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 Welcome to this Week in Health It, it's Newsday. My name is Bill Russell, former Healthcare CIO for a 16 hospital system and creator of this week in Health IT at channel dedicated to keeping Health IT staff current and engaged. Special thanks to Sirius Healthcare Health Lyrics and Worldwide Technology, who are our new state show sponsors for investing in our mission to develop the next generation of health IT leaders.

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If you subscribe, you'll be notified when they go live. We produce, produce those clips just for you, the busy health IT professionals. So go ahead and check that out. Last week I keyed you in on something that's unfolding here at this week in health. It. We started off with our influencer podcast a little over three years ago, but since then we've been able to introduce Newsday and solution showcases, and last year we expanded even further with our Daily C Ovid 19 series, and now we have a daily show today in Health it.

And I'm happy to say that we're not done growing yet. We have something really exciting happening here at this week in health. It. Our goal, as you know, is to help inform, educate, and train health leaders. And we understand lots of people take information in in different ways. That's why we're introducing written content to our site.

For the first time, you'll be able to find news writeups covering each of our shows in detail as well as feature stories. And I'm really excited about the feature stories. We've hired two great, uh, feature story writers, and they're gonna take . Topics that are highly relevant to you and relevant to our industry, and they're gonna turn them into feature stories on our website.

I'm so thankful for all of our listeners and the conversation that we've had, our sponsors and the dialogue that we've had, uh, and the back and forth has really convinced me that this is the best next step. I wanna thank all of you for listening and joining with us on our journey of raising up the next generation of health leaders by amplifying great thinking to propel healthcare forward.

Now onto today's show. Alright, today we have Newsday and we have, we've got a lot of stuff. Um, we have our friend Drex Ford on the, uh, on the show today. Hey, Drex, how's it going? Good. Good. It's early here in Seattle, but I'm happy to be on and, you know, the first thing I noticed is you have, uh, better lighting and news set up and you look.

You, you look fantastic. I mean, you, you redid your studio? I did. I changed it up a bit. I got some new gear maybe look a little bit better because, you know, last Wednesday I had a total right hip replacement, which went fantastically. I don't know if you, I've tweeted a couple of videos of like, just walking around the day after surgery.

It's incredible what they can do with this tech. And so I'm feeling, uh, yeah, I'm feeling good and yeah, life is good. Wow, so you're walking around? Yeah. I, I assume you're doing, uh, physical therapy and whatnot. I will have my first PT appointment this week, I think Thursday. I have my first PT appointment.

Wow. When my parents, so my mom had a hip replacement. When she had that done, it was painful. I mean, and it was, it was months. It was months, but it was at least a month of physical therapy before she was walking pretty well. Yeah, it was, I mean, it's amazing to me. We, I went in at six in the morning on Wednesday last week they did surgery, started at eight.

They did a spinal block and then kind of knocked me out so that I wasn't present for the. Performance and then they got, I woke up, I think probably around nine 30. PT showed up, got me outta bed. We walked a loop around the unit over some stairs and did it all with sort of crutches and everything was totally.

Totally fine. Put my clothes on. They discharged me. I was home by a little bit afternoon. I was walking around pretty normally except for stairs by that later that day and sort of two days post-op I was doing. I literally did. I. Two miles, two days post-op outside. I mean, I sort of ditched the cane and everything right away 'cause it seemed to be more of a pain than it was helpful.

And by probably the third day I was doing stairs with both feet, you know, going up and coming down. I mean, I'm being ginger, I'm being careful, right? Bone has to grow into these, uh, new implants and make them, you know, solid and make them work. So I'm not doing anything crazy, but I'm definitely. I'm definitely moving and, you know, taking care of the wound site and doing all the good compliance stuff that I'm supposed to do as a patient.

So it's, it's crazy. It's amazing to me. I mean, I totally, if things stay on track and, you know, knock on wood, everything stays on track. But I kind of think by the, you know, by April I'll be, you know, I could be snowshoeing and hiking again. You're, you're a youngster. I mean, to have I am. Yeah. I mean, so is is it sports related?

It's a, a lot of it is sports. I mean, you know, I have, I have done, I don't even know, several marathons, tons of half marathons. You know, I've been. A very avid club cyclist. I've been in several bike crashes. I've been in helicopter crash. That kind of, you know, gave me a nice knock on the right hip at one point.

And you know, all of that is, you know, my surgeon essentially, I. Kind of went through the story with me and he was like, yeah, you know, whatever, you have like 700,000 miles on a, you know, on a 500,000 mile hip. It's, it doesn't matter. You know when, when it happens, and it's been painful for like six years.

It's been going on, the arthritis has just been killing me. And I got to the point where I was having a hard time sleeping at night, and dude, it's. It's amazing. It's incredible the, the difference, the change. So if you have any kind of like a hip problem, you've been thinking about doing this, like just go do it.

It's. It's pretty awesome. So quick, quick shout out which, which health system did you go to? I went to Swedish Providence, and they did a really amazing job. Of course, we're always super sensitive to how everything works from the intake. To how many times they check to make sure that they're doing surgery on the right side to even when I rolled into the, OR checking all the gear, how's everybody gowned?

You know, what kind of gear do you have in there? They actually use a robot to do part of the work so that you're, you know, you wind up being aligned probably better than you are with original equipment. Ultimately, when they're done, and I mean, everybody was fantastic. PT, ot, the nurses, the facility. It was, it was great.

The Swedish Orthopedic Institute, just literally like four blocks away. I walked up that morning to have surgery, so. And it's, and Swedish was a phenomenal acquisition or Yeah. Acquisition by Providence. It's such a great, great team. So I, I need to apologize a little bit. I'm actually outside. I got on an airplane for the first time since March 1st of last year.

Wow. Have, have you been on an airplane? I have not. I have not. So. You know, I, I, I talked about my, my time at Disney World. 'cause people wanted to know, hey, you know, what was it like, and, and you know, social distancing, everybody with a mask. I felt as safe as I could possibly feel. That was a great story.

I'm so glad you wrote that too. Yeah, it was interesting. But, uh, I do not feel the same about getting on a plane. . I can, I can see it. Tiny little enclosed tube with recirculated air. I know. Tiny little enclosed tube. There's no checks. Right. So there's no test. If you have covid, there's no, they don't even do temperature checks.

'cause they're like, eh, I, I don't know. For what? For whatever reason. They don't even do that. Everybody has to wear a mask in the airport and on the plane. Mm. But you get on the plane and you realize they've sold every seat. Yeah. There's no social distancing at that point. Yeah. I mean, you're not even far enough.

If you're aisle and isle, you're still not far enough away. Yeah. And there's people behind you in front of you too. Yep. So you're kind of surrounded and, and they must have said about, I don't know. I mean, again, I went from one side of the country to the other. I'm in Phoenix today, and they must have said about

30 times on the, on the, you know, PA system. You know, please pull your mask up over your nose, down below your chin, you know, covered completely. But you had kids on the plane, right? You had, uh, people trying to eat and that kind of stuff. Right. And I, I looked at my wife when I got done and I'm like, I. The only reason we are flying today is it, it has nothing to do with safety.

It has everything to do with just the economy would just completely shut down if, if we weren't flying. And I think what I, the other thing I saw flying to Phoenix, although it's not just flying to Phoenix, our flight to St. Louis, I. Was full. Our flight from St. Louis to Phoenix was full and the the airports were full.

And I sort of, I sort of looked at that and said, I think people are a little rammy. They're, they're getting to a point where they want to get out there. And, you know, I was just talking to somebody who said, he saw a quote that said, I don't wanna wear a mask, you know, one more day than I have to. I don't wanna take it off one day.

One day earlier before I should. Yeah. And I think we might be. Staring on the one day before we should at this point. 'cause we are making a lot of progress. We've seen for sure a lot of positive things around the vaccine. We've seen a lot of positive things around the, the trends. I I'm sure you're watching the numbers like I'm, I am, yeah.

And I mean, it's amazing to me like we hit two, I. Million or two and a half million vaccines yesterday, something like that delivered. And I did some ma, you know, I did some math early on, maybe the last time we talked, and I was super concerned. I'm like, holy cow. Like a million, a hundred million vaccines in a hundred days that, I mean, that still is like years worth of work.

That's not gonna cut it. We gotta get to like two and a half, 3 million, three and a half million per day to be able to just. Stay, you know, even, and there's been a lot of development since then. But that number was for me, I was just like, holy cow, there's no way we're gonna get 3 million vaccines a day.

But now it looks, I mean, it totally looks like we might actually be able to pull that off. We can probably do three, 4 million vaccines a day. And with the new Johnson and Johnson vaccine. And there was an announcement, announcement this morning, I think that Merck was gonna help Johnson and Johnson actually manufacture their vaccines, so that that's the whole machine is gonna go even faster than we expected.

I'm, I'm with you. I mean, I think everybody's antsy and everybody wants to get out, but there is definitely the like, look, we're not , it's not done yet. And there's still variance and there's still a lot of things we don't know. So keep doing what you're doing. Wear your mask and wash your hands and, you know, just, just think carefully about the risks that you're taking.

Not for yourself, but for everybody around you. People like me who need to have hip surgery, right? I mean, I don't need outpatient surgery. Shut down, right? So, yeah. Are you, are you vaccinated? I'm not. I'm not. I. And, and my route in my head right now to get vaccinated is, you know, I'm not 65 healthy. I don't, I'm like, you know, number 99 out of a hundred in line right now in the normal line, which means hopefully that would be July or something.

The thing I have going for me is that I do have some medical training. I can give shots and at the very least I can direct cars at clinics and help people register and do walk-ups. So in my head, I'm thinking right now that once I'm kind of cleared by, you know, post-op and pt, that I may very well go volunteer at a clinic for, you know, for giving shots.

And that may be a way for me to get vaccinated earlier. So the biggest challenge I've heard, and I've, I've heard this from several health systems. In fact, we're recording this show early because I am actually off this week. I'm in Phoenix. That's the, the, the sound in the background is the, the, the lawnmowers on the golf course.

So everybody can feel sorry for me. My wife and I took a trip out here to visit some friends and, and whatnot, but the. You know the, so tomorrow, 'cause we're recording this Tuesday before this will actually go live tomorrow, I'm gonna release the show I did with Sarah White. Sarah White is, uh, in charge of innovation at uc Health, which is University of Colorado.

And they published that playbook, that 55 page playbook on mass vaccinations. And, you know, we recorded the whole show. And then when we get done, and this always happens by the way, I stop recording, then I ask a question that I thought, man, I should ask this question. I'm like, so, you know, I. The biggest challenge is, is really getting the vaccine.

And the crazy thing is uc, health Ed had a partnership with the state and all these entities. Mm-Hmm. . And they didn't know. They, they were, they had a mass vaccination plan. The whole playbook written, ready to go. They didn't know until about four or five days before the event. They were gonna get the 10,000 vaccines to actually administer the vaccines for their mass vaccination event.

And I'm like, man, how did you do that? So day fi fi, think of this T minus five. They get the notice. Yes, we're gonna have it. Now. You have to schedule everybody. You have like two days to get everybody scheduled. 10,000 people. All the logistics set up. So, you know, the, the tents and, and all the people lined up at the, and I'm like, man, that's, I was, I was even more impressed.

That's one of the problems I've heard from people. And the second is the experience, the user experience. Mm-hmm. For, for scheduling the vaccine has. Subpar is what, what people are describing is you, you log into the portal, you go through this questionnaire, and then it tells you, I'm sorry, we don't have any appointments.

And they're like, okay, so what do I have to do the next time? Well, you have to log into the portal, go through the questionnaire before you know that they don't have any appointments and, and that user experience is lacking. And I think advocate come out with something around that. There's now a thing called, uh, vaccine Finder.

Mm-Hmm. . Yeah, I shared that with you. Vaccine finder.org. Mm-Hmm. . Yep. And so that's a partnership with, uh, CDC Boston Children's. I'm sure a friend John Brownstein was involved in that somehow. Yeah, absolutely was. Yep. And, and Harvard. And Castlight. And so you could hit this site now, vaccine finder.org. Put in your zip code and it'll tell you what places around you actually have availability of the vaccine.

Now they're gonna follow CD, C guidelines, so. You know, me calling at my age is not gonna help at all. But I was curious. So I put it in there and I saw Walmart and I saw others. So I, I made a phone call. I was like, do you really have the vaccine? It's like, yes, we do have the vaccine. I'm like, so I imagine there's some variability on the, on the, you know, how accurate the information is because it's, it's gonna be dependent on, you know, the inform.

I don't know where they're getting the information. I'd love to know where they're getting the information, but. They, they had identified places in our area and I know there's people who are waiting to get the vaccine in our area that probably don't know that they can go to. vaccine.org and find a place that's pretty close to them.

Uh, I, I don't know about you guys, but there's still people in our area driving. My gosh, they're driving hundreds of miles to get the vaccine. Yeah, I think, you know, people are, people w we're still in the phase right now where there are tons of people who want the vaccine, so that's not a problem yet. I mean, we will eventually get to the, toward the end where we'll have people who will say.

Thanks. I'm not interested. And that will be a whole education, you know, social connection, trying to convince people to take the vaccine, the last, whatever, 30% or 20%. But there are definitely people who want the vaccine right now and are doing back flips to try to get it, including, you know, lying and cheating and stealing to, you know, dressing up as old ladies to get in line to try to get the vaccine.

We've seen all of those stories too. Are, are you kidding me? Is that really happening? Yeah, there were a couple of folks in Florida in your home state that were, were detained. I don't know if they were arrested. I think they were charged on some kind of public disorderly, you know, something, I'm not sure, but had dressed up like older folks that had somehow gotten the first shot and had come back for the second shot.

And you know, so that there are things like that that. There are things like that that bother me because I know there are people who are more deserving and should be at the front of the line that should actually be getting it. And at the same time, there's a part of me that is just like. Just everybody get the vaccine so that the guys at the back of the line like me, it's good for me too.

The more people that get the vaccine, the faster they get it, the better protected. The people who can't get the vaccine are so, no, not advocating line cheating and stealing. I mean, I think there's plenty of ways for if you want to do some work, you can probably move up at least a few notches in the line.

But yeah, people are, people are doing things they're not supposed to do to, to try to get the vaccine at this point. The other thing I'm hearing, and by the way, we're gonna get into some cybersecurity stories and, and that kinda stuff. But the other thing I'm hearing, 'cause we did a, I mean, Che and I talked about vaccine for, uh, about 40 minutes last week.

And it was, it was good and it, it was great. But people might be getting tired of us talking about vaccine, but. Regardless, you know, the, the, the, you know, Pfizer requires the coolers and so there's a lot of horse training going on at this point as well of people going, Hey, look, we, we can't really take the Pfizer vaccine 'cause we can't store it, but we can take the Moderna vaccine while the JJ vaccine doesn't have this requirement really at all, and it's a single shot.

Vaccine. Mm-Hmm. . Mm-Hmm. . So if you have, if you have the, the j and j system and Merck system producing the vaccine, I have a feeling we're gonna, we're gonna have an overproduction here shortly and the single shot, it's gonna make the logistics that much easier, I think. Oh, it changes. Changes everything.

Changes everything. And I mean, especially in places where, you know, you've read some stories lately about rural America where there's, you know, literally. A nurse and a car driving around, you know, wherever, Iowa, South Dakota, hundreds of miles per day to get to little towns where there's only 35 people and.

You know, when you, when part of the logistics of that is that I have to keep this, this stuff at Sub-Zero temperatures and you know, I have to come back again for sure in two weeks to make sure that I get everybody a second shot or three weeks to make sure the logistics are way more difficult. And so with something like Johnson and Johnson to be able to go out and just.

Plug, you know, plug a town in and then, you know, drive away and not worry about 'em again for a while. That's changes everything. So let me ask you this question, and this is just one of those mind, uh, exercises that you play, but let's just, so whenever you hear logistics, you think of who are the best logistics companies in the world?

Mm-Hmm. . It's UPS, it's Amazon. So let's just take UPS and Amazon. Let's assume we said alright. We're gonna do mass vaccinate, we're gonna do vaccination of the United States through our logistics companies. Mm-Hmm. . And let, let's start, let's just go with Amazon. How do you think Amazon, what would've the process have looked like if, and I know we wouldn't have done this, but let, let's just assume we went to Amazon said, look, you're in charge of getting everyone vaccinated.

Yeah. What do you think that would've looked like? I mean, I, I tweeted about this a few weeks ago, but the idea that, uh, you know, you could have gone to somebody like Amazon or written a contract that basically said, you have to vacate, vaccinate this, you know, this many Americans, and you could lay it out by area however you wanted to design the contract, and that you have to hit that number or we don't pay you.

Right? So you put some hardcore incentives in there, you know, and if you vaccinate more than this, you get a bonus. You set it up sort of . Financially to make it really, really attractive to a company like Amazon. You let them go to town and I think, you know, with all the logistics that they have and the ability that they've had to sort of figure out how to order something online and have it delivered two hours later, uh, they would've figured out how to, how to have done all of that.

And I think that would've . Even maybe meant taking, uh, medical assistance and putting them on Amazon trucks and going around neighborhoods to let people, you know, come out to the truck and get your vaccine. I, I don't know what it would've looked like, but, you know, there's, it's a, it's a pretty interesting idea that you could have just handed all that logistics off to a real logistics provider and not, you know, just sort of kept the states informed.

It would've been a whole different way of doing it. But you know, it is a loss of control. It's a loss of control for states that. That need to feel like they're doing something in all of this too. Interesting. So our lead story for today is that Drexel Ford is now with CrowdStrike. Is that our lead story?

No, it's not our lead story. But we're gonna, we're gonna start there. So congratulations on your new role. What is, what is your new role with CrowdStrike? I am the executive healthcare strategist for CrowdStrike. And so that's a, you know, I know for some people that's a bit of a head scratcher. CrowdStrike had been a client of mine, Drexel, my independent consulting firm, uh, a few years ago as they stood up the healthcare vertical.

And a lot of that was just to help them build their healthcare team, help them better understand having a place they could go to ask questions about how do we talk about this or. How do these products fit into other things that are happening in healthcare? And I felt really comfortable with that team the whole time.

And, you know, I don't know, they weren't ready. I wasn't ready. It wasn't a good, you know, specific match at the time. So I went off and did other things, but I continued to stay in touch with them. And just before Christmas, they came back and said, we think we're ready now. And you know, we, we . Hammered out the details and it's, it's gonna be interesting and fun.

I work with the healthcare team, but I also with the work with public sector team, government and you know, higher education, all of that whole, whole group. But I'll be really mostly focused on healthcare and a lot of it is going to be. Sort of presale stuff. A lot of thought leadership kinds of things, raising CrowdStrike's profile in healthcare.

But a lot of it also will be certainly working with existing customers, potential customers, working with the team entitled inside of CrowdStrike to make sure that we're building products that work for healthcare and do the things that that. They have already really demonstrated that they can do, just figuring out the right ways to be able to talk about those inside the healthcare sector.

So it's, it's a lot of stuff. It's honestly a bit of a job that is part utility player and part I'm going to be figuring it out. On my own, which the entrepreneurial part of this also is very attractive to me too. It's not a job that somebody else had and that person left and they hired somebody new.

It's in a lot of ways for me to come in and do some creativity in a company that has a huge amount of resources and can really help me with that. Yeah, no, that's, you know, here, here's the news of that. To be honest, and it's a great hire, and I'm not just saying that it's a great hire for them to bring in someone like yourself.

I mean, you really understand healthcare, know all the players, those kind of things, and I realize you're working on more than just that. But anyway, I, I think it's a great hire. The, I think the news of that is I'm seeing it more and more so I, in the role I'm in now, I get the phone call I get.

Hey, we're looking for somebody that sort of looks like this. Do you know of anybody? And you know your, you went to CrowdStrike, Carl West went to Sirius. Mm-Hmm. . And another company called me up and said, Hey, we've, we, we we're looking for a healthcare CIO or former CIO, who's willing to step into cybersecurity role.

Now the thing I I thought was interesting about that role is it had, it really came with a sales quota. Mm-Hmm. . I mean, my first comment then was, I'm not sure if CIO's gonna, you know, jump out of their current role to take on a sales quota, but, you know, I, you know, I'll think about it and I'll take a look at it.

So, uh, so that my data point is since January 1st, all those things have happened, Carl, you and that phone call, and I think a lot of organizations are trying to figure out with all the cybersecurity ramifications of the attacks. Of late last fall and the shutdowns Mm-Hmm. are trying to figure out, okay, how do we help healthcare?

And we, we need more insider knowledge of what are they struggling with? How, how can we better Yeah. Position our products and how can we have better conversations with healthcare to meet those needs? I think that's, I think that's the story of, of you going in there. You know, the other thing for me is that even as an independent consultant, I continued to sort of, there was one.

Cybersecurity gig after another cybersecurity gig as part of the work that I was doing as an independent consultant. And I could see where some were falling down and some were doing well. And what I really saw, you know, overall in the market is that especially as we got into the pandemic, I. There were lots of things that we wanted to do that were super cool and interesting.

From telemedicine to digital health to consumerization of healthcare. We were buying new stuff and connecting it together. We were getting pressure from the government to share data and we, and there were lots of problems in all of that. And you know, to me, a lot of it came down to where can I go that.

You know, not to pump the company but you know, are doing a really good job. That gives me a really long crowbar to help be able to sort of lift healthcare up and put them in a better position to be able to do all the things that they want to do around digital health and, and, and consumerization of healthcare and all the other things that we have on the list because.

There were, you know, every day there was a new story and it just seems like there has to be a better way to do that. There aren't enough people. Health systems are super stressed. Patients and families are worried about the things that they should even tell their doctor because they're afraid the data will get away from the health system.

This is a terrible situation. We've gotta get out of that. We've, we've, we've gotta resolve it. And, and so I. I think I can help. That leads us to our first story. So our first story is mobile health apps. Uh, mobile health apps leak sensitive data through APIs. And I wanted to talk to you about this. I covered it in today and I put it on my LinkedIn post, uh, company called Approve, A-P-P-R-O-O-V.

That's what happens when we run out of domain. Had, you know, essentially went in white hat, white hat, kind of hacked 30 mole apps. Here's what they found. All, all the, all of the apps, all 30 were found to be vulnerable to API attacks and some allowed access to electronic health records. The 30 apps collectively exposed 23 million mobile health users to attacks.

Uh, night reported. Of the 30 app tests, 77% contain coded APIs. Of which some do not expire according to the report, and 77% had hardcoded username and passwords. I, I went as far in my today show as to say, if you find an API that has hardcoded username and passwords, you should fire find and fire those, those people immediately and get rid of those companies immediately.

I mean, that's, we learned that in high school, our first programming class we ever take. You learn not to hard code, username and passwords into code. And, and so if people are wondering why I'm being so adamant on that, I mean that's like, that's, that's an egregious problem. Yeah. But anyway, we're finding these problems and I'm, I'm afraid what people are gonna take from this is, I'll see APIs are bad.

We shouldn't be going down this fire route. And, you know, all we're doing is exposing all the data. And I, I don't think that's the moral of this story. I think the moral of the story is we've gotta get better at this, at identifying these things, understanding how APIs work, understanding how, uh, complete security stacks can work around a set of APIs and, and recognize.

That you're making. Yeah. I mean, APIs are cool, right? They, they, you know, back in the day we had to write interfaces between all of these things, and they were miserable and they were hard to write. And then every time somebody upgraded the system on one side, we had to rewrite the interface and they were, you know, like.

Life sucked. It was a terrible situation. And then somebody came up with APIs and it seemed like initially it was like, that's amazing, because now it's almost like you have a power strip and you can plug these things in and they can all, you know, communicate with each other. And I don't have to worry about the way the data flows back and forth because these API APIs take care of all the.

Sort of transfer of that data, which is great until, you know, like after four APIs we started to see things like this. You know, hardcoded passwords, hardcoded usernames, and, and lots of other things. Just sloppy coding in these APIs. So they worked, but you know, at the same time we started to be, you know, really concerned about the way that they worked.

And even today, I mean, I don't know, two weeks ago I was. Working with, at the time, a client was working with another potential client and they were talking about exchanging data through an API, and when we looked at the API, you know, it was like. I mean, it was like, you know, baby's first API, you know, it was like, it was an API, it was, it was certainly written and it could certainly exchange data, but there were a lot of things in there that didn't make it super comfortable to, to use.

And so, you're exactly right. The, the point on APIs is that like everything, they come along, they're bright, shiny objects and they seem to save the day. Yay. Silver bullets. And then you start to look inside and . If there's corrosion, it doesn't work the way that you think it should work, just expect that for everything that you're gonna see.

'cause it's gonna happen more and more and faster and faster. As we continue to get into this digital health world, there's gonna be more super cool things that are gonna work great, and the government's gonna fall in love and they're gonna tell health systems that they have to use them. And then companies like Epic are gonna step in and say, wait a minute, wait a minute.

I'm not sure I'm concerned about all these APIs. And they're gonna get trash thrown at them. And look, this is a thing we're gonna have to work through over time. They're not perfect. They're not, they're, they're awesome conceptually, but you gotta make sure you spend some time under the hood and they work the way that they're supposed to.

Yeah. Well, we meandered early on in the show, so I'm gonna rifle through some stories here, so, okay, good. The, let's see, this is from, uh, Becker's Health. It a new dimension of fraud. Six Cybersecurity execs weigh in on vaccine data hacks, and so I if saw this in January, the European Medicine Agency.

Conferred that some of its data from pharmaceutical companies regarding their covid-19 vaccines and treatments had been leaked online. However, before posting the information, the hackers manipulated the data in a way that could undermine trust in vaccines. The EMA said in February, reports began to surface that South Korea's national Intelligence Service accused North attempting hack.

How does the situation such as the hacking of Pfizer and Moderna's, COVID-19 vaccine data affect public health and what does this mean for the future of healthcare cybersecurity? And, and they asked Curtis Cole, who's a physician assistant vice Provost of Information services and CIO at Weill Cornell Medical College, and he had a, a really cool answer.

I just wanna read through it real quick. Sure. And have you comment on it. Uh, there are two aspects of this Fascinating. This is a new way to Perpe per perpetuate. Perpetuate. Yeah. The problem of DeepFakes, I, I, I thought it was perpetrate, but perpetuate the problem of DeepFakes. We've been anxiously discussing how to protect from AI driven fake images, videos, and news.

And while the problem of fake data and fake research is not new, this presents a new dimension of fraud. This isn't a misguided scientist. Passing off a fake result. Rather, they are trying to undermine source data. Mm-hmm, that legitimate researchers might want to use. So that's one aspect of it. The second aspect is that this is, this is only important because of increased blurring of scientific discourse, which was confined to the protected sphere of like-minded researchers with public discourse, where it is inevitably simplified and taken context, misunderstanding.

So this is certainly concerning, but I take some solace in the fact that researchers are also trying to create legitimate synthetic data to protect privacy that turns out to be really hard. So this fraud may not be easy to replicate either. So it's interesting his perspective on this in terms of, you know, why is a hacker using the data in this way?

It, it really does, uh, undermine. And the information that we're reading and seeing this is, yeah. You know, cybersecurity is one of the most fascinating areas that we have going because it's not just about, you know, keep them in, keep them out. They're stealing their information, they're selling their information.

Now it's becoming, they're changing how we view information in society, which, which undermines trust for entire segments of, of our, of our society that used to be the most trusted. Right. I mean, his, his point about deep fakes, I mean, it's an interesting analogy, right, in that you watch a video now and you can't really For sure, there's a lot of videos that you see now that, that

They are saying, you know, they're telling you this is a deep fake, but boy, that sure really looks like Tom Cruise saying whatever crazy stuff is being said on the video and. The same idea of sort of taking databases like that and going in and maybe either, either downloading them and then manipulating the data so that it turns out the government or you know, the CDC is saying this thing is 90% effective, but they manipulate just enough data so that when they release it to the public, Hey, here's something you didn't know.

We got the database and you should look at this. It says it's only 10% effective or something right now. Who do you believe? Well, this is, you know, that's the whole point. It, it can be a nation state trying to undermine the confidence that we have in our own processes and things that really do work. They could steal it for money.

You know, some of the biggest labs in the world don't actually have any wet labs. They don't actually do that kind of lab work. What they have is lots of databases from lots of places that they bring together, and they use that data in new and interesting ways to discover things that no one else has discovered.

These are truly massive data labs. You start monkeying with some of the data that comes from some of these other sources and you can have those organizations announcing discoveries that aren't legitimate when you actually go back and look at it. So if the point of this in many ways is to destabilize our confidence in government healthcare organizations, universities, research institutions.

It's a good but terrible strategy and yeah, we, we've already, we've already, as Americans sort of exposed ourselves as being very willing to accept information from other places that isn't necessarily legitimate. Yes. Let's hit Microsoft. So yeah, in your neck of the woods. Microsoft updates cloud for healthcare.

Patient monitoring features. So I, you know, I've often said that Microsoft, an arms dealer, they're, they'll give you.

The organizations, the tools they need to be successful. Right? So, and they don't care who they're selling to, they'll sell to competitors and, and those kind things. Mm-Hmm. , the, the tech giant announced it's cloud for healthcare services back in October that brings together existing services such as Microsoft Teams, Azure, IoT, and Chatbots to help healthcare organizations manage operations.

The first update will be available in April and include services for care plan management, and we'll support eight additional languages. Virtual it goes on to talk about virtual health. We're introducing new Dynamics 365 patient access features to streamline the virtual experience for patients by allowing more flexibility in self-scheduling, both virtual and in-person appointments through their existing patient portal and integrated virtual assistance like Azure Health Bot service for triaging, scheduling and making it seamless to receive follow up and wellness guidance.

From their care team, he wrote. So this is the thing I always find interesting about Microsoft. I, I think people in Kansas City and and Madison right now are looking at this going, where are they going? And you know, one of the challenges with the EHR for years is, and we've been trying to explain this, it's not a, not a cm, it not a customer relationship management.

System, and because of that. It has gaps and it has gaps in how you inter interact with the, with the people who aren't patients in your community and how you, you know how you do things with that, with that population. And so you can't deal with customers. You can only deal with patients from an EHR, well instep Microsoft, and they start to build around dynamics, which is a true C rm.

They start to integrate things like their chat bots. Video tools and teams and whatnot, and now you start to see this pretty comprehensive looking vision that's coming out that obviously can overlay on top of the EHR, but it's not hard in my mind to fast forward and think of. Taking whole sections of the EHR and replacing them with with code in the future.

Now I understand, as Judy will say, you know, people who say, you know, this stuff isn't rocket science, and these people have been down this path before and haven't been able to really replicate the EHR, but I'm not talking about re replicating the wholly hr. I'm talking about overlaying it, bringing the data in, using it, moving it back and forth, and those kind of things last.

The last hurdle that these kinds of companies like Salesforce and Microsoft and even, you know, some other players that are out there will have to, and, and even Google for that, for that matter, will have to overcome is the movement of data back and forth through the EHR if they ever get through that barrier.

I, I think it's the best thing that could happen for health systems and healthcare in that you will open up to a world. Applications and use of data for care. Now again, with great with great. Power comes great responsibility and we'll have to go down that path in the future. But what are your thoughts on the, on the

Yeah, I, it it's, it's interesting to see, you know, Microsoft has sort of done the hokey pokey with healthcare now three or four times. And I think this, this time is kind of interesting because maybe it's a little bit different. I don't know that they're necessarily building products specifically for healthcare.

What they're doing now is that they have taken products that they already have and they have. They're now spending a lot of time to try to figure out how do we take these products and wrap them around other existing healthcare processes to make those processes better for patients and families, better for providers, whatever the case may be.

So it's really, like you said, taking tools that they already have, seeing and understanding where gaps are in healthcare data and engagement with patients, and then figuring out how they use those tools to sort of fill those gaps. That's different from, I think, . Previous approaches that they've tried to take with healthcare and.

It's probably the one that they, you know, have the most likelihood of being successful with because it's not really inventing brand new things for healthcare. It really is using products that they already know and love and use and have explored and deployed in other industries, and just figuring out how to fit them to.

A very complicated healthcare world. Yep. And I don't want people to walk away saying, bill says Microsoft's gonna build an EHR because I, that's not what I said. What I said is, they're an arms dealer. They're going to enable someone to build an ER and they're gonna have, they're gonna give a whole bunch of tools and that kind of stuff.

The changing behaviors of people and how they engage in healthcare. It's interesting to me, and, and we're gonna take a health IT perspective of this, because we're not gonna talk about the financials. I'll, I'll do that, uh, later when I have Rob Dehe back on to talk about. But for you and I from an IT perspective, here's what I'm from, s it.

Essentially everything's ramping back up, is what I'm hearing. All the projects that were put on hold are starting to ramp back up. The Covid projects are, are there as well as, you know, even some new projects are starting to, uh, come out. Like these mass vaccination events and those kind of things. How, how are we going to, you know, how are we gonna not lose focus?

The, the, the timeframe that's coming up, I, you know, we, one of the things that these losses indicate is that we're gonna have to do more with less, and we have just as much, if not more, projects coming our way. You know, what's, what's the best way for it, staff and managers, and CIOs to, to stay focused? I mean, I, it's ultimately comes down to governance, right?

It comes down to setting priorities and doing a good job of having a process to make sure that you're implementing the things that your partners in the provision of great healthcare to your patients and families who are doctors and nurses and lab and pharmacists. Whoever the, you know, case may be, you're not implementing projects for you, you're implementing projects for them.

If you have a good governance process, that process should . Be one that causes them to prioritize and deprioritize projects. Your job then becomes to make sure that you make a coherent argument about the resources that you have, or you don't have to not only be able to execute the projects, but run them after they've been deployed, continue to run them well and do all of that on a

Relatively simple, relatively modern infrastructure that is secured. And if you can tell that story, you'll be successful. And if you can compel your counterparts at the big table to do their part around prioritization, you'll be successful. But that sounds really easy. And I have spent years, and I can tell you it is not.

A simple, it's not a simple thing. You've seen it in lots of other places too. The governance is a challenge. Setting priorities at work. Somehow our brain works really differently than it does when it comes to setting priorities at home and making decisions about buying a new car, going on vacation, or paying the mortgage, right?

We think differently about this at work for some reason, and so we, we struggle with it, but if you can put the discipline in place and make that machine run, you will be more successful than the other people you're competing against. I agree. I, I, except, you know, governance to me is the, let, let's call it the stick approach.

The carrot approach to me is if you can get ahead of the story, and you, you alluded to this in your, in your answer, if you can set the narrative, what are we trying to do? Yeah. And so I've seen, I've seen effective organizations do this at, at Banner they came up with a persona of Sophia.

And they actually had a model and they took pictures of her and the cardboard cut us around the health system. And, and so when people have a conversation around a project, it's, how does this help Sophia? And what Yes, it has a way of, a narrative, has a way of, of focusing the, the energy of the organization.

Right. And I remember when Aaron Martin came into healthcare at Providence, he organized around the, the expecting mom. And his concept was really simple. He is like, look. Uh, moms make, you know, I forget what the number is and so I'm gonna make something up. Like 90% of all healthcare decisions for the family.

Mm-Hmm. And the expecting mom is gonna have a family, by definition. She will have this family and she'll take that role, kids role, and she will, she'll manage the majority of those, of those conversations. I remember him talking about that. And so what it did for their, I remember him talking and when I.

That is a, that's an organizing narrative for what's important. And so a lot of the projects that initially came out of the, their innovation group over there was around that persona in that person. And so there is an opportunity, I mean, governance is the way we project intake and hey, are we focused? And those kind of things.

But there's also a narrative approach that if the, and by the way, this has to be the entire leadership team. It can't just be for sure. It has this absolutely. But if you could get the entire leadership team to organize around a, a narrative of some kind, then you, you have a better chance of not getting overwhelmed over the next, I don't know, year to two years when they say.

Hey, we've gotta do all these projects and it feels like there's no priorities and it just all has to get done. I mean, that's what mission vision values is kind of all about, right? Or the, is the thing that we're doing, the thing that's going to get us closer to the target idea. We have for our health system.

I've become a, a big fan of this guy, uh, James Clear, who has written lots of books and does, you know, lots of speaking stuff. But I mean, his whole point, his whole point even about us personally is that every decision that we make, we have to think about am I making that decision because it makes me.

Closer to the person that I actually want to be. And if your answer is yes, you should do that thing. And if your answer is no, you really have to sort of question like why you're putting time and energy into that. That same, that same concept expands across, you know, individuals and teams and health systems and entire industries.

Are we closer to the thing that we wanna be? . Yep. Well, Drex as always, great conversation. I'm sorry for all the outdoor no noises. I've got wind blowing across my microphone. I have no idea how this is gonna sound. It's awesome. It sounds good. You'll , it's gonna be, it's gonna be fine. Lawnmowers in the background.

just, just rubbing it in for all those people. The sun in your face. Yeah, actually I have a, uh, I have a heat, a gas heater on behind me. I'm freezing . So, but it looks good. It looks legit. Yeah, it's, uh, Phoenix is a desert. But, uh, it gets really cold at night. Yeah, yeah. People don't recognize that, but it's, it'll, it'll warm up to about 70, 75 degrees today, but I missed Florida where it was 85 when I left

Well, hey, two terrible places to be when it comes to weather. Right. So, good for you. Yeah, we'll, we'll see what we can do. Hey, thanks again. Congratulations on your new role. Thank you. And, uh, look forward to seeing you up and around again. Are, are you gonna try to do the bicycling and, and running again? Or?

As soon as I can get, uh, back on the Peloton, I will be back on the Peloton. So that's kind of, I think at least mentally for me, is gonna be part of the pt. I'm looking forward to that. Fantastic. All right, well, we will, uh, we'll catch up again in about six weeks. Sounds good. All right, that's all for this week.

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