Bill Russell: 00:07 welcome to this week in health it news where we look at as many stories as we can in 20 minutes or less. It’s Tuesday news day and here’s what we have on tap. Microsoft invests $1 billion in open AI and artificial intelligence projects. the VA names their first director of AI. And let’s see, John Muir outsources a whole bunch of it to Optum and a whole bunch of other stories. I have about 10 of them listed here. There’s no way we’ll get to all of them. Let’s see how many we get to my name is Bill Russell, recovering healthcare, CIO and creator of this week in health it, a set of podcasts and videos dedicated to developing the next generation of health it leaders. This podcast is brought to you by health lyrics. Let me ask you a question. Do you have a coach? Do you need a coach? Do you think you need a coach?
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Bill Russell: 01:33 They just throw in, the Elon Musk get more hits than the news story, I think a cause. He’s no longer associated with it. But, uh, this is CNBC. Lauren Fainter is the author. So Microsoft’s gonna invest $1 billion and open AI as part of the project. Uh, the company said, while, uh, today’s AI can tackle simple tasks, which is true. The company’s said AGI, otherwise known as artificial general intelligence, a little smarter human, like, uh, we’ll be able to tackle more multidisciplinary problems. Uh, this is pretty interesting in that Microsoft slick move here. Uh, Microsoft Azure will be the sole cloud provider for open AI, uh, artificial challenge, general intelligence. They think it’s going to solve everything that ails the world. Climate Change, you name it. Um, most importantly, tech vet, tech, Dev and human, uh, oh, here’s their quote. Most this is the most important tech development in human history with the potential to shape the trajectory of humanity.
Bill Russell: 02:29 And A, they’re not the only ones that feel that way. Uh, as I said earlier, Musk left this thing back in 2018, um, a little bit because, uh, he was going to focus in on Tesla and the problems they were having in production, but also he’s a little freaked out by AI. You know, he’s, uh, you know, thinks it’s more of the future’s terminator and, uh, he’s watched that movie too many times. It doesn’t like the, uh, the way it ends. So, uh, he has, uh, pulled out of AI. Uh, the other thing obviously is that, uh, Tesla is playing an AI, especially around self driving cars. And a, there was a potential conflict there. So, uh, so he moved on. So, uh, I guess the question is what can artificial general intelligence do? And, uh, you know, in theory AGI could carry out any tasks that a human can, which, um, and actually some tasks that human humans really can’t, uh, at the very least, AGI would be able to, to combine human, like a flexible thinking in reasoning with a computational power and advantages like incident recall and split split second number crunching.
Bill Russell: 03:35 Uh, so you can imagine what it can do. It’s, it’s, it’s layering on decisions, uh, that it can do with the ability ma instant math instant recall. Um, it’s important to note that, uh, it, it really doesn’t exist yet, which is really interesting. So this is $1 billion investment in the future. Um, you know, you’ve seen it though, so you’ve seen this, uh, it’s the stuff of science fiction, terminator. Uh, the Matrix, uh, you know, Mr. Anderson, uh, whatever that, whatever the, uh, nemesis is, I can’t even think of his name right now. Anyway. A terminator, the Matrix, a bicentennial man, uh, with Robin Williams, uh, you know, AGI tends to be depicted as a mesh between, uh, the computational side of it and the machine, uh, that either destroys the world. And that is the one that we see the most because those movies gross the highest amount because it tends to capture our imagination, uh, or the other, which is, you know, it enhances the world, which is sort of your bicentennial man.
Bill Russell: 04:39 Uh, you know, it’s more fun to consider, but not as much fun to watch on film. It would appear, uh, you know, AGI is truly the holy grail for artificial intelligence. So what, you know, we end all of these stories with the, so what, and it is, you know, Microsoft is making a meaningful, meaningful investment, uh, in this important area of AI. Um, they’re trying to bring these capabilities to Azure, which is important as well. Uh, and they’re making sure that they are going to be a player in this AI space. Um, you know, there was a time where we, we, we’ve talked about what tribe you belong to. Uh, you know, we, you’re, we still do it, right? You’re an epic shop. You’re a Cerner shop, you’re a Meditech shop in network. You could be a Cisco, juniper or whatever shop, uh, in operating systems.
Bill Russell: 05:23 This is really going back, you know, before windows was the dominant player, you might have said, you know, we’re window shopping. I was to shopping Novell shop. Um, you know, as you could see from some of these examples, uh, the, these things really come and go. Uh, it, as technology evolves, they sorta dissipate. We have winners, we have losers. Uh, but there is a time where it’s really important to decide which horse you’re going to place your bet on. Uh, and, and the time is really either now or pretty close on the AI side. You know, the question becomes, are you a Microsoft shop, a Microsoft, Amazon, Google, IBM? To a certain extent, oracle, Wipro, uh, or, or even specialty type companies. I asked the rainbird and others, uh, you know, the question becomes, where do you go for a machine learning NLP automation cloud infrastructure.
Bill Russell: 06:14 Microsoft wants to be your AI cloud and they are making the investments to back it up. They’re not the only ones making the investments. By the way. I mean, you have a, we had a conversation with John Halamka on one of the, uh, earlier, uh, episodes and uh, you know, uh, John with Beth Israel deaconess, uh, moved on from the CIO roles now sort of an innovation type role and did one of the first things he did was a partnership with Amazon around a, a, a machine learning more than, uh, which is a subdivision of AI. Um, so more of a machine learning kind of thing where they’re looking at specifically how this can be applied, uh, to medicine and to improving, um, you know, at this point really improving the efficiency. I mean, John Talks a lot about, uh, improving their own, our efficiency and improving their, uh, their, uh, document processing and other things with just simple, it’s simple machine learning and AI tasks that are connected into the workflow and making things happen.
Bill Russell: 07:09 Uh, so that’s a, that’s our first story. Spent a lot of time on that, but that’s a really interesting story I think has a lot of impact. Uh, you know, let’s stay on this for a minute. Let’s stand AI for just one more minute. So the veteran VA has appointed at first director of artificial intelligence. I bring this up cause I think it’s interesting in that this role didn’t really exist. Uh, I dunno, maybe three minutes ago, but it’s, uh, it’s now a thing. So Gil Alterovitz Phd, formerly professor of division of Medical Science, Computational Health Informatics at, uh, Harvard medical school. Boston children’s hospital will lead the VA’s AI work. Uh, the VA is putting AI to work to reduce veterans waiting times, again, efficiency side for appointments. Another application is suicide prevention. Uh, though the reach through the reach vet program, the VA uses AI to scan medical records and to look for signs of vets, high risk of suicide.
Bill Russell: 08:07 Uh, a report on the VA website notes that Alterovitz. Uh, we’ll be working closely with Scott Duvall who heads up the VA informatics and computing infrastructure to put VA data to work for veterans. An example of million veterans program MVP, which was already collected genomic and health data on more than 750,000 consenting veteran volunteers making it one of the world’s largest genomic databases. Uh, this is what we need. Let’s see. Closing, Oh, here’s a good quote. Uh, this is what you need to do. Optimal AI, a lot of deep knowledge Alterovitz said in the report. AI is the key to really taking advantage of the data to help vets and potentially others as well. Uh, interesting know. So what on this, and this is really simple, uh, what’s your answer to this question? This is an important discipline.
Bill Russell: 09:04 Who in your organization is responsible for it? Specifically? AI? AI as is a very important discipline who was responsible for it within your organization. If you can’t answer that question very quickly, it might be something you want to give some mind time to cause a, this will be a specific discipline and it could be a part of your analytics and a part of your advanced analytics and big data strategy. Uh, it can be something completely different and I think it probably will be something completely different and it’s a discipline into itself. Uh, okay, let’s move on. So John Muir health outsource, is it revenue cycle analytics and more to Optum? Mike Miliard Uh, healthcare it news, John Muir health and Optum are embraced, uh, embarking on a new partnership that will see. The Bay area health system outsource most of it’s technology in billing functions to United health subsidiary optimum, why it matters.
Bill Russell: 10:02 Optimal manage a John Muir’s nonclinical. It systems analytics, revenue cycle management, purchasing claims processing and the company will also work to boost the ambulatory care coordination and utilization management services for John Muir, a physician network. The goal official say is to streamline and the efficiency of administrative operations using innovative technologies, helping reduce administrative workload and allowing health systems focus more on patient care. There is your phrase, when you hear that phrase, just think they are outsourcing a, you know, we are gonna reduce administrative workflow flow by allowing the health system focus focus more on patient care, which means, hey, we’re not that great at it in certain areas and we’re going to get really good at it because we’re just going to go partner with somebody who’s really good at it. Uh, Optum also hopes to accelerate John Muir’s value based care efforts by deploying some of the, some of its own clinical technologies and advanced analytics software at the point of care helping the health system with patient engagement and pophealth.
Bill Russell: 11:01 Uh, as part of the, uh, terms of the deal that were not disclosed. Well, I don’t know how we know it, but as part of the terms of the deal and we’re not disclosed, some 540 John Muir staff will become Optum employees as a team dedicated to the health system. Uh, officials say. Those employees will gain access to new skills, training, workforce development opportunities. So, uh, so those people are going to be optimum employees. Uh, let’s see. Anything else that you go on and say anything exciting? Uh, so, uh, here’s some. So a trend towards outsourcing of it services and revenue cycle capabilities has been gaining momentum across the industry in recent years. But this deal is more extensive and sizeable than many other different strategy has been tried recently for our providence Saint Joseph Health, a major epic client that recently acquired epic consultancy Blue Tree, bringing the company’s expertise in house to help advance its own quality improvement efforts while also diversifying its revenue stream by helping other providers with their it initiatives.
Bill Russell: 12:06 Uh, let’s see. That’s about it. So what, uh, outsourcing the basic tasks of it and revenue cycle and other things is making a comeback. Uh, you know, here’s a simple question. Can you provide the basic services of compute storage, network security better than an outsource provider? Since this shows for health, it not necessarily rev cycle. People, uh, you know, can you provide those things better? Um, and I guess the, the, the first question would be what is better? Um, so better would be more reliable, less cost, more flexible, um, more adaptive to the needs of the organization. Uh, you know, if the answer’s no to those, well you may want to get better at it real quick or start interviewing potential vendors because this is a trend that started to kick up the, uh, the margins in healthcare are not that great. You can’t afford to not be at the top of your game in terms of your ability to deliver these basic services to the health system.
Bill Russell: 13:05 And A, and business leaders are starting to try to figure out how to move a little faster and, uh, outsourcing is one of the arrows in their quiver. So, uh, just know that that’s there and know that that’s a potential. Let’s see. Let’s do this story. So, uh, cause I think this is interesting cause we’re for value based care, a Texas health system puts costs and risk data at the point of care. Healthcare it, News Bill Silica. Uh, let’s see. With the cost data technology integrated with its epic EHR, Houston Medical Youth Huston Methodist Sugarland has reported approximately 717,000 in attributable cost cost savings with an average incremental cost reduction of $105 per admission. The shift from volume to value based care and payment models requires physicians to focus on exceptional care delivery while also managing resources appropriately. Physicians always focus on quality of care, but now they also are being called upon to partner to reduce overall costs.
Bill Russell: 14:05 So how do they do that? Ultimately, however we can’t partner to manage costs if we don’t have the data we need to aid aid in cost consciousness. Clinical decision making said, uh, Dr Nicholas to say a system chief medical information officer and I’m a surgeon at Houston Methodist Search Sugarland a 2018 Deloitte survey of 620 for us primary care and specialty physicians revealed that 72% of those surveyed considered cost data to be valuable, especially at the point of care, while only 28% received that information. A smaller survey conducted with physicians at one of the Houston Methodist hospitals, a reflected a similar result. The adage you can’t manage what you can’t measure it, that it’s absolutely true. You can’t manage what you can’t measure. So that rings true. Uh, our physicians need data and, uh, to be true partners in clinical and financial stewardship efforts. And so what did they do?
Bill Russell: 15:05 They implemented a smart ribbon. Uh, this is just one of those models to, to get the data into the workflow. That smart ribbon is from a vendor called Illumi Care Illumi Care, a healthcare it startup located in Birmingham, Alabama. They bring that data right into the ribbon so that when they’re seeing the, uh, the patient and they’re caring for them, uh, they are able to see cost data in, in that cost data. They’re able to help them to navigate the, uh, most appropriate level of care for what they’re trying to do. So it’s not just, uh, putting them on a path that says, we’re going to get you 65 tests. We’re going to send you here. We’re going to do this. It’s actually, uh, considering and talking to the patient about what’s the level of care that makes the most sense for them, that they would like to, uh, that they would like to have and not have surprise bills, not be, um, uh, not be in control of their own destiny.
Bill Russell: 16:01 So I, I like this. I even though this article is really a, um, a piece to, uh, promote Illumi care, uh, but I, you know, I’ll give it a shout out because I love the solution. You know, if only 72 per, if 72% said, hey, this data would be valuable and only 28% are receiving it, this is one of those areas where you can get a quick win, get that data in front of the physicians and let them care for their patients in a, in a, in a little better way. So, um, uh, one thing I want to hit on, and this isn’t even a story, this is just a flat out advertisement. Um, a video made its way into my feed and I rarely look at these videos, but this, this looked interesting and the, the video was on, uh, AWS outpost. So AWS, Amazon web services outpost, and, uh, what AWS out are fully managed, configurable compute and storage racks built on AWS designed hardware.
Bill Russell: 16:57 Uh, and so you can use this anywhere. The, they’ll send you the AWS outpost and it extends your, your native AWS services and, uh, you can put that in your data center, in a Colo space, uh, on-prem facility and, uh, extend your AWS and your vmware cloud to your data center. I found this to be really fascinating. Um, back when we were moving to the cloud back in 2011, this stuff didn’t exist. We had to build a private cloud. So we built a private cloud because we couldn’t get a BAA done with Microsoft. We couldn’t get done with AWS, couldn’t get it done with Google. We couldn’t get it done with, uh, you know, uh, other, uh, providers, smaller providers. We just couldn’t get it done with anybody. So we had to, we had to build out our own. Um, but I, I think that’s an old model.
Bill Russell: 17:44 I think that model’s going away and I think this is, this is one of those things that I think is, is the next movement you’re going to see in cloud service from these cloud services providers. I would be shocked if we don’t see this from Microsoft today. What Microsoft relies on is that you’re going to build out your compute, your storage, um, and, and, uh, architect that rack correctly and, and then connect to their Azure. And I think what they’re finding as well as others is, you know, good architects are hard to find. Uh, the architecture on this thing, this video is worth watching. The architecture on this rack is exceptional. The, the, uh, density, they are able to get into that rack. Uh, the way it’s architected for a continuity and fail over is exceptional. And this is what happens when you, um, you take all the knowledge that they have from AWS in the racks, in their data centers around the world, and you, you put that towards a problem, which is how do we extend this thing all the way down into the, uh, environment that we are trying to serve and extend our cloud to the, uh, to the client data center.
Bill Russell: 18:49 Um, again, video’s worth watching. The concept is worth watching. I think you’re going to see this more and more. We saw this in different ways. Way back when a Google search, there was a Google search appliance that we used to, you know, we buy that Google search appliance and put it into our, uh, environment and we’d be able to provide Google, like search across, uh, all of our data stores within our, uh, environment. And that’s the, it still may be available, I haven’t looked at it recently, but those, those, uh, cloud providers with really good architects are thinking, how can we get this down into the, uh, into the environment worth a look. Um, you know what, that’s about 20 minutes. So, uh, you know, that’s all for this week. We’ll get to some of these stories hopefully next week cause there’s some really good stuff going on here.
Bill Russell: 19:35 So, uh, you know, this past Friday we spoke with uh, Seth Hain, VP of r and d for epic on AI. Wonderful conversation. If, uh, if you hadn’t had a chance to listen to it, you may want to check it out. Um, keep sending me your comments [email protected] Uh, good, bad or indifferent. It all helps. I’m getting some, uh, interesting feedback on our, uh, daily, launch that we just did and we’re probably gonna revamp it based on your comments and I, you know, again, keep ’em coming. Really appreciate it. Um, and uh, you know, be sure to tune in this Friday. Uh, we’ve already recorded a couple shows and uh, we’re going to be recording another, we’re going to be recording a couple more, uh, upcoming here shortly. Uh, you’re gonna want to check those out. So this show is a production of this week in health it for more great content. Check out the website this week in health it.com or the youtube channel @thisweekinhealthit.com. Uh, it just clicked on the video button on the top of the website. Thanks for listening. That’s all for now.