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 This is the first of the two end of the year episodes for this Weekend Health. It. We have the top 10 themes from this year, and then we just have the flat out top 10 countdown of the 10 Most listened to podcasts from, uh, from our show for this past year. So sit back, relax, uh, you know, grab a latte, grab a eggnog, whatever.

I have my, my, uh, red sweater on. For those of you watching on, uh, YouTube, you know, we're at the, uh, vacation place. The kids are home for the holidays. Uh, we are, uh, going to start celebrating as soon as I'm done recording these last two, uh, shows for the year. My name is Bill Russell, CIO, coach and creator of this Week in Health.

It a series of podcasts and videos. And collaboration events designed to develop the next generation of health IT leaders. This episode is sponsored by health lyrics. I coach healthcare executives on technology, uh, strategy, vision, and execution. Uh, you know, coaching was instrumental in my development as ACIO and, uh, I'm excited about the progress my clients have made over the past year and really over the past couple of years.

So, um, you know, if you get the opportunity, your feedback is really helpful. This week, health.com/survey. Uh, will really help us to make a better show for you. Uh, before we get started, I wanna thank everyone who appeared on the show this year. Uh, we had so many wonderful guests, uh, and I really just appreciate their time.

You know, sometimes I'm interviewing 'em at, at conferences and they are two and three people deep waiting to talk to these people. And it is just, um, you know, I, I I just appreciate them taking the time and, uh, sharing their wisdom and their, their insights with us. Um, I. And I think, uh, you know, I'm, I'm really grateful for it and I know that our listeners are grateful for it as well.

And we appreciate your dedication to developing the next generation of health leaders. Now, without further ado the top 10 themes, uh, we tried to do this scientifically that didn't work. We tried to do this with big data and ai that didn't work, so I just, you know, had to go through and look at . Uh, you , you'd laugh at how I came up with it, but I, I looked at, you know, which, uh, I, I did a, a word we transcribe every episode, so I'm able to look at how many times certain words are used.

Uh, and that got me relatively close. And then I just did, uh, a little bit of, uh, things. So even though we're talking about AI, machine learning, oh, that's really cool stuff. Uh, I still did it by hand. So, uh, you know, this year, top 10 themes, we have to start at himss. HIMSS really sets the direction. Uh, for what conversations are going to be front and center for us this year, and, uh, this year was no exception.

We, uh. You know, we had at the HIMSS stage, uh, the center stage for the first day. We had, uh, you know, four administrations represented. Uh, talking about the government's approach, uh, to really two themes, but really one theme, which is interoperability and, uh, data liquidity is the other. And, uh, this was a recurring theme this year, and I thought I would share a clip from Niche Chopra, who is one of the people on that stage.

And he has been a champion for interoperability for many years. Have a listen. Go from there. So there, there are really three things that Captain, that I think are gonna make. I, I don't wanna say that this is the year that we see material progress. 'cause it may feel a little bit like, well, everyone says that, right?

I genuinely believe it. Three things we spoke of. One, the new default and interoperability is that the patient and the apps that they choose will be the destination for health information in a standardized format. So patient-centric interoperability. That's right. That, that that was the default and that came through not just in spiritual language, like aspirationally we should do this.

It even came out of economics. Uh, the rules now say any consumer app, uh, with the, uh, consumers, uh, opt-in will have free access to the data. No fees, no burden, no special effort. So that was point number one. Consumer at the center. Point number two, and this is interesting, the decades we've been at this have been about EHRs.

Right. Doctors, hospitals, we've now introduced regulation on the health plans, right? That's a pretty bold statement. And now we're gonna have standardized claims data to combine with standardized clinical data. And I think it creates the momentum that basically says we're gonna be unfettered and, uh, moving all of healthcare data towards a common language.

It's available to consumers via open APIs, and that will cover social determinants in health. It'll cover prescription data, pricing data, quality data, a whole range of topics. That's 0.2. And then last but not least, and this is the interesting one, and I'm gonna float this idea with you, bill, and you're gonna react way or the other, I think we're entering into a net neutrality era for healthcare data business models.

And so what that means is, uh, the, the rules, information blocking rules allow . That if you're holding data and you have to invest in API technology in order to release the data, you can recoup those costs by charging fees to the applications that wish to connect, not the consumer's fees, uh, apps, but the uh, uh, physician's, apps and other apps.

But those fees have to be tied to the marginal cost of the program, and that also means that . You are allowed to provide value added services, but they have to be non-discriminatory and they're likely to be competitive. So you can't have the fact that you're in possession of the data to be the sole source of said value added service, a prediction model, a service here, there or the other, but rather others.

Should be able to compete to deliver that last mile to doctors, to insurance companies, to anybody else. That's a powerful concept 'cause it puts in place a nice rule of the road for what's been a gray area about economics as we move to an API based, uh, uh, interoperability marketplace. Alright, great stuff from Anish.

And that is, uh, voice and conversational technologies. We caught up with Joe Petrow, the CTO for nuance, uh, to discuss, uh, an exam room without a keyboard. And, uh, they were actually displaying it at the show, and I thought it was amazingly creative how they did it. They, uh, they set up a room, it was like an exam room.

They had places for you to sit, and then they actually did an exam and they showed the technology working, uh, with just voice, voice and cameras, and it was recording the whole thing. And, um, you know, this clip is actually a bit of a commercial, um, in, in terms of the conversation and what he covers. But you know what?

I give 'em credit for sharing the vision. I think they shared the vision really well with that, uh, with that room at hims. And I think Joe really captured it on this. And I think that vision is something that is, uh, exciting for us, the promise, and I think it's something that, uh, that. You know, it was a theme for this year.

I think it's gonna be a theme for next year. So let's have a listen. Uh, downstairs we have what's called an experience room and, um, the, uh, the, the name of the product or the solution that we've created is called Ambient Clinical Intelligence. And fundamentally, it's, it's almost a culmination of everything that the company has been doing literally over the last 20 years.

So, uh, it's a combination of, um. A hardware device, which basically listens to the patient. Um, and the doctor conversation it, uh, and it as it's actually listening, it turns that into, uh, into a, a transcript and it diarize the speech, which means it splits it up. So it, it separates out what the patient is saying versus what the physician is saying.

And then it starts to derive meaning, and this is where the intelligence part comes in. Provides the physician with feedback, uh, as, um, as the conversation's going on, as in real time at the point of care. So, uh, and, and we're extracting facts and evidence, and we're creating documentation, so it automatically is generating the documentation and it, it allows the physician to stay engaged with the patient without turning their back into going to the computer.

And, uh. He is a, uh, consultant with, uh, Sirius, uh, solutions, computer Solutions. And, uh, we talk about, uh, simplicity, simplifying your architecture and, uh, and about cloud and where it's, where it's going to be used. A lot of the startups that are coming in, they're cloud first, right? They have to be, they don't have the ability, right.

And capabilities to be able to, you can't scale up. Scale. Right. Um, they're, they're seeing and they're running into the problems that, that, you know, all of us, both of us for short, could have told them that they would, they would run into, which is, uh, big, burly, sort of, everything is in, within my four walls.

Healthcare organization with a lot of data and data all over the place. Right. Um, and so how do you actually connect the two, uh, very poorly or, or very expensively, right? Right. Then you have organizations like Google. I don't know if you've walked around and seen their booth. The Google Cloud, the GCP boot is massive.

It's about half the size of the Epic booth, which is saying something. Oh, wow. Right. Uh, and so GCP has made a big, huge investment in healthcare. So what they're trying to do is they're trying to fund, uh, healthcare organizations to try to get some of their data into GCP, so they can take advantage of some of these machine learning algorithms and so on, so forth.

But for the most part, we're still seeing folks trying to cobble stuff together and say, okay, how can I actually take advantage of the cloud? What I really feel we're ready to do now is working with partners like VMware and Citrix that have been in healthcare and get healthcare for a very long time, and deal with all the peripherals and deal with all the stuff that you have to deal with in a healthcare environment.

Working together with them to take this whole hybrid approach. Right that says I have stuff on premises. How can I actually start to migrate some of these things to the cloud? But things that make sense, for example, and still have a single pane of glass, that's the most important. Again, operational simplicity.

The, uh, you know, top 10 list, top 10 themes, of course security comes up. Right. Uh, I think security this year though, has finally gotten elevated to the, uh, to the level of conversation, to the point of conversation that it should have within healthcare a long time ago, which is, uh, it's at the board level.

It's at the board level. Uh, it's at the executive level. People are talking about it. Uh, it's good that we're talking about it. It's good that it's getting funded. Uh, we caught up with, uh, Michael Hamilton, the founder and chief Information Security Officer, uh, for CI Security, who discusses, uh, points of vulnerability within healthcare.

I. Have a listen and hackers, I guess, how are we getting in? I mean, the easiest is through people, right? Right. Absolutely. It's, you know, fooling somebody is a, uh, a time honored tradition and, uh, if I can get you to give me your password so that I can just, I. March into your network, maybe implant some kind of malware that's, uh, you know, put it on your computer because now I have access to it.

Um, and, you know, uh, uh, start a ransomware event or something like that, uh, in order to extort the hospital. Right. It is, but I would make a distinction here because there is a difference between, um, a targeted attack, an actual attack where somebody did some research and they penetrated your organization on purpose with the intent to steal records or to extort you.

Versus somebody visited a website today that was bad. When, yesterday it was okay. That is the background noise of the internet and tripping over the background noise of the internet isn't personal, it's not targeted, it wasn't meant for you. Um, and, and there is a difference there. But yes, that is actually, uh, another, uh, way that's fairly prevalent.

Is, uh, it's called, you know, just a drive by attack. You, you hit a website. Now, there are times when, um, uh, there are websites that are known to be frequented by a certain sector or another. You know, I'll, I'll, I'll just pick one out of the air, uh, uh, uh, the Becker's hospital site. I know the kind of people that visit that site.

And so if I can compromise that site so that the visitors then are compromised with whatever malware I throw at them, I'm pretty sure I've gotten people in hospitals, uh, that's called a watering hole attack, so that's out there too. But you know, I think it's, um, good to distinguish because the motivation of the threat actor.

Um, is something that we need to keep in mind here when we're talking about risk and, and just let me, uh, yeah. Michael was a fun guest. I really appreciate how, uh, he takes these really, uh, a lot of times these difficult concepts and makes them really, uh, digestible, uh, and easy to understand. I think that's something we will need to continue to do as health.

Uh, I thought that was interesting for a couple reasons. One is it elevated the conversation to the general public. Uh, it's not a conversation that we weren't familiar with, but it, it's getting out there to the general public. We heard a lot of . Uh, I, I'm talking about this in this sense, in that, um, you know, the, the, the theme here is, uh, really EHR optimization improvement.

Uh, it, it fell into the category of clinician burnout. A lot of time came back to this technology, um, frustration, uh, those kind of things. So I, I, I'm lumping 'em all in there. And I'm gonna take a little bit of a positive approach here. We sat down with Taylor Davis, the, uh. From the Arch Collaborative and, and class put together the arch collaborative to really do research on EHR implementations and what some systems do well and what some other systems, uh, may skip and not do well.

And, uh, you know, they have looked at hundreds of implementations. They've, they have some great insights as to what's working and what's not. Have a listen to this clip. In order to not feel stupid, I need to be a master around the EHR. It is a core piece. There's, there's a lot of studies. Stanford did a study, uh, showing that, that a majority of the time in my patient engagement is actually spent in the EHR.

So the EHR is becoming something that I spend, uh, you know, half or more of my time in as a clinician or a physician, depending on my specialty. And, uh, and so if you are now spending half of your time in a tool and you don't know the tool very well. You're gonna hate your life. But the, the flip side of it is, is that organizations that do at least six to 10 hours of training for new physicians and three to four hours of year of training a year on the newest functionality.

But even more than that, they have great trainers. So Deaconess Health system, uh, they, their trainers can't get hired until they can teach their IT and informatics leadership, how something really cool, like how to barbecues, you know, and, and or how to cross stitch or they, they have to be engaging and interesting right.

And, uh, they have to be able to capture your heart. So, so first, in order to not feel stupid, you have to create mastery. And, and we all know what a great teacher looks like. We've all had those in college and high school and, and, uh, um, and so you need to have those in place in an organization. The second piece is, is this is kind of one size fits all.

This isn't for me. And, and, and I, I present a lot out and, and this is one of my favorite things to do and, and, and steal it from me. 'cause it works really well and it communicates things really well. But, but I always say, Hey, especially if I have a group of physicians in the room, I say, what is the what, uh, technology works the very best for you.

And so, and, and, and I always see 10 people pull out their cell phones and hold 'em up, right? So I walk over to one of the physicians, I've done this a bunch of times, walk over to one of the physicians. I say, can I see your cell phone? They pull it out, they hand it to me. And I say, can you unlock it for me?

Then they get nervous and it's great and uh, um, and, and so then they unlock it and I say, okay, this, this iPhone right here. Mine is not an iPhone, but, but it always is an iPhone if it's a physician. Um, I say this iPhone right here, uh, you say is the most usable piece of technology in your life. Yes. What would you grade this iPhone?

Oh, I'd give it an A minus. It's super usable. Okay, great. I'm now gonna take your phone. I'm gonna wipe out all of your personal preferences. I'm not gonna delete anything. So all of your pictures, your emails, everything's gonna be here, but I'm just gonna put your apps and alphabetical order and your lock screen's gonna be default and all that sort of stuff.

It's just gonna all be default. Does, does the person jump up and tackle you to make sure you don't do it? Yeah, but that's the point, right? Is you wanna see those personalizations are like sacred to you, right? Yeah. And, and, and they matter a lot and you hate getting a new phone 'cause you have to go put 'em back in and, and I never, I never of course erase it.

But then I, then I turn to 'em and I say, okay, let's say that I actually did that. Well, what is, how would you grade your phone for usability? Now they say C minus, D plus, right? And, and then I, and then we say, look, you moved your phone from AC minus or AD plus to an A because of the effort that you put into it, to to set it up, to make it work well for you.

The same is true for the EHR, but, but Bill, I don't know if I said this out of Chime, but guess what? Percentage of physicians have taken the time to set up their, their EHR. It's less than 40%. And, uh, and so of course they're walking around. They're all walking around saying, I'm being stuck with C minus and d plus technology.

And, and we go, oh my gosh. And it over 95% of organizations, those who have taken the time to personalize their environment, are dramatically more satisfied than those who haven't. And, and in the group, the organizations where that's not true, they have a really problematic EHR and, uh, so that they, you need to look at the technology itself.

Yeah. Great work by class in this area. I look forward to, to more progress in the next year. Uh, if you haven't watched this episode, it's, it's really worth digging, digging it up, uh, on the, uh, on the, uh, podcast or, uh, on the YouTube site. Uh, uh, you know, Taylor does a great job in, uh, in breaking this down for us.

Uh, gender diversity as part of a larger diversity problem that exists within health. It, um, was a primary theme, uh, this year, you know, specifically women in healthcare. It, uh, and especially leadership roles, was something that was discussed on several occasions. Uh, we caught up with Carolyn McGill, the CEO of Aon, uh, at the health conference in Vegas, and she shared a pragmatic, pragmatic approach to, to really addressing this challenge.

So I think we covered multiple. I think the taking the parody pledge is a good place to start. So making your commitment known. I think leading by example is a second, and I think making it clear to your recruiters that this isn't just a nice to have, but it's actually critical to your relationship with them.

It's a requirement is also quite important. Have we created the, uh, ? Frameworks, the, the mentoring frameworks to help, um, to help. So I, I know that as, as a, as a male leader, I, I had a, a ton of different mentors frame, uh, just things that help me to get to the next step. Does that same thing exist for women to varying degrees?

I think it depends on the company. And actually that would've been the fourth thing that I'd mentioned is that it's . Not just about recruiting in the right women as an example. It's about giving them the support that they need to progress. And as we think about leaders in the organization, we don't just always wanna hire from the outside.

We would love to promote people from within as well and have that balance. And so providing mentoring relationships and support. And for us, it's not just about the fact that you have a mentoring program as an example, but it's about the substance. So how are you counseling these women, as an example, to advocate for themselves?

Or how are you ensuring that you're giving them the opportunity to get exp? Exposure to a new area of the business or to take on additional accountability for something that those are the ways that they start to get the skills that make them qualified for the next level of promotion. And so if we don't think about that from the time they're an analyst or more junior roles in the company, then they might never progress to where they have a significant leadership role.

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. 20, you know, if there's one person we talked about more than anybody else this year, it's probably CMS administrator, CMA Irma. Um, they were active this year. They, they, they just did a lot of things. They were, uh, highly visible, uh, a lot of articles, um, a lot of appearances. I saw Health conference and, and others.

Um, and I've reached out to Cima Verma to have her on the show. I, I, I, you know, I would love . To, uh, to have her on the show to ask a couple questions around the direction of where they're going. Uh, but I have not had any success in doing that. So if any of you have access to, to, uh, administrator Verma and can tap her on the shoulder and say, Hey, there's this great podcast you should really go on and talk to Bill, um, that would be fantastic.

I'd appreciate that. Um, you know, what CMS is really trying to do is to make, uh, healthcare into a true market. Uh, you know, data liquidity is about making it into a market, um, price transparency about making it into a market. And, uh, you know, I was able to sit down with a colleague of, uh, CIMA Verma, and that's Dr.

Don Rucker, the National Coordinator for Health Information Technology, uh, for the, uh, ONC. And, uh, and ask him about the federal initiatives and, and, and, you know, what were the, the goals and the aims of those federal initiatives. And here's a clip with Don, and I apologize in advance. I didn't have my camera at the Health 2.0 conference.

And, uh, so you're gonna be looking at shots of DC in the background. As you hear, Don and I talk about what it's gonna take for healthcare to become a true market. What we're really talking about is, does a patient have a right to get their data right? All the people who want to protect the patient, pretty much all of whom seem to have huge economic interests in having no transparency on their business models, it should be the patient's choice.

If you don't wanna put your data at risk, you don't have to download an app and you're exactly the way you are today, but it's the patient who should choose that. Not, um, you know, . Some paternalistic self-interested, you know, provider organization, right? And, uh, you know, we could close there except I wanna do a Simon Sinek on you.

So we begin with, okay, we begin with why. And the why. So what does, what does healthcare look like once we, let's assume 21st Century cures. We we're, we're publishing, you know, prices people can see and have we created, will we create a market . That where the market actually works in healthcare, will we, or is it possible, is it possible to build a market where people can look and say, Hey, this provider's good, I'm gonna get better outcomes, there's a better cost.

I'm not, yeah, I think, um, color, color me. Is that a goal? Yes, it's absolutely, it is absolutely unequivocally a goal. Um, it's the central goal, in fact, is to put the consumer back in charge. Consumers are in charge. When there's a free market. Yeah. Nobody told you what kind of car to buy, right? There's a free market and you pick what car you want.

You don't want a junker beat up. We're here in Silicon Valley, people seem to have a lot of money and drive fancy cars, whatever. Um, the, what we're trying to do here is by having information empower consumers to do that. Now clearly we are in a funny kind of world where . Um, we have a lot of third parties buying our healthcare, whether it's the federal government through Medicare, uh, or Medicaid, whether it's employers, and so that if a third party is buying it, it's sort of taken away from us.

It's worth noting, however, that increasingly, because of the costs, the more and more of these costs are actually being shifted to the public. So roughly, roughly half the spend for people who are covered by private payers, um, is born by the patients directly, not via the insurer. Of course, economically, they bear the entire cost 'cause that's coming out of their, their paycheck.

Um, in that world there's going to be a lot more shopping. We're already starting to see that and . At a whole bunch of edge cases, and it is going to happen more and more and more. Um, frankly, in some of the, um, Medicare world, you know, there's starting to be cost shifting copays. Um, and, you know, Medicare beneficiaries have a number of out-of-pocket costs that ultimately they're, um, responsible for.

So, . I think the combination of modern information technology and folks who are at economic risk is, is, um, going to power that even, even if we don't really make any fundamental legislative changes. Yeah. The, the rules that the federal government is coming out with was definitely a major theme for this past year.

Uh, you know, our final three themes can sometimes sound like buzzwords. And I, and I, and that's probably because in the hands of the wrong people, they are buzzwords, but in the hands of the right people, um, you know, it, it elicits really, you know, wonder and excitement to think about what is possible, uh, within healthcare.

And, uh, you know, the first major theme is innovation. And, you know, I had a lot of conversations about innovation this year, but the, the, the one . I seem to be quoting the most, uh, as I talk to clients and I talk to others, is a, uh, conversation I had with Nancy Ham, the, uh, CEO of WebPT. And her insight got me to be, it got me thinking and it, I've had several really good conversations, uh, about it since then.

So I, I just wanted to share that, uh, this piece with you and, uh, as, as something to think about as we're talking about innovation. I have started saying lately that healthcare does not have an innovation problem. We have just a straight up adoption problem, and so there are plenty of great solutions that have demonstrated in a pilot they can work.

The problem is startups focus on their technology and they don't focus on sales and distribution. So it starts with what is your go-to market model. And I can't believe how many CEOs of digital health startups, I asked that question and it's not a very good answer. They're all over the place. They're trying to go multi-channel.

It's a small company. You cannot go provider and payer out of the box, and you can't just go payer well, which payer Medicare Advantage managed Medicaid commercial, like laser focus on your go to market is what I see as completely lacking. There's also the sad fact we've trained the industry to be a bad buyer.

Uh, somebody said that, you know, payers have more pilots than American Airlines, and I just love that. But it is so sadly true when we've been willing for decades to do free pilots, to do cheap pilots. You know, other software companies don't act like that. If I wanna buy Salesforce, Salesforce does not come over and offer me a free pilot.

They offer me a very expensive contract. And so I don't know why we trained our buyers to be dabblers. It's really bad for 'em, and people need to quit doing that. It's really not helpful. Um, the, the other thing is you have to be brutal on your ROI, I don't care how pretty it is. I don't care how cool it is.

Show me ROI and then you can make the product better. Uh, the last thing people spend way too much money. You know, we've been through this arc of time where it was easy to get money. I actually think that's bad for a company. Uh, web PT only ever raised $4 million into this company and one of our eight core values, it's MAs do more with less.

And if you are ruthless about. Making it on as little money as possible, that tyranny will force you to make better decisions. It will force you to get into market earlier. It will force you to be more focused on what your customer's saying. It'll force you to be more focused on ROI. So, um, I think people have too much money and I don't think it's good.

That's interesting, isn't it? I mean, do we have an innovation problem or do we have an adoption and implementation problem? Uh, it's, it's an interesting conversation. Uh, you know, the second one that could sometimes be a buzzword and sometimes a, uh, exciting thing is digital. In fact, a lot of times when I hear people talk about digital, I'm, I'm reminded of, uh, princess Bride and, and Nita Manto.

You know, I, you keep using that word. I don't think it means what you think it means. Um, but, uh, you know, I think one system really does have a good idea of what it means, and that's Banner Health. And we sat down with Jeff Johnson to discuss, uh, you know, what they're doing in this space. And I . You know, I learned a ton from, uh, from, uh, sitting down with Jeff and I think it's exciting some of the things they're doing.

So, have a listen. So, Sophia is your, uh, your digital consumer persona. Yeah. Did I say Sophia? 'cause I, I, it's such a habit here that if I say it, I apologize for saying it without telling you who she is. Uh, yeah, you did say it. So, so elaborate, elaborate on your persona. Yeah, so this, this is really, uh, I think something that's really worked really well, and this is, this is the, you know, all credit to our chief marketing officer Alex Morehouse persona, uh, named Sophia.

and we have, you know, we have multiple personas that we might use in product development to represent different, um, you know, segmentation. But really what Sophia is, is a way to take this, you know, this, this idea, this, this value that we have, that we're customer obsessed and this mission statement that we have, that we're gonna make life easier, um, and make healthcare easier.

So life can be better to really start to translate that into something tangible that every employee in this organization can rally around. So Sophia became the face of that, and she's a real person. Um, she shows up at, uh, leadership events. We have videos with her. Uh, we have cardboard cutouts of Sophia that people take selfies with in our hospitals.

So every employee rallies around this persona of Sophia and they think about what they're doing in terms of . How does this impact Sophia? So kind of cool. It's, it's, it's really helped in digital, in all of the spaces. I'm sorry. So she's actually a real, like person who's, who's, uh, who receives care at your facility?

No, I mean, she's a, she's a. An actress, I should say, for purposes of pictures of her and those kinds of things. But you know, she needs the real face. Yeah, yeah. So it's a human being that people, people know, like if you saw her and people have seen her, if you see her in the grocery store, you would say, oh, that's Span.

Or Sophia, even though that's not her real name. Right. And, but what that ends up doing is, uh, personifying the, the people we already know. It's the people we work with, the people in our community, the people who stop us at dinner parties and say, oh, you work for Banner. You know what would be great if you guys did this?

So she sort of personifies that voice of the consumer saying, Hey, this is how I want to sort of interact with healthcare. Can you guys do this for us? Exactly. And, uh, you know, yesterday was interesting. I did a walkthrough almost all day with a, a big consumer tech company. I won't, I won't mention the name, I don't know if they want me to, but you'd know who they are, right?

Um, and we, they came out to explore some things that we could do together in health. And so we walked through our cancer center, we walked through an emergency room, we walked through an urgent care center. At the end of the day, they said, wow, never been in a hospital system where everybody's cohesively talked about either Sophia specifically.

Or knowing, talked about the customer as the very first, uh, part of the interaction, it would. So, so it's worked really well to help, you know, do that translation of the, of the, the mission to, to something tangible. Like I said, I, I, I get excited when, uh, when the right people talk about innovation, I get excited, uh, about the potential within healthcare.

Uh, finally, if you're wondering, this list is in no particular order, uh, but the final theme we're gonna talk about is data. Uh, you know, it's it far and away. The word that was used the most within our podcast this year was the, was the word data. You know, what's happening with healthcare data? How are we using it?

Who's using it? Um, we need more of it for AI and ml, uh, you know, are, are we using it without the patient's consent as in the case of Nightingale or, uh, are we using it to advance medicine as in the case of Mayo? You know, they both go to Google and you have two really different responses to it. Um, you know, we sat down with several people who live in this space.

Uh, these people are so smart. I I, I really could have pulled up any one of them. Uh, any one of these clips. Uh, but I'm gonna leave you with a little bit of a warning on this since I think it's hitting that frenzy pace where everyone's gonna start rushing at these data projects. And, um, I had a, a really good conversation with Anne Weiler and, uh, mark Van Schulenberg from, well Pepper on the topic of data bias.

And as usual, Anne delivers a succinct response, which helped me to, uh, really see the problem more clearly. And I wanted to share that with you. How does bias present itself? I assume it presents itself through the data. And then what, what are we doing about bias? How do we, how do we prevent bias?

I mean, Mike, Mike pointed this out like the, the EMR data is biased because it's biased towards billing for the most part. And you know, unfortunately, a lot of the data is, is not clean. You know, there's. You've seen the, the burdens of documentation stuff gets copied and pasted stuff is like, you know, we're gonna, we know that this, you know, this billing code applies and the patient is, sort of, has this, but like the number of times, I'm sure you've had this as a patient where you know, someone is reading something back to you and, and saying, is this correct?

And you're like. No, you know, the one that always gets me is when they read the medication list. I'm like, are you still taking amoxicillin? Well, of course not. You know, , that's a seven day course. So, you know, the data is missing a lot of information. Um, it's missing what happened really with the patient.

It's missing what's happening with the patient in their daily life, which is those activities of daily living are the things that really affect your health. Um, it may also be missing. The opinions of the full care team. So you know who, who has actually done the documentation in the MR and you know, I was thinking back, you know, we don't know how it does it, but it does it think about like when you, you see doctors, you know, especially new residents are told if you see, if, you know, if a nurse thinks something is wrong, believe that nurse.

So, you know, is that, you know, that hunch that a nurse had, that a patient is about to code or something like that. Is that in there too? So are what is the, when we're looking at, you know, we'll, we'll look at patient, when, when we're looking at patient data, is it the full spectrum of what's happen happening with that patient?

Yeah. These are just some of the themes for this year. Gosh, there are so many great clips. We really could, uh, it wouldn't be hard to do a two hour episode. And, uh, potentially just do a year in review kind of thing. Uh, but this will have to do for now. And, uh, you know, don't forget, next week we're gonna do the countdown of the top 10 most listened to podcasts from this past year.

This show is a production of this week in Health It. For more great content, check out our website this week, health.com, uh, or the YouTube channel as well. 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.