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  Today in health it is big tech bailing on healthcare. My name is Bill Russell. I'm a former 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. VMware has been committed to our mission of providing relevant content to health IT professionals since the start.

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All right, here's today's story. So I picked up this article from Becker's Hospital Review, although it is pulled from the Providence blog and it's pulled from Aaron Martin's Providence blog. Aaron was at Amazon for close to a decade. I. and from his vantage point of being at Amazon and now being the leader of digital innovation at Providence, he says, big tech is not exiting healthcare.

They're simply changing their approach. These big tech companies like their smaller and mid-size counterparts, slow down the burn, reorganize, or pivot all the time. He said, for example, Amazon is a master of the pivot. They turned failure like the auctions platform they launched to compete with eBay into fulfillment by Amazon, which powers their third party sales platform.

That business now accounts for more than half of their paid unit sales. All right, so he talks about the pivot. In addition, healthcare still has massive problems with the core platforms and technologies that the health systems and payers maintain that keep data siloed. We as an industry are decades behind other industries.

There is still massive technical debt. There's not an easy way around these challenges. Less obvious, our big tech internal challenges. Many of my former colleagues at big tech companies say these organizations have become enormous, complex matrix businesses themselves. It's harder to get things done in these organizations now.

They also have the challenge now of managing a portfolio of businesses across many industry sectors. They'll push more resources where they see near term traction and retract in others. With that in mind. We can expect big tech companies to realign and then make inroads where the strategy meshes well with their strengths.

And he has roughly five points here. He starts with Amazon. Amazon will do well in direct to consumer pharma over the counter, and at some point pharmacy benefit management. The jury is out on care delivery via Amazon care because it's really complex. That said Amazon when committed. . Is the most successful tech company in the world at growing Beyond its existing competencies.

Okay, so that's number one. Walmart. Don't forget, how can we forget Walmart? They keep popping up in healthcare is already the third largest pharmacy by store count. I think they also have a good shot at care delivery because they run pharmacies and complex service organizations. Just serving their own employees will drive significant economics.

Alright. He goes on. Microsoft has wisely stuck to its core competency and strength in selling cloud services and technology to enable the industry. Participants note that it's not without competition. As Google and Amazon are also selling similar, I. Enabling services into the industry. Google still has verily Fitbit and other very important healthcare properties and technologies working in healthcare, as a colleague pointed out to me on Twitter, I think the danger as they fold their healthcare business into their operating units, healthcare will be de-emphasized.

Okay, and then finally, apple. Who knows? We have a sense of their direction based on the limited public statements and launches they've made. I think the Apple Watch could be a great all-purpose platform for remote patient monitoring. Problem is, it's a closed platform only on iOS, and as we all know, it's expensive.

You know what could change things? He says acquisitions could change things. He's surprised there hasn't been more acquisitions at this point. And then he goes on to talk to health systems. It's time for health systems to lean into digital and drive change while big tech pivots, reorganizes or whatever health systems still have the competitive threats of well-funded disruptors and national payer providers.

Healthcare also has massive workforce challenges, a broken fee for service system and the COVID-19 pandemic, which is becoming endemic. And creating widespread workforce burnout. It could be tempting for health systems to take solace in the news, say, told you so, and go back to business as usual. Instead, we need to step up and lead disruption.

Because of this, health systems need to disrupt their existing businesses quickly, but do so deliberately and in partnership with the tech companies. Big and small tech who can propel them forward and other health systems. So how do we partner? And he has a couple of things in here. Number one, self disrupt.

Now identify where you must succeed and lead the disruption in the industry, either alone or in partnership. Next, he says, build internal capabilities in people. Then he goes on, invest in partner industry collaborations, first mover partnerships, and embrace coopetition. He closes. With this disruption will come.

The question is who leads? Health systems need to lean forward and drive disruption through partnerships. Together we can bring our domain expertise. And the full continuum of care into these partnerships to create unique, accessible, convenient, and affordable health products and services for our communities.

That means paying less attention to the manic hype cycles of who's in and who's out, but instead driving partnerships with committed big and small tech companies that will accelerate disruption into better, more convenient healthcare for our communities. All right. That's all from that story. . Here's my so what on this?

He's not wrong. Big tech is not out of this game. Not in any way, shape, or form. I had somebody say something to me about Google just last week, and I reminded them that Google just signed a major deal with Common Spirit. They have a major tenure deal with Mayo. They have a significant deal with Ascension.

These are some of the largest health systems in the country and some of the most respected in the country. Google is not out of healthcare in in, in a long shot. Amazon is definitely not outta healthcare. Walmart is definitely not out of healthcare. Microsoft has a significant amount of their revenue tied up in healthcare.

Now, granted, they're going about it different. They're not trying to take any of these specific healthcare revenue. They're just trying to sell their products into the healthcare sector, but they're not outta healthcare, and Apple is probably focused more on the consumer than anybody else. And again, he, he properly identifies the best thing that Apple's doing today.

Is giving us ways to monitor our own health so that we can be actively engaged in our own personal health. And so big tech is not out of this, but that is not the biggest point he makes in this. The biggest point he makes in this is we still have a lot of competition. If we don't change, if we don't self disrupt, somebody's going to take the areas where we are not that good, such as

The patient experience such as scheduling, such as care handoffs, such as monitoring conditions at home, such as convenience of meeting people where they're at, either in their apartment complex or at their place of work and delivering them health. Another area obviously being the cost of care and driving down the cost of care.

There are so many opportunities . This is why so many different companies are coming at healthcare. There are so many opportunities to make this better, and his point is we are uniquely positioned to make this better. We have the brands, we understand the complexity. We already have a lot of the regulatory aspects of this in place.

We just have to get focused on the consumer. On delivering those things that the consumer is looking for in a way that the consumer is looking for them. So it is requiring us to take some of our focus off the clinicians and put it on the consumer. And I understand how hard that is, but that is what's required in order to stay ahead of this curve that is coming at us faster and faster.

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