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Their weekly support of the show has allowed us to do an amazing amount of stuff this year to, uh, expand our service offerings and to develop new content for the community. And for that, we're incredibly thankful. If you haven't signed up yet for three x Drex direct to Ford, our co-host for today's show has a service.

Three x directs, three stories, three times a week. Vetted by Drex. Just text Drex. To four eight. 4 8 4 8 Drex is in the house. Good morning, Drex. How's it going? Hey, hey, how's it going? How's, how's everything down in Fluor? You know, Florida is nice. Do you know how hard it is to say three x drex, text drex to, you know, all that?

I mean, it, it just sort, you know, from a tongue twister.

How's that? How's that service going? I mean, I, I looked at it, uh, this morning. You had a, you had a story about vaccines and, and a couple other things. A bunch of security stuff. So, yeah. How's, how's, how's the service going? Yeah, it's going good. I mean, I think, you know, it's, it's something that I started really about a year ago now, and, you know, did it just, uh.

Without any sponsorship really. Kind of just wanted to try to get some stuff out there. I had originally, you know, been told by some folks that I was posting a lot of stuff on LinkedIn and that they were really honing in on that, skipping a bunch of other things. And so I said, let me try to do something by text 'cause nobody else does that.

And. You know, it's, it's going well. I get good feedback. Every, every issue that I send out, somebody winds up, or more than one winds up either sending me an email or sending me a, a text back and telling me that something in there was really surprising or good or interesting or whatever. So it's fun and it's, it's really.

You know, I, I, I don't know that it's gonna turn into anything big. It's mostly just a way for me to communicate for, to folks who like to, you know, like to hang out. Yeah. I was gonna launch three X bill, but it just didn't go. So we're just gonna , keep referring people to your service. Actually, it's a phenomenal, phenomenal service.

I pick up one or two, uh, stories for, you know, this week. Every or for this show every time. Yeah. So you're signed on for. We are gonna, this format has actually, uh, you know, a lot of people like this format. So we've, we've, I've found a couple of your peers. So Sus Shade's gonna join me every six weeks.

Awesome. You're gonna join me every six weeks. I have two others that I can't announce yet 'cause they're, they're getting permission, but they're pretty sure that they're gonna do it. So we're gonna, we're gonna get the news from a lot of different perspectives.

You know, we're gonna do this format for this show all next year. So it's gonna be gonna be a lot. And actually I enjoy this more. I enjoy the back and forth. It's, it's a lot easier. I too, I think it, I think it works really well too. And you found some folks that you work really well with and can have really good conversations with.

Suss shade is ridiculous. I mean, she's amazing. I mean, first of all, just her background and the skill and talent that she has and all the interim stuff that she's done since she's kind of pretended to hang it up. Yeah. She, she has so much experience and insight. Uh, she's gonna be a great co-host. You're gonna have a great time with her.

Yeah. We've, we've, we've had several conversations over the years. She's, you know, it's, it's interesting 'cause there's, there's some things that we don't necessarily, and this is what I like and I'm gonna really try to push this more next year, is, is the areas where we don't see eye to eye right. People, I think listen to this show and think we agree on everything and we don't necessarily agree on everything.

In terms of approach and those kind of things. I mean, there's some things, obviously we believe in, you know, project governance and intake and, you know, different, uh, ways of doing that and how important it is. And we believe in, uh, the digital foundation for health. I mean, there's, there's a whole host of things that we're like, yeah, we, we've fundamentally agree on these things, but there's ways of going about things that I think we, we spark each other's, uh, thinking and ideas towards.

So. I agree towards that. Let's talk vaccine. One of your stories from this morning was vaccine. I highlighted a couple on on LinkedIn. The vaccine rollout is, uh, we, I guess we are at the starting gate. I think a lot of health systems are saying by the end of this week. They're either gonna get the, well, I think the Pfizer vaccine is gonna start going out this week, and then the Moderna vaccine will be, uh, following in the distant.

So, you know, we, we've actually had a little bit of a conversation about this before. Uh, how just . I, I don't even, how to, I dunno how to tee this up because it's, it's, it's interesting to me because we've known this was coming, this is not a surprise. We've known this was coming for a long time. You, you would think we were, we're, we're flat out ready, we're prepared.

We're, you know, Hey, we've done flu vaccines for years and this is, you know, we'll just take that module and away we go. And your story that you highlight today is about using paper. To track the, the vaccine usage. I mean, is that, is that really gonna be the best method with, given the, the amount of money we've invested in technology at this point?

that's, that's the point that I made in three x extracts this week. Was the idea that we spend 35, or you know, depending on what numbers you see, $38 billion in the meaningful use period to build electronic health records and all this stuff. And now we have a vaccine. It might be the most important vaccine that you will ever take in your entire life, and we're gonna keep track of it on a little paper card that they're gonna give you when you get your vaccine.

Here. Sir, please take this, fold it up, put it in your wallet. And then when you come back to get your next vaccine, we're gonna need for you to produce this again so we can make sure that everything matches up. And I mean, there's a whole bunch of things in this. I mean, first of all, does anybody carry a wallet anymore?

that's just start right there. You know, that could be a problem. But just the . You know, I, I think this is why we have, uh, why we still have fax machines in healthcare, right? We've built big, complicated digital electronic health records. We've discovered, surprisingly, that they don't interoperate very well, and we're working on all that.

Don't get me wrong, people were bending over backwards. They're working really hard to try to fix this stuff. Man, it's, uh, it's, uh, it's painful to think that we're gonna go into this with paper records, and I, I sort of jokingly called it the other day when you and I and a bunch of other you did it, people were on the phone,

You did. And I, and I said, I bet you we wind up going to some kind of a paper record for this. Like, you know, I spent 20 years in the military. We had a paper shot record. You've ever, if you've been in the military, you know what I'm talking about. It's this little yellow form and you carry it around.

Precious is gold and little. We used to have that with vaccines as well. When we were kids, we had this little record and I mean, I guess no one thought about, Hey, you could easily forge that, but we had that record. We'd take it. To our school and say, look, there are little checks next to these vaccines.

We've got them. Uh, and they, they would accept it. It's crazy. Yeah. Yeah. So I, you know, I, I worry about this, but you know, the other part of me is I. Keep it simple, stupid, and if it's, if paper will work and we can figure out how to make it work, then maybe that's the, you know, maybe that's a good route. I know I'll, if I, when I get mine, I will immediately take a picture of it and store it on my phone and that's probably how I'm, how I make sure that I, you know, keep track of it, but.

I'm probably gonna get a tattoo just to let people know. . Well, I mean, how else are they gonna know there? People are gonna be walking around going, Hey, that guy doesn't have a mask on. Tackle him. And I'm gonna be like, no, no. Look at my tattoo. I've I . Yeah, I have the, I have my card. It's gonna be interesting as we go through this.

And I just was on a call with some friends from London this morning and they were saying that they, they have started giving out vaccines there and. The conversation very quickly evolved into exactly where you're going, which is some people are gonna get vaccines early, they're gonna be, uh, people who are in long-term care facilities and healthcare workers.

And so healthcare workers are. Probably going to be able to start doing things that the rest of us are gonna have to continue to be hunkered down for, for the next six months or eight months until everybody gets their vaccine. Right. So how's, how's that gonna work? Are they gonna have some kind of an special id, you know, that they produce another paper document that they, they have to carry around their shot record proving that they got their right here so they can get into a football game or a, you know.

Here's what I wanna do, I wanna structure this conversation a little bit, so you and I both have experience as CIOs, and I wanna, yeah, I, I sort of wanna break down the challenges that are associated with this. The, yeah, I mean, we were on the same call and when, when we asked some doctors, you know, when do you think we would get it?

So I'm in my fifties, fairly healthy and those kind of things, and said.

You know, because that's just the pecking order of who will be getting this, and more than likely it'll be later in the, in the spring that we would get it. So let's break this down in, in, into, uh, some of the challenges that we face. First of all, it's, it's a, it's a, a two dose vaccine, two two dose regimens.

So you have the initial shot and the booster, and that's, we're talking the right, get the first, get the. We, I mean, none of us like to go to stores that require receipts for returns anymore. Amazon's changed all that and, and so we're gonna have that card, which is, which will mean in theory, which will mean I can go to one health system for the starter shot and another for the booster shot, and have my little card and, and.

It will indicate. Now the problem with that, I mean, let's just, let's start with that two dose regimen and say, all right, we need, we need a way to notify people that they're eligible for the vaccine, right? So it's gonna start with first responders, frontline workers. It's gonna go to those who are at risk, maybe the nursing homes and other places, and.

Those channels. As we move through those channels, we have to keep track of the people who've gotten it the first time and who are, who need to come back the second time and, and follow up with them to make sure they come back the second time. But we also have to have a mechanism for scheduling this. So my parents are already saying, Hey, how do I get on the list?

How do I get scheduled? That's gonna be health system by health system kind of basis, right? And you're gonna need some, some queuing mechanism, either a digital queuing mechanism or some other mechanism. I I, I mean, maybe it's an email mechanism, maybe it's a fax, maybe it's a text. And actually I, I don't really care which one it is, but you need a queuing mechanism to let people know that they are.

You know, they can get the vaccine. Otherwise people are gonna start showing up at the, at the, at the emergency room, I think. So how, what, what mechanism are we gonna use to let people know? Because I, to be honest with you, I, there's part of me that feels like we're gonna have to convince people to take the vaccine.

but I'm really more in the camp of, I think people are kind of tired of the way we're living right now. Mm-Hmm. . And they're ready to be beyond it. I think there's gonna be a line, at least upfront, I think there's gonna be a line of people going, yeah, let's get to the other side of this. Sign me up and they're gonna be asking the question.

How do I get in line? How do I get in line? Yeah, I that, that's a great question. Hopefully there's some analytics people that are working overtime right now that are sort of figuring out what is the, what is the shot protocol, what is the vaccine protocol for? First we're gonna do this group, then we're gonna do this group.

And I mean, you know, we've, we've, they've tried to lay it out a little bit already saying healthcare workers, frontline responders, and uh, long-term care facility. Individuals get the shot first and then who gets it after that? Well, there, there are a lot of protocols that have been laid out and like you, I've gone, I think it was the New York Times that had a a pretty interesting little, I.

Tool that they published maybe last week that let you put in your age and whether or not you had comorbidities and ask you if you were a healthcare worker. And then it told you your place in line locally compared, you know, if there were only a hundred people online, where are you? And I was like 96. I was way, way in the back of the line.

But there's, there's, I mean, comorbidities, right? That's another thing that you're gonna look at. These are people who have other healthcare problems that we wanna make sure get the shot, because these are the kinds of comorbidities that are most likely to have a very negative outcome if they get C-O-V-I-D and.

They, you know, they have this, this pre-existing condition, so that has to be part of it. Like I said, I hope somewhere in your health system, there are some analytics folks who are working through this, searching through your electronic health record, finding people, building some kind of an order, and then the conversation comes down to how do you contact them and you know, where do you contact them?

Are these people who live local? Do we have the right phone number? For the folks who have Salesforce and are probably doing some at-risk contracting and are in regular contact with their customers. 'cause they're always trying to make sure that they're doing all the things they should do from a preventative health perspective and staying healthy.

They're probably gonna have a lot better luck than, uh, a lot of others who. I think they're gonna struggle with the who's, who's on first and who gets it first. So here, here are some of the questions I think we need to answer. And actually we can even make this easier and just say who gets it first within the health system.

Right. So a lot of health systems are doing surveys right now. They're staffed to, to ask the question of who wants to get the vaccine. You have determine if the insurance is gonna cover it, if the health system's gonna cover it in terms of the, the cost. You have to have a tracking mechanism, right? So I guess all EHRs have a tracking mechanism for tracking vaccines in.

Mm-Hmm. in that we've done the flu for years. I don't know how much more different the build will be for Covid or if we're just gonna use the flu, whatever the flu workflow is, and just Mark as

imagine.

Pretty easy workaround. The, the other challenge, to be honest with you, I know in the state of Florida, or at least I'm being told in the state of Florida, only five health systems are getting the first, uh, supply of vaccine. Mm-Hmm. . And in, in the month of December. Right? So first of all, not all health systems are getting it.

Second of all, they're not even getting enough to cover their workers. And, and so there's a communication process here and. That's a question that needs to be answered like today. If you're, if you're listening to this show, this needed to be answered actually last week. It needed to be answered last week, that your community, there should be news stories on, uh, all the major news you should be posting on social media.

This is how you get in line in Southern Florida. This is how you get in line in Seattle to get the vaccine. And oh, by the way, here's the CDC guidelines. You know that there's nothing magical about that New York Times. Uh, no list. No. It's super simple tool. Yeah. I mean, I mean, you and I, you and I with a little, probably with somebody with a little more programming skills than us these days, but could probably have that written up by this afternoon and put on our website to, says.

You know, I, Hey, do you want to know when, roughly when you're gonna get the vaccine? And oh by the way, when you're done taking that click on this button if you'd like to schedule an appointment for that, for this range of times, and we'll contact you via text or those kind of things. So we have, we have that aspect, but then we also have the public health.

You know, the, the, the immunity, right? We, we need to get to eight. I've been told numbers that are really high, and I don't know if this is the case or not. Uh, but given, given how, how, how this thing really passes from individual to individual. It, it, it appears to me they're saying, look, either. Either people who have had the, had, uh, covid or people who have the vaccine has to get upwards of 80 some odd percent to really slow the, the spread of this.

That is the herd immunity number. Right? That is the point at which if 80% are immune or have had the vaccine, then yeah, you, you, you're at the point where the virus has . So few places to attach that it really starts to become insignificant. So am I gonna have to report that information to the CDC?

As far as the number of vaccines that you've provided? Yeah. Or what, yeah. I'm sure that there's gonna be a reporting requirement. There has to be. Has to be. So what if I've, you know, what if I've done 75% more of the first shot than the second shot? I. You know, I definitely worry about that, right? 'cause people will come in and get the first shot and feel like they're probably gonna be okay, or they're gonna come in, they're gonna get the first shot, they're gonna feel like crap because that may very well be a side effect.

And then they're gonna decide to decide. They're gonna decide that they're not gonna go back and get the second shot. What's that effect gonna be? How many of those people are gonna fall into this? Yeah, into this, into this, you know, bucket. Alright, so let's, and what does that do for immunity, right?

Because we know. For other things like taking, uh, antibiotics, you gotta take all the antibiotics or you might just supercharge the bug. I don't know if it works the same way for a vaccine. We'd have to get a public health person on, but alright, so, so then let's move beyond. Let's, so people start getting it and actually the, the, the timeframe to me, I'm not worried about the summer.

'cause you know, as we're seeing in like Australia and other places in the summer, this thing did not. Really take off. It is, for whatever reason, more, more outside, more, more ventilation, whatever the reason is. I'm not a doctor. Don't, don't hammer me on these things, but we're seeing this in the southern hemisphere right now.

It's summer, it's not spreading as much, but we're in winter, people are indoors. It's, you know, we have, we have, uh, surge going on all over the place, but in the spring I'm worried about. You know, a certain amount of people are gonna have gotten the vaccine. A certain amount of people will have had covid.

And uh, my guess is it's gonna start looking like normal come March or April, and it really probably shouldn't yet look like normal. So how, how do we go back to normal safely? And, you know, is it a, is it a passport? Is it, is there a technology solution? I. How am I gonna know that Drex has had the vaccine and this person hasn't had the vaccine?

And, and, you know, we get to, let's, next major holiday would be, uh, Easter or Memorial Day. Mm-Hmm. , that kind of stuff. When we start to start to get together again. How are we gonna know we're safe? Mm-Hmm. . Well, I, I mean, I think it's the same, the same kind of thing we do now, and I think this is gonna go on for a while.

You're gonna have your bubble, you're gonna, probably, a lot of people are gonna continue to wear masks no matter what. Even if they've had the vaccine. I think we're gonna find out that people are gonna say, you should continue to wear the mask. Yeah. Just because it's hard to say somebody not wearing a mask, did they have the vaccine?

Right. You get into this whole issue that you were talking about earlier. The whole passport thing, you know, worries me a little bit because then that gets into the, you know, the ability to, to do fraudulent stuff. I know that there were several companies that looked early on into this idea that you could go to NBA games if you.

I took the survey about feeling not feeling well, or if you had the vaccine or you know, whatever. Then trust me, you can get into the really good show up, show up 15 minutes before the game and you can get in and otherwise you have to go through this sort of the, the, the, the line where they, they give you all, you know, you have to pass through all the tests, but man, it, it's, I think it's still pretty messy.

I think we're all very hopeful about the vaccine. We know that it's coming soon. You, you have some vague idea where you are in line, but there's, there's all the messiness that's around this right now. And that includes, I mean, all the logistics stuff, right? The, you know, the cold chain for some of these vaccines are really hardcore and, you know, you don't wanna get, I mean, if you get a shot from a spoiled, you know, batch of vaccine because it warmed up, you wouldn't know that.

And what's that effect going to be? So there's a, there are a lot of things, I mean, even. Buying refrigerators. You know, I'm talking to friends at health systems and their health systems are buying refrigerators now. And then I'm talking to friends at smaller health systems in rural communities who are like, we can't afford those refrigerators.

So you know, when, how are we gonna get the vaccine? This whole thing is really sort of. Continue to amp up the haves and the have-nots in healthcare, you know, bigger health systems and rural health systems and smaller communities. And I think, I think we're gonna continue to see this exacerbated a little bit as we get into the vaccine march.

Yeah. Well I think we've done our duty here. We, we did, we had a couple people that we were, we were on the phone with. Earlier last week where they said they were gonna do a drinking game and drink every time we said the word vaccine in the show, , at this point, they're underneath the table where you've said the word vaccine a fair amount.

It's, uh, these are, these are some interesting questions and it clearly is not answering these questions by themselves, but there's, there's an awful lot of, you know, data challenges. There's, uh, scheduling. There's follow up, uh, messaging. There's, uh, reporting, there's, there's an awful lot of challenges associated with this that will fall squarely on the health IT leaders and, and you know, it, it, it will be interesting.

I've not heard of a system yet that I've talked to who said, yeah, we've got this wired. We feel pretty good about it. There's just, it's, it's new. There's a lot of unknowns. Yeah. It's. It'll, it'll be, it. It'll be interesting to see as we get into January how this evolves and whether or not we have a national plan that is then, you know, duplicated by the states.

I mean, the challenge is, I. Vaccine is coming. Like you get it, somebody's getting it next week. So if we have a plan, it, we need to know what the plan is. I'm totally with you, bill, and, and I'm not, I don't have my, I don't, I don't have my head wrapped around it yet. I'm not seeing it. Yeah. I'm not seeing it.

And I, I actually talked to somebody in Florida yesterday. I said, you know, what are the five health systems that are getting it? And they're like, they can only name four of 'em. And when they were done, I'm like, okay, you didn't name any in Jacksonville and you didn't name any in southwest Florida.

They're like, yeah, I mean it's, you know, it's going to Miami, it's going to Orlando, it's, it's going to the major metropolitan areas because that's where. Yeah, you know, outbreak and I, and I understand that, look, the supply chain, uh, it's not like they can, they can pump out, you know, 50 million doses in December.

It, they've gotta ramp up the supply chain. They've gotta make sure that, that, that the supply chain lasts as long as it needs to last, which is a fairly long time. At this point in order to, uh, uh, because we're, we're not only talking about VA vaccines in the us we're talking about vaccines around the world.

Around the world. Yeah. Yeah. I mean, even the simple things like the glass vial problem and, you know, on and on and on, it's, it is a, it is a super complicated logistical challenge to resolve and, uh, hopefully we have some good people on it. Yes. And I, and I think we do. And so your, your space geek, we're gonna talk about SpaceX.

Uh, high altitude, Starship, we'll talk, Providence has actually announced their remote work. Yeah. Back, back from Covid. So we're gonna, we're gonna hit those in, in a minute. But I, I do need to discuss the Cliffs Referral Program. My, my team will be mad me if I don't.

An email 24 hours after each episode airs, it'll have four video clips. It'll have a summary and it'll have bullet points of the key things that were said. This is a great way to stay up to date. Great way to hear from, uh, great leaders. We just had Darren Dork on. This, this week actually, this Fri or last Friday we had Marty pass away.

He was, he was really good. I Darren, because I loved his background with all the old Mac computers and everything sitting back there. Yeah. Cadore 60 fours and yeah, I've been, I, I've been in there a couple times. He, he has fired, he fired up the trash 80. The TRS 80 radio, it's a Radio Shack machine. Uhhuh, uh, back in the day, he did fire it up, he said, and the, you could smell that sort of, uh, burning silicon smell.

And he goes, I, I thought it might be smart to, to power it down before I, I burned down a building in, in Beverly Hills, so. Yeah, you can imagine. I, it amazed me that, that, that those things run, but he, he swears that almost all of 'em will, will power on if you, uh, it's quite the collection in his office in that outer area and then in his office too, old computers.

Yeah. I think that's a hobby of his, and it's, it's pretty amazing. Well, yeah. You've been down there to help with the accelerator as well, haven't you? Yeah, yeah. Yeah. He's a, you know, they, they, they have quite a. I mean, you know, Darren just on his own super smart guy has, you know, does, does everything from, you know, investments to being the CIO at Cedar-Sinai.

Pretty, pretty incredible career. I. But the accelerator just on its own, you know, was, you know, one of his, and the team's brainstorm down there to be able to bring companies in that, that have opportunities to change healthcare. And they've actually been really successful. Many of the companies that have gone through this accelerator, the accelerator, have gone in, gone on to be, you know, really successful.

So, well, the, the thing I like, and I'll get back to notes, sorry, sidetracked with on the show. You know, I, I, I send the guests like, Hey, here's, here's, here's the topics. Here's some questions I'm thinking about asking. And for the most part, I, I stay on those. And when I get on, get On with D Darren, he essentially looks at me and says, yeah, you can ask these questions.

Ask me anything you want. Let's talk, let's talk about whatever you wanna talk about. So he's one of the few people that I can just go, Hey, you know, I, I have this question, you know, and, and, and, and he's been great to answer. The things they're doing. CliffNotes referral program. If you're not, uh, participating, the easiest way to do that, just go to, uh, go to our website.

You can, uh, hit subscribe and you can subscribe to CliffNotes if you want to, uh, recommend it to somebody. Right now, we have this referral program going on. If you. If you get one referral which directs you do have a referral, by the way, . Um, if you get one referral, you're entered in the, in the program, so you can receive a work from home kit, and we're gonna do that drawing on January 1st.

If you get 10, you get the, uh, black mulkin notebook, which is sitting over there on that table where I, where I was journaling this morning. And if you are the, uh, number one vote getter, I'm not gonna force anyone. But you get the opportunity to come on this show and discuss the, uh, health IT news. With us.

And if you're wondering if it's too late, it's not too late. Where this goes all the way through the, the month of December, and the leader on this only has about four or five, uh, referrals. So nobody's gone out. Oh, man. And gotten 20, uh, we've got a whole bunch of people that got, you know, 5, 4, 3. So it's actually a pretty close race.

I.

You know, I think the, the best way for this is if ACIO were to send it to their staff, the whole staff, the whole staff, and say, Hey, you should sign up for CliffNotes. Uh, they, they would flat out be the, be the winner and for sure. And I, you know, I think it would be interesting actually, if I were A-C-I-O-I would do that.

And here's why I would do it if nothing else. You set the foundation for your team staying current and having good conversations. So it's, yeah, that, that, that's why I would do it. Do that. Send, send them an email and tell 'em to sign up for clip notes and three extracts. , if you do that, you got, you got the old double whammy going and you know, you know your team's gonna know what they're talking about.

They're gonna, they're gonna be in the know. Yeah. So. I'm gonna save the SpaceX ones for the end. That'll keep you tuned in, uh, to the show because I know you're, uh, you're a huge SpaceX fan. Well, it's just a space case. Space fan. Yeah. Alright, Providence, how Providence will bring back remote employees. So Providence is in your neck of the woods, 51 hospitals and an awful lot of people working from home.

Let's see, with the vaccines closer to reality, providence has. Virtual work strategy for administrative employees to modernize how work will be performed in the public health, post public health crisis. What we'll be doing in the future is giving employees the ability to have more flexibility, collaborative, engaging, work experiences.

Mr. Till said a lot of that is accelerating. Plans that have been working. We've been working on for the last several years, and we've projected what the future will look like. Mr. Till, by the way, is, has to be in this article earlier, Greg Till Chief People Officer. There you go. Yes. hr. Mm-Hmm. . There you go.

July 1st will be the earliest that remote administrative employees can return to. Facilities, facilities, and offices. They can't work productively from home. Mr. Till said a few employees will work onsite daily, and a few will work from home daily. But most of Providence's administrative workforce will work anywhere from two to four days a week from home.

Where an employee works day to day will be based on the individual and their role. He said based on what we've seen so far during the pandemic, we believe that it's going to be something that improves our employee experience and their productivity, uh, our indicator that gives us confidence. This approach is our recent employee engagement survey showing that seven point improvement from those who have been able to work remotely.

Providence will replace personal offices and cubicles with flexible, open and shared hotel work and collaboration spaces to support the hybrid model. So, you know, the reason I pulled this story up is because I, I, I've talked to a lot of CIOs about it and, uh, this is the first one that's just out coming out and saying, Hey, this is what we're gonna post.

Covid have others this. No, I think there are a lot of folks who are thinking about it and considering what the, what the process is going to be to bring people back, or even if in some cases they're going to bring people back. Because I think there are a lot of folks who are thinking, long-term, this work from home thing may be a thing that at least some subset of employees are going to be very well suited for.

This is the first one that I've seen sort of publicly announced. This is our process and, you know, up and until July 1st, and probably gonna change the until July 1st. If you wanna work in the office, you're gonna have to get permission, kind of is how it sounds. Oh yeah, absolutely. Yeah. So it's the, it's the first one I've seen and it's good.

I'm glad again, people are kind of thinking over the curvature of the earth. This is going to ultimately get resolved and you're gonna have to figure out what you're gonna do post. Vaccine administration post pandemic. How are you gonna run the show? What do you, uh, curvature of the earth. What are you talking about?

It's not flat . There's, anyway, the.

Is that not everybody can work from home. And I, I, there's, there's aspects of this, I'm not sure we've thought through completely and, and we'll eventually as, as situations come up, but let's assume an employee starts to struggle working from home. They, you know, miss a couple meetings. They, for whatever reason.

You know, is, is the, is the follow-up? Is the, is the performance plan to bring them into the office so we can watch them more closely? It just, I'm wondering you, I mean, you've worked outta your home. I've worked outta my home. I've said this on the show before. It's not the easiest thing in the world. I, I think everybody thinks it's, oh, this is great and.

It, it does take a fair amount of discipline to keep that door closed, to stay at work, to not, you know, go play with the kids, go play with the dog, go, you know, whatever. It, it, it takes some discipline. So I'm wondering what the, are we training people to work from home and, you know, what are, how are we gonna address people who struggle to work from home?

Yeah. I think, I think if you're, you know. As you have people work from home, companies that have done this well, have done a lot of sort of training for those folks. Uh, here's how to set up your work environment. Here's the things you can do. These are things that you shouldn't do as far as distractions.

And then a lot of it is, you know, definitely the person. I'm a great morning person by the time I get to early afternoon, I'm my ADD kicks in. I start to get really super distracted with everything and I have a hard time getting things done in the afternoon. I have a lot of friends who are, you know, their, their sort of chronic complaint is, I don't have any rituals about, you know, I used to have to get up in the morning and take a shower and then get in the car and drive to work, and that's when work started.

And then I left work and I drove home and I saw my dog and took him for a walk, and that's when the day ended. And it, it's a much more difficult thing when you work from home. Everything runs into each other. People are finding themselves working 16, 17 hours a day because. It's just they don't, they don't have a clear break point in their day.

So you definitely need a lot of sort of ongoing training and coaching about what you expect from employees working from home. And then the other problem is, you know, not everybody has a place, not everybody has a workspace, you know, like you and I do. A lot of people have roommates and two or three of them, if you live in an expensive place like Seattle, and so trying to get work done, when you have two or three people trying to work from home, that's a whole challenge in and in and of itself.

And then of course you have kids and you know all the other issues that go with it. It's not the easiest thing in the world. Yeah. But even just the stuff you just said had so much wisdom in it. Right. It's, it's, uh, understanding your work. So I get up at roughly around five 30 every morning and the reason I do is 'cause I know I am almost worthless afternoon

So, and, and actually I knew this when I was the CIO as well, I, I planned all the really important meetings in the morning and in afternoon I did my. You know, walkabout walk rounds, right? Yeah. Right. So I either went to a hospital and walked around. I walked around my staff. I, I mean, because I, I have energy to have conversations.

I just can't sit in front of a computer and type a, you know, creative presentation or anything creative after working, you know, six or seven hours already by, by lunchtime. I, I, I don't have that creative energy left to really do anything. There's a lot of wisdom in that. I have seven things. Uh, every morning I come in number one, clean off your desk,

I, it's, it's crazy, but I will, I will tank as an individual if my desk is dirty, like I, I. Function. And so the first thing I have to do is clean my desk. I do that every morning. I, I, I create a daily planner. What are the things I need to get done today? I read and journal. I do a daily post. I have one problem that I get outta the way before I eat breakfast, and it could be write a difficult email.

It could be whatever, but you know what that represents drex. And the stuff you just said represents, it represents. Decades of working from home. Mm-Hmm. . Yeah. And being self-aware and really thinking about, you know, not, not being mad at yourself because you can't focus as well in the afternoon as you can in the morning, but consciously building a program.

For yourself that says, I'm gonna take advantage of what are my natural strengths. So if I'm good in the morning, let's do all the hard stuff in the morning. Let's do all the socialization in the afternoon. It still takes energy, but not nearly the same kind of focus and. For me, I mean, I was the same way.

Great in the morning, a little weaker in the afternoon when it came to focus, but what I had in the afternoon was a real ability to sort of be empathetic and listen and sort of process, that kind of stuff. I was better at that in the afternoon than I was in the morning, because in the morning I was trying to figure out how to get through a pile of work.

Yeah. So, yeah, and, and . As a leader, I would say the same thing. It's not only knowing yourself, it's knowing your team. So you have to not only figure out these things about yourself, you have to figure out these things about your team. 'cause you wanna take advantage of their natural strengths too. All right.

Next year you're gonna be my, my person to go-to for, uh, space, uh, story. So, SpaceX first, high altitude Starship test. Tuesday, what does this mean? I mean, first of all, what is the Starship? Why should we even care? And what high altitude tests, I mean, what they're gonna take this thing higher and then do what?

Yeah. So, you know, I'm definitely not a space SpaceX expert, but I've become a, a pretty big fan of the many of the programs over time. Starship is sort of the . That's their actic. The deep space. Exactly. That's the deep space. That's the going to Mars spaceship. And there's a lot of work and a lot of testing that's going on with, um, with Starship right now.

And if you've seen, they've done some short hops with Starship, right? This is just the ability to make sure that they can land components, how is this going to work? And basically it looks like a giant grain silo and they sort of take it off, take off, and they move it, you know, 50 yards across the . Ground and then they set it down again.

Well, this is going to be, if they, if they get it done today, they'll do about a 50,000 foot test. So they will launch this thing 50,000 feet in the air, then they will bring it back down and try to land it. And so for every one of these, there's a lot of systems. I mean, these are super complicated machines and, um, trying to get one back and not break it is a super complicated task.

And so it's gonna be kind of fun to see. You know, as, as we saw with the, you know, the falcons, the, you know, sometimes you gotta break some eggs before you sort of figure it out. So, you know, I, I fully, I fully anticipate that this will not go well and I. They'll learn a lot from that, and then they'll do it again and again until they get it perfect.

Yeah. So, you know, it, it's, it's hard not to root for Elon Musk and, and he does some goofy things. He says some goofy things, but at the end of the day, it's hard not to root for the guy. I mean, he gave us Tesla and he's given us SpaceX and you know, there's, there's such promise in both of those things.

Yeah, I mean, you look at SpaceX and you, I mean, you look at the Start Link program that he has going on right now, or he's just dumping satellites. I mean, almost on a weekly basis now, going up and dumping high speed internet satellites into the atmosphere. Into the, into the. The space atmosphere. And you know, the idea for that would be that a lot of places that can't get high speed broadband today would be able to get it and have good solid high speed connectivity.

And that, that has all kinds of implications for us. And we talk a lot about five G and how five G is gonna change everything. But I really think now we're getting into predictions maybe. But I really think that. You know, starlink, once starlink is really up and running that a lot of rural facilities and you know, rural healthcare organizations that don't have access to that kind of broadband, it's really gonna change the world for.

A lot of people who just don't, you know, we take it for granted 'cause we live in a city, but a lot of rural places, it's, it's dark out there. Yeah. And I, we might as well just go into predictions. And by the way, I agree with you on this one specifically. I think, uh, five G's day in the sun is a couple years away still.

First of all, the build not there. Second of all. Uh, it, it to, to be honest with you, there, there's still some, there's still still some hurdles in terms of, uh, coverage and, and some other things that they're gonna have to get through, getting through buildings. And, and so we still have, we still have a bunch of hiccups to get through before we get to where we want to get to.

And second of all, we already have a fair amount of bandwidth with, with . MM, with with four G and most of the time you're on a ne network anyway. We've proved that people can work remotely, which means if people can work remotely, we've proved that almost everywhere we can reach with this computer. We can do remote, remote patient monitoring and do all sorts of, we, we could start to stand up acute care facilities in the home, but I.

Now what you just said is probably going to be the biggest thing in the network, and that is, uh, starlink and some of the other competitors that are out there. And we're gonna start to see, I don't, maybe another billion people be brought onto the internet and at, uh, pretty high speeds. And the ability to do some things, uh, in those rural communities, in those, uh, remote communities that are really gonna transform healthcare.

It's gonna be interesting to watch. Yeah. No, I'm with you. I'm with you. I'm, I'm excited about it. You know, telemedicine, telehealth, uh, like you said, being able to do care in the home. All those things really depend on having access to broadband. And there's so many places in the US that don't right now that that's gonna, that's gonna change, that's gonna change you a lot of stuff.

So, any, any other predictions for next year as you look at this? You know, I, so there are things that, that I don't even know about. That I, I, you know, makes me wonder, like, so for example, going back to the vaccines, take another drink, going back to vaccines. One of the vaccines. So usually when you do vaccines, you, you inject some weakened version of the virus or some damaged version, dead version of the virus, and your body reacts to that and builds antibodies.

One of the vaccines this time actually does something, uses a technique called mRNA, which is. I mean, it could get super complicated, but essentially what it's doing is you are inject, you're being injected with a piece of DNA code that is going off to your cells and saying, you need to build this kind of, this kind of antibody and, and then you're building antibodies.

So, so your chance of getting sick at all from that vaccine is, you know, it's, it's not like they're injecting a, a dead vaccine in you. It's, I mean, the, so there are things like that that I, you know, I think we, we don't just generally purpose, you know, regular people like you, and I don't even think about it.

I think there's gonna be more of those kinds of inventions, more of those kinds of discoveries that are gonna be done next year that it's hard to even predict. I, I think back to the old . You know, trials back in the day with OJ Simpson and DNA, and you know, people didn't, people were like, DNA, what are you talking about?

That's not a, that's not a thing. They're just making this up. It can't be a real thing. And now everybody knows about DNA, and now we have this mRNA thing going on. Amazing, ridiculously cool capability that, I don't know, probably just only a tiny fraction of people could really even understand that this is something that could be done.

But once it gets accepted, then your body's immune system sort of goes to work on. I mean, just listening to all this stuff is like, just really drives home your point, which is we're doing things now. That has really been set up by great work that has come up until now, but I agree with you.

Deep mind protein folding ai Oh yeah. Right thing, which is unbelievable in terms of how fat, how much that's going to accelerate that, that solves a 50 year old problem and, and really takes what we just saw with this, with this vaccine, and accelerates it even further as well as some things I don't.

One of the things coming outta Covid outta this pandemic is gonna be the acceptance of digital, the acceptance of ai, and really watch it just go to town. And I think it's gonna start next year. I think it's gonna be AI in, in the pharma space. I think it's gonna be AI automation around communication.

I mean, I think it's.

You know, the thing about AI that, you know, I think, at least in my head, AI is something to me that is always aspirational and we always are looking forward to some AI solution for something. There are a lot of things like, you know, sir Siri or Alexa. That probably fall into that AI category, but once it becomes common use and we just, that's not AI anymore.

We'll, we'll keep doing this every, uh. We'll come together. I, I think it'll be fantastic. Thanks. Thanks for, for this year and hope you have a, hope you have a good holiday. It seems early to say this, but I hope you have good holidays. Thanks. Same, same to you. All right. That's all for this week. Don't forget, sign off for clip notes.

Hit the website. Just hit the subscribe button. Easiest way to do that. Special thanks to our sponsors, channel sponsors, VMware Advisors, Galen Healthcare Healths, sir, healthcare Pro Talent Advisors. For choosing to invest in developing the next generation of health leaders production of this week.

Oh. The, the Covid series, which I think is interesting to hear how all the different health systems were addressing Covid. Yeah. And uh, then we have our top 10 countdowns. So the last two weeks of this year, we're gonna be dropping those shows and you're gonna want to tune into those things. So that's that.

That's a wrap as they say. Thanks for listening. That's all for now.