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Episode 5: Drex DeFord on An Amazon Hospital, SpaceX captures the imagination and Culture wins the Super Bowl

[00:00:00] Bill Russell: [00:00:00] Welcome to This Week in Health IT where we discuss the news information emerging thought with leaders from across the healthcare industry. It's Friday, February 9th, this week, and Amazon hospitals space X captures the imagination and culture wins. The super bowl. This podcast is brought to you by Health [00:00:30] Lyrics, a leader in digital transformation in healthcare.

[00:00:32] This is episode number five, and my name is Bill Russell, recovering healthcare CIO, writer, and consultant. With the previously mentioned health Ericsson. Today I'm joined by Drex DeFord. Drex. Wow, this one, a longer bio. So I'll go ahead and read some of these things. Trex has a long career as a healthcare executive, including experience as a co-founder of next wave connect a CIO at Steward Healthcare in Boston, Seattle [00:01:00] children's in Seattle, obviously, and also scripts healthcare in San Diego.

[00:01:05] Prior to that, he spent 20 years in the air force where he served as a regional CIO, medical center CIO, chief technology officer for the UA U S a F health systems, worldwide operations. He's also served on the HIMS national board, past chair of CHIME and the CHIME foundation. He currently serves as a board director for synergist deck, a security consulting firm.

[00:01:29] [00:01:30]Now a recovering CIO will have to argue who gets to hold that title. But Drex spends that he spends his time bringing together trusted health systems, payers, associations, vendors, and investors to solve healthcare's toughest problems as president of his home own healthcare practice, direct CEO, digital health. Good morning Drex and welcome to the show.

[00:01:53] Drex DeFord: [00:01:53] Oh, thanks. That is a very long introduction. Thanks for doing it.

[00:01:58] Bill Russell: [00:01:58] I tried to pare it down [00:02:00] but it's all relevant. I mean, you've been a CIO at a bunch of very great systems. You've obviously done some great work with CHIME and and the stuff you're doing now of really networking and bringing these teams together is important to the industry.

[00:02:15] as we, as we try to innovate and solve some of these problems. So. With that as the backdrop, you know, question, we ask everybody who comes on the show is what are you working on now? Or what are you really excited about? At the moment?

[00:02:28] Drex DeFord: [00:02:28] Yeah. Thanks. I, I [00:02:30]I mean, I guess I would start off by saying yeah, it's a long intro and it probably tells you two things. I guess one of them is that I'm I'm old.

[00:02:41] Exactly. And the other one is that apparently I have a really hard time holding the job. So both of those things may be true. I'm working on a bunch of different stuff right now. I do. I do work is as you described in the intro, I do work with health systems and vendors and startups and VC firms and lots of others, but right [00:03:00] now kind of the most interesting stuff that I'm working on is with the health system around some strategic planning and leading initiatives. I'm a big fan of lean. I lived in Japan for three and a half years. I've been back to spend time with Toyota and Yamaha piano and, and I'm really into a lean in it and lean in and healthcare in general.

[00:03:19] And then I'm involved in in a bunch of different startups who are working kind of on their own ways to disrupt healthcare. And being from Seattle happy the [00:03:30] days are getting longer, which means that on the days that I'm home I get to spend more time in the cascades and the Olympic mountain ranges, hiking.

[00:03:39] And what else? Oh CHIME and HIMSS are coming up. And so it's always nice to see 45,000 of my closest friends. And that's happening here in a couple of weeks. So excited about that too.

[00:03:50] Bill Russell: [00:03:50] Yeah. I'm, I'm looking forward to that event and It sounds like you have designed your work around your life now instead of your life [00:04:00] around work.

[00:04:00] And that's something we all aspire to. So Oh

[00:04:04] Drex DeFord: [00:04:04] no, that's actually been a really huge, a huge part of, kind of how I've arrived to the point that I am in my life right now. A lot of it has been driven by. There's particular things, particular things that I want to do in my life. And I'm, I'm trying to arrange my work that in a way that allows that to happen.

[00:04:25] Bill Russell: [00:04:25] Yeah. And that's yeah. And that's, that's great. And I'm sure a lot of CIOs, people listening to this [00:04:30] go well, that's, that's great and wonderful. And maybe we'll, we'll do that as a topic for future future. Talk about how, how how's, when people can take steps in that direction. All right. Let's get, let's get to the news.

[00:04:41] Cause a lot's happened this week. Not well, a lot's happened this week, period. So here's what happened, directs, and I each selected a sorority to discuss and I'll, I'll kick it off with with my story space X launch, the world's most powerful rocket. So what's next though, this is an article [00:05:00] from a space.com and I think we both shared just a love and a fascination for.

[00:05:05] For the space space exploration and those kinds of things. And I wanted to share this story because I think it's relevant to healthcare, but let me recap the story first, it's a space in case you are somehow missed this space as X launched a Falcon heavy rocket this past week exceeds the largest spacecraft in capacity in terms of lift capacity by two [00:05:30] X.

[00:05:30] And reduce the cost by a third from roughly 300 plus million to its nearest competitor to about a hundred million. So double the capacity, third of the costs they were able to to recover two of the the spent fuel cylinders. They had precision side-by-side landings. I had great photos of that.

[00:05:52] That is, yeah, that is a technology. It's, it's a feat. It's amazing that they've done that. They then launched into an orbit [00:06:00] that extends out to the asteroid belt. This was actually one of the things that they overshot beyond the, the, the Mars the Mars orbit that the trajectory that they were going for, but not a bad thing.

[00:06:11] And what it shows is essentially without refueling or whatnot, they can, they can actually take these loads. Has Elon Musk is actually quoted as saying we can, without refueling, we can take something out to Pluto if we needed to. And you know, in true Elon Musk fashion, they did it in style. They [00:06:30] placed Musk's red Tesla roaster in the cargo with a mannequin named Sterman and a space X space suit that played the corresponding song by David Bowie, thus completing the world's most expensive car commercial.

[00:06:45] But man, did they get some, some phenomenal pictures? And there's a there's a whole feed. And and some of those pictures of, of the roaster with with him, with the [00:07:00] the don't panic the, yeah. The shout out to the Douglas Adams trilogy there's well, so here's, here's why I think this is relevant to healthcare besides, I mean, we can talk about Elan, mosque and innovation and those kinds of things, but I, we are in that kind of golden age of healthcare as well, where anything's really possible.

[00:07:22] You, if you've ever heard Ray Kurzweil's speak about some of this stuff. He's talking about a future where. You know, precision medicine is, [00:07:30] is, is, is an amazing advancement for us where we are predicting things where we are doing pre preventative procedures, really with a nanotechnology and, and those kinds of things.

[00:07:44] And we should be as CIOs, we should be celebrating these kinds of advancements. When we see. When we see these new technologies and these innovators, and we have these conversations, we should figure out ways to be a part of [00:08:00] helping them to experiment, helping them to be able to create environments where they can move these things forward and, and just see what's what's possible and keep introducing the, the, the what's possible to our, to our staff and to the people that are out there.

[00:08:15] Cause this, this will be over the next five years or so. I think it's universally. Accepted that this is going to be a fun time within healthcare to see some really great advancements, almost like we've seen in commercial spacecrafts over the last couple of years. I'm curious what your, [00:08:30] you know, as you see this, this does capture the imagination, but what, what are some of your thoughts as you sort of replay the events of the past week?

[00:08:37] Drex DeFord: [00:08:37] Yeah, it's been super exciting. I'm getting a little echo, but Okay, good. It has been super exciting. I, you know, I was a space nerd as a kid. I followed the Apollo missions when when I was in elementary school and, and they launched from 39 82, which I thought was pretty awesome. Sort of such a historical kind of landmark app down in Florida.

[00:08:59] And there are, [00:09:00] there are a ton of lessons. I think one, one of the real lessons, you know, he started this whole program with some really big ideas that I think even. Most avid space fans thought were on the verge of being ridiculous things like being able to land reusable rockets back at the launch side.

[00:09:15] And Elon Musk went out and he made a big commitment and he screwed up several times and things exploded and he just kept at it nose to the grindstone. He kept, you know, rooting on the troops and he had. This [00:09:30] relentless faith that it could be done and that mistakes were okay. As long as the team learned from them.

[00:09:35] And he started landing these rockets and doing recovering and turning them around and launching them again. And after a while I think any of the problems that they faced when they happen, they weren't really a disaster. They were viewed kind of as opportunities for success or lesson to learn and.

[00:09:54] And I think he kept the faith and the team kept the faith and the fans kind of watching this from the outside, kept the [00:10:00] faith that he, he he'd ultimately when he sort of drags everybody up off the floor and he does some off and he sheds the disappointment and they keep moving forward. So in a lot of ways, that's why Falcon heavy was such a big deal.

[00:10:12] We had low expectations. But we kind of all came into it in the context you have this thing doesn't work well, we know he's not going to quit and he's going to gather data and he's going to learn from the problem and he's going to continue to inspire everyone. So, so I mean, in some ways too, I would say not to get too political, but the government shutting down and all of [00:10:30] that, we used to look to kind of big, hairy, audacious goals.

[00:10:36] Driving government programs like space and exploration. And we used to look at our political leaders for inspiration and pride. In this case, we're all rooting for this crazy South African to get us back to resupplying the international space station and ultimately even taken astronauts to the international space station, the moon and the Mars and beyond.

[00:10:57] So it's, it's quite a story [00:11:00] and, and there are a lot of lessons in there. And. Leadership and management and innovation and all of that.

[00:11:08] Bill Russell: [00:11:08] Yeah. And that that's, you know, w when you look at Elon Musk, there's just a couple things. One is and you, you sort of hit on this, you know, the first couple of times that space X tried to launch a rocket, they both failed.

[00:11:20] And then really they had to, he had to leverage his future to to get that third one. And that's why we know space X today. If that third one had failed. [00:11:30] You know, he's on record as saying that we wouldn't be here talking about space X today, more than likely. The other thing you have to love love about him is the it, he really does lead with vision and it's not space X being the most profitable or the biggest or the best he's leading with.

[00:11:48] You know, the Simon Sinek, why kind of, thing of, you know, we we, we want to, we want to explore, we want to we want to colonize Mars and we want to do that because we want to [00:12:00] make the human race more than a single planet species so that we can ensure our existence, regardless of what happens to this planet, that the human race will be out there.

[00:12:11] And when he speaks in those terms, I think those of us who who grew up, who grew up, you know, looking at the Apollo missions, wishing that we were still there while we were doing these you know, I, I don't know what to call them, but these shuttle missions that were just sorta looping around the earth instead of really activating our imagination, [00:12:30] this, this really has, has brought us back to.

[00:12:32] A mission we can all celebrate and get, get excited around. So I know, I think, I think you hit it, hit it on the head. I mean, there's, this is a great cultural piece for us around. How do you, how do you create that, that environment within your it organization, where people identify problems that they're inspired to dream and they take chances and sometimes they fail and that's a success in that you move forward and sometimes they succeed.

[00:13:00] [00:12:59] That's also obviously moving us forward. So exciting time for the space program, extended time in healthcare. So I'm going to kick it to you and, and for, for you to, to give us context for your story.

[00:13:11] Drex DeFord: [00:13:11] Yeah, sure. My story comes from a website called the medical futurist and a it's called what if Amazon ran hospitals?

[00:13:19] So probably a good place to start in. All of this is to say. Oh, and don't forget Bezos and Amazon have their own space program too. It's called blue origin. So [00:13:30] in a lot of ways dreamers like Musk and Bezos have have a lot in common. The story that's that's on the side is a pretty interesting, kind of a fun story.

[00:13:41] I stay on top of the Amazon discussions and the. Kind of super secret at 1492 healthcare projects, since I've, since I live here in Seattle there's a regular drum beat here about Amazon getting deeper into healthcare and, and maybe even buying a hospital kind of in the, in the [00:14:00] underground of the, the city here, we talk about that quite a bit, and that's obviously been rubbed up of course, by the JP Morgan, Amazon Berkshire announcement that happened a couple of weeks ago.

[00:14:13] This, this article really sort of takes that to the next stage and talks about some interesting scenarios. So everything from supply chain, disruption to selling prescription drugs directly to consumers at a discount to opening drug stores in the whole food. [00:14:30]Chain it, it talks about drones and health care and surgical robots and 3d printing of medical devices and things like splints and casts, but even things like drugs and how you could use it, use that technology to make pills, for example, shaped like dinosaurs to make it easier to get kids, to take their medicines.

[00:14:51] And of course it talks a lot about artificial intelligence and for physician leaders, how to leverage the techno, how that Amazon has to sort of [00:15:00] drive a reduction in administrative burden. So, so that's good. And I think in the end, the author talks about, you know, it's not all pros, there's definitely some downside.

[00:15:12] And as a CIO, I think. We're all, probably a little jaded. We, we love the idea of someone getting in and really disrupting healthcare. But at the same time, Microsoft has been all in and then out of healthcare, seriously at least a couple of times, Google made a big push [00:15:30] with a personal health record and fizzled.

[00:15:32] And I think all those companies have kind of learned from that you know, healthcare, super complicated and super regulated, and there's a lot of unwritten rules and. Every health system in every market operates differently. So there's a lot of, there's a lot of things to sort of think about in this article.

[00:15:49] And it is a really fun article to sort of think about how, how healthcare could change and how it could look different if somebody like Amazon really got it and to [00:16:00] the delivery business right flicking back on that, the space story I think most of the space industry, most of those big companies, general dynamics and the Russians and the French government and everyone else, I think they had to at least have been a little bit surprised at some point, the guy from South Africa came in and really has sort of changed how space may work.

[00:16:24] And I think in a lot of ways, healthcare's looking around to the outside, wondering if somebody he's [00:16:30] going to come in and disrupt, disrupt healthcare in the same way.

[00:16:35] Bill Russell: [00:16:35] Yeah, that's a, I mean, that's an interesting point. Will, will disruption come from within or will it come from without I I've posted two stories about this and the responses are always interesting to me is it does range from, you know, welcome Amazon to, to the game, to some others that are essentially saying, yeah, we've heard all this before, as you said, you know, Microsoft was all in Google was all in now.

[00:16:58] They're sort of [00:17:00] in. Apple keeps tiptoeing in and doesn't really get all the way in. We haven't seen Facebook really, or some of the others get get in here yet, but Amazon is an interesting play to me. Cause I think it's, I think what we're asking for when we hope that Amazon gets in is a consumer grade experience within healthcare.

[00:17:21] Right? So Amazon has a way of. Making transactions easy to make them frictionless to make them [00:17:30]you know, something that is, is much more convenient to the, to the user. And we w we all, I mean, as, as health within the industry, that's what we're striving for. But you have to know also that, because if you've gone to any dinner parties, if you have any family conversations over Thanksgiving and you say I'm in healthcare, You invariably get the story where they go, Oh, let me tell you my, I saw a guy, you know, I had the same test three times and then this doctor and I got [00:18:00] passed over here.

[00:18:00] I got the same questions. I got handed the clipboard again, we get all those things and we've been striving to really knock those down. One of the time. Our hope is that Amazon has somehow has a magic bullet for this. I don't think there is a magic bullet, but I think Amazon has some unique assets and a unique perspective.

[00:18:19] They do not try to. They're not gonna try to reinvent the hospital or not. Let me rephrase it. They're not going to try to run a hospital better. They are literally going to try to reinvent [00:18:30] healthcare. They're about establishing new ways of doing things, new ways of thinking about things. And so them actually buying a hospital and running a hospital.

[00:18:42] That's I think that's pretty fetched. I do think they, the. Amazon Berkshire announcement and JP Morgan is fascinating to me because I think they're looking at it a little different saying, how can we, how can we, what part of this can we take on [00:19:00] and make it more consumer centric where we can bring the best that we have offer and really move it forward.

[00:19:06] And, yeah. Yeah. And it's important to note this article doesn't make any case for. For Amazon being in there. In fact, I'll read this quote because I think it's interesting, but healthcare should not healthcare should not be pure business, medical evidence, empathy, and caregivers dedicated to their jobs make healthcare unique.

[00:19:24] And I think that's I think that's really true. And that's what we hear when people, the pushback we hear from [00:19:30] people is it's a lot harder than when Amazon thinks what they're really saying is. There's a lot more people aspect to it. You're not just going to do a transaction over your phone or online.

[00:19:40] And there's, there's the whole person that we have to really care for. I'll let you close this one up since it was your story.

[00:19:47] Drex DeFord: [00:19:47] Oh, I, I, I know, I think you're right on the money. There's a. No, if there's one piece of it that I look at that I know we struggle with as we make this transition from fee for service to value based care, it's patient [00:20:00] engagement, how do we really engage the patient and get them involved and keep them involved on a daily basis in creating an environment and identifying problems in their environment that ultimately keep them from being healthy and living healthily.

[00:20:17] And and in some ways Amazon has sort of figured out not sort of figured out, they have really figured out how to do customer engagement and make, as you said about this, you said, make that experience really [00:20:30] frictionless and easy to do and easy to understand and not a problem and not something else and different that I have to do, but something that works with the way I work and live in my daily life.

[00:20:41] And if we can just bring that kind of skill and that kind of capability into healthcare that might be a huge advantage. And how will you provide care as we move into the future? So I'm excited about folks from the outside. I think there are a lot of great lessons to be learned from the outside. And I know healthcare [00:21:00] is complicated and we do have our own way of doing things, but maybe some of that needs to be broken.

[00:21:05] And, and. We need to leave the broken glass on the floor after that happens

[00:21:11] Bill Russell: [00:21:11] Think different as our at Apple once said, well, all right. So w we great stories and we went a little longer than that. So we're going to try to package up culture in about five minutes or less. That should be no problem at all.

[00:21:25] So in our second segment, we typically talk about leadership or an emerging technology. [00:21:30] This week. I want to talk about about culture. I you've written a couple of really good pieces. I re posted a piece from my executive coach on the Philadelphia Eagles win in the super bowl. And I'll just give you two quotes from that to try to shorten this up.

[00:21:46] So he closes with this statement, Tom Brady threw for over 500 yards. The Patriots never punted the entire game. He's the best quarterback to ever play the game. But this year, the impressive numbers didn't matter. He couldn't beat culture. And he goes on [00:22:00] in that you can check out that store on health Derrick's the, in the blog site, he goes on to talk about the things that made them distinct going forward on fourth.

[00:22:08] That was not an anomaly. When the coach that he really believed in the team, he believes in the team, even on fourth down, even in the Superbowl. And those kinds of things really make a culture. And then the other quote, he throws out, which we all know, and we've all we've all been quoted many times, which is Peter Drucker's, quote, culture, eats strategy for breakfast every day.

[00:22:30] [00:22:30] You know, as we, as we jump into this, I just wanted to you know, you've part of some great, great cultures. You've built some good cultures. You've you've seen some great cultures. What are some of the, what are some of the characteristics of some of these cultures and what are some of the cultures that, that you've been a part of that, that you would highlight some of what makes them great?

[00:22:51] Drex DeFord: [00:22:51] Yeah. Well, first of all, I have to say, I watched some of the parade yesterday, and I don't know if you saw Brian, Kelsey, the center's speech yesterday during the [00:23:00] celebration, but he calls out virtually every person on the team and how the critics early in the season said. They weren't good enough. They weren't fast enough.

[00:23:08] They didn't have good hands. They couldn't play defense, the most terrible coaching decision ever made and all of those things. And then he refers to something that wound up treating trending as a, as a hashtag last night. He talks about how hungry dogs run faster. And I, I think, you know, the article that you posted and the idea [00:23:30] behind it is is just right on the money, this idea that hungry dogs run faster than they wanted it more.

[00:23:36] They were starving for it, not just the team, but on behalf of the city. So it was a really good story. And I think that this idea that culture eats strategy, you know, continues to be really sound. It's not the easiest thing in the world to build or change culture. I'm in the process of writing a LinkedIn article series right now with a friend of mine.

[00:23:55] I think a lot of this culture change starts with a [00:24:00] concept of empathy. You have to be able to understand and relate well to others on the team. If you're really going to affect change. And then if you have a true North, then you talk about it and you're transparent in your actions and you expect the same of the team.

[00:24:14] Ultimately you build trust and that's the kind of culture you want. Not really blind trust, although you may need that sometimes in emergencies, but the kind of trust that makes you vulnerable as a leader and also appreciated and respected. And, you know, I've worked with some [00:24:30] great folks. I came to Seattle children's because it was a, we you know, Wayne as a culture based organization and it had some, some great people here, Tom Hanson at the time was the CEO and Pat Hagan, who was the president.

[00:24:43] And Lisa Brandenburg. Who's now the CEO at the university of Washington, all had really great ways of helping people understand where they wanted to go and what they needed from them and gave them guide rails and let them go out and, and do their work. So and [00:25:00] the other thing, of course, I think culture wise I'd have to call up the air force, serve it, service integrity.

[00:25:05] Excellence is kind of the motto of the air force is still a personal motto. It's the way I do business. It's kind of the way I live my life. And the last thing I would say about this is I think it's hard to be a different person at work than you are at home. It's simpler. If you kind of tell the truth and work hard and try to make everything that you do better.

[00:25:24] But if you've got that kind of leader and those kinds of teammates, you wind up with [00:25:30] really great culture.

[00:25:31] Bill Russell: [00:25:31] Yeah. And that's the role of the CIO within their department is to foster that culture, obviously within the context of a larger culture. And, you know, I'll just highlight a couple of things from this article that that I repost from Bob Perkins, you know, the, the, the, you mentioned this, you know, that the leader has to be consistent, you know, all the time, and it's consistent in their personal life, as well as their, their business life.

[00:25:58] They have to. You [00:26:00] know, have have confidence, have confidence in their team and, and, and be able to speak to, to encourage someone as to speak courage into them. And you, as a, as a CIO, you have to, you have to speak courage into people and, and, and, and show your confidence in them, knowing that, you know, they can make mistakes.

[00:26:18] You in fact, would like them to make mistakes. And as we've talked about earlier, in terms of innovation, I like the point he makes, in terms of the least of these, there's a great story of John. Darren boss, who was [00:26:30] traded before the season started traded from the Eagles to the saints. And he had to go through a physical and during the physical, I found he had a heart condition and couldn't play football and Jeffrey Lori, who's the owner for the Eagles.

[00:26:42] We got a great move in terms of the culture invited him to be an honorary teammate at the super bowl and said, if we win, you will get a ring. And he is going to get a ring for being a part of that. Being a part of that team. And, you know, just saying that story gives me chills because it's, it's those kinds of things that [00:27:00] really define a culture and people see it, they know it, and they know I'm not going to be left behind that.

[00:27:06] This is an organization that cares for everybody within the organization and you know, great cultures have a way of communicating that and reinforcing that over and over again. And you know, as a CIO, it's a lot easier to recruit when you have a great culture. But there's so many other side benefits to to spending the time doing it doing it right.

[00:27:29] And [00:27:30] making it happen. So. Yeah, so th I mean, it's actually that discussion. We, we could probably spend another hour talking about that. Well

[00:27:36]Drex DeFord: [00:27:36] for sure that's a whole show by itself, right?

[00:27:39] Bill Russell: [00:27:39] Yeah, we really could. And maybe, maybe we'll do that sometime. So our final segment, we we highlight our favorite social media posts of the week.

[00:27:47] And I'm going to switch it up on you in the last minute. I'm you know, I was going to highlight the Thurman posts that were out there, but I found an even better one. From Elon Musk, he in the [00:28:00] spacecraft that he shot up there, he has printed circuit boards on the car in deep space and printed on that circuit board.

[00:28:08] It says, made on earth by humans. And I found that to be funny, you can check that out on Elon Musk's Twitter feed. And so and that's maybe how we're going to start identifying things instead of made in countries. We're going to say made on earth as we start to move throughout the galaxy over to you.

[00:28:26] And what, what do you want to highlight?

[00:28:28] Drex DeFord: [00:28:28] I liked that. I mean, I think [00:28:30]you know, if you think about this, the earth really is a spaceship and. There's a bunch of people crowded on this little spaceship and we better take care of the spaceship because it's the only spaceship we have right now. And thank goodness for guys like Musk and Bezos and others who are, and figure out how to make sure we're not a one spaceship group, but made on earth is a, is a pretty cool idea.

[00:28:51] And by the way, somebody else has said something to me that I thought was funny the other day, after this launch with star man up there, I don't know if. If you needed to hide a [00:29:00] body, that would be a really fun and interesting way, right? Maybe there's actually somebody in that suit. I'm not sure

[00:29:06] Bill Russell: [00:29:06] that's not what the show is about.

[00:29:11] Drex DeFord: [00:29:11] My tweet is from Andy Slavitt this week where he announces a new movement called U S of care. And it's, it's being lodged. There's a bunch of people involved. You can look it up@usfcare.org. It's a really interesting kind of approach kind of has three main tenants. Every American should have affordable [00:29:30] healthcare.

[00:29:30] All Americans should be protected from financial devastation due to illness or injury, and that the policies to achieve achieve these aims. Must be economically responsible. And when political support needed to ensure long-term state votes stability slab, it of course has has a long history in healthcare and, and government.

[00:29:51] And and I think if anybody can, can get a bunch of different people and they have a lot of different people on their board and their advisory group it's interesting to go [00:30:00] look at the site. So U S care lot or the U S of care.org. And and it's, it's certainly something that everybody in healthcare should at least be aware as it's happening right now.

[00:30:10] Bill Russell: [00:30:10] Absolutely. U S U S of care. You know, a couple. Couple of that is a bipartisan group. I took a look at the list of people on that. It's a, it's a pretty good list of people. A couple of side notes about Andy Slavitt. He should really be our hero. If you ever get a chance to have a conversation with them, ask them about how he turned [00:30:30] around healthcare.gov.

[00:30:30] It is a it is a it project is it should be a white paper that we all read. It's, it's amazing what he did in a very short period of time to sort of turn that around. And the second thing I would say is we're just watching Andy Slavitt mature in front of us. I know that's kind of it, he went from being very partisan during the healthcare debate to really moving beyond that and saying, okay, what's it going to take for me?

[00:30:56] To be effective in really molding [00:31:00] policy and having an influence. And I've seen him really take away a lot of his divisive language and really come back to our what really matters and what really what's really important in this argument. And who do I need to get around me in order to really move this forward?

[00:31:16] And this is a great move. So again, if you ever get a chance, ask him about healthcare.gov, I'm sure he's tired of telling the story, but it's, it's it's worth hearing. Drex thanks for being on. Well for now you can follow Drex at on Twitter [00:31:30]Drex DeFord, D R E X, D F R D, and me at the patient's CIO. And don't forget to follow the show on Twitter at this week and hit. And check out our new website at this week in health. It please come back every Friday for more news commentary from industry influencers. That's all.