February 19, 2021

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February 19, 2021: Whichever way you look at the pandemic, it truly is a fascinating topic. Today we dive into it from a data, information and innovation standpoint with John Brownstein, Epidemiologist, Harvard Professor and Chief Innovation Officer at Boston Children’s Hospital. How can we utilize the data that we have at our fingertips to make better decisions? How can we bring in AI, voice, machine vision and other new areas of tech in order to supplement the clinician, reduce their burnout and improve patient outcomes? As a Chief Innovation Officer how do you determine what areas you’re going to focus on? How do we bring the disciplines of disease, surveillance and modeling to a federal level where we have full visibility? And what kinds of things can we put into an education program to make the next generation more aware of what’s facing them?

Key Points:

  • Until recently, there’s been a bit of a void in articulating the science and being as evidence-based as possible to get the public engaged in these very challenging times [00:02:20] 
  • The pandemic has exposed major data gaps [00:09:13] 
  • There’s a big data gap in what government agencies are providing today in terms of a real-time visibility [00:12:01] 
  • What is the value of participatory surveillance? [00:12:55] 
  • The mask wearing debate still rages on [00:14:40] 
  • We were caught flat footed with this virus. We started applying control strategies but with very uneven control efforts in different parts of the country. We didn’t have a national strategy. [00:17:05] 
  • Boston Children’s Hospital 
  • ABC News: John Brownstein 

Fighting a Pandemic with Data and Information with an Epidemiologist

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Fighting a Pandemic with Data and Information with Epidemiologist John Brownstein

Episode 367: Transcript – February 19, 2021

This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

[00:00:00] Bill Russell: [00:00:00] Thanks for joining us on This Week in Health IT influence. My name is Bill Russell, former healthcare CIO for 16 hospital system and creator of This Week in Health IT, a channel dedicated to keeping health IT staff current and engaged. 

[00:00:17]Today John Brownstein joins us. He’s an epidemiologist Harvard professor and chief innovation officer for Boston children’s. And we’re going to talk about fighting the pandemic with data and information and just some of the interesting [00:00:30] things they have done to get the word out.

[00:00:31]We’ve introduced a new podcast under the This Week in Health IT Channel. Today in Health IT. THis is a place where we recap a news story and we break it down every weekday morning. I’m excited that we’re able to take those conversations we’re having on LinkedIn and go one step further and really examine the so what of each one of these stories. So please go give us a follow on todayinhealthit.com. You can follow us wherever you listen to podcasts. [00:01:00] Apple, Google, Spotify, Stitcher it’s out there. We’d love to have you also join the conversation on LinkedIn. Also share it with your team and continue to partner with us as we propel healthcare forward.

[00:01:11]Special thanks to our influence show sponsors Sirius Healthcare and Health Lyrics for choosing to invest in our mission to develop the next generation of health IT leaders. If you want to be a part of our mission, you can become a show sponsor. The first step is to send an email to [email protected] 

[00:01:27] Today. We are having a conversation with John [00:01:30] Brownstein, who is the Epic, he’s an epidemiologist Harvard professor and chief innovation officer at Boston children’s hospital. Hey, John, welcome to the show.

[00:01:38] John Brownstein: [00:01:38] Yeah, it’s great to be here. Thanks so much. 

[00:01:40] Bill Russell: [00:01:40] I see, I see your Dr. Fauci pillow in the background. 

[00:01:43] John Brownstein: [00:01:43] Yeah. It’s the Fauc on the couch always looking over me making sure that I’m communicating public health messaging and the right way. 

[00:01:51] Bill Russell: [00:01:51] Yeah. So you’re  are an epidemiologist. And one of the things as I was doing research for the show you do a lot of work with ABC. I mean, you’re, you’re getting the [00:02:00] message out. Is that just in the Boston or the new England area? 

[00:02:03] John Brownstein: [00:02:03] No it’s a national effort. And I spent a lot of time you know, it’s been as part of this pandemic, you know, the epidemiologist, you know, doing research is a big part of it, but also science communication and really trying to distill the best of science and message that.

[00:02:20] And there, you know, clearly up until recently, there’s been a bit of a void in sort of articulating the science and really [00:02:30] being as evidence-based as possible and to get the public engaged in these very challenging times. 

[00:02:35]Bill Russell: [00:02:35] I just did episode for the Newsday show and we were talking about the vaccine rollout and I personally feel like we’re focusing on the wrong things. I think we’ll, we’ll, we’ll production. We’ll get there. Johnson & Johnson will come out with their new vaccine. We’ll have more vaccine that we know what to do with in, in the very near future, because there’s still like, I see different numbers, but it feels like anywhere between 20 and 40% of [00:03:00] the population.

[00:03:01] That don’t want the vaccine. There’s a significant education that still needs to happen to get those people to, to want to get it. Is that what you’re seeing as well? 

[00:03:11] John Brownstein: [00:03:11] I think that we have not focused nearly enough on communication and education. We have been so hyper-focused on of course the development of this vaccine, which clearly is an amazing scientific achievement we should all be proud of. And then the secondary focus has been distribution. [00:03:30] But we have not nearly focused on the communication. That often gets left behind in public health. And so I think, you know, we, we’re going to have a hesitancy issue. We’re going to have people that are not believing the science and people that, you know, for good reasons, some to feel like that, you know, they shouldn’t get this vaccine cause of mistrust in the government and some may be believing some of the things that they read. Some of the rumors that sprout. And [00:04:00] we need, we need a whole discipline of science and communication. That’s focused on. The right messaging around this vaccine to get everyone on board. And I just, I don’t think we’ve put the resources to match operation warp speed in on communication.

[00:04:15] Bill Russell: [00:04:15] Yeah. And I’m not going to rehash all the things that you’re going to talk about on ABC. If people  want to see all those things, it’s actually pretty interesting. Just type in ABC John Brownstein in Google and you’ll, you’ll see a bunch [00:04:30] of clips. And you’re doing a great service to the community.

[00:04:33] I really want to, I want to focus it on data, fighting the pandemic from data and information and innovation standpoint. So but before we get to that topic, tell us about Boston children’s and your, in your role there. 

[00:04:44] John Brownstein: [00:04:44] Yeah, so I have I think one of the best jobs out there I get to be the Chief Innovation Officer of a top pediatric hospital where I focus on.

[00:04:56] You know, bringing the, sort of the digital journey to a [00:05:00] healthcare system and work ranging from working for, with startups as an accelerator, to working with larger companies and thinking about how the future of practice of medicine, you know, digital we’ll, we’ll, we’ll be commonplace. And, you know, that can range from of course innovations on the electronic medical record to, you know, telemedicine, which we had ramped up right before the pandemic.

[00:05:23] Remote patient monitoring. And then, you know, more forward things like how does AI sort of change the [00:05:30] practice of medicine? How do we think about utilizing the data that we have at our fingertips make better decisions? How do we bring in, you know, voice and biomarkers and machine vision, and other new, you know, areas of tech to the forefront and, and sort of supplement the clinician, reduce their burnout and of course, improve patient outcomes through better engagement and an improved [00:06:00] experience. 

[00:06:01] Bill Russell: [00:06:01] As the chief innovation officer how do you determine this is the age old governance and priority standpoint. How do you determine what areas you’re going to focus in on and what solutions get, you know, get mine time. It’s Boston Children’s is world-class. But it doesn’t have an unlimited budget. Right. So you have to be very selective.

[00:06:22] John Brownstein: [00:06:22] Well, so we, we even in you know, we have a small mighty team we’ve actually been able to accomplish a lot, but yes, discipline is super important [00:06:30] because we can’t boil the ocean in all sorts of ideas. We set you know, priorities for the year, every year. And we go off, you know, you know, three or four pillars and, you know, those pillars for us right now are sort of AI and optimization of care delivery, their behavioral health there. You know, innovations in primary care you know, physician burnout, we set sort of priority areas, and we will go after them uncover where there’s opportunities to partner with [00:07:00] companies. And when there’s gaps, especially when that’s pediatrics, we have a team that can help build some of these solutions.

[00:07:06] So you know, we’ve had a long series of partnerships from companies like Amazon and Google and Nuance to like spin out companies that we’ve developed ourselves, where we found opportunities. 

[00:07:18] Bill Russell: [00:07:18] Yeah. So small mighty team. What does that look like? We have teams like Providence had, you know, 200 people sitting in the downtown Seattle. I don’t think it’s that big anymore, but it, but it was a [00:07:30] pretty big team, small mighty. What does that look like? 

[00:07:32] John Brownstein: [00:07:32] It’s grown up. Well, it used to be much more small and mighty. I think we’ve taken on some of the larger digital health efforts of the hospital, like telemedicine and the patient portal.

[00:07:42] And so that team has grown to probably more like 60, 70 people, but yeah. You know, a lot of it is in sort of the large scale implementations that are required, you know, cause we have this sort of principle of sort of source launch scale. We have a team that is focused on identifying, you know, companies [00:08:00] or efforts or your IP that can help solve some of those priorities.

[00:08:03] And then we launched those efforts and you know, we pilot in different service lines and then. The opera operationalizing, some of these bigger topics requires a larger team, right? How do we, how do we go after, you know you know, use, you know major nuance deployment that requires, you know, a lot of people or how do we stand up telemedicine and pandemic there’s a lot of people involved in doing that.

[00:08:29] Bill Russell: [00:08:29] Absolutely. [00:08:30] All right. I, I sorta want to look at the pandemic from a data and information standpoint. And just sort of tap your expertise in this. So the data journey on the pandemic has been what’s the best way to say this uneven, I guess, would be the nicest way of saying that we, that sets in starts, and we didn’t have information with that.

[00:08:53] So I want to rewind a year. I, it at least, at least early on in the pandemic and [00:09:00] just talk about, you know, what did it look like? What information did we have? What were we missing? And what did we need to fill in pretty quickly in order to start to address some of the challenges that a pandemic would deal us?

[00:09:13] John Brownstein: [00:09:13] I mean, the pandemic has exposed major data gaps when it comes to pandemics from the very initial stages to even today. You know, at the beginning stages, you know, we focus a lot on early detection [00:09:30] of outbreaks. So my other hat, other than chief innovation officers, I’m a Professor Harvard medical school run a lab that has been focused on public health technologies for many years. And so we’ve been involved in early identification of, you know, range of disease vans, like H1N1 and Zika. And in this case, we definitely identified at the end of December something that was going on in Wuhan December 30th. And we sent the first alert of something unusual happening, but clearly something [00:10:00] was brewing for weeks, if not months ahead of that.

[00:10:03] And we didn’t have the right technologies either at a global scale, but probably not at a local scale either to identify that aberration in symptoms or emergency department visits that sort of delayed our ability to, to track this virus. And whether that’s because we’re limited by access to these kinds of whether it’s, you know, individual level data on symptoms or because we don’t have the right kinds of diagnostics in [00:10:30] place, we are challenged.

[00:10:31] So we already out of the gate, we were already delayed. Then from there, like being able to track this virus as it spread around the world. I mean, we built this international network of volunteers that were contributing data from various parts of the globe to sort of pull together our sort of a global understanding of what was happening with COVID.

[00:10:53] Again, this was, you know the network of volunteers, because there was no sort of real global body that was [00:11:00] really focused on pulling these data together and giving that sort of global picture. And then of course, when the virus hit the shores of the U S you know we were pretty data blind. We didn’t have good surveillance systems around symptoms or cases. Of course, we didn’t have the diagnostics. We didn’t have understanding. We ended up launching a platform called COVID near you, funded by Google. Which ultimately allowed us to fully [00:11:30] uncover some of the emergence events of COVID and communities, because we had no ability to test now, eventually, you know, systems caught up more testing.

[00:11:42] You started getting feeds of hospitalization, data, mortality, that eventually all those things. Became more commonplace and we, but again, like we go to like the Johns Hopkins websites or the COVID tracking project or Kodak now, like these are all efforts that were our Denovo and [00:12:00] they aren’t really government efforts.

[00:12:01] And there’s a big data gap in what government agencies are providing today in terms of a real-time visibility. We’re challenged in this country because of the way that public health has set up. And so it makes sense that it’s, it’s hard to keep a national picture in real time. 

[00:12:18] Bill Russell: [00:12:18] You know, I’ve been, I haven’t thought about this, the Johns Hopkins model what’s feeding that, is that CDC data or what is feeding that?

[00:12:25] John Brownstein: [00:12:25] They’re scraping like, you know what we’ve done for our health net platform. Very similarly, like they’re [00:12:30] scraping public health websites. And aggregating that data, right? So they’ve found different parts of the web that are putting up daily data about cases. And they’re scraping that information at the U S level. It’s not a CDC website.  They’re going to like local public health department websites and grabbing that data.

[00:12:51] Bill Russell: [00:12:51] Wow. All right. So, wow. You’ve given me a lot of platelets, but let’s start with, COVID near you. So participatory surveillance. Talk about what that is and [00:13:00] what the value of it is. 

[00:13:01] John Brownstein: [00:13:01] So, because we’re limited in widespread testing, and we actually, we’re still limited today. I mean, when not doing nearly enough testing you know, one of the areas of surveillance that can come become really handy is this an area of syndromic surveillance, understanding symptoms in populations, it gives you an insight of how bad the epidemic is.

[00:13:24] And we’ve been crowdsourcing symptoms for actually many years. We actually were doing it for flu beforehand in a [00:13:30] system called flu near you. And immediately we recognize that we did not understand how this virus was spreading and communities across the country. We were fully data blind and you know, so we built this crowdsourcing tool where people can report in their symptoms and get text message reminders.

[00:13:45] And we got millions of people in the system that are telling us, you know, Few times a week, how they’re feeling, getting data about their demographics, their, their, their testing status. And now we’ll get data about their vaccination status. So it can give you incredibly granular [00:14:00] information at the, you know, the demographics level, the behavior levels.

[00:14:03] I mean, we just published a paper a couple of days ago. And Lance said that we could use this data to understand the value of masking the community, because we can see sort of what cases were popping up in a particular location. And then look at mask wearing behavior and show that sort of increase in mask wearing behavior led to you know, the ability to the higher probability to control the pandemic in that location. Not earth shattering, but even to this day in this pandemic [00:14:30] publishing that paper generated a huge amount of controversy that people still don’t believe in mask wearing. So you’d think at this point we’d be sort of over the mask debate that rages on even to this date. 

[00:14:45] Bill Russell: [00:14:45] You know, so, you know, you talk about something like COVID near you. It just struck me that, I mean, we’ve known this for years, right? So a Google search. There’s a lot of people that are out there, you know, symptoms they’re searching for this and that and everything else. I mean, Google would probably [00:15:00] create just an in and out of their own search data, let alone you know, an Amazon with purchase and searches and purchases for, you know, different types of things.

[00:15:09] They could probably, there’s probably enough data out there to build some type of model that would show what’s going on in the country. Isn’t there. It’s just hard to get all that data together. 

[00:15:20] John Brownstein: [00:15:20] Exactly. We actually were part of the team that helped the initially built Google flu trends and have been working with search query data for a lot of years. Absolutely. [00:15:30] It’s we’ve always found that it’s about integrating various data streams and pulling them together to give the best sort of insight of what’s happening in the ground. Not relying on one data source, but how do you pull various strings together and create sort of a better sort of situational awareness picture?

[00:15:44] Bill Russell: [00:15:44] I do want to ask you if we’re collecting the right information at the point of care, but before I get there, I want to talk about models a little bit cause the, you know, early on we did this, I guess we all assume that this thing would spread like it did in New York. And it would [00:16:00] spread across the country and we would have sort of this, this massive thing, but that’s not what happened.

[00:16:04] It spread in New York and spread in new Orleans, Seattle, LA, and it’s spread in pockets. And then then it sort of subsided then it’s sort of spread again. I mean, it has it has a weird pattern. Is there a defined pattern? It would be one of my questions. And then the second would be just around building models, because one of the things that as we shut down electric procedures.

[00:16:26] You know, these hospitals, I just attended the JP Morgan conference and [00:16:30] these hospitals have this big donut from March to May, in terms of their revenue. And some of it was not really warranted. I mean, they were during that time, some of them only had like five COVID patients, but they literally had people sitting around not doing anything.

[00:16:47] So the models sort of failed us at that point. So I guess the question is you know, is there any pattern and have we there, [00:17:00] or were we just guessing early on for the most part? 

[00:17:04] John Brownstein: [00:17:04] Well, I think, you know, clearly we were caught flat footed. There was this expectation that we weren’t going to have the pandemic.

[00:17:14] And there were there was a lot of mixed messaging and unfortunately New York got hit very early on when. We didn’t have a lot of understanding of this virus. Obviously New York is very large city and that there’s in densely populated and there are a lot of [00:17:30] demographic factors for why it was sort of a breeding ground for the initial sort of wave, obviously because there’s inbound transportation in there as well.

[00:17:39] And then of course we started applying control strategies, part of the issue, and why it’s hard to predict is that we’ve had very uneven control efforts in different parts of the country. We change mobility patterns. We did social distancing masks wearing, but it was uneven. We didn’t have sort of a national strategy or there was no national [00:18:00] advocacy for one sort of common approach.

[00:18:02] So some communities were able to manage things and others weren’t. And then of course, pandemic fatigue sets in and people’s change their behavior. And ability goes up indoor gatherings go up and, you know, that’s where you see some of the problems arise. And of course, as temperatures drop and people starting to move inside, we see those rises again. New York city just had, you know, a really bad time because, you know, again, like that’s when we sort of, we’re still [00:18:30] living life in this sort of new, normal way.

[00:18:33] Clearly we made a major pivot right after that and got the pandemic under control, but slowly but surely it started merging itself. And especially in parts of the country that were probably more reluctant to make a decision on disease control over the economy. 

[00:18:51] Bill Russell: [00:18:51] Yeah. So let’s talk about data. We’re collecting at the point of care. And it’s interesting because that data [00:19:00] sort of changed as the pandemic went along and where you were going to report it changed and then changed back. So, you know, are we collecting the right information even today at the point of care with regard to I guess there’s a lot of different perspectives, right?

[00:19:17] Utilization of the health system, utilization of PPE but also the spread and those kinds of things. Are we collecting the right information? Are we collecting too much information. [00:19:30] What’s the status. 

[00:19:31] John Brownstein: [00:19:31] Yeah. I mean, listen, I think we have decent visibility on the pandemic now. I think we miss, you know, when you start to aggregate geographies, you start to miss certain details in terms of race and ethnicity and disparities and you know, granular differences that make a difference in this pandemic.

[00:19:52] Right. We know that, so communities of color are hit much harder rural communities that gone hit much harder. So, you know, [00:20:00] oftentimes the data that gets presented isn’t at the level of detail or does it have the attributes that allow us to fully understand. And we know that those kinds of data elements are super important.

[00:20:11] I mean, we know that with that kind of knowledge, you can, you can properly intervene or set up testing or improve communications. Of course now with a vaccine, like how do you target vaccination clinics to the places that needed the most? We’re not necessarily using. Either, we don’t have [00:20:30] all the attributes and we’re not using those attributes in the best possible way to inform the response.

[00:20:34] So that’s been a problem from the beginning. I think it definitely got better. But you know, again, we’re not the best in, you know, as much as we like to talk a big game about using data to drive decisions, whether it’s healthcare or public health, I don’t think sort of that is necessarily when, especially when it comes to real-time response. I don’t think we do a good enough job in that space. 

[00:20:57] Bill Russell: [00:20:57] I want to talk about public health, but also [00:21:00] maybe from this perspective, let’s fast forward five years from now. Cause we’re still in the middle. I don’t know if we’re in the middle of it. We’re still smack dab  in the pandemic, in getting to the other side of it.

[00:21:13] But five years from now what would it, what will it look like if we take these lessons and apply them well? And you can talk about any of the different areas in terms of surveillance in terms of public health or that kind of stuff. What will it look like in five years? [00:21:30] If we learn the right lessons?

[00:21:31] John Brownstein: [00:21:31] Yeah. Well, listen, I think that there, we have to do it a better job of, you know, investing in the public health workforce. Clearly we have seen major gaps in sort of talented people that can respond. You know, that public health departments are severely underfunded and resort under-resourced. I mean, we’re expecting public health departments right now to maintain surveillance and efforts. But while at the same time now roll out a vaccine. It’s [00:22:00] it just doesn’t work well. I mean, I understand the need to have distributed and local based public health, but this level of distributed effort, it creates so much dysfunction. And unevenness. Of resourcing in terms of public health.

[00:22:16] So hopefully, you know, some of the new supports that’s coming in at the federal level will help to even the playing field. I think that, of course we need to strengthen our ability to respond to, to global threats. Over the [00:22:30] last several years, we’ve had significant underfunding of efforts. I was part of a project funded by USA ID to look for novel coronaviruses in populations. And that project was defunded last summer. So bad timing to defund a novel coronavirus surveillance project, right before a pandemic, but that happened. And so hopefully some of these larger efforts that are involved in sort of field-based surveillance, identify new viruses or efforts that are above strengthening global public health surveillance.

[00:22:59] And then, you [00:23:00] know, I think at at a federal level, you know, there’s this hope and a push right now to invest in sort of a national disease forecasting center, which apply the same with the principles from weather, where you’re tracking, where you’re both now casting, but also forecasting. And you know, in this case it would be diseases.

[00:23:19] How, what is the outlook and how do we bring the discipline of disease, surveillance and modeling and bring that to a federal level where we have full visibility. And what is [00:23:30] happening across the wide spectrum of pathogens. I mean, the likelihood that we’re going to see another pandemic is significant.

[00:23:37] You know, who knows what the timing will be for that, but, you know, hopefully core sort of underlying resources will come to sort of make sure that, you know, we are ready. And then again, then the last thing I would just mentioned is diagnostics. We have not done a good enough job to fund and develop died at home rapid.

[00:23:57] Connected diagnostics that can give us that quick [00:24:00] view of what’s happening on a population level. Those are things that we should have been implementing years ago. And, you know I think, you know, there’s, there’s real technology that could be put out.

[00:24:11] Bill Russell: [00:24:11] You know, education has always a silver bullet in a lot of this.

[00:24:15] And we talked about that earlier. How important education is. Do you see, I mean, as a result of the pandemic, so many things are gonna change. How we approach our doctors and how we looked at telehealth has fundamentally changed forever. I don’t [00:24:30] think we’re all back. You know, work from home you know, our, the nature of work.

[00:24:35] Commercial real estate the makeup of hospitals. There’s a lot of things that are probably changed forever. Education. Do you think we will start to introduce different things maybe even as, you know, as early on, as in grade school so that, you know, when we’re having conversations about you know, we say, well, we’re having conversations about science, but the reality is a significant number of people you know, [00:25:00] don’t have a chemistry and a biology background or definitely an epidemiology background. And so they rely on their sources of information for to get to get that. What kind of things can we put into into an education program to make the next generation just more aware of what’s facing them?

[00:25:21] John Brownstein: [00:25:21] Yeah. I mean, I think that basic health education is something that isn’t part of generally. I mean, obviously there’s [00:25:30] components of of understanding, you know, biology that come into early education, but then we don’t really talk about human health and risk factors. And we don’t talk about, you know, of course emerging infectious diseases, but also chronic diseases and sort of the general population level impacts of major major illnesses and populations.

[00:25:55] There’s there’s room for that, I would say, but you know, of course I’m an epidemiologist, I would say. [00:26:00] I would definitely say that. And, but, you know, there’s a high, there’s a lot of focus on climate change and that’s a great opportunity to talk about the intersection of human health and climate. So yeah, I think, you know, it’s amazing to me right now as an epidemiologist numbers of people that have understand basic epidemiological concepts.

[00:26:20] I mean, some clearly don’t fully grasp them, but you know, have friends and colleagues talk about it. Are not and understanding, you know, mortality and your [00:26:30] infection rates and case fatality rate. So it’s amazing that some of these basic epi concepts are now mainstream. So I would love to see some of these things be sort of become mainstream.

[00:26:40] And the first time I got any education around epidemiology and public health was because I forced my way into class while I was an undergrad. Otherwise, you know, you’d have no access as it’s kind of knowledge to, well, after your undergraduate education. 

[00:26:55] Bill Russell: [00:26:55] How how has the pandemic shaped what you’re doing at Boston Children’s?

[00:27:00] [00:27:00] John Brownstein: [00:27:00] Yeah, I think it’s permanently changed how we think about digital, which is great because we’ve been preparing it for this for a long time. But, you know, we, you know, went from having a very small sort of telemedicine program to like being, you know, at one point doing the bulk of our visits virtually, and now, you know, we’re in a steady state with which still a lot of visits are being done virtually.

[00:27:24] And what lo and behold, our physicians loved it. Patients loved it, you know, satisfaction through the [00:27:30] roof, saved people trips. So I think that again, that has changed our ability to deliver care in ways that, you know, again, in some ways we expected, but we never thought it’d be this dramatic. It’s forced us to think about how.

[00:27:44] We, we, you know, get content, you know, we get check-ins from, from patients it’s, it’s accelerated our pace in, in remote patient monitoring. You know, it’s, it’s, it’s made everyone aware of that. Digital is not sort of this like [00:28:00] lesser. Experience or sort of a dumbed down version of the, of the in-person it’s it’s an augmentation.

[00:28:05] Yeah. And so, you know, it’s, it’s, it’s been really transformational. I mean, obviously we focus so much more on the patient portal and in text-based communications and all sorts of things. So yeah, it’s, it’s, it’s been incredibly meaningful to our sort of trajectory, I think, where we always expected we’d go, it just shorten that timeline.

[00:28:25] Bill Russell: [00:28:25] So talk, talk to me a little bit about your work with with ABC. [00:28:30] How did that come about, I guess, and your health system must prioritize it. And we’ve been actually, when I was in the CIO, we talk a lot about this, developing this new muscle of interacting with the community at a different level. We started putting doctors in the grocery stores and the doctors were there for consultation because you know, most, a lot of bad health decisions are made in that grocery store.

[00:28:55] So having a doctor there was a pretty, it, wasn’t my idea of somebody else’s idea and I loved [00:29:00] it though, because. It was interesting because we thought though, who’s going to ask them a question. Well, it turns out they were fairly busy. People had a lot of questions. So so clearly you guys have prioritize this how did it come about? And how’s it going? 

[00:29:17] John Brownstein: [00:29:17] Yeah, I mean, I, you know, we did some segments early on in the pandemic. I mean, I’ve always been. A big proponent of translating knowledge to broader media. I mean, I publish a lot in [00:29:30] paper in journals that colleagues will read, but nobody they don’t get the same sort of visibility.

[00:29:35] You know, the sort of the direct impact is incremental. You don’t get to, you know, I always thought that, you know, getting visibility on some of the research can have, you know, bigger impact. And so you know, I’d done some initial work with ABC, actually, my sister. I was on Good Morning America.

[00:29:54] And so I had some connections there. And so you know, it, it sort of grew from there and, you know, I I’ve done [00:30:00] did some live clips and then it’s just been sort of a constant sort of channel. And I think, you know, for me, it’s been a good sort of growth area because I’ve learned to sort of communicate in different ways and of course, you know, doing live televisions uses just, yeah, as you said a totally different muscle. But I think it’s, it’s, it’s, it’s been helpful. And I think it. It plays a role that I think, you know, a lot of my colleagues have also played. I mean, I think, you know, I can’t turn on the, on CNN or [00:30:30] MSNBC without seeing someone I know talking about the pandemic.

[00:30:33] So I think there’s been a lot of people that have sort of been called in and have been willing to help at help explain sort of complicated areas of epidemiology and reinforce science, and also be willing to say, you know, we just don’t know yet, and there’s still not enough data and not be necessarily be so sure of ourselves when the data is unclear.

[00:30:55] And, but you know, of course my hope is now. We have a lot of new sort [00:31:00] of people in the administration that are, are kinda talk about they’re gonna, they’re going to be able to be put out in front to talk about science. So maybe the roles of some of the academics that hospital people may not be as, as needed.

[00:31:11] But you know, I think, you know, it, I think it’s good to have all these perspectives and people that have like some, some background or education to be able to have those platforms to talk it through the American people. 

[00:31:23] Bill Russell: [00:31:23] Any stories come out of it or any major learnings as you’re doing live television? [00:31:30] I would imagine at some point you mess up, I dunno. 

[00:31:33] John Brownstein: [00:31:33] Oh, for sure. I mean, I’m hypercritical of myself. Like I’ve definitely, ah, unfortunately I did have one second situation where, where my, the internet kicked out in the middle of a live show. And that was, you know, that was pretty traumatizing where, you know, like, Holy crap, in the middle of the live segment, you know, I lose. So I’ve been very cautious about my internet speed right before, you know, there’s things, things, tech, stuff that goes wrong and [00:32:00] that’s challenging, you know, the world of doing this all via Zoom. That’s not the normal way someone would do television is from your office, but yeah. You know, you got to roll with the punches. 

[00:32:10] Bill Russell: [00:32:10] So we had, we had Daniel Nagrin on the show during the COVID series. So we talked about what they were doing, but he has since moved on. Yeah. So so you are, you are the only CIO there? 

[00:32:26] John Brownstein: [00:32:26] No, no, we have an interim CIO. We also have [00:32:30] another CIO, which is the chief investment officer. So we have other CIOs. We always add more. CIO is yeah, no, Dan was great. He was a long-term partner of mine. We worked really closely together. You know, I pushed him hard to go fast.

[00:32:45] He explained to me some of the reasons why, you know, my expectations were too grand and you know, I think we we’ve, we’ve met each other in the middle and we had a great time. So I learned a lot from him. I definitely miss him. He’s on to Maine medical center [00:33:00] doing some great things there. 

[00:33:01] Bill Russell: [00:33:01] Yeah, you described that tension that exists. I know that, you know, I was lucky enough to have the innovation and information officer, but I had a team members under me that were in the innovation group and team members that were on the operational side. And I felt like I had to have the conversation just described. I had to have in my own head where you can only move so fast on certain things because there’s operational realities, there’s training, there’s, you know, there’s technology and stuff.

[00:33:28] John, thank you for your time. [00:33:30] I really appreciate it. 

[00:33:31] John Brownstein: [00:33:31] Yeah, it was great to be here. Thanks so much for having me.

[00:33:33]Bill Russell: [00:33:33] What a great discussion. If you know someone that might benefit from our channel, from these kinds of discussions, please forward them a note, perhaps your team, your staff. I know if I were a CIO today, I would have every one of my team members listening to this show. It’s conference level value every week. They can subscribe on our website thisweekhealth.com or they can go wherever you listen to podcasts, Apple, Google, overcast, which is what I use, Spotify, Stitcher. You name [00:34:00] it. We’re out there. They can find us. Go ahead. Subscribe today. Send a note to someone and have them subscribe as well. We want to thank our channel sponsors who are investing in our mission to develop the next generation of health IT leaders. Those are VMware, Hill-Rom, StarBridge Advisers, Aruba and McAfee. Thanks for listening. That’s all for now.

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