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 Welcome to this Week in Health it. It's Tuesday News Day where we look at the news which will impact health it today, job losses, telehealth five G, and much more. My name is Bill Russell Healthcare, CIO, coach and creator of this week in Health. It a set of podcast videos in collaboration events dedicated to developing the next generation of health leaders.

Uh, the coun, the country is transitioning and so are we, we are now doing three shows per week instead of the five we've been dropping. Uh, we're gonna have a show on Tuesday and Friday as we did prior to the pandemic, and we're gonna drop another show every Wednesday. Uh, we're gonna continue to do a live show once a month.

At the end of the month. Uh, we will only do a few more episodes of the Covid series, and then we're going to, uh. Put a bow on that and, uh, call it a series and, uh, put it into the archive. Um, as part of that, we're introducing new cards that's gonna match the website redesign that we did a while ago. We just decided not to redo the cards in the middle of the, uh, COVID series.

Uh, we're launching a thing called clip notes that I'm really not allowed to speak about yet. We will talk about that in the next couple of weeks. Uh, I'm also, I wanted to make you aware, I'm speaking at the Atmosphere Digital Conference for Aruba and hosting a, a panel discussion with, um, uh, Dr. Chaudry from CI ICIO, from Seattle Children's and Rick Allen, the CTO from Navicent.

Uh, we're gonna be doing a session called Healthcare at the Edge, the Convergence of Devices, data, patients, providers, and Care. I hope you followed all that. Um, you know, we're extremely busy at this moment in time, working to develop great content. For the next generation of health leaders, this episode and every episode since we started the Covid 19 series, has been sponsored by Sirius Healthcare.

It is their commitment to making this content available that has made the daily episodes possible. Uh, special thanks to Sirius for supporting the show's efforts during the crisis. Okay, let's get to the news. Uh, here's what my promise to you. It is. Uh, I'm gonna do 10 stories in 20 minutes, I promise. Set the timer.

Here it goes. I'm looking at the timer. Okay. 10 stories. 10 minutes with a so what for each one? Here we go. Uh, over 10% of healthcare CFOs expect digital transformations, uh, to cut digital transformation spending. It's interesting that article title, over 10% of healthcare CFOs expect to cut digital transformation spending when in reality what they're saying is 90% don't expect to cut it.

So here's what the article says, it would seem most CFOs understand that the pandemic has proved the need. To speed up digital transformation in initiatives, uh, to not only survive, but to prosper in the new normal. Doug Brown, president of Blackbook Research said in a statement for CFOs eager to expedite their organization's digital transformation, the standardization and simplification leaders want their backend processes.

Are allowing for less complicated, faster adoption despite the times. Additionally, the survey found that 90% of the providers have embraced virtual care solutions. 75% have initiated high highly. Uh. Highly patient positive experiences and over half have had to commence with layoffs and process changes.

Uh, you know, what's the so what on this? The so what on this is Absolutely, you know, there's, there's a whole host of things coming out of this pandemic, which are going to be silver linings. And some of that is going to be essentially that, uh, that patients have experienced new, uh, new modalities and, uh, providers have, we've educated a whole.

Host of people, huge amounts of people on the value of telehealth, on the value of, uh, remote patient monitoring, uh, the value of, uh, online scheduling, the, I mean, you name it, it, it's, uh, quite frankly, we had, we were forced to do it and now everyone's experienced it and they sort of stepped back and said, Hey, I actually liked that meal.

That was actually good. I actually enjoyed that. Let's do more of that. So I think you're gonna see that. In light of some of the other stories that are coming up. So Covid Ovid 19, story number two. Uh, COVID 19. Impact on hospitals worse than previously estimated Healthcare finance News. A Coffman Hall report.

Looking at April Hospital, financial performance showed that steep volume and revenue declines drove margin performance so low that it broke records. Uh, despite $50 billion in funding allocated through the CARES Act, operating EBITDA margins fell to negative 19%. They felt 174% or 2,791 basis points compared to the same period last year.

And 118% compared to March. This shows a steady and dramatic decline as EBITDA margins were as high as 6.5% in April. Uh, so what the, so what of this is, um, it's bad. It's not uniform, but it's bad. Uh. And, uh, mitigating factors, as we've talked about on the show before, uh, if you had a lot of, uh, uh, managed care patients, uh, you would weather this better than, uh, organizations that didn't have managed care patients.

There's gonna be hospitals and health systems that have, uh, billion dollars in investments. Uh, even though the investments didn't do all that well during the, uh, pandemic, they have rebounded nicely. And, uh, they're gonna have some reserves to play with to come out of this. Uh, some of the other health systems are going to, uh, struggle mightily.

Uh, I don't suspect that we will see it. Budgets increase. In fact, I think we will see pressure on it, budgets to contract, but we will see digital transformation, digital, uh, very targeted, uh, digital consumer experiences. Uh, investments continue to grow. Alright, number three, story number three. Cerner hires a new CTO.

Uh, Jerome Labatt Labatt, L-A-B-A-T. Healthcare IT News. Uh, Labatt has. Deep experience with cloud and software as a service. Most recently, he served as CTO for Microfocus International, a British pure play enterprise software and information technology business. Before that, he served as CTO for HPE software leading the cloud automation business.

Prior to that, Labatt served 20 years at Oracle, where he led infrastructure automation and development operation. Uh, among his goals at Cerner is to build out cloud capabilities while integrating cognitive computing capabilities according to the company. So what, I don't know what to make of this, to be honest with you.

I, I wish I could give you a definitive, I was pretty high on Cerner last year. I thought their move to the cloud was good. Um, I thought the partnership with AWS was pretty smart. I, I, I saw some, I saw some, uh, light there. I saw some, some things to get excited about. Um, I, I'm never excited when you're replacing the CTO and, uh, you know, and quite frankly, uh, 20 years at, uh.

Um, you know, 20 years at Oracle and what this, this announcement does not excite me as much as it maybe should. I don't know. I, I don't know this person all that well. Uh, I know that the Oracle background doesn't really excite me. The HPE background doesn't excite me. The micro focus background, maybe, um, maybe this is the kind of person they need.

Um. I would hope for, you know, the direction they were heading with AWS in the cloud seemed to me to be a forward leaning, forward looking, and then you just hire somebody with, um, you know, 30 plus years of experience in the industry. I just, I don't, there's something about this that doesn't sit right with me.

I'm not sure what it is yet. I have no, so what for this, I reserve the right to comment on this later, uh, five G Revolution, unlocking the digital age. Um, this was, uh. This is, you know, visual capitalist comes out with these things, and every now and then I'll click on 'em and look at 'em. This was interesting to me, and I, I pulled this out for one reason.

Uh, Patty wrote this art, uh, Patty, uh, p Manon, who, uh, does consulting in the industry. Who stuff I, I, I like, he has a podcast as well. It's with Damo Consulting. Uh, let's see. He wrote . Uh, a handful of things. So I'm just gonna pull out the, you know, 20, 20 or 10 stories in 10, 20 minutes. Um, three main points.

The rise of contactless experiences as is often happens in major catastrophic events, natural or human made. I. Many societal practices change irreversibly. The pandemic has made us all afraid to touch any surface ex exposed to the public, so there's gonna be a rise of contactless experiences is first point.

Second one, contact tracing. Inspired by the success of Singapore and South Korea, contact tracing applications on Bluetooth enabled devices have been positioned as an effective means to track and trace infections to reduce the spread of covid 19. And, uh, his third thing is remote monitoring and au automated communication.

Healthcare executives are more motivated than ever to keep their populations healthy in their homes. The rise of telehealth and intelligent remote monitoring devices now allow patient populations to stay at home and manage their chronic care conditions, avoid visits to hospitals and communicate on real-time basis with their caregivers.

Here's the so what. Absolutely. Yes. On the contactless experience, uh, I'm starting to experience that. Uh, I had some furniture delivered. Um, we moved into a new house. We got a new chair and they delivered it. And the whole experience was contactless. I mean, they took a picture. I. Uh, in the house of the thing.

I didn't have to sign anything. I didn't even have to do the finger thing on somebody's phone, which, as you know, a phone is one of the, just the complete carrier of, uh, of, uh, you know, germs and, and viruses. So, um, you know, I think that contactless experience is gonna be a new thing in our, uh, in our culture.

Uh, contact tracing. I think it's going absolutely nowhere. I think it's gonna be swallowed up in the political abyss. Um, again, not a technology problem. I think it's a, uh, it's an adoption problem and I think it's a politics problem. And I, again, not stating whether we should or should not be doing it, I'm just saying it's gonna get swallowed up.

Uh, we are not South Korea and we are not Singapore. We don't have, I. Uh, the, the same culture. And so I think that's going to get swallowed up. Uh, remote monitoring and auto automated, uh, communication. Absolutely. I think we're gonna see the rise of the home as the new, uh, locus for, uh, caring for the aged.

I think we're gonna see, uh, people really try to stay away from, uh, going into, uh, long-term care facilities, stay at home more. . Um, I think you're gonna see chronic patients start to, uh, wire up their homes with, uh, internet of things, devices, and you're gonna see a whole host of things happen around that.

I think that's the thing to keep an eye on. Um, uh, it's really gonna be interesting. Okay. Next story. Medicare leaders call for expanded telehealth access. After Covid 19, president Trump's top Medicare officials said Tuesday that expanded access to telemedicine should continue after the coronavirus.

Excuse me, pandemic proceeds and that officials are examining ways to act without waiting for legislation from Congress. I can't imagine going back said, CIMA Verma, administrators of CMS and Medicaid services told STAT during a live virtual event, people recognize the value of this. So it seems that it would not be a good thing to force our beneficiaries to go back to in-person visits.

Absolutely. Here's the, uh, here's my so what on this? Sema Ver Verma is arguably one of the most powerful people in healthcare. There are 64 million people on Medicare. Um, and she is speaking as someone who holds significant influence. Uh, I wouldn't take this to the bank because she needs money to make this happen, but they're very creative, right?

So, uh, people recognize the value. So it seems it would not be a good thing to force beneficiaries to go back. That actually was, um, that officials are examining ways to act without . Uh, waiting for legislation from Congress. Interesting. Okay. So I made this point last week on the show that, um, Congress is where you go to get money.

MA plans will now have broader flexibility than is currently available in how they pay for coverage of Telehealth benefits to meet the needs of the ese. These changes will provide MA plans with the ability to offer expanded telehealth coverage to meet the needs of their patients. Patients and MA plans have always been able to receive.

Love it. Learn it, integrate it, figure it out. Uh, next story. Ooh. Okay, I get moving here. Seattle Coronavirus survivor gets $1.1 million bill, one hundred and one, one hundred eighty one pages long. Uh, Michael Flore the longest hospitalized Covid 19 patient who, when he unexpectedly did not die, was jokingly dubbed the Miracle Child.

Now that he, he also, you can also call him the Million Dollar Baby total tab, 1.1 million. Uh, one, uh, a little over 1.1. All in 181 pages. The bill is technically an explanation of charges, and, uh, in fact, uh, because it's C Ovid 19, he will likely not pay . Anything, uh, that will be picked up by various things, including, uh, money that was put aside for the CARES Act and other things.

Um, why do I cover this story? It's just a reminder. It's an election year. . I was telling somebody the other day, this is the oddest election year ever. You just don't even hear about it. Normally, you would be the, the, the sound would be so high on this election year stuff, uh, but there are so many things going on in our world.

Um, it is an election year. Healthcare costs are an issue. This normally would be a massive story in an election year, and it would become an election year issue, and it may still, uh, the cost of healthcare, 20% of GDP still too high, uh, approaching 20% of GDP still too high. Uh, cost to individuals. Cost to businesses still too high.

So, um, it's an election year. It's an issue. Just keep that in mind as we move forward. Next story. Hospitals continue to struggle with job losses as other areas of healthcare rebound. Uh, healthcare, finance, news, overall education and health services employed. Uh, employment increased in May, adding 424,000 jobs after suffering a decrease of 2.6 million in April.

However, the numbers also show that hospitals have yet to recover financially from this surge. Of Covid 19 patients and the loss of revenue from post postponed or canceled elective procedures, many were forced to furlough or layoff staff because the billions earmarked for hospitals in the coronavirus aid relief, uh, caress act, sorry, um, was not enough for most hospitals to operate at previous expense levels.

Uh, you know, to, to a certain. So what on this is, uh, you know, these are tough times for hospitals. We are gonna tighten our belt across the board. Uh, some, some health systems, . Are really doing okay coming out of this. It's been interesting. Uh, I think some of it has to do with your, uh, market share, your essentiality in the markets that you serve.

Some of it may have to do with the amount of money you decided to spend going into it. Some people really drug their feet going into the preparedness saying, you know, we know we can sort of make this transition when we need to. We're not going to . You know, I clearly, they, they followed the, the state guidelines and whatnot, but they didn't

Spend a ton of money standing up additional facilities or even transitioning a ton of, of space. And so they didn't incur those ex excess costs. They did have the decrease in revenue. I, I'm just saying it, it hit health systems unevenly. The so what on this is, uh, that it, it's gonna take a little while for healthcare to recover.

Some people are saying. Uh, you know that, that actually some people I'm talking to, the numbers have recovered somewhat where it seems pretty simple for people to get back to about 80 to 85% of their run rate. But when you hear that run rate, keep in mind it's different run rates, right? Uh, percentage of ED visits, percentage of procedures, percentage of office visits, percentage of, um,

Yeah, clinics and whatnot, the percentages are different and they mean different amounts of revenue and different amount, different amounts of, uh, money to the health system. To keep that in mind, as you hear these numbers, you gotta sort of balance 'em out, but I think getting back to 85% in general is something that is happening pretty quickly across the board.

But keep in mind, 85% is not enough. They have to cut significant. We as a health system will have to cut significant amount of costs to, uh, stay ahead of that. Okay, and final story, and I'm almost delivering on my promise at Stanford Children's Health, the telehealth bubble won't burst. Uh, Natalie, uh. ler, MD Chief Medical CMIO of Stanford Children's Health Time will tell what the future holds, and I expect some drop in Telehealth numbers as we go forward, but clearly we won't return to the baseline we were before the pandemic.

There are so many stories of both patients and providers who have discovered unknown value in telehealth, and in many cases, telehealth may be the more optimal method of delivering care. We have had cases where. Our development and behavioral pediatricians are seeing children in their home environment and getting much more information about the development of the natural environment compared to the clinic setting.

It's actually gotten to the point in which our division Chief for Development and Behavioral Pediatrics has said that going forward, the at-home assessments will be standard part of these evaluations. Uh, you know, the somewhat on this is, I I agree wholeheartedly. Although it is. Primarily gonna be a, a numbers game.

Uh, it depends how much of this is going to get. Um, I, there's two aspects of this really. It's gotta get funded. We all know that, so I should just stop saying it. It has to get funded in some way. It's a zero sum game. You cannot, uh, you know, all of a sudden create all these new capabilities. It doesn't get funded, but there's different ways to fund it.

You can get actually paid for it, or you can drive out costs by doing things in a different way. Um, now if, if it doesn't get funded. I, I mean, there's. Case to be made that it is gonna be hard to sustain these gains. But as you saw in the earlier story, Medicare Advantage is, uh, funded. I think you're gonna see Medicare get funded.

I think you're gonna have, uh, new plans get developed by the, uh, payers, by the commercial payers, which have telehealth only type options. It's gonna be an exciting time in healthcare is, isn't it always? Uh, that's all for, for now for the news. Special thanks to our sponsors, VMware Starbridge Advisors.

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