David Chou Explores: Is My Medical Record for Sale? Who is profiting from it?

David Chou - This Week in Health IT
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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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Bill Russell:                   00:54                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 to schedule a free consult. My name is Bill Russell. Recovering healthcare CIO, writer and consultant with the previously mentioned health lyrics. Today I’m joined by a friend, wonderful CIO, Cdo of mercy children’s Hospital in Kansas City, digital transformation leader and prolific social media presence. David Chou. David, welcome back to the show.

David Chou:                  01:40                Thanks bill. Hey everyone. How’s it going? Thanks for having me. Glad to be here.

Bill Russell:                   01:44                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 lots, a lots 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 Cio, Cdo for children’s mercy or mercy children’s backwards. Um, formerly CIO at a University of Mississippi Medical Center. Uh, you had a cool job with Cleveland Clinic in Abu Dhabi. Did you actually live in Abu Dhabi? Then I assume

David Chou:                  02:14                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 it’s, we’ve made some really good friends that we still keep in touch with today.

Bill Russell:                   02:26                Well that’s awesome. So you’re, uh, you’re also one of the most mentioned CIO’s and social media. I’m an active member of chime and HIMSS, so we’re gonna uh, we’re just going to jump into it. So one of the things we like to do with each of our cohost is to just give you an opportunity is what, what are you working on today that maybe you’re excited about or something that’s new since last time we spoke?

David Chou:                  02:46                Yeah. So now everyone is talking about transformation. That’s probably the biggest buzzwords that you hear about, whether you’re talking about organizational transformation or you’re talking about departmental transformation. I was using that buzzword. What I see is no one was really changing right now. No one’s really making that big leap. So one of the things that we’re going to work on is really changing our department structure. You think about just how traditional it has been, structured that traditional pyramid, that centralized governance model, I’m really going to try to transform that into a more distributed model. Number one and number two try to think about how can we be more agile? Uh, it was 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 they may take us a year to do infrastructure type of work and these are the fundamental stuff that needs to be done quickly.

David Chou:                  03:40                Otherwise you can’t transform. So we’re looking to really change up our structure, number one and number two, put it in a really nontraditional manner that we could be a lot more agile. So they’re distributed model for sure. Teams are going to 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, 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? No, but I’m still trying to think about what that model would look like. So that’s what I’m focusing on and hopefully get something out there and in the next month and a half or so.

Bill Russell:                   04:28                Yeah, if you, if you could get the perfect model, we’ll definitely have to have you back on the show. That’s um, you know, agility. I remember when I came into healthcare it, we used to provision servers and it took 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. And you know, 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 health care. And, uh, but it’s not only on that infrastructure side, it’s, it’s just across the board. We have to be able to roll out applications quicker, uh, update windows, operating systems quicker, the whole thing.

Bill Russell:                   05:14                So it’s a, that’s a great, uh, I look forward to having more conversations with you about that. Perfect. So here’s how, here’s how the show works. We, uh, we just discuss the news, then we go a deep dive into some topic and a, today we’re going to do something, a little special, something I’ve wanted to do. So it’s going to be fun. And then we’ll close out with our favorite social media posts. Um, we’re only gonna do one news story today, uh, just 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 it’s a moving around. We, there’s a lot of stories out there.

Bill Russell:                   05:59                Um, uh, we pulled one from scientific American, uh, that is how data brokers make money off your medical records, date of 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 sort of tee this up and we’ll just go back and forth a little bit. So, um, is, is the medical record being sold and shared is it happening. And, uh, the, you know, the article goes on to talk about the unit brokers. It highlights a handful of them. Uh, ims being the largest one. IMS, if you’re not familiar, it started off as a company that, that captured all the scripts, uh, with, uh, around pharmacies.

Bill Russell:                   06:53                And they help pharmacies by taking paper and turning it into a computer records. But in the process, they also retained the right to resell that information. And, um, anonymized in some cases and other cases, not a, but mostly anonymized data. And there are $7 billion company now with a $20 billion market cap. So there’s definitely a market for this. You have other players like Ibm, IBM bought explorer. Uh, explorer was a product that we had at my health system and, and, uh, they’re, they clearly sell the information to the pharmaceutical industry. I don’t know if IBM has continued that practice with the explores product, but, uh, I know that that was the case. And a LexisNexis is another data broker that’s out there. But I, you know, David, the thing, I think the question I’m getting more and more are the EMR providers or the health systems themselves actively selling this data.

Bill Russell:                   07:46                And, uh, I, I’m sorta curious. You’re taking now we know that practice, practice fusion is a free Emr and we had a lot of 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 anonymize data out on the market. That’s also how they make money. I guess the old adage of if it’s free, you’re the product and that’s uh, that’s the case with practice fusion. But do you think this is pervasive with our health systems actively selling? Let’s start, there are health systems actively selling, uh, the medical record or anonymized medical record?

David Chou:                  08:30                Yeah, the, on the health system side and not that I am aware of or I had been that were really protective as far as this is our data. We do not sell it. We do not even distributed. We do not have to. And we make sure that they are anonymized.

Bill Russell:                   08:47                You get to the vendor side, that may be a different story. Right. Well, and that’s, that’s my question because, you know, I think people think that the health systems are making money by selling the record and, and we weren’t, I mean, 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 Emr providers? Are, are they actively selling, um, the data? You know, I’m, I’m curious what your take is on it.

David Chou:                  09:24                I’ve heard pieces of it. I’ve heard that they do sell pieces of it from a intelligence perspective to gain insights, to gain information, how to create products. You do, Give your Data to third party. You may never be able to improve your product so good for, you do need to have some sort of behavior understanding whether it’s demographic data of the entire population, but these aren’t anomolized. I think that’s the key where you should not be able to associate an individual. But if someone is smarter with Ai, you take all the various pieces together from everywhere, you may be able to come together and say, okay, this is, it looks like this is one individual that we could kind of piece together. But that’s a lot of work to do that. I don’t see anyone out there. I’m sort of doing that work that’s trying to take all the various pieces as being distributed.

David Chou:                  10:15                But I do believe the companies are providing data to third parties, whether they’re selling or they’re using it for improved their particular home product. I think that is definitely happening as we speak. And practice fusion. That goes back to what you said, it’s a free product. Just like Facebook, the free product, you don’t like it, don’t use it. Um, that’s right. So it’s hard. 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, the community side, I do, I do see that happening. Um, whether they admit it or not.

Bill Russell:                   10:53                Yeah, I know that a 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 Emr itself. I doubt that they would be selling data, although, you know, I’m not entirely sure, uh, allscripts. That’ll be interesting cause they bought practice fusion to see if they continue that practice. Um, and I, I’m not 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 even talks 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 things that you, you know, if you subscribe to a magazine, Health magazine or those kinds of things, that that data gets sold.

Bill Russell:                   11:40                If you sign up for, say, a fitness app or a website, that information a lot of times get sold. And, uh, you know, obviously social media posts get scraped all the time, which is what we’re learning from the Facebook, uh, 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 we’re really, we’re 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 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 ims.

Bill Russell:                   12:36                Ims is collecting that data. It’s a strike directly from the pharmacies. So they might get it from cvs, they might get it from any of the, of the various vendors that are out there. The, uh, uh, the Dr. May also recommend a blood test. And you know, recently some of the companies that have the larger company has to do blood tests or are reselling some of that data as anonymized data. And um, and quite frankly, you can get insurance claims. There are a, I worked with a startup that was getting insurance claim data and you know, it’s all, you know, so it’s fairly pervasive I guess even if you go to 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, but there is a good purpose for it, right?

Bill Russell:                   13:32                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 progress’s within a family and those kinds of things. So that there, there is a benefit. Do you think if patients understood the benefit and understood what was being shared, that they would care or if they would be upset or do you think they would? Uh, they wouldn’t mind that it’s being sold, being shared.

David Chou:                  14:11                My opinion on this there is a generation tolerance. So we look at the generation that did not grow up with the Internet Did not grow up with social media. They probably are a little bit more risk averse as far as sharing the data. They may theyre probably even hesitant on joining Facebook and 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 they could probably save lives versus harm lives. Um, but I do believe it is really for the more for the good name, you know, and they looked at the generation that grew up without the internet and it’s sort of like my generation. I grew up without the Internet, early stages in my life and then also on the Internet and, I started to realize, well you know, we do give up a lot of privacy but at the same time I gained the convenience, you know, something as simple as the map, like ways that is going to tell you the fastest route to get from point a to point B.

David Chou:                  15:08                Well, in order for them to do that, they need to know all the data points from everyone using um, ways and where they’re at, the traffic pattern and then they can kind of direct you to the best performing routes. The same thing applies in healthcare. We’re, we have to give over some of that privacy and information to be able to get the convenience factor and then you look at the later generation, it’s like my kids, they know nothing but you tube. They know nothing but the Internet. That’s like they’re the Maslow hierarchy, right. The Internet is probably the bottom of it. They got to have connectivity. Now those, they don’t care about the privacy to them privacy and does not matter as much because they value convenience. So I do see, I do see the need for education, especially on the patient side. Telling him it was 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 of the research part of the health data that’s being shared or even being so. So that’s sort of my take. I think that the generation really plays a, plays the viewpoint. In that,

Bill Russell:                   16:10                I think that’s true. You know, with all this, with all this stuff that’s going on with Facebook and the grilling on Capitol Hill, I think there’s two things that I would communicate to, uh, uh, well there’s one thing I’d communicate to a CIO and then there’s probably one change I would like to see. Uh, that happens. The thing I would communicate to a CIO on this is you probably need to know what your company’s disposition is with regard to data sharing. Even if you don’t think it’s going on. You might, might want to look at your, uh, might want to ask your EMR providers, uh, are they sharing the data? Uh, look at if the data’s being shared through a big data platform like explorers or others, uh, that you’re utilizing and just be able to answer the questions. So when the physicians come in and ask, are we sharing data?

Bill Russell:                   16:57                You have an answer to that question. And I think the other is a conversation I’ve had with Aneesh Chopra on this, that, uh, you know, sort of a patient bill of rights. I don’t mind that my data’s being used to further, uh, you know, health research and those kinds of things. I just want to 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 want to 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 ims is making all the money on it when it’s, when it’s my data. I mean their data brokers, I understand why they are, they’ve set up the infrastructure and those kinds of things.

Bill Russell:                   17:40                But, um, I do think that there’s value that’s being created by the patient and the patient is not wrecking. There’s not recognizing any of that bad 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 going to do best of David Chow, social media posts, which I’ve wanted to do for a while here. So, um, I, what I’ve done is I’ve taken a four of your posts that have gotten some significant feedback and I just want to go through them with you. So you have, the first one we’re going to do is you have a graphic with operational CIO versus strategic CIO’s. And, uh, can you give us an idea of, uh, you know, in the, in this got a lot of feed, a lot of likes within our peer group and, and whatnot. What do you, what is this post really highlighting in terms of operational versus strategic CIO? What, what transition

David Chou:                  18:35                was going on? Well, if you think about just the role itself and healthcare specifically, even 1520 years ago, there was no CIO role. It started in a department called data processing and then it moves towards well, Can you manage a server? Can you manage a telecom. So you have a lot of folks who are in the CIO seat that are operating on that capacity to this day and that’s more operational. They are not really thinking big picture. They’re not here trying to create new business models using technology. They’re, they’re not utilizing technology to be a competitive vantage or 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 with CEOs. They want that thought leader that’s going to help them drive business outcome using technology.

David Chou:                  19:21                So operation, that was the one that’s still true. Focusing on keeping the lights on, focusing on implementing EMR. That’s the biggest project. Oh, let me implement the Emr. Yes, it’s a huge task. But what are you going to do after the year mark? And the strategic CIO is here coming in, talking about, wow, let you, let’s change it. And you, while your technology investments, can you monetize something like you brought up a good point. Why is the patient not monetizing this? That’s a business model itself. Health system can probably monetize and says, well, let me sell this to you. They’re there. So those are the, those are the strategic CIO’s 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?

Bill Russell:                   20:05                So the operational CIO is in the business of it and the strategic CIO 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 that are their business partner. So that’s, that’s, that’s a great distinction. And you know what, I at chime this, this past year or this, this past, uh, uh, event in Vegas. Um, I’ve, I’ve seen a lot of CIO’s could falling into that operational CIO 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 jump and it’s really focusing on the business. What does the business needs and drivers and not, uh, not talk about your servers, your data center. You’re Emr. So that’s, that’s cool. So, so the next, the next uh, post is pretty interesting.

Bill Russell:                   20:55                He says we live in a digital world that means, uh, the health care vertical as well. And what it has is a physician’s on one side, consumers on the other and it had a survey that looked at for things, care coordination, do it yourself services, data sharing and mobile app usage. And it’s fascinating to me that, you know, they ask this series of questions, you know, can, can digital help, can mobile help in care coordination? And you have it be between the 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 think people would be surprised at this graphic just that the physicians are, are asking for digital or are you finding that the physicians are, are really, uh, I mean obviously the population, it depends on the population, but uh, you, you see the, the physicians really starting to get excited about the possibilities that digital

David Chou:                  21:54                definitely, I mean, if you think about what 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 an 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 as a CIO, 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 going to make their life better. So yes, people want to do things on mobile, but 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 an adopted. So all of these, this, this trend 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 the experience because we don’t, we’re always going to have that disconnect between service that’s being provided as an orientation versus the ones at an organization.

Bill Russell:                   23:01                Yeah, and I think we’ve talked about this before and that the, um, the extra, the, you’re not being paid as a hospital CIO 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 FTP and those kinds of things. And, and physicians are going, I’m just going to spin up a version of Dropbox or box or something like that, or, uh, or file share. So the comparison now as 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 kinds of things. So have we, uh, are you seeing that kind of comparison that, that they are saying, they’re not saying, hey, the last health system I was at had this, why don’t we have this? Or they saying, hey, why can I do this at home and I can’t do this at work?

David Chou:                  23:57                We see some of that. Definitely we see some of that. I’m also educating folks a lot more. I mean historically just sometimes emails. How many organizations still have email onsite versus utilizing an office 365 gene? I mean that’s absolutely astounding. When I talk about, when I talk to people and they say, oh I’m managing my email server, why are you matching exchange server? Who does that anymore? And then you talk about the tool that just come with office 365 like a one drive box, things of that nature. You shouldn’t have to use your something that simple email to be a file cabinet, put it in the the centralized cloud storage and that 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 and the naming convention.

David Chou:                  24:39                Yeah, there’s one file that everyone can collaborate. So some of these simple things where we still have to push them a little bit in terms of it’s getting users to adopt and then vice versa. We do get challenged with, oh, can I can I had the same experience that I have at home? Whether it’s your, your sort of comparison to Dropbox and other things like that. Even conferences. Let me tell you something. I, every time I walkied into the conference room it is so embarrassing when I see wires. Well why do we have wires laying around and then you go to people’s home. Well and to have a nice flat screen TV, no wires. Well, I’ll just put it down and apple TV on there and then projected on where somebody assemble versus buying these multi hundred 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, no, we do get those questions all the time as far as, well I had the same experience at home and 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.

Bill Russell:                   25:41                All right, so we’ll, we’ll make this the last one. Cause I know you have a meeting to run to. So it says it in business executives don’t see eye to eye on its 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?

David Chou:                  26:06                I see that definitely. I think the purpose of this post goes back to when you look at every orientation, what are they focusing on? Right now they’re focusing on some sort of performance improvement, which is a consulting work for saying we’re cutting costs. So this is a very hard thing for CIO’s are innovators to figure out is your, everyone’s focusing on cost cutting and it has the big one of the biggest budgets. So it’s very easy to say it just cut a few dollars 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 he gets it takes a very creative CEO’s to go, there’s cost cutting exercise and at the same time find one or two things that they could do to still keep innovation going on.

David Chou:                  26:49                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 outsource pieces of it. Right. And help that. I mean all of these things are I want to talk about they’re going to manage service and that’s a result of this reduction and expense exercise that every organization of goes through they think it’s cheaper to go that way? It may be, but are you going to lose some, some, some of the other advantage of it still to be determined and which is why we’re starting to see that trend.

Bill Russell:                   27:18                Yup. Uh, you know, that’s interesting. And then you have, uh, you have another post on digital transformation, which is a topic for a whole nother podcast, but it has 20 ways to achieve digital transformation and a, they highlight four things, a change in mindset, uh, maybe a change in skills and people, uh, process. And then tools, um, are, I guess my only question on this one would be 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, it just, is, there’s just so much blocking and tackling that needs to happen. That A, I was talking with Sarah Richardson a couple of weeks ago and she said, you know, this weekend I’m putting on my heart hat, I’m going out, we’re opening four new facilities and I’m going to be there with the team to sort of roll things out. I mean that’s sort of the reality of certain health systems and the size of, of the it organization. Um, how, you know, how, how do you balance that? How do you balance the day to day and in the digital transformation that you know is necessary?

David Chou:                  28:22                Yeah. It really starts with the culture and it starts with you as a leader and then there’s things that you have to let go. That’s what I’m seeing. I tried to let go of a lot the operational stuff, um, in order for me to start socializing new ideas with the organization. So you gotta be a lot more hands off if you’re, the traditional style of them likes to be in the weeds and really blocking and tackling. You may not be able to have the time, so you got to figure out how to let go of that. How do you 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 always emphasize business model because that that’s what the end result that you’re trying to create that, so that’s, that’s been my approach is gave me out of the weeds as much as I can.

David Chou:                  29:04                Focusing a lot more on this. Setting a new culture is setting a new way of thinking and that also involves making a lot of changes, whether it was having difficult discussions and building new teams and with your peers or even within your own internal department, but that’s where it fundamentally has to start with that culture. And then for me is just being out there with all the senior leaders and having them see a different lights. You’re really not a technology anymore. You’re, you’re really a business leader because you’re in the middle of every department and we think about the role of it. We see everything, we see everything from I just all the way up and saying, hey, that is critical. And being out there with your partners and helping them achieve their success, I think that’s how you could transform and that’s where you can inject new ideas.

Bill Russell:                   29:52                Yeah. And I’ve seen two major health systems that now have chief digital officers on the executive team. Uh, and the CIO’s are not on that, on those 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 and if they don’t find it in the CIO, they will create a new role of a person that can, can lead them into the digital economy. Well, uh, so I, let’s, let’s close out the show. We usually close with um, uh, social media posts. I’ll do one real quick and if you have one you could share one. So my end to stay on this theme of David Chow posts, I have a post that you put, it’s a market, uh, the seed market,, uh, with all the cutbacks from the airline on their services as a great pick and you have last chance to purchase an upgrade from economy class. It’s a plane with little tow rope and it looks like a skier holding onto the back of the airplane, sorta telling us that that’s how he’s going to get across the country. And having just flown from La to Philadelphia that uh, you know what? Sometimes it feels more and more like a airlines are buses in the sky.

David Chou:                  31:04                Yep.

Bill Russell:                   31:05                Small, smaller American Airlines are pretty small. Uh, do, do you have one for us?

David Chou:                  31:13                I think the one that always comes to my mind, it was, I think it was tweeted by Ed marks. Sue is from a physician exec that he worked with David Butler out in Sutter a great quote. You know, when we talk, people love talking about having an experience in healthcare, but let’s think about it. No one has experienced in the health care today, right? This change so much that the experience of the 15 years ago, probably it doesn’t matter as much. So when you talk about do you have the experience in healthcare today? No one has, so it’s a really aspiring theme to think about it 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 it looks like. So go create it.

Bill Russell:                   32:01                Cool. Well I’m looking forward to Ed marks will be on in two weeks, I think. Um, all right. 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.

David Chou:                  32:11                Yeah, definitely follow me on Twitter. My handle is @dchou1107 or Linkedin, even my Facebook page. So lots of different ways to get connected and reach out anytime you guys want.

Bill Russell:                   32:23                Awesome. And, uh, you can follow me on Twitter @thepatientscio, my writing on the Health Lyrics website, health system CIO were David also published some articles and, uh, follow the show on Twitter @thisweekinhit and check out our new website this week in health I If you liked the show, please take a few seconds and give us a review on iTunes or Google play a catch our videos on youtube. Um, you can go the easiest way to get there, it’s this week in health and please come back every Friday for more news commentary, uh, from industry.

Speaker 3:                    32:57                That’s all for this week.


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