News Day – Microsoft’s Big Bet on AGI, Outsource Trend and AWS Outpost
Episode 10523rd July 2019 • This Week Health: Conference • This Week Health
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This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

  Welcome to this week in Health IT News, where we look at as many stories as we can in 20 minutes or less. It's Tuesday News Day, and here's what we have on tap. . Microsoft's invested a billion dollars in open AI and artificial intelligence project va Uh, the VA names their first director of AI and let's see, John Muir outsources a whole bunch of it to Optum and a whole bunch of other stories.

Uh, we have about 10 of 'em listed here. There's no way we'll get to all of 'em. Let's see how many we get to. My name's Russell. We're covering healthcare, CIO, and creator of this week in Health. It I've set a podcast and videos dedicated to developing the next generation of health IT leaders. This podcast is brought to you by health lyrics.

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The fourth way, send me feedback. I love this. Send me questions, guest recommendations. You name it, love the feedback, uh, and then subscribe to our newsletter on the website. So let's get to the news. . Uh, Microsoft's invest $1 billion in artificial intelligence project OpenAI Co-founded by Elon Musk. They just threw in the Elon Musk to get more hits to the news story, I think, uh, 'cause he's no longer associated with it.

But, uh, this is CNBC. Lauren Feener is the author. So Microsoft's gonna invest a billion dollars in OpenAI as part of the project. Uh, the company said, while, uh, today's AI can tackle simple tasks, which is true, the company's said AGI, otherwise known as artificial general intelligence, a little smarter human-like, uh, we'll be able to tackle more multidisciplinary problems.

Uh, this is pretty interesting in that Microsoft slick move here. Uh, Microsoft Azure will be the sole cloud provider for open ai. Uh, artificial gel general intelligence, they think it's gonna solve everything that ails the world. Climate change, you name it. Uh, most importantly, tech dev, uh, tech dev and human, uh oh.

Musk left this thing back in:

You know, he's, uh, you know, thinks it's more of the future is Terminator. And, uh, he's watched that movie too many times and doesn't like the, uh, the way it ends. So, uh, he has, uh, pulled out of ai. Uh, the other thing obviously is that, uh, Tesla is playing in ai, especially around self-driving cars. And, uh, there was a potential conflict there.

So, uh, so he moved on. So, uh, I guess the question is what can artificial general intelligence do? And, uh, you know, in theory, AGI could carry out any tasks that a human can, which, uh, and actually some tasks that human humans really can't. Uh, uh, at the very least, AGI would be able to, to combine human-like.

Uh, flexible thinking and reasoning with, uh, computational power and advantages like instant recall and split, split. Second number crunching. Uh, so you can imagine what it can do. It's, it's, it's layering on decisions. Uh, that it can do with the ability, ma, instant math, instant recall. Um, it's important to note that, uh, it, it really doesn't exist yet.

which is really interesting. So this is a billion dollar investment in the future. Um, you know, you've seen it though, so you've seen this, uh, it's the stuff of science fiction. . Terminator, uh, the Matrix, uh, you know, Mr. Anderson, uh, whatever that, whatever the, uh, nemesis is, I can't even think of his name right now.

Anyway, uh, Terminator of the Matrix, uh, bicentennial man, uh, with Robin Williams. Uh, you know, HEI tends to be depicted as a mesh between, uh, the computational side of it and the machine. Uh, that either destroys the world and that is the, the one that we see the most because those movies gross the highest amount because it tends to, uh, capture our imagination, uh, or the other, which is, you know, it enhances the world, which is sort of your bicentennial man.

Uh, you know, it's more fun to consider, but not as much fun to watch on film. It, it would appear, uh, you know, AGI is truly the holy grail of artificial intelligence. So, what, you know, we end all these stories with a, so what? And it is, you know, Microsoft is making a meaningful, meaningful investment, uh, in this important area of ai.

Um, they're trying to bring these capabilities to Azure, which is important as well. Uh, and they're making sure that they're gonna be a player in this AI space. Um. . You know, there was a time where we, we, we talked about what tribe you belong to. Uh, you know, you're, we still do it right? You're an epic shop, you're a Cerner shop, you're a Meditech shop, uh, in network.

You could be a Cisco, Juniper, whatever shop, uh, in operating systems. Uh, this is really going back, you know, before Windows was the dominant player, you might've said, you know, we're a Windows shop, an OST shop, a Novell shop. Um, you know, as you can see from some of these examples. Uh, the, these things really come and go.

Uh, it as technology evolves, they sort of dissipate. We have winners, we have losers. Uh, but there is a time where it's really important to decide which horse you're gonna place your bet on. Uh, and, and the time is really . Either now or pretty close on the AI side. You know, the question becomes, are you a Microsoft shop?

Uh, Microsoft, Amazon, Google, uh, IBM to a certain extent, Oracle, Wipro, uh, or, or even specialty type companies. I asked the Rain Bird and others. Um, you know, the question becomes where do you go for, uh, machine learning, NLP, automation, cloud infrastructure? Microsoft wants to be your AI cloud and they are making the investments to back it up.

They're not the only ones making the investments, by the way. I mean, you have, uh, we had a conversation with John Halamka on one of the, uh, earlier . Uh, episodes and, uh, you know, uh, John with meth, Israel Deaconess, uh, moved on from the CIO role now, uh, sort of an innovation type role. And did one of the first things he did was a partnership with Amazon around, uh, uh, uh, machine learning more than, uh, which is a subdivision of ai.

Um, so more of a machine learning kind of thing, where they're looking at specifically how this can be applied, uh, to medicine and to improving. Um, you know, at this point really improving the efficiency. I mean, John talks a lot about, uh, improving their or efficiency and improving their, uh, their, uh, document processing and other things with just simple, simple machine learning and AI tasks that are, uh, connected into the workflow and making things happen.

Uh, so that's, uh, that's our first story. Spent a lot of time on that, but that's a really interesting story, I think has a lot of impact. Uh, you know, let's stay on this for a minute. Let's stay on AI for just one more minute. So the veteran VA has appointed a first director of artificial intelligence. I bring this up 'cause I think it's interesting in that this role didn't really exist, uh, I don't know, maybe three minutes ago, but it's, uh, it's now a thing.

So Gil Oh wow. Alter Viz PhD. Formerly professor of Division of Medical Science, computational Health Informatics at, uh, Harvard Medical School, Boston Children's Hospital will lead the VA's AI work. Uh, the va VA is putting AI to work to reduce veterans waiting times. Again, efficiency side for appointments.

Another application is suicide prevention. Uh, though the reach. Through the, uh, REACH vet program, the VA uses AI to scan medical records and to look for signs of vets, high risk of suicide. Uh, a, a report on the VA website notes that Alvez, uh, vets, I better get that right. Atz, uh, will be working closely with Scott Duvall, who heads up the VA informatics and uh, computing infrastructure.

To put VA data to work for veterans. An example of million veterans program MVP, which has already collected genomic and health data on more than 750,000 consenting veteran volunteers, making it one of the world's largest genomic databases. Uh, this is what we need. Let's see. Closing. Oh, here's a good quote.

Uh, this is what you need to do. Optimal ai, a lot of deep knowledge. Altera VITs. Said in the report, AI is the key to really taking advantage of the data to help vets and potentially others as well. Uh, interesting. You know, so what on this, and this is really simple, uh, what's your answer to this question?

This is an important discipline. Who in your organization is responsible for it specifically? ai. AI is is a very important discipline. Who is responsible for it within your organization? If you can't answer that question very quickly. It might be something you want to give some mind time to. 'cause uh, this will be a specific diff discipline and, and it could be a part of your analytics and, um, part of your advanced analytics as, and big data strategy.

Uh, it could be something completely different and I think it probably will be something completely different. It is a discipline into itself. Uh, okay, let's move on. So John Muir Health outsources it revenue cycle analytics, and more to Optum, Mike Millard. . , uh, Millard, no. Yeah. Millard, uh, healthcare IT News.

John Muir Health and Optum are embrace, uh, embarking on a new partnership that will see the Bay Area Health System outsource most of its technology and billing functions to United Health. Subsidiary Optum. Why it matters, Optum will manage, uh, John Muir's, nonclinical IT systems analytics, revenue cycle management, purchasing, and claims processing.

The company will also work to boost the ambulatory care. Coordination and utilization management services for John Muir, uh, physician network. The goal officials say is to streamline the efficiency of administrative operations using innovative technologies, helping reduce administrative workload and allowing health systems focus more on patient care.

There's your phrase when you hear that phrase, just think they are outsourcing. Uh, you know, we are gonna reduce administrative workflow by allowing the health system to focus, focus more on patient care, which means. Hey, we're not that great at it in certain areas, and we're gonna get really good at it because we're just gonna go partner with somebody who's really good at it.

Uh, Optum also hopes to accelerate John Muir's value-based care efforts by deploying some of the, some of its own clinical technologies and advanced analytics software at the point of care, helping the health system with patient engagement and pop health, uh, as part of the, uh, terms of the deal that were not disclosed.

Well, I don't know how we know it, but as part of the terms of the deal that were not disclosed, some 540 John Muir staff will become Optum employees as a team dedicated to the health system, uh, officials say, uh, noting that those employees will gain access to new skills training, workforce development opportunities.

So, uh, so those people are gonna be Optum employees. Uh, let's see. Anything else they go on and say anything exciting? . Uh, so, uh oh, here's some. So a trend towards outsourcing of IT services and revenue cycle capabilities has been gaining momentum across the industry in recent years. But this deal is more extensive and sizable than many.

Another different strategy has been tried recently for Providence St. Joseph Health, a major epic client that recently acquired Epic Consultancy Blue Tree, bringing the company's expertise in-House to help advance its own quality improvement efforts. While also diversifying its revenue stream by helping other providers with their IT initiatives.

Uh, let's see. That's about it. So what uh, outsourcing the basic tasks of it and revenue cycle and other things is making a comeback. Uh, you know, here's the simple question. Can you provide the basic services of compute, storage, network security better than an outsource provider since this shows for health, it not necessarily RevCycle people,

Uh, you know, can you provide those things better? Um, and I guess the, the, the first question would be, what is better? Um, so better would be more reliable, less cost, more flexible, um, more adaptive to the needs of the organization. I. Uh, you know, if the answer's no to those, well, you may wanna get better at it real quick or start interviewing potential vendors because this is a trend that's starting to kick up.

The, uh, the margins in healthcare are not that great. You can't afford to not be at the top of your game in terms of your ability to deliver these basic services to the health system. And, uh, and business leaders are starting to try to figure out how to move a little faster. And, uh, outsourcing is one of the arrows in there quiver.

So, uh, just know that that's there, know that that's a, uh, potential. Let's see. Let's do this story. So, uh, 'cause I think this is interesting. So for, for value-based care, a Texas health system puts cost and risk data at the point of care. Healthcare IT News, bill Swick, uh, let's see. With the cost data technology integrated with its Epic, EHR, Houston Medical Youth, Houston Methodist, Sugarland.

Has reported approximately 717,000 in attributable cost cost savings with an average incremental cost reduction of $105 per admission. The shift from volume to value-based care and payment models requires physicians to focus on exceptional care delivery. While also managing resources appropriately.

Physicians always focus on quality of care, but now they also are being called upon to partner to reduce overall costs. So how do they do that? Ultimately, however we can, we can't partner to manage costs if we don't have the data. We need to aid, aid in cost consciousness, clinical decision making said, uh, Dr.

ston Methodist Sugarland, uh,:

A smaller survey conducted with physicians at one of the Houston Methodist hospitals, uh, reflected a similar result. The adage, you can't manage what you can't measure it. Uh, it's absolutely true. You can't manage what you can't measure. Uh, so that rings true. Uh, our physicians need data and, uh, to be true partners in clinical and financial stewardship efforts.

And so what did they do? They implemented a smart ribbon. Uh, this is just one of those models to, to get the data into the workflow. The Smart Ribbon is from a vendor called Lummi Ilum. I-L-L-U-M-I Care, Lummi Care, uh, a healthcare IT startup located in Birmingham, Alabama. They bring that data right into the ribbon so that when, when they're seeing the, uh, the patient and they're caring for them.

Uh, they're able to see cost data, and in that cost data, they're able to help them to navigate the, uh, most appropriate level of care for what they're trying to do. So it's not just, uh, putting them on a path that says, we're gonna get you 65 tests. We're gonna send you here, we're gonna do this. It's actually.

Uh, considering and talking to the patient about what's the level of care that makes the most sense for them, that they would like to, uh, that they would like to have and not have surprise bills, not be, um, uh, not be in control of their own destiny. So I'd, I'd like this, I even though this article is really a.

Um, a piece to, uh, promote Illumina care. Uh, but I, you know, I'll give it a shout out because I love the solution. You know, if only 72 per, if 72% said, Hey, this data would be valuable, and only 28% are receiving it. This is one of those areas where you can get a quick win, get that data in front of the physicians, and let them to care for their patients in a, in a.

In a little better way. So, um, uh, one thing I wanna hit on, and this isn't even a story, this is just a flat out advertisement. Um, a video made its way into my feed, and I'd rarely look at these videos, but this, this looked interesting. And the, the video was on, uh, AWS outposts. So AWS Amazon Web Services outpost.

And, uh, what AWS outposts are, are fully managed configurable, compute and storage racks. Built on AWS designed hardware. Uh, and so you can use this anywhere. They'll, they'll send you the AWS outpost and it extends your, your native AWS services. And, uh, you can put that in your data center in a colo space, uh, on-prem facility and, uh, and, and extend your AWS and your VMware cloud to your data center.

e moving to the cloud back in:

Uh, we just couldn't get it done with anybody. So we had to, we had to build out our own. Um, but I, I think that's an old model. I think that model's going away, and I think this is, this is one of those things that I think is, is the next movement you're gonna see in cloud services from these cloud services providers.

I would be shocked if we don't see this from Microsoft today. What Microsoft relies on is that you're gonna build out your compute, your storage, um, and, and, and, uh, architect that rack correctly and, and then connect to their Azure. And I think what they're finding as well as others is . You know, good architectures are hard to find.

Uh, the architecture on this thing is this video is worth watching. The architecture on this rack is exceptional. The, the, uh, density, they're able to get into that rack, uh, the way it's architected for, uh, continuity and failover is exceptional. And this is what happens when you, um, you, you, you, you take all the knowledge that they have from AAWS in the racks in, in their data centers around the world.

And you, you put that towards a problem, which is how do we extend this thing all the way down into the, uh, environment that we are trying to serve and extend our cloud to the, uh, to the client data center. Um, again, video's worth watching. The concept is worth watching. I think you're gonna see this, uh, more and more.

We saw this in different ways. Way back when, uh, Google search, there was a Google search appliance. . That we used to, you know, we used to buy that Google search appliance and put it into our, uh, environment, and we'd be able to provide Google-like search across, uh, all of our data stores within our, uh, environment.

And that's still may be available. I, I haven't looked at it, uh, recently, but those, those, uh, cloud providers with really good architects are thinking, how can we get this down into the, uh, into the environment? Worth a look. Um, you know what, that's about 20 minutes. So, uh, you know, that's all for this week.

We'll get to some of these stories hopefully next week, 'cause there's, uh, some really good stuff, uh, going on here. So, uh, you know, this past Friday we spoke with, uh, Seth Hane, VP of RD for Epic on ai. Wonderful conversation. If, uh, if you hadn't had a chance to listen to it, you, you may want to check it out.

Um, keep sending me your comments. Bill it this week in health it.com. Uh, good, bad or indifferent. It all helps. I'm getting some, uh, interesting feedback on our, uh, daily, uh, launch that we just did, and we're probably gonna revamp it based on your comments. And I, you know, again, keep 'em coming. Really appreciate it.

Um, and, uh, you know, be sure to tune in this Friday. Uh, we've already recorded a couple shows and, uh, we're gonna be recording another, uh, we're gonna be recording a couple more, uh, up upcoming here shortly. Uh, you're gonna wanna check those out. So this show is a production of this week in Health It. For more great content, check out the website this week@healthit.com.

Or the YouTube channel at this week in health it.com. Uh, just click on the video button on the top of the website. Thanks for listening. That's all for now.

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