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  Welcome to this Week in Health It, it's Newsday. My name is Bill Russell. Former healthcare CIO for a 16 hospital system and creator of this week in Health IT a channel dedicated to keeping Health IT staff current and engaged. Special thanks to Sirius Healthcare Health Lyrics and Worldwide Technology who are our news day show sponsors for investing in our mission to develop the next generation of health IT leaders.

We set a goal for our show, and one of those goals for this year is to grow our YouTube followers. Uh, we have about 600 plus followers today on our YouTube channel. Why you might ask, because not only do we produce this show in video format, but we also produce four short video clips from each show that we do.

If you subscribe, you'll be notified when they go live. We produce, produce those clips just for you, the busy health IT professional. So go ahead and check that out. Common question I get is how do we determine who comes on this week in health it, to be honest, it started organically, it was just me inviting my peer network and after each show I'd ask them, is there anyone else I should talk to?

The network grew larger and larger, and it helped us to expand our community of thought leaders and practitioners who could just share their, their wisdom and and expertise with the community. But another way is that we receive emails from you saying, Hey, cover this topic. Have this person on the show.

We really appreciate those submissions as well. You can go ahead and shoot an email to hello at this weekend, health it.com. We'll take a look at it and see if there's a good fit to bring their knowledge and wisdom to the community as well. Today we are joined by Anne Weiler. She's an advisor to this weekend, health It, and recovering health Tech CEO.

Good morning, Anne. Welcome back to the show. Morning. Are you okay with recovering healthcare health tech, CEO? You know, I think that is the perfect way to frame it. I am currently doing, actually, I'm, so, I'm currently at AWS and I run a service for interactive messaging. And many of my customers are healthcare.

And so that's, I love it, but I also love that many of my customers are not healthcare . So recovering is exactly right. Well, it's a little different, right? When you're a health tech startup, you, you have to get your first client, otherwise you have no credibility. After you get your first client, now you're going out and saying, Hey, we're doing work with, fill in the blank, whatever the big name is.

On, uh, it is hard to get that, that momentum going and it feels like with every time you get that one client, you've really gotten one client and you have to go out and do the whole thing over again every time. That's right. I, I just saw a tweet from some vc and there's like many people on Twitter who make fun of VCs.

But it was like, one great story in your deck is from named customers, so much better than a hundred data points. And I'm like, Hmm, a hundred data points. Pretty horrible of anonymous customer shows that you have a hundred customers. Like one customer story might mean that you have one customer. Well, one of the things that impressed me about you is you did go the study route.

That's one of the roadblocks that you hit is they say, okay, show me. Prove it to me. Can you do this? Yeah. So it's, yeah. And was that effective? So effective. But that was, you know, I would say that was the smartest thing we did. But that was a very smart thing that we did very early. And I think it was because we came from Microsoft, which is very data driven, and so.

The ability for somebody else to do a study, improve the efficacy of what we were doing. We jumped on that right away. And on like one of the very first people we met when we, we started this was Dr. Terry Ellis from Boston University who wanted to do a clinical trial more like Sure, oh, this sounds good,

And so not only did we, you know, get that she introduced us to Dr. Jonathan Bean at Harvard. But they did the studies independently because they didn't want their research to be biased. So they did the studies, the outcomes were there and we didn't pay for the studies. Like now, the thing that scares VCs and startups about them is that from the time of conceiving the study through, published in a peer reviewed JO Journal, which is the point where everybody goes, okay, yes, this is correct.

I can be five to seven years. Yeah, you could. And that is, that's not a startup timeframe. I was gonna say, you could be outta business and starting your second or third startup time, you could be. Yeah. You, you totally could be. We, we were fortunate that we weren't, but yeah, I mean, there was, there were times where we were just like, we'd have the early results, but the are, are you people who were going to publish them?

They don't want you to talk about them until they're published, so it.

Impossible, uh, sale, which is essentially selling your soul to a large system just to get that reference client. I mean, almost giving the product away, knowing money, knowing that whatever, or have sophisticated. Well, okay. I wanna say yes and no. I mean, we, we went down the path of let's pilot, let's pilot, and then we got to a point where we're like, no free.

Yeah, you can pilot and you can pay us. And as soon as you figure out there are no free pilots, like, I think that's a, a challenge that, I mean, obviously if somebody pays you. You're always better off, but I think in other industries, they're more likely to go from a pilot to deployment. Whereas in healthcare, we had a lot of like kicking the tires and then also I would say kicking the tires and then face like going, oh, we'll, we'll build it ourselves.

And then a year and a half later, of course, they hadn't built it themselves, right? So we very quickly got to the. You can do a pilot and you can pay us for it because there's value here and you can continue to pay us when you go into deployment. We have five stories here, but you know, one more question on this.

The, uh, how, how important is the lawyer, the legal team that you have upfront? It's gotta be hard, right? It, it's hard. It's so important. And we had a few before we, we settled, not say, settled before we found this fantastic person. Do they have to specialize in in healthcare or health tech or we had one who was specialized in health tech, IP and contracts and.

I wish , if the camera weren't rolling, I would tell you some stories, but he was fantastic. Yeah. Uh, he, he understood. So the other thing that you have to make sure as a startup is that your lawyer understands the risk you're willing to take. So if you've got somebody who's really only done big corporate stuff.

They're so risk averse. And, and we did actually have one like that at one point. We had the, we got, I don't wanna say sucked in, but there was this big law firm who was like, we're gonna start working with startups and, and we'll pilot with you and all this. And we go in there and I was just like, person could not understand that we were willing to take certain risk because we had to, because Right.

We were screwed up and 'cause we had to get these contracts done and things like that. And so when we found this next person, um. I'll say, I'll say his name in case anybody is looking for a lawyer, David Finney of Atkins Plant or Atkins Black. He, he understood the risk We, we were willing to take startup and he would lay it out.

Like he would say, okay, well here, if we do this, this is the risk. Are you okay with it? And obviously the client has to agree. So that was amazing. He could also deescalate any situation. Now, you were in a health system. I don't know, you were on the other side of the table. I don't know how you felt about your lawyers, but , but the health system lawyers are very tough and they were often, I don't wanna say, I don't know, things would escalate and my lawyer would just be like, Hey, we understand what you're saying.

But F fantastic. Yeah, a absolutely I, if you're selling to large enterprises, and that's, if you're in healthcare, that's pretty, unless you're doing top to bottom yourself. But even if you are, you're still selling to insurers. You're gonna be a startup. You're working with these massive corporations or organizations who have fantastic in-house counsel.

You better have a good lawyer. Yeah. That's my, that's what I'm gonna say. And, and good insurance too. It's, it's kind of crazy good insurance. Yeah. I had, I had somebody look at our insurance and they're just like, why do you have so much insurance? I'm like, why do business with healthcare organizations?

They're like, do contract. All these limits and things on, on the insurance. So you, you really do have to maintain that level of insurance. And to be honest with you, I'm not working with PHI, I'm not working with right data and those kind of things. I'm, I'm providing advisory services now. I might see strategy documents, I might see technology strategy, but at the end of the day.

I still have to have the insurance that covers the loss of PHI through my entity because I'm contract. Right. And when you might give them bad advice, , well that's a different po that's a different policy. But yes, errors and emissions is, is in there as well. Alright, let's get to the five stories before we reveal all of our secrets here.

Let's see, uh, where do you wanna start? Do you wanna start with the Kaiser story? Sure. Alright. I was gonna say, if you've seen me on this show before and you have, because we've talked, you'll know that I am very passionate about technology for seniors. . So Kaiser Health News article is talking about computer help for seniors and also how things have accelerated during the pandemic.

And so the reason I I chose this one is because this is a, a topic that is. To close. I didn't realize there was this many kind agencies that are helping seniors. There's a lot listed here. Well, so this, the interesting thing and what this article is listing is both not-for-profits and, and for-profits.

And I think that the, the idea that helping seniors use technology should be altruism is kind of odd, right? Like, first of all. This is a very large population. Second of all, it's obvious now if you didn't realize it before, but the pandemic really showed like, we need to keep everybody connected. We need to be able to do things remotely.

We need to be able to do things digitally. And seniors are a large population of the people that need to do these things. And then you look at like, some services don't even have in-person things anymore, or they require you, you know. To do multifactor authentication, all of these, these things. And so on the one hand, great, that there are all these organizations helping seniors.

On the other hand, I'm also very passionate that we should just make things that are easy to use. I mean, I, I don't know why I think about this all the time. Like I, I, when maybe it was like when I was little, I spent a lot of time with my grandmother, , um, and, and her friends and stuff. I think about aging a lot and.

Whenever I can't open something, a package or whenever I am like beyond frustrated, trying to figure something out, how to figure, figuring out something works techno, especially with technology, and I'm thinking, I work in technology and I can't figure this out. I don't know if, I don't know if I've ever told you this part, but I, I need it.

I have an Apple tv, uh, and it's like the second generation, so it's very old and it stopped supporting HBO Plus, so I was like, okay. I'm gonna get a new one. I get the new one and the remote on it was so unusable that within the fi first five minutes I had accidentally just subscribed to Disney Plus or something like, and I was just like, are you kidding me?

Like, I could not make this thing work. And I was just, I sent it back and I, I learned later, you can use the old remote with it, but like, first of all, how did I learn that? And second of all, I'm thinking of like, I'm looking at this and I'm like, yeah, no wonder I. When I'm on the phone with my parents, like I'm trying to troubleshoot things remotely and I just can't do it.

So I think that this initiative is, is amazing. There's, there's a couple things We need to stop thinking that seniors are incapable. We actually need to examine what we're building because I heard all these pandemic stories of seniors doing now, doing all their community center stuff on Zoom, doing classes on Zoom.

So I think Zoom is pretty usable. There's a whole lot of things that aren't, so that's, that's the part of like, and I'm hoping that these e, even if they're altruistic, that they're giving feedback to the tech industry. Rather than just saying, the problem is the seniors, they can't use technology. I mean, that was going back to my startup time and, and before we came on, or No, we were talking about the, were we talking about the clinical studies before or after we came

Yeah. So the clinical studies, we had a long conversation before we came on there. Yeah, I know. We, we just talked, we talk a lot. So the clinical studies were specifically because when we started the . The startup people said, well, this digital technology is great, but it's seniors who have the problem and they can't use tech.

And so that was what the studies were to. Well, I mean, the studies were to prove two things. One, that the tech actually improved patient outcomes, which is obviously the most important. And second was that it was usable by people in in older age bracket. And, and it absolutely was. And, and here's the most important part, and I say this to teams all the time.

If you design something that's highly usable. A more advanced, more technical user is not going to complain. Right? . Right. And we never had like a younger person say, oh gee, this app is too easy for me to track my patient outcomes. The, the age old story, the walled garden is beautiful. From this perspective.

I, none of us really like the walled garden, except when Apple hands a. Two year old or a one and a half year old, an iPad, and you watch them just go flip, hit the game, do thing to close it up, open a video. Oh my gosh. This is like a, not even a fully developed brain sitting there with the iPad. They intuitively know what to do and they just start flipping through things.

That's the level of, of simplicity, that's the goal. Apple's always the goal from a simplicity standpoint. I love the fact that you shared Apple tv . I was gonna say, except they seem to have glossed the plot a little bit. 'cause this. I mean, this was unbelievable. Well, it's, it's interesting. This is a good article from this perspective.

You have, uh, generations online. You have cyber seniors, you have Digi age, you have, uh, aging connected. They list a whole bunch of the, uh, candy tech. They have a whole bunch of companies. They list. Are helping seniors. So it's really good from that perspective. Lemme tell you my story for the week. I shared this on today in health it yesterday.

My neighbor is seeing an academic medical center. I'll leave the name off for purposes of this story. And, and so he said, look, I, I have this meeting with a specialist at one 30 tomorrow. Can you come over and make sure I get connected correctly? So I go over.

It pops up, but the first thing is he's on AOL. Right? So I, I'm looking at this thing going AOL Really? Okay. So, but it works, it pops up, but there's a little error message that pops up in the background. And first of all, I had to get past popup blockers, right? Yep. Because it popped up, which is not a small deal for a senior.

So I'm there, I know how to do this. I get through it, we open it again, it's sitting there, 30 comes and goes,

goes. 1 45 ish. He goes, I'm gonna call him. So he calls the help desk number and says, Hey, I'm online. I'm supposed to be seeing doctor, whatever, and it, and it's just spinning. I don't know if it's working or not at this point. I'm a former CIO. I'm looking at it going, I don't know if it's working or not.

And it was just a Zoom call and I know what Zoom calls.

There's part of me in the back of my mind going, what was that error message? And did that really cause us? So he's, he's sitting there waiting on hold and she goes, well, I can't see the physician doing. I'm actually at a call center.

So that whole thing takes about three minutes, transfers to the department, and about 1 48, he's, he's on finally on hold with the radiology department, or I'm sorry, with cardiology department at 1 49. All of a sudden, boom, physician pops up on the screen. I'm like, I knew that's what should happen. But think about that.

19 minutes late and the workflow was broken, the workflow is broken. The patient didn't know he could have very easily just closed up and said. This just didn't work for me. I, I'm not sure that would've been different for a senior or you and I, right? I mean, 19 minutes, there should be some process where the physician's running late that I don't know, you can send a text message or something to the user that says, I'm running behind.

Stay on the line. I will be there a little late. Yes, yes. The basic usability basic, like you think of, you think of Zoom, any sort of meeting software you can tell people that you're running lights, . I, you, you would, you would think I was, I was kind of, I don't know. I, I was kind of. It. We have to be thinking through the user experience.

We have to be thinking through how they use the technology, and I understand the complexity of that. We've now expanded from not only from a IT standpoint, not only supporting the computer four walls, we now have. Yeah. All kinds of locations. Yep. Alright. Lemme hit the Harvard Business Review article. I think this is interesting.

So the Scottsdale Institute got their CIO forum results. What they do is they bring a bunch of CIOs from the Scottdale Institute together. They have a conversation and they said, all right, let's talk about the new normal post pandemic. What are the three things that we have to deal with? And they said there's three overarching things that they have to deal with.

And, and what the Scottsdale Institute did is they actually published this through the Harvard Business Review. It'll get a, a larger reading, I think, from there anyway. So, uh, the three things that they have to deal with virtual care. Obviously coping with the financial impact of the pandemic, and I wanna talk about that a little bit with you and embracing the lessons learned from Managing the crisis.

Let's go in, let's go in reverse order. So the lessons learned from managing the crisis, the number one lesson learned from Managing the Crisis is we can do a lot in healthcare if we are focused. Yes. That is the number one lesson. We were able to be agile. We made decisions very rapidly. We reduced the administrative burden around things.

We got things ordered quickly. We moved people quickly. Yes, because we knew what it was about. It was about safety. It was about protecting our, our providers, that it was about protecting our people and our community, and we were gonna do everything we could around those two things. How do we keep that going?

Why can't we keep that going? I'm already hearing people go, our culture's snapping back. I could feel it snapping back. We have 150 projects again. Yeah. Yeah. It is interesting because this is, it's not just healthcare. We think that. Healthcare. I mean, healthcare was, was behind, but, but as I said, I now work in more general tech and, and we, what we've seen in digital investments is they have moved ahead three to five years in very short periods of time and companies that you didn't expect not to be Text messaging set up, text messaging.

So I think the. The key thing, and this was my concern at with telehealth at the beginning, is these investments were made. So somebody needs to be on top of like, okay, we made the investment, we got over the hump, we did the thing that we didn't think we could do. Now what are we gonna use it for? What's next?

And for things like vaccine notifications and covid tests, the volume and the urgency is never gonna be as high. Why, why are you not doing flu shot reminders? Why are you not doing ? Well, this visit, when the infrastructure's set up, why are, what are the other things you're gonna use it for? I, I, I'm gonna go right there where you just went, because I get this question all the time.

Do some studies in the community. We, we believe telehealth is gonna be a major component. Is it, uh, I don't know. Give, get the data, let's, we believe that. But there's a lot of healthcare decisions that are made on the belief of a few people that doesn't get pressure tested out in the community. And that's why you end up with a lot of failed startups and those kind of things, or failed projects or projects that don't get the right, uh, emphasis within the organization because.

The management might believe it, and then they say, go kick it off. And then the clinicians look at you and go, that'll never fly. Yeah, you just have to pressure test things. But I would start with the belief statements. That's how you stay focused because you're gonna put together a five year strategy and, and really what you should look at.

Has anything changed? Do we believe that healthcare is heading in this direction? Do we believe that competition will materialize in this way? Do we believe that technology will start to enable us to provide more care in the home? Once you have those belief statements in place, then go ahead and put the projects around it, and that will help you to prioritize 'em and hopefully get all these other things to fall off to fall by the wayside.

Because they're all good projects, as we always say. They, they're all good projects. They're all in in pursuit of health and making the clinician's life easier and yeah, more, they're all good projects. Yes, but you can only do so many of 'em. And when we do narrow that down, we are much more effective, I believe.

Yeah, totally. It's funny you say that because I saw a large health system advertising, Hey, we we're expanding our innovation group, and I was like, huh, okay, I'll look at this. And I looked and I said, look at all these projects we've done, and there were 20 or more projects on their website, and I was like.

Oh yeah. This innovation theater, you, you're the one who talks about that. It's like, yeah, prioritize. Like this is, I, and I think this is one of the challenges in healthcare, right? Is that everything is, has meaning everything could benefit patients and or providers or whoever. And so yeah, it's about the prioritization and that's what the pandemic did was hyper.

Yeah, I agree. So the second thing is financial health. We don't talk about this a I'm glad it March.

Billion. Billion as a result of foregone revenue. And it's important to note that a lot of health systems are running on, operating margins are running on one to 6%. Really successful one. Yeah. Um, now, now Mayo might be 12% and Cedars might be 12% or whatnot, but UPMC might be high. Intermountain might be high.

I'm naming all the really high ones because they're, they're rare cases. They're well run, right. Specialty care kind of places. Yeah, a majority of them are. One does, and you take two, $2 billion out of that system. That means a lot of them are operating at a loss during the pandemic. Mm-hmm. for sure. And potentially if volumes haven't come back, which they're saying they're, they're not coming back just yet.

Could also be down. They're talking s are essentially saying is, Hey, this is one of the realities we have to grapple with. So yes, we have to continue to prioritize and we have put virtual care everywhere. It makes sense. But one of the realities we have to grapple with is. That there's less revenue to play with and which means, typically what it means is revenue is this big and our costs were this big.

Well, when revenue shrinks, costs have to shrink. They have the normal things that you have in here around consolidating instances of applications, which is an epidemic in healthcare. I mean, it is. They're just proliferation of applications happened over decades, and I'm not sure we've pulled that back enough.

Yet we should, we should be able to really continue to pull that back, explore the use of cloud, initiate, initiate efforts to optimize performance of existing applications and leverage vendor capabilities where possible. And then the other thing they talked about is capitation. That their health systems, what they've noticed through the pandemic is that health systems did better when they had managed lives, when they had capitated agreements because the payers did.

Well during the pandemic, but the providers did not do well during the pandemic. But one of the things they point to is their analytics need to be better support systems. One of the things I'll say is they, they think it's easy to go out and get a patient population to put 'em under contract, but.

Healthcare systems don't know how to market and they don't know how to sell. They really don't know how to sell. They think marketing is sales. Yes, and marketing isn't sales. I remember when I went in, I said, alright, you need to hire a sales organization. They're like, well, no. The executives will take these meetings and stuff.

I'm like, that's fine. Have any of 'em ever had a sales quota? Have any of 'em ever? There's actually a skill to selling that was so undervalued in this, and sure enough, I think over a two.

One employer on our, our program, and I'm like, it's because you don't do sales. Yeah. And you don't really do marketing. Yeah. Either. Either the marketing, yeah. , it's, I mean it's marketing, but it's like that. The thing that we're seeing elsewhere is the, you know, customer experience and there's that reluctance to consider patients to be customers, but they're actually customers.

But I saw, oh shoot, I'm gonna forget his name now, but he's someone I know from healthcare journalist, uh, freelance writer posted on Twitter. He had just had a ba well, he hadn't had the baby, his wife did, had the baby. The first outreach from the hospital. Was an HCAP survey, and it's like, we understand you may have recently visited our hospital.

And he is like, like, do you understand that? Like the most amazing thing just happened to me and my family and it because it, and you can imagine also well, like, what if it hadn't gone well, , it's like, right, right. Welcome. Like, like he's like the, where's the like. Congratulations. New parents like it is the, it's the, Nope, we're worried about our, our HCAP survey and our, our patient.

It's when I was trying to make the case for CRM and we did bring CRM into our system, it was kind of interesting. It's like, well, we have all these databases of people and we know their birth dates. We know they're addressed. Do we really need another system to track? It's like it's not a system to track that.

It's a system of engagement. Right. And to, to explain that to people. They're just, it's like, it's, it's not just sending the email out, but it's actually knowing whether they opened the email. Yeah. It's interacting with them through texting. It's interacting with them in, in a lot of different ways. It's knowing that it was a child that was just born and we can customize the letter to say, Hey, congratulations.

Well, whatever. Now the challenge we had, of course, was you're taking, uh, HIPAA data. You're taking C data and you're, you have to be very careful when you're doing that. But at the end of the day saying, Hey, congratulations on your new child. It's not, it's not really violating that. You really have to understand HIPAA and know what they're, I mean, there's definitely a lot more sensitivity when you're dealing with health data, but think about like financial services.

There's a lot of sensitivity there. And they manage to understand who their customers are. Yep, that's true. And we do, we have to understand who our customers are. Have you been hearing the same things around financial health? Uh, of health systems? Yeah, well, sort of, I mean, definitely, definitely at the beginning of the pandemic it was obvious when everyone's canceling all of their elective uh, procedures.

And then I think that was always an interesting conversation was people didn't understand what elective was, that having a benign brain tumor removed is actually elective surgery. So like the seriousness of of elective surgery is quite high. Anyway, the, so it was obvious they were losing money, but that was the first time I saw the full collective stat.

And I, I'm curious about. What does that mean? Like where, where are the, are the budget cuts coming or are they coming and where are they coming from? And then also there's a, before this, the, the rural hospitals were in trouble, right? Like the safety net hospitals. So like what is gonna be the long-term fallout of this?

I, I think I'm gonna do a week on today in health it on rural hospitals and their situation. I've been, I've been reading a lot of articles. I've been researching it, and the, the crazy thing is. I don't think there's gonna be a huge audience that's gonna say, well, all bill's covering rural health. But the reality is it's a major, it's a major challenge and I, I think it presents a ma a real significant opportunity for us in healthcare if we really think through it well, but I, I don't wanna go into that just yet 'cause I'm just still forming my, my thoughts on that in terms of where, where do cuts come from?

Unfortunately they're gonna come from operations and that could be anything from administrative cuts to nursing and some other areas that it, it's hard, it's hard to make those. I've been, I've been at a system where we had to make those cuts and it's, it's really hard to make those cuts and it's hard to justify too, 'cause you're letting people go and they look at you and go.

Don't we have a billion dollars in investments and Mm-Hmm. don't we collect money in philanthropy? And, but you have to ask yourself, is the role of the health system to provide employment? I think the answer to that is somewhat. It is they're the largest employer in, in the community, but part of that is to remain fiscally healthy in order to provide employment for Right and, and care for the community as well.

We, we always took heat every time we did the cuts, 'cause we were not-for-profit and we were making a profit . But not that we were making a profit, but we were, we had an, we had an operating profit every year that got reinvested back into the organization. So people were like, why did you do cuts in a year that you were, and this was always an interesting conversation.

Why did you do cuts in a year that you were profitable? And the answer to that was we were not meeting the mission of our organization, which was to provide . It's the triple aim and to, to provide access to everyone in the community and to lower the costs. And what we realized is we were making more money, but it's because we were raising the cost of healthcare across the board.

And the sisters essentially looked at us and said, no more stop. You're, you're making money on the backs of people that can't afford it. And, and so even though we were driving profit, we were still doing cuts and it was hard to explain. Yeah. That, that is hard to explain. It's, it's, well, as we know. It's so complicated.

It's complicated. The last thing they talk about is, is virtual care, and you'll be glad to know. That they say creating a great patient experience has been elevated as a result of, of covid and delivering care in the right setting is one of the things that we are looking at very closely with telehealth.

I'm bullish on telehealth, but I'm not sure it's gonna be phenomenal for providers. My other story of my telehealth visit is my wife had a nagging problem and I said, I think UnitedHealthcare offers telehealth through Teladoc. Sure enough they do. It's free to me. Seven by 24, 365. It's free to us. I said, just, and she goes, well, is it hard to use?

I'm like, well, let's go see . She logs, she logs in and says, fill out this medical information and click on this button, and sure enough you select a telephone visit or video visit. She selected telephone. She got a text message and an email almost immediately, and the call was initiated within five minutes.

I'm like, Hmm. Did any money go to the provider in that case? Well, I went to Teladoc as the provider. Hmm. Right. And, and I'm sitting there going, that's really interesting to me. If the local health system doesn't figure out a way to Yeah. Create a relationship with the consumer. Yeah. Somebody else is gonna be directing care.

I think this comes back to the, this years ago I talked to somebody who was doing team-based medicine and they, of course it was out of a, it might have been out of Stanford, like the kind of thing where you could fund something like that. But the team . There was a primary care physician, there were a number of nurse practitioners.

There were some PTs, there were OTs, there might have been even behavioral health, and they worked as a pod. And I think that if the health systems want to have telehealth that maintains their patient continuity and their patient, that's the way to go because the, the frustration with, I mean, it's if you need something.

Urgently urgent and you don't wanna leave home, it's great. But if you want that continuity of care with your health team, like you can't have a doctor who's available 24 7 for telemedicine visits and seeing people in person and like the whole scheduling of this is ridiculous. Right, but you also, like I go to University of Washington Medicine and for telemedicine, they'll just put me on with any doctor and Okay, sure.

It'll still go into the same record, but I have no relationship with this person, but my doctor's not gonna be available. I mean, she, she does do some telehealth, telemedicine visits, but it's not that like you gotta book the telemedicine visit far in advance. So I think they need to move to this. Like we're gonna have a pod of

Clinicians who work with patients so that if I'm not talking to my doctor, I'm talking to the nurse practitioner that works with my doctor and they might even talk later about me versus like, this doctor I've never seen who's only gonna put notes in and never go back and talk to my doctor about me. I think that's the model.

Like they have to move to this and they can have, they could have those people rotate in, in telemedicine. Like maybe the nurse practitioner sometimes does telemedicine, sometimes doesn't, like this is the thing that Dr. That's how you have to do it. Dr. Veed, our, uh, American Telemedicine Association, he's like chairman or something to that effect.

And he essentially was saying one of the benefits we have in going as providers is you can actually talk to someone who knows you. Somebody you have a relationship with, whereas a Teladoc or something like that, you're gonna get whoever's on the phone if your experience is the same as tele. I, I mean, that's missing, missing the boat.

But I agree with you, the scheduling was so hard. It was so hard to take somebody who sees patients physically Yeah. All day and figure out how to do the, the telehealth visits well on. Scheduling is so hard, right. . Right. Alright, here's what we're gonna try

and incorporate stories left. The new normal digital health in the post covid world. This is, uh, Carina Edwards writing on LinkedIn. She has two points I'm gonna ask you about one of them. Okay. So eng engaging consumers and giving consumers control, engaging consumers. We've already talked about giving consumers control.

Do you think the pandemic has changed that, that consumers want control of their health? It still feels to me like a very passive kind of thing. I mean, I, I am not in control of my health when I need help. It just. I don't know how to demand control of, of the process. Yeah. I don't think it's, I think it's the people who always wanted to have some control have it, and the other, I mean, it's not that people don't want to, it's just they don't know how.

But like I look at, I look at people when the, the resourcefulness of getting vaccines, like I was astounded at like . People sharing information. Um, among my friends who are all Type A technology people like there, people were very, I don't wanna say creative, but resourceful about like, oh, I found a vaccine over here Before it was like they were widely available.

So there are always people who are. Being proactive. And I don't wanna say that other people aren't being proactive. I'm saying like it's who's willing to, to deal with the pain and make the effort to try and figure out how to manage your own health is the issue, right? So from that perspective, I hope Corina's right?

That health systems are figuring that out. Otherwise, United Healthcare is trying to figure it out. Optum's trying to figure it out. Walmart. Others. I'll just say others with you on the line are trying to figure it out. , lemme tell you the next story. 13 Health systems are investing in their innovation dollars, where they're investing their innovation dollars.

This year. This article was in Becker's, struck me as amazing from this perspective. Ascension Ventures, a billion dollars. Northwell Health investing hundreds of millions of dollars. You have Mayo Invest. Anyway, they're all investing significant dollars. Here's the one, the thing I thought was interesting.

Mayo has partnered with Kaiser Mm-Hmm on the hospital at Home Initiative, whose name I forget right now. And they also have partnered with Providence on Dex Care. So you have, you have these, these funding arms coming together and yeah, that creates kind of a, an interesting dynamic too, doesn't it? I mean, is is this a way, are they using their venture arms as a way to partner with each other where they, they normally Yeah, I don't, no, I think there's, I think there might be a little bit of fomo, first of all.

And then second of all this, there always were these . I don't wanna say secret, but like the Scottsdale Institute, you gave that example, they were already all sort of collaborating in various things. Obvious like that too. You've got a bunch of competitors that go in together to invest in things. So I think it was always there.

And then there's the fomo, and then there's also the, it's easier if someone else has validated it. So if you know that Providence or Mayo have these . Great venture groups who are doing all the validation, then it's easier to go and go, oh yeah, I'll come into, I'll come in on this too with Providence and Mayo, I would say are not really competitors, right?

Like Providence is not a destination and they're so far geographically that that's pretty safe too. Yeah, so that's, that's my take. Providence and Kaiser are for sure in, in certain markets, and I wanna thank you for your time. Really appreciate you coming on the show. Always great to talk to you. What a great discussion.

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