News Day - Amazon, Google, Privacy with Drex DeFord
Episode 2971st September 2020 • This Week Health: Conference • This Week Health
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 Before we get started, I wanna share with you something that we are extremely excited about here at this week in Health it, and that is CliffNotes. CliffNotes is the fastest growing email list that we've ever put together. If you can't listen to every show, but you want to know who was on and what was said, the best thing to do is to sign up for CliffNotes.

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All right. Welcome to this week in Health it. It's Tuesday News Day where we look at the news which will impact health it. Today, Drex to Ford is in the house to discuss the news, and I know you guys look forward to that, and so we're gonna do a little back and forth. It should be fun. My name is Bill Russell Healthcare, CIO, coach and creator of this week in Health.

It a set of podcast videos and collaboration events.

This episode, every episode since we started the Covid 19 series, been sponsored by Sirius Healthcare. Now we're exiting the series and Sirius has stepped up to be a weekly sponsor of the show through the end of the year. Special thanks to Sirius for supporting the show's efforts. All right. Hey, good morning, Drex.

Welcome back to the show. Good morning. Good morning. Thanks for having me. You gotta love those serious guys for continuing to Oh, they're, they're fantastic. And, uh, put wood on the fire, right? Yep. And I'm gonna be hosting a, one of their healthcare events coming up here shortly. I'm gonna be moderate MCing, I think is what they said.

I don't know what the difference between a moderator, an mc, or a speaker. I think an mc is somebody when you don't really want 'em to speak. But you just want 'em there. I don't know. No, no. I think mc requires you to tell jokes. I'm pretty sure you have to have some jokes. Oh, man, my kids are just cringing right now.

if, if that's really, I'll work with you on that. That's about some dad jokes right in the middle of the audience. It'll be fine. Hey, you know what? Every now and then I, I, for the new show, I usually give a shout out to three x Drex. How did you come up with three extracts? Why did you come up with three extracts?

Huh. That's a very interesting question. I, and so I should be at Burning Man right now, , but it was canceled last year at Burning Man. I. I happened to run into somebody that I knew who said, I follow you on LinkedIn. You post really good stories. I always, whatever you post, I always read that and I avoid everything else.

text Because it's limited to:

You can't overwhelm anybody. Maybe it's one or two or maybe three stories, and just talk about the stuff that you know is. The big stuff to you, the stuff that you find most interesting or most important, and that turned into figuring out how to do text-based blast and signing people up and what started with two or three or four and we're just keep growing and keep growing.

And so that's a story. It was born of, of Burning Man and, and keeps on going. I kind of gotta love every answer. That starts with, I should be a Burning man right now. and the whole concept happened at Burning Man, to which there's 15 follow-up questions that I, I'm not going to ask , but the, it is a great service.

I love that you could just click on 'em, uh, easy for me to pull 'em up. Then I just file stories away to, uh, talk about. And the good news is, thanks, you found them for me. I don't have to go find them. Which is wonderful. I, I think that's the, that's the, I have time right now. I have a bunch of feeds from a bunch of different places, so I read tons of stories and I really do try to just figure out like, this is one that's probably the most interesting, or these are the two or three that are the most interesting today.

Those are the ones I'll punch out. And then sometimes I find something that's oddball or weird or interesting, and I'll do that as a bonus post. And. Yeah, sign up. It's, uh, really easy. Text the keyword Drex, DREX to 4 8 4 8 4 8. And, and we'll start hitting you with three. Text me three text messages a week and, uh, pretty easy reads.

Cool. Drex the best radio name for people who don't know what radio is. It's like the precursor to Do podcast. And anyway, Drex though, man, that, that is such a great name. I wish Bill is just not quite the, the name that really gets it going for, uh. I need a new radio personality name. That's what we'll do.

Start sending me, uh, bill at this week, health it.com. I'm gonna rename, I'm gonna get a new name. That's gonna be my radio personality name. Feel free to send me some, some ideas. You need a handle, right? Like AUFC, farter Fighter . So it could be bill something and then we will get an announcer. Maybe I'll do it.

Come on and do like AUFC kind of announcement. And that's step into the ring. This probably shows how old I am. I'm, I'm thinking of like George, the Animal Steel, Jimmy Superfly, Nuka. Right. These are, these were the professional wrestlers back when I was at I Sure, sure. Professional wrestling introduction.

Yeah. Yeah, exactly. Same thing. Tune in for this, although I, I don't know, maybe they did. Uh, here's what we're gonna do. We started something new, uh, a couple weeks back. We just hit the headlines on a couple of things real quick and then we go a little deeper into some of the, uh, stories that are out there.

First thing, let's take a look. People have been busy. Amazon, uh, launched a new wearable. I think is interesting. The modern healthcare story is that Sharp healthcare first to deploy Amazon's new health wearable. There's a, a couple stories out there on this. Lemme see if I can find the other one. So they had to be working with Sharp, I would assume they had to be working with Sharp ahead of launching this, wouldn't you think in order for them to announce and be at Sharp already?

Yeah, as part of the, sort of the scoop of the product, you would think, so they have some kind of a relationship that they've built in advance of this, and whether it's around this specifically, the wearable or something else, it's definitely an early adopter program, an innovation program of some kind. It would be, it'd be interesting to dive in and find out the details on that, but lemme give you, it must have been tied in.

Yeah, lemme give you a couple of the details on, uh, Amazon Unveils Halo to Battle. Apple Watch and Fitbit tracks activity, body fat emotions. Amazon is interested, interested to wristband. You got that? That brings new offerings, including technology to trap people's body fabric. Uh, anyway, it's just a recap here.

Amazon's first significant move into wearables, which Gartner estimates will be a $52 billion market this year alone. Are there really that many wearables? I, I guess if you're putting the Apple Watch into that category, you're putting the Fitbit into that category, and then there's just a whole host of other things.

Fall into wearable category, like, uh, some clothes and some other stuff. Mm-Hmm? . Mm-Hmm. . This one was interesting. I think I remember seeing something maybe this morning or last night about how it records temperature, and if that's the case. There were some really interesting reports early on in the Covid outbreak where people were taking their temperature with smart thermometers, and based on the geolocating data that they could do with those temperatures, they were able to like, unfortunately it was after the fact, but go back and look and say, wow, yeah, we could have maybe predicted the outbreak in New York because a lot of people were taking their temperatures and their temperatures were elevated, and maybe that's correlated.

Um, so. I find that interesting because if people shared data and that became a public re public health resource, maybe it's another thing that could help predict pandemic outbreaks or new blooms of covid or something. Yeah. And that, that's the pro, that's the promise of wearables. Here's a good article on this.

Becker's Hospital Review did a good article six details you need to know. Uh, the Halo Band, advanced sensors, as you would guess. And, uh, temperature, heart rate, sleep, fitness activity. Uh, it's also equipped with two microphones. Interesting. We could talk about privacy on that, which can be turned on or off at the user's discretion.

I'm sure by default they're on to analyze energy and positivity in their voice. That's new. Uh, yeah, that's interesting to me. I guess that's how they're getting moods and uh, right. Yeah. And an important part of health, so that's probably something that's . I mean, back in, back in our day, we just had mood rings.

Right, exactly. Where you put 'em on and they turned purple and you were Yeah. Until you had 'em for a while, in which case they were black at all times. They alter black . Oh right. Who knows what was in there. The Halo band's tone feature aims to help users understand how their voice may sound to others.

For example, tone may identify that it's that a difficult. Work call leads to less positivity and communication with a customer's family. Again, this is interesting. They're listening into our conversations, so there's gonna be, do you want them? Allow them to do that. And if you don't, you miss out on some of the, uh, core capabilities of this thing, which sounds, uh, interesting.

The other thing that's interesting on this, it seems like Amazon's really using their expertise and voice. They've collected a lot of just Mm-Hmm. experience. Alexa and, Mm-Hmm. . Oh yeah, it's, uh, it makes me so from a funny perspective, it's you, it makes you wonder if you sound very aggressive right now.

Would you like for me to turn on all caps for your pleat? But, and maybe there's a connection there, but maybe not, but it might be something that gives you a little buzz and says, you, you. Sounds like you're irritated. Would you like to do a breathing exercise or you know, something like that. I wonder how they're gonna connect all this and make it useful to a person.

I know that some applications now have will run a microphone and listen to the sound around you to just give you some feedback on, you are in a really noisy environment and you need to use hearing protection at this point. But it's interesting to see how it's gonna work with mood. This is, the reason I'm smiling and laughing is because this, you could actually, you know, put this on a whole bunch of people's arms and as they're speaking in a meeting, I could see it saying, it's time for you to shut up.

It's time for you to step out of this meeting. You're saying too many dumb things. You're gonna get fired. You know that kind, right? Because I've been in those meetings where somebody's talking and I'm like, oh man, you should stop talking right now. Yes, it's so obvious. You're angry and this is not the place.

You wanna kick them under the table or something, try to send them some kind of a sign. Yep. Absolutely. Throw 'em a life preserver. But yeah, I'll tell you, here's what I like about it. Halo's integrated with Cerner at this point, and there's also this labs feature. Which are health challenges, experiments, and workouts designed to help users build healthier habits, such as improving sleep quality and finding more effective workouts.

The beautiful thing about the Apple Watch and the beautiful thing about Apple is it is a walled garden. The awful thing about Apple is it is a walled garden. Mm-Hmm. and I the, I like this. It seems like they're putting in a little opportunity for you and I to create. Habits together, or a family to create habits together.

I also like that this is not me too there, it, it is gonna have a lot of the same sensors and those kind of things, but it's interesting what they've done with voice and some other things. This, if I were CI, I'm curious your take, if you were ACIO, would this are, are you still looking pretty closely at some of these devices?

I think I would probably think of this in the context of what's. Care at home and remote care and, and those kinds of things. Are there ways that this ties into giving us another piece of data that might be useful for our clinicians? So there's a lot of c clinician collaboration that has to happen around this.

I think really understand what's useful and what's interesting, because you and I both know when you talk to clinicians about EHRs today, a lot of that's so, it's overwhelming and doesn't them. It's hard to say what those are. Sometimes from patient to patient, more information out of context isn't necessarily better.

I think it will take a lot of collaboration to really understand how these things are gonna play into helping physicians or clinicians in general do do their work more effectively. I think there'll be pockets of things they'll figure out. But that's how a lot of this stuff works. It's little experiments, little, little experiments, things turn into a routine that becomes something that everybody does, and then we continue to expand from there.

Uh, all right. So here's one that's more close to home ascension to lay off. 230, 223 IT workers in Michigan. So this isn't just healthcare workers in general. This is specifically IT workers, and the short snippet here is Ascension Technologies, the St. Louis based. Hospital giant information technology services, arm outsource network operations and service desk jobs as part of its digital transformation efforts.

Interesting. When we talk about digital transformation, a lot of times we're talking about tools and the ability to take in this information from sensors and to take that sensors and, and funnel it through, uh, another layer so that we could create meaning and context for the clinicians. And so we're talking about all the fun things, but there's also an aspect of, uh, greater efficiency that comes with digital transformation that can lead to reductions in the it.

Staff, is it disingenuous to not, if you're the CIO, to not be talking about this potential? I'm gonna give you, I'm gonna give you the hard questions instead of trying to confirm myself. Yeah, no, we've talked about some of these things before. My brain works in Maslow's hierarchy of needs, uh, kind of way.

And so when I look at some of this stuff and they tell me that they're outsourcing network operations, what else did you say? A service desk. Service desk, so this isn't, these aren't super surprising. There are a lot of companies today that do service desk for health systems. There are a lot of companies today that will provide network operations as a service for health systems or other organizations.

These are things that are absolutely necessarily to run. You have to run them well. To be able to do the things that are higher on Maslow's hierarchy of needs. So if you wanna do business intelligence or other things, the network has to run really well. The power has. To stay on in the data center. All those things have to work really well, and if you're having a hard time hiring good people to do that and running it really well, because maybe where you are, uh, geographically or maybe healthcare isn't the most exciting place in the world, uh, for some of these people to work, then I think you have to be looking all the time at what are the things.

With the right structure of contract and support and SLAs and everything else, what are the things that I could outsource so that I could refocus my energy on the things that are really unique and hard and different about healthcare that we really wanna do? So I think the things on the lower end of, uh, Maslow's hierarchy of needs for healthcare, it probably get looked at pretty regularly and should.

Yeah, I did a, uh, monthly town hall and I was asked this question all the time. I would say at at least nine out of the 12 town halls that I did, are there gonna be reductions? Are you, those kind of things. And that's a difficult question to answer and you can never answer absolutely positively, no. Covid could hit.

You have no idea what's gonna come down the pike. But the other thing about it I always used to say is, I'll make a commitment to you every day you're here. I will make you more valuable. I'll give you opportunities to learn. I'll give you opportunities to do things. That's my commitment. I'm not guaranteeing you a job, but I'm guaranteeing you.

You'll be more valuable for having worked at this organization. But the next thing I would invariably talk about is some aspect where I say, look. Three years ago, we used to provision servers, and when we did that, we would go online on a Dell website, we'd order servers. The servers would arrive, somebody would unpack them, somebody would take them into the data center.

We would then, we would then coordinate the activity to actually put it in there. And then we'd bring in a different networking person who would connect up the networking and. Do all those things. And that's before we even installed the operating system or had anybody come on and to find the VPN, the routes and all that other stuff that needed to be done in order for that to be, uh, to, to happen.

And then I pick up my phone and I go, I can now provision an entire data center from this phone in the next three minutes. Literally, I could go on and provision as much compute and storage as we. Data center, uh, with a credit card in a couple of minutes. Yeah. It didn't require me to go online order. And so if I can do that, shouldn't that be the model for this organization?

If we were about the, and there the answer is yes, that should be the direction we're going. I say, okay, if that's direction we're going, do we still need some? Do we still need a data center? Do we still need somebody to um mm-Hmm, clean below the floors? Do we still need somebody, uh, shipping and receiving for that stuff?

We, while I was at CIO at St. Joe's, we e we emptied this massive room of parts. Yeah. I walked in, I was like, what is all this stuff? They're like, this is parts in case something breaks. Spare parts. Yeah. Like, wow, this is, it was a big room. It represented hundreds of thousands of dollars worth of equipment, an inventory management system, uh, a person dedicated to it.

And I walked out of that room, I looked at my CFO for the IT organization. I'm like, okay, we're getting rid of that room and everything it represents, we're getting rid of it. Yeah, I think it's, you're always gonna be looking for efficiencies and you should always be looking for efficiencies, and you should tell your team that it's part of your expectation that they will always be looking for efficiencies, and you'll do the best to not make that turn into something where somebody loses their job.

We'll do our best if somebody loses a job to try to figure out another place for you, or a way to retrain you, or a way to use you in a different way in the department. But I. Efficiencies are how we are going to continue to be able to do more with less. You do more with less, not by working harder, but by finding waste and taking it out of the process by finding efficiencies and, and implementing those efficiencies as a way to do your work.

Better. And it is a thing that I think, like you said, you have to be really careful about ever saying, I promise that we'll never lay you off and that you'll always have a job because you just don't know what's gonna happen tomorrow. Something crazy could happen and we could change computing forever. It can change what we do forever.

So you can't really make that promise. Yeah. But I love what you've said. I'll always work. My promise to you is that I'll always make you better than you are. Work to make you more valuable either to me or to someplace else. And if you have to go someplace else, that's also something that I'll do very graciously.

I'll help you make that transition if you need to. And, and the best people to work for, by the way, is if, just watch when they have to do, 'cause every organization has to do cuts at some point. Watch how they do it. If it's just, if it's just a day event where, hey, people came in, they were told they were let go, they walked out with a box.

That's, that doesn't say much for the organization, but if they go out of their way to write references, to uh, make phone calls, to make connections, to utilize their network on your behalf, that's probably an organization you wanna be a part of. 'cause Mm-Hmm, , you just, it just communicates a better culture.

They care about the people while they're at the organization and beyond. Right? Yeah, yeah. No doubt. Uh, rapid $5 Coronavirus test doesn't need specialty equipment. So Abbott Labs came out with a $5 15 minute test for coronavirus. This is a, this is a significant move, and actually I'll talk about this in the context 'cause you're, you're one of the people I'd wanna talk to about this.

Let's see. So NPRI though for five, do I get a subway sandwich or do I want a coronavirus test?

So my wife called me today. She goes, Hey, you should cover this on your show. I was like, all right, give this storyline. And it was an NPR story. So I went out and it's uh, if you hit the NPR uh website, you can actually listen to the story. And they have a reporter at the University of Missouri and a reporter at the University of Illinois, and they talked about how university, colleges and universities are handling this differently.

So the University of Illinois has mandatory testing. It's a saliva based test that they developed at University of Illinois or bna. Mm-Hmm. . Uh, because smart people go to go there and work there, and they develop this test. They administer 10,000 tests per day on the campus. They had 300 positive cases when people came back and they said they anticipated that they thought that was gonna happen.

People that didn't know they had it. There was people 300, 300 out of, uh, I don't have the total number of students, but I would imagine it's a state college, tens of thousands. So that's probably a pretty good percentage. Yeah. 70% of their classes are online. So here's what they did. You're required to test before you come back on site.

You're required to, uh, test during the day. And the reason this is a technology project is because they're implementing a health passport. Okay, so you can have the, the test results on your phone or you can have a piece of paper, not as techy as we would like, but essentially you have to show that before going to class.

Mm-Hmm? . Mm-Hmm. . It's a health passport, which I think is interesting. So the second they talked to the University of Missouri, no mandated testing to come back on site. No testing. You can get a test if you have any symptoms while you're, uh, at the university. They're doing in-person classes for freshmen.

And, uh, a lot of the other classes are online, but a majority of the freshman classes are in person. The people and, and, and what's interesting is they, they interviewed people at both universities. They interviewed people at the university or a student at the University of Illinois and she said, I don't mind the lines.

This is great. I know that the person sitting next to me doesn't have Covid. They interviewed the person at the University of Missouri and they're like, Hey, I appreciate I'm getting the full college experience and those kind of things. I, it, it's, uh, I I almost don't want to comment on this because this will get us into really gray area.

We, but I thought it was fascinating. That the different approach. And my daughter goes to college right now. I had to decide whether I was gonna send her back. And I think it's fascinating. These colleges, I, I think they're, you could tell which ones have academic medical centers. You could tell which ones are partnered really well with the, uh, healthcare community.

My daughter's university is, uh, really well connected. It's, she goes to Baylor, uh, great academic medical center. They partnered, they did a lot of great stuff. I talked to her a couple times now, and she feels really relatively safe on site. They're wearing masks everywhere. University of Illinois, they're wearing masks everywhere.

I, I didn't pick up the University of Missouri if they're wearing it or not. Mm-Hmm. . Um, but this is a, this is an interesting. I just thought it was an interesting story. I don't, if you wanna comment, go ahead, but if it gets too political, I'm gonna throw up my hands. Okay. You and I have had a little bit of this debate online on LinkedIn, along with several other people who have commented on some stuff that you have posted about this on LinkedIn.

So I actually really liked the idea of being able to do. Part of this is ultimately not just being able to do a test, but it's, do you have a whole infrastructure program in place to do contact tracing and everything else? And if you don't, then one part of it is one leg of a stool. The stool only has one leg and not the other two, it's gonna fall over.

So all of that sort of has to be taken in context. But if you do have comprehensive program, . At the university, then you also have to look and see, do you have a comprehensive program in the community? Because it's probably unreasonable to expect that those kids are only going to stay on campus and they're not gonna interact with anybody from off campus.

And that also then gets to other issues like. Is the health system in that community already overwhelmed with covid cases and other things, then maybe those schools shouldn't be back in session until things get squared away. So some of it's common sense. I, I love the idea of having some kind of a passport on the phone.

I get tested every I. Three days and it's updated on my phone and I'm working with an early stage company right now who's doing something like that right now that would allow you to do things like show up, eventually show up at a football game and say, oh, I can show that I've been tested so I can bypass the line.

That's the temperature check and the question set and all of that. I get the, you know, fast at ts a for football games. Is that what you're, that that people would wind up, um. Going to, even going to class, you can show your code, walk right in, or you could, you don't have, you don't have a code. You have to, uh, get the temperature tech and check in the question set and set on a different, in a different part of the room or something like that.

There's probably a a hundred ways to skin this cat, but yeah, it's definitely been a big topic of conversation about going back to school, going back to university. I hope nobody's developing a health passport app. It makes no sense. They should. We can just put in an Apple wallet or whatever Androids thing.

If I can put my movie tickets, my plane tickets and everything else, I can put my Health Passport in there. And so I just hope no one's spending millions of dollars pursuing a health passport specific unless they have ideas for how it's.

I just find that's interesting, the, the article that you and I just screened on, if people are wondering. So I now post a, I take one of the stories we're gonna talk about and I post it out on LinkedIn every day. I put a little commentary. Right now, they're getting a lot of back and forth. In fact, I'm gonna go over here.

The one you and I disagreed on was, I think the school one or the contract tracing one, one of the two. I don't know. I think it was, so, for everybody who's listening right now, I know sometimes you think, bill and I agree on everything, but I. That really turns out not to be the case, which is actually why I love the guy.

Uh, we get to talk and debate about a lot of stuff, and we do it reasonably. There's never any shouting or hand waving , you, you're left of center. I'm right of center. I happen to be an environmentalist who's right of center. I don't know if that's, if that even makes sense to people, but Yeah. No. But anyway, so I put the thing out on contact tracing you and I went and did deep dive into contact tracing.

A while back, but there Mm-Hmm. , there's still a lot of back and forth of other countries have done this and they've done it big time and I've seen some CIOs saying, Hey, we're doing this across our campus. Mm-Hmm. . But generally speaking, bringing the patients or even, uh, school population of students into it, uh, just feels like it's asking a little bit too much for, for our society right now, our, the, the society in the United States.

We're super suspicious from a privacy perspective in some ways, right? So on this topic, everyone seems to be really concerned that, I'm not sure I want somebody tracking where I've been. And even if it's de-identified, will everybody do what they're supposed to do? And if everybody isn't participating, does it really make it worthwhile?

And so I'm really skip. We'll use Facebook and Twitter and Amazon Alexa listening on all of our conversations and all of that. We don't seem to have a problem with, so there's some probably the wrong word, but there's some bipolar problem that we have around privacy when it comes to something like this.

I'm like, dude, come on. This could save your life. It could keep you from getting your grandma infected. Um, but the people are really skeptical about it, and I understand why. They asked Bill Gates, why aren't we more effective, uh, on the whole response to Covid 19, why aren't people buying? And those kind of things.

He had a one word answer. You know what it was freedom. He said, this country is more free than other countries. In other countries, you don't have a choice what to do. Contact tracing. You don't have a choice what to do. Wear a mask, you know? And in our country, we've been brought up that no one gets to bully you.

No one gets to tell you what to do. And, and unfortunately. That stuff equates to, Hey, you have to wear a mask. No one gets to tell me what to do. Mm-Hmm. . Wait a minute. There's a rational argument here for wearing a mask and protecting each other and those kind of things, but there's just this knee jerk of freedom.

Mm-Hmm. , we were taught, what was the old thing? Don't tread on me. That actually had those revolutionary war flags. It's like, yeah, you know, my rights are my rights. It was an interesting, no, I, I, I, interesting article. I get that. Anything else on that? The other thing I put the CDCI talked about last week, the change from HHS to CDCI, I don't really wanna talk about that anymore, but it did remind me of that Saturday Night Live skit.

Remember where they used to have Roseanne, Roseanna, Dana Uhhuh , and she would go off on something and be really adamant on something and then somebody would say, Roseanne. It's, she'd have a word wrong or something saying it's actually this. And she'd go, oh, nevermind. Nevermind. That's what it felt like. It felt like they were like, we're gonna do this.

This is gonna be good. We should do this. And then all of a sudden they just go, eh, we were wrong. Nevermind. Back, back to what we were doing. There's, it's, uh. It's definitely, it continues to be interesting to watch happen. What's, watch what happens between the CDC and HHS. It's the classic right hand, left hand challenge and even the issue of they'll issue guidance.

The CDC will issue guidance and then even the CDC will come back the next day and say, nevermind we, we didn't mean it like that. Yeah. And so it's, it makes it hard, right? It creates a general purpose, trust problem that I. Makes the dealing, figuring out how to deal with the pandemic even harder. Yeah, absolutely.

I, I agree. You, you need clarity to address a problem, you need clarity and that's, it's welcome to have clarity. The, I I'm curious on this. Google Cloud Amwell coming together. Oh yeah. Uh, a hundred million dollar investment and they're going public. Are you worried at all with Google? There's, we talk about the surveillance, you know, economy that exists if people, I think people are just ignorant of the amount of surveillance that is actually going on.

Yeah. Yeah. So, so when we say, Hey, we're gonna, we're gonna track you for Covid, they're like, no, you don't get to track me. It's like you realize if you're carrying an Android phone, you're being tracked every which way. But Sunday. Mm-Hmm. . And, and there go, well, you see these stories that sort of show, oh, here's where all the cell phones that were located at the Sturgis motorcycle rally went to after they left Sturgis.

Now, none of those people consented to be, uh, monitored on their cell phones and where they're going, but it happens and it's a de-identified and it's, you know, publicly available and you can go look at it. It's, yeah, you're exactly right. We're being monitored all the time. There are folks always tracking us.

They may not really know who we are, but. We're being tracked. What's Google's? Uh, well, I I don't want to ask you that question because you, you have no idea what Google, what's in their mind here, but does the privacy aspect concern you at all? Google has the, the deal with Ascension, the deal with, uh, Mayo, um, and they have the, now they have to deal with Amwell.

They just did a deal, verily did a deal. I saw on the news on Stop-loss insurance as well. So Google's making their betts. Oh yeah. They're they're making their plays right now. Are you worried about that privacy aspect as Google starts to step in? Would you like to see more from them in terms of a I I wouldn't mind if Google themselves came out with a patient Bill of Rights that said, we won't use your information in this way.

We will only use it in this way. That would be interesting. Yeah. I think for all of the companies, and honestly it doesn't matter who it is, whether it's Microsoft or uh, Google or Amazon or you know, whoever, transparency is probably most important. Being readily able to and willing to answer questions about how you're using the data, um, that you're getting and, and.

Having those conversations turned into, like you said, a bill of rights or clear places where you draw a line and say, you can't use it like that, because a lot of people are putting, getting data put into these. Big data machines, these big data companies, and they don't really know where it's going or how it's being used, and they're trusting that it's being de-identified.

We're not totally sure, which means in a lot of ways you're operating in the blind and as a consumer you don't know where your data's going and what it's being used for. I think it's interesting to too, to see Google and Amwell come together. There's a little bit of a hurry up and get in the telemedicine game while it's hot issue.

And then, I don't know if you saw the article from CT Lynn at the CMIO at the University of Colorado Health recently did a blog post, but he talked about how telemedicine skyrocketed and then now it's trailed back off and they've gone from a hundred visits a week to something like 8,000 visits a week.

That's where they are now, but. In person in clinic visits are back to sort of 95% of where they were. So overall, they're seeing more patients and maybe more efficiently because they're using telemedicine for some of that. But the idea that telemedicine was gonna change everything, I still think it's we're on a slow plotting.

Course to get to the point where as much stuff as we can do by telemedicine, we will eventually do, we will do virtually. But, but it's interesting to see from his notes and his diagrams that like things really turned around for them. They still do a lot of telemedicine visits, but in-person visits went right back to where they were pre covid.

Yeah. So here's, here's my take on telemedicine at this point. It, it is. There's no doubt it's gonna snap back because you just have to follow the money. And that will will dictate that people are gonna come back into the office. They're gonna get higher reimbursements and those kind of things. And generally speaking, if a doctor says, Hey, come into my office, you're gonna go into their office.

That's one, one aspect. But the thing that is, the expectations have changed. So the consumers are more readily open to telehealth. Mm-Hmm. . Six months ago to people, Hey, we wanna see you via telehealth. They'd be like, ah, I don't know. But now almost everyone has experienced it and they're like, that wasn't bad

And so if you, uh, now some people messed it up a little bit and the first impression wasn't that good, that's bad. Some people, the scheduling was a little off and whatnot. We threw some things together, but generally speaking, not that bad. So there's gonna be things where they go, Hey, you know what? For my follow-up visit, more than happy.

Or for a visit where, Hey, I already know I'm sick, I just need you to prescribe something. Mm-Hmm. , do you wanna do a telehealth visit? Sure. Yeah. Let's, let's go ahead and do that. So I think that's gonna be one aspect. The other thing is the health systems that really, uh, have thought are starting to think through where video and, and virtual care start to bake in.

And there's a bunch of, there's a lot conversation going on in virtual care, the. Going to be baked into our normal, uh, care processes and whatnot. They are, they're gonna position themselves for the future. Mm-Hmm. . And there is gonna be this future of age in place, out of the home. Mm-Hmm. , that kind stuff.

And so a lot of conversation going on there. And then quite frankly, I think there's an opportunity for significant efficiencies to the health system that brings their smart people together and starts to look at. Where they can insert, uh, video between clinicians and consults and, Mm-Hmm. . Mm-Hmm. , you know, things that may be Yeah.

Rounding. Rounding that weren't as, that they were forced to do in Covid. Mm-Hmm. . Maybe they can step back and say, Hey, you know what? That actually worked pretty good for us. Mm-Hmm. . A lot of that is like in-house, telemedicine sort of stuff. When it came to things like rounds where somebody just couldn't be there physically, but they brought 'em in by video because you know that the doc had some preexisting.

A condition and didn't want to be in the hospital, but was able to be on rounds using a cow or something like that. A lot of those things going in preserving PPE by being able to do a tele ICU thing with a patient as opposed to. Putting all the gear on and going in to do one little thing and then coming out and having to trash all the gear that you just put on.

All those things are turn out to be like really good habits. Um, and probably good for the patient too. And definitely protects, in some cases, protects the clinicians. So it's, there's a lot of, we, we learned a lot of stuff, I think, and we're still learning a lot of stuff that, that we shouldn't throw out.

We should keep using, keep leveraging these ideas. So let me, so one of , you're, you're my cybersecurity guy. You're one of my cybersecurity guys. The, so I, I love this story. So I highlighted today it's probably the one that got the biggest uptake of all the stories I've done over the last two weeks. And, uh, it is based on Tesla.

There's a Tesla employee that was offered a million dollars to implant malware and instead of doing it, he actually worked with the FBI. Is worth the cyber attack. And I just posed this question, if I had a million dollars in some malware, could I entice someone at your company to insert the code to gain access to critical information?

And I guess my question to you cybersecurity expert is how worried do we need to be about internal attacks about our employees being. I don't know, being coerced in some way to, uh, plant malware or ransomware or those kind of things. Is that a common thing? I think in a nutshell, in its simplest form, that's what phishing is, that you send somebody an email and you ask them something, you give them some piece of information that they're really interested in, and they click on a link and they accidentally install malware and you're not even paying them for it.

You're giving them something that they think they want and they, and then they accidentally misstep. I think we saw it with the Twitter breach a couple of a month or so ago where the kid from Florida. Went in and had some kind of conversation with a Twitter employee who had some kind of super user access to Twitter accounts, and he gave up the username and password or something and suddenly the, the Bitcoin kid was out there posting under all kinds of celebrities names, Hey, send me a thousand dollars in Bitcoin and I'll send you $10,000 back.

And he rounded up a lot of Bitcoin cash. So I think if. You have employees who will do it accidentally. There's certainly the possibility that you have employees that would do it for. Payment. It's probably just a matter of what's the number and then the individual, I don't know. This is like everything else, right?

People are just doing some kind of calculation in their head about the risk of being caught, the amount of damage that it might actually do if they took part in it, and how much do they want a million dollars. But yeah, I think the risk is there and it's something we have to look out for all the time.

So it's probably not common that somebody's going to knock on your door and say, let's go out for lunch and, uh, I'm willing to give you money. To put this malware in it, because it's just as easy at this point to get you to click on an email, figure out another way to do it. Yeah. This is the, the problem with these, with these kind of cyber crimes is that once you bring one more person into it, or two more people into it, the you're way more likely to be caught.

So if you can figure out how to maintain your anonymity and get somebody to do it accidentally, then . Your odds of being caught are very slim. But if you've gotta pay somebody for it, now that's another person that's in the conspiracy. And, you know, once they're caught, we're not, we're, we're not trying to train the hackers here, you know?

No, no. This bring people in as you can

this is, I think this is a, I have a friend at CI Security who does a a, a Facebook Live every week. And the, the same conversation comes up as when we may be talking about things, there are times where I'm just . Oh man. Don't say that out loud because you like bad guys are listening. His opinion about this, he's A-C-I-S-O, is that anything that I've thought of, there's tons of people that have already thought of it.

So even if you think it's a genius idea and nobody's come up with it, people have come up with it. Yeah. Yeah. Gotta stay one step ahead. Yeah. Hey, thanks again for hosting the show a couple weeks back. Appreciate it. Gave me a week job. Oh, for sure. That was great fun. And the ratings were so good. I'm thinking of having you do it every week.

You have a real job. Okay. I'm sure we can figure something out, but it was great fun. I appreciate you entrusting the, the brand to me for a week. 'cause I, I surely could erect it, but, uh, fortunately I didn't. It is a recorded show, so it's , you couldn't erect it too much. You're gonna review it before it goes out anyway, so, and I was on vacation, but my staff wasn't, so they still reviewed the , all the stuff.

I, yeah, I did. I do trust you Drax. I'm just saying. I know there, there were some checks and balances in place. So anyway, . Hey, thanks. Thanks again for, uh, stopping in this week. Um, we didn't really get to dive into anything too deep, but, uh, it's always fun to just. Go through the headlines with you and, and see what's going on in in Health.

It, yeah, I get a kick out of it. Thanks. And anytime. I'm happy to come on. Fantastic. All right. That's all for this week. Don't forget to sign up for CliffNotes. Send an email to CliffNotes at this week in health it.com. Easy way to do it. Special thanks to our channel sponsors, VMware Starbridge Advisors, Galen Healthcare Health lyrics, Sirius Healthcare Pro Talent Advisors, and HealthNEXT.

Choosing to invest in developing the next generation of health leaders. This show is a production of this week in Health It. For more great content, check out the website this week, health.com or the YouTube channel if you wanna support the show. If you're still listening, you're a fan of the show. So if you wanna support the show, the best way to do that, share it with the peer.

Uh, another way, sign up for clip notes, get it forwarded to you, forward it on to somebody else and say, I'm listening to the show. Get a lot out of it. You're gonna, you're gonna really this direct guy, he has a lot of good things to say and he's on every now and then. So, uh, please check back every Tuesday, Wednesday, and Friday for more great content.

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