around in my head, you know, do you think that competitive landscape changed at all during the C Ovid, uh, 19 pandemic?

Um, well, the. You know, the, if the rest of the economy is any indication, the healthcare economy has been impacted. So let's talk about it. Which healthcare entities did well during the crisis? I. . If you don't think any of 'em did well, then you're probably not paying attention. 'cause right now the insurance companies are swimming in cash.

They collect monthly fees and none of their clients have had to go to the hospital for surgery or other procedures. Uh, they've collected, you know, two and a half, three months of cash with little to no outlays. You know, uh, that to me means that they're gonna be cash rich coming outta this thing and not many organizations are gonna be cash rich

Coming out of this thing. So, uh, you know, who operates the most in that model and how much cash do they have? If, um, you know, one of the things I'm thinking is, does that create a new opportunity? If who's gonna have cash coming outta this, who's not gonna have cash coming outta this? How are they gonna use that cash?

If regulations don't change? Will people be able to launch new services into your market? Are they gonna be able to do telehealth into your market? Are they, you know, what are they gonna be able to do? Will people be more open to telehealth? I don't know, just some things that are bouncing around in my head.

Will your communities be looking for different services post covid? Right? If your doctors say, Hey, I wanna go back to seeing patients in house, and people say, no, no, no, I want to keep doing telehealth. Are are we going to do that? Is that something that, you know, are they gonna say, look, I, I like the drive-through testing.

I want the drive-through testing for, uh, flu season. Makes sense to me. Why would I go sit in a, you know, if flu had, people didn't know what the transfer rates are, are, you know, were for the flu and for other conditions. Now they do. They've been educated. Well that's great that they've been educated, but now that they've been educated, they might be sitting there going, Hey, why, why are we practicing that way?

Maybe we should do drive-through testing for flu. Maybe we should do some of that stuff. Um, you know, another question. Did any of the non-traditional competitors take ahead. Right. So our non-traditional competitors were, were making headway. You know, Walmart was opening up, uh, facilities. Did they do well?

Uh, how about CVS? Uh, CVS Aetna CVS really, uh, how did they do during this, how did their, uh, their, uh, care centers do during this? , uh, Walgreens. How did they do? Uh, how did, uh, Amazon do during this? Amazon actually announced, um, some of their financials today. They seem to have done pretty well. I just dunno what areas or what sectors that did really well.

Uh, but I, I just wondering, did any of the non-traditional competitors take a hit? Are there any other services opportunities that are going to bounce back, but, you know, they're gonna be short on cash. Uh, it's, you know. . There are a couple of industries that are related to healthcare that took a major hit.

Dentistry being one of 'em, right? So just like none of us have gone to get haircuts, very few of us have gone to get any dentistry work done in the last two months. If this drags on, there's gonna be a, a significant shortage of cash within the dentistry space, which is, uh, related to healthcare. And there's gonna be an opportunity there for organizations with cash.

Um. You know, what about 20, 21st century cures and interoperability? You know, do you think the urgency on that increased or decreased during this covid season? And, uh, I, I think it's likely increased and I think it's gonna move forward. Just wondering if we're ready. Well, those are just some of the things that are floating around in my head.

Love to discuss with you. If you have some ideas, shoot me a note. Bill it this week in health it.com. Alright, let me hit. I want to hit this, uh, playbook. Hey, this is a great playbook. If you get a chance to take a look at it. It's at the United States of Care and it's the, uh. It's called the, uh, playbook City level C Ovid 19 Rapid Response to serve at-Risk Populations case Study New York City C Ovid 19 Rapid Response Coalition.

Uh, the scope it has actually, it's, first of all, it's just a really well done presentation. Uh, has their guiding principles, um, has their goals, and then it talks about their product. And their product really is about, uh, the C-R-C-C-R-R-C product is about, um, . Providing the information to that vulnerable po, the information to the vulnerable population so that they can receive care.

And what they're doing is they're stitching together this, this patchwork of, uh, organizations in order to provide the best care. To that, uh, to that population. So they have a dynamic texting platform that allows simple script writing to connect patients, uh, with support draws from analysis tools and preexisting data sources, uh, contacts, high need individuals identified through patient risk assessments and connects them with telehealth, telehealth and TE services.

And, uh, and then it goes on to say a network of relationships that weave together. Care provision and support from a coalition of 60 plus social and clinical services, data and analytics from a variety of sources, including healthcare payers and navigators. I'll have a link to this, uh, presentation. Uh, I think, you know, again, really well done.

The, uh, CRRC process and tech overview has a flow chart, which I think again is, uh. It's high level, but it's really well thought through. It starts with the data they create the analytics, they end up creating the registries, which they call rosters. Um, and then they have a coordinating, a coordinating center, which uh, makes the right contact.

Connects people with the right, um, with the right care at the right setting. Uh, the partnerships are providers and some significant providers within, uh, New York, uh, payers, social services, alternate care providers, uh, legal capital and project management, uh, technology providers delivery, um, Uber, Lyft, CVS.

You get the idea, uh, as well as others, and then they go on and talk about their tactics. I like this presentation. I think we're gonna be giving a bunch of presentations in the not too distant future, uh, around our plans around, uh, C Ovid 19 and what we've learned and what our strategy is gonna be, uh, moving forward.

And I think . Uh, I'm looking forward to seeing some of those presentations and seeing how we, uh, how we sort of frame up what we've learned and what we think the, uh, the world post covid is going to look like. Anyway. Great. Uh, great presentation. I really wanted to hit this last story two weeks in a row. I really haven't been able to National cor coronavirus response roadmap, uh, to reopening.

Um, you know, it's, it's interesting this, the, the, uh, idea of reopening. Is, uh, something we all are. We're, we really want to get there, but it's a lot more complex. We don't have enough information right now to really understand. I think there's people on one side that say, Hey, you know, let's just open and see what happens.

There's others that's like, let's stay, uh, self, uh, self-isolation for another six months. Uh, clearly if we stayed self isolated for another six months, the economic catastrophe would be beyond, uh, measure. Uh, but on the other side, . Um, you know, if we all started going out, I think all the experts would say that, uh, we're going to, uh, potentially overwhelm the system and have a, uh, second wave of, uh, uh, second spike, if you will.

This article is actually really well thought out. I thought, uh, Dr. Scott Gottlieb. Uh, it's on the, uh, American Enterprise Institute and once again, I just don't have enough time to really go through it. Here's what I like about it. Executive summary start starts talking about four phases. Slow the spread.

State by state reopening, establish immune protection and lift physical distancing during phase three and rebuild our readiness for, uh, in phase four. The reason I like this is it's so well thought out. Uh, has a set of goals, has the triggers to begin, uh, each phase and the trigger to move to the next phase, right?

So if you're wondering how the, um, . The epidemiologists are thinking about this and how they're gonna, uh, protect, uh, you, you have a really clear roadmap in this article, so I'll share this link to this article there as well. I, I think it's a lot more complex than this. I think the, uh, the doctors and the epidemiologists are absolutely at the table and should have a very strong say in what's going on.

Um, and I don't think it's wrong to be talking about the economy because, uh, you know, more people could die. Quite frankly, from a economy where you have, uh, double digit employment, unemployment, um, we've already talked to people on the show about the, uh, mental health crisis that's going on right now with, uh, uh, with people losing their jobs, being stuck at home, not having the opportunity to, um, to pursue employment or feed their families and just, uh, you know, these are difficult.

Difficult and complex decisions that, uh, people are gonna be have having to make. Well, that's all for this week. Special thanks to our sponsors, VMware, Starbridge advisors, Galen Healthcare health areas and pro talent advisors. I. Uh, for choosing to invest in developing the next generation of health leaders.

Uh, this show is a production of this week in Health It. For more great content, you check out our website this week, health.com, or the YouTube channel. If you wanna support the show, the best way to do that is to share it with the peer. Send 'em an email, shoot 'em a dmm, however you do it. Uh, go ahead and share it with the, share it with somebody.

That is the best way to support the show. Uh, we're gonna be back again with more shows this week. . I really thank my friend Dr. Ford for, uh, interviewing, uh, the security professionals and that's giving me a chance to catch up on my life and, uh, get some things done and I really appreciate that. Thanks for listening.

That's all for now.