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 Welcome to this week in Health IT News, where we look at as many stories as we can in 23 minutes or less that is gonna impact health it. My name is Bill Russell Healthcare, CIO, coach and creator of this Week in Health. It have set up podcast videos and collaboration events designed. To develop the next generation of health leaders.

It's Tuesday News Day, and we're going to ease into the news year, new year with, uh, by taking a look at the predictions for the upcoming year. Instead of, as you know, we normally took a look at the top 10 news stories and I, uh, give you my take on it and then circle back on a couple of 'em and go into a little more detail.

Uh, for this, I'm, we're just gonna take a look at 10 predictions that people are putting out there. I took a look at 10 stories. . And then I'm just going to, uh, some of 'em are the same predictions over and over again. We're just gonna look at 10 predictions, uh, from those various stories. We wanna thank our founding channel sponsors who make this content possible, health lyrics and VMware.

If you wanna be a part of our mission to develop health leaders, go to this week health.com/sponsor for more information, and you're gonna wanna stay tuned on that front. We will be announcing three more channel sponsors here shortly. Thanks to Drex, to Ford who helps me with research, with his new service, three X Drex, where you get three stories texted to you in three day, uh, uh, three stories, three days a week.

Uh, to sign up, you just text Drex to 4 8 4 8 4 8. All right. Um, again, for those of you who are watching this on the video, this is a bucket list item. We are renting a place for, uh, December, January and February. And, uh, this is in between us moving out of our old studio and into a new studio or . You can, uh, take that as moving out of our old home and moving into a new home.

So, uh, and we decided to rent here at Sunset Beach, and the views are breathtaking, so hopefully you'll get some of that in the background. All right, here we go. You know, here, here are the stories I'm pulling from, uh, there was a fierce healthcare story. Editorial Advisory Council offers insights, uh, that's a good story.

That's a completely different story, by the way, I read that. I'm not gonna quote any of it in this, uh, in this episode. It is worth a read. It's about, it's really looking at the mega trends across society and, uh, uh, just some things that really, uh, stretch my thinking and I think it will, uh, for you as well.

Uh, we had this goofy thing about Apple buying epic in the middle of the year, and might as well put the story out there 'cause we, we ended up talking about it a lot. For some reason people got all, uh, jazzed about it until people started to sit back and really think about it. And it's like, you know, Apple's never been a enterprise software company per se.

I know somebody will argue that, but, uh, they are not buying Epic. Um, you had a bunch of stuff on ai. Eric Topel wrote his book. That came out, uh, you had, uh, Chris Ross, Mayo Clinic, CIO, the, this artificial intelligence stuff is real. He announced at the Healthcare 2.0 conference. Uh, Don Rucker, uh, was interviewed state of the, uh, state and next frontier of interoperability, talking about, uh, fire, uh, version four and a bunch of other stuff around, uh, AI and other things that are out there.

Um, and, you know, there could be a potential purchase in the future, but I, you know, if the partnership's done right, there's, it's not really necessary. And I, it appears like they've, they've driven a really good partnership between the two of them. And so now you have the, uh, AWS Rocket Engine strapped to Cerner.

Uh, this is from, uh, Dick Daniel, CIO. Kaiser Permanente said that his hospital and health insurance company is investing in making their data centers more. Energy efficient. To that end, some of the initiatives include wind, power, natural gas, gas without, uh, combustion byproducts to generate power, uh, for some of its data centers.

And actually what's interesting to me is . Uh, there's an awful lot of people who believe that global warming is a health issue, and it's a lot of issues really, when you think about it. It's, it's an energy issue, it's an environment issue and, and clearly, uh, it can be a health issue. Um, and so I. Uh, because of those expectations on the health system to be a good global citizen.

I think the CEOs are gonna be asked those kinds of questions in, uh, forums and I think eventually the CIO is gonna be asked. I think, I think Dick Daniels is right. I think this is one of the things that we're going to, uh, need to keep an eye on. Uh, the second one, you know, return to home-based care models.

All with a de desire to reinvent, cure delivery. Now, some of these have sort of a bent of, you know, of course somebody from the payer is going to say this, but I think this is really a, a real trend that is going to happen. And uh, and, and really it's about time, you know, care is finally going out of the hospital itself, and I think we would all agree it's about time.

It's very expensive and there's a certain amount of risk to it. Um, you know, clinics of all shapes and sizes are popping up across the landscape. You know, some are run by health systems. Uh, some are, uh, you know, actually some, they're, they're being run by a lot of different things. They're being run by employers, being run by venture backed groups.

Uh, some retailers, uh, Walmart obviously is, is getting into it. Uh, Amazon Care, Amazon's running, uh, that's an employer back, uh, employer, uh, program. Um, you know, it's a lower cost venue and it's really becoming the preferred choice of, um, of many. But it, I, I agree with him that this is just a stepping stone to some more bold moves in telehealth and home-based care, uh, model.

So, uh, yeah, I, I think this one's going to accelerate a little bit. Uh, you always have to look at the financial models and where it makes sense, 'cause that really will determine the speed at which something moves. But, uh, this is, uh, this is gaining some traction and it's a, uh, way for, uh, new entrants to compete.

I would love this prediction to be true, and I think it will make some, uh, serious progress in certain areas within healthcare. I think, uh, you know, visits that don't make sense. We saw this in New York with, uh, orthopedic, uh, you know, after surgery people are, are doing telehealth visits. You don't want to drive into New York.

It's hard to drive into New York. It's, it's expensive to drive into New York. So if you are in Jersey and you have your surgery done. Uh, in a New York hospital, the follow-up visits being done, uh, via telehealth. Uh, and I think, you know, there's a whole bunch of use cases where it's, it, it is, it is expanding.

But as we heard from, uh, Dr. Klasko, uh, you know, doing this requires health systems to cannibalize their revenue unless they are a payer, uh, an insurance carrier and a uh, provider. It requires them to cannibalize their revenue. And it's really hard to make that case to, to anyone, especially your board. Um, and so I think for that reason, it's gonna become a weapon of choice for people who are looking to be new entrants and competitors in those space.

And then eventually it's gonna have to be a defense defensive strategy, uh, in highly populated areas. In, in reaching out to rural areas. I still think it's a very good, uh, strategy. So, uh, if you take, uh, markets that are densely populated in Chicago, uh, . New York, uh, la, San Francisco and others, you can use telehealth as an offensive strategy to take patients away by u utilizing convenience.

So, you know, will telehealth take hold this year? Uh, I think health systems are gonna move slowly because they have to cannibalize their revenue, and, but I do think it will continue to make that progress. I think the VA announcement was huge last year. And I hope to see more of those kind of things, breaking down the barriers between states.

Uh, recently saw the, uh, I think it was the AMA, uh, support, the, um, cross state licensure. I forget what it's called, some pact or something. Um, so again, I, I expect to see a lot of movement there. Uh, a bunch of five G announcements, uh, or five G predictions. Five G will enable all sorts of new solutions. . Uh, color me is skeptic here a little bit and, um, I, I don't get me wrong, keep an eye on five G.

When five G is implemented correctly in earnest across the country, it will completely change the landscape of just about every industry. With that being said, we're not there yet. Of what you're seeing right now is, you know, you have T-Mobile saying, Hey, we're doing five G across the country. They're doing four g plus.

Across the country. So it's just a slight improvement, uh, until we get the, the next level, which is, uh, really building out the, uh, requires a lot of, uh, infrastructure build out. And, uh, there's some other things to overcome. Like, uh, the signal going through, uh, walls is not as good. You're gonna have to have carriers.

The, this T-Mobile and Sprint, uh, merger is really important because Sprint has all this bandwidth. They have, uh, the different, uh, layers of bandwidth so that they can do, uh, long haul and, uh, into buildings and all sorts of other things. And that's why that that merger is so important for T-Mobile and for Sprint.

Um, T-Mobile has the cash to take sprint's, uh, bandwidth and really put it to use. Uh, but anyway, regardless, . I, here's, here's the thing around healthcare on this, there's a lot of solutions that we could be doing on four G that we're not doing today. So I'm not sure why all of a sudden we think five G is gonna be available and we're gonna start doing a whole bunch of stuff, uh, that we could really be doing today across four G.

Uh, the fifth thing, AI and machine learning. A lot of predictions around AI and machine learning. I, I'm sticking to my, uh, premise here, which is, uh, huge advancements in administrative and it uses using it around security, using it, uh, uh, machines, managing machines, if you will. Uh, as your, uh, network becomes complex and you have to, uh, manage ex exfiltration and those kind of things, uh, machine learning and AI used in those cases, uh, uh.

RPA being used in the, uh, in the call, repetitive tasks, call centers, um, uh, ar, you, you name it. I think you're gonna see it. Uh, you're gonna see it expand there. I think it's gonna be slow on the clinical side, although some people disagree with me. They say big push in clinical this year. I think we're seeing it replace, uh, some of our, uh, some of our analytics models from the past.

But we're not, you know, it's replacing some of our sepsis models. It's replacing some other things. But, uh, really the promise of AI is, is real time, uh, calling of the information and providing support to the people who are delivering care. Uh, in real time. And I think that's still a little ways away for a couple reasons.

One is, uh, we lack the credibility we need with physicians and we're still earning that back with some, uh, poor EHR implementations over the years and, and some other systems. Um, and so we can't just walk in and say, Hey, this is the future. That, that argument just doesn't cut it anymore. We have to truly implement this in a collaborative way.

And, uh, and you know, that takes time and it takes, uh, it, it takes some, uh, savvy and sophistication in the form of the CIO leader. Uh, the second thing is some, uh, see or some, uh, clinicians are calling for clinical trials around ai. And there's some, uh, concerns around the black box of ai, both of which are probably valid in clinical, in a clinical setting.

If we were doing a new drug, we would ask for clinical trials. Uh, AI and machine learning has that same impact. and we are gonna be making decisions off of these things. We probably should put them through a little, uh, a little bit more, uh, significant, uh, rigorous testing, uh, before they get deployed. So I think it's gonna slow down the clinical side.

Not that we're not gonna see progress and not that we're not, we shouldn't be investing that time right now so that we see significant progress in 21 and 22. So again, AI machine learning is the future. I agree with Chris Ross. I agree with everyone who's, who makes these predictions. Uh, I'm just trying to fine tune the timing of it, if you will.

Uh, data, um, gosh, the, the predictions around data are all over the place, but the, the reality is we're still using only about 10% of the stored data, uh, in healthcare for analytics or, or intelligence of any kind. And, and that's really unacceptable. And so from that perspective. Everyone's predicting that we're gonna start using the other 90% or really make inroads.

And there's a lot of different ways that that's being said. You know, we're gonna see, we have a lot of this stored in data lakes. We have a lot of it tied up in different silos and those kind of things. Um, and so there's, uh, people predicting new tools that are gonna come out. There's people predicting, uh, new methods are gonna come out.

Uh, and, uh, you know, I am really a strong proponent that I believe two, two things are gonna win out here. Uh, one is I think some people are just gonna throw it over to the fence and say, uh, Hey, Google. Hey, health Catalyst. Hey, fill in the blank. Uh, Amazon, potentially, uh, Microsoft. Hey, I'm gonna throw this over the wall.

Can you help me to implement these new tools? And I will bring the, uh, the algorithms and the analytics and the healthcare knowledge. To bear. I think you're gonna see that, uh, throwing over the wall kind of thing is going to be primary. The second thing I think you're gonna see is, um, service providers that are really good at this, like, uh, you know, health, if they have the tools and they have, the people are really gonna do well in this space.

So the, I think you're gonna see a lot of partnerships and a lot of, uh, vendors really focusing in on this data side. And we'll get back to our show in just a minute. As you know, health Catalyst is a new sponsor for our show and a company I'm really excited to talk about. In the digital age. Cloud computing is an essential part of an effective healthcare and precision medicine strategy, and we've talked about it many times on the podcast, but healthcare organizations themselves are still facing huge challenges in migrating to the cloud.

Currently, only 8% of EHR data needed for precision medicine and population health is being effectively captured and used. That's 8%. One of the things I like about Health Catalyst is that they are committed to making healthcare more effective through freely sharing what they have learned over the years.

Uh, they published a free ebook on how to accelerate the use of data in the delivery of healthcare and precision medicine. You can get that ebook by visiting this week, health.com/health catalyst. And, uh, you know, this is a great opportunity to learn how a data platform, uh, brings healthcare organizations the benefits of a more flexible computing infrastructure in the cloud.

I wanna give a special thanks to Health Catalyst for investing in our show and more specifically for investing in developing the next generation of health leaders. Now back to our show. Alright, coming in at number seven, um, rod Hockman, again, a great thinker. I have two of the things that he said in his article of his 10 trends.

Uh, the first being, uh, the race to bring voice activated technology to healthcare will heat up and will be a central feature in . The hospital and Clinic of the future. Um, we have talked a lot about this on the show. We've had, uh, several guests we've highlighted, uh, Orbita and others, uh, on the, on the show as well.

Uh, number eight, new alternatives, uh, to Medicare for All will emerge in the presidential debate. One viable option should be taken seriously free primary care for every American rod Hockman. Well, well, I hate to disagree with Rod on this one, but I understand where he is coming from as a health system, CEO, I would hope for free primary care for everyone because someone is gonna pay for that.

But I do think he's right in the fact that, uh, the presidential debate is gonna kick up all sorts of new . Uh, thoughts and ideas around this, and one of them is, um, we've started to see rumblings of this Medicare advantage for some, or Medicare advantage for all, I guess is a way of saying it. Medicare for some, Medicare advantage for all.

Uh, and we will hear, obviously the boast, both, uh, the other sides, which is, you know, make it a, a. A true, uh, market as you do in capitalism, and we'll hear the other side, which is, um, uh, you know, completely centralized healthcare and uh, uh, turn it into Medicare for all. So I, yeah, I think we're gonna have that conversation.

Um, you know, one thought on the election cycle, and I just wanna throw out there, and I just wanna keep saying this, 'cause, uh, you, Peter Diamandis has his quote. In his article where he says, healthcare is the biggest business in the world and it is phenomenally broken, and, uh, you're gonna hear a lot of this kind of stuff in spades in an election year.

Um, you may be convinced that our health system is so bad that you should go outside of the country. And I know in that, uh, any of the last two or three elections, that's may have been how you felt I should go to Canada to be cared for. But the reality is we continue to export our care around the world.

Uh, you know, people seek out our healthcare, our healthcare tourism business is thriving. Uh, we have the best healthcare in the world. We don't nec, we aren't necessarily the healthiest country in the world. And, uh, you can blame that on a lot of other things. Uh, but, uh, we have some of the best healthcare.

In the world, period. Uh, so, um, it's gonna be a tough year. It's an election year, you know, people win points on, uh, creating some fear, uncertainty, and doubt around that. Um, our healthcare might cost a lot. We have some things to fix for sure. Absolutely. Um, but we still have great healthcare in the United States.

Uh, Amazon care was a big announcement this year, and I think that's interesting. Uh, apple has their own, um, program that they, you know, you still have Amazon Care separate from the JPM Berkshire. Uh, Amazon, uh, Haven announcement, and we really haven't seen where that's going to take us. So, uh, I, I agree. The, the cost of care for their employees is still a major, uh, concern for many employers, and they are taking matters into their own hands.

And, uh, to be honest with you, not all the incentives aligned in that way. We, again, we had that conversation with, uh, um, . Dr. Klasko where he said his, his incentive as ACEO did not align to that objective to taking care of the people in Philadelphia. It didn't really align to that. It was really about the business.

And so he pushed them to make, to align his incentives with improving the care of the people of Philadelphia. And if more health systems and CEOs do that, I think that will make progress. I'm not sure that that has happened yet, so that's why I'm a little skeptical on it. Alright, those were the 10. Let me give you a couple, couple more things that I'm keeping my eye on.

is Google search. And I know that some of you just turned off your, your podcast, but it is literally the front lines of care. A billion health related searches are done a day on Google search. Um, it is the front lines. It's where people are going to find out where should I go, uh, what do I have? And, uh, if, if I were working for a health system marketing team and they were to tell me that they spend more money on sponsoring the baseball stadium than Google ads, I would tell them that they've missed the boat

they should be figuring out a way to insert themselves. They've been dis intermediated already. People are going to Google instead of to their primary care physician. 'cause it's just easier. Right? It's on your phone. It's right in front of you. It's right in front of me. I can ask all sorts of questions right now.

So that's it. How do you insert yourself in that process? How do you get back in that process? You can pay to get back in with Google ads, uh, or you can, you know, try to work. . Some, some way around that system. The other way, you know, Google search, the, the voice assistants have an all new search algorithm that you can insert yourself into, and there's all new, there's a whole new field to play out there for positioning within search on voice assistance.

Uh, now we'll see going to the JP Morgan conference next week, we'll see what people are talking about. But uh, you know, healthcare continues to play monopoly, but the regulators, I think . are starting to, uh, be onto this whole thing. They are looking at the research. The research does not support that, uh, that outcomes improve at all.

And it does not support that, uh, costs go down at all, or that access to care improves at all. Uh, and so we have a, we have a problem, , we have a problem, and that that's what we're using to sell these mergers. And that is not what's really coming out as a result of it. Now, uh, rod Hockman in one of his points makes that, that, uh, this is the year that you're gonna see that progress.

And I hope that's the case. I hope it just takes a little longer than we think. But to date, uh, we're not, we have not seen that progress, uh, as quickly as we should, uh, see that progress. And so, state regulators are starting to look sideways, and I think they're gonna, uh, now what they're doing is asking for bigger concessions on these.

Uh, what we did is, uh, we looked at . We looked at those trends, we looked at the mega trends, we looked at society trends like, uh, around the aging population, the trends around our community, uh, what type of people were moving in, what was the demographics, um, how were they consuming healthcare? Where were they looking for their healthcare information?

And then we built out, uh, models over a five-year timeframe. To build out those continuum of cares and the continuum of care, transitions of care and those kind of things, and digital tools that were gonna be required to serve that population. That's how we looked at it. And then what I would do with these trends, to be honest with you, is just say, you know, are, are we still trending where we thought we were?

Do we need to adjust any of those assumptions? So maybe you're doing the same thing, maybe you're not, maybe you're putting an awful lot of stock in these things. Uh, it sells newspapers, which is why I think everybody came out with their . You know, trends for, uh, 20 20 19, 20 20, and I am now a part of that, um, uh, of that cabal, if you will, to, to, uh, sell newspapers by talking about predictions, I guess.

So I am a hypocrite. I talked about 'em. Next week we will get back to the news. We will look at 10 stories and I'm looking forward to that. And then the following week, we will do our annual JP Morgan conference Rundown. Uh, because next week on Tuesday, I'll actually be at the JP Morgan conference. I'm gonna record, uh, probably on Sunday, the new show for, for, uh, next week.

So, uh, looking forward to that. Hey, that's all for this week. This show is a production of this week in Health It. For more great content, you can check out our website at this week, health.com or the YouTube channel. Special thanks to our sponsors, VMware and health lyrics. For choosing to invest in developing the next generation of health leaders.

Thanks for listening. That's all for now.