#JPMHC2020 – The Good, The Bad, and the Opaque

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Bill Russell

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January 24, 2020: Today we continue our debriefing of this year’s J.P. Morgan Healthcare Conference, the annual symposium that brings together industry leaders and members of the investment community. In the last episode, we covered the types of organizations that presented as well as some of the key themes that came up in the last two iterations of the event. Today we zoom in on the 2020 proceedings, taking a deeper look at what each of the presenters brought to the table. Some of the key themes that came up this year were customer data use, customer experience, asset-light solutions, expense management, diversified revenue, and applied genetics. Most of the developments were positive, with strong examples of how to handle mergers and upgrade UI technology given by Bons Secours Mercy and Ascension respectively. As far as technology goes we also get an idea of where AI precision medicine is at from Geisinger. Additionally, we saw some great new innovations with institutions like Aurora and NYU Langone implementing self-diagnostic structures such as a living well metric and a capacity command center. It is becoming clear that there are many things that need to start being done differently in the industry, so it was heartening to see health systems beginning to take heed of this at the event.

Key Points From This Episode:

  • Appreciation for Intermountain’s good financials and facilitation of a gun use conversation.
  • How well Bons Secours Mercy has orchestrated their merger.
  • Baylor Scott and White’s health plan and asset-light strategy for entering the Austin market.
  • Mass General Brigham’s aim to enter new markets and diversify their revenue.
  • Advocate Aurora’s new idea to gauge their performance by implementing a living well metric.
  • What CHOP is doing to help kids by using gene therapy.
  • How Northwestern Medicine could be even more of a ‘healthcare-without-borders’ type.
  • Appreciation for Henry Ford which is practicing responsible growth on many fronts.
  • A brilliant tech innovation at NYU Langone: a capacity command center.
  • Moves Geisinger is making as a major player in the area of AI precision medicine.
  • Heartwarming stories told by Seattle Children’s Hospital and their good use of partnerships.
  • The forward-thinking strategies and propensity for partnerships at Jefferson Health.
  • A need for specialty centers and what City of Hope is doing to fill it.
  • Many fronts of improvement seen at SSM, such as a health plan and growing TeleVisits.
  • Privacy concerns and Ascension’s decision to focus internally on tech-related UX.
  • Why the Providence presentation was confusing due to a lack of operations transparency.
  • The good strategies displayed by OSF related to the markets they serve.
  • Important stresses on platforms displayed by Mayo’s presentation.

#JPMHC2020 – The Good, The Bad, and the Opaque

Episode 177: Transcript – January 24, 2020

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

[0:00:05.3] BR: Welcome to This Week in Health IT where we provide great thinking to propel healthcare forward. My name is Bill Russell, Healthcare CIO coach and creator of This Week in Health IT, a set of podcast videos and collaboration events, dedicating to developing the next generation of health leaders.

This episode is an in-between episode. You know, on Tuesdays, we do the new. We do Tuesday Newsday. I look at top 10 stories giving you my input on each one of those stories. On Fridays, we interview influencers from the industry who are influencing healthcare and health IT, and today, this episode is really both. I got to sit down with the J.P. Morgan Conference, listen to your CEOs and CFOs share their insights, accomplishments, strategies, financials, and on Tuesday, I covered the themes from the J.P. Morgan Healthcare Conference.Today, I cover insights from individual presentations.

This episode is sponsored by Health Lyrics. I coach health leaders on all things health IT. Coaching was instrumental in my success and it is the focus of my work at Health Lyrics. I’ve coached CEOs for health systems, startups, CIOs, CTOs. If you want to elevate your game in 2020, visit healthlyrics.com to schedule your free consultation.

[EPISODE]

[0:01:16.0] BR: Okay, here we go. As I said in the last episode, and if you haven’t listened to that, it’s really almost a pre-listen to this episode. Most of them stand on their own. This one, you’re going to want to hear what the themes were. I’ll probably cover them real quick but it’s really good to catch up on that episode. The J.P. Morgan conference is in San Francisco, great conference, 27 health system leaders. Usually the CEO and CFO stand up and share their accomplishments, their strategies and their financials for the year. They have about 30 minutes to do so.

It is one of the more valuable conferences that I go to every year to listen to 27 straight health systems just get up there and share their story and their financials is great. We talked about the different types of presentations, the merger presentation, the traditional player, the innovator presentation, and then I talked about this, ‘healthcare without boundaries’ type player and this ‘research’ or ‘treatment’ type player presentation this year.

The presentations went into really probably those six kinds of categories. Just to reiterate some of the – most of the themes for the 2019 conference held true, health systems had a good year financially, virtual care, self-disruption, trust, simplify, integrate, consolidate, social determinants, partnerships, continue to be themes going into this year and we added a few more: risk and covered lives, getting paid to keep people healthy was a new theme.

Technology was elevated but the EHR took a back seat, that was interesting. Asset-light growth strategies. Experience: consumers, really. The consumer in both directions. The clinicians and the patient was a theme. Expense management, huge theme. Diversify revenues, almost universally a theme. Really strong balance sheets. It’s been a good couple of years, good decade in the stock market so health systems have strong balance sheets.

Generally applied genetics, gene therapy took center stage, really to the forefront at this conference.A lot of really heartwarming and great touching stories around that. This whole idea that healthcare is being influenced by ‘He Who Must Not Be Named’ and sort of use that Voldemort reference but that healthcare strategies are being influenced. Investment strategies are being really influenced by new entrants or potential entrants into the healthcare space.

[0:03:35.1] BR: We’re getting ready for them and we’re trying to stay ahead of them. Those were the big themes. This week, I’m going to go into the individual presentations, right? I sat through 23 of the 27 presentations and I’m going to give you a little bit more color on each one of those. Let’s just get right to it.

Intermountain was the first presenter, Marc Harrison will be undergoing – he’s the CEO for Intermountain and he’s going to be undergoing bone marrow transplant in the next 60 days and he was – Mark is a great presenter, really set the tone and he talked about how he doesn’t have to worry about personal bankruptcy or not being able to pay his bills or not understanding his bills and all those things but that personal bankruptcies are – the number one cause of that is healthcare

We have to do something about that as an industry and he was inspirational in that talk and really – he really set a good tone for that. Doing the right thing in healthcare and doing the right thing for patients. A couple of my takeaways from this presentation. One is, Intermountain has pristine financials and I use the word pristine on purpose. I mean, it is really hard to look at their financials and find fault. I’m sure somebody really wanted to nitpick, they could but it’s – they have phenomenal financials.

I thought what was interesting is, even though they had pristine financials, they are still doubling down on efficiency and they are looking for ways to really improve their overall throughput and their overall – the services that they deliver and cost improvement. That could be why their financials are pristine, they never really take their foot off the gas in that area.

[0:05:07.8] BR: The other thing I took away from this is, they talk about simple solutions and not massive technology solutions and as an example of that, they had a conversation that – I sort of got the impression that they sponsored this conversation. It was between gun rights group and a group that was really opposed to guns and taking them off the streets and taking them out of really personal ownership.

You had these two diametrically opposed camps, they brought them together to facilitate a dialogue and it was aired, it was on a radio station and even though they are complete opposite ends of the spectrum in terms of what could be done, the dialog found common ground and, you know, it might not be enough for some and it might be too much for others but the common ground was things like education and gun locks. They distributed free gun locks as a result of this. I just applaud Intermountain, facilitating the conversation and working on those aspects, the social determinants aspects, which are, as we know, a larger percentage of overall health.

Bons Secours Mercy Health. John Starcher is the CEO. He came from the Mercy merger. I was going to say acquisition but a merger. He came from the Mercy side and he now oversees the merge organizations. My take away from this is, this is a merger done right.

I’ve talked about this before on the show. They pick the technologies within either 30 or 60 days, I don’t remember the timeframe and, you know, when you think about it, we already know. When two health systems come together, we already know what the EHR is going to be, we already know what the selection on the ERP is going to be.

[0:06:41.3] BR: All you’re looking for is, is there a reason why this doesn’t happen? Still, a lot of health systems take years to make these decisions and to make movement on these decisions. They pick the technology really quickly, it keeps vendors from trying to position and change things, it’s just a far better way to go.

They also announced the key leaders within the first 30 days and the next level of leaders within the first 60 days. You removed all that fear, uncertainty and doubt in the acquisition. I thought it was a courageous and bold way to go about doing it, doing a merger and I think it was appreciated by the employees.

The good thing is, they performed well as you would expect, and they also identified the right metrics coming right out of the shoot as like, “This is how we’re going to measure if we’re successful.” They were able to maintain 3.8, between, 3% and 3.8% operating income during the year, during a year that they’re doing a major acquisition.

Not only are they – did they have that major merger going on, they ended up – acquiring is probably the wrong term but they ended up taking on the responsibility for a health system in Ireland which is another 750 million-ish, I think is the number I vaguely remember, in revenue. So they picked up an oversees group of hospitals to manage, they also acquired three CHS hospitals in a market and they started that work as well.

[0:08:02.4] BR: John set the foundation for rapid growth and he put together a strong M&A strategy to make that happen. In the category of It Can Be Done is Bons Secours Mercy doing a merger and acquisition well.

Baylor Scott and White. Baylor Scott and White, number one brand in the state of Texas according to their presentation. A couple of things I pulled out of their presentation, a thousand people moving to Texas every day. I happen to be wearing my sweatshirt Baylor University sweatshirt so it’s not that I’m biased here but I send a lot of money to Baylor for my daughter’s education.

Thousand people moving, making Texas their home, permanent residency a day. Strong growth in their markets but the one thing I really took from this presentation and I eluded to in the last podcast is their Austin Strategy. Their Austin Strategy was to take their health plan and they entered the Austin Market which they were not really strong in.

They entered the Austin market with their health plan first to establish a foothold. Then what they did is they followed it up with an asset-light investment strategy. The care locations that they popped in there were asset-light. Think clinics and retail locations and some partnerships and those kind of things.

[0:09:21.5] BR: They were able to take that foothold from the health plan and really blow it out over the course of 18 months and now they have a really strong presence in Austin and I think at the recording of this, I think they are now starting to put the hospital infrastructure in place around that.

My thought on this is, rinse and repeat. It looked to me, on the surface – again, 30-minute presentation. This was five minutes of it. It looked to me like great strategy, great execution, and makes a lot of sense. Rinse, repeat, do it again and if other health systems have these kinds of assets.

The health plan to go into a market and asset-light kind of strategy. It seems to be a way to enter a new market without spending whatever, a billion dollars to acquire, to get into those markets. In fact, this could be something that other health systems might start to be concerned about because if Baylor Scott and White and others figure out this way of moving into a market, it really has some – it’s powerful.

They also give me a great visual, the F1 – there is a slide with an F150 and a Mustang EV, the electric vehicle and it’s the age old thing of, you got to keep the old going, keep your fee for service business strong, the old model going, and invest in the future at the same time. I like that visual that they shared.

[0:10:43.6] BR: The next presentation, it was CommonSpirit. It was Lloyd Dean the CEO. And I like Lloyd Dean, he’s funny, he’s engaging, but I was a little disappointed in this presentation. Mostly because I didn’t learn anything new, there was nothing new in this presentation. There was no financials shared, so I don’t know how the CHI and Dignity merger is going. I have no indication of that whatsoever outside of just conversations I’m having in the industry.

You know, I was disappointed just because coming from Catholic Healthcare, I really believe in its mission, I believe in its necessity in the markets that they serve and, you know, I’m left to wonder, how are they doing? How’s the merger going? Yes, I appreciate the fact that they’re serving underserved markets, I appreciate the fact they’re living out their mission, I appreciate the fact that bringing the cultures together is challenging.

They announced some things like their COO is now overseeing all of the operations which quite frankly, if you go back to the Bons Secours merger, I think they figured that out in the first 30 days. If that was something that took them a year to figure out then we could assume that the merger is moving very slowly. I was a little disappointed, again, love Lloyd Dean, love his leadership in the industry but just would want a little bit more out of a presentation, especially no financials, just left guessing.

Mass General Brigham was the next presentation. Dr. Anne Klibankski and this is the former Partners Healthcare. There is a couple of things. One is I talked about this theme of destination healthcare. Mass General wants to be recognized as the place to go.

Not only the place to go within the Massachusetts marketplaces that they serve but also, internationally. They are destination location but not only are they a destination location at Mass General but they are also doing international growth as well. National and international growth as well through various strategies.

[0:12:38.8] BR: You know these brands, these strong brands in a specific market are looking for ways to enter new markets, so there’s a strong diversification of revenue conversation that was going on here. You know, another diversification of revenue was around innovation. Diagnostics, therapies, devices, were all areas that they’re increasing their amount of revenue that’s coming into the organization. They also stood up a center for clinical data science so in this analytics area they see an opportunity to diversify revenues as well.

I didn’t capture the financials but I vaguely remember, I was looking at my notes and I really couldn’t pull them out. I remember them being good but not great. Given their brand and given where they’re at, I would expect them to be a tick higher than they were.

Advocate Aurora, they are two years into their merger. Strong financials but they still have a lot of work to do on the merger itself. One of the things I pulled out of this presentation was, they’re looking to create a ‘living well metric’. I love the thinking around this. It’s sort of the next evolution of a population health metric. How well are the people in your community living? Not only from a healthcare standpoint but lifestyle standpoint, behavioral health, mental health kind of standpoint. Just some sort off metric that could say, how are we doing as an institution and helping our communities to live well? To live healthy lives, healthy being defined as not just physical health but in a lot of different areas.

I’m looking forward to them coming out with that metric. I’m going to try to follow that closely and hopefully they’ll publish some of that so that we can gain access to it. I think it’s a good metric. I think it’s a good direction to start looking at health systems and seeing how health systems can and are impacting the health of their community, because if you’re investing a lot of money in social determinants and other programs, behavioral health within your communities, first of all, you’re going to want to measure that. Are we being effective? Second of all, you’re going to want to get credit for it. You’re spending hundreds and millions if not billions of dollars on these programs. You’re going to want to tout that.

[0:14:41.1] BR: Thinking off the top of my head here. Next one, Children’s Hospital of Philadelphia. Exciting presentation, really well done. This was the first one where they really talked about gene therapy, Centered for Applied Genetics. Heartwarming stories, great stories about what they’re doing, you know. People who were general at – kids who are generally in categories that were not going to be able to helped by traditional means, through their research, through the work that they’re doing in the Center for Applied Genetics.

They were able to really hone in on a specific gene to do these gene therapies and then you see these kids living healthy lives. These are great stories. If my child were sick, I would really welcome the two children’s hospitals that were here, Children’s Hospital of Philadelphia is exceptional and Seattles Children’s is exceptional as well.

Really exciting stuff going on there. They’re also diversifying their revenue through research, the gene therapy. They’re also diversifying in locations, they’re going out into the county so they had a center city Philadelphia location and going out in to the county as well. Great presentation, the two children’s hospitals, you literally had people tearing up in the presentations, great stories and hopeful stories. I’m excited about what they’re doing.

The next one was Northwestern Medicine. Northwestern Medicine is also a destination medicine strategy. They are really strong in the markets that they serve in the Chicago land area and then they also touted the number of people that are flying in to Northwestern Medicine.

[0:16:10.7] BR: Also looking to diversify their revenue, research, they’re doing it as well. Great financials for 2019. They seem to be really executing on the strategies that they have. To be honest, if you put them in that category of ‘healthcare-without-borders’ which is where I think they should be really looking and planning, they could probably be a little more aggressive. Given their balance sheet and where they’re at and the programs they have and the reputations that they have. They could probably be a little more aggressive, maybe like a Mass General or the next presentation which was Henry Ford health systems. Again, nothing bad to say about Northwestern, just think with their resources and their expertise that they could start to be a little bit more aggressive. Not in the Chicago area but more with their brand on a global basis.

Henry Ford. Phenomenal presentation. You’re going to hear this probably a little too much. Actually, there’s really only two presentations I was a little disappointed in but Henry Ford was a phenomenal presentation. Global growth strategy, they’re going to Saudi Arabia. Innovation strategies so they’re doing some really cool things in innovation.

[0:17:17.5] BR: They’re taking on risk. They have a GM contract, employer contract, where they are a partnering to reduce the overall cost of healthcare for GM and they took on that risk contract. They’re doing things around social determinants and regional health. Responsible growth, strong financials. Really exceptional presentation. Kudos, hats off, whatever the right terminology is here. Well done at Henry Ford. Seem to be firing on all cylinders and doing a good job.

Next health system I have notes on. NYU Langone, good year. Year over year financial performance was good. They weren’t in the stellar category. They weren’t even in the great category. But good year over year improvement and good financials.

The one thing I wanted to highlight for our health IT crowd was, they have a capacity command center. Think of this like air traffic control for the entire health system and the movement of patients and resources around the health systems. They didn’t give a lot of details, how are they doing this, RFID, Bluetooth low energy. I’m not sure entirely how they’re doing it.

It’s probably RFID if I thought about it. But they’re able to, from a command center, look at the flow of patients throughout the entire health system and determine where they should change things and this is like up to the second, on the fly.

[0:18:34.8] BR: They’re able to make adjustments to make sure that the flow of patients through the health system works and works well. I was really impressed. I’d like to get more details on that, so if somebody from NYU Langone is listening, I would love to have you on the podcast and talk specifically about that capacity command center and some of the other technology things that you guys are doing. Looked very promising and I love that idea.

If I thought about it, we were doing that in individual hospitals, it would be interesting to have that capability across the entire health system to really optimize the location of assets across the board.

The next one is Geisinger. I always look forward to Geisinger’s presentation. They are unique in the populations that they serve. They are a rural health system that really acts like a strong urban health system. They do really innovative things, taking advantage of the markets that they do serve.

So last year, we talked about they are doing primary care visits and they are collecting all of this genetic data. They are allowing people to collect genetic data. Genetic data is then being used turn it around and using it for AI precision medicine to identify the right targets and they started to show some fruits of that this year in their presentation. So I think they’re one of the more interesting AI and precision medicine players in the country.

I think they are building up the number of people they have that information on. They are targeting AI on, again, not diagnosing patients but looking at the – all the data that they have and identifying maybe a set of registry of patients that they should reach out to or they should recommend for additional screening. Again, I really like their stuff. They did have a hiccup in their health plan. Effected their operating margin but again still a solid performance.

It could have been a lot better if they didn’t have that hiccup but generally speaking Geisinger continues to be one of the well-run health systems in the country.

[0:20:22.5] Seattle Children’s is next. I eluded to this before. They – again, heartwarming stories. They partner with everyone. So the key to a children’s hospital is as many partnerships as you can within the markets and you know they partner with UW Medicine, they partner with Providence, Saint Joseph Health, which is now just Providence. They partner with everybody in the region. They are the destination for the region for complex cases involving children.

They are really making headway in research and innovation and quite frankly very good financials especially for a children’s hospital, very good financials. So they had the resources to continue to invest and hopefully continue to move that mission forward.

Next was Jefferson Health. So we heard from Jefferson Health last year. We had Dr. Klasko and Nassar Nizami on the show and I got to actually sit next to Nassar during this presentation where Dr. Klasko was up there talking and Jefferson Health’s story is they are one of those innovation players that they have one foot in the current model but they are heavily leaning towards the future. They are making bets on the future. They are looking to diversify their revenue in tele health, health plan expansion, investment and startups.

They are looking for new revenue streams, traditional revenue streams. We heard that on the podcast with Dr. Klasko so that is nothing new to this audience and he drove that home. Some of their investments like Livongo investment paid dividends this year because they went public and that is really how those things pay dividends is when those companies either get bought out by private equity or they go public, which is the big pay out.

[0:21:55.6] Jefferson Health is eating an elephant one bite at a time here. So they have acquired, or have been handed the keys to an awful lot of health systems that were on the brink of just not being able to scale up. They read the tea leaves, they looked at the future and they said, “We’re not going to be able to scale up. We need a partner,” and they decided to partner with Jefferson. So they have a significant number of health systems and EHR work and consolidation work that they’re doing.

So that takes toll on the financial. So the financials are on the positive range but just barely. Again, I love what they are doing. I like how they are looking at the future and I think as I talked about earlier with Bon Secours and Mercy, I’d like to see them move a little quicker on the operational side and be able to assimilate more of these hospitals quicker I guess, is the way I would say it but generally speaking, Jefferson is still absolutely one of the health systems to watch especially in this. What are the new revenue models going to be for health systems moving forward.

City of Hope, new presenter, first time presenter. Cancer and diabetes center. Mostly cancer is what they are known for. In fact to be honest with you when he said cancer and diabetes, I didn’t know they were known for diabetes. They are right down the street here in California. So I know they are known for cancer. In fact, some of the exciting things they talked about were their research that they do. They do a ton of research. They contribute that NAH funding, you name it.

They are doing a ton of research. It creates an alternate revenue stream for them as well. They also are touting themselves as a destination. You know, they got one of the major contracts last year. Amazon selected them as a cure destination. That is a huge win for them and when that happens, essentially what they’re saying is for our complex or probably for anyone who is diagnosed with cancer, they are going to get a second opinion or a flight bound to the City of Hope to determine if they are on the right care plan or if it was a misdiagnosis.

[0:23:47.2] And again, we have talked about this on the show before. Walmart started doing this with Mayo for cancer and they are doing it with Geisinger for something else and it is that same kind of model that says, you know the number of misdiagnosis on cancer is a little too high to take whoever the local player is. So they are identifying these places that are focused in on cancer. A good model, good revenue diversification of revenue for them.

You know I didn’t capture their financials per se. I think the other thing ,and I am not even sure they talked about this but it is interesting to me. I think this specialty centers have an opportunity and one of the things that City of Hope is doing is they are putting a cancer center right in the heart of Keiser’s probably one of Keiser’s strongest markets in southern California and Providence. One of Providence’s strongest markets in Southern California.

And they are just plopping a cancer center right down in the middle or Irvine and I think it is going to be successful. I think it is a really smart strategy. People from Orange County in Southern California have been traveling up to UCLA and traveling up to Cedars-Sinai for years for that kind of care and if you can get the same level of care at the City of Hope in Irvine that you could drive out of the county I think that is to say smart, smart play.

[0:25:04.2] The last presentation on the day for Monday was SSM. This is going a little long so I am going to pick up the pace a little bit here. So SSM, good and improving financials, healthy self-disruption was their key. They are implementing on a lot of different areas. They are implementing on the health plan, growing tele visits, direct to employer program, home expansion. Actually it was really impressive the number of areas that they are seeing progress. This is one to keep an eye on. I did reach out to their CEO to talk to her and we are going to try to have them on the podcast a little later on in the year.

Ascension far away for me, one of the more interesting presentations. I was curious, in the previous years, they had the Tony & Tony Show and the two Tony’s CEO and CFO. This year they had a whole new team. They did succession planning really well. Almost the entire team came from within.

So you had just operational consistency moving forward and based on their financials and their performance you want that but my favorite part of the presentation was from someone who came from outside of their organization that is Eduardo Conrado, the chief strategy and innovation officer for J.P. Morgan and I already talked to him about having him on the show and he gave me the quote of the conference, which was, “Tech companies are figuring out health care faster than health care is figuring out tech.”

So that is a great quote. He went in there and actually as a strategy officer took over the IT organization. So IT falls under strategy and it should. Wow this, as he was saying it I am like, “That makes a lot of sense.” It definitely shouldn’t be under the CFO. I mean if it is under the CFO that tells me exactly how you’re thinking but if it’s under the strategy officer I am saying, “Yes that makes so much sense.” I can’t begin to tell you how much sense that makes.

[0:26:48.7]: So he established new roles, product management, design, data science, software engineering, enterprise architecture, he hired new workforce and he ended up co-locating in Austin, Chicago, as well as their St. Louis location. He bifurcated the organization into run versus build, which makes sense. Gartner has been talking about this for years. Running the business of modernizing the infrastructure versus delivering new innovation and services to the market.

You know, why are they doing this? They researched it, 68% of 18 to 24 year olds indicate frustration with healthcare providers, lack of digital experience and then he had a bunch of other metrics to back this up. 64% want programs to help them select the best treatment plan. 75% want online booking. 77% want to pre-register online. You get the picture, but they have done their research around the consumer journey and they are making the right investment.They are making investments.

Another thing he brought up, which I thought was fascinating, hospital at home, admitting patients into their home. Think about that, admitting patients into their home. So they are setting up an acute, post-acute, virtual disease management and wrap around services for live at home services. Again, fascinating low asset way of expanding in the markets that you serve. Partnering with world-class technology companies and we know where this is going because of the big conversation around Ascension and Google and the privacy.

They just looked at it. The experience for the clinicians is not that great and hospital has spent 30% of their time searching for information rather than caring for patients and so you can go out onto YouTube and see the Google presentation on the health record that they have created. I got to see the Ascension presentation, which is an internal presentation that they shared at the conference. To be clear, this is the Ascension health record presentation.

[0:28:35.9] Google is providing the services to help create it but it is Ascension’s data. Ascension is controlling how that data gets used. It is not being used by the search engine. It is being used on the Google health side to help clinicians to be more effective and here is a couple of things. So the presentation was great, the unified view of the patient’s information, all of the visits, it shows trends, search will instantly return results, which is what you would expect with Google.

Every record is searchable including scanned documents and hand written notes. New information is emphasized. So if there is a new visit or new information about the patient, it is emphasized, it is brought out because you have designers designing this, right? It is designed for quick diagnostics, dynamic charting to see new relationships and trends across the data, mobile app to free the hospitals from their desk, which is estimated to be 50% of the time during their shift.

Notification on patient status changing because they are bringing in the telemetry data as well. So the nurses can be mobile and still see the change in the patient status and contextual searching and multi-device access, voice navigation so also voice navigation of this record. This is far away the most effective HIE strategy in the country and that is what they were trying to solve first. That is what they are trying to solve.

They have a 110 some odd hospital locations. Different EHR’s across the board. They were able to bring this data together. The record I saw and how they were navigating that record, voice navigation what not – if this were a national HIE strategy it would be exceptional. Now they would have to break it off from Google for it to be acceptable as the national HIE strategy. I get that and Ascension and Google have some work to do on really the privacy aspects.

[0:30:17.9] It just was not handled all that well and they need to get out in front of it. They need to continue to talk to the patient community about what are the implications and how is this technology going to be used and that wasn’t it. They are also redesigning care teams. They took a specific hospital and they are redesigning care teams around the patient and really good results around that. They are looking to scale that up across their entire health system.

And I know there are other health systems. You look at Mayo’s model and Cleveland’s model. They have designed around care teams around the patient but a lot of health systems don’t function that way. They function in silos and this is a really aggressive play for a traditional player and if they are able to do that across the board and really improve their quality metrics could be interesting.

All right, so I have three more. I am going to go through them real quick.

Providence, this was a confusing presentation. It is the best thing I could say about it. No real financials to speak of, they did share their IBIDA margin but unfortunately IBA are real things and they are real numbers so just based on where the IBIDA margin number was, I am guessing they are in the red. This will be the second year in a row they are in the red and you know, again, you are talking about strategy and they got up and spent a better part of 15 of the minutes talking about a re-org.

And, you know, the re-org itself is confusing to be honest with you. They organize based on an internal lens versus an external lens. I am not sure that that’s really going to play plus when you get a chance to stand up in front of investors and bond holders, I am not sure talking about a re-org really inspires confidence unless it is just really over the top. Anyway, they spend a lot of time talking about diversifying revenue and the reality is they are already number one and two in a lot of markets they serve.

[0:32:06.8] They are clearly not operating. They are not delivering on operational excellence across the board. If they were and they are number one and two in the markets, as you have seen with these other health systems, their numbers should be stellar quite frankly. I mean holding the number one and two spot in a market gives you a certain amount of pull in that market. So operationally it would appear that they are not doing that well.

And there are also – they’re trying to diversify, spin out new companies and those kind of things but the reality is they would have to really start dishing out unicorn after unicorn in order for it to really have a material impact on their bottom line. So I am not sure I understand where that is going. You know if I were sitting in that boardroom I would say, “Can we just put together a strong operational focus for our organization?” Drive this thing back to the 3% operating margin that it should have across the board if not higher, and instead of looking for our revenue and our margin outside of health care, let’s get this thing back to running the way it should.

So, you know, they are five years removed from the major mergers and they seem to be running in place. I’d like to – again it was confusing. I love these people. They are friends, they are smart people. They are absolutely smart people but sometimes the basic blocking and tackling of running a health system is not sexy enough and it needs to be. Providence needs to make operations the new sexy for them for the next 24 months if not for the next five years.

OSF health care, decent financials, good strategy based on their markets. So I like organizations that look at the markets they serve, they come up with strategies that are specific to those markets instead of the “me too” pulling from these others. Care at home, rural health care without hospitals. I may even visit with them.

[0:33:45.6] I really like the things they were saying. I think it was very appropriate for those types of markets and I know we have a lot of listeners in those kinds of markets. So good presentation from OSF healthcare.

The final presentation that I am going to talk about is Mayo. Mayo is Mayo and they continue to be Mayo, right? Phenomenal financials, phenomenal quality, and because they are Mayo and they are given the benefit of the doubt they turned over almost a significant portion of the presentation to John Halamka who has been on the show a couple of times.

And he made his debut at J.P.M as the president of the Mayo Clinic platform and we did speak. He will be on the show again here shortly. I just have to get my schedule. He doesn’t sleep as you know. He only sleeps four hours a night. So he is ready to be on the show tomorrow. I just have to get my act together over here. So we will have him on shortly. John talked about platforms and this is going to be one of the major concepts for the year.

You know, it is the reason why we can’t scale the things that we do or replicate our success across or at scale and too many people in healthcare jump to the end solutions and without really laying the foundation with these platforms. John shared an example of how they’re handling their data and they are building out a platform for data where they had anonymized the data. When you think about platforms you just think differently and you implement differently.

So they took their data, the raw data that they have, they move it into this platform. They anonymize it, they then move it into another platform so their partners can access that anonymized data. They are not accessing the raw data. That would be bad. They are not even accessing the platform where they are doing the work to anonymize data. They are accessing really a cleanroom of data where they can get to. That’s platform thinking.

[0:35:22.9] Now they have a way to engage a lot of partners very rapidly. They have a program and a method for doing that. Platforms are going to be one of the most important elements for health care’s systems to get right in the next 18 months. John shared a bunch. We are going to have him on the podcast so we will go into more detail.

That is all for this week and that is really all from the J.P. Morgan Conference. Two great days hearing from your CEOs and CFOs and really cool strategies going across the country. Global growth is happening as well. So this year in your election year when you hear how bad our health system is, just remember that we are exporting around the world. Maybe not the payment models but we – and the complexity of it but we are exporting our quality of care around the world because it is sought after around the world.

That’s all for this week. Special thanks to our channel sponsors, VMware, Galen Healthcare and StarBridge Advisers for choosing to invest in developing the next generation of health leaders. This show is a production of This Week in Health IT. For more great content, you can check out the website at thisweekhealth.com or the YouTube channel as well. If you want to support the show, the best way to do that is to share with a peer.

Just shoot them an email and say, “Hey I am listening to this podcast, This Week in Health IT, thisweekhealth.com. I get a lot out of it. I love for you to listen to it as well so we could talk about it.” We are going to be back again on Friday for another great interview with an industry influencer and don’t forget every Tuesday we do the top 10 stories that are going to impact health IT. I give you my take on it in 23 minutes or less.

Thanks for listening. That is all for now.

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