This Week Health

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David Chou and I sit down to discuss data privacy with regard to the medical record. In addition, we take a look at some of my favorite "David Chou" social media posts. Role of the CIO, Digital Transformation, and alignment of priorities between the business and the office of the CIO. 

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Welcome to this week in Health It where we discuss news, information and emerging thought with leaders from across the healthcare industry. This is episode number 14. It's Friday, April 13th. Today we discuss a topic which may come up in your next physician meeting, or your physicians might start getting it from patients, which is is my medical record for sale and who's profiting from it.

This podcast is brought to you by health lyrics. Get ahead of the wave. Get your plan to harness the power of technology to improve healthcare. Visit health lyrics com to schedule a free consult. My name is Bill Russell. We're covering healthcare, c i o, writer and consultant with the previously mentioned health lyrics.

Today I'm joined by a friend, a wonderful C I O C D O of Mercy Children's Hospital in Kansas City, digital transformation leader and prolific social media presence. David Chow. David, welcome back to the show. Thanks, bill. Hey everyone. How's it going? Thanks for having me. Glad to be here. Oh, absolutely. It's, it's been a while you were on episode number two, and here we are on episode number 14.

So, Um, uh, you know, a lot's, a lot's changed. So let me, uh, let me reintroduce people to you if in case they don't know you, which is hard to believe at this point. But, uh, I said C I C D O for Children's Mercy. Mercy Children's backwards. Um, formerly c i o at, uh, university of Mississippi Medical Center. Uh, you had a cool job with, uh, Cleveland Clinic in Abu Dhabi.

Did you actually live in Abu Dhabi then? I assume I did three years. So my last child was actually born there. My entire family moved there. So that was a great experience and I mean, we some really good friends that we still keep in touch with. Uh, That's awesome. So you're, uh, you're also one of the most mentioned CIOs in social media and an active member of Chime and hys.

So we're gonna, uh, we're just gonna jump into it. So one of the things we like to do with each of our co-hosts is to just, uh, give you an opportunity is what, what are you working on today that maybe you're excited about or something that's new since the last time we spoke? Yeah. So no, everyone's talking about transformation.

That's probably the biggest buzzword that you hear about, whether you're talking about. Organizational transformation. Are you talking about departmental transformation? Everyone's using that buzzword, but what I see is no one's really changing. Right? No one's really making that big leap. So one of the things that we're gonna work on is really changing our department structure.

If you think about just how traditional it has been structured is that traditional pyramid, that centralized governance model, I'm really going.

Number two, try to think about how can we be more agile. Uh, it's really about speed Now, how can we get things rolled out in weeks and months versus years? Because I've seen lots of organizations including my own, where it may take us a year to do infrastructure type of work, and these are the fundamental stuff that needs to be done quickly, otherwise you can't transform.

So we're change up our tructure number one and number in a really nontraditional. A lot more agile. So the distributor model for sure, uh, teams are gonna be embedded a lot more into the departments, but also internally start thinking about how can I have a group that's focusing primarily on keeping things moving, you know?

Some keeping the lights on, but I hate using that word, but that's, that's a big requirement. But having a separate group really out there, just pushing the envelope and getting things done, and implementing the new stuff in a agile methodology. Now, do I have the perfect solution yet? No, but I'm still trying to think about what that model will look like.

So that's what I'm focusing on. And hopefully get something out there in the next month. And, If, if you get the perfect model, we'll definitely have to have you back on the show. That's, um, you know, agility. I, I remember when I came into healthcare it, we used to provision servers and it took i, you know, almost two and a half, three weeks to provision a server.

I know that sounds like a lot to people outside the industry, but, um, you know, just, just compliance, uh, data center, all that stuff. From an agility standpoint, when I left, uh, left the health system, we were provisioning servers in like two to five minutes. And you know, that's, that's the kind of agility that other industries have enjoyed.

And now it's coming to healthcare and, uh, but it's not only on that infrastructure side, it's, it's just across the board. We have to roll out applications quicker. Update windows operating systems quicker, the whole thing. So it's, it's a, that's a great, uh, I look forward to having more conversations with you about that.

Perfect. So here's how, uh, here's how the show works. We, uh, we just discussed the news. Then we go, uh, deep dive into, uh, some topic. And, uh, today we're gonna do something a little special, something I've wanted to do. So it's close. Our social media post, um, we're story today. Uh, Uh, for time and because of the emphasis this week on this topic of, um, of privacy with Facebook being on the hill and Zuckerberg getting grilled, uh, we thought it would be a good time to talk about the, um, the medical record and, uh, is the medical record for sale and is it moving around?

So we, there's a lot of stories out there. Um, uh, we pulled one from Scientific American, uh, That is how data brokers make money off your medical records. Data brokers legally buy, sell and trade health information, but practices, but practice risks, undermining public confidence. And what I'd like to do is just look at, you know, five things here.

I, you know, is it happening? How, how would it be happening? How pervasive is it? Do people really care and why should they or should they not care? So, so I'll, I'll sort of tee this up and we'll just go back and forth a little bit. So, Is, is the medical record being sold and shared? Is it happening? And, uh, article goes high.

Handful of. Uh, I m s being the largest one. I m s if you're not familiar, started off as a company that, that captured all the scripts, uh, with, uh, around pharmacies. And they, they helped pharmacies by taking paper and turning it into computer records. But in the process, they also retained the right to, uh, resell that information.

And, um, anonymized in some cases, in other cases, not, uh, but mostly anonymized data. And, uh, they're a $7 billion company now with a $20 billion market cap. So there's definitely a market for this. You have other players like I B M I B M bought Explorers. Uh, explorers was a product that we had at my health system and, and, uh, they're, they clearly sell the information to the pharmaceutical in industry.

I don't know if I b m has continued that practice with the Explorers product, but, uh, I know that that was the case and, uh, LexisNexis is another data broker that's out there. But I, you know what, David, the thing I, I think the question I'm getting more and more is, are the E M R providers or are the health systems themselves actively selling this data and, uh, I, I, I, I, I'm sort of curious your take Now we know that Practice, practice Fusion is a free e m r, and we had a lot of, uh, physician practices that had practice Fusion.

It's just like Facebook, it's ad-based. If it's free, they have to make money somehow. So it's ad-based. They're looking at the data and putting ads in front of the doctors. That's how they're, that's how they're making money, and they're also reselling anonymized data out on the market. That's also how they make money.

I. The old adage of if it's free, you are the product. And that's, uh, that's case with PracticeFusion. But do you think this is pervasive with, are, are health systems actively selling? Let's start there Are health systems actively selling? Uh, the medical record or anonymized medical record? Yeah. The, on the health system side, not that I am aware of, um, or organization that I have been at.

We're really protective as far as this is our data. We do not sell it. We do not even distribute it. We do not have to, and we make sure that they, they're anonymized. You get to the vendor side, that may be a different story. Right? Well, and that's, that's my question. 'cause you know, I think people think that the health systems are making money for selling the record.

And, and we weren't. I mean, I, I, I don't know of any health system that would, that would jeopardize the confidence that between the patient and the physician, uh, by selling the information on the backend. Now with that being said, uh, Cerner, epic, Allscripts are, are the, are the predominant. M r providers are, are they actively selling, um, the, the data?

You know, I'm, I'm curious what your take is on it. Um, I, I, I've heard pieces of it. I've heard that they do sell pieces of it from a, um, intelligence perspective to gain insights, to gain, uh, information on how to improve. Yeah, you do study, right? Don't add data to third parties. You may never be able to improve your product, so therefore you do need to have some sort of behavior understanding, whether it's, you know, demographic data of the entire population.

But these are anonmized. I, I think that's the key word. You, you should not be able to associate an individual, but if someone's smart up with ai, you take all the various pieces together from everywhere. Be able together and say, okay, this is, looks like this is one individual that we could piece together's.

Don't see anyone out there, um, sort of doing that work that's trying to take all the pieces being distributed. But I do believe companies are. Data to third parties, whether they're selling or they're using it for their own product. That is definitely happening as we speak. And fusion, that goes back to what you said, it's a free product just like Facebook.

It's a free product. If you don't like it, don't use it. Right? That's right. So it's, it's hard. They, they can't make money without having the ads and you should know, you should be aware of that going into it. So, health systems, no, I don't see that happening. But on the vendors community side, I do, I do see that happening.

Um, whether they emit it or not. Yeah, I know that, uh, epic has pretty much come out and said that they do not resell the data. I don't, I haven't found anything on Cerner, but I would imagine that, you know, they're making a significant amount of money from the, the, uh, the E M R itself. I doubt that they would be selling data, although I.

You know, I'm not entirely sure. Uh, all scripts, it'll be interesting 'cause they bought Practice Fusion to see if they continue that practice. Um, and I, I'm not, uh, entirely sure there. So here's how, here's, you know, as I was doing some research on this, here's how some of the, uh, or in this article we even talked about how some of the data gets shared.

So there's identifiable information that gets shared and it's, uh, It's not really through the health system. It's, it's things that you, you know, if you subscribe to a magazine, a health magazine, or those kind of things that, that data gets sold, if you, uh, sign up for, say, a fitness app or a website, that information a lot of times gets sold.

And, uh, you know, obviously social media, uh, posts gets all the time, which is what we're. Situation and, and that gets sold. But that's really a buyer beware kind of thing. I mean, this is the patient giving away some information, not through the health system, but other ways. That's important information and where it really, where it really starts to become powerful for, uh, for the buyers, the marketers, and the pharmaceuticals, is when they can match it up with, uh, with some other data from health systems.

So here's. Here's the thing that actually surprised me a little bit. So the doctor, here's how some information is getting out, uh, to the world through, through every health system. So when your doctor sends you to get some medication at the pharmacy, that data is probably going into i m s. I m s is collecting that data directly from the pharmacy.

So they, they might get it from C v Ss, they might get it from, uh, any of the, of the various vendors that are out there. The, um, uh, the Dr. May also recommend a blood test. And, you know, recently some of the companies that, the larger companies that do blood tests are, are reselling some of that data as anonymized data and, um, And quite frankly, you can get insurance claims.

There are, uh, I, I worked with a startup that was getting insurance, uh, claim data and, you know, it's all, you know, so it's, it's fairly pervasive I guess, even if you go to a, a health system that you trust, there are pieces of your, of your data getting out there and I'm not sure, I'm not sure how many people are really aware of that.

And, um, I guess the question becomes with this, that data's getting out there. There is a good purpose for it, right? So it's going to pharmaceutical companies in an anonymized fashion so they can see historical data. I mean, this is, this is how we make progress in healthcare. If you can, uh, you know, if you can study a population over a long period of time, you can, uh, you can identify how heart risk develops.

You can identify how diabetes progresses within a family and those kinds of things. So there, there. There is a benefit. Do you think if patients understood the benefit and understood what was being shared, that they would care or they would be upset? Or do you think they would uh, they wouldn't mind that it's being sold?

Uh, being shared? My opinion on this, there is a generation tolerance. So we look at, um, the generation that did not grow up with. Internet did not grow up with social media. They're probably a little bit more risk averse as far as sharing the data. They may, they're probably even hesitant on joining Facebook.

They're probably the last adopters in terms of using Facebook. So they're not used to having this data sharing, um, even though it may benefit them. So you do have to educate them on the benefit of the research, the benefit that it could probably save lives versus harm lives. Um, but I do believe it is really for the more, for the good than.

Then you look at the generation that grew up without the internet and sort of like my generation, I, I grew up without the internet, early stages in my life, and then also on internet. And I, I started to realize, well, you know, we do give a lot of privacy, but at the same time I gained the convenience. You know, something as simple as an app, like ways that's gonna tell you the fastest route to get from, need to know all the data points from everyone.

Um, ways and where they're at, um, from, from the traffic pattern, and then they could kind of direct you to the, the, the best, um, performing route. The same thing implies in healthcare, we, we have to give some of that privacy and information to be able to get the convenience factor. And then you look at the latest generation, like my kids, they know nothing but YouTube.

They know nothing but the internet. That's like their, the Maslow hierarchy, right? The internet's probably the bottom of it. They gotta have connectivity. Now those, they don't care about the privacy. To them, privacy does not matter as much because they value the convenience. So I do see, I do see the, the need for education, uh, especially on the patient side, telling 'em that it is more for the good.

But then when you see the media, you hear more about the bad side of it. People never hear about the good that comes out, the research part of, um, the, the health data that's being shared or even being sold. So that's sort of my take. I think that, that the generation really plays. Plays a, a viewpoint in that.

Yeah, I think, I think that's true. You know, with all this, uh, with all this stuff that's going on with Facebook and the, uh, grilling on Capitol Hill, I think there's two things that I would communicate to, uh, uh, There's one thing I'd communicate to a C I o and then there's probably one change I would like to see, uh, that happens.

The thing I would communicate to a C I O on this is you, you probably need to know what your, uh, company's disposition is with regard to data sharing. Even if you don't think it's going on. You might, might wanna look at your, uh, might want to ask your E M R providers. Uh, are they sharing the data? Uh, look at if the data's being shared through, uh, a big data platform like Explorers or others.

That you're utilizing and just be able to answer the question. So when the physicians come in and ask, are we sharing data? You have an answer to that question. And I, I think the other is a conversation I've had with Anise Chopper on this, that, uh, you know, sort of a patient bill of rights. I, I don't mind that my data's being used.

To, uh, further, uh, you know, health research and those kind of things. I just wanna know. And to be honest, if I, if I took it one step further, I'd rather if I had the choice and I made money from it. So if you said, bill, do you wanna share your information with a cancer study or with a heart study? I might say yes.

And quite frankly, I, I don't know why i m s is making all the money on it. It's my data. I mean, they're data brokers. I understand why they are. They've set up the infrastructure. Um, I do think that there's value that's being created by the patient, and the patient is not rec is not recognizing any of that VA value.

So that's, you know, that's a much bigger conversation. We'll, we'll save that for another time. I do want to, uh, you know, so let's move to our second segment, our second segment, leadership or Tech Talk. This week we're gonna do a best of David's social media post, which I've wanted to do for while. Um, I, what I've done is I've taken, uh, four of your posts that I've gotten some significant feedback and I just wanna go through 'em with you.

So you have, the first one we're gonna do is you have a graphic with operational c i o versus strategic c i o. And, um, can you give us an idea of, Uh, you know, and, and this got a lot of feedback, a lot of, uh, likes within our peer group, uh, and, and whatnot. What, what do, what is this post really highlighting in terms of operational versus strategic cio?

What, what transition is going on? Well, if you think about just the CIO role itself in healthcare specifically, even 15, 20 years ago, there was no c i O role. It started in a department called data processing. And then it moved towards, well, can you manage to serve? Can you manage telecom? So you have a lot of folks who are in the C I O C that are operating on that capacity to this day, and that's more operational.

They're not really thinking big picture. They're not here trying to create new business models using technology. They're not utilizing technology to be a competitive advantage. They're just keeping status quo versus what they have done 15 years ago. And we still have a lot of that, um, and that there's still a place for that, but, The organization needs now have changed so much where CEOs, they want that thought leader that's gonna help them drive business outcome using technology.

So operational is the one that's still focusing on keeping lights on, focusing on implementing E M R. That's like the biggest project. Oh, let me implement the emr. Yes, it's a huge task, but what are you gonna do after the E M R and the strategic CIOs here coming in, talking about, wow, let you. Let's change it.

Pay new while here. Technology investments. Can you monetize something? Right? You brought up a good point. Why is the patient not monetizing this? That's a business model itself. Health systems can probably monetize and say, well, lemme sell this to you. They're, there're so those are the, those are the strategic CIOs that are out there thinking about not just being a user of technology, but how do you create business model?

How do you try to gain some revenue based upon your investments? So the operational c i o is in the business of it, and the strategic c i o is in the business of the business, is in the business of healthcare, and they're figuring out how to apply technology to new business models. They're, they're a business partner.

So that's, that's, that's a great distinction. And, um, you know what, I at chime this, this past year. This, this past, uh, uh, event in Vegas. Um, I've, I've seen a lot of CIOs get falling into that operational c i o trap. So that's, uh, that's why I think that's getting so much traction. People are trying to figure out how to, how to make that that jump.

And it's really focusing on the business. What is the business needs and drivers and not. Um, not talk about your servers. Your data center. Yep. Your E M R. So that's, that's cool. So, so the next, the next, uh, post is pretty interesting. It says, we live in a digital world that means, uh, the healthcare vertical as well.

And what it has is, uh, physicians on one side, consumers on the other, and had a survey that looked at four things, care coordination, do it yourself, services, data sharing. Mobile app, app usage. And it's fascinating to me that, you know, they ask this series of questions, you know, can, can, uh, digital help, can mobile help in care coordination?

And you have, uh, between the physic physicians and the patients, and it's almost the same percentages. They're saying, Hey, yeah, this can really help. And the consumers are saying, Hey, yeah, this can really help. I, I, I think people would be surprised at this graphic, just that the physicians are. Are asking for digital are, are you finding that the, the physicians are, are really, uh, I mean obviously the population, it depends on the population, but, uh, do you, do you see the, the physicians really starting to get excited about the possibilities of digital?

Definitely. I mean, if you think about what the really easy discussion going digital, you're trying to make someone's life easier. That's, that's what the outcome is supposed to be. Physicians want easier life too, right? They see it at, at home as a consumer, and then they come to work and. I also take blame personally for it as a C I O.

We may not be providing these capabilities like the consumer experience that they have at home. So that's where I strive to really improve and agility. That's why I go back to what I mentioned earlier, agility. How can we roll out things faster? Because people do want that convenience. They want to have a better experience and all overall it's gonna make their life better.

So yes, people want to do things on mobile. We can't because things are not mobile friendly. It may be mobile ready, but the experience is poor, therefore, they may not use it as and adopt it. So all these, this, this trend is, will continue and it's up to us as technology leaders, as sort of, um, buyers of technology to really push organizations and get the right partnership that's going to create that experience.

Because if we don't, we're always gonna have that disconnect between service that being provided as an organization versus the wants. And I think we've talked about this before in that the, um, the ex, the, you're not being as a hospital, c i o now, you're not being compared against other hospitals. They're comparing you against the digital world.

So they're coming in and saying, why don't I have something like Dropbox here? I mean, you guys, uh, you know, some health systems are still using F T P and those kind of things and, and physicians are going, I. Version of Dropbox or Box or something like that, or uh, or file share. So the comparison now is to, you know, why do I have 25 gig of storage at home on my email server, but at at work I only have five gig.

It's those kind of things. So are are, have we, uh, are you seeing that kind of comparison that, that they are saying, uh, they're not saying, Hey, the, the last health system I was at had this, why don't we have this? Or are they saying, Hey, why can I do this at home and I can't do this at work? We see some of that.

Um, definitely we see some of that, but I'm also educating folks a lot more. I mean, historically, just something as emails, how many organizations still have emails on site versus utilizing an Office 365 Gmail? I mean, that's out astounding when I talk about, when I talk to people and they say, oh, I'm managing my email server.

Why are you managing exchange server? Who does that anymore? And then you talk about the tools that just come with Office 365, like a OneDrive box, things of that nature. You shouldn't have to use your, something as simple as email to be a file cabinet, put it in the, the, the centralized cloud storage, and then you could have multiple edits.

You don't have to have this version control where, you know, everyone emails back and forth, version one, version two, version three. In the naming convention, you have this one file that everyone can collaborate. So some of these simple things where we still have to push the envelope in terms of getting users to adopt.

And then vice versa. We, we do get challenged with, oh,

Your sort of comparison to Dropbox and other things like that. Even conference room. Lemme tell you something, I, every time I walk to the conference room, it is so embarrassing when I see wires. Well, why do we have wires laying around? And then you go to your people's home, well, and they have a nice flat screen tv, no wires.

Well just put a damn Apple TV on there, , and then project it or something simple versus buying these multi hundreds thousand dollars of equipment to do a conference room. I mean, you could take advantage of some of these simple things. Just to have a better look and a better experience. And I think that's up to us to really change that culture.

But yes, you know, we, we do get those questions all the time as far as, well, I have the same experience at home, can I have it here? And it's up to us to make that change. So I try to make that change, but we're also trying to push it outwards to get people educated. So, we'll, we'll make this the last one 'cause I, I, I know you have a meeting to run to.

So, um, it says it and business executives don't see eye to eye on it's priorities, especially on cost cutting. So, um, are you, are you still seeing that today when you, um, that the, the business is looking for one thing and it maybe has a different set of priorities? I see that definitely. I think the, the purpose of this post goes back to when you look at every organization, what are they focusing on?

Right now, they're focusing on some sort of performance improvement, which is a consulting word for saying, we're cutting costs. So this is a very hard thing for CIOs or innovators to figure out. Is you're everyone's focusing on cost cutting and it has the biggest, one of the biggest budgets. So it is very easy to say it's cut a few million out, so how do you innovate at the same time you're going through cost cutting?

That was sort of my theme is how do you do that? And that's a very hard thing to do when you don't have the resources to innovate and that's where it gets, it takes a very creative CIOs to go through those cost cutting exercise at. Find one or two things that they could do to still keep innovation going.

Otherwise, all you're doing is reducing things, just reduction. And then you see the trend right now. You're seeing the trend right now as we speak, where lots of health system IT departments are getting outsourced pieces of it, right? Help desk. I mean, all these things are everyone's talking about. They're going manage service, and that's a result of this reduction in expense exercise that every organization would go to.

They think it's cheaper to go that way. It may be. Are you gonna lose some, some, some of the other advantages of it still to be determined and which is why we're starting to see that trend. Yep. Uh, you know, that's interesting. And then you have a, you have another post on digital transformation. Which is a, a topic for a whole nother podcast, but it has 20 ways to achieve digital transformation.

And, uh, they highlight four things, a change in mindset, uh, maybe a change in skills, in people, uh, process, and then tools. Um, our, I guess my only question on this one would be I. From a digital transformation standpoint, are we so focused on the operational that it's hard to really make progress on the digital transformation?

Is there just, is there just so much blocking and tackling that needs to happen that, uh, I was talking with Sarah Richardson a couple weeks ago. I. She said, you know, this weekend I'm putting on my hard hat. I'm going out, we're opening four new facilities, and I'm gonna be there with the, the team to sort of roll things out.

I mean, that's sort of the reality of certain health systems and, and the size of, of the IT organization, um, are how, you know, how, how do you balance that, how do you balance the, the day-to-day and, and the digital transformation that you know is necessary. It really starts with a culture and it starts with you as a leader and there's things that you have to let go.

That's what what I'm seeing. I try to let go of a lot of the operational stuff, um, in order for me to start socializing new ideas with the organization. So you, you gotta be a lot more hands off if you're, if you're the traditional Seattle that likes to be in the weeds and really. Tackling, um, you may not be able to have the time, so you gotta figure out how to let go of that.

How to create a new culture to where you're focused on speed, you're focusing on agility, you're focusing on creating a new business model. I, I always emphasize business model because that, that's what the end result is. You're trying to create that. So that's, that's been my approach is getting out of the weeds as much as I can.

Focusing a lot more on this. Setting a new culture, setting a new way of thinking. And that also involves making a lot of changes, whether it is having difficult discussions and building new teams and with your peers or even within your own, own internal department. But that's where it fundamentally has to start with that culture.

And then for me, it is just being out there with all the senior leaders and having them see a different light. You're really not a technology anymore. You're, you're really a business leader because you're in the middle. Of every department. If you think about the role of it, we see everything. We see everything from registration all the way up, and that is critical.

And being out there with your partners is, and helping them achieve their success, I think that's how you can transform and that's where you can inject new ideas. Yeah, and I've seen two major health systems that now have chief digital officers on the executive team. Uh, and the CIOs are not on that, on those, uh, executive teams, which I, which I think is sort of a cautionary tale to say, um, You may want to start thinking in terms of the business because the organization's looking for it.

And if they don't find it in the c i o, they will create a new role of a person that can, can lead them into the, the digital economy. Well, uh, so I, let's, let's close out the show. We usually close with, um, uh, social media posts. Uh, I'll do one real quick and if you have one, you can share one. So my end to stay on this theme of David Chow Post, I have, uh, Post that you put, it's, uh, market, uh, let's see, market tuni.com, uh, with all the cutbacks from the airline on their services is a great pick.

And you have last chance to purchase an upgrade from economy class. It's a plane with a little tow rope and it, it looks like a, a skier holding onto the back of the airplane, sort of telling us that that's how he's gonna get across, uh, the country. And having just flown from, uh, LA to Philadelphia, that's, uh, You know what, sometimes it feels more and more like, uh, airlines are buses in the sky, so.

Yep. I mean, bathrooms are gonna a smaller American airline, right? . I dunno how small you get. Pretty small. Uh, do, do you have one for us? I do. The one that always comes to my mind, it was, uh, I think it was retweeted by Ed Marks, it was from a physician exec that he worked with David Butler out in Sutter.

Great quilt. It's, you know, when we talk, people love talking about having an experience in healthcare, but let's think about it. No one has the experience in healthcare today. There's changed so much that the experience of the 15 year goal probably doesn't matter as much. So when you talk about do you have the experience in healthcare today, no one has it.

So it's a really, I aspiring theme to think about is just go out there, change the world, change your organization, because don't feel as if someone else knows this better than you do. No one does. We're all in the sort of as a journey. So take advantage of that. And that's sort of my theme to my team is no one knows what the healthcare today looks like, so go create it.

Cool. Well, I'm looking forward to Ed. Marks will be on in, uh, two weeks, I think. Um, alright, so that's, that's all we have time for, uh, for now. Uh, David, tell us the best way that people can follow you. Yeah, definitely follow me on Twitter. Um, my handle is D C H. Or LinkedIn, even my Facebook page. So lots of different ways to get connected and reach out anytime you guys want.

Awesome. And uh, you can follow me on Twitter at the patient CIO by writing on the health Eric's website, health system c i o, where David also publishes some articles. And, uh, follow the show on Twitter this week in h i t. And check out our new website this week in health it.com. If you like the show, please take a few seconds and give us a review on iTunes or Google Play.

Uh, catch our videos on YouTube. Um, you can go. The easiest way to get there is this week in health it.com/video. And, uh, please come back every Friday for more news commentary, uh, from industry and for, that's, uh, that's all for this week. Thank you. Thank you.

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