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 Welcome to this week in Health IT News, where we look at as many stories as we can in 20 minutes or less that will impact health it. My name is Bill Russell Healthcare, CIO, coach and creator of this Week in Health. It a set of podcasts and videos dedicated to developing the next generation of health leaders.

I am in a hotel room, as you can see. If you're watching the video, if you're watching the, if you're listening to the podcast, you have no idea where I'm at, but I'm in New York City. Gonna hang out with a couple of, uh, CIOs and, uh, this week in New York, and look forward to that conversation on innovation and, uh, maybe sharing some of that with you, uh, in the future, uh, depending on what we talk about.

Looking forward to that. But there's a lot of news stories going on this week. We have the, uh, start of the, uh, clone wars. No, not the clone wars, the voice wars. We have, uh, Amazon transcribed medical, uh, has come out. Uh, we also see that, uh, let's see. Down here, Microsoft Nuance and Microsoft have announced a partnership.

So we'll read that together, see what that's about. Uh, the va VA sees a surge in veterans using telehealth services, uh, and we will talk about that. Amazon taps, uh, first pharmacy for Alexa medication management. Uh, apple has, uh, survived the backlash of tech, uh, the tech world while Amazon, Google and Facebook continue to get it, and it's about trust.

Uh, Publix commits 4 billion to food donations and many . More stories to cover. So, uh, we're gonna do, uh, we're gonna do the same format we did last week. It was our first attempt at it. I got a little bit of feedback, but I think the holiday week, uh, stifled the feedback a little bit. Um, but what we're doing is, uh, you got tired of me just saying, Hey, I've got 10 stories and I only cover three.

Uh, so what I'm gonna do is I'm gonna go through 10 stories real fast, uh, what the story's about, and, uh, what the, so what is on the story, and then come back to a couple and go a little deeper in that. And, um, and that way we'll get to all 10 of the stories. Uh, we wanna thank our founding channel sponsors who make this content possible, health lyrics and VMware.

If you wanna be a part of our mission to develop health leaders, go to this week, health.com/sponsor for more information. This episode is sponsored by Health Lyrics. When I became ACIO, uh, I, I was really overwhelmed at first, and one of the things I did right off the bat was to hire ACIO coach, uh, to walk with me through the journey.

Uh, this is someone who has wisdom that can only be gained through years of experience, uh, and it was invaluable to my success in the role. And I now coach CIOs through health lyrics. Uh, if you wanna learn more, visit health lyrics.com or drop me a note at Bill at this week in health it.com. And don't forget, we still we're in the last of the, uh, handful of Chime CIO interviews.

I think they'll go through the, uh, through Thursday of this week. And then on Friday we're gonna hear from, uh, SCL Health, the guys in, uh, uh, Craig Richards and the uh, uh, people from, uh, Colorado, Denver, Colorado. So. And, uh, also don't forget, uh, Drex to forge new service. Uh, three X Drex. You can, uh, get, uh, three stories texted to you three times a week from ACIO perspective.

Uh, just text drex to 4 8 4 8 4 8 and, uh, you'll get those. And I, I like calling that out because, uh, again, I, I love using his service, uh, to identify some of the stories I'm gonna talk about. Okay. So. Gonna do a little different. We're gonna go through the top 10 stories and, uh, see what we talk about.

Let's take a look at am Amazon Transcribed Medical? This is probably the newest of the stories, and, uh, the reason we're talking about the, the reason it's one of the newer the stories is you have, uh, the Amazon Reinvent Conference going on this week. And, uh, with that you will have a bunch of Amazon announcements, uh, coming out.

They're extending that to medical speech with Amazon, transcribed medical, and you know, it's, um, let's see. Thanks to Amazon transcribed, medical physicians will now be able to easily and quickly dictate their clinical notes and see their speech converted to accurate texts in real time without any human intervention, clinicians can use natural speech and do not have to explicit, explicitly call out punctuation like comma or full stop.

This text can then be automatically fed into a downstream application such as ERR systems or the AWS language Service, which Amazon comprehend medical for . Uh, entity extraction, uh, in this spiritual. And so you have, you know, so they release the service, you, uh, record in a standard, uh, format. You send it up to transcribe medical, it then takes it and turns it into text.

Uh, I'm not gonna say the so what on this and tell, I get to the next story and then I'll come back to it. So, uh, nuance in Microsoft announced partnership to tackle clinical burnout. And this will be around voice. Um. ACI is built on nuances. Dragon Medical one Cloud platform and speech recognition and natural language understanding technology.

The partnership will combine nuances, expertise of conversational ai, clinical documentation and decision support solutions for healthcare with Microsoft strengths in delivering cloud and AI solutions. Dragon Medical one, a secure cloud-based, uh, . Speech platform for where physicians and other clinicians already helps securely document, so forth and so on.

A lot of people have nuance throughout their health systems. Uh, this, uh, represents the next step, I believe. I think you're gonna see voice, uh, we talked to Orbita. You're gonna see voice platforms start to emerge that allow you to automate the, uh, workflows within the, uh, health system. You're gonna see, uh, voice and AI come together so that you're gonna see, uh, a lot of this really address the, uh, clinical burnout.

And, um, you know, clinicians didn't sign up to be . You know, uh, data entry clerks. And, uh, it leads to so many issues, so many problems. Uh, it's much better if the technology understands what's what's, uh, being said, and, uh, and, and makes that into a note that's readable and then takes into account that things that need to be taken into account in order to create

The proper bill, the proper regulatory environment, and all those things. So you start to take all that burden off the clinicians and make that, uh, uh, really handled by the computer systems. And this is gonna be a, we all know this is gonna be a significant move forward, uh, in workflow, in, uh, the, the, uh, experience for the clinicians and the experience for the patients.

This is a good thing, and I'm glad to see. Uh, the Titan's weighing in, you know, the Amazon's and Microsoft's weighing in. You also have Google weighing in, uh, as well with this, uh, you have them bringing their AI technologies, their machine learning technologies, uh, their cloud technologies. So you're gonna see this, uh, proliferate very quickly, I believe.

I think you're gonna see, uh, you may want to reevaluate your. Voice technologies and really look for platforms next year. So the so what for this is, uh, next year is the year to really start to figure out what your platforms are gonna be for conversational and voice technologies throughout the health system from the patient interacting with voice in the home.

That is communicating back to the health system all the way to the operating room, to the, uh, exam room, to the clinician's office, uh, across the board. Uh, we, the keyboard is not going away, but the keyboard will be minimized significantly in the, uh, interaction with the EHR. Um, so, you know, and there's gonna be a lot of different plays.

Up 235% in the same period. Uh, they also, uh, have noted in here that a majority of that is, uh, veterans using the, um, mental health through telehealth platform. So, uh, you know, so there's two big wins here and I think . Bode well for, um, organizations that are looking to make a business out of, uh, telehealth.

Telehealth is a much better experience than going to an urgent care center. It's a much better experience than, um. You, you know, when you need behavioral health, when you need, uh, to sit down and talk to somebody, you need that experience very quickly. And so, um, you know, we talked to, to Ginger at the, uh, health conference, and I love their concept of, uh, and now it's very limited.

It's, you can only do it within a. An employer program, but I love the concept of when you need help, you can get connected. Um, you know, within minutes, hit the app store, get the Ginger app, be talking to a, uh, a clinician that quickly. Um, so the so what for this is telehealth. I. Is a viable business model, it will continue to grow.

You have to figure out how to get it paid for. Still, that becomes still the challenge. The thing with the va, and the reason we're seeing it surge in the VA is because there's no payment mechanism. It's very easy, uh, to do so we, the, the payment mechanisms still have to marry with telehealth services. But, uh, I think what you're seeing is people saying, Hey, I'm willing to pay for the convenience.

You know, 10, 15, 20 bucks, we have to figure out what that, uh, what that equal equilibrium is on the price that people are willing to pay for that telehealth visit. Uh, and then it, you start to expand it and, and then expand the services on top of it. So, uh, I think that is a, an important move. Let's see.

That's the VA story. Let's go to this one. This is, uh, modern Healthcare story. Amazon taps first pharmacy for Alexa RX management. I. So Amazon on Tuesday unveiled. What the company hopes to be the first step in a broader effort to let patients manage their medications. Using Alexa, the company's voice assistant is the cornerstone of the tech giants push into the healthcare sector.

This past spring, Seattle based Amazon launched the invite only program for healthcare companies, including hospitals and health insurers to develop skills and transmit. Uh, protected health information through the Voice assistant while meeting HIPAA compliance. The new skill collaboration between Amazon and Medication Management Company, Omnicell was built as part of that program.

Uh, Amazon partnered with supermarket and pharmacy chain Giant Eagle for the skills initial launch. Customers of the chain, which has more than 250 pharmacy locations in the Midwest and Mid-Atlantic, are now able to review their current prescription set reminders and take medications and request prescription refills through the new Alexa feature.

Um, the reason I highlight this story is I think it's important for us as healthcare providers, healthcare, health, IT providers to realize that there is a, uh, there is a, uh, battle for the, uh, for the home. That is, uh, starting to go on and we, we want to be in that battle. We want to be in that conversation.

And right now what's happening is you have Amazon, uh, hooking up pharmacy information, uh, probably through their pill pack or, or, or through this partnership, um, where people like my father-in-Law, who are 87 years old, who forget to take their medications. You can set reminders on Alexa. Now he interacts with Alexa, with his Amazon Echo, uh, all the time.

It's, uh, you know. It, it plays his country music forum. It, uh, it really is kind of an amazing, um, an amazing dynamic between an 87 year old, um, uh. Whatever, octogenarian, whatever the, whatever the term is for it. And, uh, and technology. And it's, and it's a very natural connection. Uh, he, he talk, he asks about the, uh, football scores, about what games we're on today.

Um, you know, how are the cowboys doing? I. And, uh, you know, it's a, it's a very natural, they've, they've created something that's very, uh, interesting and it connects very well into the natural workflow of the home. And I think we as health system providers need to be thinking about how we're going to do that.

So that's the so what on that story, and it's why I highlight that story. Uh, let's see. Publix commits $4 billion to fund, uh, donations to alleviate hunger. And as I said last week, you know, 70 to 80% of health is not healthcare related. It is related to social determinants. And I, I think we should not, uh, minimize these stories.

We should continue to, uh, highlight them in our communities. Um. And, uh, by the way, this is on the heels of them already contributing 2 billion in food donations. So this is actually doubling up on that. And, uh, the commitment commitments over another, uh, another 10 years, I believe. So another $2 billion towards, uh, food donations to alleviate hunger.

Um, again, partner with. Figure out the partnerships that are gonna matter for delivering health. Um, healthcare is about restoring health. Uh, how are we gonna deliver health, keep people healthy in our communities? And I think it's through partnerships with companies like Publix who are, uh, making these kinds of commitments.

Uh, we talked about Amazon reminding you of your pills. I did these stories out of order or nuance, Microsoft, we talked about that. Um, here's one. Patient's open to remote monitoring. There it's patients open to remote monitoring to reduce doctor visits, survey shows, and, uh, overall interest in wearable certain devices such as Fitbit and Apple Watch was high with more than half of those polls saying they would use such a device at home.

And, uh, I, I think the important thing here is to, is to realize people are willing to trade privacy for, uh, for convenience, for cost. For benefits to them. So there is a, uh. Uh, these ads now that are coming out, you have people who are driving around, don't mess with my discount, right? So they're driving around with an app on their phone, which is monitoring the, their, uh, movement of their car, their speed of their car, and where they're going.

And what people are essentially saying is, you know, what, for State Farm or for, um, uh, progressive or whoever it is, I think it's, those are the two I remember. Um. You know, I'm willing to trade my privacy information if you are willing to reduce my costs or if you are willing to fill in the blank. I think that same opening exists for healthcare.

Uh, if we're willing to walk through it, if we're willing to come up with the solutions that add value to people's lives, reduce the cost of care, improve their overall health, uh, and uh, and that privacy trade is gonna be one that they're willing to make. So, um, I, so here's another one, uh, another Microsoft story, and I highlight this 'cause we don't talk about security.

We have a security episode coming up in a couple of weeks with the, uh, Cleveland Clinic team, uh, where we talk about security in depth. And I think it's gonna be a good episode for people to hear. Um. And, uh, it's actually the last episode, uh, where, uh, ed Marks was still the CIO of, uh, Cleveland Clinic. He has now moved on and I did it with him and his, uh, chief Security Officer.

Uh, really good episode. I appreciate, uh, ed putting that together. Um, this story is from the MIT Technology review, which is one of my favorite. Um. Uh, journals to read. And the reason is because it really goes in depth on the technology. So, uh, inside the Microsoft team tracking the world's most dangerous hackers.

And what it talks about is that, uh, the Pentagon recently awarded Microsoft $10 billion contract to transform, um, transform and host the US uh, military's cloud computing system. But as part of that, what they needed to demonstrate was their ability to protect that data because . Uh, if you think the health system is under attack pretty often because people want access to those records, the Pentagon is under attack literally by nation states all the time, and they go into detail here of how Microsoft has really organized itself in such a way to monitor these attacks and to start thinking like attack attackers.

And they have, uh, they have set up some really cool, um, groups that are dedicated . To, uh, dedicated to certain countries, uh, certain attack vectors, um, uh, you know, certain groups, uh, hostile groups. And what they're doing is they continue to, they're taking this massive amount. Of data that they receive. Um, and because they're monitoring and and processing it in real time, they're able to respond very rapidly to to these attacks.

As they evolve, they're able to evolve. 'cause when you think about it, we send data to Apple and Microsoft pretty often when our, our system. Fails or when our system has an issue or those kind of things, and they're taking that telemetry data and they're marrying it with other systems to identify when the attacks are hitting and how they're spreading, uh, throughout.

Um, I think this is, this is interesting, you know, Microsoft. Used to be the biggest hole within most organizations back in the, uh, windows XP days. And I think they got their act together and they continue to evolve, evolve, evolve, evolve to, to now being the point at the point where they can be trusted with the, uh, security of, uh, of the Pentagon.

Now, I, I know it's more complex than what I'm making it and what this story, uh, makes it out to be. It's a, uh. Uh, you're talking about many vectors. You're talking about a lot of new technologies, a lot, a lot of new things. But, uh, but, uh, you know, Microsoft has stood that up. The so what for this story, and it's worth a read, the MIT technology review inside Microsoft team tracking the world's most dangerous hackers and, uh, the so what for this is around security.

It is really good to identify partners at this point, anyone who's trying to go to do the security thing on your own, thinking that your staff is good enough to defend against the attacks that are coming into healthcare. Uh. First of all, that's a huge mistake, and I don't think that represents a lot of health systems, but I think some think that their chief security officer or their, uh, you know, dual factor authentication is protecting them.

Uh, the reality is, you know, I'll just share from my experience, um, you know, the, the, the biggest breach comes through. Your people are giving away their passwords. They just absolutely will give away their passwords and they'll give 'em away, not . Maliciously, they'll give them away in, in ways that are, uh, you know, it's, it's crafted for them to do it, and they give it away by using their same password that they're using on their clinical systems, uh, on their banking system and on other systems that may not be as secure.

You know, the average person isn't remembering a hundred passwords, and when you think about a hundred passwords, you think, oh, that's crazy. But you know, I'm using one of those, uh, . You know, password things. And I thought, I wonder, you know, let me check how many passwords this thing is holding for me. It's holding 125 passwords.

Well, no individual is holding 125 passwords. And so what they do is they end up, um, if they're sophisticated, they end up with a pattern that they're using. Uh, but the passwords are different, but the pattern, uh, is the same so that they, all they have to do is remember the pattern and they can figure out what their password is for these various systems.

Um, or they can, anyway, there's, there's a lot of reasons they give 'em away. Uh, the second is, you know, phishing and, and spear phishing and, and targeted attacks, uh, cause them to give it away. And, you know, I used to think that, uh, you know, these attacks were for unsophisticated users and they're not for sophisticated users.

So just with a, uh, CIO who said, you know, for the first time, uh, he fell victim to one of the, the, they do, uh, um, they do the, uh, internal . Uh, spear phishing and, uh, phishing attack software to test their group and to educate their group. And he, and it's gotten more, much more sophisticated as it's gone along.

And he fell victim to, uh, to one of the emails here recently. And I think that's true. I think the, the attacks are getting more sophisticated and it's getting harder to protect. You need a partner that has a very sophisticated way of, uh, monitoring, exfiltration monitoring, uh, anomalies of patterns across your wire, uh, monitoring, um, you know, your perimeter, um, but also the, the new, uh, devices that are gonna be moving stuff in and out.

Right? So are you using TLS two? Are you, how are you, how are you encrypting that data? Is that, is that data really, um, . Safe from one end to the other. Uh, I, I, I just think it's security has gotten so sophisticated that it requires an outsource partner relationship. Not outsource it completely, but to bring in that expertise to help you out.

And, uh, the final story, and I'm still getting used to this format, it's a little different for me, uh, we're gonna go into is why Google's move into patient information is a big deal. This is David Blumenthal. Um. And this goes into the story that we've been covering for the last three weeks, and I, I'm just gonna.

Hit it on. Hit on it on at the end here. So a recent agreement between Google and Ascension Fusion Natural Health System, which we've talked about, is yet another sign of how Digital Revolution is transforming healthcare. We're at the dawn of a new era where clinicians will be able to apply in real time the collective human experience in treating any particular problem to the care of every patient with that condition.

And that is the promise of all this data we've been collecting. People have have said, you know. This is has hurt healthcare. The promise though, is once we get those data points, when we get, uh, all those data points around each individual visit around each individual person together, uh, we can now start to apply that data in ways that we've seen in other industries really change the industry.

So, um. But the critical reactions to the agreement under which Ascension will send to Google Cloud the critical data it collects on its 50 million patients, and Google will process that data to help Ascension better manage its patients and its finances. Make it clear that changes of this magnitude are never smooth.

The announcement generated concerns about pri uh, patient privacy. And the misuse of information for the private gain of third parties. It triggered an investigation by the US Department of Health and Human Services and calls from members of Congress, Congress for further inquiries. Uh, we are obviously at the beginning of what will likely be a long, contentious and vital debate over the manage.

Uh, how to manage personal health information In the digital age, uh, patients have the undeni undeniable right to privacy and control over their personal health data. Doctors and hospitals need leeway to use patient information in their care. Patients, health professionals and larger society have an interest in learning from our collective experience, how to care, to, uh, how, I'm sorry, and the larger society have an interest in learning.

From our collective experience with care to better prevent and treat disease and tech, entrepreneurs want a return on their capital. When they add value to that management of healthcare data. The coming debate will be about how to manage these sometimes conflicting interests as health information technology revolutionizes the healthcare system.

Um, this is an important article. This is Harvard Business Review. Uh, David Blumenthal. It's recent. It's uh, November 25th. Uh, it is definitely worth a worth a read. Um. You know, setting the legalities aside for a moment, here are the fundamentals. Underline the ascension. Google relationship Ascension sits on a trove of data accumulated in the course of caring for millions of patients who pass through its facilities.

That data used to be locked away in paper records that had to be physically transported and laboriously, uh, abstracted to serve any purpose other than the care of an individual patient at a particular place in time. As a result, the near universal adoption of electronic health records over the last decade.

All that information is now stored in electrons that can flow instantly to wherever it's needed use, uh, and useful to provide patients' privacy. And, and it's protected. It's, it's interesting 'cause as you read this article, you'd be hard for, if, if I didn't tell you it was David Blumenthal who served with the Obama administration.

It is now the president of the Commonwealth Fund. You would not know what administration this was from. 'cause I could, I could easily have just, I, I could say this was a, an article with, uh. In, uh, secretary Azar or, or Cima Verma. The, the reality of this argument is that both, um, the, both the, the dominant parties in our two party system believe that health data is going to transform healthcare.

And so we have to have this debate. The so what of this story is we have to have this debate and we have to be thinking about how we're gonna use this data. and we have to be open about how we're gonna use this data. I, you know, the, uh, the, one of the things we talked about, uh, or talked about, uh, recently about the Ascension deal was ascension was under no obligation to inform the patients that they were sharing the data with Google, uh, to, you know, to generate value from that data.

They, there was no laws in place. Um. And, and there was a lot of people who were, who were, who were really angry about it in, uh, voicing their concern about it. But the reality was there's no laws that said they had to, uh, under the, uh, under hipaa. They, they're a business associate who's adding value to the health system in unlocking that data.

The reality is, if we don't unlock that data and it just sits there, that is the, the biggest waste of, of data. It's like a, um, it's like an oil field that we're not drilling in, uh, for whatever reason. But we're just saying, uh, you know, that we're gonna leave that data alone and. Because we're worried about the ramifications, we're just not gonna tap into it.

But, uh, I think there was a step that could have been done to include the patients. I. Um, and give them a little heads up of, Hey, here's, here's the value we expect to derive from this. And here's how we expect to, uh, drive down the cost of healthcare, improve outcomes, improve convenience for you, improve the physician's experience, give the physicians more time.

Uh, all those things are the promise of this data and this data coming together. And, uh. And I believe that everybody's intentions on, on all sides of this are good patients, providers, uh, Ascension and the providers as well as Google. I think all the intentions are good. Um, but I think there's a, a, a conversation that is, is going to need to happen in order for us to do this right.

Uh, moving forward, and I can't believe I'm already up at 28 minutes, but I am already up at 28 minutes, which means. It's time to end already. Hard to believe. Um, I'm gonna have to start saying, uh, as many stories as we can in 25 minutes or less. 'cause that seems to be the, uh, uh, the going timeframe. Uh, so this week, remember to check back.

We have, uh, new episodes every day this week. Uh, following that, come back for our normal, uh, . Uh, series. Every Tuesday we'll have the news. Every Friday we'll have an interview with a, uh, health system, uh, or, uh, some industry influencer. Uh, if you want to for support, the fastest growing podcast in the health IT space.

We just cracked a hundred thousand downloads for this year, which, uh. You know, is, is fantastic and, uh, I appreciate you guys and your support of the show. Uh, you can share it with the peer. Continue to share it with the peer sign up for insights and staff meeting. Uh, these are services designed to help your career on our website.

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And, uh, this week in Health It. For more great content, you can check out our website this week, health.com or the YouTube channel. Special thanks to our sponsors, VMware and health lyrics for choosing to invest in developing the next generation of health leaders. Thanks for listening. That's all for now.