FOR THE NEXT GENERATION OF HEALTH LEADERS

Rod Hochman with a Health System CEO Perspective on the Digital Transformation of Healthcare

Rod Hochman This Week in Health IT
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Digital changes everything or it soon will. Rod Hochman joins us to discuss the digital transformation of healthcare.  A wide-ranging discussion on priorities, investments, and competition.

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Bill Russell:                   00:07                Welcome to this week in health it where we discussed the news information and emerging thought with leaders from across the healthcare industry. This is episode number 27. Today we get a CEO’s perspective on the digital transformation of healthcare. This podcast is brought to you by health lyrics. Are your strategies constrained by infrastructure or are you tied in a knot of applications? We’ve been in your shoes. We’ve been moving health systems to the cloud since 2010. Find out how to leverage cloud to new levels of efficiency and productivity. Visit Health lyrics .com to schedule your free consultation. My name is Bill Russell, recovering healthcare cio, writer, an advisor with the previously mentioned health lyrics. Before I get to our guests and update our listener drive, we’ve exceeded 200 combined new subscribers between our youtube and podcast outlets, which means we’ve raised $2,000 for hope builders, which provides disadvantage, youth life skills and job training needed to achieve enduring personal professional success.

Bill Russell:                   01:01                I’ve hired their graduates and their stories are really nothing short of amazing. They’re very inspiring. We have six more weeks where our sponsor has agreed to give $1,000 for every additional hundred subscribers. Join us by subscribing today and be a part of giving someone a second chance. Uh, today’s guest is the president and CEO of Providence Saint Joseph Health, a faith based faith based, non for profit health and social services system with 111,000 caregivers in 50 hospitals. Eight hundred 29 clinics and, uh, someone I consider to be a digital health visionary today, Dr. Rod Hochman joins us. Good morning Rod. Welcome to the show. You know, your, your bio is pretty awesome, but the show has a limited timeframe. So if you don’t mind, I’d like to condense it a little bit. Are you okay with that? Uh, so, so you’ve had leadership positions at a providence Swedish Sentara in Virginia, Health Alliance of Greater Cincinnati and Guthrie in Pennsylvania. A Rod has served as a clinical fellow in internal medicine at Harvard Medical School and Dartmouth medical school. In addition, he is a fellow at the American College of physicians and a fellow at the American College of rheumatology. He received his bachelor degree in medical degrees from Boston University. Actually my daughter is interested in bu and we’re heading up there in the fall for a visit. Is there anything I should know about BU before I head up there?

Rod Hochman:              02:28                Absolutely. I was just there on campus I was actually giving a talk at the medical school and the campus is growing like crazy and the big sell is in Boston and you know, and the university in great. So I go for it and any way I can help.

Bill Russell:                   02:47                Yeah. Well I am looking forward to anytime you get to visit Boston in the fall, it’s a, it’s, it’s a, it’s a wonderful experience. So I’m looking forward to. We’re going to visit some, I don’t know, you know, your youngest daughter going to Boston or she wants to look at schools in New York City and Philadelphia. I mean these are big cities and I live on the other coast so it’s A. Anyway,

Rod Hochman:              03:08                I’ll tell you, I know all three cities. I vote Boston hands down.

Bill Russell:                   03:14                Well, let’s see, so that there’s two other great sentences in your bio. So I’m, I’m going to touch on these. So under Rods leadership, providence Saint Joseph health is transforming healthcare for the future through digital innovation, genomics, and scientific wellness, pophealth and outreach to the poor and vulnerable. In addition, mental health is a top priority for providence Saint Joseph Health, which is contributing $100,000,000 to establish an independent foundation focused on improving the mental health and wellness of communities. Uh, so let’s break that down a little bit. So, digital innovation, genomic scientific wellness, pophealth and outreach. Give us a high level on some of the things that you have going on right now at, at Providence St Joseph Health and in those areas,

Rod Hochman:              03:57                We’re in the belief that the health system of the future, it’s going to have to look different than it is today, but there are certain areas that we felt we had to make a commitment to the two areas that have been slower to get the digital revolution that’s been higher ed and healthcare. And whether we like it or not, it’s here. And what we did. I think the smartest thing you did about four years ago, we hired Aaron Mark from Amazon for to be our, a chief of the digital informatics that handle this for us and is it was as much a cultural change as it was a technological for us. You know, Aaron has a great diagram, but to put technology and people together with healthcare, people in the middle and you get magic because they both need each other, whether they recognize it or not. And I think we recognize that four years ago that if you’re going to take this digital revolution on, you better put those folks together.

Rod Hochman:              04:56                So we’ve come to the realization that digital is the way healthcare is going to go. It’s the only way we get the scale. So we’ve been working in a whole bunch of and treatments before but we considered that to be job one for the transformation of our system. The second area was, you know, we felt the largest health crisis. The United States. If you look at folks, about 40 percent of patients that we seen have some common primary or secondary mental health disorder. Then if we don’t get on top of this and we’re seeing this in the country as suicide rates a lot of that’s been out there, you look at opioid epidemic. Really if this was ebola or something else, we can say, gosh, we have an epidemic we’ve got to do something about it. So we focus as a health system, the stake in the ground, we’ve got to put our money where our mouth is and said we need to openly develope and creat this new organization with an element of trust other people could join us so that this isn’t just the providence St Joseph effort, this is a national effort.

Rod Hochman:              06:02                We’ve gotten folks from all around the country for Patrick Kennedy, Marine to be part of our advisory board, so that people could see us creating a solution that will help. The third is, you know we have the other revolution that we have is the genomics revoltion where we have this intersection between biologic science and computational science and what that enables us to do is to explore new innovations in healthcare that you couldn’t dream of when I started med school 40 years ago. But it’s all about computational ability and being able to do it, Leroy Hood is our chief scientific officer, he is a Caltech, Phd combined with a degree from Johns Hopkins. So really it’s this intersection between computational science and biologic science and he spends a good part of his career and sometimes in the keynote. But now his area of interest is what is that are clues to why people stay well, and he’s use the term scientific wellness. So it’s the approach that if he can look at the genomic, the biomic characteristics of folks and figure out what they, they have been making us all living and use lab, it’s in southwest Amazon is really helped us transform our thinking about how we look at not just healthcare but health in general and how do we apply science to health and wellness. And then the last area is our insitute for human caring, which looks at how do we look at as we enter the latter stages of our life, how do we do that in a way that we all would want as doctors, it people how would we want to pass through that. And you know, our approach is that you don’t necessarily need a build that you have assisted suicide, we think there’s another path and it’s really a movement to let people know that as they reach the other parts of their lives that theres an alternative to the way we think. So those are just some of the areas that we think are critically important to the health system to be engaged in. And that’s where some of the future is.

Bill Russell:                   08:35                That’s an awful lot and it’s really exciting. I know that, um, you know, the sisters and you and Deborah were so excited about the mental health initiative and it’s really exciting to see, uh, I mean not only providence St Joe’s, but we’re seeing this as really a couple of organizations across the country start to really step up in that area and maybe take the, uh, take the mantle of this. This is really an epidemic that needs to be addressed head on. Um, so let’s, let’s jump into, you know, for those of our listeners, we usually do in the new sound bites and, um, we do a social media close. We’re going to lose a social media close. We only have 45 minutes with, with Rod, so I’m going to spend more time on sound bites, a little bit on, in the news. So, so, right. Here’s what we usually do during this section. I toss out some questions, usually one to three minute answers. If you go longer than that, um, I’m not going to stop you. It’s more of a guideline than a rule. Uh, and from time to time, people throw questions back at me, I cannot guarantee answers, but it happens. So, so here we go. Um, uh, first question, how does a, how does the competitive landscape really chang in healthcare with the emergence of digital technology,

Rod Hochman:              09:48                So I think what digital helps us do is get to scale, and I think that the biggest problem that health systems have had is how do you get to scale, for us We take care of 13 million here, how do we make that 20 million? You cannot do that having people visit your office for a visit, you’ve got to use technology, and the digital tools are here. It’s not digital versus hands on. It’s digital and hands on. So we look at digital being able to really improve our scale and be able to get us out the places, where we’ve never been before whether it’s either through telehealth, it’s through Apps, it’s through people having their own personal health record. So we think unless you have digital tools, you can’t take care of people health, you cant get to scale.

Bill Russell:                   10:37                Yeah. But it’s also going to bring in potentially some new competitors. So as we look at the new competitor, potentially partner landscape, a new things are emerging. So you have cvs, aetna, a jpm chase, uh, uh, Amazon, optum, Devita, and various other mergers, uh, coming, coming to bear. So, um, let’s take this from two perspectives. What, what challenges are those leaders, uh, with those new models going to face, given how, how much of a physical plant is required for medicine at this point and how are these, these models going to change the traditional health system? Uh, like providence, St Joe’s.

Rod Hochman:              11:20                Well there’s words of caution all the way through, So if we use a uber analogy and Uber’s been able to revoltionize mobility, without owing a car, or plane or train or anything else nor do they have plans on doing that. So I think we in healthcare and feel so secure in big buildings better watch out because it’s a, it’s a blockbuster analogy. It’s all of those ones that are out there, a bricks and mortar, I wouldn’t feel comfortable just sitting back. So I think for folks in healthcare, we’ve got to, we have to partner we have to devolop, but we have to have a digital solution to what we do, so it’s the equivalent of saying I’m just going to have my stores and sell my DVDS versus I’m not going to go out in the digital space. So I think that’s a, that’s a threat and an opportunity for healthcare, but it’s not an elective whether you go onto the digital side, you have to. Then for smaller organizations, depending on who you are I think you’ve got to find the partners that will help you.

Bill Russell:                   12:27                As we look at. Let’s change gears a little bit here. So, um, let’s, let’s take a look at the role of the consumer. So the consumer in, in today’s marketplace is very different than the consumer in previous years. And what we’re seeing is a lot of health systems changed their models. Um, I’ve had a cio on the, on the show who was talking about how they’re really taking apart the health system and now they have, literally, they’re taking the departments that are breaking out the big campus and you’re seeing them on street corners and all over the city. They’re making them more accessible. Um, how, how is the consumer really dictating a, your next moves and your next steps in terms of how you, uh, make it more convenient, more accessible, a really focus in on, on experience and outcomes.

Rod Hochman:              13:24                When we look at our strategic plan, which we call health 2.0 we put the consumer right in the middle, and we say as a consumer, how do I want it? I want healthcare where I want. when I want it, how I want it. Sometimes it’s at home. Sometimes it’s on my iphone, sometimes it’s in the office, sometimes it’s in the hospital, but that’s our whole focus. And I think that’s one of the things our Amazon folks, that they’ve heped us with that works for us, is they are completely consumer driven and they’re really teaching us how we have to do that. We’ve shifted our focus completely in that direction to put the patient, the consumer at the center of everything we do do. And that is for all of our care givers, as you said, you know, we take care of the vulnerable, for our medicade mom in Washington state, or for Microsoft executive, or for an executive from southern California. We want to make sure we taylor our exploits to them. So we’re all in on the consumer side. We think everything has to be directed towards the individual, They want their personal record, they want to have that personal attention and thats what we been, and digital really helps us to do that.

Bill Russell:                   14:39                So precision medicine, you mentioned a Dr Leroy Hood your chief science officer. So precision medicine based on genomics holds great promise. We know that uh, this technology is really advancing pretty rapidly. Um, how does, how does your health system prepare for what really could be a radical change in the way care is delivered and received in the future?

Rod Hochman:              15:09                Well, I think that’s why we hired Lee on because we recognized. We didn’t have that expertise in our large health system. We’re also not an academic health system. but Lee is the one that’s helping us shape what are the practical considerations of genome sequencing, but you know, what’s interesting about Lee’s work, it’s not just about the genome and I need to say that, it’s about the biome it’s about the laboratory data, the data but today’s world let’s us do is put this very dense data cloud together and figure out for Bill Russell, okay, what’s, what’s, what, what do you need to do next? And so we think Lee and his work at personalized health really helps us to put us in a position to know what we need to do and sequencing continues to spiral into. It’s almost, it’s gonna be available and ready for everyone. You’ve got to just figure out how to use it effectively, both if ill but to also feel well and I think we put our, we put our chips on the work that lees’s doing help us navigate through that.

Bill Russell:                   16:20                Yeah. I don’t know if you’ve done this yet, but I went down to human longevity down in San Diego and I did the full battery of genomic sequencing and, and uh, the rest of the services that they offered. It was fascinating to me. Um, just how, uh, how much more precise they can be and how much did they could say, you know, if you’re, if you’re a physician, prescribes for you these medicines, you’re going to want to direct them in this direction instead of this direction. It’s amazing that when you treat them as treat people as just people as opposed to bill Russell, the individual, the diagnosis could change and the, the, the, the path, the treatment path could, could change pretty dramatically.

Rod Hochman:              17:07                Well, what we’re finding with the work with the genome is that many medications that we prescribe they work for you, but not for me. And how do we know that right now? It’s trial and error. I guess it’s not working, you know, and what we’re finding are there secrets in genomic pattern that will help reveal wether, Which medicine works for you? Obviously the most obvious thing that we’ve been talking a lot about is how we’ve been overtreated women with breast cancer and we kind of treated everyone the same, so everyone got the same cocktail therapy, but what you really find is that there are subsets amungst that group of women, that for this group, this treatment makes sense, but for this group, it doesn’t make sense. So what its helping us do is create a lot of specificity, abour tailoring both your treatment, and what we should do according to who are, and that work is just accelerating. Matter fact, my wife is in a program that came out of Lee’s group called arival similar to what you’ve experienced, the San Diego and she’s on the phone with her coach today, going through all of her data, her genomic data, her biomic data to figure out what she should be doing next. And that is, that’s a whole different world from where I was 10 years ago for healthcare.

Bill Russell:                   18:30                I love the direction it’s going. So, you know, one of the things we probably don’t talk about enough on this show or in other context is just the cultural change that’s required. So digital requires significant cultural change. We saw a slow uptake in telehealth because it’s, it’s a new behavior and even though now we’re starting to see a significant rise in telehealth, it’s taken many years for that to happen. Ai requires acceptance, uh, within the health system as well. Uh, and there’s many other examples. Um, how does, how does a leader a lead cultural change that is, that is required to really accelerate the acceptance of these new technologies?

Rod Hochman:              19:13                That’s a great question because I think, I think we’re starting to see its motion, it’s moving a lot faster than it was in the past. Uh, you know, Tom Friedman in his book talks a lot about this kind of explosion in the curve of how fast you have to be able to move. So what I’ve been impressed with is I’ve noticed that what took longer before is not taking it, but if you don’t pay attention to the culture, you can really get burned, you know, you and I have both experienced that in our roles, that if you’re not thinking about how the doctors and nurses work, you just throw some technology at it or something else, that’s sometimes why you just hit up against the wall, so getting people to understand and adapt with the change and I think just as important it’s this whole science of change management, I think that large groups of poeple change their behaviors and there’s a lot of good work that’s been done in that area, then I hit that tipping point in telehealth for sure. I think we’re starting to see some of that tipping point in genomics, we’re starting to see that change. Acceptance of telehealth and being on the scrern. Telepsychiatry, people want Telepsychiatry visits more than they want face to face visits, they don’t want to sit in the office anymore. I think that understanding what are the cultural issues and then you know, it’s the same way we feel with a lot of diverse population there’s also cultural sensitivity, with different groups that we take care of, that their approach may be different than our group of executives that live in Washington versus someone who is in La somewhere else. So it’s being aware of that And I think having some people on the team.

Bill Russell:                   21:02                Yeah. We almost need to be a sociologist today to help people to really see and understand the changes that people are going through as we introduce technology. Um, so beyond, beyond the politics, because I don’t want to end up in a rabbit trail here, how important is health care policy in the delivery of a triple or quadruple a cost quality patient and clinician experience for healthcare?

Rod Hochman:              21:32                Well, you know, I’d say again without going down a rabbit trail it’s kind of like the markets we like consistency. So just, just tell us what the rules are. But people need a say in it, you know, and I think whether it’s it technology or privacy or all the issues that the it folks are dealing with or the health care delivery folks are dealing with or the markets are dealing with what we really crave is consistency because then we’re very adaptable. But the problem is when the rules change constantly, we’re not quite sure where we are and I think that’s, if you put it down, that’s probably the greatest frustration. We had a, you know, now we’re going to see a whole spade of change in privacy laws in southern California and that’s set off a whole sequence of different ways that we need to think about from a healthcare informatics standpoint. What do we do with that? Uh, you know, the rules are changing whether it’s on P40B drug pricing or something else.

Rod Hochman:              22:29                So I’d say the biggest challenge that we have with policy is inconsistency and I wish sometimes policymakers more understood what I did and what I feel my comment on policy makers, policymakers and soemtimes stifle innovation. One of the great things about the United States is that we’re great innovators, but you’ve got to get out of our way a little bit. Okay, tell me what I need to get to but don’t tell me how to do it. And that’s what makes us great. I think in this country we’ve got some incredibly bright people that have grown up and just been able to do it we’ll figure it out, but don’t micromanage us with policy. I won’t talk about lawyers and people in Washington, but you know, kind of what we need are say what you want the goals to, but let us innovate in the public private partnerships that we can do and I think we’re starting to see that between different companies or technology companies, healthcare organizations working together, that’s where we’re going to make real progress.

Bill Russell:                   23:31                So consistency. We’re looking for consistency and policy. Well, I think as long as we have a democracy where that’s what we’re going to have inconsistent inconsistency for awhile, but you know, uh, Dr John Halamka who was on and we’ve talked about this and it was, he said almost the exact same thing he said, you know, we, we started meaningful use, started out in one direction and then everyone took it as their policy lever and they started adding to it. And specifically the thing he said is they started to tell everyone how. So this is how you have to do this and how you have to do this. And quite frankly, how you do it in Washington might be different than how you do it in Lubbock, might be different than how you do it in Topeka, Kansas. So it becomes, becomes very hard for health systems to keep responding to that. At least I’m, uh, innovate and not drive costs through the, through the roof. Uh, I did. I did prior to this ask, uh, uh, one of your peers for a question. And uh, he, he wanted me to ask you about artificial intelligence there. Um, there are so many different places that we can utilize ai. How, how are you going to determine what area you’re going to focus in on. So I guess it’s really true of any emerging technology, but how do you prioritize your technology investments?

Rod Hochman:              24:50                Right, right. So I think cause otherwise I think that’s the biggest problem for a couple of systems is that you can get lost. So every day when you and I go to one of these conferences theres a hundred and 50 new companies, that probably won’t be therenext year. The question is how do you figured that out. So our approach to that has been to create a fund. Which we evaluate emerging companies that we think have value to us. So we like to be investors and users at the same time, so I think that’s a good way to kind of sort through that something. And we put people in chargeof just looking through technology and sorting through it because you know, the one thing I know as a CEO we shouldn’t be trying to figure that out, get someone that actually knows what they’re doing. and the whole area and I always divided up theres the different digital technologies that are out there and then there’s the whole area of data and how do we approach that. And particularly how do we approach the a lot. I’ve had the opportunity to be with the folks at Microsoft and they talk a lot about ai, how to apply it and then also what are the ethics that are involved in how you use AI. So I’m looking at a partner it looks like we’re learning a lot from the folks at Microsoft about how we do that but I see that before we just dive in sorted out with the different technology partners and look at it from a standpoint, of what are our problems we’re trying to solve and then what are the best solutions. So we’ve taken a very I would say systematic approach to that but recognizing that we’re going to probably need some help as well.

Bill Russell:                   26:35                So one of the things you did is you split out innovation from it. I mean you haven’t split innovation. Innovation is across the entire organization, clinical, innovation is innovation, but you do have a, a, a group led by Aaron Martin and you have your it that’s separate. And we’ve seen a lot of these models and even some newer emerging models where you have a chief transformation officer is now sort of a thing that’s out there. Um, I guess the question is, do you do that because of this thing because there’s so many emerging technologies and so many partners to evaluate and so many, um, and, and you want to sort of introduce new ideas to the organization and there’s this, is this really something that’s a, a, a, any health system of any size or is this because of your scale that you’ve split these things out?

Rod Hochman:              27:27                I think it’s just a great principal. I think what’s happened in the past with digital and innovation, it’s got crushed out by the rest of the organization. We’ve seen other models in other industries where the core business just crushes out that new idea. We’ve got a separate it, you’ve got to fund it. And it needs the direct support of the CEO, and I think those are key words the CEO has to believe in. It has to be funded and it can’t be allowed to be subserving perdition, mainline core business, which for us is our hospitals our clinics and everything else that are out there. So I think that’s really important. I think every organization can do it, I think if you’re a smaller organization that’s where you got to look at who’s your partner, you can’t maybe hire someone like Aaron, but maybe you can get together with some other partners to be able to do that. So you don’t get off the hook just because you’re smaller, you just have to figure out a different way to do it. Some of that is through partnerships, colloitions and ancillary support. We’ve had a lot of smaller places through our partners both on technology on it They can’t do it on their own, but hey we can partner with Providence and both contribute something. So that’s the model for the future. But I don’t think anyone gets off the hook they ended up on having to make sure that they have innovation as part of their organization.

Bill Russell:                   29:03                I was asked on a panel, uh, who, who I thought led the digital initiatives at a, at a health system. And my answer was the CEO and no exceptions. I think the CEO has to be the leader because digital strategy is strategy today. There’s, there’s really no separating them. Um, all right, well let’s, let’s move to the news. So perhaps this is old news to some, uh, the non merger with ascension, uh, the merger would have created something in, in the scope of 200 plus hospitals, 30 some odd states that this scales really breathtaking. Uh, in, in the end you said the timing wasn’t right. I guess there’s two questions. The first being the obvious one, uh, tell us about the decision and then the second, uh, question being, do you think we’re going to continue to see more mergers in healthcare? A traditional and nontraditional. And, and just elaborate on that a little bit.

Rod Hochman:              29:59                First of all, I think Ascension is a great organization. Tony Tersigni and I are very, very close to their CEO and you know, we went right down to the wire. I think what we both stepped back on was that we both had a lot of initiatives, both at Ascension and providence that needed to be taken care of and you know, all of merger mergers or about timing and we both felt that we needed to take a pause and Kinda think about what both organizations are doing we had a lot on our plate. You know, our, our agenda was intensive, Tony had a similar agenda and we just felt timing wasn’t just right that it would almost be too much of a distraction for both organizations. And we both decided that we liked everything we saw. You still think the fundamentals were 100 percent correct about creating scale but also allowing both organizations to be able to function with where they are, but that the timing wasn’t right now, we put it on hold uh, but I, I think we’re going to continue to see advocate and Aurora come together, a Chi, Dignity health There is many. I think we’re going to continue to see that organization scale but they also need to lower their operating costs and there are good merger sort of rice. But if they’ve done the right way they are going to be incredibly helpful as we go forward. So I think we’re gonna continue to see this. I think the Provider sectors gonna be under a lot of stress next year I think we wil continue to see stress reimbursement and I think more organizations are going to come prepared and try to get better. The second alternative to mergers, which are, you know, sometimes with total nightmares and all the things that are apparent are now creating coalitions around certain things we need to see, whether it’s around data and recently, you know, we’re part of the initiative, the Eric with Microsoft with Inner Mountain, ACA, Ssm, St Providence, St Joseph Trinity of all comes together and said, look, this generic and I think they’re going to see more of that organizations come together collectively. creating a project, doing something together to find where we have for a long time We’re going to get really serious about that because that’s the only way we can lower our operating costs and we have to lower our operating costs. I think we’re gonna see both. And then you’ll see some nontraditional partnerships and you mentioned a couple of them, CVS, ETNA a lot of those that are out there in order to kind of put position yourselves in the market a little bit differently.

Bill Russell:                   33:05                I’m going to reference a healthcare leaders article, um, you, you said we’re deconstructing the traditional health system. We have built a, we’ve been built around large hospitals. That’s an old version of a successful health system or soon will be our new plan. Makes us more digital, more ambulatory, and there’s less emphasis on the hospital as the core, and this goes back to something we talked about earlier where, you know, you have health systems that have really pushed out into the community. They’ve deconstructed, uh, their, their buildings and really quick, you know, labor and delivery, they put these really facilities all over the city. Um, but I don’t. This isn’t the end of deconstruction is it? I mean, digital technologies, the consumer revolution, new paradigms for delivery of care. Um, we’re going to see much more deconstruction moving forward. How do you see that playing out?

Rod Hochman:              33:58                Well, I think the only way for us to compete in the market that will win, how do you compete against a natural national ambulatory surgery company? Well, if every inventory surgery center, is part of a hospital community somewhere, they’re not going to be competitive. So what we’ve said is that we’ve got to bring all of those units together so the ambulatory is efficent for all seven states then allows us to function as a business in those things and add on to an acute care facility Now the same way. I’d say the acute care facility needs to tighten up how they work. They’ve got to get streamlined, better, smarter, faster as well, but they need to concentrate on acute care in those facilities, the medical group needs to really function as a medical group across seven states. That’s a different type of delivery of care that has probably a digital arm to it, but it also has to be much more for. So really taking apart those. Now the other thing for Providence, St Joseph has also become a services company. We’re taking a page out of Optum did right, we’ve got to optimize providence St Joseph. So really in addition to our scale have to become a services company to other medical groups, to other hospitals, we’re supplying EMRs to other hospitals that we don’t own, and we’re making that work. I think we’re going to have to figure out ways to produce revenue on things other than direct patient care.

Bill Russell:                   35:40                That makes perfect sense. So we’re coming to the end of our time, but I wanted to cover one last topic and that’s data with you and there’s, there’s a handful of ways I want to talk about this. Um, you’ve talked about the power of data in healthcare and how it can have a meaningful impact on, on how come so many other things. Uh, we, uh, uh, we really have a ton of data within healthcare already. Uh, so let’s talk about ownership of that data, scope of that data and privacy. So let’s start with the first question, which is, um, uh, who do you, who do you think owns the medical record or who should own the medical record and how will that change the way we view data and use data moving?

Rod Hochman:              36:23                I think ultimately individuals should be in control of their own record I mean I thik that’s almost a given. The question is who do they give proxy to and who they trust and uh, unfortunately we’ve had some bad examples out in the social media venue, you know, I think in healthcare we always considered the sanctity of data and you know, we’re regulated to do that, so we protect that, uh, incredibly well. So what I hope is that I want individuals to have control over their data, but I hope they will trust their health organization to be that trusted partner with them. To then figure out how that data gets used and where it gets used. And I would not be afraid to say just try some of the other organizations out there that are now trying to accumulate data on folks I just think that one of the advantages that we have in the sector where we are is that our patients and our form still trust us. And we have a relationship with them so that I would see that not working. Then the question is, is how do we use that data for our patients benefit but also trying to advance how we do care and in a way that, you know, as, as you know, we’re 501c, we’re a publicly paid company. Our interest is the health of our patients and community. So we see ourselves being able to use that data to advance that not necessarily going to shareholder value.

Bill Russell:                   38:05                It’s interesting to develop some new skills, some new capabilities. The data question that to me always delves into the scope of, uh, you know, the other data that’s out there because we know that the clinical data and the claims data tell a certain side of the story, but social determinants tells us so much more. Um, and you know, as social as, as healthcare providers are, should we be,

Bill Russell:                   38:36                uh, on behalf of our patients, on behalf of the community, starting to talk to them about providing us their, their facebook data and their google search data. And their Amazon data, because we know that when you combine those things, you can have more of an impact on their health outcome given that, you know, they gave us proxy, they trust us, we have clinical and data experts, we’re looking at it and putting together a whole picture of health. Do you think that’s in the future or do you think that’s a little too out there at this point?

Rod Hochman:              39:09                No I think its critical, you know we’ve talked a lot about Social determinants of health. We recognize that the biggest determinants are education, housing, food, you know, those things have far more effect on your health than your genome does. So those are critical aspects of how we keep people healthy. I think it’s going to be essential at Providence. Saint Joseph we have one of the largest housing facilities in Washington and Oregon. So we’ve been in housing, we’re an Education we’re at the University of Montana. We recognize how important those elements are. I think capturing those elements in a very secure way are going to be essential in providing individual, the best health for an indvivdual. What we’re particularly seeing that as we look at taking care of our medicade pateints is that the data that’s more useful to us is really a lot of the social determinants than any more so than. So I think it’s critical. I see. I see it coming. I hope that our patients will trust us to be that trusted source that they could share it with. So my answer is yes, and I think it’ll happen sooner than we think, but it’s going to have to happen in the way that people feel secure about it. I think people have been pretty rattled by some of the things they’ve read about recently, and I think that’s unfortunate and may getin the way of how we care for people and we’ve experienced some of this around mental health data thatat one of the problems that we have in taking care of patients a lot of times are the black box around mental health information that when someone shows up in the emergency room the people are unable to get at that. But I think people are always reticent about what is out there and not and we see it strictly from a stand point to be able to care for peoples health and help them.

Bill Russell:                   41:06                Rod. I just want to, I want to thank you for coming on the show. Uh, I always enjoy our conversations. Um, what’s, uh, what’s the best way for people to follow you? I always ask this question at the end of the show, do you have a, do you have a blog that you. Because your fulltime job isn’t enough?

Rod Hochman:              41:27                I have some of the greatest people that work for me and they really, uh, were able to kind of get after me, but I think the best way is just rodhochmanmd.org H o c h m a n a m d dot Org and that has most of what I’m thinking about on a, on a regular basis out there. So it’s, it’s fun and I love hearing from folks and getting your ideas. I mean I would say that the two way exchange really helps. I find that from our caregivers and from everyone else, it’s great that your folks come and where we’re willing to put ourselves out there and, but we’re also willing to Kinda hear some people have a different take on it with what they’re thinking so that, that’d be great. I’d love to hear from folks

Bill Russell:                   42:13                so you can follow me @thepatientscio and twitter health Lyrics website. Uh, you can follow the show @thisweekinhit and check out the website @thisweekinhealthit.com. Catch the videos on the youtube channel thisweekinhealthit.com/video. Please come back every Friday for more news, information and commentary from industry influencers. That’s all for now. Thanks Rod. Really appreciate it.

 

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