Bill Russell on What Your Health System CEO shared at JP Morgan 2019

JPM 2019 - This Week in Health IT
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Almost 30 CEOs and CFOs from major health systems came to JP Morgan to present to their bond holders.  Find out what everyone talked about.  This Week in Health IT.

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Bill Russell:                   00:08                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 56. You know, wouldn’t it be interesting if we could sit down and listen to over 25 leaders of healthcare providers share their accomplishments, their financials, and their strategies for the next year. While I just did that, I was at the JP Morgan conference this past week and I’m going to share with you what I learned. This podcast is brought to you by health lyrics. Be a market leader. We help you to clarify your health it plan, eliminate confusion, align your work experience breakthroughs. Visit to schedule your free consultation. My name is Bill Russell, recovering healthcare cio, writer and advisor with the previously mentioned health Lyrics. I was supposed to take a few weeks off at the start of this year and do our first full episode in February, but I just didn’t make it so I’m going to drop this one episode and then I will come back to our weekly episodes with our usual guest format starting on February eighth.

Bill Russell:                   01:09                So between now and February eighth, you’re going to have to listen to reruns or um, I don’t know, whatever you do as you’re walking the dog or exercising or driving in your car. So February eighth will be back and we’ll go right into it because himss is, uh, the, the week following that and we’ll just have a ton of stuff to talk about. So the JP Morgan conference is over and it continues to be one of my favorite conferences of the year. Um, it is really around the financials and, and, uh, in innovation and investment within healthcare. I decided a while back that you just can’t do it all. There’s so many receptions, there’s so many things that you could do at this conference. So many tracks and different lines so that you could be a part of and you just have to decide to focus in on something.

Bill Russell:                   02:01                And so when I decided to do a while back was to focus in on the nonprofit provider track. Now some of my peers have called this the boring track. I find it to be one of the most compelling things that I get to do every year, uh, in this track. Essentially these healthcare leaders get 30 minute, 30 minutes to present their organizations to bond holders. And, uh, it, it is really fascinating to watch, um, now the, the conferences in San Francisco. It’s at the Westin St Francis and this particular tracks on the 32nd floor where you get to sit on the most uncomfortable chairs in the history of man and uh, but in compensation for that, you get just a phenomenal view of San Francisco and the bay and the skyline, which, uh, is just amazing and it’s a great, a great venue. So today what I’m going to do is I’m just going to run through some of the things that I learned, uh, do some high level stuff.

Bill Russell:                   03:04                And now I’ll do some specifics around a specific healthcare systems. So here are the presenters for this year, uh, advocate aurora are officially together. So they present it together for the first time, a kaiser permanente intermountain, a msk memorial salon kettering, common spirit, which you probably know as dignity. And Chi, so this is the combined entity which is now known as common spirit, Boston Children’s, northwestern medicine, geisinger bon cores mercy, that’s a new one, a mercy presented last year and the year before, and now they’ve come together with bonds cores and the CEO for mercy has taken the reins of that. So, um, so they did a presentation northwell health out of New York, Henry Ford health system, wellforce Navon health out of the Carolinas and Virginia, a UPMC SSM health out of St Louis Spectrum Health, uh, and that is just day one. So if you can get this picture of CEO and CFO getting up there over and over again, uh, in 30 minute increments and just presenting a, they’re the best that they have.

Bill Russell:                   04:17                That’s, that’s day one. And uh, that’s full day two, starts off with Mayo, then goes to ascension hospital for special surgery, advent health, Baylor Scott and white, university of California health, Oregon Health and Science University, Jefferson health, Hartford healthcare and Providence St Joseph Health. Uh, so just again to set the stage, these presentations to bond holders. These are the people and the institutions that hold billions in debt for these health systems. These presentations are not to be taken lightly and At some point, each of these systems will have to hit the markets to secure funding, uh, probably most likely for growth and they’re going to have to go back to these bondholders through JP Morgan and other entities to secure funding. So these leaders have about 30 minutes to put their best foot forward. I would say that the presentations fall into four categories, really the types of presentations. There’s the merger presentation in the merger presentation.

Bill Russell:                   05:20                They will spend a significant amount of time talking about bringing the cultures together and the operations. And, and as you can imagine, there’s been an awful lot of these presentations over the last three years and what we will hear about is they’re their, you know, how the entities will stack up either once they come together or they’ve come together and how the integration is going and, uh, and how the cultures are coming together and how they’re producing results. So that’s the merger presentation again, and I’ll, I’ll highlight some of these little later. The second type of presentation is what I would call the traditional presentation that traditional health system player, and these are people that haven’t done a major merger, uh, or they, they’ve done them in the past. They, uh, they’re not doing any really far out innovative things. They’re just serving the markets where they’re at and you know, with steady growth steady services and what they’re trying to show is that they do have a plan for growth, that it is sustainable and that they are hitting against their operational metrics.

Bill Russell:                   06:26                So there’s a handful of traditional players. I’m not going to identify each one of these, I’m just giving you a feel for the types of presentations. The next one is really the specialty provider. The specialty providers are, you know, cancer centers and children’s hospitals. In some cases you can almost say, uh, I, I don’t, I don’t know if you could say this or not, but you could say maybe a Mayo falls into that category. Uh, just the way they talk about health and the, the, you know, the margins and just the things they do are just different. They’re sort of in this own category a, you could almost call them a, a branded, a brand presentation is one of the things I’ve called it and called it in the past and in the final, a final type of presentation is, is the innovator either self proclaimed innovators or actual innovators.

Bill Russell:                   07:14                These are people that are looking at the market and saying, Hey, this is going to get disrupted over the next three to five years is generally what people are saying and they have a plan. They want you to know that they have a plan for how it’s going to be disruptive. Either it’s, it’s going to go in one direction or another. They have a thesis, they have a point of view and they’re presenting that point of view and how they are well positioned to take advantage of that. Not only are they well positioned to take advantage of that, but each one of them sort of makes the case for a, we are strong in the existing model, so we’re going to, we’re going to be able to make this transition from a point of health into a new, um, into the new model, a whatever that is.

Bill Russell:                   07:59                And then they talk about the new model and how they’re well positioned. So those are the four types of presentations. The merger, the merger plays a traditional player, the specialty provider and the innovator, I would say they fall into those categories. Um, the presentations, as I said earlier, our is really part forward looking, part rear view. And then each one of them will give you a financial snapshot because again, this is, you know, you’re talking to bond holders and in rare cases there is no financial snapshot. And uh, uh, the only one I can think of this year was a, was common spirit, which was dignity and Chi. And I think the reason for that is the, the actual, uh, coming together, the two entities happen soon if it hasn’t happened yet. So they couldn’t present a combined financials for dignity Chi and I think they chose given 30 minutes not to try to present for dignity and Chi separately.

Bill Russell:                   08:58                So, um, but that’s the only one I think everybody else comes in. They talked about their profit margins and it, you know, in generally speaking, profit margins, you know, two percent up to gosh, up to seven and half, eight percent. So, um, but that’s getting into the theme. So let me give you some of the high level themes from the presentations. A theme number one, if you didn’t make money in 2018, you have a serious problem. I mean that the numbers were staggering. They are, uh, these health systems are profitable, they’re doing well, the revenue is growing.

Bill Russell:                   09:35                Twenty 18 will be a high watermark in regard to reimbursements and health system performance. This isn’t my belief that although it is my belief, but this is a comment that was echoed by several of the industry leaders in their remarks. Twenty 18 was a great year for making money in healthcare. Okay? So the second theme really is, you know, mergers are everywhere. Mergers are a thing, um, and the first way they looked at it talked about mergers was just they have to be implemented. Well, just putting a merger down on paper is the start of a journey. And uh, some people do the journey one way, some people do, uh, do it another, uh, but generally speaking, some of these will not go well, some of them will go really well. Some of them will not go well. And uh, you know, a merger will put the leadership capabilities of a team on full display and you have to pull it off.

Bill Russell:                   10:30                It’s a, you know, it, it, it’s just interesting because when they get up there at jpm and you can’t hide, it is obvious which health systems are pulling off the merger as well and which ones are not pulling it off. Well. So, uh, it just, uh, that’s one aspect of mergers that gets talked about a lot. The other is that mergers are also in the conversation and are factored into the conversation moving forward. So, um, you know, if from this perspective, small health systems are now about 7 billion. And so the idea of scale, people are talking about scale a little different than they used to, even the specialty presentation as the Cancer Center’s Children’s hospitals, their a billion to $3,000,000,000 organizations. This isn’t a small business anymore. Uh, it may feel like a small in healthcare, but it’s not small. These multibillion dollar businesses are not small businesses and the other mergers that are out there that the nontraditional players merging the, the, uh, pairs Pharma, uh, just coming together.

Bill Russell:                   11:34                Um, that’s part of the conversation. Everyone’s looking at it. Everyone’s talking about it. The third major theme is that virtual care is a thing. I talked about this last year and um, I just really want to drive this home, which is the numbers again, are pretty amazing. Kaiser has the best numbers and it’s because of their model. It really makes sense financially for them to do this. But at the end of the day, what I hear more and more people go, well, telahealth hasn’t taken off. And the reality is telehealth. If it hasn’t taken off in your system, you’re probably not doing it right. Kaiser touted they had 77 million visits and 59 percent of those visits were virtual. Fifty nine percent of $77 million visits were virtual. So it’s not a cultural thing. It is a probably a reimbursement thing and operating model thing. I, I don’t know what it is for certain health systems, but virtual care is now something that is going to start to accelerate a intermountain is using telehealth to expand geographically.

Bill Russell:                   12:38                Uh, I thought their model was interesting. I thought they were going to do it as a competitive model, but um, what they touted was they entered these markets with complimentary services to existing health providers and in a way that wasn’t competitive. So they, you know, they, they have 40 plus services and the number of transactions and interactions is growing. And they started off with about 12 partners and now the potential partner list has grown to about 40 partners. So exciting growth in that, in that area. And there’s just different ways of thinking about a telehealth strategies and remote strategies. And uh, you know, the leaders in this space have mature models and they’re starting to scale them. But even the laggards that, I mean at this point, even the laggers have telehealth, um, but generally if you’re a laggard, you have less integration and you’re not doing telehealth with a purpose, you don’t have a clear cut strategy around it and that strategy as much as a defined purpose statement around it.

Bill Russell:                   13:36                What are you trying to accomplish with telehealth and where does it fit and have you operationalize that? Well, so, um, so anyway, virtual care is a thing for thing. A fourth high level trend or theme that I saw at this was, was this whole concept of self disruption from a position of strength. So everyone who was talking about disruption in healthcare was talking about we are healthy, we have this balance sheet, we have, we are successful in this existing model with these kinds of profit margins. This kind of, I mean they’re, their financial sheet is solid, so position of strength, but then they’re looking at self disruption. So they’re saying, okay, we know you bond holders believe there is going to be disruption in healthcare. We agree with you that there’s going to be disruption in healthcare. We believe that we are the ones to make it happen and we’re going to be able to make this, this transition across this chasm because we have planned ahead and we are, we have a healthy balance sheet, we have the right tools, we’re hiring the right people.

Bill Russell:                   14:42                So this whole idea of self disruption from a position of strength is a, I believe, a common theme we’re going to hear over and over again and it’s going to start to permeate a lot of board discussions out there. And, um, and I think it’s, I think it’s a strong, I think it’s a strong statement, but I’m going to get more on that a little bit later, but I wanted to highlight it as a theme it before I go too much further. I’m, one of the more interesting themes to me was this whole idea of trust. Um, the leaders of the larger health systems are worried about losing the trust of the people they serve. Now they didn’t come out there and say this specifically, but they talked about the fact that there’s a growing unrest and, um, you know, it, it is a healthcare is a political issue.

Bill Russell:                   15:34                It’s one of the top. You generally one of the top two or three, uh, political issues that are going on. People have very strong opinions about healthcare. Uh, you have a situation where people are, uh, you know, hear stories of the cost of healthcare and massive bills and people having, having to mortgage their homes and not being able to afford this. I mean, that’s what happens in this political debate that’s going on is these kinds of stories get out there as a lead, uh, to try to prove a point. And what I believe these health providers are worried about is getting caught in the crossfire. They’re generally, health systems are generally trusted partners in the communities that they serve. They are generally trusted. Their physicians are trusted, uh, by the patients they serve in the community. But, um, you know, but there is this, this political debate that’s going on.

Bill Russell:                   16:31                And in fact, somebody commented at, at one of the breaks that we were having a conversation that they commented that, you know, these, uh, these healthcare leaders sound more like politicians and you know, and that’s probably true. And I think the reason that’s true is because, uh, these are the leaders of the largest employers in many of the communities that they serve. And with consolidation, they increasingly serve the health needs of a growing majority of the population. They are public figures and they can’t afford to lose the trust of the community. So, uh, this whole idea of trust, I think you’re going to see this over and over again of health systems trying to get out in front of this conversation. The a sixth theme I would say I heard was about a simplify, integrate, consolidate, automate, those kinds of words, simplify, integrate, consolidate, automate.

Bill Russell:                   17:23                A, if I had a nickel for each time I heard those words in a presentation, uh, I would have been able to pay, well probably for like a half hour of my stay in the hotel, if you, if you’re not aware of this, I mean, the, the hotel rates during the JP Morgan Conference are unbelievable. It’s a, you know, $600 to 1500 bucks a night, three night minimum. So it’s, uh, it’s pretty, pretty kind of crazy. But these were simplify, integrate, consolidate, automate. Um, uh, you know, three years ago when I went to the conference, this could be the central theme of a presentation, uh, this year. It was more like they were table stakes conversations. You saw the, you saw these move from the forward looking conversations really to the rear view conversations. Um, and they were talking about how they simplified a clinical workflows and integrated and consolidated and automated, uh, to deliver on the performance that they’re currently experiencing.

Bill Russell:                   18:23                A, the question now is how much of these things have they done and how well are they doing it within the system? Um, and you know, quite frankly, it’s hard to hide these things. This generally showed up in the financial performance. Uh, the seventh theme was social determinants, uh, you know, are just increasingly a part of the scope of health systems. Things like fresh food banks, housing, education, geographic disparities, uh, we’re all a major part of the conversation and, uh, and I think that’s gonna Continue. So that’s going to continue to be a theme, especially of the leaders leaders who have a significant and growing market share in a specific, a specific community. And a lot of the health systems highlighted that they, you know, the old mantra of they are number one or two in the communities that they serve. And if you are, you have to be focusing on social determinants.

Bill Russell:                   19:17                Um, I think the eigth theme is going to be, you know, partnerships are the new norm. It’s a, they really come in all shapes and sizes. There’s innovation partnerships and where, uh, you know, people are coming together with a vc and the money people are coming together with the health tech startups, uh, with, uh, international agreements or they’re a farmer agreements. You have, um, uh, a Civica, uh, where you have the pharmaceuticals, uh, the generics being developed by a consortium of a health systems to drive down prices and, uh, and it’s still, there’s their service offerings that are being developed by health systems for other health systems and, uh, you know, you, you had the traditional rev cycle kind of things and now that they’re just expanding, uh, all, all over the place in some traditional areas, some nontraditional areas and it’s large health systems taking advantage of their scale in order to bring a advanced capabilities to some smaller health, some smaller health systems.

Bill Russell:                   20:26                So, um, so those are the themes. Those are the high level themes that we saw at the JP Morgan conference this year. So what we’re gonna do is I’m just going to hit some highlights from my notes here in my book. Uh, I was the nerd sitting in the front row taking notes, um, so that I could share some of this stuff with you. So advocate Aurora, what I have here is, you know, very traditional merger presentation they believe scale is going to give them, um, you know, improved outcomes. Uh, you know, support clinical programs, accelerate innovation to attract and retain talent, uh, enhanced their advocacy stature and access to capital and those kinds of things. So, um, you know, nothing, nothing really to write home about here other than Kinda keep an eye on how well they implement. So all of these merger, it’s just about blocking and tackling execution of the, uh, of the plan and uh, and you know, every year when they come to jp Morgan they will share their financials and you’ll see how they’re doing a next step was Bernard Tyson, Bernard Tyson’s just an inspirational leader.

Bill Russell:                   21:29                I like listening to him. I like how he talks about how uh, the health care organization can make such a difference in the communities that we serve. Um, and you know, they’re leading the way and in a lot of areas, if nothing else in size, I mean this, the scope and the scale of Kaiser is, is, uh, is pretty breathtaking. Actually. I’m, one of the things I have in my notes here, 23,500 hip surgeries, a 2,700 same day, a hips, same day hip surgeries. So those kinds of programs and the ability to make more of those 23,500 hip surgeries and the same day surgeries is gonna go a long way to reducing hospital stays and, uh, the cost of healthcare. So look forward to Kaiser leading the way there. He also talked to a fair amount about social determinants of health. As you would imagine, a, and we’ve talked about this before, only 10 percent of outcomes can be tied to medical care.

Bill Russell:                   22:25                The other 90 percent 20 percent is environmental and social factors. Forty percent personal behaviors. Your ability to stop going to a burger king and Mcdonald’s the other 30 percent family history and genetics. And, uh, they have created a whole program around that I think called social care. Um, and, you know, they’re trying to address the, uh, you know, access to good food, shelter a safe communities, uh, infrastructure schools, uh, economic opportunity. And, uh, and you know, those are all good things. I think we heard some of that from just about everybody. In fact, the, uh, the next presenter was Mark Harrison from a intermountain. And, uh, the, the thing that’s, I mean, he also talked about social determinants. I’ll get that in a minute. But, uh, he, uh, the thing about mark, which struck me was he took over an organization that was a, you know, fairly well functioning very well.

Bill Russell:                   23:23                I mean, they were, you know, doing well financially, doing well clinically, a well respected in the industry. And he shook things up a, he saw a couple of things that they could do better and, uh, put some programs in place to make that happen. Uh, the one Internet intermountain a program was one of the things that I thought was worth noting because it’s something that we, we really want to do in every health system and that is to highlight best practices and into propagate them around the health system. And he talked about how, you know, two years ago, uh, you know, they found a, a process that a reduced the length of stay by two weeks, reduced hospital acquired infections down to zero. Uh, and, uh, they were able to propagate that and they weren’t able to propagate that two years ago and now they’re able to propagate that saving over a million dollars each year and it’s those kinds of programs that are, um, that are going to help us to really address that, uh, cost of care.

Bill Russell:                   24:23                The, uh, the next thing he shared, which I thought, again, getting back to the social determinants, the Utah Alliance, this is probably one of the neater population health initiatives that I’ve seen. I’m sure there’s others out there, but they’ve highlighted this and I’ve highlighted on the show before, uh, when we had mark probes on the, uh, what they’ve done is they’ve adopted two communities, Weber County and Washington county. They’ve committed a couple of million dollars to it, um, and they’ve partnered with Medicaid and they’re targeting a health outcomes in those communities. And we’ll have to keep an eye on that. That’s, that’s really exciting. I like, I liked their leadership in that area and uh, I’m looking forward to seeing what the outcomes of that are so that we can, you know, take that message out to more health systems. A Memorial Salon Kettering, Memorial Salon Kettering was interesting in that, um, really took on sort of a professorial role talk, talking to us about a matching the patient to a clinical trial, how important that is, how difficult that is, and the technology that they’re utilizing on top of their, a Darwin Platform, which I think is a, a self baked, a kind of a big data platform which gives them the ability to create these profiles and better match.

Bill Russell:                   25:36                Patients to clinical trials. Again, interesting work around big data, interesting work around data in general and a, so keep an eye on memorial solan kettering. Very, uh, a very good work there in, on the data side. So, uh, next was common spirit. Uh, my only note on common spirit was, uh, just not much substance there for obvious reasons. They haven’t finished the, the announcement. Um, and uh, so this is dignity Chi. And once they come together, there’ll be able to do a joint presentation, but that next year I expect to see a merger presentation, uh, you know, how are they doing operationally as they’re bringing the two organizations together. So that’s, that’s the net of that presentation. Uh, my note notes on Boston Children’s, uh, the star goes next to, oh, the had a slide on, uh, the impact of reduced Medicaid funding in millions and, and, uh, this was a good discussion on how public policy and state policy is a, is impacting, impacting the outcomes of the financial results of some of these health systems and impacting potentially impacting the care of children in our communities.

Bill Russell:                   26:48                So that’s something to keep an eye on. And I, you know, I thought it was worth worth noting on northwestern medicine, uh, you know, very traditional integration, a growth through a couple of new locations. But, you know, again, it’s a, you know, traditional growth model, a kind of a presentation and they, they are doing really well with their, uh, with their operational plan. So, um, the next one is geisinger. I, the thing I always highlight about geisinger is just the programs they’re able to put together, um, I think that are distinct because of the communities that they serve and because of their long standing presence in those communities and, uh, and, and also their visionary approach to some of these problems. So they highlighted their fresh food pharmacy. Uh, some of the numbers I have written down here are a 40 percent decrease in risk of death or serious complications, 6,000 meals served per week.

Bill Russell:                   27:49                The scale of that is awesome. I think they’re planning to double that, uh, in the next year or so because of the success of this program and it’s been at least a 24,000 costs cost reduction per, per participant, uh, in the, in the program. In addition, they talked about food as medicine. As part of this program, they’ve tracked a 74 percent decrease in the admission rates, 27 percent decrease in Ed visits and a 19 percent increase in primary care visits. Uh, you know, all good indicators. I love the work they’re doing and will continue to highlight that for you. The audience. So, um, let’s see, bonds cores mercy health, the thing that struck me about this was a speed of execution. Um, you know, there’s sometimes, so this is a merger situation, uh, they were able to do the merger within six months. Most mergers take a, uh, a bunch of longer than that, uh, that they were able to pull it off within six months.

Bill Russell:                   28:44                But the thing I highlighted in my notes here was within 30 days they had selected a, the crm are, I’m sorry, not crm, the EHR, the ERP system, and they had decided the top 400 leaders and put them in place. You know, I think that kind of, you will have to see how this works out. Um, but I, I think it bodes well. We sometimes we spend a little bit too much time on deliberation and a, and I’m not sure it serves us that well. I think sometimes on the day that a merger happens, it’s obvious to everyone what direction we should go with the EHR and when we sit around and have meeting after meeting, talking about it, uh, I’m, I’m not sure it serves anyone really well. And I think it actually, uh, you know, it, it does not project a well on the leadership that, uh, that they can’t make a decision on something that, it’s that obvious to the, uh, to the staff.

Bill Russell:                   29:38                So, uh, next was northwell. What I have on Northwell is, uh, let’s see next to the star next to A. Oh, they’re shark tank. Shark tank was a, was fascinating, I think because they backed it up with money so you could actually get funding from their shark tank in two ways. They’re shark tank program in two ways. One, you could actually get funded and, and a startup, a startup a company. And then the second is you could actually win prizes like trips and those kinds of things. So I think when we have the resources to do those kinds of things, it makes it more exciting and potentially leads to some better ideas. Um, uh, they also, they also talked about their digital solution and there’s been a lot of talk about digital and not leading to better outcomes. But the one thing I don’t think we can argue is that digital leads to a better experience.

Bill Russell:                   30:29                And, uh, and they talked about the experience, uh, let’s see, wellforce, um, and nothing really talked about. And while forest very traditional, you know, tufts at Tufts Medical Center at the center, a very traditional executing well on their operational plan, a growing new locations, uh, acquisitions. Um, so, but nothing really to highlight to this audience. Uh, next one is Nova. I think the thing I highlighted here was they hired a chief digital officer from outside of healthcare. Uh, they did not replace their cio, I don’t believe, and I think they have a cto, so they have a c, chief digital officer and a cto running their it organization. And, uh, I think the thing that’s interesting about that is it causes them to, to talk different. They use different language and it really is with the customer at the center of the equation and they talk about an Omni channel presence.

Bill Russell:                   31:22                They talk about a digitally enhanced experiences and those kinds of things. So I, I think they’re bringing different language and hopefully, you know, some, some new and some different outcomes. So I’m looking forward to, um, seeing that, uh, ssm was next. Laura Kaiser with Ssm CEO. Uh, the one thing I have noted here is there’s no secret sauce was one of the parts of her presentation and there she highlighted that, you know, no matter how much we talked about digital solutions and other things, there’s still an awful lot of just a operational work to be done around those things. Cleaning the data, writing code, quality checking the code, um, you know, working with the clinicians, getting it integrated into the workflow. There’s just an awful lot to do no matter how you slice it. So there’s, there’s no secret sauce, uh, you know, things take time.

Bill Russell:                   32:17                A Mayo Clinic. So Mayo Clinic is another one of those inspirational, uh, presentations, uh, their, their scale and scope is pretty, uh, pretty cool. Um, they know who they are and they are executing on a plan and it is very, it’s good to. It’s good to see what happens. Someone knows who they are, they, they’re funding the things that they’re good at and they’re, they’re growing because of those things. Uh, so a couple things I noted. One is, uh, you know, they’re going to be the global destination for health and they have a public private partnership with a city Rochester in Minnesota, state of Minnesota and um, they are building this campus which is really the centerpiece of destination medicine, which I think, you know, again, it between what they’re doing in Rochester, Jacksonville, and they’re doubling the size and Scottsdale, Phoenix, a lot of exciting things happening at Mayo, uh, not the least of which is their Mayo clinic ventures.

Bill Russell:                   33:22                They shared a lot of stories from that. Um, I have a number written down in your seven hundred million returned in value to Mayo Clinic and uh, you know, that’s money well invested. They highlighted handful of their companies, one of the more exciting ones I didn’t, I didn’t get the name of the company, but what they’re doing is they’re taking viruses and their reprogramming, reprogramming the virus to attack cancer cells. And so it’s using something that typically attacks our health and reprogramming it to attack the things which are hurting us. Very exciting. Very interesting. I’m looking forward to seeing where that goes. And, you know, it’s one of those things that makes you very optimistic about now being a great time to be alive. Uh, in addition, they highlighted their international work. The slide one came in, went too quickly, so I wasn’t able to, to capture, but I know there’s an awful lot of dots on that, uh, on that map.

Bill Russell:                   34:15                So something to look for. And then finally they were one of the few organizations that talked about their epic implementation, which I think is telling, by the way, I think when your ceos and cfos get up there, um, you know, when cios get up there, and we talked an awful lot about the EHR, but when Ceos and cfos get up there, uh, they realize that’s not what investors want to hear. And uh, but one of the things that mayo highlighted was they did all the hard work. They believe they did, you know, all the hard work around, um, around getting a standard set of order sets, a problem lists, I’m a terminology chargemaster, you name it, thinking they did all the hard work of really standardizing that platform. So they believe their data’s going to be cleaner than most systems out there. And I believe if what they’re saying is true in terms of the work that they did, they probably will have a cleaner data set, which they believe they’re going to be able to lead in the areas of Ai, machine learning and big data.

Bill Russell:                   35:14                And we’ll have to keep an eye on that. That will be really exciting. Uh, my notes from ascension, so ascencsion got up and, you know, one of the things I noted was if you take out one or two their slides, you wouldn’t know that they have hospitals. They are in so many different things and they have a literally a couple of billion dollars in businesses that are related to healthcare but aren’t in running hospitals or treating patients. So, um, you know, that’s, that’s fascinating to me. And so they have a, um, you know, they have a mission inspired transformation that’s going on right now. They talked to a fair amount about that. Uh, I’m going to skip that because that’s, that’s a pretty common thing at this point of, of organizations that have gone through those transformations. I don’t think they shared anything that, uh, jumped off the page at me or at least anything I highlighted a, the is the evaluation of the companies that they have.

Bill Russell:                   36:08                You know, one of the things, oh, here’s one of the things I wanted to highlight a jellify is their RPA company. I talked about this last year a little bit. A RPA is, is something that’s coming up over and over again. If you haven’t looked into it and haven’t dug into it, it’s, it’s worth looking at. It can really automate a lot of these pretty mundane processes. Um, jellified doing it. Uh, I know that I’m a New York Presbyterian. We talked about how RPA is being used there. Uh, you can, you can set this in here and things that take an awful lot of cliques and screen scrapes and those kinds of things. You can utilize Rpa, uh, to, to really, really drive a significant amount of savings through that. Uh, and if you wanted to jumpstart those programs, uh, this is one of those companies that you can look at.

Bill Russell:                   36:57                Um, interesting, interesting thing that they noted was a majority of their businesses now coming from outside of healthcare even though they started within healthcare. So, uh, just consider that to jumpstart your program, a advent health was a, was next, or at least next in my notes, a pretty traditional presentation. Oh, here’s what I have noted. Vision 20/20, vision 20/20 is interesting because a lot of health systems, it was pretty Cliche, but 20, 20 vision vision 20 slash 20 was something that everyone did about five six years ago. Put together a plan of what we were going to be by 2020. I think they’re really cool thing is I think everyone, all these smart people with five years of additional history looking at the technology and the advances that we’ve made are right now putting together a vision 20/25 or vision 20/30 type presentations and I look forward to next year’s JP Morgan because I think we’re going to see a lot of that start to come out and uh, a lot of that thinking and I think when that all comes together, it’s gonna be pretty exciting.

Bill Russell:                   38:01                See Baylor Scott and white, Baylor Scott and white had more uh, maps than anybody else in there slide which tells you that they are about geographic expansion and a memorial Hermann is their acquisition, the, you know, Austin expansion. They, uh, it was just expansion, expansion. Have nothing really jumped off the page at me there, um, other than that. So a next step is one of my favorite people in healthcare and that’s Dr Steven Klasko, uh, the CEO for Jefferson Health and uh, Thomas Jefferson University. Um, and he speaks with an awful lot of passion around digital transformation in healthcare. I really enjoy listening to him and in fact, one of his first slides was can a 195 year old academic medical center. Make it as a startup company. And that’s a, he’s not blowing smoke there. He really believes that they have to transform in that capacity. Uh, you know, one of the programs that he highlights is healthcare with no address and really has digital as the foundation for that health care is a healthcare with no address.

Bill Russell:                   39:07                So that’s a, you know, just one of the anecdotes of these shares and I love is, you know, how come I can do all my holiday shopping the day after Thanksgiving while I’m in my pajamas, binge watching game of thrones. But if I have a stomach ache, I have to still get on a phone, listen to 11 options to get an appointment next Wednesday. And uh, you know, he just drives home that, uh, healthcare, uh, will change over the next couple of years and they want to be at the forefront of that change. And again, just getting back to that theme of a, we want to lead the change, but we’re going to lead it from a position of we’re in the current model, we’re healthy, we’re doing it well. But we’re also defining and designing the, uh, uh, the next generation of what healthcare will look like. And in the final presentation again, uh, it was, uh, the whole thing was closed up by a providence St Joseph Health, uh, Dr Rod Hochman presented and he just drove home that a healthcare is going to change a between him and Venkat Bhamidipati, who is their evp and chief financial officer, a chief financial officer.

Bill Russell:                   40:13                He, uh, uh, the two of them really drove home that healthcare is going to change and what that model for change might look like. You know, rod really had two things to say, uh, the first being that he believes we need an infusion of new ideas and he is a, you know, he’s living that. He brought in BJ more from Microsoft and it was now as evp and chief information officer, he brought in Aaron Martin from Amazon who is his chief digital and innovation officer and Venkat Bhamidipati came from Microsoft and it was really Kinda Kinda cool to, to listen to, to VenKat, but I’ll get that in a minute. The other thing that, um, that rod announced was the providence ventures, uh, their, their, their second fund, their funding, their there a second fund to the tune of $150,000,000. Uh, the first fund was a, I think fairly successful.

Bill Russell:                   41:06                You had a Avia in that, which I know a lot of you are familiar with a Kairos in that I’m a binary found was in there as well. Uh, Zelth was in there. I talked to their CEO at the conference and they’re doing well. So, um, you know, this is one of those, a pure play, a vc type funds. And uh, so they have another $150 million. So getting back to Venkat. So vencat a, uh, you sort of reminded me of me seven years ago coming in from outside and looking at this and saying why he just kept asking the question of why can’t we apply these things that we do from other industries to healthcare. And I, I love that. I think that is one of the big things that people from outside of healthcare bring to us is why can’t we do that?

Bill Russell:                   41:53                Um, and forcing us to answer that question and forcing us to defend our position that it can’t be done. Um, when they point out, you know, this is how it’s done in digital companies is such done in manufacturing. This is how it’s done in these other industries. And we like to think that healthcare is a, you know, just immensely more complicated and it is more complicated than a lot of other things that, uh, that we talked that these other industries. But with that being said, if we break these down into smaller problems, more simple problems, we’re able to apply some of the same solutions. So he talked a lot about, uh, about, uh, data and the consumer experience about automation. I’m a machine learning ai and where they were, it plays across the entire spectrum, um, you know, from supply chain all the way to a clinical decision support and, you know, from a, from an outsider’s perspective, from a CFO’s perspective, not from a clinical perspective, but just someone saying, I’ve seen the promise of technology, I’ve seen how transformation happens in other industries and I believe it can happen in healthcare.

Bill Russell:                   43:02                So a very interesting, I think the last thing I would highlight from that as, um, you know, he talked about bringing practices from other industries. So he’s talking about, you know, at Microsoft, uh, you know, sourcing and vendor consolidation and a labor models and structures, uh, near sourcing those kinds of things, uh, and automation and process improvement. I think all of those things, you’re going to see those as the forward thinking organizations are going to start to do that, to drive efficiencies, uh, that’s going to be able to fund the transformation initiatives as, as they move forward. So, um, you know, that’s my notes. That’s my notes from the, uh, from the conference. Hopefully you get a picture for what I experienced while I was there. Uh, it is exciting to listen to these CEOS and cfos. The industry is healthy. It’s doing well. A consolidation has not hurt the industry, um, but also it has made it more profitable.

Bill Russell:                   44:01                Uh, the question is how are we doing in serving our patients in lowering costs and increasing access and those kinds of things. And I think those are all things that we are as an industry. What I heard was we’re taking them seriously and we have programs in place and that’s something we’re going to look for it next year is a jpm conference. Are we making progress on the, on, on all of those key triple aim objectives as well as the experience. So, um, that’s, that’s really all I have for the notes. So, uh, just a reminder, come back on, uh, February eighth. That’ll be our next show. If you want something to listen to between now and then, you could always hit the, uh, website and listened to some of our previous episodes. You can also check out the youtube channel. will take you over to our youtube channel. It’s just the easiest way to find it. You can also just go over to youtube and search for this week in health it, uh, you’ll be taken there. I’m sure a, are a vendor are, um, are a sponsor’s website. Health also hosts the podcast as well. So, um, hopefully you’ll come back every Friday the information and emerging thought from industry leaders. That’s all for now.


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