Episode 470: Transcript - December 10, 2021

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Here is what I'm going to do today. There's no interview for this show. What we're going to do is we're going to do a handful of housekeeping. I'm getting you prepared for the changes at This Week in Health IT. I'm going to cover that in a little bit of detail. I'm going to give you an idea of our production schedule for December. This is one of several end of the year episodes, and I want you to be aware of those. I think there's a bunch that are can't miss episodes. Gonna be fun. I'm going to go through 2021 and [00:01:00] reminisce and just stream of consciousness share the headlines that we've covered. We've done 240 episodes on the Today show. And the bulk of this conversation is going to be me going through the year. I think you'll be surprised what stories actually happen this year. You know, when you look back and you're like, oh, solar winds happened in 2021.

And finally, I'm going to thank a few people that have come on the show towards the end of this, and really appreciate them making this show what it is. All right, ready? Here we go. For next year let me give you an idea of what we're going to be doing on This Week in Health IT. We have four channels. So we're going to have four distinct channels on iTunes, on Google play, wherever you listen to podcasts. Those are [00:02:00] This Week Health News This week health news is where we cover the news. And it is our Newsday show and it is our Today show. So anything that is about keeping current on health IT that's where it's going to be. That's our interviews in action when we are talking to people from the floor that is going to be in our news section.

The goal with this week health conference is to create a conference that goes on all year long. And we're going to have this show, the Keynote, we're going to have solutions showcase. That's going to give you a feel for which products are up and coming, and which products are making a splash.

They'll be around things like ransomware, cloud, cybersecurity. They could be around you know, some aspect of data and analytics, AI, you name it. But those campaigns generally are short burst episodes. 10 to 15 minute episodes followed by a webinar. So that's going to go in conference.

And the first show we're going to launch in that is called Townhall. These are 10 to 20 minute episodes. They're going to air on Tuesdays and Thursdays. And this is the first time we are inviting guests [00:04:00] podcasters, if you will. And so we've sent out some invites to people and we're asking them to tap into their network.

So we have some CIOs who have agreed to participate in that. We have some data scientists, clinical informaticist, CMIOs and our hope there is that they will tap into their networks and talk about some of the topics that we are dealing with at a level that you are interacting with them on a daily basis.

And then finally, we're going to close it out. We have this week health academy. This is our IT university. This is where people go, who want to get up to speed on what's going on in healthcare and in healthcare IT. These are people who are new to healthcare. These are people that are looking for a platform to help mentor.

Let me tell you what we're doing with regard to interoperability, or we've heard Craig Richardville talk about cloud computing over here and how they're doing it at SCL. Let me tell you how we're thinking about cloud computing within our health system. So I think it's a good platform. We consider IT university.

If you want to subscribe, go to this weekhealth.com and it's actually right there on the front page, but you could also go to our shows page this weekcom/shows. health.com/shows. It'll have a description of each one of the channels.

Before we go to the chronological look at the news. Let me tell you about our production calendar for December. There are five special episodes that we've produced. Most of them I've already recorded. So I know they're very good. I've done two shows with the advisers of this week in health IT. If you're wondering who my advisors are there, Dr. David Bensema, who has been a friend of the show since the beginning. Anne [00:07:30] Weiler who has been on our Newsday show, she's phenomenal as well. Sarah Richardson has been a great advisor and has helped us to map out our growth strategy.

And so, they keep me sane. They keep me on the straight and narrow. And they keep me focused on what is going to provide value to you, the community. Well, we did two shows with them. Broke it up. And we asked them to take a look back at 2021. What are the stories or events that shaped the year?

This show is the chronological look at the [00:08:30] news and that's, that's what we're going to be doing today.

This is one of our end of the year episodes. And then we also have a look at the Newsday conversations that we've had with this year's guests hosts. As you know, the Newsday different from today. Today is me just talking about the news. The Newsday shows me and other people having a conversation around the news.

So we're going to cover those in a compilation. And then finally you're going to meet the team. So I'm going to have my team, this weekinhealthit team come on the show and share their favorite moments from the interviews that we've conducted this year. This is going to be fun to get their perspective.

You know, our today's show, we do one week of shows in December and then that's it. We won't pick that up again until early January. We take a break from producing new shows at the end of the year to prepare for 2022. All right, let me do the chronological look at the year [00:10:00] that was 2021. So clearly the story that shaped all stories is the pandemic. And we are going to come back to the pandemic over and over again. Again, I'm going to do chronologically some of the stories that we covered. So, you're going to hear me come back to cybersecurity a couple of times, come back to the pandemic and where we were.

But early on it was believed that, you know, just about everything that the Trump administration did was wrong. And so we had to keep an eye on that. Where was the [00:11:00] new government going to take healthcare? Where were the policies and the regulations going to go? Who were they going to appoint and to keep positions. All of that stuff was pretty important.

You know, how long of a wait they could expect. We had blocks of people that could get the vaccine and blocks of people that couldn't get the vaccine. So I remember in January, I was saying it'll probably be until April until I could get the vaccine. I think I got it earlier than that. In fact, here's my vaccine card.

And we just had logistics challenges. A lot of those kinds of things. Let me run through some of the headlines we had here. The second story of the year that we covered was rolling out the vaccine and how much of a huge challenge it was going to be. Some of the tools did not exist from a scheduling standpoint.

One of the things that Anne Weiler and others commented on the show this year is Atul Gawande held like multiple roles. He wasn't truly the CEO of Haven. He was the CEO of Haven as on a part-time [00:13:00] basis, which seems to everyone that it would have been a full-time job.

So there's a lot of challenges. Whenever you try to build those kinds of partnerships, it is very difficult to to pull off because you have conflicting cultures and potential outcomes and those kinds of things that are the expectations of the actual partnership. So that that came to an end. Healthcare made some of those normal comments that we make. You know, this, this shows how hard healthcare is.

Actually, it was a virtual conference this year, so we didn't go to San Francisco. We sat right here in my studio and watched 24 CEOs and CFOs get up and talk about the year that was 2021. And we covered some of the some of the highlights from this. Two highlights. I'll give you one is there was a significant financial hit for the two months where we did not do elective surgeries and that impacted healthcare a little differently across the board.

So, there was that financial aspect. The other two things I highlighted, which I think were worth taking a look at one is more than half of the [00:15:00] CEOs got up and talked about cybersecurity. And I thought that was a huge movement for us. if you're a CIO or if you're in IT you know that for years that was an uphill battle.

You had a number of incidents that happened in 2020, which sort of changed the the calculus on that. And it was that hospitals were getting shut down .Completely ransomware was taking down hospitals completely. And obviously we'll talk about the event at Scripps which happened this year, which was if the CEO's hadn't woken up at the JP Morgan conference, they'd definitely woken up after the Scripps event [00:16:00] and recognize that cybersecurity is a top of mind strategic issue for every health system.

So those were significant stories at the JP Morgan conference. The vaccine credential initiative became something that, we're still in January vaccine credential initiative became something to keep an eye on. I decided not to focus in on, you know, vaccine mandates and showing proof of vaccine and all that other stuff.

You could show it wherever you're going to show it. And again, I didn't focus on the civil liberties or the health aspects of everyone getting their vaccine. What I was focused on is I, I believe [00:17:30]that patient centered interoperability is going to be one of those things that changes healthcare. When we finally get the information in people's hands and they can determine how they're going to use it.

So for instance, this year I bought a whoop and I'm wearing the whoop. And I really like it. I'm getting a lot of really interesting information on my sleep and my recovery and those kinds of things, but it would be interesting if I had my information that I could provide to them and they could start to develop services in addition to the health that they're providing me right now.

We were going to see a continuity of thought around 21st century cures and interoperability which was welcome. Right? So this is one thing we can't have. We can't go from administration to administration and have a different view of interoperability and have it be, you know, we're going to be interoperable now and we're not going to be in four years.

Let's see bunch of things on vaccine distribution. We, we highlighted some of the really cool stories. Atrium Health and University of Colorado health system did mass vaccination events and University Colorado Health system created a playbook. It was a great playbook. We highlighted it on the show.

So the Atrium event, they were able to drive onto the track, go into pit row, get their vaccine, drive the rest of the track and then out. And that's the kind of stuff I thought was really well thought out from a you know, vaccine standpoint from an efficiency standpoint and from getting people on the right track.

And I noted early on that that is a horrible approach. Has always been a horrible approach. It's a horrible approach to parenting as well. And what happens when you do it as a parent, is your kids dig in and they make sure that they don't do something. And we've seen a lot of people dig in and they're not going to get the vaccine.

It gave people, it, it made it real. So that was one of the things. We also highlighted some of the better marketing that came forward from health systems and it was [00:21:30] predominantly from health systems. One of the ones I highlighted was from Providence and they did a sort of a myth about the vaccine and a truth about the vaccine on either side and really addressed that.

I thought it was really well done. It was done more from an education standpoint. And I think that is the tack.

The education standpoint, the incentive standpoint that I thought early on in the year that would work well, of course, you know, time tells a different story, but that's that's what I was recommending early on in the year.

We had a significant conversation around events, right? So, postpone events. Go to virtual events. CHIME and HIMSS. HIMSS Postponed until late in the year. And they finally had that event in Vegas. They were twice bit, I mean, they got [00:22:30] canceled in 2020 right in the last minute.

We know that that's a virtual and a physical number. [00:23:00] I did go to the HLTH event in the fall. Really well run event from the perspective of everyone was tested at the event.

The only people who got into the event were those who tested negative for COVID. And because it was the state of Massachusetts, there were state laws in effect around wearing masks.

So a lot of people that lowered the masks had conversations and then went on. But as you walked around and moved from place to place, you put your mask on out of respect to other people and to abide by the state regulations that were going on. A number of people at that event was roughly 4,000 people on site.

They have to pick sides here and decide which event you are going to go to. So it's going to be interesting to see what decisions people make around that. Plus, you know, some people are still under travel restrictions is, is one of the things we learned later on of this [00:24:30] year, 2021. And even if they had wanted to go to certain events, they weren't going to be able to make it.

People were saying that we, you know, we need to make sure that the funding doesn't go away. The [00:25:00] funding still hasn't gone away. That is one of the things that you know, early on in the year I covered and I said that the federal health emergency would go on through the entire year of 2021, which meant that the telehealth funding would remain intact through the end of the year, which it has.

So if a physician says, Hey, our next visit will be via telehealth as a follow-up visit or whatever. That is one of the biggest indicators of if they will do a telehealth visit. And so if your physicians aren't saying, Hey, let's do telehealth. That is going to drive it. Let's see, also in February.

And also I think the valuation on this thing has to be pretty astronomical at this point. And so we will see how that how that plays out. I gave three suggestions to them back on February 12th. See if they take any of them. [00:26:30] We we took a look at price transparency. Price transparency was one of those interesting things that we were all worried about early on in the year.

And then the Biden administration came in and it appeared like they were not going to enforce anything. Which is the same thing as saying, you know, don't worry about this law. It doesn't really matter. And then a little later after things sort of settled down, they reaffirmed the goals of price transparency.

And we highlighted one or two of those apps on the show And I think that's going to be pretty interesting. We also highlighted the fact that the rule was a little convoluted. It wasn't real clear on where you should put the information in what format was somewhat defined, but not well enough defined.

And we go to the HLTH event in the fall, sure enough, Walmart gets up there cause they've very strong presentation. And essentially says we've been in healthcare since 1978. And we have no plans of pulling out of healthcare anytime soon. You have the [00:28:00] normal things that go on. You had some changes in leadership.

You did have some changes in priorities throughout the year. The pandemic had a way of doing that. You know, you're running down the road in one direction something happened and you had to pivot, took your focus off of let's say building clinics. And so their clinic plans are moving slower while they were focused on other things.

IBM Watson is going to be one of those cases that gets talked about forever in healthcare. They came in loud and proud into healthcare, and they chose a extremely hard pressed set of problems to try to solve. I mean, they went after oncology, they went after diagnoses and they essentially said, look you know, Watson is going to go out and read all the medical journals.

Amazon care. So this is also in March. We start talking about Amazon care and their expansion. Amazon [00:29:30] care announces they're going to be in all 50 states for their employees.

And this continues to be one of those things to keep an eye on. So they launched into all 50 states, where are they going to go to next? Well, they're going to go to start signing other employers onto their programs. They expand to 50 states for their own employees. Then they sign the company that owns Peloton.

Medications when not shipped directly to the home or the office, wherever somebody wants to somebody wants to receive that. So an awful lot happening in the employer market. You had Transcarent Glen Tullman's new company at the end of March come out of the woods and we started to see how [00:30:30] that is going to materialize.

And again, I like it and I like it because Glen has a way of seeing the the experience and the economics and the partnerships that are required to address the problem. And when he looks at the triangle of those things what he looked at and said, look, employers are getting more and more frustrated.

And Transcarent is off with a hundred million dollar raise at this point and they're off and starting to create some value in [00:31:30] healthcare for those employers. And I think they've signed up a significant number while not significant number of employee employers, but large employers with a lot of employees, if you will.

So you know, and so I sort of wanted to poke fun at all those stories that continue to pop up throughout the year. And I decided to do that on April 1st. I don't know, I wonder what I'll do for 2022 on April 1st. I'll have to start thinking about that.

Let's see information blocking became a big conversation that you know, what is the actual rule?

And the thing I loved about Mickey is he's like a historian of interoperability in healthcare. I mean, he can tell you what the intention was, what the misstep was. What the correction was. How 21st century cures is going to address those things. So again, it was a, I think a great move [00:33:00] to put him in that it's signaled to the industry, that it is full speed ahead.

Maybe a little different tack and approach. Mickey is very collaborative. He is very he wants to hear from you. He wants to ensure that everyone understands what is the intention. And he also comes from Massachusetts where they are doing the HIE and interoperability extremely well.

And so again, the news stories started to correct themselves as they went on. We talked about patient centered interoperability. Since I've already talked about that, I will go on from there.

So a lot of the telehealth not a lot, most of telehealth was done via. Okay, so that's number one. Number two, the so they weren't done with the fancy technology. Number two, Zoom was the number one mode of doing doing telehealth visits for video visits. So that's number two. And the reason for that was it just worked.

And so they would fail from that, from that perspective. So we had a lot of things to try to reintegrate and rethink through [00:35:00] from a from a telehealth standpoint, to try to establish a new baseline, right? So we don't anticipate where we're gonna go back to 70 or 80% like we did in the two months at the peak of the pandemic early on in 2020.

All right. So cybersecurity again is top of mind is something we need to talk about. Scripps goes down. Here's the thing. We don't know a ton about this there. I mean, it's not that they weren't forthcoming it's that you know, maybe they weren't able to talk about some of these things, but here are the details we do have, the EHR was down for probably close to about 30 days.

June 1st. So for the most of the month of May, they were offline from a perspective. So you ended up with a lot of ransomware stories that we covered. A [00:36:30] lot of security stories that we covered. There were some significant stories, right? Solar Winds still affected us coming into this year. We had a Azure vulnerability that came forward this year.

Then we did a recap, the CHIME summer forum. We took a look at the response from Chris van Gorder who's the CEO of Scripps and just some awful lot happening from that perspective. All right. So then we go, where are we at? We're almost in July.

And the reason it's an important movement is because Dollar General tends to serve the underserved areas. And Walmart also made this case as well, that they are in a lot of underserved areas and they are a good conduit to to a population that doesn't necessarily have access to great healthcare.

But that part of that bill would go towards building out rural broadband to support things like education and to support things like, telehealth. So, so a lot of interesting things going on there. One of the things we saw is a [00:39:00] move to different care venues. And this happened in a lot of different ways.

We saw the move to the home. Obviously we had an announcement from Mayo and Kaiser in support of medically home towards the middle to end of this year. We had a bunch of telehealth stories that talked about different ways that they were delivering care and care venues. We also did stories about the pushback on the medical licensure around telehealth.

And to be honest with you, it doesn't appear to have enough momentum from any source of energy to change the way things are being done today. I mean, we'll see if that changes, but today it doesn't seem like there's going to be any significant move movement. Let's see, we look at the [00:40:00] COVID-19 numbers.

We did that a couple of times this year to see what was going on and see how we were progressing. It seems like we've sort of stagnated around the 60%. Each state's a little different I think based on the demographics and the culture of those states. State I'm in Florida is at 60% California where we visited with 62%.

And I don't know, maybe we thought it would be we would be further along at this point, but it looks like the pandemic will be with us going into 2022. And we'll see where that goes. Towards the end of the year, I started going to some conferences. The HLTH conference. The CHIME fall [00:41:00]forum and a healthcare to healthcare event and started to just air those interviews.

A lot of really good interviews. We talked to Mike McNamara with Impact Health. They conducted all the testing. They have a group they essentially have nurses, they have a pool of nurses that they could call from. They pull them in, they establish the process for testing and they could stand that up.

We have a change in the nature of [00:42:00] work in general, which is very interesting. The nature of work you know, being remote and the desire to be remote and work from anywhere to do a job has really changed things. It's changed the way we manage people. It's changed the culture of the organization that we work for. And what we saw is a lot of people change jobs. But we also saw 5 million people leave the workforce. About 3 million women leave the workforce. And we, we continue to see record numbers of baby boomers reach retirement age. And so there was a labor [00:42:30] shortage. And so a lot of conversation around how are we going to address culture?

How are we gonna address the labor shortage and how are we going to hire the best people? That brings us about up to date. I sort of flew through the second half of the year, but that gives you an idea of just some of the great conversations that we had this year. Some of the stories that we covered.

The incomparable Sue Schade has been on several times. Mari Savickis was on. Dr. Q. Dr. Quinones has been on a couple of times as well. We had the Sirius people who had come on just phenomenal conversations. Karl West, and I dissected the Sky Lakes ransomware event. That was really good.

Dirk Stanley, not a CIO, but a CMIO came on. Craig Richardville, Ed Kopetsky. John Brownstein. Again, not a CIO, but appreciate him coming on. Joseph Kvedar was also on. Sarah White from university of Colorado came on and talked about their playbook. Again fantastic. Patrick Anderson, Zafar Chaudry. We had Karen Murphy, Chief digital officer at Geisinger. BJ Moore is always a great guest, incredibly smart. Becky [00:44:30] Fox from Atrium CNO talking about their mass vaccination event. William Walders came on a couple of times this year and appreciated him. Nassar Nizami at Jefferson. David Baker one of my favorite CIO's cause he's used to work for me as Saint Joseph's. Gone on to be the CIO at Pacific Dental, which is a billion dollar plus dental service organization which was great.

And so we will see what happens with regard to that as well. Reid Stephan came on for the first time CIO at St. Luke's. Jamie Nelson hospital for special surgery. Andrew Rosenberg, Sarah Richardson came on CIO's. Joey S udomir came on. Wow, just some great guests this year. And I really appreciate I guess we'll say John Halamca [00:46:00] and we'll give him an honorary CIO.

He's actually the president of the Mayo clinic platform. Cletis Earl came on as well. Now at Penn state health. Love having him on the show. Two guests, I always want to call out Rob DeMichiei former CFO for UPFC is always great. He really educates me on the financial outlook. I tell him what I see at the JP Morgan conference.

Just knows so much about architecture and data and really the investment side as well. So great to have conversations with him. Brent Lamm came on and the university of North Carolina Associate CIO. Kristen Myers. Love having Kristen on the show another CIO. Brian Sterud was on. David Ting CTO and founder of T ausight came [00:47:00] on.

So Tausight's coming onto the scenes. Some new product coming out, very interesting. Paula Edwards and Angelique Russell, back to back episodes. Great data episodes. If you're looking for great data episodes Dr. Paula Edwards is phenomenal around governance, analytics, human centered design. And then we had Angelique Russell who's really practical on the clinical data models.

Michelle Stansbury with chief digital at Houston Methodist also came on. Another great conversation. And I also have to thank Charles Boicey who came on from Clearsense. CTO from Clearsense and we continued our series of CIO to CTO conversations. I remember sitting down with a CTO in my office.

We went away from that as CIO for health systems a while back, and now it's coming full circle. We're starting to try to create experiences and knit some things together. And granted we're not building big systems where We're actually [00:48:30] we're actually building the glue that builds out experiences between the multiple systems.

And so those are just some of the people. It's not a comprehensive list of everyone who's been on the show, but those are some of the people I want to thank. We had another great year. This year, quarter of a million downloads. I'd like to tell people we've had close to half a million downloads since the start of the pandemic.

And we always appreciate your feedback. Send it to bill@thisweekinhealthit.com. I read them all.

We want to thank our channel sponsors who are investing in our mission to develop the next generation of health IT leaders. [00:50:00] Those are VMware, Hill-Rom, StarBridge Advisers, Aruba and McAfee. Thanks for listening. That's all for now.