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 Welcome to this Week in Health it. It's Tuesday News Day where we take a look at the news, which will impact health. It today looks like Amazon finally opened their pharmacy offering, which caused some interesting I. Ripples in the industry. We're closer to a vaccine. I asked the question, are you ready for your vaccine rollout plan?

Apple came out with some new, uh, silicon, which is, uh, really fascinating and I'm looking forward to Christmas at this point. CVS, uh, put out some contactless, uh, payment options, and we talked about that a little bit as well. So we've got a lot on the plate, plus a hundred hundreds of other stories out there, a lot going on.

My name is Bill Russell, former healthcare, C-I-O-C-I-O, coach. . Consultant and creator of this week in Health. It is set of podcast videos and collaboration events dedicated to developing the next generation of health leaders. . I wanna thank Sirius Healthcare for supporting the mission of our show to develop the next generation of health leaders.

Their weekly support of the show this year has allowed us to expand and develop new offerings for the community. And for that we are incredibly grateful. Three x extracts is a service of Drexel Ford, frequent contributor of the show, and I'll probably . Have Drex back on first week of December or so.

We'll see what his schedule's like. I'm looking forward to that. Drex has this service, three X Drex, where he sends out three texts three times a week and he vets three, three or four stories, and he puts those right there in that text. If you wanna stay current. Great way to do that. Go ahead to receive those texts.

Go ahead and text Drex, DREX to 4 8 4 8. Four, eight. All right. As we have been doing lately, we, uh, start the conversation on LinkedIn and then we move over to, to the headlines just to take a look at the headlines real quick and what's going on. So this past week, what happened? Well, bef , here's, here's, here's what the story read before the opening bell shares of CVS Health Corp fell almost 7%.

Walgreens and Rite Aid tumbled 10%. And the story that was announced was that Amazon opens online pharmacy shaking up another industry. I pulled the Politico report, but there's, there's an awful lot of places you could pull this story from the article. Amazon will begin. . Let's see am Amazon will begin offering commonly prescribed medications Tuesday, including creams, pills, as well as medications that need to be stay refrigerated, like insulin shoppers have to set up a profile on Amazon's website and have their doctors send prescriptions there.

Uh, most insurance is accepted. Amazon said, but prime members who don't have insurance can also buy generic or brand name drugs from Amazon for a discount. I just asked the question, what are your thoughts? Is this a game changer or just another ? Player trying to get, trying to get their place in the industry.

And the, the, the response in that was that people thought this was gonna be a significant play and a potential game changer. People do want that one-stop shop, uh, for getting their drugs. And so it, it, it, it's interesting because . Jeff Bezos, that whole team, that Amazon team is really good at getting the, the distribution channel out there, the access channel.

They've set up the loyalty program in Amazon, uh, prime. And uh, so there's a belief out there that this could, this could be fairly disruptive and if, if you're only claim to fame is that you're within two miles of the location, uh, that somebody is sitting, that may not even be good enough. At this point, you may need.

To have a digital strategy in order to, to compete on the, on the pharmacy and prescription drugs, so that'll be interesting. . Another thing that happened this week, Moderna's Coronavirus vaccine found to be nearly 95% effective in p preliminary analysis. That makes two. So yeah, the Pfizer drug, yeah, the Moderna drug, they're a little different.

It needs to go through peer review. Questions remain. How long will the protection last? Will the results be similar across all subgroups? Does the vaccine decrease the infectious infectiousness of the virus in people without symptoms? Both vaccines deliver a strip of genetic material called Messenger, RNA.

To teach the body to defend against the virus, and we talked about this last week. This is a significant change from what we have done in the past, right? So we used to inject, uh, a form of the virus in there, small aspect or even a dead aspect of the virus into your body, and then your. Body would, uh, generate the antibodies.

This is a, a genetic solution, genetic, genetically engineered solution where they actually put in that messenger, RNA, and your body develops the, uh, defense against the virus on its own without, without actually bringing the virus into the body. So new aspect to that. Pretty interesting. The first shots could become available in December.

Can be stable at refrigerator temperatures for a month. So you have that aspect, aspect of it as well to consider. Uh, I just asked the question, what's your plan for distribution? I didn't get a lot of responses on this, to be honest with you, and, uh, a little concerning. I, I'm, I'm hoping that this is top of mind.

How are we going to, how are we, uh, first of all, how are you gonna, if you're gonna do the Pfizer vaccine, how are you gonna store it? And do you have the capabilities to store it? How are you going to track people? Are you going to . Do you have the, the fields necessary in your EHR or whatever mechanism you're going to use?

Do you have the partnerships in the community to track it as well? What system is gonna be the system of record for the vaccine and who's getting the vaccine? I, I, I saw Chime sent out something in terms of, and never let a disaster go to waste. Saying, Hey, we need a national patient identifier. Again, I think it's a specious argument for why you need a national patient identifier.

We don't even have the, the core systems in most geographies to track this at the local health system level. So we, we should be developing those things. We have patient records, we, we can address the duplicates and those kind of things without a national patient ID at this point in time, we can't make the excuse that we weren't able to track this because we didn't have an NPI in in place.

With that being said, what is your plan? What's your plan for distribution? What's your plan for tracking? What's your, what's your, uh, digital strategy around that? I think that's, uh, something we should all be asking and figuring out. I think that one step further on this would be what's your plan to communicate to the community?

Right. So nothing has been more politi. I, I, I don't remember anything healthcare related that has been more politicized than this vaccine. You could have, uh, progressives saying, I'm not gonna take this vaccine 'cause it was developed under the Trump administration. I don't trust it. And we've heard some of that.

We've heard conservatives or even right of conservative people saying, I'm not gonna take the vaccine 'cause I, I, this isn't, we don't need to. It's not a real virus. I won't say that. That's the, the people are saying that's what all conservatives think. I don't think that's true. I think that is the, the right end of it.

The extreme right end of it. And I think it's the. Extreme left end of it. That's saying this is a, a Trump developed vaccine. It's not a Trump developed vaccine. It's a Pfizer developed vaccine. It's a Moderna developed vaccine. They're going through trials, they're going through peer review. So it, it, it's, but now it's, it's upon us really as the trusted source for health information in our communities.

How are we gonna work with marketing? How are we gonna get the message out there? How are we going to, to get as many people to take the vaccine as possible? This is one of the, the, probably the, the greatest challenges from a marketing standpoint. Marketing your health system. Not that hard, to be honest with you.

I mean, people have to go to the hospital for acute care and other things. You've built a network. This will really tax our marketing. Groups, how do you influence the behavior of your communities to do what's in the best interest of their health? And the more people that have developed antibodies, the more people that have taken the vaccine, the closer we are to getting to the other side of this.

People listen to Fox, they listen to CNN, and they listen to NBC and whatever, but they don't place as much trust in that as they do their local health system and it's specifically their local doctor. And so how do we get that message out using the trust that we have developed over the years? To, to get people to take the vaccine.

I a, again, I think that's an important project and I hope to see, I hope to see some really interesting and cool solutions moving forward. I, I, I'm, I expect a lot from Atrium. I think they do a great job marketing to the community. Mayo does a great job. I, I think different health system. I don't want to, uh, Intermountain does a great job.

I, I don't wanna call out different health systems, but there, there are systems that really understand how to . How to communicate with their communities in a way that their community can, uh, understand it and, uh, take it in. So that's, that's one of the things I wanted to call attention to. Let's see, CVS.

So CVS, uh, nothing exciting here, right? They're doing some contactless payment options, uh, pay PayPal, Venmo, QR codes and whatnot. My question on this, to be honest with you is Covid was actually the catalyst. It is a catalytic event. Right. And it was a catalyst event that we could have used in health it to get rid of the clipboard and pen across the board.

No one wants to go into the, the waiting room and be handed a clipboard and pen anymore based on just if they've done any reading of articles and, and they know about fomites or, I mean, with limited information we have. . We don't want to be handed things in the weighted room, waiting room. The only thing we want to be handed is, is, is uh, some sort of sanitizer for our hands and that kinda stuff.

So we've been educated. We don't, we don't want to, uh, be touching a lot of surfaces. We want to, we wanna be careful. Uh, and then we go to the hospital and we're still being handed clipboards and pens. And so I used this article to say, look, CVS is going to contactless. Uh, there's a bunch of stats in here.

Let's see. CVS. Has seen contactless payments increase by 43% since the beginning of the year. Right? Contactless payment is now being used by nearly 80% of consumers worldwide. According to the survey by MasterCard, most consumers say they have turned to this option for cleanliness and safety reasons.

Additionally, 40% of consumers who prefer to pay with digital wallets would not purchase from merchants that do not allow customers to pay with them. While 34% of those who prefer paying with QR codes would not pay using any other method according to the survey from PayPal and payments. I think this resonates with us.

I think we know that this is true. This is an opportunity for us to clean up a lot of these manual processes we still have in our health system. I know for me, I, I've identified the stores that I can use my phone to pay. And I'm going to those over stores where I still have to swipe with a credit card.

I'd rather not swipe with a credit card. If I swipe with a credit card, I have to do something else, right? I have to pick up a pen, sign my name, whatever. I, I really like the, the phone payment system. And I, I think a lot of people do as well. Uh, and I think there's, there's gotta be, we've gotta be really smart about being able to check in with our phone, being able to fill out forms with our phone.

Look, it's not hard to send a, a form. To any device out there and have people go ahead and fill it out on their own phone and then, uh, send it back to you. You could do that in any number of different ways. So anyway, I think this is a. I think this is a good conversation to have. We had a, a little back and forth with Jerry Tony's President Mobile integrate.

Uh, I think Amazon's pharma licensing and other competitors will reduce the need to go to the physical pharmacy CVS and others are living on their prescription practices. This actually goes back to the other story. He's essentially saying, Hey, this is great. Good luck. But you know, you, you're looking at an older model and I, I don't necessarily disagree with him.

although I will say this, I was talking to somebody, uh, just last night, in fact about, uh, the local grocery stores and I'm like, are the grocery, are the local grocery stores the ones that you haven't heard of? The, the, the Publix and the Schnucks and the the Albertsons? Are they worried about Amazon's position?

And the answer I got was pretty interesting. And this is from a commercial real estate person, and it's like . They're worried about some things, but generally speaking, they're not, their business is pretty stable. It's pretty strong. It's based on where they've positioned their, their locations, the traffic patterns, the they, they've, they've really embedded themselves in the, in the, I was gonna say in the traffic patterns, but essentially that's what it is.

I mean, they've embedded themselves in the community in such a way, . That they're still a part of, of the everyday habits that people have. So it'll be interesting to see if this really does mean the end for CVS and Walgreens. And, and in their, their play as pharmacies in the local market, because we still see seven elevens everywhere.

We still see, I mean, there's still, there's still a, I don't know, there's still habits where people like to go somewhere. We're seeing this with telehealth as well. People still like to see a doctor that is still a. Thing. And so there's something about physical face-to-face that, uh, that people prefer.

We have Mark probes for Intermountain. Stephanie Real from, uh, Johns Hopkins, Gil Hoffman Mercy. Somebody just can't read real well. Oh, Dick Daniels, Kaiser Permanente, university of Utah Health. Jim Turnbull, a retired May 1st, Beverly Jordan, vice President and Chief Information Officer. Memphis, Tennessee Baptist Memorial Health, retired in May as well, and, and that that represents some people with a fair amount of longevity.

If I'm not mistaken, Stephanie Rio has been there for almost . Uh, a couple decades, maybe even three decades if I thought about it at Hopkins. And so I, I talk about the, the changing role. How important is the role of the CIO today and the ? And, and I realized when I wrote that sentence, I'm like, somebody's gonna take this the wrong way.

I, and I don't think you should. I think we should always be asking this question, what's the value of our role and what's the value we bring to the organization? And so what I took a look at is . From an operational side, keeping the systems running and making them secure, CIO's role is undisputed, right?

You're expected to do those things. Those things need to happen. The incremental in innovation role is probably unchanged as well, right? I. You need to continue to, to upgrade the EHR, continue to give it new capabilities, continue to bring in new modules, ERP, the same way core systems, pacs and other things.

That's still the, the purview and the domain of the CIO make our systems better, uh, incrementally better every year. Every year we want to see progress, uh, around that. It's, it's really on the innovation side where this thing has started to move away from a monolithic. The CIO is the technology person that we hired for all things technology, and it started to to change pretty significantly.

If, if the health system is heading in a investment direction, you'll, you'll have a innovation officer that's really focused on a portfolio of companies. And we see that at, we see that at UPMC. We see that at at Jefferson. We see that at Providence and others. We see that kind of role. If you see an innovation officer that's more, uh, internally focused, they could actually be tied to operations.

They could be tied to other parts of the organization to try to bring that in. We could, we can take a look at those. Ascension is one of the ones . That I think you see that Texas Health Resources is another one where you see that I actually, I know there's a bunch of 'em. I'm just blanking right now. And so it really depends on what the innovation officer's doing and, and, and where they roll.

And, and in a couple of cases, we've actually seen the CIO, the information officer reporting to the CIO, the innovation officer. We've also seen, uh, combined, we had Myra Davis on last week and she, uh, was talking about last week or next week. I don't remember. Uh, my whole life is, is coming together. It's, it's me meshing together.

But anyway, Myra Davis is the C-I-O-C-I-O for Texas Health, our Texas Children's, and she's the Chief Innovation Officer and information officer. I think you see that same thing at Cedars. Darren Dorchen is the, essentially the, the in, in charge of the incubator in charge of, uh, the IT operation as well.

And so there's, they're splitting and they're bifurcating. So I I, I was just wondering what's. What is the role and where are things coming or where are they going? Dan Howard has some great, uh, comments here. He said, well, in most of these retirements, the retiring CIO was co succeeded by another experienced healthcare, CIO, right?

And, and he's, he's not wrong. If you look at where these people are coming from, they're either coming from within the. Within the health system where the person is retiring from or they are picking up somebody who was already a ci, healthcare CIO. So I had argue it's still a vitally relevant at a min. It is still vitally relevant at a minimum, even if just from an operational perspective, org size and culture play big roles too.

But the emergence of CDOs. And similar PO positions that are now driving the digital innovation efforts Does, does make your question very relevant. Whether you are a current recovering or retired CIO, I'd say technology, automation and success in the role can naturally lead to where the necessity of the CIO is questioned.

Yeah, I didn't, I I just asked the question. I threw it out there, and, and judging from his answer, I, I don't, I don't believe the CIO role is irrelevant. I think though I'm seeing in a lot of cases where it just becomes more operational, right? So it's, uh, more operational, less strategic if you allow it to go there, it doesn't have to go there by, by any stretch.

It does not have to end up as an operational role. It can easily continue to be a. Uh, strategic role in the organization. I mean, think about it. You're touching the EHR, you're touching the ERP, you're touching the PAC system, and you're responsible for security. You're, I mean, you should be speaking into all, you should be speaking into all forms of, uh, digital health of access.

You should be speaking into telehealth and how it plays out. You should have strong relationships with the clinical community. You should have strong relationships from a, from a data sharing perspective with the partners in the community. It is absolutely a strategic role and can be a strategic role. I think what I might be saying is if it's not a strategic, if you're in the CIO role and you feel like you've been relegated to the operational, that may be your fault because there are opportunities to step out of that role and to be strategic within the organization just by nature of the fact that you're in technology and you're touching the most important systems.

That the health system, uh, relies on a daily basis. So that's, uh, that's the conversation. Remember, if you wanna participate in the conversation, go ahead and follow me, bill j Russell at, on LinkedIn. And I'm gonna be posting one story, uh, every day of the week, Monday through Friday with a little question.

Love to have you participate, love to highlight the things that you're saying, uh, on the show. Alright, so before we get to the headlines, and we'll get back to that in just a second, I, I want, want to ask you the question, have you signed up for clip notes? CliffNotes is you get a, you get an email 24 hours following each episode with a summary, bullet points, four video clips.

You get to know what's going on, stay up to date. It's a great way to do that with CliffNotes. We're also in the middle of our CliffNotes referral program. and if you refer someone, you get entered into a, a, a drawing to receive a work from home kit. If you get up to 10 referrals, you get a black moleskin notebook, looks something like this has this Weekend Health IT logo and uh, if you get the most referrals, you're gonna be given the opportunity to come on this show this week, weekend Health It, and discuss the news with me.

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All right, let's take a look at the news. Here's what we've got. We've got, I mentioned, I, I wanted to talk about this last week. We talked about the Zoom 5.0 release, the security update to Zoom. Uh, and I, that's a, a really solid upgrade. A lot of things to look at. You can listen to last week's show about that, but Zoom reached a settlement with the FTC over misleading security practices, so they got their slap on the wrist.

And I, I highlight this story to say that . There's probably an ethical conversation to have, which I'm not gonna have around why they did what they did in terms of misrepresenting their security practices and capabilities. But the F-C-T-F-T-C, essentially there was a spotlight on them. They identified it, they slapped 'em on the wrist.

I think zoom's actually a, a pretty solid player at this point. And ethics aside, I believe that they, uh, are probably one of the more pressure tested . Video platforms out there, right? So they're just in such wide use. I think that the, uh, hacking communities trying to open it up on a regular basis. So take a look at the Zoom.

If you're using Zoom at all, take a look at the 5.0 upgrade. And some of you, it's getting to the point. If you're like me, you have to have 'em. All right? I have teams, I have Zoom, I have, uh, GoToMeeting, I have um, Cisco WebEx. I have all of 'em on my computer. 'cause I, it depends on who I'm gonna be communicating to.

I. Uh, on any given, on any given day, which one of these I'm gonna be using. So I, it's, it's important to not only consider the platform that you're using for your telehealth, but also the ones that your organization is gonna be using, not only internally, which is something you can, you can control pretty well, but also the ones that they're gonna be using externally.

Okay. Next one. Highly successful digital leaders possess seven characteristics. This is from Gartner. And I always, I always hit these up just to see what people are saying and you know, they, they talk about digital leaders tend to think of . Digital transformation and accelerate, uh, acceleration in terms of technology, business outcomes, process changes, and their impact on people.

But they often overlook the massive disruption. I, I don't think that's the case as much anymore, but I like this. The list of seven was interesting to me. I. Number one, digital leaders are neo iliacs. Then of course, you have to look up the term neo. Neo. Being new is a term for people who are naturally attracted to newness.

Neo iliacs are always ready to explore new situations, tend to be more open to making and embracing new opportunities and curious about new ideas, right? So they're talking about successful digital business transformation leaders. Find these characteristics. So neo facs. Number two, digital leaders invent, but also copy and keep that in mind.

'cause we're gonna come up with a story on that in just a minute. Digital leaders skew industry boundaries. Number four, digital leaders appreciate that innovation is more than just creativity. Number five, digital leaders build teams with high aq. Okay, we have IQ intelligence, quotient. eq, emotional quotient are, they're fairly well known, but few leaders measure the adversity quotient.

aq AQ measures human resilience and the capacity to come back from being dealt below High AQ lends itself to better employee retention, uh, those critical for digital leadership. Number six, digital leaders never consider digital to be the outcome, right? The outcome is what the business does. And number seven, digital leaders geek out on technology and so do their people.

And it's okay to geek out on technology. Okay? It, it, it really is okay. But technology is not the ends. It's, it is a means. Alright? So I want to find this one Epic. CEO says, hospitals should have a Chief Imitation officer as its new initiative. So Epic. CEO This is a, uh, Becker story. . Becker's Health it obviously, this is Judy Faulkner and she talks about the need to have not only a good chief innovation officer, but also an imitation officer.

And all she's talking about here is, uh, and, and you can imagine this if you're sitting in Judy's seat, you see a lot of health systems doing some really cool things, and then you talk to a health system tomorrow and they're saying, Hey, we really wanna do this. And you're like, . Well, they're doing it. Why don't you just do what they're doing?

Uh, and you see it day in and day out. I think it's one of the things that makes using consultants and using the various vendor partners that we have, effectively so important for the CIO because they act as bees. That are pollinating, they're taking information from one health system to the other and, and helping you to see what other health systems are doing.

We need to do more of that. The Imitation Officer, to me is not the worst idea in the world. In fact, no reason to recreate things over and over again. Almost make it, I I wouldn't create a Chief Imitation Officer role to be honest with you, but I would make it part of your operating procedure for people to suss out.

Other health systems that are doing something similar. So if you're deciding, hey, we're gonna do something around telehealth in the diabetic space, I would do the research. I would contact those health systems, . And I would, as much as possible, I would imitate what they're doing. Obviously, taking into account the different communities that you serve, the different populations, the different technology patterns and usage as well.

So, so anyway, Judy's saying that, let's see some of the other, uh, Amwell posted 62 million in quarterly revenue, up 80%. I think I talked about that. Uh, Biden planned to lower Medicare eligibility age to 60 faces hostility from hospitals. Uh, and you can understand why, uh, hospitals don't make a lot of money from, from Medicare.

And if they see a significant portion of the population go in that direction, that could be, uh, a challenge. If you wanna read that, that is in Modern Healthcare, Cleveland Clinic extends postponement of some surgeries. I wanted to talk about this a little bit 'cause I think we, we did something early on in this pandemic.

I think that we would undo if we had the chance, and that is we instructed all health systems across the country. To, to postpone elective surgeries. And the reality is, I was talking to health systems way back when in March and April that had postponed their elective surgeries and they were just empty.

They had one COVID patient, two covid patients, and they were just empty. So to a certain extent, uh, I like this. I like now that is in the hands of the local health system to say, look, we're at 75% of our ICU beds are filled. And we can project out what it's going to look like. We can do some elective procedures or we can't do any elective procedures in the best interest of the health system.

But again, early on in the pandemic, we didn't know what we didn't know. But I like the local response. I like, I. I like that Cleveland Clinic is deciding to postpone some surgeries as opposed to being told by the governor, or even worse by the federal government, how they're going to operate in order to serve the people in Cleveland, uh, and beyond.

For Cleveland Clinic, actually 2.1 million patients had data exposed in October reported in, and this is also a modern healthcare story as well. These numbers are just . It is kind of staggering, right? So more than 2.1 million patients had their data exposed in healthcare data breaches reported to the federal government last month.

As of Thursday, HHS Office of Civil Rights posted 59 data breach reports that healthcare providers, insurers, and their business associates had submitted, uh, to the agency. Obviously a lot of this is . Stories that we have talked about in, in the, in the not too distant past. So I won't go into some of these stories, but, you know, there's, uh, this, this remains the, the issue that I think we're gonna have to get a lot better at.

And I, I know I'm, I'm, I'm, it's like, no duh. Clearly we need to get better at it, but I sit with CISOs . And I hear a lot of plans and strategies that aren't overly innovative. They are, they're incremental in their thinking, and I can guarantee you that the attackers are not incremental in their thinking.

It also requires more than just a security officer and a security office over here operating in a silo. This thing needs to be tightly integrated across the entire health system. Uh, and I think that's pretty well understood. But again, 2.1 million, uh, patients had their data exposed. I don't expect that to go down.

I expect that to go up. Until we make the make the right investments. And again, I'm not, I'm not virtually signaling, I'm not trying to shame anyone into making more investments. I think we can be more creative here. I think we need to do better partnerships. I think we need to just do the basic blocking and tackling.

If you have a BAAs and you haven't looked at your agreements with them in terms of your security posturing, they may be breached right now in breaching your information for all you know, so. . Lack of, lack of looking into it. And ignorance is no, what, what's the word I'm looking for? Ignorance is no, uh, excuse, I think is the word I'm looking for.

All right. Let's, let's close down. Let's close out on a positive story. See, hey, there's some money available. This, this is positive. SCC opens applications for, its a hundred million dollars Telehealth pilot. I got this from Modern Healthcare as well. Uh, the Connected Care program will distribute up to a hundred million dollars over three years to not-for-profit and public healthcare providers to help defray broadband costs related to bringing telehealth to low income Americans and veterans.

The program will cover 85% of the cost of select services and network equipment such as internet access for patients. The FCC said providers will not be able to use program funds to purchase devices or medical equipment for patients. In the past year, connectivity has become an increasingly critical component of delivering healthcare services in our uh, country.

Said FCC Chairman, Ajit Pi. In a statement with the opening of this application window, the FCC affirm its commitment to driving the future of healthcare delivery and supporting innovative pilot projects across the country. And so if you are looking to increase access to rural, to veteran populations, to to the underserved in your community, there is a hundred million dollars available with the FCC.

Take a look at that story. Take a look at what's available to you. Love to see that. Continue to continue to flourish. If we can get that, that broadband connectivity to as many people in our communities as possible, we're gonna be able to do the services that we envision in bringing them in a digital world.

All right. Well, I mean, there's a ton of other stories. What, what a Biden administration, Fauci talked about data sharing, public HE health needs. We'll, we'll come back. We'll talk about those things. So that's all for this week. Don't forget to sign up for CliffNotes. Send an email CliffNotes at this week in health it.com.

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