News Day - Chief Telehealth Officer? CMS Crackdown on Reporting
Episode 32027th October 2020 • This Week Health: Conference • This Week Health
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 Welcome to this week in Health. It, it's Tuesday Newsday, where we look at the news, which will impact health. It. We've got a lot of great stories. This week I posted a bunch out on LinkedIn who's gonna lead telehealth, uh, Trump administration cracked down, couldn't come at a worse time for hospitals. A little back and forth on that.

I. Very interesting conversation. We have some voice stuff, telehealth stuff, some HCA returning their Cares Act money. There's a bunch of interesting things to talk about this week. My name is Bill Russell, former healthcare CIO, coach, consultant, and creator of this week in Health. it I set a 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 our services to the community. Special thanks to them for supporting the show's efforts. Three x Drex.

If you're not signed up yet, Drex to Ford has a text service. He sends out three texts three times a week with three stories vetted by him to help you stay current. To receive these texts, text Drex, DREX to 4 8 4 8 4 8. If you don't know, Drex to Ford is a frequent contributor of this show. Don't forget to join us next week.

Drex Ford and I are gonna do a special election day, get out the vote, kind of Tuesday News Day, and we're really looking forward to that conversation. Love for you to join us. All right, ma'am, , I have 35 stories in front of me. We are not gonna get to all of 'em, but hey, we're gonna start out on LinkedIn.

You guys have been engaging with the Post and it's been a lot of fun to, to go back and forth with you. Uh, let's see. Let's start back here. This was about a week ago now. and I asked the question, who should lead telehealth at healthcare providers? I set it up as a poll and I asked the, these are the options.

CIO, chief Digital Officer, uh, CMIO. C-O-O-C-M-O, VP of Telehealth, chief telehealth officer or other. And wow, we got a bunch of comments on this, a lot of views on it. One of the first ones which cracked me up was I had my friend Sherry Deve. Who's been a guest on the show, throw back at me a show that I just recently did with David McSwain, where he actually answered this question.

But we're gonna assume that David McSwain is not all, all knowing and omniscient, although he did comment here as well. And he is extremely knowledgeable on the telehealth front. In fact, he says it really comes down to the culture of your organization and the willingness, enthusiasm of those leading the effort to work collaboratively across the organizational structure, regardless of their role or title, bottom line, as many of as

As many have mentioned is that healthcare is healthcare. As such, integrating it effectively requires expertise in many areas, compliance, billing, operations, clinical, technical, quality, et cetera. And no one person, in fact, no one team can do it effectively alone. I agree with that. No one team can do it effectively alone.

My point here, I think, in asking the question is it would appear to me that someone has to be the energy. Somebody has to be focusing the energy of the organization. And the efforts of the organization, because you could be doing telehealth, telemedicine, you could be doing teleconsults, you could be doing a lot of different things in a lot of different ways.

How do you prioritize what's going down? I, I guess if you have really good governance within your organization, it's easy, but at some point, even at some of these smaller organizations aren't gonna have this choice of who do you give it to? It's gonna have to be somebody's other job, John . Let's see, what did John say?

Uh, CEO Pro Talent advisors. I like your idea of creating a telehealth officer, likely adding another C-M-I-O-C-I-O type to your overhead and would pair them up with a stirring committee, steering committee made up of clinicians, business operations and specialized I, and I agree with that. The. Again, I just come back to, it feels to me like someone needs to lead it.

And I don't know who that is, but it really, it can be the CIO and I think in smaller organizations it will probably be the CIO Chief Digital Officers. Interesting because they're thinking of new venues and new ways to generate revenue. So perhaps it makes sense there. You know, VP of telehealth, chief telehealth officer is actually one of my least

Favorite ideas. We don't need any more administrative overhead, I don't think, unless your organization is really highly focused on this. And sees it as their next major move. Clearly a American well or Teladoc would have a someone in that type of capacity or type of role. And if your health system's making that kind of major move, maybe it makes sense to do that.

Yeah. Again, a lot of, a lot of good comments you should check out that post. A lot of great back and forth again. Stay on that one post the whole time. Otherwise I get lost. Let's see. Trump administration crackdown couldn't come at a worse time for hospitals. . And this is the story of they are requiring, so the CCMS is requiring, uh, reporting on, uh, covid and flu.

And if you don't report, there's a risk of your CMS funding. , right? And I think there's some aspect of this that has to be reported electronically. And I started this with a little bit of a starky comment. I'm sorry, I don't want to be admitted to your hospital if you can't do basic reporting with a 14 week lead time.

Now, I also understand, look, I have empathy. I understand there's a lot of things coming your way. There's also 11 new codes we're recoding, things we're, there's a massive amount of requirements on this same team. But at the end of the day. We already collect the flu information, the covid information we've had since July.

It just feels to me like if you can't do this high priority item, make room for it, that there's other issues at play there. And I would be concerned of, uh, being actually admitted into your hospital, and I'm not, I that's, I say it's snarky, but at the end of the day, I would be concerned and I have been in hospitals or I've taken my father-in-law to hospitals and those kinda things where the administration was so bad, it made me question the quality of care.

And I don't think I'm the only one. I think I, I think we equate the cleanliness of the hospital and the hospitality of the staff, and we equate that with, are we receiving good care? And all of those things become important. And, and if you have a outdated, if you're handing me a lot of papers, I immediately scratch my head.

If you are handing me an app that's really outdated and looks silly, if you have AURL that is not secure in any way, all that stuff drives home a . Brand problem that's there. Now, I did make a mistake in this post, so I will, uh, correct it here. One of my physician friends reached out to me and said, Hey, look, we haven't, we, the reporting of the flu stuff was voluntary and it was a lot of it was retrospective.

It was done at the end of the flu season. So this does represent a change for that. Although he did go on to say that, that my concerns are still valid, uh, that not being able to produce this information is a cause. Uh, for concern about that health system. Again, a lot of good back and forth. Really appreciate everyone, all the comments.

And all, all the things that you guys are, are talking about. I'm just, I'm sorry. I'm reading 'em as I'm going through this and some of 'em are really good. Alright, next one. What strategies are health systems utilizing to move beyond the four walls of the hospital? So anytime there's a, anytime there's a a, an event like this, like covid, there's a significant change in behaviors and habits.

In, uh, in waves, people, uh, consume services. Now we're seeing that all over in, in the wave. People are shopping absolutely in the way people are traveling. We're seeing it, absolutely, but I think we're gonna see it in healthcare as well. And I call out two, uh, this article calls out One, and that is, uh, BayCare Health System as partnered with Tampa International Airport.

And they're offering, uh, screening at the hospital. So covid testing at the hospital while you wait, when you come in, those kind of things. And now, before you're too flippant on this . I live in a community where before you come back before you, because a lot of people, I'm in Florida, a lot of people come north from the northeast back and from the Midwest back down to Florida.

But before you can start participating in some of the events here, you have to get a covid test. You have to show a, a clean bill of health. So having this done at the airport is . Not the worst thing in the world. And by the way, you can't do it in your home state and then come down here. You have to come down here and test down here before you start participating in events.

Uh, so some of this stuff we could see some of these other things, some of these testing, I think it's the most obvious that's gonna pop up. Another one I point out is, uh, an article. Southwest Airlines mentioned their collaboration with Stanford University School of Medicine. I mentioned that last week on the show.

I think there's an opportunity for academic medical centers to step into this void of how do we get back to work? What does it look like to get back to work? What is a safe work environment, I think is a service that a lot of AMCs can offer to the community. I point out that we have the National Football League going major league baseball colleges.

They're really demonstrating how to do this. Uh, we talked about some college programs and how they've been able to keep students on campus through the entire semester, and my daughter's one of those at a . Major university in Texas and all indicate, I I I have a dashboard that is phenomenal that they, uh, have given all the parents, not only the statistics of the campus, but statistics of the community in which they serve.

So I feel pretty well informed. I get a weekly, uh, letter from the president updating us on the services, the changes they have made to the testing schedule. But there's a lot of things going on for how do we . How do we get back to it? How do we get back to work? And I think that's the question that drives all these things.

And, and it is, what do we need to do to get society moving again? Uh, you know, and, and some other obvious ones I think are the movie industry needs to get started again. So first they need to start filming. Uh, at some point we're gonna get tired of seeing reruns. We're gonna need to start seeing movies, uh, in theaters and those kind of things.

And we're gonna have to do testing, we're gonna have to do testing of actors, we're gonna have to do testing. Uh, I, I don't know, we're, we're just gonna have to figure out how to get . Industries, whole industry is moving again, like we did with the food industry and the, and the, and the meat packing industry and other things.

So, uh, little bit of back and forth here. Let's see, six comments on this. This didn't get a lot at play to be honest with you. Only about a thousand views of this one. What happens, I, I think I told you this last week, what happens is some of these get a lot of play. This one about the, the Trump administration crackdown couldn't come at worst time, got a significant amount.

So it steps on the, the next days just based on how feeds work and social media. And let's see, Holly White. What about home testing? Of course Oracle referencing a study, but this would be an interesting method to try to manage the spread of the virus. And, and I agree with that. That is a, it makes sense.

And my question is, who's gonna do that? Is that healthcare providers? Is that uh, ACVS Aetna kind of thing where they're going to start doing home testing? Is it a home-based care organization that's gonna do that? So, uh, a lot of opportunities, and I think it is, it's good to be having those conversations.

All right. I don't do this often, but I actually reposted somebody else's post. Josh. So who is a, uh, guest of the show, digital and Clinical Innovation Leader at Houston Methodist, highlighted a talk that was done by Roberta Schwartz, the Chief Innovation Officer for United or United for Houston Methodist, and, uh, Phoebe Yang.

Healthcare general manager for AWS and they talked a bunch about voice and ambient listening and what is going on. And I decided to, to repost that. And the reason I decided to repost it, 'cause I think it's worth watching what they are doing. I. And as they're doing ambient listening in the or, which I think is a perfect location for ambient listening, right?

struggling with this back in:

Joe's, and he went to work. On using Xbox Connect controller to do hands-free navigation of the medical record. And it was a little clergy, a little clunky. He had a couple doctors, uh, using it and they were, they were navigating the record, but voice is so much more elegant and, and, and I think it's gonna be, I.

Really fascinating. The reason I highlight this story is at the end of the day, the complexity of voice cannot be overstated. It's not just as simple as taking that Alexa, putting it in the or, and away we go. But there's a distinct distinction in language, right? There's dialect, of course, there's the healthcare vocabularies that have slowed progress, right?

The different types of, of, uh, documentation that's required for an orthopedic visit versus an oncology visit is, is significant in nature. So you have to . Get those vocabularies into the system and that is no small task. So I think any one of these announcements that come out are exciting to me because it shows that we are making progress in this, uh, important field.

And I think quite frankly, I think this is going to be one of the areas where we really make a difference in the clinician's lives. They're gonna be able to walk around and say, before they walk into a room, there's gonna be an iPad there. That said, and they could say, gimme the vitals. It'll give 'em the vital information or what's going on.

When's the last time this doctor visit? Just a whole bunch of information at the, not necessarily the touch, at the tip of your fingers, but at the tip of your tongue, I guess, is your voice. So we'll say, Hey, next article. Pretty important article, right? Let's see, CMS has, uh, started collating all their information on telehealth visits, and they said there were 35, 34 0.5 million telehealth services delivered in March through June.

ing , but still unsustainable:

We had to keep the, uh, patient safe. Uh, and so care at a distance was huge. The enablers for this were, uh, reimbursement and there's still questions about where reimbursement's gonna go. There was relaxation of federal guidelines and funding of infrastructure. You had some FCC money that went out, and that was helpful as well.

And things are starting to change now, right? So CMS has the data. They're looking at it, they're adjusting reimbursements, they're being more targeted. I don't think CMS is, if you've read anything, CMS is all in on telehealth. So when you see them pulling back some funding and putting funding towards other things, it's because they are being strategic.

They're looking at it and saying, where are we making a difference? Where is this actually impacting outcomes? And, and driving better care, getting to that point. It's the Valerie Leser, Dr. Valerie Leser. Bill Russell. Yes, I agree. Virtual care should be a key enabler for pop health initiatives to scale and succeed in their mission, and at least to extend that, I am aware Telehealth as a mode of care has not yet shown specific measure measurable impact on HE DDIs performance.

Or change clinical outcomes for chronic conditions during this covid fueled telehealth pilot. Without proof of value, it will be hard to lure our payers to support or better to prefer. Recommend telehealth modality of care. Over in real life care. It's a new flavor of our old circular argument of fee-for-service versus value-based care models.

We've had four years. Yeah, there's a lot of wisdom there. This is what I've been saying all along with this. It's a huge pilot. We got a ton of information. We may have done some things right, some things wrong. We will find that out. We will also find out where we can actually move the needle and where we can't move the needle.

And I think you're gonna see CMS leading here. As long as the under this administration, which could go on, may not go on, we will know that in, uh, what is it, two weeks a week? Wow. It's coming up. Uh, it's right around the corner. So after the election we'll know, but if, if, if SEMA Verma and Azar and, and that.

Group stays in. What you're gonna see is a continued push on telehealth, on electronic delivery of care, because it drives their costs down and, but again, fee for service. It does not help the health systems. Who rely heavily on fee for service, and so that's one of the things that's going on. John Moore, CEO, founder of Chili, mark Research says it's likely to sell at about a 15 to 18% of all visits will certainly be higher for providers in value-based care capitation versus fee for service.

As we are already seeing more payers pulling back on telehealth reimbursement. And I think that is, yeah, 15 to 20%. Yeah, that feels about right regardless of reimbursement. I think there's areas where we've looked at it and said, Hey, look, this just makes more sense. Plus, I think you're gonna see the reimbursement continue in some areas.

All right. I asked the question ACA returned $6 billion in Care Cares Act funds and accelerated payments, and I just asked the question, what does paying back the Caress Act money indicate about a health system? And this hasn't gotten a lot of back and forth yet. And I really stepped on it pretty quick by putting another article out there, but I'm, I'm just curious.

So ACA returning the CARES Act money got me to thinking, which, first of all, what other health systems return The CARES Act Money? I know that Mayo talked about it. I don't know that they followed through on it or not. I haven't seen an article to that effect. And then I started wondering, do I really want health systems to return the Caress Act money?

I'm not really sure. You know, the Caress Act money was, uh, to provide liquidity at a time of, of crisis and the, the . Revenue dropped by almost, you know, 40, 50% at a certain period of time. There was a lot of unknowns. We were worried about the liquidity of those health health systems for obvious reasons, right?

Healthcare's largest employer in most communities, they're the frontline of the pandemic and they were facing some, some really dire choices. Let people go at a time when they're needed the most. And so I just threw that out there. Thought I would just ask the question again. It didn't get much traction because I dropped another story, which is

% in:

Now, clearly, if this is people deferring care, that's not a good thing. And, and that's not what I'm saying here, but what I'm saying here is that should be one of our goals, right? A, a 10% drop in people actually being admitted to hospitals. That's good. I'd really like data scientists to, to dive into this number.

There's this sort of theory that, that the there, the mortality and the sickness is the same year in and year out. I, I, I, I'm pushing back on that theory and saying, look, I, my habits have changed pretty dramatically. I. , and I'm wondering if everybody else's habits have changed dramatically and if they're healthier, right?

ssumptions correct going into:

Are we, is the 10% drop a permanent drop or is it a, a blip that we're just gonna see it come back because mortality and, and sickness is constant and, uh, doesn't change even though a lot of things have changed. Dan Howard commented on this, Dan Howard's a uh. Friend who we interact a bunch on social media.

I would hope that the investments and efforts in education and patient engagement strategies over the last several years is resulting in healthier communities and populations. Yes. Need for deeper dive into the details of this sort, sort out deferred care versus healthier populace. Many pre covid behaviors that are negative health multiplier, smoking and drug abuse, poor diet, exercise habits, et cetera.

Will those change moving forward? I like to think so and believe one of the silver lining linings of Covid is that it puts a spotlight on personal health and personal responsibility. Uh, I, I love that optimism. And agree with a, an awful lot of that. And from this perspective, we have done a lot of patient engagement strategies.

We've done a lot to get people, uh, thinking about health. We've put a lot more tools out there. We have texting tools. We have apps out there. We have tech partners who are putting apps out there. Our, I, I know if you do individual studies, you're like, Hey, that's not taking hold, that's not taking hold.

Maybe all of it's starting to take hold. I, I tend to be optimistic about this stuff. And if you hammer on a . On a problem long enough, you tend to make some progress. We'll, uh, last comment and then I'll get to uh, some of the other news headlines. Will Stewart, I sometimes feel like healthcare is like the auto industry.

Imagine if I had an insurance plan that said that allowed for a mechanical coverage of my car every time I took it to the shop for maintenance. I would bet that as long as it was covered, something would need to be replaced. I think our financial model sometimes rewards unnecessary interventions, uh, and that could be.

right? We're not showing up for appointments because we're not showing up for appointments, we're not being admitted to hospitals. And I could be the case. I'm sure if we go back in history and look at some of this stuff, we will see that history will show that this would not be an unprecedented thing to have that be, have that occurring, uh, within healthcare, some of the headlines.

So, lemme check my time real quick, see how many headlines I can get to. . All right, 24 minutes. I'll do about five minutes headlines. Here we go. CMS will reimburse 11 new telehealth services during the public health emergency. This has aged a little bit. I didn't get in front of this one. You probably already know about it, right?

So there's, and if you don't, this is from healthcare finance news. Worth hitting the story. But there's a lot of it out there already. So CMS will reimburse 11 new telehealth services during the public health emergency key and operative word being there during the public health emergency. So this is what people are talking about.

Is this stuff gonna continue? I don't know if it's gonna continue. I would suspect that this is a major, uh, issue in this election and I would, I imagine . That if the money is there, this will continue. It's a bunch of stuff. They're also providing support, so there's a lot of new services. They're also providing support for state Medicaid children, health chip agencies and their efforts.

Efforts to expand access to telehealth through the lease of new supplemental to its state medicated chip telehealth toolkit. Alright, so there's a lot going on there. So let's take a look at some of the others. Children's Hospital of LA Launches Accelerator for Pediatric Digital Health. I always love these stories and I may have touched on this before as well, now that I think about it.

Sometimes my headlines, I get, uh, a bunch of 'em, but I'll hit on it real quick just in case I didn't. I like these things. So Children's Hospital, LA Incubator, 30 hospitals across the US and UK, Australia. With technologies, companies focused on increasing digital innovations on pediatric patients. Again, fierce healthcare article.

I just like it. I, I like bringing all these like-minded, similar problems together. It focuses the energy of the innovation community. It gets some visibility into some of the things that these tech startups are doing. If you're doing anything around pediatrics, I would, I would get into this and, uh, participate.

This is, uh. It looks like something I would love to be a part of if I was in a children's hospital, but that is launched by Children's Hospital of LA 30 hospitals participating. I'd imagine it's a, uh, fair amount of good, good participation and interaction from all those health systems. The next article, Becker's, I have a bunch of Becker's articles here.

I went through their, their print issue. September print issue this week and pulled out a bunch of articles, so Mayo ramping up Google partnership and plans to open AI factory worth. Reid, this is Chris Ross again, previous guest on the show, and he goes into how the pandemic has affected their efforts with regard to moving forward with Google and how they worked with Google through that.

And he also talks about some of the IT investments they're planning for next year. If you want to, I, I always keep an eye on, I keep, keep an eye on Cleveland Clinic. I keep an eye on Mayo Clinic. Keep an eye on just a handful of health systems out there that have the funds and the wherewithal to let me know.

Figuring out the future isn't all that difficult. You just have to keep an eye on somebody who's ahead of you. And Mayo is generally gonna be ahead of most health systems, just in terms of how they, uh, operate and how they organize. And you can take a close look at that and determine which of their initiatives.

And they're very vo, they're out there, they're in the market space. They're talking about all the things that they're doing. So keep an eye on them. Keep an eye on Chris Ross. Keep an eye on John, uh, Halamka. Keep an eye on, uh, keep an eye on what's going on at Cleveland. I actually, the New York Hospital, there's, there's just a bunch of great hospitals out there.

They're doing good stuff to stay ahead of, let's see.

Suit dismissed over patient data sharing by Google University of Chicago. All right, so this is news because I think as people start to dig into this, . Uh, and you can go after Google with Google and their partners for the medical record stuff. But I think as you start to dig into this, what you're gonna realize is, uh, they're following all the right procedures and protocols.

They knew this was gonna happen. There's pe when you generally say say, Hey, my house is some sharing data with Google. You have this immediate. Visceral reaction, oh my gosh, somebody's gonna be able to search for fill in the blank disease and they're gonna, A picture of me is gonna pop up in the search.

Those two data stores couldn't be further apart if you tried there. If, if any of that Google data, if any of that medical data shows up in a Google search, more than likely it came from the health system. There was a breach of the health system and it's being shared that way. Uh, there's very little chance that the stuff that's being shared with Google Health is gonna end up in the search.

So anyway, this suit was dismissed. I would imagine this will, you know, push back on anybody else who's thinking about going after them saying, Hey, I didn't give 'em permission to share my data with, with Google. And we'll see. We'll see what happens. We'll see how this pans out. Other big news for Google is the, the push by the federal government.

I don't know if I have a story in here on that. I don't, but anyway, so the federal government going after Google for anti-competitive practices, i, I, I believe, again, this is Bill Russell's opinion, but I believe we're gonna see at at least one tech breakup in the next five years. In the next four years, four or five years, we'll see a, a tech breakup.

And I think Google is the most likely candidate for that. Their, their search . Capabilities at this point make them a, a likely target. They are the, the, uh, Rockefeller of search, right? So John Rockefeller had a monopoly on oil back in the day when oil was everything, and search and data and information is everything today.

And we joke about Dr. Google. Most health visits start with a, with a visit to a Google search. And that's true, that's true across the board. Somebody once told me, I think it was Aaron Martin once said to me, the check that Amazon hates and that Jeff Bezos hates writing the most every, every time he turns around is that check to Google, because he has to get positioned on Google for the placement of Amazon goods and services.

Amazon doesn't stand on its own even as big as Amazon is, . They have to put money on the altar of Google to make sure that they are not forgotten. And Google has that kind of power right now. So it'll be interesting to see how this federal government, uh, going after and really looking at the competitive practices of Google.

Let's see, consequences of remote work, the unintended consequences of remote work, three health systems, CIOs on new challenges and what lies ahead. I'm actually hosting this week. I'm actually hosting two, two events. With CIOs, CTOs, and others for vendors and people who've pulled me in, uh, to be really a moderator and facilitator.

And I think this is gonna be a significant topic. I think this, in fact, I know it is. How, what is, what does the model look like to bring people back? And these are three people I, uh, highly respect. Andrew Rosenberg, M-D-C-I-O, Michigan Medicine, Reed. Stephan. Vice President, CIO St. Luke's Health System in Boise, Idaho.

And Joel Vanko, a senior vice president, chief Information and digital officer of Baystate Health. And two of them have been, uh, guests on the show. And I, I know Reed pretty well. This is a Becker's article worth a read. If, uh, you are, uh, fig trying to figure out the, the. Hybrid work models versus the work from home, when you're gonna come back, what culture looks like, how you train your employees, how you train your managers to work with your employees, you know, and how people are thinking.

These are three good minds, uh, on, on this subject. Again, I, I just do headlines in this section, so if you want to check that story out, it is worth checking out. Let's see, one or two more. . Intermountain Healthcare to cut 250 business positions. I think it's interesting that they focused in on business positions, so it's administrative type positions that were, that were cut.

And that goes along with a significant amount of, uh, cuts and furloughs over the previous year. I, I think this just underscores we have to get better at automation, we have to get better at efficiency. We have to utilize tools that don't require as much labor and are not as labor intensive. We have to get better at our management structures within it so that we can create margin and capacity where there

Is seemingly none today. We've gotta be always looking for those, those ways that we can create focus. And that's one of the things I'm talking to people about is focus is so important. We saw that during Covid, we got so much done when we were focused and funded. And so the, the role of CIOs to get it funded and to really create that focus so that the team always knows what's the most important thing to be working on and to, uh, be moving towards getting that done.

Let's see. So Cerner unveiled some stuff at their conference, unveils new interoperability tools as CEO. Brent Schaeffer says innovation is accelerating. Uh, and I think that's true, and I think that's true for, for Cerner. I did not comment, I didn't bring this to the LinkedIn community. And again, I like the stuff that starter's doing.

their, their partnership with AWSI think gives them the ability to tap into things and really move this, move the needle forward quicker. And again, a lot of this stuff is good and I, I really have, uh, they're, they're utilizing the voice technology. So you have, Hey, epic. Now you're gonna have, Hey, Cerner, that's a me too thing.

But you would expect that it's also in a partnership with Nuance. I don't expect any groundbreaking types of things. From them that you won't get from Epic. To be honest on that, I think the area where they're gonna be able to really make a difference is in, in the analytics space and the machine learning and AI space.

And so I, that's the place, if I were Cerner right now, I'd be stepping on the pedal and, and also the clinical usability if I can make my EHR that much easier, where you finally have Cerner users at conferences saying, I got my life back. It, they're utilizing ai machine learning in ways that are, are giving me time back.

It's searching massive amounts of information. It's calling that information, it's putting the most important information in front of me so that I am actually saving minutes of my day. And I'm actually practicing medicine at the top of my license because of the way that the machines are helping me to practice.

I think that's the opportunity that Cerner has. I'm not sure anybody else really has, uh, Meditech may have that in the smaller health systems. I don't hold out much hope for Meditech being the innovation arm, but I do continue to be a Meditech fan. Just some of these systems are getting very expensive.

It's expensive to run Epic. It's expensive to run. Cerner and Meditech just is a, is a nice self-contained, runs a hospital, gives you the compliance reporting and things you need. But I don't expect, I don't expect to see the major innovation I. From them now, hopefully, hey, if somebody from Meditech wants to come on, talk about those things, more than happy to do that.

If somebody from Cerner wants to come on and talk about some of these announcements, always happy to do that. And Epic as well. Let's see, is that the last one I wanna talk about? Hey, a lot of activity on cyber. I decided purposefully not to talk about cyber today, although I should be. It's like cyber awareness month or something to that effect, but I've been talking about it for the last

Uh, five or six weeks. So I decided not to. But again, a lot of activity there. Vigilance is important. Keep an eye on that. Wow, I hit a lot of these stories. Those are the headlines. I give you the headlines to tell you, uh, what's going on. Hopefully you'll go out and read some of these and stay current on what's going on, which is one of our one, one of our goals.

Hey, we, that's about all for this week. We want you to participate in the conversation. Follow me on LinkedIn, bill j Russell. . Uh, you can follow the show at this week in Health It, but follow me. I'm Bill at Bill j Russell and I post a story every day and, uh, you can participate and go back and forth with me on those, on those, uh, stories.

If you think I missed the mark, send me a story. Uh, bill at this week in health it.com. Say, bill, I don't know why you're not covering this story. This is the most important thing that's happening in health. It more than happy to give it a look and, uh, cover it on the show. That's all for this week. Don't forget to sign up for clip notes, participate in the, in the clip notes referral program.

And if you don't know what that is, go ahead and listen to one of our episodes from last week. I shared a bunch of information. There's also information on our website about the referral program. You can win an opportunity to be sit across the table while sit across the Zoom, call with me and discuss Health IT News on this show.

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