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 Welcome to this Week in Health, it influence where we discuss the influence of technology on health. With the people who are making it happen today. Jason Joseph with Spectrum Health, the Chief Information and Digital Officer, who is quickly becoming one of my favorite interviews, and I think after you listen to this, you'll understand why.

My name is Bill Russell, former Healthcare, C-I-O-C-I-O, coach, consultant, and creator of this Weekend Health. it. As we come to the end of the year, I really wanna call out our sponsors who have made this show possible. We've produced close to 150 shows this year. And, uh, without their support, we wouldn't have been able to do that.

I wanna thank Sirius Healthcare for supporting the mission of our show to develop the next generation of health leaders, their weekly support, starting during the covid, the initial covid surge, our Covid series. Really helped us to expand and develop our service offerings through the community. And a special thanks to our channel sponsors VMware, who is one of our first sponsors, Starbridge Advisors, Galen Healthcare Health lyrics, Sirius Healthcare Pro Talent Advisors, HealthNEXT, McAfee, and Hillrom for choosing to invest as well in developing the next generation of health leaders.

We have a special treat coming up for you. We have our three end of the year episodes. We have our end of the year news day, which is really a recap of the news, which made this year special. We have our end of the year covid series as we did, uh, daily episodes during the initial Covid surge for about three months.

We did daily episodes and we capture the best thinking and the shows that really the most watched during that covid series. And we pull out some of the highlights for you. And then we have our annual . Top 10 Countdown of the most. Listened to podcast for the year, and we're excited to share those with you in the month of December.

Towards the end of this month, we're gonna be doing that until, uh, we get to the new year. and we have two and a half weeks left of our CliffNotes referral program. If you don't know what CliffNotes is based on your feedback, we went back and created an email that goes out 24 hours after each show, and you get to see who was on the show.

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Just so you're aware of it, uh, a couple of prizes in there. One is we're gonna do a drawing on January 1st for a work from home kit from this weekend Health. It. Anyone who gets 10 referrals is gonna get a black moleskin notebook. And the uh, person who gets the most referrals is gonna get the opportunity to come on the Newsday Show and discuss the news with me and just an opportunity you're not obligated to.

But we would love to have you do that. Uh, it's a lot of fun and we have a great time. And now onto today's show, today we have Jason Joseph, the Chief digital and Innovation Officer, I'm sorry, chief Digital and Information Officer for with us. Jason. Welcome. Bill here

spoke minted, been been two.

Actually, but before we get into it, give us a little background on Spectrum Health and then we'll get into your journey over the last couple of years. Yeah, no, that's great. So Spectrum Health, we're located in Michigan. We're an integrated system, so we have a health plan and a care delivery, uh, organization, about 8 billion, we'll be about 8 billion for this year.

And unlike many. Health plan slash uh, delivery organizations. Our health plan is actually a bit larger than our care delivery in terms of revenue, so that's a little bit unique. We've got over a million members in our health plan this year, and as a total system, we're about 31,000 employees. And we have hospitals, treatment facilities, urgent care facilities, uh, and physician practices primarily located in the western Michigan area.

But we have, uh, coverage really through most of the state of Michigan. Yeah, so.

Right information for for both? Yeah. So I'm the, the system CIO and uh, we really have three main divisions, a health plan division, then two care delivery divisions. And then our IS organization is structured that we have some shared services, obviously security infrastructure, information management, analytics.

Some of our. End user services and uh, kind of how we run the department are at the system level. And then we have applications services really focused on each division with some of those that are corporate and shared across all of them, like ERP, and then some that are specific to the divisions like our claims processing system on our Epic teams, et cetera.

So you've had, you've had roughly, uh, roughly about two years in, in the role. So you had a little runway before we, we hit this, hit the pandemic. Give us a little idea of the journey over the two years. What, what have you been? And actually we'll get into the Covid timeframe and we'll talk specifically about your Covid journey, but give us a little idea of the two years.

Well, it's interesting, one of the, the first things we did was just kind of reframe ourselves and I came in, uh, to the organization at a time when we had a new CEO as well, and we had worked together before, so we were both actually. At Spectrum Health prior to filling into our current roles, which was very helpful, right?

We didn't have to hit the ground and, and learn a new system and spend a year kind of figuring out where the bathrooms were. So we kind of hit the ground running and developed a new system strategy. And then we reframed our IS strategy as well. And really it's, it's very interesting that strategy really revolved around consumer focus experience.

Improving value and digitization. Right? And although we did tweak some things as covid hit, and we'll talk about that, that strategy and the is component of it, we didn't modify at all once Covid hit. Um, we started off with kind of that focus on digital transformation and then our pillars and the things that we needed to do to enable that.

And what Covid really did is just sharpened our focus. So we reviewed it and said, boy, what do we need to update? And we came away and said, actually nothing. Yeah, some tactics needed to change and we needed to reprioritize some stuff, but we were really on that journey. And it's, you mentioned that my, my title is Chief Digital and Information Officer, which is, which is a relatively new change.

And really what that's, it's speaking to is that digital is the evolution of how technology is gonna be used in our organizations, right? You can't separate digital and technology. These platforms are all interconnected. The way we engage with our. Workforce, our providers, the consumers, patients members in our communities is all going to be digital in the future.

And so if we're driving towards that, we need to think strategically about it. But we also need to recognize that digital isn't just about the tech. Digital is actually about rethinking the way our business operates and how we actually perform those services. And that's really the renovation. So we're retooling the way we think about that in terms of our skill sets and some of the things that we're driving.

But that is our focus. It's, uh, at the heart what, what I would say is that digital transformation has been our focus and continues to be our focus. Yeah. So you guys actually started before Covid, but covid for a lot of organizations, was it, it was an acceler. Well, first of all, give us a little background of what it's looked like in your communities, the sort of the, the covid, the pandemic in your communities, and then how has health IT and technology really supported, uh, your efforts as a health system and as a.

Yeah, that's a a great question. We like many, when Covid really hit in the spring, shut a lot of things down, right? And we, we prepared, we, uh, stood up extra facilities, did all the things that you would expect to do, but Covid didn't hit our communities that we care for really very much in the spring at all.

So we put all that in, shut down. Many much of the care, everything went to virtual, right? Our virtual visits went through the roof. We enabled hundreds of providers with virtual capabilities. Literally overnight, 7,000 workers went home. Thankfully, we were already on the Microsoft 365 platform, so we, we turned that corner like.

On a weekend and had very little hi, very few hiccups. So we were fortunate in that, that we had done that work a year ago. And it was interesting 'cause a year ago when we were getting everybody off the inter call system and the phone numbers and the other disparate tools and putting them on teams, people really had a tough time adjusting.

It's just hard. This is not how we work, what about the meetings? And so it was a really slow uptick, but we got through it. In advance of, of covid hitting and when Covid hit, it just was, it was natural. I was so thankful that we had done that work because I know many organizations really struggled just to be productive.

Uh, we track a lot of our productivity and it, it blipped for a couple of days and it was right back. And actually we're about 20% higher now. And a lot of our is teams, but right now we're in the middle of a. So we've started that about two months ago. Just started seeing that uptick. We believe we've kind of hit a plateau here.

We'll see if the Thanksgiving work really impacts us, but we're managing to it well. But we are really, really busy and really, really full. And our teams, of course, are focused on making all of that work. But this time around, unlike the spring, we are still trying to keep the other non. Running as much as we can and do so safely for our patients in our community without overwhelming.

We're a little about an idea. Your telehealth people have given me some numbers of up. Were you guys sort of trending there before Covid, or did you really take a, a dramatic spike up? We, we had a dramatic spike and the big difference for us is our virtual health was primarily what I call convenient urgent care type substitutes.

Yeah, I need care now and I want to do it virtually. We hadn't put a virtual visit structure in across all of our primary care and specialties as a normal way of doing business, and so we had actually a separate service doing that. We still staffed it ourselves. And we had the capabilities and the tech in place, but all of a sudden we had to say, well, we need to do all of our primary care visits this way.

We need to do all of our specialty care visits this way. So as we ramp that up, Beth, I, I don't know if you recall the numbers here, but I. I think we went from about 5,000 visits a month to something in the neighborhood of 60,000 visits in a a month. Wow. We're, we're, so it was definitely a 10 plus fold. I think maybe at one point we peaked at about a 20 fold increase, but a lot of that really became, I.

It's settled back down as our practices have opened back up and, and we've settled down to a plateau that's about three times our, our starting point. I expect that's gonna now steadily continue to climb because we've kind of broken through that barrier. People are getting more comfortable with it. Bill, one of the interesting things we found that you wouldn't see otherwise is the barriers that exist to doing virtual for people that aren't inclined to do it.

Right. We, we didn't see those because the only people that did a virtual visits are the ones that wanted to or could. And so now all of a sudden when we didn't have a choice, connectivity was an issue. Downloading an app was an issue, right? We got a lot of pressure just to have like a, A one click virtual visit experience.

The connectivity of just the workflow to get somebody into a room and meeting with a physician on time became harder to scale. And so operationally we really had to put a lot of effort into make that visit experience as seamless as it would be in person, and we're still working through that, but I think we're getting much closer to that now.

As I think most people in the country, it is interesting. The barriers have changed. The barrier before. As a former CIO was sitting across from the physician and trying to convince them that this was, this was a viable option for them, that it made sense. And then Covid hits, and of course that barrier turns into the, the exact opposite, where the physicians are sitting across from you saying, I need this yesterday.

Get it done. And the other was just the regulatory we had. We had CMS and others sitting back and going, well, is this really going to work? Is it going to improve care in our communities? And those kind of things to a well, it's, it's necessary. And now we, we just have a ton of information and we'll have to sift through that information to see if how much it really has improved care.

But you took down the regulatory, you took down the physician and we. There and really progress through those. That was actually, that was exactly it. Now as care has come back and facilities has opened some of those barriers creep in again. Right? So not all physicians love this idea. more are comfortable with it, right?

Not all specialties, it works as well, right? Not everyone is in the same boat. But I think what you're seeing is we at least broke through that initial sound barrier, if you will, the the resistance. And now we're gonna be able to steadily . Accelerate this from what is our new normal on the way up. And of course the VI virtual visit is one piece, but we, we've done a ton of stuff just in terms of like virtual waiting rooms, digital check-in covid screening, chat bots, and many of those things that are all surrounding the care experience that have also.

Been very, very quick to implement and, and moved, moved forward to support Covid. So you just rattled off a couple of the, the ways that you're reducing touch points. The, the, the chat bots is interesting and, but what were some of those things We've heard some really creative stories of, of use of iPads in the rooms, bringing families together, chat bots.

I mean, there's, there's a lot of different ways people have done this. How have you guys really reduced the touch points? Yeah, so. One of the early things we did certainly was the chat bot, and it, it was interesting. The driver for that was just, we were worried our call centers are gonna be overloaded, like PE with people just saying, do I have covid?

Right? So the chat bot was actually driven by that. More than anything. We saw a really big peak early. It's, it's kind of stabilized now. People are, you know, comfortable. Our call centers can handle the volume. People are settled into whether they should get tested. It's not as big of a question. So we did that really, I mean literally within three days we had a chat bot in our, uh, innovations team kind of.

Ready to use for some different workflows and we just repurposed it and it was very, very, uh, quick and easy for us to get it out there. In terms of the other use cases, iPads on a stick, as we like to call them, were not only useful for consults, right? You have this, this physician consult need. Well, what if the patient is isolated with Covid and you don't want to peep.

Created some of that. We have some of our rooms wired for virtual ICU anyways, that you can do that easily. But for those that weren't, we needed a mobile solution. So we've got some of those that allow the virtual consults to occur and extend it. We already had a virtual consult infrastructure, just not to scale it to hundreds of patients all at once.

So we did that quickly. One of the most heartbreaking things, of course, is how isolated people are in this disease 'cause of the, the physical separation. And so very early on we did use an iPad based solution, . To allow, uh, patients to connect with their family members via video, and we're now going to kind of the next iteration of that to allow a new infrastructure that's a little bit easier, a little bit more consistent, can use some of the, the TV infrastructure in the rooms on occasion, or a mobile device.

For that. So we, we've done some of those things as well along the way. Implemented some text based, uh, inter interactions. I talked about the work virtual waiting room. So we know that we didn't want people waiting and congregating in the building so they can sit in the parking lot, send a text message, do the, the check-in and all that procedure essentially in their car, and then get a text message when to come in and where to go directly.

So we kind of avoid that, that distancing issues. But we also have . Revised waiting rooms just physically with more social distancing, put the plexiglass up and done all of that stuff as well in the process. So if you think about the entire span of things where we weren't digital, we tried to drive some digital in and we still have more room, more space to go.

And then in areas where we're physical, we just kind of looked at how can we leverage digital and tech in, in addition to just the basic stuff to make that a safer and less touch. Touch are, are you doing anything out the home? Are you. Monitoring Covid patients outta the home or anything to that effect.

We are, we're not doing a very broad like deployment of in-home monitoring technology. So we do callbacks and follow ups. We've got, uh, care management provider offices that'll follow up, recommend a pulse ox checking this kind of stuff, check in every few days as the course of treatment for patients under our care, we usually kind of push that into the primary care lane.

So in some cases, those are primary care physicians in our communities that are caring for those, uh, patients. In some cases, they're our, our own providers. And it's, it's in some of the more complex cases, we've start to push remote technology out that they can actually connect directly to their virtual visit experience.

But in most cases, with covid, we've just opted for kind of a, a chat based response system using some of our Epic tools to capture that information and then to follow up with, uh, some management. You're the, the second I who's mentioned to me this whole. Uh, one click telehealth visit where there's no app to download.

So we're finding that on the other side, the patient side of this, that, that they're struggling with the technology they're struggling with, with scheduling, and they're struggling with downloading the app and doing that whole process. So are, have you, are you starting to move in direction of one click?

Yeah, we've been doing that for a while. Our, our strategy has always been to really wrap our virtual visit into our app and have it integrated so that the video, the check-in the post check-in experience, the survey, all that stuff could be one unified experience. Well, the challenge with that, of course, is you're dependent on that video client and how that's essentially gonna work in the process.

And so we started, uh, early on with that experience, had some struggles with just getting it set up and so brought in one of. Piece of technology that allowed that. Just text me a link and then we'll do a quick video chat. We're now building that into our core, so that is something where as the provider gets in and says, I'm ready to go, initiate this.

Visit, it can send a link with a one click visit join, and that's gonna be part of our new framework so that you can do that within the app, or we can actually initiate that with just a text message. And we found that to be a huge differentiator in many of our, for many of our patients, as to whether it's simple and easy or not.

Yeah, I can see that. All right. So the nature of work has changed pretty substantially. You. Terms immediate productivity drop, but then the advance. Yeah. Calling this our work from home experiment, uh, sort of forced upon us experiment, but how's that gone for you guys and how has your IT leadership team adapted to it?

You know, I think for, for us, it's gone remarkably well. I will say that even my own attitude towards work from home. Early on was how do you maintain culture? How do you communicate with people? How do you maintain collaboration and innovation when everybody's separate? And that that was the concern when we initially, and I mentioned this earlier when we initially covid hit and we had to go home that Friday, we said, pack your stuff up Monday, you're home.

Nobody's really been back since. Right? And so we were fortunate enough to have already been down the journey for creating a digital workforce, digital workplace experience with our tools, our devices were already enabled with VPNs that only connect. As soon as you're on the internet, they connect. So there's no kind of leakage around the edges of those capabilities.

Our digital, uh, workspace tools were already embedded. We had, uh, updated our technology so most people had the camera embedded and some of the basic things you don't think about it was, we still had some gaps, but it was a, a small gap rather than a huge gap for us to fill. We got there pretty quickly. In terms of the overall experiment, we're, we've communicated formally to our teams, no, we're not coming back into the office in any significant way.

Obviously, people who need to be there to do their job, they're, they're in there now, PC techs, et cetera. But for the vast majority of our office-based workers, we expect they won't be back in the office until June-ish. Right. The, uh, vaccine is widely available and even then, we're likely going to see that as a very purposeful interaction where you're coming in the office for a team meeting that we requires interactive collaboration, uh, for team building purposes for culture, those kind of things.

The productivity question in my mind has been largely answered most. We know that we can be as productive, if not more productive in this environment. I think the question that we're still looking to answer is A, what about those folks that struggle? 'cause there are a percentage of people just based on their personality, based on how they're wired, they're really craving that personal interaction.

So how do we help 'em? And then how do we maintain that sense of team spirit, comradery, collaboration, and creativity. That really comes out when you're in a room with someone. We all know it feels different when you're on a Zoom call or whatever. So how do we actually go about doing that? So we're gonna probably eek our way through that.

I expect that for the most part, we will not see our entire IT staff or back office staff coming back in more than halftime. And I say that plus or minus maybe ever, because we've reset what the new normal is for the workforce and what's possible and. We can get a lot of efficiencies if we're able to do that.

Also expands the, the reach of the possible workforce, right? There's more people we can reach. The downside is our talent is also, I. People who as well, . Yeah, exactly. So, hey, I, I live in Grand Rapids, Michigan, which is a great community to live in, and it's a, it's a great asset of ours, but boy, if I can live here and work for somebody in California, making a lot of money, doing something interesting over there.

Now we're comp competing with. Range of companies that we never thought were competitors. So it goes both ways. Yeah. Yeah. Information and digital officer and.

It's, it's a really great question. It's a great experiment, right? Because as Covid hit everybody, we need to make decisions in the day, right? And not, or within the hour, not even within the week or the month. And so as you bring these two things together, we've been on a journey for Agile for a while, and.

Started implementing safe, which is a methodology to, to really drive Agile into our organization in some cases several years ago, but really got serious in the last 12 to 18 months. And so when Covid hit, we just saw a huge opportunity to take that and focus it in there. And so we set up camps, we called them, which are essentially agile.

Trains or cars or, or working teams and appointed somebody that was the decision maker to, to organize the questions. And then we basically ran micro sprints through that. And each of those areas would have a cross-functional team of people working on it. Some from IAS operations, clinical leaders say, all right, we're working on the lab testing problem.

We're working on the workforce problem, we're working on the, you know, communication PPE problem and. Just work through that and what, what I think was really cool about is it demonstrated that Agile and this idea wasn't about an A way for it to work better themselves. It was a way actually to break through the decision making problem that we all face as CIOs and as leaders in is, right.

It's been the problem on every CIO's mind for a decade, and every time somebody says, I we're talking about governance, I'm interested because it's like, how did you solve this because. To me, agile not only helps the work get organized, it fundamentally brings the people who know what they need and the people who can deliver it and puts 'em together and says, figure it out with a structure.

And that whole idea of governance and decision making shifts right now, you have strategy and you have long range, you know, future state planning that can guide these teams. But you basically empower them to say, what needs to happen now? What's most important? How do I get it done? And removes all those layers of.

Process of nonsense in the middle. And it, it's hard. It's an adjustment. Uh, some teams, it works beautifully well out of the box and some teams it's like, oh boy, how are we gonna do that? But we've applied it now to our applications teams, to our Epic support teams. We're applying it to our field services teams, our infrastructure space.

We've been doing our digital teams for a while, but. It looks a little different in each space, but to me, covid speed, just put a spotlight on, let's accelerate this thing we call Agile and bring our business and clinical partners into it and we're seeing the benefits and it's really helped us respond and prepare for Covid along.

Do, do you think there's any, are there any plans to take it s Systemwide, outside of it, into the rest of the organization? Yeah. As a matter of fact, our, uh, care delivery organization we've been in our health plan. Honestly operating this way for a couple of years now, right? They call 'em fixed teams. They invest differently, make decisions kind of at allocation team size, and then prioritize.

Prioritize within there. But then our care delivery, uh, divisions, we're driving that in this year. And I think the covid thing sparked that. We have a couple of early areas. Our pop health team, uh, for example, has been operating this way for a. Since pre covid and went from really kind of struggling to get work done and prioritized to absolutely just laser focused and making progress on a regular basis.

And what's amazing is when you start down that path, these are clinical leaders, right? When you start down that path, the first, the first thing is, oh my gosh, this is an IAT thing. Boy, I'm not so sure. I just want you to get what I want done. And if you take the time to wire people up and train them and say, here's how we're gonna go, like just step through this a few times, they're raving fans.

They say, we didn't really understand this, but this allows us to really say, I. We can reprioritize or prioritize and see progress every two weeks and every single day we're focused on the things that are most important and the things that we were anxious about. 'cause we had a list of 400 wants that never make it into that sprint clearly aren't that important.

And if they are that important, then we have an easy decision to make, which is how do we get more capacity or velocity into this lane? It's a, it's an easier way to look at it versus doing what I call, you know, multidimensional. Differential equations to try to figure out how to balance resources and needs as we've tried to in the past.

It's just a simple way to do it. And yeah, our, it's, it's not universal yet, but the areas that we're having success help us and then we build and continue it expand in other, yeah. For, I, I'm just hearkening back to my time as CIO, the, the amount of resources we had dedicated to Waterfall and the number of times, the answers that they gave were just.

Is staggering. . It's a false, it's a false sense of accuracy, right? And so the question is really, what do you need to accomplish over the next quarter, over the next two weeks? And if you can do that repeatedly, all of a sudden you realize you're actually achieving your goals faster. Does it really matter whether you are accurate down the road a year?

And so talk to me about realtime information and data and analytics.

What were some of the use cases for your team? What were some of the things they were asked to do and, and, and some of the tools that, that they utilized to, to get real-time information in the hands of the, uh, care providers and administration for that matter? Yeah. This, this was an area where we probably started a little slower than we had hoped, honestly, because we, when you start off, you're like, well, what are we trying to pull together?

And so we went really fast into gathering data, pulling it out of the systems and saying, okay, here's our dashboard and. Uh. Our BI infrastructure, a lot of what we present is in Tableau. We're using the Epic capabilities when we can as well, and we've built some new data marts and some capabilities to, to really drive through that.

And so we're, we're getting much better at the predictive side. Right? Which, which mostly for us looks like predicting inpatient admissions volumes and all that based on a bunch of data. But the, the other side of that, which is what do we really need to know? Whether we're good on PPE supplies, how many days do we have?

How, how is the testing going? How many people are testing positive? What's the positive rates? What about our employee population? Where are they getting it from? Is it in the community? Is it from exposure? Is it from each other? Starting to bring all of that together has been a, an ongoing journey and we've, we've.

Evolved it from very simplistic to getting more sophisticated now and more accurate as we've learned, we've got analytics teams that are kind of bringing clinical operations data people together. We've organized them in an agile way, so we have an agile train where these needs, as they evolve out of covid, just go into this team as, is this a data problem?

Is it analytics problem? What tool are we gonna use? The interesting thing that I would say is probably at the heart of analytics. Whatever tech debt you have on data governance shows up. So if you didn't have it solid to begin with, you're not gonna have it solid there. And some things that have changed, like what?

How do you count a covid patient? Simple question, right? Well, is it somebody who had covid, who has COVID now, who's diagnosed with covid? What if they had covid a month ago, but they're still here? They, they a COVID patient. Like all those counting mechanisms, the way we define things. Stabilize and understand where you are.

Excuse me. How can you predict where you're gonna be? And so we've actually found this is really reinvigorated our program around data governance and what it means and how to make data governance work at Lightspeed in an agile way so that as you are doing the work, you're doing the data governance along the way.

And that's been, uh, a real interesting journey for us. But our goal is that that information can be processed and available on the. Is accurate in the process as well. Yeah. That foundation is, is so key. We're, we're actually coming to the end of our time. I have like 15 more questions. , um, yeah, let me, lemme narrow.

You just need a longer show Bill. Yeah. Know. Lemme narrow it down to two. One of the, one of the questions I want to get on the record just 'cause I've been asking everybody, uh, all the CIOs have been interviewing in the fall, the same question and I sort of, and, and some of have been going in different directions.

That is, what do you think the lasting impact on health it will be as a result of the pandemic? Well, I think, I think this is as much as covid is the time for healthcare to really shine. I think the pandemic has spotlighted the importance of digital technology data as a way to deliver that care, right? I think in the the past we may have still thought of it, and technology is just something we had to do to run the place.

And I think it's been very, very interesting and enlightening for so many to say, no, no, no, it's more than that. This is actually the way we're gonna make this all better. So I, I expect that the organizations that see that future will make very strategic investments in advancing digital data technology as a way to drive their business and not see it as just a cost to manage within a threshold, right?

Because. That that doesn't account for the fact that there are investments that you can make in this that are akin to launching new businesses or having a positive return. I also think that we're gonna get clearer and have better opportunities to articulate what that value actually is. Sometimes it's a struggle to say, well, what's the value of an EMR?

But we can say, what's the value of automating these capabilities and creating this ? Reducing this gap from Diagnos diagnosis to treatment. Those are very, very real things that have not only financial return, but absolutely a quality and experience return as well. So, last question, and sometimes I put a date on these just so if people are listening to, to it in the future.

Sort of marks it because it's the 11th of December. We're recording this, I think this episode,

hour by hour, fluctuating. Which is the vaccine distribution may.

Making it the, the most effective it can be. In your communities, there's obviously a lot of challenges. Just, you talked about definitions, you talked about tracking. You talked about two dose, I mean, you didn't talk about, but there's two doses we have to make sure people come back. Are, how are, where are you guys at in that process?

How do you feel about the, the program that that's coming together? I, I, I appreciate the fact that you're di day stamping this so that a month from now people can either say I was right or wrong, but I, I have really high degree of confidence in our organization. We are early on, we've got multiple freezers so we can handle all the vaccines that we're gonna need.

We have the operational capability to distribute this probably as fast as we get supply. We're a little bit nervous that we're not gonna get as much supply of vaccine as fast as we will be able to deliver it. And then it's just a matter of us really going through and applying that prioritization MA matrix to who gets in and when.

In terms of the multi-dose tracking, we've already built that stuff into our . EMR system for our employees. We've tracked that into our, our system that we use for flu shots and everything. And that also gets into our EMR. So we've had a really good team talking about agile and Covid response in that space.

Already planning on this, quite frankly, for months. And now as it gets closer, we're just refining those plans. So I think we're as well prepared as hopefully anybody to really be successful and, and get this, uh. I think this is one of those areas where the digital tools really come into play. I mean, making the appointment, making sure you queue people correctly.

Yeah. Uh, making sure they follow up, texting and, and other alerts to make sure that people come in for.

One of them's 21, one's 28, I think, depending on the vaccine. So that's the, the other confusion in this, right? Depending on, you know, which one you're getting, and early on that won't be as big an issue. But as we get the multi vaccines in the system, that's gonna be a real challenge. Make sure we know which one we're giving to whom and what the rules apply for those things.

But we've got. I, I feel really good about this. Again, back to that agile thing, right? We've got the right people from a clinical and ethics and operational technology working that problem end to end and wiring our systems in to be able to do that. Yeah. Well thanks for taking that question. I mean, in the middle of the, I mean, we, it's the 11th.

I, I don't think we have distribution yet. I think distribution will start next. So, we'll, as of today, it sounds like we're at on approved side of things. We're, we're hoping that by next week we'll see some things rolling forward and, uh, I'm very hopeful and bullish that by end of spring, early summer next year, we're gonna see that this thing is widely available and distributed, and maybe life will resume to normal.

I think that there's a lot of folks that are hoping it'll come quicker than that. I just, it'll be interesting to see how people treat that interim period of some being vaccinated and not, and what roles apply to people. Well, Jason, thanks. Thanks for your time. I know how busy, uh, things are. Let's, let's not make it so long between the, the next visit.

I'll, I'll follow up next year and we'll, we'll get together and have another conversation. That sounds awesome. Thanks, bill. Thanks for having me. What a great conversation. That's all for this week. Don't forget to sign up for clip notes. It's a great way to support the show. It's also a great way for you to stay current if you're not familiar, clip Notes is an email that we send out immediately following the shows, actually 24 hours after the show airs, and it'll have a summary of the show, bullet points, key moments from the show, and also one to four video clips that you could just watch.

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