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 Welcome to this Week in Health. It it's news day where we take a look at the news, which will impact health it today. Gosh, there's so much going on. We have a bunch of stories. Uh, we're gonna talk a little cloud. We're gonna talk a little, oh, we're gonna talk a little biotech revolution around the vaccines.

I think that's interesting. We're gonna talk a little interoperability. Things that are going on there. And my gosh, there's a hundred stories. We're gonna talk some Zoom as well, if you are, uh, wondering what's going on with Zoom. They've got a bunch of security patches and they were just sort of dinged for not being, uh, as upfront as they could be around their security posture.

Um. Prior to Covid, so, uh, we'll see where that goes. My name is Bill Russell, former healthcare, C-I-O-C-I-O, coach, consultant, 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. Speaking of developing the next generation of health leaders, I wanna thank Sirius for supporting that mission.

Uh, their weekly support of the show has allowed us to expand and develop our services offerings to the community, and we are very thankful for Sirius and all that they've done. Three X Drex is a service of Drex to Ford, a frequent contributor of the show, and sometimes co-host of Newsday. . And one of the things that Drex does is he curates, uh, stories and he sends out three texts three times a week with three stories that he has gone through his feeds and said, these are important for health IT leaders.

And, uh, it's a great way to stay current. I use it for this show, uh, to receive these texts. The easiest way to do that is to text Drex, DREX to 4 8 4 8 4 8. . All right. We've got a lot going on. Let's get over to the conversation this week. Let's go to LinkedIn over here. I'll hit some of these stories real quick.

Hey, there was a lot going on. Uh, first of all, kudos to chime. They did a phenomenal job. I love the, uh, virtual platform that they used. It almost, uh, I mean, clearly we're all still sitting in our offices. We're sitting in, in our, at our homes. It's. It's a time where, uh, c Ovid 19 is surging in a lot of markets.

Um, if you're like me, I signed up, I attended four sessions. I struggled because my, my calendar was just getting hammered. Uh, this week I'm trying to land some consulting projects. I wasn't able to do that, uh, and attend all the sessions that I wanted to. But the four I did attend, really well done, the virtual platform that they, uh, utilized.

Also I thought was, uh, really well done. I didn't, I didn't hit any of the, the keynotes. I wish I could give you more feedback on that. Just, there's a lot going on as there's a lot going on, and I think that's one of the things that has been sort of out there, which is I, we have record numbers of people signing up for these events for the health event for.

For the various conferences this summer and maybe even this chime conference, I have no idea what the number of signups were, but at the end of the day, I think we're all struggling to carve out time. And if we are leaders for healthcare, uh, we may want to help our staff to carve out that time and just dedicate it to going to some of these conferences if we think there's value in the conferences.

Because, uh, I, I know for me. Trying to juggle all those things was extremely hard. But again, four, four sessions I did go to, uh, really well done. A couple of guests of the show were on panels and, uh, they were excellent as always. So I'm not gonna go into too much detail on, on that. I just wanted to give the, uh, chime team, you know, just some applause for, for what they did last week.

I thought it was really well done. Alright, let's get over to LinkedIn where we are continuing the conversation with you guys. Now, you guys were busy this week, I get it. I understand. Not a lot of back and forth, but, uh, I'm gonna give you some of the stories that we shared. Uh, if you are interested in participating in going back and forth on some of the stories, I'm gonna be sharing a story on Monday, Tuesday, Wednesday, Thursday, Friday, every day of the week.

I share one story out on LinkedIn. Uh, you can follow me at Bill j Russell and then just put your comments in. What do you think of some of these stories? So for example, I. A week ago I pulled CIMA ER's article, she's the administrator for CMS, and she wr wrote, uh, every patient has a right to know the price of their care upfront.

Anything less is, is unacceptable. And I, I just pose this question. I'm curious if anyone disagrees with this. You know, price transparency, we everywhere else. Right before you buy anything else, you know how much it costs and you make a decision, right? Am I gonna fly first class? Am I gonna fly a coach? Am I going to, you know, buy a leather couch?

Am I gonna buy, you know it. But we don't do that in healthcare. I. And we don't allow that to even happen in healthcare. And it is something that I feel pretty passionate about that uh, people should be given the option. They should, they should understand what it, what it's gonna cost for, for their care and what it's gonna cost for their medications, uh, and those kinds of things.

In fact, uh, we're doing a show tomorrow where we highlight, uh, a company that's bringing that . That information of what the medications are gonna cost to the point of care, so the doctors can actually look at it, see what's covered, what's not covered, um, how much is covered, and what medications will cost that individual that's sitting right in front of them so they could see this patient and say, this medication's gonna cost this.

The next patient needs the same medication. It could cost. Uh, something entirely different based on their plan that information's being brought to the point of care. I love those kinds of solutions. I think that's exactly what we need to be doing, and that's a great way for technology to play. Uh, you know, and I also commented here, Scott Becker's been running some great posts on LinkedIn.

He had the seven, uh, the seven or eight things that this election means. And one of the things he pointed out was he said, uh, price transparency, which is supposed to start on January 1st, may or may not be enforced by the way. I agree with his statement. I don't like his statement, but I agree with his statement.

Uh, I think he's right that it may not be enforced, and I think that's actually kind of sad. I wish it was enforced. Christ. Transparency to me is, is, is is not a political stance in, in any way, shape or form. It really should be, uh, a right of the patient to know how much their care is gonna cost. I know there's a lot of challenges around that, but at the end of the day, it's my care, it's my money.

It's. You know, it's my life and, and how I choose to live it and spend that money really should be a choice that I get to make. And I'm not sure why we would push back, but we have pushed back as an industry, we push back, we say this is too much work, it's too hard. The healthcare systems can't. Possibly comply with helping people to know how much their care is gonna cost.

I don't think that's true. So I'm gonna continue to, to hit that theme because I think it's something that I, I mean, I've yet to run across somebody who says, no, no, the patient shouldn't know what, how much it costs. I think it's something we all agree on. I'm just not sure why we're, we're not pushing it forward anyway, that was the first article.

Not a lot of back and forth on that one. . A little disappointed. I was kind of hoping we'd get some back and forth, but you know, it's a political time. People are worried about what they're gonna say on post and on social media because they don't want to get canceled, I guess. So the second post I didn't expect a lot of back and forth on, and that is the Zoom 5.0 upgrade.

If you went to Zoom. for whatever reason, you may have gone to Zoom as your platform for collaboration amongst the administrative staff. You may have gone to it for, uh, any various forms of your telehealth. You might be using it for, uh, virtual consults. You might be using it for, uh, patient visits. , there's a lot of different places we could use it.

Uh, you're gonna wanna look at this Zoom 5.0 upgrade, bunch of encryption things, bunch of things to defend against Zoom bombing and other stuff. So take a look at that. Just know that it's out there and, uh, worth, uh, staying ahead of the next post. Just got a lot of, Hey, that's really interesting. That's really impressive.

But again, not a lot of back and forth. I'm not sure I expected too much back and forth. This isn't really health it per se. But Pfizer came out with a vaccine, which is really fascinating to me, and I said, this isn't your father's vaccine. And it really is new thinking for a new world. I. And I'm just gonna read from the article, it's another wondrous miracle of the biotech revolution in which knowledge of genetic coding will become as important as digital coding and molecules will become the new microchips.

So we're gonna program molecules the same way we program microchips, uh, vaccines work by stimulating a person's immune system. One traditional approach is to inject a weakened version of the. Dangerous virus. That is the, that is the way we now fend off measles, mumps, rubella, chickenpox. Another method is to use a version of the virus, or a part of the virus that has been totally killed, right?

These vaccines deliver a piece of genetic coating that will instruct human cells to produce on their own components of the targeted virus. These safe components can then stimulate the patient's immune system. Uh, I I just think that's fascinating. I think it's a fantastic. Uh, again, most of your comments are just, Hey, this is, this is really interesting.

Uh, so we'll just have to keep an eye on this. And this is one of the vaccines that is out there and, uh, there's a lot of, a lot of positive talk about this vaccine. So we'll see. See where it goes. Alright, the next story. I pulled this considerations for Cloud-based EHR hosting hospital. C CIOs and CTOs weigh in.

So I'm hearing an awful lot of talk of chatter of webinars, of different health systems exploring this. We're hearing of an epic in Azure. Instance actually going for dr. We're also seeing Epic workloads on AWS, or at least, let me rephrase that. I don't know of anyone running epic workloads in AWS yet, but I do know that AWS is doing webinars on putting epic workloads in AWS.

We know that Cerner workloads in AWS is happening 'cause Cerner signed the big deal with AWS and I just ask, what are your thoughts on this? Great quote in here. Jeff Alper, uh, the former CIO at Valley Ian Ho Hospital recently retired. Made this comment. Other industries identify their core values that they bring to the market, and everything they do is in service to that.

A lot of wisdom in that statement, by the way, what is your core business? What do you bring to the market? Why are you going to the cloud? What does this enable you to do in going to the cloud? And Jeff makes this distinction between large health systems and community hospitals. He says for community hospitals, I think it's hard for, from a sustainability perspective, to find a reason to host anything that's, anything he's saying it, it's hard to host anything.

And think about it from a community hospital perspective, you are probably, you're, you're running a lean ship. I mean, cost is probably your number one driver if cost is your number one driver. Than running Meditech is your lowest cost, EHR. You could run a Meditech in the cloud, but do you want to commit to those ongoing costs?

Right, so you're gonna have a, an ongoing monthly cost or do you just want to set it up in your data center, buy those servers with some capital dollars, and then run that stuff and really as long as you possibly can, that has been proven to be one of the lowest cost, what routes, uh, to go And, and Jeff makes that distinction.

He also goes on to say, large systems and integrated delivery networks, however, may have different requirements and greater need to manage locally. And I'm a proponent of the cloud, but primarily for agility, right? Being able to do things rapidly, respond rapidly, like to say a pandemic or to a new reporting requirements, or to stand up AI capabilities or machine learning capabilities.

To integrate in in ways that you weren't able to integrate before? There's an awful lot of reasons to go to the cloud. Most of them are around agility, the ability to do things that you couldn't normally do, but I often have to warn health systems about two things. One is cost. There's an ongoing cost of moving to the cloud and for some health systems that that cost is not sustainable.

The second thing I have to warn them about is lock-in. Right. So to avoid lockin, you have to put the right architecture in place, which is some sort of abstraction layer so that you can move it from one cloud to the other. If you don't put that abstraction layer in, you're gonna end up with a contract that's similar to your EHR contract.

We don't switch EHRs every three years or five years 'cause new features have come out in in the other EHR. If you don't do this right, you're not gonna be able to switch your cloud provider three or five years from now either. So, . Architecture around lock-in is really important. And I'm just wondering, we now, we now live in an era where, uh, EHR workloads, which are traditionally done locally are now being advertised and capabilities being brought to market where we can run those EHR workloads in the cloud.

And I'm wondering, uh, what your health system is thinking around that. Now, this, this one hasn't gotten enough time to really, to really . Get too many comments out there, but I'm curious if you have some comments that is out there on LinkedIn. Love to hear your comments. What are you, what are you thinking?

Are you thinking we're . Are, are we in that era of cloud? First we gotta get to the cloud. I remember like four years ago at Chime, everybody was cloud, cloud, cloud, cloud first. We're a cloud first health system. I'm not sure what that means, but I guess it means that anytime you're looking at a so solution, you look at cloud first.

It doesn't necessarily mean you select cloud, but you're looking at cloud first. Uh, and again, from a agility standpoint makes perfect sense. But from a . Doing the best thing for your health system, you may have to step back and determine what's the right solution for the direction that you're going and for, and I think Jeff is right for community hospitals, you may have to ask yourself if the cloud really does make.

Sense, and I think security plays a lot into that as well. But I don't wanna get too lost in this one story. All right, that's the, that's the LinkedIn conversation. Again, if you wanna participate, follow me, bill Jay Russell on LinkedIn. Go out there, go ahead and comment on some of the stories. Alright, we're gonna get back to the news in just a second.

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And all they have to do is put your email address in, in the, uh, referred by, and you'll get credit for that. We have some great prizes lined up. They can also still, uh, subscribe the same way, uh, we were doing before, which is they can send an email to CliffNotes at this week in health it.com and it will kick off an automated workflow.

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Great way to get the word out. So let 'em know. Let's get back to the news. Lemme tell you some of the headlines that are out there. All right, so first one we're gonna hit. . And this is healthcare IT news, interoperability in cities is improving, but small hospitals still lag behind. Of the 15 cities examined Cleveland had the highest rate of hospitals that are are reported to have the ability to find, send, and receive integrated electronic health information with sources outside their health system according to a new report from the ONC.

Only. And, but then they, they go on to talk about smaller hospitals. Only 44% of small hospitals engaged in interoperability according to the brief, compared to 58% of the medium and large ones. Similarly, independent hospitals are less likely to engage in interoperability than system owned ones. Only 13% of small independent hospitals reported findings, sending, receiving, and integrating data.

Um, . And a lot of that has to do with resources, right? If you're a smaller system, you don't have the resources. Financial incentives aren't there for them to share information there. I, there just isn't a financial reason for them to share their information with another hospital. There are absolutely reasons to support the health of your community to cut down on over-prescribing drugs.

I mean, there's, there's a million reasons to do it that are, it is just the right thing to do. But again, from a financial standpoint, if you're just trying to figure out how to keep your doors open as a small hospital, this isn't gonna be one of your top priorities, sharing information. And so that really comes up in this.

And I'm wondering what we're gonna need to do there in order to make that happen. And this could be one of the areas where we just see consolidation, really change that metric and really move things forward. Dynamic partnerships, uh, . We know a lot of health systems are really pushing their community connect and, uh, their, and, and even their services to smaller health systems.

And I think that will help to, uh, drive that as well. So that's just something to keep an eye on. Very interesting. Alright, another story why the US still has a sphere shortage of medical supplies. So we have a surge going on in several markets. My . One of the markets I'm familiar with is one that my daughter lives in.

My daughter and a couple of her friends have Covid right now, and they're on the tail end of that and they're doing well. But this is a story from Harvard Business Review, and it's actually, it's fairly old, September 17th. I don't know if I'm just now getting to this or just picked it up 'cause it showed up in my feed, but at the end of the day.

There is a strategic national stockpile, and which was created under George, the GW Bush, so W Bush administration.

It was originally set up as a safety net in case of short-term threats, such as bio terror attacks was not designated to handle a pandemic of this scale, so, . They go on to talk about the, the SNS and that the profile's too low and how to expand it and those kinda things. So Harvard Business Review article, if you are interested in that.

That is, uh, that's interesting. I think that's one of the things. We will see, uh, a lot of conversation over the next years just around public health and pandemic preparedness. Uh, and hopefully we will get in front of, uh, some of these, uh, some of these challenges. I think we have a manufacturing challenge for drugs that we have to take a look at.

We have a,

we have obviously some PPE supply challenges that are going to be, need to be addressed as well.

Let's see, what other articles do we have here? Alright, here's an interesting piece. The price of ransomware. What security leaders need to know. Mitch Parker wrote this. Mitch has been on the show before and he's the Chief Information Security Officer for Indiana University Health. And he gives a, a couple bullet points here.

It's in HealthSystem cio.com. Again, it's the price of ransomware. What security leaders need to know worth, uh, worth taking a look at. I, I, this one fascinates me. The ver Vermont governor deploys National Guard and response to the UVM cyber attack. Now, I don't know if they've followed through on this, but it looks like they were getting ready to the, the combined cyber response teams will assist the University of Vermont Health System.

Health network, sorry, in ensuring thousands of end user devices are free of malware and viruses. So you have a governor deploying the National Guard to help their health network stay safe. I think that's interesting. If nothing else, this is in, uh, healthcare IT news. I don't know if they followed through on this.

If they did, I think it's. Actually probably an interesting use of the National Guard and if the, if the health system didn't have enough resources to, to put up a good defense. I don't, it's interesting. I never, I never thought of the National Guard being deployed in that way and might be something to keep in mind in the future.

and Drug enforcement Agency Wow announced enforcement actions involving 345 individuals across 51 districts in what the US government described as the largest healthcare fraud takedown in the agency's history. Collectively, the cases announced in the nationwide enforcement operation alleged more than 6 billion in false and fraudulent claims to private insurance and federal health programs.

Notably the largest portion of the alleged fraud. 4.5 billion relates to schemes involving telemedicine. Wow. The provision of healthcare services remotely rather than in person through the use of an internal or the phone. These the, wow, that's an awful lot of fraud. 4.5 billion in telemedicine fraud. So anyway, goodwin law.com is where I pulled that article up and I just think that is fascinating that we're looking at that level of fraud and that's something

That, uh, I'm sure they're gonna continue to look at moving forward. Alright, I mentioned the Scott Becker post, and I, I actually pulled one of those up. It's not necessarily a news story, but it's, it's an interesting post. So Scott Becker wrote, wrote, uh, what to Expect Now, and this is post-election, seven Points.

His first point was health systems as well as the state and local budgets have been hurt badly this past year. They can probably expect a little more support from DC Number two, Biden. If need be, we'll try to strengthen the ACA or parts of it via executive order. The most important parts of the ACA have been twofold.

One is pre-existing conditions, and two, uh, regarding Medicaid expansion. The other provisions, while directionally important, have not been, had as much impact. Again, I, I love the fact that writing this stuff. And, uh, putting it out there. The third point, ACA concepts regarding behavioral health are also important and will be supported.

I don't think you're gonna see a national mask mandate because if I remember correctly, I read an article where it is. Uh, they can't do it . They, they just can't do it. The states have the ability to override it. So I think what you're gonna see is Joe Biden really building a coalition of governors who are going to, uh, support the, uh, mask mandate and, uh, push it forward, uh, in their, in their, in their states.

I think what he's saying there is, at least at the time of this writing, it was looking like we were gonna have a split Congress. House of Representatives and Senate being split by party, which means that you weren't gonna have any major legislation around healthcare. It was all gonna have to be done with executive order or they were gonna have to get bipartisan legislation.

I don't know why we just write off the fact that we can't do bipartisan legislation anymore. It just seems kind of counterproductive to me. It would be nice if people started from the assumption that we can actually get things done. The next thing was, uh, pharmacy Drug pricing is a very difficult problem because nation wants the new drugs being developed badly, like President Trump.

You may hear more noise than action, and I think that's true. I think drug pricing is a, uh, significant issue, but not an easy one to tackle. So let me check, let me check the time here. Lemme check how many. . All right, let me close with this article. It's a, I think it's an important article for us. It's an important topic for us as health IT leaders.

Uh, are you at risk of burnout? Okay. It pros are spending more time working remotely. These tips can help you to keep calm and carry on during these times of change. Other than people who are frontline medical workers, it has been the hardest hit when it comes to job stress and burnout. Said Andrew shot, S-H-A-T-T-E.

co-founder and Chief Knowledge Officer at M Equal Me Equilibrium. Me Equilibrium, a Science-based resilience training program or provider. We saw many experienced sleep disorders a drop in their motivation. The best we can sur surmise is that a lot were put under pressure. When companies moved to remote work, some IT workers were expected to continue to show up.

Burnout symptoms, well, you hurt some of 'em. Stomach ache, headaches, back pain, anxiety, sleeplessness anxiety, causes a downturn in quality of our sleep. But he said our sleep essentially. If you, but sleep is essential if you're going to vo, avoid burnout. Right. . You may be experiencing anger, frustration, sadness.

We're also seeing a lot of spiking in shame with thoughts that we're not meeting our own standards in the world. For example, I'm not, I'm not doing anything well or I'm not a good parent, partner or employee. These are signs because burnout symptoms are difficult to recognize. It can. Keep it can help to keep a journal suggest Dr.

Ted Sun, organizational psychologist and president of Transcontinental University, a nonprofit organization that offers programs. The human brain is brilliant at making up reasons to justify one's decisions, even when they are poor decisions. Sun said, using a journal to note. Down certain thoughts and behaviors, and then reading it to assess the major change is one self-diagnosis tool.

Look for people who are normally aren't emotional, but who seem to be starting to flame out. He said anxiety and frustration are understandable, and these emotions are normal. But if a person isn't taking care of themselves or they're coming late to a meeting or they're procrastinating with their work, they may feel isolated, disengaged.

Uh, disengaging from work is a sure sign of burnout. So they go on to talk about ex ex extinguishing burnout. Self-care is the first step towards addressing work burnout. Make sure you're getting enough sleep, you're eating well, and you're exercising. Although healthy habits are always good, they don't address the root issues according to sun, who believes companies must therefore take responsibility as well.

Uh, leaders should help people develop positive responses to stress in the workplace and focus on empowerment as a mindset. Uh, said son, who suggests providing courses on empowerment to employees as well as changing procedures to give them more control over their environment. Uh, development of emotional intelligence will be key.

And they go on business issues. Consider first, which tasks are actually value add for your in-house team to carry out and might require intrinsic organizational knowledge to complete. He said, from there, consider outsourcing the tasks that are highly repeatable or might require less internal strategy.

I, I use this, I mean, not necessarily that I would jump on all these things, but I use this as a. As a backstop for a discussion around burnout, this is a very real thing. We're all handling this stress just a little different, and we're going into another, uh, season of surge, which means that we're gonna put added pressure on your team.

They might have their, their, uh, children at home again. They might have, uh, home stress that you're not familiar with. We know that there have been hurricanes, there have been fires, there have been people displaced by fires. A big part of being a manager today is, is organizational, is it, it's, it's, it's being a psychologist, it's identifying those people that are just connecting.

It's having the conversations. It's making yourself available. It's having one-on-ones. It's being able to be accessible, to discuss things, to give people the, the right amount of time to, uh, encourage people to sleep, to, to take care of themselves, to exercise. Now, you can't force people to do any of these things.

But it should be part of your thought process at this point as a leader. Now, CIOs get this, I'm talking to CIOs all the time. They have programs. They're thinking about it. They're encouraging people. It's the next line of man managers. It's the the next generation of health leaders who we're talking to here.

This is part of the, part of the deal is how do you take care of your team? How do you identify those things that are going on in your team and how do you take care of your team? This is something you should be reading articles about and something you should be, uh, really stepping forward and leading as strong as you possibly can in this area.

This is a stressful time. We just had an election. There's a bunch of people that feel disenfranchised. We have . We just mentioned that the, the fires, the hurricanes, the pandemic, uh, there's home things going on. The divorce rate is up significantly during the pandemic. Um, people are now talking about not being able to get together with their family for Thanksgiving.

Uh, who knows what, uh, uh, Christmas is gonna look like. Uh, these are very trying times for all of us. . And if we are leading a team in any way, shape, or form, we have to be aware of that and we have to be asking the right questions, promoting the right behaviors, and encouraging e, encouraging people as much as possible to, uh, take care of themselves.

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