Today in health, it, we are going to revisit my
Bill Russell:predictions from earlier in the year, actually from early February.
Bill Russell:We had three shows, which we did predictions on.
Bill Russell:I'm going to try to condense that down into two shows and
Bill Russell:we're going to see how do I do.
Bill Russell:Did I get anywhere close.
Bill Russell:My name is bill Russell.
Bill Russell:I'm a former CIO for a 16 hospital system and creator of this week and
Bill Russell:health it a channel dedicated to keeping health it staff current and engaged.
Bill Russell:All right.
Bill Russell:Let's just jump in.
Bill Russell:Here's what I'm going to do.
Bill Russell:I'm just going to play these episodes in their entirety, cutting down some of the
Bill Russell:parts, just so you can get the gist of it.
Bill Russell:And so that we could fit it into two days and just let you decide,
Bill Russell:how did I do, let me know how I did bill it this week and health it.com.
Bill Russell:Here we go.
Bill Russell:Let's just get right to them.
Bill Russell:My first one is.
Bill Russell:It's really around cloud and cloud adoption.
Bill Russell:So, uh, Microsoft is winning the move to the cloud and healthcare.
Bill Russell:There's no doubt about that.
Bill Russell:This was one of my predictions from last year, COVID threw a serious
Bill Russell:wrench into all predictions, but this one held up in spades.
Bill Russell:In fact, COVID help Microsoft.
Bill Russell:, the reason people go to Microsoft is because it's the incumbent and they make
Bill Russell:it easy with their renewal agreement to just check a box and get more software.
Bill Russell:You know, in, in, in a crisis, Ms.
Bill Russell:Teams became the go-to platform for remote work and collaboration for
Bill Russell:just about every health care system.
Bill Russell:I'm on, I'm on a lot of team teams meetings these days.
Bill Russell:Uh, this isn't the only reason they are winning.
Bill Russell:Uh, they also have a, a tool set that, that doesn't require any change to the
Bill Russell:existing staff skills when you move to the cloud or, or at least not much of
Bill Russell:a change, let's just say it that way.
Bill Russell:Uh, you know, data moved to the cloud in 2020 as well.
Bill Russell:Um, and that is really my prediction for 2020.
Bill Russell:There w there will be the start of a serious move to the cloud for
Bill Russell:healthcare, uh, and, and specifically healthcare data, uh, Mayo and
Bill Russell:Ascension have tapped into Google.
Bill Russell:Cerner's tapped into AWS.
Bill Russell:Providence has a massive agreement with Microsoft, uh, and health catalyst, uh,
Bill Russell:is built on Microsoft for that matter.
Bill Russell:Uh, 20, 21.
Bill Russell:We'll see health systems go beyond extending into the cloud for data
Bill Russell:platforms, and there will be full on use of the cloud for data tools and cloud
Bill Russell:data platforms will be used extensively for non transactional data requirements.
Bill Russell:Uh, this will facilitate multicloud data platforms in 2022 and beyond
Bill Russell:with a transactional systems really starting to follow.
Bill Russell:In 2022 with things like epic in the cloud on top of Irish,
Bill Russell:Irish was designed for the cloud.
Bill Russell:Uh, but I think you're going to see the, uh, performance enhancements
Bill Russell:and other things that come along with the new architecture is
Bill Russell:going to allow epic to fully.
Bill Russell:Work in the cloud.
Bill Russell:So that's a 20, 21 prediction.
Bill Russell:I think we're going to see more cloud data, uh, movement from healthcare.
Bill Russell:We're going to see a data platform start to emerge.
Bill Russell:We're going to see cross data platforms and, uh, interesting agreements
Bill Russell:start to form between health systems.
Bill Russell:To share their data for the, uh, for the good of all.
Bill Russell:So, uh, that's uh, that, that's how the cloud is going to grow in 2021.
Bill Russell:Uh, let's look at, uh, prediction, number two, the federal health emergencies going
Bill Russell:to continue through the end of this year.
Bill Russell:Right.
Bill Russell:And why is that important?
Bill Russell:And while it's important, because tele-health funding is attached to it.
Bill Russell:Right.
Bill Russell:So we were all worried during the election, you know, is Trump going to
Bill Russell:continue the federal health emergency?
Bill Russell:And back then I said, this is the silliest conversation going.
Bill Russell:This is at least going to continue through the end of the year.
Bill Russell:Okay.
Bill Russell:So we got through the end of the year, we're looking at this and we're saying,
Bill Russell:where are we at with regard to number of people who have had COVID number of
Bill Russell:number of people who have been vaccinated.
Bill Russell:And, uh, and then you can just look at it and say, let's make the
Bill Russell:prediction of how long the federal health emergency is going to go.
Bill Russell:Essentially saying we've got another 11 months of the federal health emergency.
Bill Russell:I don't think there's any rush to pull this thing off.
Bill Russell:I think we're going to get stagnated some somewhere around July timeframe,
Bill Russell:where we have plenty of vaccine, but not enough people lined up and we're
Bill Russell:going to sort of stutter through that.
Bill Russell:Uh, we're going to be stuck at a, uh, I dunno, let's just.
Bill Russell:Uh, 60% rate, which by the way, w will be fantastic, uh, compared to where we
Bill Russell:are, we were at, uh, in December and where we're at today, um, the, uh, the
Bill Russell:virus will slow down significantly, but with that being said, the
Bill Russell:federal health emergency is going to continue through the end of the year.
Bill Russell:So the biggest thing that means for health, it is that, uh, you
Bill Russell:know, tele-health funding, uh, or telehealth will remain funded
Bill Russell:at parody for most of 2021.
Bill Russell:And this is a chance for every house with some to really build out their
Bill Russell:capability with a viable funding stream.
Bill Russell:So if I told you, look, we're going to fund tele-health for the next 11 months.
Bill Russell:So, you know, continue to build out that you have a revenue stream for
Bill Russell:it, but at the end of 2021, you've got to figure out where the revenue
Bill Russell:streams is going to come from.
Bill Russell:Uh, that to me would be a huge opportunity.
Bill Russell:You're you're essentially you're backstopping my, my,
Bill Russell:all my telehealth efforts.
Bill Russell:And.
Bill Russell:You know, so obviously people are going to ask you too, how
Bill Russell:are you going to fund it in 2022?
Bill Russell:Uh, you know, it's, it's really the age old, you know, there will be, uh,
Bill Russell:there will be lines where CMS comes in and funds they're going to fund,
Bill Russell:um, uh, behavioral health is going to be funded at almost full parody.
Bill Russell:Uh, states are going to try to jump in.
Bill Russell:They just don't have enough money to fund it.
Bill Russell:Um, but you know, the question is where CMS going to fund
Bill Russell:it, they're going to fund it.
Bill Russell:They're there.
Bill Russell:They're going to have a trove of information, and they're going to
Bill Russell:look at where it has been effective and they're going to fund it.
Bill Russell:They're I think they're going to fund it around a remote health, into
Bill Russell:a rural and underserved communities I think will remain funded.
Bill Russell:So there's going to be a, a, an actual funding source, but you can also.
Bill Russell:Look at lowering your costs, improving efficiency and outcomes.
Bill Russell:And, uh, there's also that, that aspect of, uh, the patient experience
Bill Russell:and improving the patient experience because we've done that we can
Bill Russell:actually draw more people into our health system in the long run.
Bill Russell:So that's a, a, that's a significant move.
Bill Russell:The last prediction is for today is returned to bundles and bundled payments.
Bill Russell:And I talk about this on today's news stations.
Bill Russell:The, uh, you know, bundled payments was really something we saw during the Obama
Bill Russell:administration and essentially took things like knees and hip replacements
Bill Russell:and said, look, we're going to look at all of the organizations that deliver.
Bill Russell:These kinds of services across a significant geography.
Bill Russell:And we're going to see what the cost variation is to deliver the same service.
Bill Russell:And so they looked at, let's just say, knee replacement, they've looked at knee
Bill Russell:replacements across this large swath.
Bill Russell:And they said, oh my gosh, look, I mean, the disparity is huge.
Bill Russell:Here's what we're going to do at CMS.
Bill Russell:We're going to say.
Bill Russell:A bundle for knee replacement starts at diagnosis and ends at when you're
Bill Russell:actually walking without a Walker or a cane or that kind of stuff.
Bill Russell:So it ends up full recovery and we're going to assign a certain amount to that.
Bill Russell:And it's going to be based on, I don't know the mean or the average for a
Bill Russell:certain geography for delivering that.
Bill Russell:And that was, that was the norm during the bide, during the Obama administration.
Bill Russell:And therefore it's not hard to extrapolate.
Bill Russell:That will probably be the norm, uh, coming into the Biden administration.
Bill Russell:We're going to see a return to bundle payments.
Bill Russell:Uh, so, you know, what does that mean for health?
Bill Russell:It, well, bundled payments are hard and they're hard for a couple of reasons.
Bill Russell:One is, you know, you might be one of the people that's above that mean, or
Bill Russell:that average, in which case you're gonna have to look at driving your costs down.
Bill Russell:Uh, the second is you have to, you have to orchestrate the care.
Bill Russell:And a lot of times that care starts before your health system gets involved and it
Bill Russell:ends after your health systems involved.
Bill Russell:So it stretches your capabilities.
Bill Russell:It stretches your digital capabilities to stretch stretches
Bill Russell:your health systems capabilities.
Bill Russell:You have to figure out a way to deliver a good, I mean, it's
Bill Russell:really not at the diagnosis stage.
Bill Russell:That's actually the easy part.
Bill Russell:The hard part is, is really after.
Bill Russell:It's the rehab.
Bill Russell:It's the, it's the rehab facilities.
Bill Russell:And, uh, where in a lot of cases, we're not owned by the, by the health system.
Bill Russell:In which case you had to manage quality, you had to pass data
Bill Russell:along to those facilities and you had to manage the delivery.
Bill Russell:Uh, so that you didn't have any complications or those kinds of things.
Bill Russell:Cause quite frankly, your payment is fixed.
Bill Russell:You're not going to get any more than that payment.
Bill Russell:Therefore you had to make sure that you were within or below that payment.
Bill Russell:And so technologies play a huge role.
Bill Russell:They play a huge role in a couple of ways.
Bill Russell:We talked about data and.
Bill Russell:Transporting the data across the entire continuum, that's obvious, but
Bill Russell:the next one is, is really the, uh, the, the whole recovery mechanism.
Bill Russell:I think you're going to see a lot of different tools driving care
Bill Russell:out of the home and how are we going to be able to, uh, manage and
Bill Russell:orchestrate the entire experience?
Bill Russell:So that has multiple touch points with technology to determine
Bill Russell:pain, to determine, um, you know, complications, uh, to have people
Bill Russell:come back at the right time.
Bill Russell:So you'll have, uh, the types of digital tools where you're checking
Bill Russell:in with a patient on almost a daily basis, if not every other day.
Bill Russell:Uh, digitally so that you can track that patient from beginning to
Bill Russell:end to ensure that you are going to get the outcome that you need.
Bill Russell:So again, not rocket science, but 2021, you'll see a return
Bill Russell:to the two bundled payments.
Bill Russell:I don't know what they're going to bundle next.
Bill Russell:That would be a good prediction.
Bill Russell:I should, I should probably think about that.
Bill Russell:Talk to some people, figure out what they're going to bundle
Bill Russell:next, but, uh, um, you're going to see follow through on that.
Bill Russell:And that is where we're going to go.
Bill Russell:So that's the first wave of predictions.
Bill Russell:You have a move to the cloud specifically with data platforms and lo and behold,
Bill Russell:this year we had true Veta and we had, uh, some other solutions that came
Bill Russell:to the market, which were significant for the good of mankind, kind of big
Bill Russell:data data platforms, but that's not all we, we saw a lot of stuff happened
Bill Russell:with individual health systems making moves to the cloud, uh, with regard
Bill Russell:to their data platforms as well.
Bill Russell:And I still hold to the prediction that in 2022, you're going to see
Bill Russell:a lot of transactional systems.
Bill Russell:Moved to the cloud as well, such as EHR platforms, which will be
Bill Russell:interesting to watch at least.
Bill Russell:We will see that start to happen.
Bill Russell:At a, data backup and recovery kind of solution.
Bill Russell:, the second prediction was federal health emergency.
Bill Russell:We'll go through the end of the year.
Bill Russell:, because we will get stuck at somewhere around 60% vaccination rate.
Bill Russell:It turns out my state is currently at 60% vaccination rate state of California.
Bill Russell:62%.
Bill Russell:Vaccination rate.
Bill Russell:And so we still have the federal health emergency in place, which
Bill Russell:means the tele-health funding.
Bill Russell:Is still pretty much intact for health systems.
Bill Russell:And the returned to bundle payments.
Bill Russell:Uh, it remains to be seen whether we're going to see that really go.
Bill Russell:, anywhere, but, , I, I believe that we are going to see return to that.
Bill Russell:We're going to see that expand and continue to expand.
Bill Russell:, and it didn't happen in 2021 could be because of the pandemic
Bill Russell:going on and the transitions.
Bill Russell:That happened at the federal government level, but, uh, 20,
Bill Russell:22, I think we could see that one.
Bill Russell:Come back again.
Bill Russell:Uh, that's where I'm at today.
Bill Russell:I feel pretty good about those three predictions.
Bill Russell:There's about four or five more tuning tomorrow and you'll hear the rest.
Bill Russell:And then you can give me a grade.
Bill Russell:I'd love to hear it.
Bill Russell:That's all for today.
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