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 Welcome to this week in Health IT News, where we look at as many stories as we can in 30 minutes or less that will impact health it. My name is Bill Russell Healthcare, CIO, coach and creator of this Week in Health. It a set of podcast videos and collaboration events dedicated to developing the next generation of health leaders.

It's Tuesday Newsday, and here are some of the stories we're gonna talk about why digital healthcare lags from Ed Marks former CIO of the Cleveland Clinic. Uh, standardizing metrics for EHR log data. Uh, interesting work that's being done by the AMA, uh, VA set to open fully five G enabled hospital in California.

I have no idea what that means, uh, but we'll take a look at it. Advent Health Switches from, uh, Cerner, EHR to Epic. Interesting Providence and Cedars break ground on half billion dollar expansion. Bon Secours Champions best idea wins through merger. Uh, a really good article from Becker's and ONC Don Rucker calls out hospital leaders who signed Epic's opposition letter.

He is a lot of fun. Uh, we had him on the show. A lot of fun to listen to, a lot of fun to read about. So we will, uh, take a look at that story. This episode is sponsored by health lyrics. I coach healthcare leaders on all things health. IT Coaching was instrumental in my success and is the focus of my work at Health Lyrics.

Uh, it's really, uh, quite simple. Healthcare suffers 'cause health. It is lagging. We amplify great thinking to propel healthcare forward. That's it. And, uh, you know, that's what we're trying to do. Uh, with the show. That's what we're trying to do by, uh, on Tuesdays we look at the news to keep people current.

And on Fridays we interview industry influencers. So that, uh, we can uncover the best thinking within the industry and, uh, get it out there to as many people as we possibly can. So if you wanna help the show, best way to do it, share it with a peer, uh, get it out there. Um, so, uh, today it may sound like I'm in a bad mood.

I've read a lot of things that I'm sort of scratching my head on. Uh, but, uh, you know, I try to be constructive on the show, try to present solutions so, uh, you can hold me accountable to that. Alright, let's go 10 stories under 30 minutes. Uh, why digital Healthcare lags? This is Ed Marks former CIO of the Cleveland Clinic and a frequent guest on the show.

Um, ed wrote this on LinkedIn, so if you wanna find this article, go to LinkedIn and find his profile and pull it up. So he gives 10 reasons why digital healthcare lags and I . I love it. It's, it is really good thinking. So IT leadership, uh, . He says, gulp, this is me, my circle, my friends. We unintentionally became inbred.

We believed that to be effective, our workforce had to possess healthcare experience. We are special, unique balder Dash, we stifled innovation that comes from hiring from outside ourselves. To include progressive industries. We insisted everyone have 10 years of this or that in healthcare. Worse, we specify technical degrees.

The best teams have a mix of degrees and experience in and outside of healthcare. We can fix this. Alright, so he goes on 10 more of these. I'm gonna gonna touch on some of 'em. I'm not gonna read all of them. Uh, people development. We stopped growing our teens once they left orientation. Great point. Uh, finance.

He talks about old practices and how we, you know, we have this return on investment metric and these . Governance structures, uh, but digital changes things. It's marked by agility, velocity, return on experience, but we still employ the old methods, uh, supply chain. He talks about operations. Uh, we desire digital technology adoption such as virtual care, but struggle to evolve because of tradition and cannibalization fears.

There's a fear of use cases for, uh, emergency departments to adopt virtual care, but resist because of potential revenue loss or ed. Patient volume decreases. Uh, this is all true. Clinics digital synonymous with transparency, simplicity, service and automation. Bottom line, the experience. USAA, Marriott, American Airlines know more.

Uh, about me and my family, uh, than my hair healthcare system. It is easy to communicate through multiple channels, easy to make appointments, easy to interact, easy to share information. Easy, easy, easy. We could fix this. Uh, he talks about fear. Uh, fear of failure. People have said, you know, fail fast. This is what they do.

And then, um, and then healthcare says, Hey, we can't fail fast. We're talking about people's lives. And he talks about failing safe, utilizing the technology in areas where, you know, it's not gonna impact patient care, but you can see how it impacts, uh, the overall environment and then slowly adopted. Uh, in other areas, but failing safe, but still failing fast, we have to be able to make mistakes within healthcare.

He talks about the Lone Ranger, uh, mentality. And then the last one is chiefs. I, I like this one, so I will read this one. So each year we fall further behind. Digital CEOs get increasingly frustrated. I. I've seen that. I've talked to CEOs who say that appropriately. So we hire more chiefs. We don't address culture too difficult, too controversial, too confrontational, uh, easier to hire more chiefs.

We ri the, we see rise of chief digital officers, experience officers, innovation officers, transformation officers, digital, uh, uh, what'd I do wrong here? Data officers, knowledge officers, business development officers. Uh, new chiefs plus existing chiefs make a bunch of chiefs . You can, you can see where this is going.

Inadvertently gridlock, multiplies smart ideas and people, uh, smart ideas and people, but execution paralysis, given competing agendas, silos, and duplicative teams. Costco up frustration increases, gaps Widen, we can fix this. The, you know, as you know, I try to end each, uh, story with a so what? And the so what on this is.

I have nothing to add other than amen. This is a great, really well read, uh, written article. Um, LinkedIn Hit Ed's profile. You can, uh, download it, take a look at it. Alright, next, uh, next article. Standardizing metrics for EHR log data could help combat clinician burnout, healthcare IT news. I pulled two, uh, two uh, things from the bottom of the article up just to highlight this.

Meanwhile found that EHR messaging improvements. It could be key to reducing physician burnout and concluded health systems should reconsider whether system generated automatic messages are the best way to ensure quality of care. Alright, so you have these two studies. Now I'm gonna go into the articles.

So the research was led by Dr. Christine Sinsky, S-I-N-S-K-Y, vice President of Professional Satisfaction at the AMA and an expert on physician burnout. The report notes that the use of EHR log data to further understand the clin clinical environment in a nascent science and sinski proposed standardizing or standardized metric is comprised of seven core measures for auditing EHR log data, which reflects multiple dimensions of practice efficiency.

Those encompass total EHR time work, outside of work time on documentation, time on prescriptions. Inbox time. Teamwork for orders, teamwork for orders, and an aspirational measure for the amount of undivided attention patients receive from their physician during an encounter. So that's the Unin undivided attention metric.

This is a good set of metrics. I, you know, my so what on this is good work, good approach. I, uh, you know, I, I'd love to see us to really tackle this problem of clinician burnout. Uh, as you heard in last week's show, I experienced some of this with the, the poor nurse practitioner sitting in front of, uh, the EHR and not leaving the side of the EHR.

If, if I had to say, you know, which one she, you know, cared for more, she cared more for the . Uh, computer. Then she cared for the patient. Now, the good news is there was a lot of nurses coming in and out. That was sort of her, her prescribed role was to sit in front of that, um, sit in front of that com, uh, computer, and they orchestrated it in that way.

So, uh, here's the thing I wanna make sure that we don't do, and, uh, don't treat this as a, as, as a potential leading metric. It may, it might be a lagging metric. Um, you know, this could be the result. As you know, we've talked to other people in the industry. About clinician burnout, and it could be a result of changing business practices, uh, compensation practices, reimbursement, bad policies, business culture, uh, as well as bad imp uh, software and bad implementation.

But it, it's, it's really a, there's a lot of things. If we wanted to create a clinician burnout metric, it would have to encompass more than just these things. Although this is a great set of . Uh, metrics to, uh, to start with, and I'm sure Dr. Sinski's gonna head in that direction, uh, once they really tackle this, uh, the burden of the technology on the, uh, practice of medicine.

So, uh, I just wanna make sure we see the whole picture on this and keep our eye on, uh, the, the, the, the greater problem that is out there. Alright, next, next story. VA is set to open fully five G enabled hospital in California healthcare IT news. So, uh, here's what it has to say. The advanced cellular networking capabilities will enable the delivery of telesurgery services to veterans, allowing physicians to consult during surgery even across the country's sec said Secretary Robert Wilke.

Along with decreased wait times for appointments and better overall care, the secretary appointed several other programs designed to provide veteran better veteran care, including a pilot program to develop exoskeletons that stimulate the SM spinal cord. Instead, the exo, uh, instead of the exoskeleton moving the patient around, the patient can increasingly control the exoskeleton as the, as their own muscles are reactivated.

So Voki. With further research at the va, we are hoping to turn exoskeleton from a mobility device into something that trains injured people to walk again under their own power. Uh, not to call anyone out, but this, this story is probably goof written. It's a goof written article. Um, 'cause I, I, if I'd looked at these two things, this, this article is really about the exoskeletons.

Wow, awesome. I mean, this is awesome stuff. It's the stuff that the VA should be leading on given the, uh, mix of their patients and the things that they're dealing with. Uh, it's exciting stuff. Uh, you have, you have, uh, uh, neural uh, connectivity to these exoskeletons. You have the ability for them to start to control to ga regain movement.

That is ex, that's exciting stuff. Now maybe it doesn't get as many clicks as five G today, and maybe that's why it was highlighted, the five G stuff. Quite frankly, uh, you wouldn't make a hospital five G enabled. It's . I'm not even sure what that means. Uh, you're still putting in fiber optics, you're still putting in CAT six E.

Um, a five, five G would not be able to run the entire hospital. So you have this underlying network that's still in place. All the things that are talked about in this article in terms of, uh, being able to do consults and telesurgery across, uh, the country, even across the world, have already been, uh, demonstrated.

There's a surgery that was done between the US and India. Uh, where the patient, where they were in, I mean, we could do this across fiber optic, we could do this across Cat six E and actually it's preferred to do it that way. It's much more reliable. Um, so there's really nothing in terms of how that, uh, you know, how it, it's a, it's a bad title for the article.

VA set to open fully five G enabled hospital. I don't think there is a fully five G enabled hospital. . Metric at this point. And the exoskeleton stuff is really awesome. Uh, and I would love to hear more about that and love to see the VA really pump a lot of money. Research time, uh, report, give us, you know, information, how is this progressing and, and how are we gonna see this, uh, come out into the, uh, commercial hospitals, um, as well.

So, . Exciting work. I like what the VA's doing. I like that. Secretary Wilkie is really pushing the envelope, uh, there, um, in terms of advancing, uh, advancing the VA through technology. So exciting work. Um, alright. Advent Health switches from Cerner EHR to Epic. Uh, this is a, uh, I, I got this from Becker's. This was reported in a lot of places, as you would imagine.

Uh, here's their statement. Advent Health is making a multimillion dollar investment in the transition to a new enterprise wide platform. And it is an investment that we see as necessary and essential in keeping our promise to our patients and caregivers in light, uh, of. That a significant portion of that investment is focused on ensuring that our entire system is properly trained on the new platform, helping to ensure a safe and secure and smooth transition.

Alright, just in the interest of time, you get, you, you've read a hundred of these articles, you know how it sort of goes. The so what on this? Uh, my take is the best. HR is the one that you're on. I maintain that this is the case, unless there are extenuating circumstances, 37 hospitals, it's gonna take a billion dollars or more to complete.

Um. This was gonna be a eat up a bunch of time and focus for the health system and the people, uh, involved in it. Uh, when they complete, they're gonna be where the rest of the industry was five years ago. They're gonna be completing their EHR implementation and starting their optimization process. Uh, there could be cultural rea.

I I will admit there could be cultural reasons to do this. Uh, there could be operational reasons to do this. There could even be clinical reasons to do this, but I doubt you can convince me that any of these couldn't be overcome with far less than a billion dollars in five years of time. Uh, that plus the fact that the market is moving.

There's new entrants, there's new digital solutions, there's new requirements. Uh, there's, uh, you know, even the, the other thing I would consider is Cerner's partnership with AAWS may propel them ahead of Epic in the next five years. Won't, this seems silly. If that is the case. I'm not a fan of switching EHRs, unless the case is really compelling.

Solve the right problems. Stop switching EHRs. Um, that's, that's what I maintain to be the case. Again, I am more than happy to discuss that with anyone. I'm sure there could be valid reasons for doing this. I just can't imagine the amount of time and the amount of money that's gonna be spent that it makes sense.

Plus, I really do think Cerner's AWS uh, implementation, I think their new leadership, uh, I think they had lost their way, and that's one of the reasons that this switch is probably happening, but I think they're heading in the right direction. Alright, next story. Providers must invest in consumer technologies or risk irrelevance healthcare IT news.

Um, let me sum this up. This is a, uh, article, um, written, uh, really an interview with, uh, Aaron Martin from, uh, Providence and I can sum up this article in three sentences. Healthcare is behind digital enhancement. Engagement is necessary, and if you can't get there yourself, you should partner with somebody.

That's essentially what this says. This article could have, could have been written eight years ago, six years ago. Four years ago, two years ago, um, I could republish it in two years, uh, without changing a word and it would be true. Uh, so here's my take. Uh, my take is know what you're reading. Providence is a vendor.

They're not the only one, but Providence is a vendor. There are a bunch of health systems that have decided that they are going to be in the business of selling things to other health systems. So just know what you're reading. Aaron is smart and I appreciate a lot of what he says. Um. And as I said, there's nothing really new in this article.

The only thing that's new is that Providence has a new digital engagement tool that they are taking to market. They also have several other point solutions that they're investors in. They may be good tools, they may be great tools. My only point is to know what you are reading. This is a pitch from a vendor.

Uh, there's another story out there with some good thinking in it as well, but it is marketing. Know what you're reading. Um, take the good ideas. Evaluate the tools for what they are. So, uh, another Providence story. So, Providence, Cedars-Sinai Break ground on 520, uh, $542 million expansion at jointly owned hospital.

The expansion includes building a six story 223,000 square foot patient tower, expanding the medical center's emergency department, and adding space for more outpatient services. The project is a joint venture between Renton, Washington based Providence and Los Angeles based Cedar-Sinai. The two organizations signed a co-ownership deal for Providence Tarzana early last year.

Uh, Providence will retain controlling interest in the medical center. Uh, so what, actually, to be honest with you, I don't know what to make of this. I think we're gonna see more of it, uh, but it's kind of perplexing to me. Cedars has the brand in la. Providence has bought into the market. Uh, I guess they call this co-Opetition is, uh, what we've heard it called.

Um, Cedars had the money to do this themselves. It's just a curious thing, but let's talk about it for a minute on this. Uh, if this becomes the norm, I have a couple questions. You know, how much will it be a consideration or will it be required to adapt to these kind of models? Uh, when someone checks into this hospital, are they a Cedars patient or are they a Providence patient who owns the record?

Uh, who controls the record? Can one health system sell access to the record to pharma without the other one knowing? Um, when they select a PAC system, will it interoperate with Cedar's platform or will it interoperate with Providence's platform? Uh, you know, these are interesting deals. What, um, I, I'm more curious what you think of this deal and what, what it will require of health it moving forward.

The philosophy was never for one system to take over the other. Rather leadership, including CIO, of the combined Bon Corps's Mercy, mercy Health, Laci Williams, Carlson work to merge the best practices of each system. Okay. Uh, this is Becker's article as well, by the way. Uh, she followed the model set by CEO, John Starcher of moving from alacrity and zeal of moving with alacrity and zeal.

Love that. . That's great. Uh, he would say, we are not going to have the Noah's arc model. Uh, with two of everything. This model leaves your organization in a state of limbo for a longer period, and it's destabilizing, said Ms. Williams Carlson. It's important to move quickly and thoughtfully when making tough decisions.

Uh, the so what on this is, uh, you know, we talked about this before we talked about this because I heard, uh, John Starcher, the CEO speak at the, um, at the JP Morgan conference the last two years and two years ago he talked about the merger, and then this year he gave an update on the merger. And, uh, it was interesting when he talked about it the first time, he said, you know, we made a bunch of decisions right out of the gate.

We knew which EHR we were gonna go on. We knew which ERP we were gonna do. We knew which PAC system we were gonna do. He goes, we made those decisions very rapidly. We also, um, identified the top 30 leaders within the health system very rapidly. And we identified the next layer underneath that of leaders, and we identified them within the first 30 to 60 days.

They removed a lot of the fear, uncertainty, and doubt associated with the merger, and then . You know what they did and from an IT standpoint is. They, you know, they pick those right solutions and they started work almost immediately. Too many of these mergers come together, and then they start the work of, oh, what are we gonna do?

And then they spend the next six to nine months, or year or two years, uh, with committees trying to make decisions on what systems to do. The problem is that that just breeds a bad culture when you're making these decisions that quickly you start working together on a shared . Uh, and common goal of, of, uh, eliminating these applications, bringing these systems together.

If you keep people working towards common set of, uh, objectives and goals, they're not gonna have time to get all bogged down into, do I have a job? Do I not have a job? They have a job. There's a lot of work to do. We're always saying this in mergers. There's a lot of work to do. Uh, they did this well, they did this right.

It's a model. I hope we, uh, get more documentation out of this merger and how they did it. Uh, because it is, uh, it is truly exciting. Alright, last, uh, last but not least the story. I will leave you with O C's. Rucker calls out hospital leaders who sign Epic's opposition letter. Uh, fierce Healthcare is where I'm pulling this from.

Uh, speaking at Health Datapalooza on Tuesday, Rucker, who's the head of ONC, uh, for health, it acknowledged that privacy in a digital world is a challenging issue, but he reiterated his perspective that patients should be able to easily access and share their medical data. It is our human right as patients to have access to our data.

He said most of their customers, uh, did not sign that letter. Rucker said, if you parsed out the big academic medical centers, only three out of a hundred AMCs signed on. He also called out hospitals that signed the opposition letter due to the claims about data privacy concerns, but then disregard patient privacy when filing lawsuits for unpaid medical bills.

One of the signers of the letter is known for taking thousands of patients to court. If you take someone to court, that information becomes public discovery. Their medical care is now public. It's part of the court record. He said, looking at protecting privacy, we need to walk the walk here as we look at who is saying what, and letter writing, uh, who's saying what in the letter writing campaigns.

Um, I, and you know, I said this. A couple weeks ago when people signed this letter, I said, I would stay out of this. The reason I'd stay out of it is 'cause big punches are gonna be thrown in both directions. And, uh, you know what happens when you get in the middle of a big fight with, uh, prize fighters?

You, you get hit and you, uh, and that's what is starting to play out. This is gonna start to play out in the court of public opinion. I. I think we may see some, uh, poli, uh, you know, some political candidates start talking about this type of issue. Uh, it's really interesting he went on to say, APIs are the technology used to link IT systems such as EHRs with apps, and we'll bring healthcare into the modern app economy according to Rucker.

O C'S vision is for patients to choose what apps to use. He said, we often looked at interoperability in a narrow view. I love this. We often looked at interoperability in a narrow view, which is just as a replacement for moving the patient's chart. Modern computing and APIs offer a vastly richer and more empowering global computing environment.

Well-built APIs can almost, uh, can do almost anything that your creativity allows. He said, here's my so what. He's not wrong. Uh, you may not like how he says it, but he's not wrong. APIs and we've experienced this, you know, we used to, um, we used to have green screens and then we, you know, the internet came out and then we had visual internet and, you know, graphics and we could click on images.

And then we had, uh, you know, we had APIs sort of come about and then we had apps sort sort of come about. And I don't know about you, but I'd rather interact with, uh, there's a whole host of things now I'd rather do on my phone. Than on the, uh, on the webpage. And that's just the morphing of how data moves and how we interact with data and how data is used in our environment.

And, uh, and that's gonna continue. The, the ONC is gonna win this, by the way. The government is gonna win this. Go figure. Um, and, uh, and this is gonna become the, uh, the rule, the operating rule. We're gonna have to figure out how to operate with this and, uh, and we should. Quite frankly, uh, this is, this is the future.

We say we're about technology and moving healthcare into the future, and we're about what's best for the patients. This is what's best for the patients. This is what the future is. That's all for this week. Special thanks to our sponsors, VMware Starbridge Advisors, Galen Healthcare Health lyrics and Pro Talent Advisors for choosing to invest in developing the next generation of health leaders.

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That is greatly appreciated. We'll be back again on Friday with another inter interview, and on Tuesday we'll be back with another news story. Thanks for listening.