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Special thanks to Health Lyrics, our Newsday show sponsor for investing in our mission to develop the next generation of health leaders. If you wanna be a part of our mission and becoming a show sponsor, sent me an email at partner at this weekend, health it.com. Uh, quick note, we did launch a new podcast today in Health It, where we look at one news story every weekday morning.

In fact, check it out, subscribe anywhere you subscribe to podcasts. Also, we have a new schedule for the, for the year. We're kicking it off this week. We have a Newsday on Monday. Influence or showcase on Wednesday and an influence again on Friday. Uh, so be sure to check back. In fact, this is a shortened episode of our, uh, Newsday show as this year we're gonna be doing Newsday back and forth with our round robin group of, of about six co-hosts.

I guess we'll call 'em moving forward. We'll call 'em co-host. Uh, however, through scheduling snafu, didn't really think this through. We took off the last two weeks of the year and did not schedule to record this show, but I wanted to put one out there 'cause there's a fair amount going on and I sort of want to, uh, catch you up and give you a little bit of what's, what's been going on.

All right, so before we get to the news today, I wanna give everyone a little bit of an update. We've been doing this show now for about three years, and I've used my father-in-Law as an example, and, and really our experience in providing care for him. We, we, at first we provided care for him. We were in California.

He was in Pennsylvania, and I was talking about care to distance and just how hard it was and how technology could really fill that gap. Uh, and that was the experience early on. While eventually he moved in with us. In Southern California and we became the primary care provider, and it, it was, uh, a different experience at that point.

Well, my, my wife's father passed away two weeks ago from what was essentially complications from COPD and uh, CHF and. I, I wanted to give a little, a little tribute to him. He has been a part of the show, and, and I've shared his experience. We shared his experience with going to the ed, the medical record, not transferring.

And since we've talked about him so much, I thought I'd give you guys a little very short, uh, tribute to him. I, he really was a wonderful man. Just give you a little perspective here. He left the military to care for his family. Once his father became ill, his father later, later, died in his arms. To give you an idea of how much of a caring person this guy was, he cared for his son who was born with, with brain damage and never learned to walk or talk.

Uh, never really progressed past an infant. Mindset, but he cared for him in the home for 44 years until he died and all that that entailed. He was the, we used to joke, he was the executor of so many wills of, of the people who lived around him. And, and part of that was he was such a trustworthy person. He said what he meant and he did what he said.

He lived pretty much by routine. He was a, a bookkeeper by trade, so he was very methodical. In fact, . He would, when he would come out and visit. Early on in our marriage, we'd go out for dinner and I would do everything I could to try to pay the bill, and I would leave the table, I'd pay it and whatever, and invariably a week later I would get an itemized checklist of all the things that he felt like I.

Uh, they should have paid for with a, with a check in it. Just to give you an idea of his bookkeeper mindset. Uh, he lived by routine. Price is right. Let's make a deal. Uh, sit out in the sun. Uh, happy hour was every day at four o'clock dinner and, uh, a game of gin every night. Uh, wheel, fortune, jeopardy. And then a good Clint Eastwood movie would round out his day.

And that pretty much described a lot of his days. That's what he was doing the last couple of years he was with us. In his final, in his final days, he could only get a few words out. And I think this says a lot about who somebody is and the few words he could get out, all of them were, I love you to his daughter.

And a, a friend of mine once said to me that when you get squeezed by life, you get to see what's really inside of a person. And in his dying days, we got to see what was inside of him. He loved us well, and we will miss him. Just to give you a tie this in a little bit, here's, here's what we learned about healthcare in the, in his final years, but really in his final days.

I already shared about the medical record movement. It was challenging going from Pennsylvania to Southern California, but then Southern Cal, California to Florida was not as challenging. Mostly because we knew what to tell them to do in order to get the medical records. So we were really . Telling them not something that everybody's gonna have the advantage of the knowledge of how the EHR works and how interoperability works, how to get the records from one place to another.

And, uh, it's, it's really a shame, but it's still the case that you have to help the health systems to provide the best care for you. It just, it's not, it's not, it's not wired. It's not . It's not synced up yet. Finding doctors is hard when you move to a new location. That's one of the things we found. We moved to, moved him a couple times and getting that right mix of doctors is, is challenging and it's, and the information is, is not that great.

We're still doing it by word of mouth for the most part. Uh, choosing insurance is really hard without a coach. If you think about this, a child trying to care for an aging parent coaches, and you're really looking for a coach who isn't connected with the insurance company, and when you find them, they're invaluable.

And we did find a, uh, woman who walked us through all the different options, what to consider, what was paid for what wasn't, which was really helpful. Technology was not really helpful in caring for him. And perhaps that's a little over the top, to be honest with you. He, his, his care was coordinated well, that was obvious.

And, and many care providers he saw were informed. So the information was flowing from one care provider to another. But outside of that, there weren't, there were a ton of phone calls, a ton of faxes and papers flying all around. Almost no online scheduling and even texting was, was not something that the doctor's office wanted to.

Uh, partake in his home care nurse was exceptional and it was a great program. Once a week in the house, she octo also acted as the, uh, quarterback for the care team. And it was really effective. I mean, she would come in and say, you know, what's your next doctor? Well, that's not the next doctor you should see.

You should see this one. And then she would make the phone calls and change the appointments for us and do all that stuff. Uh, that was a really good program. I if, if your health system's doing that, and I'd put some money behind that. That's very. Very effective, great experience from our perspective. It's, it's interesting 'cause we, we talk about experience a lot, right?

And the experience is interesting. So same hospital, same course of two weeks. His I, his care in the ICU was phenomenal as you would expect. It's expensive. There's a lot of nurses that. The patient per per care care provider is, is pretty, the ratio's, the right ratio. And on the fourth floor, exceptional care.

I mean, the nurse was constantly coming in. She was kind and, and those kind of things. On the second floor, you couldn't find anybody. I. It's just interesting, like nobody would come into the room, his food would sit there, he needed to be fed towards the end and, and he wasn't fed and, and those kind of things, we'd have to go out and find somebody so it wasn't uniform around the hospital.

And so we could do all sorts of things around the experience, all sorts of things around the technology. But at the end of the day, if we can't, uh, figure out what Disney has figured out and what others have in Southwest has figured out and what others have figured out in terms of . Keeping our staff motivated, keeping them, uh, valued and, and, and trained on doing the right things and, and then measuring those things we're, we're still gonna fall down in certain areas.

I will say this, frontline caregivers have a tough job. We saw families come in and they were incredibly demanding, and I understand that that happens. You know, people are at the lowest point in their lives. It's a very difficult job. I. Even though you're sitting there going, Hey, why, why aren't they coming in?

If you, if you get beat up all week with a bunch of families that you know are, are very demanding, I can understand how that could wear on you after a while. On the flip side, there's people who you could tell this is their life calling. They are amazing. They can take that and they take it with a smile and they a kind word back and those kind of things, they diffuse those situations really well.

They're, they're just, uh, heroes is thrown around a little too much In our industry, we used to say all frontline workers are heroes. I, I believe that they are, have been in challenging times. All of them have been in challenging times for the last year for granted. But not all of them really are heroes per se.

I mean, yes, they have courage and yes, they work really hard, but when you, you . hero when you see them, it's, it's that, it's that person that puts the dying person at ease. It's the, it's the doctor who sat with my wife and told. Spent the time. Yeah. I think this was a cardiologist, actually. I'm sure it was a cardiologist.

Spent the time talking to my wife about his family experience and just the empathy that came across and, and, uh, how he had to, he just recently had to bury his, uh, mother and, and he knew what she was going through and, and she was, she was moved. I mean, there, I, there's just so many of those stories in our industry.

I, and, and I sort of, I, I, I get a little concerned that we throw hero around and we say all healthcare workers are heroes. When there are people that really are distinctive in terms of the amazing care, compassion, empathy skill that they, that they practice with. So, so anyway, that, that was, that was amazing.

I, I, I think it, you know, it was . They sent a financial person in. One of the things you start to think, after a while, you hear all these surprise bill stories and whatnot. You start to wonder, it's like, how much is this gonna cost? And they sat down with us and went through everything and, uh, and, and not only, you know, Hey, here's what this is gonna cost.

Here's what this is costing you, here's what the insurance is gonna cover. It was, it was really well done. Not only that, we found out that his hospice care was gonna be covered by Medicare, uh, something we didn't really know. And for that matter, while we're talking about Medicare, Medicare really is good insurance.

I. We can argue if the country can afford it. We, we can argue if a single payer system for all really makes sense, but I'm not sure we can argue too much that Medicare is, is pretty good insurance. It covered a significant amount of his care coming into, or coming out of this experience, so, so that, that took a, took a load off I.

I, I appreciate you letting me share this, this tribute and a little bit of the personal experience. I, I think we're all gonna have this kind of experience and it, it helps us to think through from the. From the patient perspective, from the family perspective, how our, our work is really impacting people.

Let's see anybody else who's also been on the show. Uh, some people I'm trying to get on the show, Darren Din. Andrew Rosenberg. So a lot of, uh, a lot of people who have been on the show, well, they, they published this article late, late in the year last year. And this is, this is what, some of these are predictions.

Some of these are just observations. So let's start with some of the predictions. Stephen Klasko, I, I, everyone loves Stephen Klasko 'cause he, he's out there, he speaks. He speaks in the future. He lives in the future. He speaks in the future. This is what he has to say. This is healthcare's Amazon moment. If you are a provider and you think you're going to go back to your business model solely being based on hospital revenue and not.

And not relevant to people who want care at home. I think you will end up outta business. If you are an insurer and think you can just be the middleman between the hospital and the patient, you'll, you'll become irrelevant. If a hospital believes that innovation can be just a little cute thing that they do in the background, but the but the real business is just getting heads in beds, they're nuts.

I think we're always wondering what the big disruption would be that got us into . It got us to join the consumer revolution, and I think this is it. Since I don't have my glasses, I'm going to increase the font size here so I can read it a little better for you. I love that. I think that's what we're gonna be talking about next.

Oh, this, he's absolutely right. This is one of the things we're gonna be talking about going into next year. Uh, in fairness, we've, we've been talking about this. When's the digital evolution really gonna hit? When is the hospital model gonna change? When's the payer model gonna change? Uh, who is the most relevant in the, in the model?

Is it going to be the insurance, the payers is gonna be the providers? Is it gonna be the, uh, it startups, the, regardless of who is gonna win out in that, he's right. Some things have changed, expectations have changed, and if expectations have changed, then we have to keep our, our eye on the, on the ball and, and understand where expectations are going.

Uh, BJ Moore, CIO, Providence, he's talking a little bit about their Microsoft thing, uh, Microsoft Partnership. He said from the beginning we defined, we defined this within our strategic framework of simplify, modernize, innovate. I love that in and of itself. Simplify. Simplify the environment, modernize the environment, innovate around that environment.

In fact, innovate is really hard to do if you haven't simplified and modernized. It's, it's almost a continuum in, in the innovate space, we are focused on the future of care delivery, a future that has the patient, not the site of care at the center with innovations on how care is delivered, for example, around telehealth and home monitoring scenarios.

And innovation on the way we enable care providers for greater experience and outcomes. An example emerging from the collaboration with Microsoft is natural language processing and cancer treatment. I have so much wisdom here, and I, BJ Moore will be on the show, uh, again, probably February Mar, uh, February, March timeframe.

I think it's already scheduled. I, I love this. In the innovative space, we focus on the future care delivery, a future where the patient, not the site of care, is at the center. And I think we're gonna see the locus of care change and, and that will require us to rethink some things. We will see more stuff go to the home.

We will see more things go outside of the hospital. We will see more care at a distance. I think those are, those are givens just based on what we saw during the pandemic. And the pandemic's not going away. It's not like. We're gonna start January 1st, pandemic's gone away, and we can go back to normal.

This is gonna be something that has, that will go on for a fair amount of time. And because it's going on for a fair amount of time, it's creating new habits, new habits form in about, you know, 30, 60 days type thing. Well, this has really hit us and changed the way we operate since March of last year. And it's probably gonna go, uh uh, most people I'm talking to are saying

At least July before we get some semblance of nor normalcy, but more than likely through the end of the year is what I'm hearing. So a lot of, a lot of new habits are gonna be formed, A lot of how people, their expectations we already talked about. So we're gonna have to look at delivering care in different venues in different ways.

Expectation for next year we're going to have more demand for telemedicine, telehealth, hospital level care in the home wearables, and the ability to apply machine learning and artificial intelligence to new data sources for cure plans that that's going to be here very soon because we have changed so much so fast with C Ovid 19 and that is gonna be the legacy of Covid 19.

COVID 19. It didn't kick off the digital transformation, but it, it, it proved the imperative of digital transformation in healthcare. So Kristen Meyers, executive Vice President, CIO, and Dean of it at Mount Sinai Health System. As someone who we will also have back on the show, we've already reached out delivering the patient experience so that patients and families strengthen their relationship with their health system is our best opportunity.

Technology can be an enabler when there is a holistic experience from scheduling all the way through. The discharge and remote monitoring at home will be an important part of our strategy. The key to all of this. Is providing a seamless patient experience, one that is easy, clear, and from the tech perspective, not fragmented.

Pulling all that together is a challenge, but patients will become more empowered in the future and they will expect the kind of consumer experience that they get in retail and other sectors. Again, a lot, a lot of wisdom there, but I just wanna drive home this, this whole idea of. Uh, who's gonna be the locus or who's going to be the, the center of this payer provider?

Tech companies. Now tech companies understand the consumer better than anybody. The payer's least trusted in the equation, and sometimes people are wondering, you know, why are they even there? And then the provider, the provider is in an interesting space and they can claim that that mantle of trusted source of health information and trusted source of

Of building a healthy community. They can be the foundation for a healthy community, uh, in which they live. They just have to grab that mantle, take it. And what that means is not only from a technology perspective, but also from a communications perspective. And this is the area where I think health systems have gotten better and they've exercised a new muscle over the last year.

And that is in utilizing communication platforms to get information out into the community. Right. So utilizing social media, utilizing the local news, utilizing billboards, utilizing everything they can to get a message out to the community. Uh, and we're actually flexing this muscle right now as we speak around the.

vaccine distribution as well. Letting people know how they can get in line, what it looks like and those kind of things. I'm not sure we're doing a great job of it yet. This is still a muscle that we have to be convinced that this is an important thing to build. I don't know where it sits. This is, this is that weird dynamic that exists within a lot of health systems of marketing and it.

And we never thought of marketing and it really coming to loggerheads on certain things, but they really have, because you're hiring these new chief marketing officers who, who, who fashion themselves as, as tech savvy. And that's great. They understand the tech aspect of it and they can really move the needle forward.

But on the flip side, there's, there's a lot of health systems that don't have that tech savvy CMO. And the, the CIO needs to step forward and say, I know how to use these communication platforms and to make you more effective, and they have to drive that relationship anyway, just something that's been, uh, bouncing around.

Because of their retail exposure in the remotest communities. I'm a true believer that giving com consumers low cost better and expanded access to primary and urgent care will lead to better community access, reduced hospital admissions, and therefore lower healthcare costs. Again, this is gonna be something we're gonna be talking about next year.

It might be more, uh, appropriate for some communities than others. Uh, I think if you're one of the rural communities that, uh, this became very real to you. I mean, the . Uh, vaccine distribution is going through, uh, CVS, right? It's going through some of these players because it was a more effective supply chain to get the vaccine out into the remotest parts of the country.

I. And it's, when you're talking about the logistics of this, we're trying to get it to 10,000 hospitals versus getting it to Walmart who can get it into all those communities as part of a distribution mechanism they already have. Or, or even an Amazon who can do that or ACVS that can do that. We don't have that kind of logistic capability, and it's something, uh, that we will have to, uh, consider moving forward.

a great insight today, Forry, let's see. Ryan Smith, CIO. Intermountain Healthcare Talks a lot. I, I'm not gonna read all these things. He talks a lot about how the pandemic really changed things, and we talked a lot about this on the show, right? We have a lot of people working out of the home. We have a huge increase in telehealth, health visits and virtual visits, new clinical workflows, analytics, uh, a lot of things, a lot of new lessons learned, and.

Important person in the healthcare community at, uh, Kaiser. It's important, this is from his quote. It's important for the healthcare industry to recognize that AI algorithms trained on insufficiently diverse data can lead to AI bias. Again, a topic we've talked about on the show and we will continue to, to focus in on at a time when we are incorporating more and more AI in medicine.

This bias can inadvertently contribute to a widening of healthcare disparities. One of the first steps we need to take is to be intentional in looking for bias. If we don't look, we'll never find it. So understanding the AI bias can be a part of any algorithm, can be a part of any algorithm is essential.

Ultimately, I consider AI to be augmented intelligence and not simply artificial intelligence. It is most impactful when used as a tool for physicians to augment, assist, and compliment their clinical decision making rather than standalone technology. I, again, I think we've seen that these, these technologies that were on the edge are now mainstream or they are becoming mainstream.

Let's say that they're becoming mainstream. You're starting to see them baked into just about, uh, as many workflows as you can. AI is really taking off in the administrative space and it is gonna continue to do so, but it's also gonna see huge. Huge movement and, and most mostly driven from the academic medical centers who are gonna drive this forward.

And we're gonna see AI start to, uh, get baked into a lot of the, uh, a lot into the workflows. The analytics platforms are gonna need to become more real time and, and we're really gonna have to clean up our data. 'cause AI isn't magic, it doesn't clean up your data for you. You have to have, uh, clean as clean of data as you could possibly get.

Michael Peffer, md CIO at UCLA Health. We know that social determinants of health play a critical role in health outcomes, but often are hard to capture fully within office visits. But now I have a lot of physicians commenting to me how they're able to connect with patients on a different level with video visits to better obtain this key information.

And that's really true. I heard this as well. In fact, I may have even heard it from Michael when we interviewed him on the show. There's a, there's a benefit of, of the video visit and it brings you right into their home. You can see things in the home. You can have conversations of what's going on in the home.

It. I, I don't think that's the end all, be all of social determinants. We did a show with Intermountain and United Way towards the end of last year. It's, it's worth listening to. Intermountain has really taken to heart the social determinants. It's gonna lead to healthier communities. Uh, they've partnered with the United Way.

The United Way has brought together a lot of other organizations. These are the people who are on the front line of the social determinants. They are the frontline workers of social determinants. Healthcare workers see it, but they see it on a cursory level. These are people who are actually in the house, they're in the community.

They're, they're working the soup kitchens, they're working, uh, they're working in the communities, uh, with the kids and those kind of things. They're gonna see it at a different level than the healthcare workers do. And without those partnerships, I don't think we're gonna make nearly enough progress. And so it is gonna require, again, a new muscle of creating those partnerships.

And. In, in really leveraging information flow, technology, communication back and forth for the good of the community as a whole. Uh, Jason Joseph again, uh, CIO of Spectrum Health. There's still a lot of variation in care processes that get, uh. It gets in the way of digital transformation. For example, while we have a high degree of automation and digitization within our health system, we still use faxes in healthcare to communicate with other providers.

The faxes essentially a giant red flag sticking up saying a process somewhere around here is broken. Because I have now resorted to the least common denominator of communications, uh, that is true about the facts is absolutely true. But don't miss out on his first statement, which is there is still a lot of variation in care processes that gets in the way of digital transformation.

Care, care process. VA variation is not something that's solved with technology. It is exposed with technology, it's exposed with data, but it isn't solved. It is still gonna require a significant operational partnership in order to and, and clinical leadership in order to really address the clinical variation across any health system.

And. It's, it's interesting. I, I don't think there's, I don't care how good your health system is. I don't think there's a single health system that doesn't have that challenge and, and, and really could use, I, I wouldn't say more emphasis, but could use emphasis on reducing, uh, care variation. Let's see. How far, how far have we gone here?

I said short episode, and I'm already getting up around 30 minutes, so. Let's see. I will pick one or two more. Michaelia, rest, good. Italian name, senior Vice President and CIO for corporate information services. As our region, state, country, and world react to the spike in Covid 19 cases, we have recognized that our corporate is teams top priority is less project focused, but more focused on mirroring the behavior of our frontline caregivers and leadership team.

As a result, together, we all need to be nimble, available, and flexible to adapt our systems, technologies, and processes in support of our community and frontline caregivers. I love this whole concept of. Mirroring the behavior of our frontline caregivers. That's, that's an interesting concept to me. One, I'd have to really digest and think about, but the reason I like this quote was to say we were incredibly nimble last year, and we might be wrestling on our laurels saying, look how nimble we were last year.

I don't think that's gonna change. I don't think it's gonna change ever again. I think the, we have proven the uh, uh, ability to be nimble. And we have restructured our platforms and well, we've adopted platforms and we've re restructured our technologies to be more nimble. And I think that's gonna be the expectation of the system.

So we are gonna have to be very careful not to overwork our people. We're gonna have to figure out this remote work environment. One of the quotes I was gonna read was on how I think healthcare's gonna remain remote work. Uh, this was Joseph, Joseph, Jonathan, uh, Schumacher, CIO of Lena Health. I'm not sure that's the case.

I, I think. Clearly there's some people that need to work in the hospital and that's gonna continue to to happen. We still need frontline IT staff, if you will, in the hospital. And around the, around the healthcare system. There are jobs that will continue to be remote. Again, I just don't think it's a panacea.

I don't, I don't think it's a panacea. I think it's hard to maintain culture. It's easy or it's hard to maintain culture over a longer period of time. You have to be intentional about it. I'm not sure health systems have really thought through building and maintaining a culture across a virtual environment.

And so while it feel, and again, I think it feels good this year, the, the employee satisfaction numbers are up probably across the board and people are saying, look, that's what we want. That's a huge win. That's where we're gonna stay. We'll see if we can do that. We'll see if we can maintain it. I am skeptical.

I think we're gonna have to, I think what's gonna happen is our, our staff is going to get split and I think there is going to be a, a virtual staff that can remain virtual without really a lot changing and their productivity probably will be higher. But I think there's gonna be a bunch that are going to have to be on site.

I think it's gonna build resentment. I think it's really gonna require, uh, significant thought. In order to build the right culture around this and the right mix of onsite and remote. Let's see. Any other Man, there's so much wisdom here. Stephanie Real talks about artificial intelligence. Again, and I think that's important.

Heather Nelson talks about how our focus has become so.

I think we're gonna need, we're gonna need better ways of turning our data into information, into knowledge. We're gonna need better. Workflows in order to get that information to the right, uh, place. In fact, one of the things Darren talks about is getting into the portals and mobile apps and tablets and you name it.

I think the, the fast followers are spending a lot of money trying to keep up. Up and they're gonna struggle to spend that money to keep up. They're gonna have to really put in the right platforms in order to keep up. And then I think the laggers are just saying, well, once my EHR provider has the technology I'm going to, I, I will be good to go at that point.

And that requires you to set up a platform. So you know that that's what some of the leaders are saying. This is a good article if you get a chance. 22, what is it called? 22 Hospital C-Level Execs Share their IT Perspectives and, and it was not only, not only the ones you heard, there's plenty more where that came from.

So that's all for this week. . Someone that might benefit from our channel, please forward them a note. They can subscribe on our website this week, health.com, or wherever you listen to podcasts. Apple, Google, overcast. That's my, that's where I listen. Uh, Spotify, Stitcher, you get it. We wanna thank our channel sponsors who are investing in our vision and mission to develop the next generation of health IT leaders, VMware, hillrom, and Starbridge Advisors.

Thanks for listening. That's all for now.