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Welcome to this week in Health it. It's Tuesday News State, where we look at the news, which will impact health it. Today we do a quick run through the headlines like we did. We started it last week. . I have 26 stories. I can't get through 26 stories. So the first eight or so, I just hit the headline, give you my so what, uh, and then we'll go deep on a couple of others.

So that's a new format for you. We're gonna take a look at the battle lines for telehealth and what's going on there. And the emerging role of the CMO Chief Medical Officer, they are popping up everywhere. 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.

I. This episode and every episode since we started the Covid to 19 series has been sponsored by Sirius Healthcare. Now we're exiting the series, and Sirius has stepped up to be a weekly sponsor of the show through the end of the year. Special thanks to Sirius for supporting the show's efforts during the crisis and beyond.

You know what CliffNotes was your idea. Expanded shows was your idea. We're committed to deliver a show that meets your needs. If you have ideas, send me a note Bill at this week in health it.com. Do I get spam? Absolutely. But it's worth it because I also get a, a few emails a week. Uh, they'll let me know what we're on track with some of the things we're doing.

Uh, it helps me prepare for the show and this is a service of Drex de Ford. A frequent contributor of the show. Alright, news, this is headlines only. This isn't the deep dive headlines only. Here we go. Comcast rolls out new internet essentials partnership program for schools in its footprints.

Philadelphia Business Journal. I love this. I know it's marketing. I don't really care. The reality is we need broadband to every . Every inch of this country in order to really take healthcare to the next level. And, you know, without broadband, we're always gonna struggle. So anytime I see, uh, broadband being rolled out, even if it's in support of schools, it just means that that broadband connection has gotten to a new home or another place.

You know, my so what on this is, you know, support Chime in their, their lobbying efforts. On the national level and support your state and local efforts to get broadband everywhere. The other thing I would say is this is a great growth strategy for many health systems. You know it, think about it this way.

You could be doing teleconsults telehealth to remote locations. You could partner with these rural and remote health systems. You could take. You know, you can provide teleconsults on their high acuity services. You can then transfer those services in or transfer some of those patients into your health system.

You can form very strong partnerships via this broadband and telehealth strategy. If you are in front of it, get in front of it. All right. So I, I love that. So Comcast continue to do that, and other providers hopefully just expand the, the national footprint for broadband. Next story, US Health Insurers doubled profits in the second quarter Amid Pandemic.

This is, uh, a Guardian article. Does this, does this surprise anyone that health insurers took money in? And their patients were not going anywhere. So we've talked about this a couple times and, and in fact one of a couple of the shows, I said, health insurers will be the big winners coming outta this.

They're gonna have huge war chests coming outta this, and they're gonna be able to buy up anyone who is struggling. So that can be physician practices and others. That, uh, are gonna need cash moving forward. So the other thing I would say about this is that, you know, the providers that were also insurers were, it was a great hedge.

Being a payer was a great hedge against the pandemic losses during C Ovid 19. So it, you know, that's just something to consider. I don't know what I'm saying there. I'm saying that your competition is probably gonna, if you're a provider, it's probably gonna come from the insurers starting. . Well, starting a year ago, 10 years ago, whatever.

That's the, that's the direction this is going in. They're well-funded and ready to go. Alright, next story. HHS Chief Officer abruptly resigns. . I wanna start here with, I'm not shocked. I have no special knowledge. Actually, that's where I should start. I have no special knowledge here. I haven't talked to anyone.

Nobody's whispered anything in my ear. I don't know anything here. I'm just reading the headline. HHS, chief Information Officer abruptly resigns. I don't think it's a shock because we just did a major shift, right? We moved all the . The, the reporting from the CDCD database to the HHS database, that's a major transition akin to an EHR transition for a provider.

And we know that many EHR transitions lead to job transition. And I, again, I don't have any special knowledge. I can imagine what happened. Uh, you know, this whole thing's predicated on better, better insights, better tools, better data collection, better something. It may be that they didn't deliver. I have no idea.

It may have been transitioned poorly. That often leads to some challenges. The CIO may not have gotten the support they expected from leadership. That could be another thing to happen. Again, I have no idea my So what on this is, it's this. The only reason I'm covering this story is to say. Don't expect a reversal to the CDC database.

Right. So they are really good at moving things around with, with, with ease, with grace, the transactions, they, they just know how to do it. And this will be a, a pilot at the scale of a country. So that's pretty, uh, interesting. I would just keep an eye on this and, uh, precursor to maybe future plans in the United States.

So something to keep an eye on. Sentara Sentara Healthcare set to merge with North Carolina's Cone Health. All right, so interesting to me. My weekend brief from healthcare IT News had as its elite story, m and a activity went way down in the first half of this year, and I thought that could be the most misleading headline I've ever seen.

Did the activity actually go down? Well, they measure the activity based on deals closed and those kind of things. But you know, okay. So I agree with you. The actual announcements probably went way down. People were preoccupied, a lot of things going on, but I think the conversations went way up. The number of conversations that we're having around m and a went way up.

And here's my proof of that. So we've had, Drex did a, uh, a show where he talked about one of the first announcements, and that was in the Seattle area, excuse me, Washington State area, la We had Cedars last week with, uh, Huntington. and, uh, I talked about that last week or the week before. I don't remember.

Weeks are running together, and now we have this one, Sentara and Cone Health. And this is not a small one. It's not a, it's not a massive one. Actually, none of these three were massive, but I, I think it's an indication of even well run healthy systems of a certain scale. Are now looking for cover. They're now looking to partner with somebody.

They're now looking to get back to scale, and this could be a balance sheet issue. I, I have no idea what it is. I would have to look closer at the, uh, numbers and if I can get access to the numbers, I will see what I can find. Here's my so what, expect more of these. Expect a lot more of these. That's my 2 cents.

I think the headline I'll get from Healthcare IT News in January will say the number of, uh, the amount of m and a activity in the second half of this year sets a record. That's what I expected to read in January. Alright, next story. Nevin Hefty and Associates, if you're not familiar with them, they're a huge Meditech solutions, uh, provider.

Uh, we use them. When, uh, we did our Meditech implementations at our hospitals and Engage, and if you're not familiar with Engage, engage is essentially a part of Providence. Providence has, has broken out the service Arms and Engage is their, uh, Meditech solution provider. They also have an Epic solution provider.

They bought, uh, blue Tree. Blue Tree. That's the name of it. So they're now essentially a, a large epic implementation partner. They're probably the largest Meditech implementation partner. They have a huge Microsoft partnership, which you read about every week on social media. Their innovation arm is, uh, constantly doing posts about the companies that they've invested, invested in.

You know, Providence wants to provide healthcare with the IT services and, and tools and products it needs to run effectively. You know, I, I mean my, so what on this is, uh, great, you know, this is a completely, completely different business than running and providing healthcare in your markets. And so my, so what is, use them.

Don't use them. They might be a good partner for you. You should evaluate them, and you probably will, because if you're doing Meditech, you probably will, because we just shrunk that market significantly. So if you're doing a Meditech implementation, you're probably gonna look at them. But I would say evaluate them like you would any other supplier talk to their references?

Are they eating their own dog food? The usual evaluation still applies just because they happen to be a healthcare provider. You're gonna evaluate them the same way I think I'm telling you what you already know. So I'll just move on. JAMA study 38% of of older US adults Ill-equipped for video visits, healthcare innovation.

and I, you know, I commented on this on social media, which by the way, just as, as an aside, I'm gonna start doing, I'm gonna start taking one story a day, uh, on Monday through Friday. I'm gonna post the story, uh, ask some questions, try to interact with you guys, and this was part of our splitting up our, our social media strategy.

So if you wanna follow the show, we have a show web webpage that you'll get the clips, you'll get a bunch of stuff. We'll continue to come out there. But my personal . Bill Russell, CIO, uh, LinkedIn page. I'm gonna start posting, uh, a story a day, some comments on it, and invite you into a conversation. This one, the JAMA study got a fair amount of back and forth.

You know, my take on this is I saw some people comment on these numbers. Can't be true. 38% of . Older us. Are you telling me that older US adults don't know how to use a a cell phone and don't talk to their kids via FaceTime? And the answer to that is, of course they do. You know, a lot of 'em do, and maybe even a majority of 'em do.

And the 38% doesn't represent all of those people. It represents, uh, a group that's even broader than just those people. So the, so let me, let me fine tune that a little bit. Some do not have broadband. Let's, let's say that's 10% don't have broadband, so just flat out you're, you're not gonna be able to reach them or their broadband is not adequate enough.

And, and that does exist. My father does not have a cell phone. My, you know, my father-in-law's cell phone is a flip phone. If he didn't live with us, he wouldn't have access to any of the things we're talking about here. All right? So many, and, and it's not like they live in a place that doesn't have cell phones or broadband.

They choose not to. All right, so that's at least 10%, if not 15%. If I think about it. You know, the other thing is many enjoy just getting out of the house, right? So think about it. We, we've isolated all these people and it, and this is probably not just older adults, but it's probably other adults as well.

We've isolated these people. For some people, getting outta the house to see their doctor or see anyone is, is a major event. It's, it's, it's, it addresses the isolation that, that people are feeling right now. Right. So that's, you know, so that's an important factor. I think the other thing is, you know, we've trained people to go to a doctor and they don't like the telehealth vehicle.

They, they want to know that somebody's looking at them, right? So there are ti and we have these stories, right, that there are things that you will not see over a telehealth visit that you could potentially see if the person was sitting in front of you. . I would say the other thing I, I said in, in that post was, technology isn't really magic.

It doesn't change habits, it doesn't cure isolation. The so what on this is we still have a lot of work to do. It's not only a technology project, it's a change management project on a cultural level, right? So it requires marketing, communication, private public partnerships for broadband, access it pro, you know, it's a significant partnership probably beyond your four walls.

To get that, get that adoption number, uh, you know, even higher within your communities. Lots of things beyond technology on this one. All right, so my last story I wanna cover real quick is policy implications for C Ovid 19 pandemic. In light of most patients spending only one night at the hospital after elective major therapeutic procedures, s greater than 72%.

Are now spending only one night at the hospital after elective major therapeutic procedures. Interesting. You know, carry a distance is now a thing. It's part of our vernacular. We educated people really well. It's not that we don't have rigorous processes to make sure that our, that our hospitals, you know, are, are safe and that we're not transmitting, uh, disease and those kind of things.

But what we communicated to the community was, Hey, . You know, what, if all these people who are sick converge on a single location, it increases the likelihood of transmission in that location. Alright? So that's what we communicated. And so that, that's now a part of the, the, the mindset as people are looking at it, you know?

So the, the so what on this? I, I, I don't, don't really want to go into that aspect of hospitals, but I wanna focus in on the title hospitals and their procedures and that kind of thing. I wanna focus in on the title, which is . Shorter length of stay, you know, people seeking remote, remote locations for electric procedures.

You know, it's, it's interesting, I heard of another hospital this week building a large tower billion dollar tower, and you know, unless you're an academic medical center with really focusing in on high acuity patients, I wouldn't invest much in new towers or campuses. Asset light strategies are the most logical next step in healthcare.

Right. . We, people are now going to look at that hospital very differently. I would rather go to that place. They used to look at retail and say, oh, really? I mean, the, the, you know, the smart and final is right next to the place. I'm gonna go see my doctor. Do I really wanna have a procedure there? But now they might look at the.

The campus and say, oh, that's where sick people are. I'd rather go to the place that's, that has fewer sick people in it to have my procedure done. I'm just saying that I, it's something to have a conversation around. I would keep an eye on these numbers. They indicate significant spending pattern changes.

And reimbursement rate changes and a case mix, index changes. I mean, there's a lot of things that could affect the bottom line here and it's worth keeping an eye on. Alright, so let's go deep dive. telehealth is interesting to me. Telehealth has I, if I were to read these, these articles in and of themselves, I would be thoroughly confused about telehealth.

Alright, so the first one was a survey American plan to use telehealth after covid 19. And this was actually sent to me by a vendor. So full disclosure, harmony Healthcare, it. And I, I looked at this and I'm like, Hey, you know what? It was a well done, uh, group of research. They gave me good insights. I'm gonna share it with you guys.

That number's down, by the way, that number, at one point, that number was approaching between 85 and 90%, which is, uh. Yeah, but still the fact that it's at 71, I, I hope that number's still coming down. 'cause that's a, that's gonna be a challenge for us if people are afraid to go to the doctor's office anyway.

63% were apprehensive about the first telehealth visit. 72% enjoyed their telehealth experience. 72%. You know what that tells me? , it tells me 28% didn't. I'm not shocked that 72% did. I'm shocked that 28% didn't. , why would they not enjoy the experience? Okay, would they most, uh, well, I'm gonna come back to that in a second.

What patients liked the most about telehealth? Convenience. Makes sense. Safety? Yep. Flexibility. Less wait time. Comfort. Easier to schedule, follow-up. Better communication. 28%. Didn't like it. Why is that? Telehealth wait times. Here's the, it, it starts to reveal itself. It does. It's not pulled out specifically, but it reveals itself in this way.

right? So the, the wait time should be shorter between telehealth and in person. And, uh, 34% experienced a delay due to technical difficulties in their telehealth experience. All right? So 34% and we said, what? 28% were not happy with their, their visit. Why is that? I think, I think you know why that is. Most preferred platforms to use for telehealth.

So this is their preferred platforms. This is the consumer they're asking, right? They prefer to use Zoom. The medical, uh, at 28 7% prefer to use Zoom, 25%. The medical provider's app or website, 19% Skype, uh, 14% FaceTime. 6% Microsoft teams, 5% Google Hangouts, 4% other. Okay. I find that fascinating, but that's also indicative of what we've done, right?

So we've stood up a lot of different platforms and it's now time, or I'm sorry. We stood up a lot of different applications to deliver telehealth services, and it's now time to start orchestrating the experience from end to end to make sure from scheduling, to getting the person on the line to troubleshooting if there is an issue, to talking to the doctor, to getting it.

Documented to getting the prescriptions filled. If there is, I mean that whole orchestrated experience needs to be thought through. This number of 28% are not happy with it is a little high for me, given the number of things that people are looking for from this that we are delivering on anyway. A lot of, so harmony, healthcare, harmony.

h i.com and they have a survey out there, you know, very interesting. It's good. Uh, good survey. Alright. So that's the first thing. It's like, hey, people love telehealth. It's going well. Things are great. The next thing is probably my favorite thing I've seen a long time 'cause I've been asking you guys for statistics and chimes asking you for statistics and others are asking you for, for statistics and my

Friends at the charter group. Again, they're not a sponsor, I'm just, I'm impressed with their work. Went out and created a thing called the Telehealth adoption tracker. If you haven't seen this thing, it's worth seeing reports, charter reports.charters.com. And then there's uh, some long URL I'm not gonna give you, but it seems like they're gonna update it on a monthly basis, which is great, and I love this.

Here's what they did. So the Charters group and . Kathea Labs have brought together a team of data scientists, visualization experts, and industry thought leaders to develop a telehealth adoption tracker. The thing I like about this is, you know, when you have the visualization experts, they don't try to overdo it.

It's a very simple graph set of graphs and graphics. Uh, it looks like it's all built on tableau. It's really easy to navigate. Really well done. All right. So, and it's not complex. There's not a, a ton of 'em to interact with. It's really well done. Uh, the interactive tool will allow you to filter by geographic, uh, market.

In fact, that's a really cool US graphic there. And you can look at the usage of telehealth by state. , right? And so I'm gonna go through some of their findings in a minute, but it's really cool. So I'm looking at this right now. I can look, Florida's at 21%, Missouri's at 11% New Hampshire's at 18%. Uh, and this is for, uh, the, the week ending 7 29.

Now I can move this little graph back and get the week ending, whatever, you know, seven 14 R 6 3, 20 20. And I could see that the numbers were a lot higher. If you go back to six three and they have the different weeks. And the amounts and those kind of things. So very, uh, very well done. Lemme, let me tell you some of the insights they, they give again 'cause it's worth looking at their insights.

All right, so the first thing they say is National telehealth utilization is stabilized. So at one point we were up around 50%. That was mid-April. It's now seems to have stabilized around 18 to 20%, and this is the sixth straight week that telehealth utilization has remained between 18 and 20%, which gives them the indication that this might be the new norm.

Alright, we went from 50 to 20. That's if reimbursement stays the same, right? Reimbursement has to stay the same. And some of the other exceptions have to, uh, stay the same. But if they do stay the same, we're at about 20%. And we're gonna go into some of those things which might be changing anyway.

Meanwhile, telehealth adoption rates with Covid. Ovid 19 hotspots. Covid high tea Covid, 19 hotspot states rose. This is not a shock to anyone, right? So Florida went up to 21%, Texas, 23, Arizona, 21. When you are in the midst of a surge, more people use telehealth, urban and rural Telehealth divide is pronounced and shows signs of widening.

Rates of telehealth use in urban areas has exceeded those in rural geographies since the beginning of the pandemic, the telehealth adoption rate for primary care visits was 28% higher in urban geographies than rural ones. Okay. I expected a, a, a gap. I didn't expect it to be that high. So that's, that's a pretty interesting divide.

While overall telehealth adoption has stabilized recently, the urban rural telehealth divide has widened since the early weeks of the pandemic. Up from 18% differential during the peak telehealth adoption weeks in mid-April. So we've gone from 18 to 28% pandemic change. So interesting. Our telehealth usage during the pandemic and the change between urban and rural.

It's interesting. I think we are experiencing tele our C ovid 19 very differently depending on where you live. Urban experience is very different than the rural experience. I think that's somewhat to do with that gap. Right. In, uh, rural locations for the longest time, we weren't wearing masks because you quite frankly we're, we're far away.

I, you know, I look out my window. The next house is pretty in a suburban area. It's pretty far away. In an urban area, I get on an elevator and I'm reminded of how many people live within feet of my front door. So very different ways of experiencing c ovid. 19 very different ways of seeking out your healthcare based on how you're experiencing covid.

Anyway, uh, their last insight, telehealth has predominantly functioned as a modality to manage established patients. This one's interesting to me. So new patients represent just 5% of overall Telehealth visits compared to 13% of in-person visits throughout the Covid period, indicating that virtual care modalities to date have been primarily utilized as tools to manage care for established patients.

Finding ways to leverage Telehealth to expand access to new patients will be a key driver in Telehealth's continued adoption and growth. Interesting. So that's gonna lead us to the next story. But again, great, uh, graphic. You can look at this, it has a really interesting curve here that shows me that we were at 0.7% telehealth, uh, usage in February, and that ballooned up to mid-April at 51.

Well, 50.8% and that was the peak. And then it started to come down gradually. And, and they're right. You're looking at about six weeks, at about 18 to 19%. And that seems to be where it's seems to be, where it's come down to. Alright, so a percentage of telehealth by physician specialty is the last thing I'll hit on here.

Psychiatry is the big winner. Psychiatry, telehealth visits 64.2%. Phenomenal. And I think that's, I think that's here to stay. You know, psychiatry is one of those things, uh, we, we struggled with at our health system. You know, we needed psychiatry in our eds. Really? 7 24, 365. You never knew who, who was gonna come in, who needed a, a psychiatric consult, but it wasn't, it wasn't perpetual.

We didn't need psychiatric services in all of our edss all the time I. And so we actually did use telehealth at, and that was one of the, one of the, uh, use cases for us. Uh, neurology is number two at 30%, and then internal medicine 23, and then a bunch of 'em at, at 20%, right? So internal medicine, uh, gastroenterology, pulmonology, pediatrics, family medicine.

So there, that rounds out your 20% list. Again, great work from Charters group. Highly recommend that site. Very interesting. Alright, where should I go next here? Uh, CMS may eliminate most emergency codes for C Ovid 19. Alright, this is where it gets a little confusing 'cause it's a government thing. Uh, CMS is planning to eliminate 74 of the 83 codes created to cover telehealth services During the Coronavirus pandemic, though it's adding 13 new codes and could be swayed by public comments to add more coverage.

Alright, so this is what they're doing. They are same as always. They're putting out their, Hey, here's our, here's what we're looking at. Here's the data we're looking at, and here's what has really impacted care and actually moved care forward. And here's stuff that we don't see any evidence that care has really substantially been changed from one modality to another.

and, uh, therefore we're, we're proposing not to, not to reimburse these moving forward. And then we're moving some of those to a new category, I guess they're calling it category three, and they're adding some new codes to that category three, which is we're gonna temporarily reimburse these probably to get some more data and those kind of things.

The services CMS proposes to add and remove from the list of telehealth services covered under Medicare. This year's list is usually robust because CMS took into consideration all the telehealth services. Medicare currently covers on a temporary basis due to c Ovid 19 public health emergency, right? So CMS grouped the telehealth services into three lists, nine codes that will become permanent, 74 codes that will be removed when the PHE expires and 13 codes to add to the list, but only on a temporary basis.

CMS dubbed these category three codes. All right, so I'm gonna hit these real quick. This might be more detail than you would like, but it's probably more detail than you would find elsewhere, so I thought I would give it to you. Telehealth services that will become permanent group psychotherapy, domiciliary, rest, home, and custodial care services for established patients.

That's an important distinction. Home visits for established patients, cognitive assessment and care planning services visit complexity inherent to certain office outpatient prolonged services, psychological and neurologic, neuropsych, psychological testing. All right, so those are the ones that are become, become permanent.

Then there's another list, 75 codes that are going to be coming off of it. Initial nursing visits. Right for low, moderate, or high uh, complexity, psychological or neuropsychological testing therapy services. So physical and occupational therapy at all levels, in fact represents I. A lot of the codes that are coming off, wow, that's a lot of codes.

Initial hospital care and hospital discharge, day management, inpatient neonatal and pediatric care, critical care. Initial and subsequent. Initial. And continuing neonatal intensive care services. Critical care services. End stage renal disease monthly. Capitation Payment codes, radiation treatment management services, emergency department visits, level four, four through five, uh, domiciliary, rest, home and custodial care services, new home visits, new patients, all levels, initial and subsequent observation, observation, discharge.

We should have a pretty robust set of reports right now on how we are doing with telehealth. In what areas are we doing well with telehealth and what areas do we feel like it is actually, um, moving the needle in terms of care that we are delivering to our community and to our patients, and can we prove that?

When we, when we comment on these services, it's one thing to jump up and down and say, look, the world wants this and we should pay for it. But at the end of the day, the money is not an endless supply. So there has to be decisions that are made and it's based on facts, and we have to have those facts. So anyway.

That's, that's about as much detail as I can give you on that. The next story, expanding access to telehealth is a hundreds of billion dollar question. Healthcare IT news, I'm not, because of time, I'm not gonna go too much into that story other than to say, you know, to get broadband everywhere. I. Assumes that for telehealth to be everywhere, you know, that's a significant cost.

We have the, the cost to, to Medicare for delivering these services. And what they're saying is if there is not a measurable distinction between delivering from a cost, from a care and uh, a progressive care standpoint, then we're not willing to fund it. It's actually. It's actually , you know, really responsible of them to do that analysis.

We should be doing that analysis. We should have our own analysis. We should know what's going on. So that's my big So what on that? Here's the thing, the, these reimbursements, as I've said before, we are safe through the end of the year, but at the end of the year, this is gonna change and we need to keep an eye on this and determine what areas we can, uh, utilize telehealth effectively as a health system.

As healthcare providers and you know, again, we've talked about, uh, earlier I was talking about strategy of saying how do you expand the number of patients that you're interacting with? And, and maybe it's teleconsults. We did, we did stroke teleconsults for, uh, remote locations through our one hospital.

That was an effective way to, to provide those services to remote and rural locations. It was also a way to, to really work with those. Again, it changed our case mix index on a bunch of things. There's, there's a lot of ways to use telehealth. We need to be thinking through those things. We need to be collecting the data enough.

Okay. It's hard for me to stop sometimes when I get started. All right. Chief Medical Officer, so Covid 19 is elevating a new type of executive chief medical officer. The reason I highlight this. And I think it might be interesting to you is you might be losing some of your doctors. And the reason you might be losing some of your doctors is because companies like Tyson Foods who had the problem in their, in their, their plants where they're, they're processing food, hired a chief medical officer, Royal Caribbean Cruises hired a chief medical officer.

Right? And, and I don't think that, I think that's the tip of the iceberg. I think we're gonna see Chief Medical Officer's amusement par, you name it. I think every company because of this, is going to have a chief medical officer moving forward, and so that is gonna be a hot role. You might be losing some of your doctors.

It might be a partnership opportunity. I haven't really thought through it, but it's, I, I just found that interesting and fascinating. Something we should, we should definitely keep an eye on. All right, went a little long. I do want to cover this one story, so ONC to offer new funding for state and local HHIE innovation using 2.5 million of the CARES Act.

The agency will give money to as many as five new projects that boost health information exchanges through the new Star HIE program. So you know, this is a healthcare IT news article. And I love their format. You know, why does it matter? Through its new strengthening Technical Advancement and Readiness star, HIE program, ONC aims to leverage work done by the industry to advance HIE services for the benefit of public health.

The goal of the program is to both bolster existing state and local HIE infrastructure, so public health agencies are able to better access, share, and use health data during and after. The C Ovid 19 pandemic, ONC will disperse 2.5 million, which quite frankly is not that much, but you know, again, it's, it's better than, than nothing.

The problem we had with RHIE is they, they, they couldn't operate profitably. And they went out of business. Uh, that happened in, in one of our Texas markets. Quite frankly, it was, we were in danger of that happening in our Southern California market. So if you think, oh, well, maybe that was a rural location.

Now we, we had, we struggled to, they struggled operationally to keep these things running and to keep the technology current. So any, any kind of money going in this direction is good. If you are working with an HIE partner, make sure they're aware of this, uh, potential money. . And how to go about getting access to this money.

So that's an important, uh, development on the health it space. Let me think. Is there, gosh, there's a bunch of things I wanted to talk about. I'm gonna talk, I'm not gonna talk about the Livongo Teladoc merger. I don't think it's, I don't think it's gonna impact any of you in the next week. If I talk about it later, I think we'll be fine.

There was an interesting article. That's not the article I want. The article I want is

there was an article of a bunch of CIOs talking about . The most dangerous health IT trends. I thought this was worth looking at. Most dangerous, dangerous health IT trends. This is a Becker's Health IT article from eight execs, so BJ Moore, E-V-P-C-I-O at Providence Guest on the show a couple times. He said a health it trend that causes me.

Pause right now is the rate at which healthcare companies embrace new technology. From my perspective, healthcare systems across the nation are about 15 to 20 years behind, uh, other industries. We need to be more quickly embracing cloud computing, machine learning, artificial intelligence. Big data, internet of things, consumerization of health experiences, and other emerging technologies to accelerate health insights, improve caregiver productivity, and to improve access to health outcomes for our patients.

Um, you know, I, again, who, who, who can argue, I don't know if it's 15 to 20 years, who can argue that we should, uh, adopt some of these technologies, uh, a a little faster. There is a difference between adopting them in the clinical setting and adopting them in the operation setting. In the operational setting, you can adopt some of these things as quickly as you want in the, uh, clinical setting.

There's all sorts of, I mean, it's the thing that slows down is the regulatory environment. I'm not putting that out there as an excuse. I agree with BJ Moore. I think we have adopted things way too slowly and that there's things we could, uh, adopt that would really move, move, move things forward pretty rapidly.

John Boscos, SVP and CIO for Northwell out of New York. To me, the most dangerous trend would be for CIOs to assume it's back to work as normal before the pandemic hit us. As with most major events like this, the hardest work doesn't happen during the event itself, but rather with the recovery from it.

This was the case with the Superstorm Sandy that hit the East Coast as well as others, other emergencies we have experienced. Even though the pandemic is still going, we have learned many lessons, not only about how to respond even better the next time, but also. Pointed out inefficiencies in areas in our organization where improvement is needed.

Absolutely. Amen. You are preaching to the choir. Yeah. Coming out of, there's a lot of work coming outta this. We should not assume that we're coming out with the same set of assumptions that we went into it with. Uh, the world has changed, expectations have changed. Financials have changed, markets have changed.

How we interact with our patients will change. I think the emphasis on home care or care at a distance is going to . Uh, dramatically impact us. Michael Stansberry's, vice President of IT Innovation at Houston Methodist has health organizations continue to innovate, to provide better consumer patient experience, great efficiencies for clinicians, and utilize data to improve the health of our population.

Organizations could easily overlook the importance of data security. Absolutely. Even one security breach is one too many. Sure. Now with that being said. I would love to see a lot more innovation around data security. We, we don't seem to spend enough money and time. There. We're, we're, we're focused on a lot of really cool things and, uh, that is not one of the more sexy things of data security.

I. In that space. So we, I would like to see innovation groups, you know, offer some challenges in that area and see if, we can't, can't really, we should be one of the industries that's pushing this forward somehow. We, we, we look at banking and other industries and we go, oh, you know, they're protecting money.

We're dealing people's lives. We, we should have really good security and we should be funding it at a certain level. So let me see if there's any others. Let's see. . This is interesting. Lee Carmen, associate Vice President of Information Systems, university of Iowa Hospitals and clinics. I think one of the most dangerous trends in health IT right now is the increasing demand to integrate clinical data across different sources and from different organizations without a national patient id.

I, I talked about this last week. I'm not gonna go into it. Yeah, he's right. You know, if you're, if we're not matching the patients. I, I don't know if patient ID is the right way to go, but if we're not matching the patients effectively, yeah, that's a, that's a significant risk. Say for Shari, we had him on the show.

I believe the most dangerous trend in health it today is medical device vulnerabilities. Amen, brother. My gosh. , I feel like I'm outta a revival. That is absolutely true. I'll tell you, our biomed devices, we had some that were on the Windows xp now that this was eight years ago. I hope that's not the case.

Any, uh, anymore today? Uh, part of that was the, the pro, the FDA process was slow and cumbersome. Anytime they changed it, you know, we wanted to upgrade those things and it would not have been that hard to upgrade 'em. But then they, they don't become compliant anymore, right? So that whole process needs to be looked at.

And, uh, that's, that's a, a little, uh, little disconcerting. Let's see, any others that I want to touch on there? There's a lot here. Uh, good article if you get a chance to read it. Becker's Hospital Review five of the most dangerous health it trends, insights from eight executives, and I'm sure you guys have your own list.

If I thought about it, I could probably add to that list as as well. But that's all for this week. Don't forget to sign up for CliffNotes. Get your staff to sign up for CliffNotes. We are producing this show for you to keep your staff current, to help them to advance. So not only sign yourself up, get your staff.

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