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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 going to impact health it. My name is Bill Russell Healthcare, CIO, coach and creator of this Week in Health. It a set of podcasts and videos dedicated to developing the next generation of health leaders.

HHS on cybersecurity. Uh, John Halamka spoke at a, a, a security conference, talked about some of the holes in machine learning and ai. We'll touch on that a little bit. Uh, interesting use case. Boston Children's for ai, and we'll hit on that via launches. National Artificial Intelligence. Uh, we have two articles, you know, one's a.

And I wanted to share that with you as well. So, uh, before we get into the news brief word about our sponsors, I want you to know that I only sponsor . Uh, organization and services that I really believe in, uh, their, uh, their leadership. I believe in their products. I believe in the value that they bring to healthcare, and it's the reason that I choose to, um, have them as sponsors.

And I want to have sponsors that I believe in so that I can, uh, I can recommend them wholeheartedly to you and know that what you're gonna get is a, a great experience and a great product. And today I'm excited to announce a new sponsor in Health Catalyst. And, uh, you know, in the digital age, cloud computing is an essential part of more effective healthcare and precision medicine, but healthcare organizations themselves are still facing 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. And so Health Catalyst has written this article and, uh, has written this white paper and I, I just wanna call your attention to it. And it talks about how Health Catalyst Data Platform brings healthcare organizations the benefit of a more flexible cloud computing infrastructure in the cloud.

And you can get to that whitepaper by visiting this week, health.com/health Catalyst, and it'll redirect you to a site where you can download this white paper. It is a, uh, it's actually an ebook more than a white paper. On how to accelerate your use of data in the delivery of healthcare and precision medicine.

And, uh, I highly recommend the, the, uh, the ebook. It is really well written and, uh, has a lot of really good information if you're losing, looking to utilize. Uh, the cloud and the benefits of the cloud and getting your data out into the cloud. I think this is a must read for any healthcare, uh, IT professional.

Uh, we also want to thank, thank our founding channel sponsors who make this content possible, health lyrics and VMware. Uh, if you wanna be a part of our mission to develop health leaders, go to this week, health.com/sponsor for more information. Uh, here's our schedule through the end of the year. Friday shows will not stop for the holidays.

We're gonna do 'em. Straight through and straight through hims. We're gonna have, uh, shows for you. I took a three week break last year. My way of taking a break this year is I've already recorded all the shows for January, so I am gonna take a break in January, but I have the shows already recorded for you.

Um, the, this is the last Tuesday Newsday episode between now and the end of the year. I will kick those off again, uh, come January and uh, you'll look forward to our normal Tuesday, Friday schedule as normal. Um, . We are gonna be doing two episodes I wanna call your attention to. One is our yearend review, which is where I highlight some one.

Some of what I think were, uh, some of the key learnings for me. Uh, I find that the more I do this show, the smarter I get because I'm interviewing such great people. I. And I want to pull out some of those and highlight those. And then the other is just a flat out Nielsen rating top 10. So there are the 10 most listened to podcasts for the year, and I'm gonna pull out an excerpt from each one and share them with you and do sort of a countdown episode so you can see which one is the, uh, the number one show.

We have a lot of ideas. I. Floating around. I have a, a team of people I work with. I have a, uh, team of advisors as well. Um, Sarah Richardson is part of that. David SMA is part of that. So I have healthcare professionals who are helping me to think it through. I also have, uh, a team of my millennial consultants, as I call 'em, who are helping me with this whole social media and.

Uh, I just wanna keep doing this because it is such a great service. Uh, quick shout out to Drex Forges, new service, three X Drex, uh, where you get three stories. Texted you, uh, three days a week to sign up Drex to 4 8 4 8 4 8. Just text Drex to 4 8 4 8 4 8, uh, as I have done. And you get to see these stories.

Uh, delivered straight to your phone. You can click on 'em and see what Drex thinks is important. And some of them are important 'cause I keep pulling 'em up as my story, which is awesome. Uh, and right now, uh, we are doing a, a, a little different format based on your feedback. We have a hundred percent approval rating for the new format, so we're gonna continue to do it.

But essentially what I'm doing is. I go through the 12, uh, uh, 10. Today's 12. Anyway, I'll go through the 10 stories. Uh, I'll just give you my take on it real quick. Then we'll circle back and go deeper in on, uh, some of those stories. So here we go. Healthcare leaders urge, full core breath press on social determinants of health.

Here's the so what on this? Healthcare is not incented to do social determinants of health o other than from a mission standpoint. Faith-based organizations and organizations that are committed to the the . Care of the community. Uh, and, uh, those that are really supported, Phil philanthropically have sort of a, uh, an ethical imperative to, to work with social determinants.

But at the end of the day, healthcare gets paid. Um, when you're sick, it's still sick care, it's still it helping you once you get to that point where you need your health restored. Um. So I, I think this, this push is great. I just don't think it's gonna go anywhere until the money starts to, to change. The people who are incentive for this is, uh, payer organizations.

And so the healthcare organizations that are doing the most around this, you're gonna hear are mostly payer organizations, right? So Intermountain's doing a bunch around this. Kaiser's doing a bunch around this, Geisinger's doing around this, doing a bunch around this. And so what are the three of them have in common?

They have a strong payer organization. Uh, they, they have an insurance organization. They're incentive to keep people, uh, healthy. They get paid whether people are healthy or sick. And uh, those are the kind of organizations. I think the people who are gonna make the biggest move in this space are gonna be health tech.

Uh, when you think about, uh, the large health tech players, it's Amazon and Google. It's why I keep talking about 'em. I know I've gotten some feedback from people saying . Hey, you're talking too much about Amazon and Google. I practically don't know what to do that within health it, uh, the reason I do it is because, uh, they have some interesting new ways of looking at things.

And when you think about the literally billion searches a day around health that Google gets and their ability to aggregate services and to present them in such a way, they are gonna have . A, uh, really interesting play when it comes to social determinants of health and as well as Amazon. That's why, uh, I keep that in the back of my mind.

So, um, while I appreciate healthcare leaders urging a full court press on social determinants, I only see a handful of 'em doing it. And the ones I see doing it, uh, are, are predominantly once with a, uh, with a deter component. Um, and the so what for health? It is understand the organization you work for and how they get compensated because that will determine the priorities of the organization.

The some one on this is, um, the foundation for digital. The foundation of for digital is trust. The foundation for business is trust. And, uh, people expect you to have a good cybersecurity platform in place. Now that's, that's like a no duh kind of, uh. So what, so I'll give you the next level. So what is, we have to be able to tell this story effectively within our organization.

We have to educate the board, the subcommittees of the board, uh, the leadership teams. Uh, we have to identify the right, uh, mix, right? So are we gonna be the organization that is the most secure? 'cause we're spending $20 million a year on it? Are we gonna be an organization that has found that balance?

Between spending, you know, trying to be the DOD and uh, and really doing what we can to protect . Our, uh, our patients. So you gotta find that right mix. But more importantly, you have to be able to tell the story effectively around cybersecurity. And we're gonna continue. In fact, I think, uh, one of the shows we're doing towards the end of this year is around cybersecurity and telling that story effectively.

Uh, the AMA asked Walmart to reconsider a January EPCS requirement. I'm gonna give you the so what on this. So, uh, this is, uh, uh, e-prescribing. . Of, uh, opioids and those kind of things and, and, uh, Walmart saying, Hey, you know what, in order for us to get ahead of this thing, we need it all to be electronic.

And, uh, the AMA is fighting, stepping back because only 30 some odd percent of, uh, of the prescriptions today are electronic. and you know, this is the second time that the AMA is and, and others, uh, A-H-A-A-M-A are stepping up and fighting on behalf of health systems, but they're fighting in a way that makes us look incompetent.

Right? We can't do this. We only have 36% of the, uh, prescriptions coming in electronically, or the AHA fighting, uh, against transparency because it's just too hard to do. Um, I think the reality is. In an election year, we have to be really sensitive to these topics and how they're being portrayed out in the marketplace.

Uh, the so what for it is for the love of heaven, get ahead of this stuff. Your platform should be agile. You should be able to implement this stuff. You should be able to find the funding to do, uh, electronic prescriptions. This is like basic blocking and tackling across your health system. Get the basics done.

Build it on top of platform thinking, platform technologies, so that you're ready for the next one. Because this is last year's problem, . If there's gonna be a whole new set of this year's problems that we need to be agile and effective, uh, in order to, uh, to go after, uh, catalyst for platform reform finds value-based healthcare, not moving quickly enough.

Uh, I highlight this story, not to go into detail on it, but to just say that, uh, value-based care is the future, but it is moving slowly. So we continue to be fee for service. Just keep that in mind as you're building budgets. Uh, it's an important distinction. HHS cybersecurity leaders. Describe the active threats on agency on the agency's radar.

I will circle back to this. This is really interesting. They go into, they go into depth, they go into a lot of detail on this. Um, and it's, it's a really good article, so it's a healthcare IT news article. I'll come back to that. So remind me on that. Number five, I'm gonna come back to, uh, machine learning, ai, telemedicine, and other technologies will pose the data security risks.

Says Dr. John Halamka, healthcare finance News. Uh, so John spoke at a cybersecurity conference and he talked about the risk of aggregating all of our data in the, uh, in the cloud. What's interesting about this is, uh, , you know, John talks about the risk of aggregating the cloud. And so all of you who are, uh, cloud phobic.

Right now we're saying Yes, John. All right. I had a fight. And then John goes on to make the point that, uh, that these cloud providers have hundreds of people on their security staff looking at, uh, minute details, uh, around security. And we have like a handful. And, uh, he then makes the point of. You know, where do you think hackers are gonna go at, go to try to find that data?

Do you think they're gonna try to go at Fort Knox or do you think they're gonna go after the cardboard box? And the answer is they're gonna go after the cardboard box. So, um, he believes as I do that the cloud is actually more secure. . Uh, we have, we still have to write our contracts correctly. We still have to architect.

Architecture still matters in the cloud, but, um, he makes that point that, uh, as we're building out these models, cybersecurity and security has to be at the foundation of it. Of course, he's speaking at a security conference, so makes sense that that was his, the thrust of that conversation. Um, machine learning, ai, telemedicine.

Oh, that's, that's John's number six. Number seven, a different use case for BO ai, Boston Children's Explorers automating patient provider communication. I will come back to this story 'cause it's, it's really interesting and they do a good job. Um, you know, one of the things as we look at ai, AI in the clinical setting, setting is gonna move slow.

It is, it's. You know, it's sort of replacing, um, you know, clinical decision support models that are a little slower, if you will, with, uh, some new updated models. But at the end of the day, anything in the clinical setting will move slow because the, uh, the risk is so high. Uh, so they're looking at the, uh, how AI can be applied to provi patient provider communication.

Great use case. It, it's right on the edge. It's right around the, uh, consumer experience. Very good use case. So I'll come back to that. Uh, va, VA launches National Artificial Intelligence Institute. Uh, I pulled that out as a story just because I believe that, uh, many of us are gonna have a lot of questions around artificial intelligence.

It's good to set up, uh, governance might be too strong a word, but, uh, some sort of group within your organization that's looking at the various ways that AI is gonna be used. Uh. Start talking about the ethics of ai. Start, start talking about the governance of AI within, uh, your organization. And maybe it is a governance body.

Nobody wants another governance group, but maybe there's like a quarterly group that you can set up that is starting to explore those kinds of things. I think that's the way you can be viewed as a forward-thinking, uh, leader without actually diving in and implementing everything and, uh, and you know, being the first one to hit your head against the wall.

The first is to predict patient health events or diseases. So bring their, all their data in and give them access to, uh, some higher level computing, uh, capabilities and algorithms. That's one of the things they're doing with Amazon. The second is . Uh, the personalized, customized, the consumer health journey.

That is the digital front door. And then the third thing is promoting interoperability. Uh, and that is the liquidity of data. So those are the three things that Shez shared with, uh, with the, on this article that people are looking to do with Amazon. And that's really what I wanted to highlight from that story.

Uh, Amazon also received, or, or, uh, announced Lex, which is Alexa without the a's on either end. And it is, it is to differentiate the platform, but it's their voice platform. It's Alexa. But it's Lex and it's designed with HIPAA eligibility, so just something to keep in mind. . Uh, another one was, uh, and this is just flat out a, uh, a press release, but I like it.

Uh, RX Review, which is a company I'm familiar with, uh, I know the, uh, founders and Cerner worked together to improve prescription price transparency for millions of patients. Uh, I highlight this because, um, it hits on so many great topics. Uh, arc review is a really good startup, been around for a while. Uh, price transcript, transparency around prescriptions is something consumers are asking for.

And then the, uh, the, the last thing I would say is it just accentuates that Cerner is all in and moving fast. And, uh, so we will see what, how this, uh, how this plays out. This is sort of a pre-announcement more than anything. They're working together. They're, they've, they've decided to work together. I think it's a great area to work in.

Uh, so this will give the price, transparency data right there to the physician so that they can, uh, that help the, uh, patient navigate quicker. Let me see how much time we have left. Not much . Alright, so let me, uh, I'm gonna end up going a little over here. What did I say? Come back to. So I come back to the HHS story.

Let me hit that first. Uh, HHS. Here it is. HHS Cybersecurity. Here's the, uh, here's the two things I'll highlight from this. Somebody asked from the audience, you regulated us. Why would we talk with you? He said, imagining a question. Uh, or actually he, he was, the speaker was talking about, you know, why would you share that?

And he said, uh, you know, he shared within the, the US subsection code, which holds that any. Any non-federal organization that shares cyber threat indicators with an appropriate federal entity is deemed voluntary data sharing that shared information cannot be further shared for specific regulatory purposes.

He explained meaning that HC three will not report any vulnerable information, vulnerability information shared. Uh, I highlight that 'cause I didn't know that. So that is good to know. And, uh, it's, it's a good partnership to have. Here's some of the active threats they have on the radar, which he shared that I think it's worth looking at.

Deja blue, uh, e Eternal blue. These are all things that are impacting the, uh, windows environment. Uh, something to take a look at, uh, especially around RDP and other things like that. And then urgent 11. As we have shown here, the vulnerability, uh, could impact real time operating systems used for devices such as MRI machines, firewalls, and printers.

There are more than 2 billion such RTDS services worldwide. I like this. I, you know, when I was A-C-I-O-I had access to consulting firms, which kept me updated on these things. Some of you may or may not be updated on these things. This gave me some specifics and so I thought it was worth. While in sharing those specifics with you, healthcare IT News is where the story is worth.

Taking a look at the headline, again, it, it'll be in the, uh, show notes, but HHS cybersecurity leaders describe active threats, uh, the on the agency's radar. So, uh, use case, let's go to the use case for, um, Boston Children's. . Uh, this has re uh, recently become a new focus area for leaders at Boston Children's Hospital, as they believe that while the patient care will see benefits from AAYA AI in the clinical settings over a long period of time.

Take care. It can be also used in other aspects of the organization. For example, when implemented within patient provider communication, AI and automation can eliminate the need for providers to ask routine questions in turn fueling a more meaningful connection. I, I just, I just wanted to highlight, uh.

How, uh, I think it's cool to find those use cases that are close to, uh, the clinical setting that are helping the clinicians, that are helping the patients to navigate. Very good use case. Uh, I highly recommend, uh, taking a look at that. If you know somebody at Boston Children's, uh, reach out here, what they're doing, lemme give you a Mark Tarts.

Um, we talk about this all the time. ai, uh, all these technology projects are becoming less and less technology projects and much more, uh, clinical operations projects and operations projects just flat out. And, uh, it's for that reason that I really like digital leaders being operational experts and, and.

People who understand. So when people bring in people from outside of healthcare, I like that 'cause it gives us new thinking. But here's the aspect I don't like about it, is I think they need to be tightly partnered with operational expertise. And the operational leaders need to almost be leading. So the, uh, people from outside the industry are helping us to see things a little different.

Uh, but the operational leaders see things, how things can actually be done within healthcare, and that's what he's pointing out. Number two, the shift to value-based care is not going away. That is true, but it's going slowly. Number three, as the population gets older, the dam, the demand to age in place and live independently longer will also grow, uh, important business opportunity for a lot of health systems.

Uh, so we're taking a look at, uh, here's something I did not know 'cause I'm, I don't follow this that closely, but Florida's repeal of its con law, um, I. Which is the certificate of need law, which, uh, any, uh, uh, will open up new opportunities for growth. So this law has been in place for many years, and with it going away, uh, the, uh, in-depth regulatory, uh, hurdles that are, that are in Florida, uh, will, uh.

Dissipate and allow a lot more, uh, activity to happen within Florida, uh, and expect some heated debates surrounding the future of healthcare. No kidding. And it's an election year, but Mark is correct in, uh, identifying that because it is a, uh, significant thing. So, uh, it, in an election year, we will talk about healthcare in ways that are not gonna be comfortable for us who are in the, uh, healthcare world.

Uh, but number one, encourage innovation in normal processes. Uh, challenge the status quo. Respectfully. Uh, this is one of David's big themes is, uh, that we are part of larger team and that we need to introduce things in a respectful manner. Uh, but . You know, we, but we need to encourage innovation, uh, within the organization.

It's one of the, one of our roles as, uh, technology leaders. The second is embrace AI cautiously, um, . You know, there's a lot of stuff happening in ai. We've talked about this earlier. Uh, you know, but, you know, stand up the right groups so that you can start to have conversations, uh, around ai. Uh, again, look at the black box, look at the, uh, ethics of it.

Look at, um. You know, how you're gonna apply it, how you're gonna bring it into the workflow, those kind of things. Uh, number three, address unhappiness with EHRs and other IT products and services poorly implemented. HIT will continue to contribute to caregiver burnout if we don't make changes with renewed, with a renewed sense of urgency.

Uh, again, I, I think that's a, a great point that David makes that, uh, we still have a lot of stuff to clean up. We still have a lot of . We have tech debt and then we have trust debt. We have to take care of that trust debt that we've, uh, built up over the years. Uh, number four, revisit your ERP implementation.

And it just, it pays dividends over and over again. Set it up right. If you don't know how to set it up, bring it into organization to help you to identify the right, uh, right way to set it up within your organization. Thing I'm hearing over and over again, too many meetings. So identify the right cadence for governance within your organization and, uh, and, and the right participant.

Uh, number six, address the increasingly important social determinants of health conversation. Absolutely. You need to address that. Uh, keep in mind what I said earlier about, uh, SDOH, which is, uh, uh, we have no way to pay for it yet. So while it's important to address, it's, uh, keep in mind. What are the priorities of your organization specifically?

Uh, number seven, research and outsource research outsourcing. Again, very interesting. I am hearing this over and over and over again. Um, you have organizations like BJC went to Tech Mahindra. You have, uh, uh, you know, Providence bought Blue Tree, and they were, you know, exploring, uh, you know, aspects of really becoming an outsource partner.

Which is, uh, which they've been for many years, but they're exploring it in new ways, which I think is interesting. Um, I, I'm just hearing a lot more talk, a lot of the stuff in the data center as, as David points out here, has become commodity type services. And when things become commodity, you are able to outsource them.

Uh, number eight, protect your, protect, protected, second trust with the patients and the families have placed you with absolutely. Number nine, earn your seat at the executive council. Digital services requires you to lead. It's not just a support and enable. I heard that from CIOs over and over again. You know, we don't, I, I'm not sure they said this strongly, but it came off this way.

We don't lead, we just, we just enable the organization. We support the organization. And, um, you know, one of the things I'm saying over and over again to the, uh, CIO leaders, I coach and to the CIO leaders in the industry, is people are looking to us to make meaning of the world. How do we make meaning of the world?

And, and so, you know, how is, how is digital going to play? What are the key digital technologies and how are they going to, how are they important? How important is cybersecurity? And where, where, where should we be investing in cybersecurity? People have a million questions and they're looking to us and saying, can you answer my questions?

And when we sort of advocate that role, they go out and hire somebody who can answer those, those questions. And, and you, you proceed to step back from that seat at the table. So it's important to know that we are being asked to make meaning of the world, and that is how you gain your seat at the table when they're looking at a merger and they say, how will our digital strategy, how will our technology, how will that play?

Not just, well, we have to bring the two HR together, and that's complex, but how are we going to knit together the advances we've made with our patients in this community, with the advances we could make in this community? And how is our digital strategy different, potentially . Uh, for a rural community as it is for a, an urban community.

Anyway, make meaning of the world for your, uh, to earn your seat at the table. Then the final one is, uh, do a self-assessment. Um, David, right rightfully points out, it's the end of the year. It's a great time to say, uh, to look at a lot of things, to look at your life and say, you know, am I in the right role?

Am I doing the right things? Uh, you know. Oh, am I killing myself? I just had a, uh, great conversation with, uh, former CIO, uh, who said, you know, the job was killing him and he stepped down. And, uh, you know, it's an awful lot of, it's hard to do that and there's an awful lot of wisdom in doing that and saying, is this the right role for me?

But also evaluate when you decide this is the right role for me. Get re-energized for next year. Ask yourself the questions. What is my team looking for? What are the challenges? We're, you know, what is our mission? Do we have a shared mission? Does everybody understand the mission And are they aligned behind it is the communication.

Right? Um, that's it. We're going a little long for, uh, our last. Episode of the year, but, uh, you'll have a little bit more time to, um, little bit more time to listen to it, I guess, at the end of the year. Uh, so that's all for this week. If you wanna support the fastest Growing podcast in the Health IT space, uh, here's a few ways you can do it.

You can share with the peer, uh, sign up for insights staff meeting on the, uh, on the website. And, uh, you can interact with our social media content, Twitter and LinkedIn, predominantly post or repost. Our content is really helpful. And, uh, fill out the survey this week, health.com/survey, or just send me feedback bill at this week in health it.com.

Uh, love your feedback. It's very helpful. This shows production of this week in health. It from 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.