This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

 Welcome to this Weekend in Health IT News, where we look at as many stories as we can in 20 minutes or less that will impact health it. It's Tuesday Newsday, and here's what we have on tap. Providence St. Joseph Health acquires Epic Consulting Firm Blue Tree. Uh, Philadelphia's Hahnemann University Hospital Files for bankruptcy and why No Single Health Incentive Works.

New England Journal of Medicine Catalyst. Look forward to covering that. My name is Bill Russell. We're covering healthcare, c i o, and creator of this week in health. It a set of podcasts and videos dedicated to developing the next generation of health IT leaders. This podcast is brought to you by Health Lyrics Technology Coach for health executives.

Let's talk visit health lyrics.com to schedule your free consultation. Wanna support the fastest growing podcast in the health IT space? Here are five easy ways. You can do that. One, share it with a peer. Number two, follow our social accounts, LinkedIn, Twitter, YouTube. Number three, interact and repost our social media content.

Number four, send me feedback. I love getting, uh, questions, recommendations, uh, story suggestions. Uh, . You know, it's just phenomenal to get your feedback. Really appreciate it, bill, at this week in health it.com and subscribe to our newsletter on the website. So let's get to the news. Providence, St. Joseph Health acquires epic consulting firm Blue Tree.

This is, uh, pulled this story from h i consultant.net by Fred Nik. Let's get to it. So Providence St. Joseph Health, a national non-for-profit not-for-profit Catholic Health system. Announced today that it will acquire Blue Tree, an epic consulting and strategy company. That helps healthcare providers maximize the use of their technology.

Use of their technology based in Madison, Wisconsin, which I guess would tell you which technology they're focused in on. And with offices in Denver and New York, Bree's integrated team approach helps healthcare providers realize higher returns from their Epic e h R platform investment. Uh, let's see.

What, what are the benefits for Providence? By acquiring Bree Providence, agents of Health will expand its current offerings to increase the value. It delivers to other health systems across the country. There's number one, the acquisition is part of a strategy to to diversify revenue, to support patient care.

In the mission of Providence St. Joseph Health, that's number two. And with the addition of Blue Tree, Providence St. Joseph Health now has two of the top E H R solution companies in the country. It will also engage. Which has, uh, it also owns Engage. Engage is the name of the company, which has grown to become one of the largest Meditech solution companies in the United States.

So what is Mike Butler? President of Strategy and Operations for Providence said, uh, many health systems have invested heavily in Epic as the backbone to provide seamless patient care. The value add of E M R Consulting is modernizing talent management, revenue cycle, and operations. So providers can focus on their core strengths.

Of delivery of care instead of pouring resources into technology investments as one of epic's largest customers already, blue Tree will enable us to build new revenue streams by expanding these services to other health systems. Uh, let's see. Is there anything else in this story? Uh, one last thing. So, Providence, St.

I. So, you know, so what's the so what for this? And, and I, I think the answer to this is, uh, this makes perfect sense for Providence, uh, St. Joseph Health. Uh, the, they have a, the up upcoming implementation, which I discussed, 16 hospitals going to Epic. I have a feeling the details of the financials on this were not announced, but I have a feeling

It'll pay for itself in just those 16 hospitals being implemented. Um, you know, and, and so the transaction itself makes sense. Uh, I think they needed the in-house expertise. It's part of what they, their value proposition is they go into the community and they talk to other health providers to either partner with them on, uh, extending their, uh, continuum of care, or it's, uh, part of their strategy for acquisition and growth is being able to, uh, integrate those other health systems a lot quicker.

Uh, and with, um, you know, I, I guess more defined programs around the E H R consolidation during those, uh, during those con consolidation events. So, um, and I think the other thing that's obvious is it, it's gonna, uh, grow the, the critical shared service, uh, revenue, um, that they're looking for. So, um, . It, it's interesting 'cause the conversations I've had have have primarily been with solution providers and, and they say, what does this mean?

Well, I, I think it means you just gained a competitor, . I mean, TRE was always a competitor, but now you've gained a competitor that's also a client, so you may have lost a, a potential client. In the process of gaining a competitor. The other thing I would say about this is, uh, you can't underestimate the relationships that these hospitals have, uh, networks, uh, across the country.

When you look at it, uh, the innovation groups from these various, uh, organizations across the country, they work closely together to, uh, to either, you know, get these startups off the ground or to fund their second rounds, and you see them coming together more and more. I think this is a, another one of those situations where

Uh, you know, Providence is gonna have a leg up on some of these E H R implementations, uh, because they have relationships, they're seeing these people, they're having the conversations. So, uh, I, I think you have gained a competitor. I think you've lost a potential client, those who are looking to get into that, uh, 16 hospital rollout.

Now with that being said, an epic implementation across 16 hospitals is gonna take. Hundreds of people, and I doubt that, uh, Bree is gonna provide all of those. There's gonna be specialty services. There's still gonna be a lot of staffing, uh, associated with that. I imagine the big players are gonna be around Leidos and others, uh, are gonna be looking at that revenue.

Uh, so there's still an opportunity there. Um, You know, the good news, I, I guess there is good news for a, uh, solution provider in this is that, uh, other systems might look to follow suit and compete against Providence, which could create a market. Uh, for these, uh, I think that the players that make the most sense are, are the players that are focused in on E H R only.

Not, uh, a hundred different services, but really focusing on E H R. They're sort of a niche player, . Focusing on E M R implementations or even E R P implementations, and there could be a market for that. Now you could see a large health system, a, you know, a 10, $15 billion health system say, Hey, that move makes sense to me.

That will provide revenue so that we can do our internal, I think Amazon a W Ss. Amazon a w s essentially funds all of it, and then some for beyond that, for, for Amazon. At this point, if you can grow your shared services revenue, uh, as a, uh, percentage of your overall revenue, that's gonna fund a lot of technology initiatives.

So, uh, interesting story. I thought I'd start with that one just because I, I got so many questions about it. Thought I'd just throw it out there. Our second story, and, um, this is not as much of a fun story, but it's, uh, it's one that's . Uh, very, very much talked about on social media and definitely talked about in the city of Philadelphia.

So Philadelphia's, Hahnemann University Hospital Files for bankruptcy. This story I pulled from W P V I, uh, A B C and Philadelphia and it, um, the parent company filed for bankruptcy for both Hahnemann and St. Christopher's Hospital for Children, and now the city's trying to intervene. Changes already are already happening at Hahnemann.

With emergency department no longer accepting trauma patients as of this weekend, and that was before the 4th of July weekend. Uh, St. Christopher's has said to remain open, but there's still a lot of unanswered questions from both hospitals, although it seems like the intention is, well, I'll go on, I'll just read it.

The, uh, this morning, the parent company, Philadelphia Academic Health System. Voluntarily, voluntarily filed for Chapter 11 bankruptcy saying it will ensure an orderly wind down of operations of Hahnemann while assuring patient safety, it will facilitate a restructuring of St. Christopher's, which will enable it to remain in full operation.

Uh, nurses at St. Christopher's say morale is low. And there's a, a lot of, you know, back and forth in terms of, uh, not really knowing what's going on and what's next, uh, mean. Meanwhile, Drexel University says the lawsuit filed against the hospital owners to block the closing to get back, uh, compensation for its partnership with Hahnemann to train physicians has now been referred to Federal Bankruptcy Court in Wilmington, Delaware.

So, um, Let's see, uh, a couple more things on this. So, uh, they've not exactly been the best to work with. It's driven by a personality of one person, and that personality can be erratic at times. Uh, said p a. P a h s owner, Joel Friedman. If this was a nonprofit company, we'd have the ability to force situations.

But this is a private nonprofit or, yeah, a private nonprofit. He continued. I'm worried that the health community and, and jobs of the employees and the doctors that we're going to do our best to put our best foot forward says Friedman. Uh, lemme give you some of the numbers here. So in the filing, P a h Ss.

Said it had liabilities between a hundred and $500 million. Liabilities, meaning deficits, debt, uh, with only 10 to 50 million in assets. Um, I don't think that, that, that can't possibly include the hospital and the land. It's sitting on. The land. It's sitting on is . Easily covers that debt, um, because it's downtown Philadelphia and in an area that's being revitalized.

But regardless, a hundred to 500 million in debt, 10 to 50 million in assets. Uh, the company abruptly announced on Wednesday that it would shut down to its 495 Bed Center City, Philadelphia Hospital, and begin diverting patients to, uh, from its level one trauma center. P H P A H SS owes $20.1 million. To Tenant Healthcare, Hahnemann and St.

Christopher, uh, former owners, uh, owe $14.1 million to Drexel University, which operates Hahnemann's Medical School and nearly $700,000 to the city among other debts. So there's some numbers. Oh, and the last number. Hahnemann handles 56,000 emergency visits each year in addition to the thousands of other patients.

Uh, at its center city location. Um, you know, so what for, and I'm gonna do this from a health IT perspective in as much as I possibly can. Uh, I was treated at Hahnemann as a child. I grew up not too far from Philadelphia. I had to go down. I was one of those rural communities where you go to the city for, uh, some specialty care.

So I, I, I was treated at Hahnemann. Uh, you know, this is gonna be hard for the staff. Uh, it's really hard for the people involved, hard for the staff, hard for the medical residents, um, hard for the local residents. Um, you know, I've been through this multiple times in my career and, uh, you know, it's just flat out hard.

It does impact families. It's, they're difficult conversations. Um, and so I don't mean this to sound insensitive. I'm really . I'm just going from a health IT business perspective. Um, but you know, at the end of the day, there's five academic medical centers in Philly. Um, they're not at a loss for healthcare.

There was this map on the Philadelphia Inquirer, which showed all the health systems and the geographies that they served, and this is surrounded by other really high ranking, high performing health systems. Um, you know, there's several edss and the closest of which is, uh, is I, I think it said less than a mile.

So the, the Jefferson Health. Uh, ed is less than a mile from where Hahnemann is. The city technically is probably overserved in terms of healthcare, and the ed is, is, is less than a mile. And when I think about if say, uh, say St. Joseph Health were to close in Orange County, the closest ED would be 10 miles.

And, and that's a major city that's, uh, you know it, when you think about that, 10 miles I think has an impact. One mile . Is not that much of an impact now. I understand. It's, it's a, um, it's a, uh, uh, it's a, it's a community that doesn't have a lot of money, that there's, uh, a lot of homeless, a lot of Medicaid, uh, care and those kind of things.

And they're saying that that one mile can make the difference between them getting care and not getting care. I can't really speak to that. That is probably true. Um, but I, I think there's an opportunity here, and I'm gonna go into that in a minute. . The reality is the business is broken. It doesn't make money.

This surprises, no one surprises no one. Um, the, you know, it's a for-profit business and they really can't be forced to stay open. So, uh, so it is gonna close. You know, I, I think this will make the overall ecosystem in Philly as a result, uh, better. Uh, there's gonna be pain in the process, but it's gonna be better, uh, long term.

And, uh, you know, here's, here's some of the things from a health IT perspective. Um, number one, health systems, health innovators. The, the, the ED continues to be overused. I mean, one of the biggest complaints about this is the ED because quite frankly, if you're doing specialty care at this point, you, you're going to Penn, you're going to Jefferson, you're going to, uh, temple, you're going somewhere else already.

Uh, really what this is about is the ED shutting down and the reality is the ED is overused. Um, and from a health IT perspective, we need new solutions to route people to the right level of care, period. However that's done, we, we should be thinking through that. We, which I think gets to my second point, which is we need to be thinking outside the four walls.

That hospital is not necessary. I. It's, it's, it's just not needed. There are so many things, so many different form factors that can be put in there that would be much better. Um, we need to be thinking outside the four walls and how are we gonna deliver care where it's needed? How are we gonna get people to the place where, um, where they can get the right, the appropriate level of care at the right time.

And, and more times than not, it's not the ed. They, they had a story about a person with 104 degree fever, or not 104, 101 degree fever who went to the ed who said, well, I don't know what I'm gonna do now that the Ed's not there. I'm like, c v s, Walgreens. There's, there's a lot of places where we can deliver care to that person with a fever for heaven's sake.

So, um, which gets to my last point, which is new venues of care. You know, banks are, are being reimagined as a cross between a Starbucks and an Apple store. You know, even complete with a, a genius bar on financial services. So, uh, Haman and others should be replaced with more appropriate, and you can read that.

Financially sustainable locations for health and care. I think a across between, um, I don't know, like, like a health food store, like a G N C. Um, oh no. Food. Food would be better. So a food store and, uh, and, and, you know, like a fitness store, you know, complete with access to a genius bar with health services and all those, those physicians and nurses and whatnot don't need to reside in that store.

There. There could be ways to access those health services, but think of Genius Bar that you can go and ask those health questions that you want to ask. Or if you're sick, you could actually talk to somebody. And there is a way to, uh, to direct people to the right level of care. Um, You know, as, as the poster on my wall says, my daughter, uh, painted me a, uh, a great, um, rendition of the old apple, um, the old Apple, uh, ad campaign.

Think different. And, and, uh, I have um, I have this thing right up here, which it says to me every day think different. And I think we need to think different. That hospital doesn't need to be there. There's a lot of other venues that could be there, and that community would receive far better care. And that's, that's not a knock on the people.

The people are serving in an old model, in an old building, um, that has been underfunded. And, and people can rethink how care gets delivered to that center city population. And I think this is gonna be one of the easier transitions if this were to happen, say in Kentucky, in, uh, rural California or even rural Pennsylvania.

This would be a problem. It would be 40 minutes to, to your level one trauma care. But here we're talking blocks, so, uh, I'm not trying to sound insensitive, I'm just saying I think this, this care, any care gaps that get created will be closed very rapidly here. And, um, you know, on a side note, just expect more of these, more consolidations, more, uh, closures.

Um, . And, uh, I would say from, again, from a health IT perspective, be thinking this way. I'm amazed how few health systems have it m and a strategies before the, the acquisition actually occurs. Uh, you know, get a plan in place. Okay. Enough, uh, let's, let's go to one final story here. So, um, and this is from the, uh, new England Journal of Medicine, catalyst by, uh, Charlene Wong and nida, Seth Moda.

So Charlene Wong goes on to say she's the assistant professor of Duke University Department of Pediatrics amongst . Five other titles. Uh, she says that financial incentives have a reputation for providing uneven results when it comes to modifying patient behavior. And I'm gonna focus in on that modifying patient behavior statement 'cause I wanna come back to that.

Uh, and number two, uh, the presence of real sustainability is limited. Patients change their behavior while financial reward is on, but when the financial reward goes away, Their behavior tends to snap back, uh, along with a lack of sustainability. The impact of monetary rewards can become minimized if delivered in the form of biweekly paycheck, or if the reward takes the form of premium reduction that comes once a year.

Uh, at insurance plan time because it's not in their face enough, I guess, is the reason that it's not really, uh, stated Well there, uh, in contrast approaches rooted in social aspects such as the support of friends and family may have more lasting impact 'cause people involved will at least theoretically have permanence in patients' lives.

And, uh, I don't think anyone's gonna disagree with that. Lemme get to some of the verbatims. 'cause the verbatims I think are interesting. Um, . So these are the, uh, similar of the responses to, you know, what would work. And number one was explanation from, or this person, which is a clinician at a small nonprofit government health organization in the west.

Uh, one explanation from providers, two level of understanding of patients, three level of commitment on patients to follow what he or she understands. And four, we have enough tools to monitor improvement. Uh, vice president of large nonprofit health system in the South says An engaging, persuasive, passionate, caring doctor is the only thing that will work well.

I'm not sure it's the only thing that will work, but it's a, a very bold statement. Uh, director of large nonprofit teaching hospital in the Midwest. Reduction in benefit costs for healthy behaviors like smoking cessation, colonoscopy, mammography. Weight targets, et cetera. So, uh, and, and actually in, in this study, it does note that some of those incentives do work better for those very specific items.

So our clinic, uh, developed food pharmacy, which dispenses healthy food by prescription from health from physicians who our patients with diabetes, that's A C M O at a small nonprofit clinic in the west. And um, and it also has the, uh, . Has the chart, family and friends, support, education, clinician support, financial reward for healthy behaviors, making healthy choices easier through design, uh, benefit design and incentives, financial penalties for unhealthy behavior and, uh, peer pressure, et cetera, et cetera.

So, so what on this one, it's the right question. Uh, how do we get better health behavior? It is a behavioral question. Uh, you know, I get the results of the diet that I sustained. How do you change my behavior becomes the right question. Uh, too many of our digital tools are, are, are lacking this ana uh, analysis and, uh, Efficacy on behavioral change.

You know, we measure the success based on did they get series A funding, B funding, C funding, uh, have they attained unicorn status? And to a certain extent, I say, who gives a rep, um, you know, does the health system get the right, uh, press in the trade rags? Can we brag about our accomplishment at the next peer meeting?

I'm not trying to, I'm not trying to, to, uh, you know, point fingers at anybody. I'm just saying . Essentially are we, are we measuring the right things? Are we getting better health as a result of it? Are we just looking at our success in this new math, uh, that we're, we're looking at for healthcare systems?

Um, you know, I really only care about how well a digital tool can help people like me and my family to live, uh, really live a healthier life to, to save us money, to simplify the navigation of health. Uh, to live with a chronic condition. I, I mean, those are the kind of things I care about. Gimme a toll that does one of these things, and I, and I think you've, you, you've really done something.

Uh, finally, I, I, if you haven't thought through behavior change in populations you serve and, and, and, uh, uh, you're not, I just don't think you're going to be able to get me to be healthy. Just throwing education, uh, in, in front of a, uh, a medical record is not gonna get me to skip ice cream tonight after dinner.

Uh, and quite frankly, that is what is gonna have, uh, a lasting impact. That's what's gonna be able to, to, to, uh, make a difference in my health and my diet. So think behavioral change in your digital tools. I, you know, I love talking to digital health startups about their tools, their business models. Um, you know, there are such great promise there and I'm glad they're getting series A, b, C funding and I'm glad health systems are investing in these things.

This is really exciting stuff. Um, but let's see if we can't cross, uh, digital and behavior, digital tools and behavioral change, uh, and really make a dent in, uh, in my poor eating habits. So there . There you have it. So that's all for this week. Uh, you know, this Friday I'd, I'd, I'd love for you to tune in. We have a, uh, a really cool startup out of Philadelphia and I have a great conversation with them.

I look forward to, uh, uh, sharing that with you. Uh, and I recorded that a couple weeks ago when I was in Philly. . Um, you can check out, uh, this past week we talked about security and a couple weeks ago we had a conversation with, uh, Dr. Steven Klasko and Nasser Nazami. Those are on the Friday shows. As always, on Tuesday, we cover the news, hit any of those shows.

Uh, some of that stuff is, uh, still very fresh and exciting. Hopefully you're enjoying this. Um, really appreciate you, uh, uh, tuning into the show. Uh, keep the comments coming to bill it this week in health. It. Dot com. Good, bad or difference It, it really all helps. This show is a production of this week in Health It.

For more great content, you can check out our website at this week in health it.com or the YouTube channel at this week in health it.com/video. Thanks for listening. That's all for now.