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 Welcome to this Week in Health It where we amplify great thinking to Propel Healthcare Forward. My name is Bill Russell Healthcare, CIO, coach and creator of this week in Health. It a set of podcast videos and collaboration events dedicated to developing the next generation of health leaders. Have you missed our live show?

It is only available on our YouTube channel. What a fantastic conversation we had with, uh, direct Ford David Mutz. S Shade. Around what's next in health. It, uh, you can view it on our website with our new menu item appropriately named live. Or just jump over to the YouTube channel. And while you're at it, you might as well subscribe to our YouTube channel and click on Get Notifications to get access to a bunch of content only available on our YouTube channel.

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Special thanks to Sirius for supporting the show's efforts during the crisis now onto today's show. This morning we are joined by Chris Ross, the CIO for Mayo Clinic. Good morning, Chris, and welcome to the show. Hey, bill, good morning. Well, I'm looking forward to this conversation. We've, uh, you know, this, this will be episode, I don't know, 53 in the Coon series, , but you're the first one where we're starting to transition the conversation.

To, um, really emerging from the, the crisis. And, and not to be premature, but, but that's where the, the thinking is of the leadership at this point of, you know, what steps do we have to take to, to come outta this. But before we get into that, give us an idea of how your health system has experienced the pandemic so far.

Well, bill, it's been pretty impressive. We've been, uh, fortunate that in the geographies in which we operate, which is in Minnesota and Wisconsin, in Florida and in Arizona, uh, the caseloads have not been overwhelming as they have been in some of the areas that have been particularly hard hit. So, Mayo's role, of course, is to treat patients and we're doing that, but especially because our

Caseload has not been overwhelming. We've had a chance to, to double down on things like research, uh, into cures and treatments. So, uh, you know, a couple of things that have been pretty amazing. One, our commercial LAR lab is large and, um, pretty successful has introduced tests for detection of the disease and for antibodies, and those are in production.

Um, we're doing a lot of work in treatment areas, so. Dr. Michael Joiner is leading a national program on convalescent plasma to take plasma donations from sick, uh, covid patients and use that, uh, inject it into other patients to create immunity. Uh, the FDA just last week approved the emergency use of a algorithm to detect heart failure.

As Paul Friedman, the Department of Cardiology, and who is a renowned AIDS researcher and physician bringing. 30, 40 years of talent, uh, to bear in leading our combined research activities. And as of last week, we had 109, uh, projects underway. Uh, everything from how to recycle masks, uh, to how to provide oxygen better to patients, uh, to uh, do research on community response, those kinds of things.

So while we're continuing to treat patients as the first thing we do, uh, the research and education, uh, shields of Mayo Clinic have been on hyperdrive and been doing really incredible stuff. I, when you talk about this stuff, I get so jealous every time. 'cause you, you guys are, uh, you know, truly one of the leaders and, and out there doing some amazing things.

I do wanna, I do wanna shift a little bit just to. Um, you know, pragmatic. Yep. Majority of our listeners and, and really talk about, uh, the delivery of care. So, you know, as you consider, you know, we saw this spike in telehealth, we saw digital tools, patient monitoring, chat box, those kind of things. Um, you know, talk a little bit about that and, and how you see that stuff integrating into the post pandemic work.

Sure. So we went from a small fraction like everybody else of our visits done through virtual means to the majority of them being done by virtual means. Uh, now that we have the capacity to do more inpatient and outpatient visits, we're continuing to do a lot more virtual care, and it's been in three areas.

One has been dialogue with a clinician, with a patient, excuse me, often by video, but also just by phone. Uh, the second has been, um, things to do to support patients and their family when they're contagious, uh, and may be under constrained circumstances. So think about the iPads and use to communicate with patients in an ICU or similar kinds of devices to help support patients who are in long term.

Care post-treatment. Uh, and then, uh, the, the third area has been how can we get patients home with surveillance with more intensive kinds of treatment? All three of those will continue. Maybe we won't have a pandemic need. To, um, deal with as many patients in isolation. But the two areas of trying to keep people from coming into the hospital and to get them home quicker is something that we're working hard on and gaining some great experience.

And then of course, the, the telehealth visits, um, will continue to be part of our practice. I don't think they'll be exactly the same. A lot of our visits were to maintain patients while they were waiting, uh, to come in for care. And a lot of things require physical touch, especially things like procedures.

Um, but it's clear it's never going away, and it'll be an important part of our arsenal going forward. I. Yeah. And for, for you guys, it, it was a, an important part of your arsenal before. I mean, this was pretty much baked into a lot of the things you're doing. 'cause you guys end up being a destination facility.

You're communicating a lot, uh, remotely with patients. Even prior to this, I would assume. . Yeah. Thanks for mentioning that, bill. I mean, many patients travel a long ways to come visit us at Mayo, so if there's ways that we can have a pre-visit, incorporate it more into our screening and scheduling processes.

You know, we had a lot in the works to try and rev up our digital practice to create more of a consumer experience, to create a more clinically relevant experience for people, uh, without having to come to one of our destination medical centers opportunity to. Prove out the fact that that works. Um, and we're just gonna go faster.

Yep. All right. So you're working from your house. I love the artwork in the background. How have you, , how have you experienced work from home and, and what do you anticipate the future to be, uh, within, uh, your health system? So we had very much a face-to-face culture as a lot of organizations do. We certainly had teleworkers, especially people who could remote work remote in

Task based kind of work, like revenue cycle or those kinds of things. Uh, but we've really tested it, you know, personally. Um, I have a 90 mile commute from my home in St. Paul to Rochester, Minnesota. So it's been nice to not spend quite so many hours, uh, on the road. So that's helped with my productivity a lot.

I think a lot of people now have this experience of, rather than running from conference room to conference room across a campus, now you just jump from. One, uh, virtual, uh, meeting to another virtual meeting. So the productivity isn't bad. Uh, the fact that we all are working at home has been sort of a shock to the system, to force us to have to address our culture.

We're not in a hurry to bring people back on campus. I'm telling my team and the rest of the administrative areas are hearing the same thing, that they should plan to work from home through the end of the summer and maybe into September. We're going to have to do some things to make physical space better.

Uh, to deal with, uh, social distancing and those kinds of things. So we're not in a hurry. We're working well in a virtual way and, you know, I think that's gonna shape our future. That's that. That's fantastic. It'll be interesting to see, and I know that some health systems are creating surveys to gather a lot of feedback and those kind of things.

It was, it was great to you mention Paul Minnesota growing up as a kid, my dad worked his entire career at 3M Travel, Paul. For, uh, I remember as a kid waiting at the airport for my dad to get back from St. Paul from training, and he would tell me these stories of, they have underground tunnels in St. Paul because it's so cold outside

It's, well, that's true, but you know, you're in Florida. But you know, there there's advantages of being in Minnesota too. It's right now, it's gorgeous outside. Yeah. I.

So my data team, for example, has really pivoted. In supplying a lot more flexible, deeper, richer data to help those areas. And we've had to shelve a couple of other things that our data team would otherwise work on, but it's exactly the right thing to do. But what I'd also say, bill, is, you know, the triple AIM goals didn't go away.

Cost of healthcare in the US is still too expensive. It's still still too inaccessible. Uh, it's not affordable. Uh, and we can improve quality and outcomes. Those don't go away. So hopefully we'll take some of this hypercharged Learning from this public health event. Apply it to other diseases, uh, to move on them with the same level of urgency and immediacy.

We're excited about that. Uh, and believe that we, we really can use this as an inflection point. Will, will there be a reevaluation of some of the projects? 'cause you know, you're talking about, we, we set these projects probably nine months ago, a year ago, where the conversations were happening. Uh, has the world changed enough to reconsider some of the projects that we, we prioritize back then?

Well, for sure. So our clinical practice canceled right off the bat, about 80% of the kind of keep the practice advancing projects. We expect to restart most of them, maybe all of them, but you know, I'll bet that some will be sidelined. Um, the good news, and I, I don't wanna brag too much about Mayo, but we had been making some areas, uh, some movement in some important areas like the improvement of digital care.

We also launched a platform business where the intention is to use data and technology to work with partners to bring more powerful cures to a broader population than maybe could be treated again by coming to one of our destination medical centers. And we've already started partnerships in, uh.

Discovery with data to look for new cures in, uh, new, uh, pharmaceutical cures. We've been working on home hospital initiatives and we've been working on remote diagnostic and disease management, uh, capabilities all within this platform idea. So to some degree it's a, it's an affirmation that the vision that our, uh, CEO Dr.

Riko Faria brought into office a year and a half ago is just as current, if not more current. So what we have to do is to deal with the conse, the financial consequences of this crisis, uh, to keep our eye on the ball on treating patients as we get through the pandemic. Uh, but then I think to some degree, bill, we're just gonna put more logs on the fire on some of the initiatives that we had already started.

Yeah, that makes sense. Um, you know, we're, we're seeing signs that claims data is growing, which means the, the volumes are starting to tick up, uh, really across the country. And what kind of things is your health system doing as you expand procedures in, in the way of safety, in the way of, uh, just preparing the health system to receive visitors again?

Yeah, it's a great question. And Job one obviously is safety. Making sure that our, that our patients and our staff are protected, uh, from C Ovid 19 if they come into our clinics. So, uh, you know, healthcare is a very human intensive. Kind of endeavor. So we have the capability to use our registration and our nursing staff to screen patients, to give them clear indications, uh, to, uh, do covid testing on everyone who needs it before they come to the clinic.

Um, and then provide, you know, wall to wall support. Uh, throughout our operations. So I'm working with my colleagues in facility and, uh, safety, um, and, uh, security, um, to help the practice with things like how do we route people around our facility and get people, uh, to use less crowded waiting areas. How do we do more touchless things?

Uh, fortunately we have a completely a touch-free payment environment. So if someone wants to pay using, you know, Google Pay or Apple Pay, they can do that in our environment without having to touch anything. We're looking at things like signature pads and we've taken iPads out of circulation. We'd like to get, figure out how to get those used safely again.

So it's kind of a thousand little things Bill safety. It's reassuring people that they.

We know that across the US people are delaying care and that's really a bad thing. Um, you know, you have to worry about the people with chronic diseases who are not getting timely treatment. So we need to reassure folks. And then again, because a lot of people travel to come to Mayo, we have to work with airlines and hotels and hospitality, um, to create a great community environment.

Uh, when people come to see us. Yeah. So as, as we start to, uh, receive patience again, are you planning or are actually, I know you're planning, so what kind of planning are you putting in place for a potential second surge if that happens? So we certainly have contingency plans in place, uh, as I said in, in most of the geographies in which we operate, the curve got bent pretty well.

Although there's certainly things to worry about in all of our geographies and of course nationwide.

But, um, you know, I think we have a lot on the shelf that is ready to go. Uh, there's some of it that was the best we could do in the moment that we're going to wanna refresh and make sure it's, uh, as good as possible. Um, we've done some things around, uh, contact tracing within our environment. One of our occupation, occupational health physicians, Dr.

Laura Breer, um, worked with a tech team to create a, a very rapid and contact tracing tool. So we can assure that our staff is gonna be safe, um, uh, when they're treating our patients. I, I think we're ready to go. Um, we certainly hope that the second surge isn't significant, but, you know, all the data suggests that this is, you know, the first chapter in a long book.

The contract tracing, uh, solution you talked about, is that something other health systems can implement? So we wrote, uh, uh, Dr. Breer wrote it up as a white paper and it'll be published in mail proceedings. It may have already been published actually, um, this week. But, um, it, it's a considered a blueprint as opposed to a tool we can share with other people.

It, it combined some lab results data and our epic data and some HR data, um, and kind of glued it together in an agile fashion. So hopefully some other people can use that as a blueprint, but we, unfortunately, it's not something we can just give away as is, but we are giving away interesting's. My last question, you know, what do consider the greatest learning, uh, to from this experience?

So, you know, one of the cliches that's not a cliche is, you know, we learned how to do 10 years worth of change in a couple of months, and that's true. The cultural requirements were true. We battle tested a bunch of things, and we found that sometimes good enough is good enough. We always want things to be perfect, um, especially at a place that's as demanding as male.

Um, but we found that, you know, simple, lightweight, good enough is probably okay. The, the second big thing that I hope will have legs, uh, bill, is we have been struggling to communicate. Broadly about our mission to use data ethically and responsibly to drive new cures. And people see that as a trade-off between their privacy rights and the ability to create cures.

And, and I just don't believe that. I think it's a case of, and not, or I think we can protect people's privacy, uh, and still use data to advance medicine. And my hope is people will come out this understanding. Uh, by sharing data and by working together in big collaboratives, not just in the country, but around the world, uh, we were able to address this illness.

And hopefully that will make people understand that even while their privacy is sacrosanct and we're absolutely committed to patient privacy and the security of their data, that there's value in that use of data. And my hope is that that will unlock unbelievable potential, uh, that there's incredible cures.

Uh, that are just waiting to happen. Uh, if we can use data in more progressive, interoperable, immediate right now kinds of ways. So I'm excited about that too. Chris, you I, that, that's fantastic way to end, which is a segue to we're gonna have to have you back on to have that conversation, 21st century tours.

We have just, uh, your work with Google. Uh, there's so much to talk about, but, uh, for another time, thanks again for your, your time and coming on the show today. You, but Bill, thanks for doing these shows. They help us all learn from each other and they help us advance. It's really been a service to the country and our industry.

Thanks very much, and I'm honored to have been here. Thanks, Chris. Take care. That's all for this week. Special thanks to our sponsors, VMware Starbridge Advisors, Galen Healthcare Health lyrics, Sirius Healthcare and Pro Talent Advisors for choosing to invest in developing the next generation of health leaders.

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