June 15, 2020

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June 15, 2020: We’re back with another Tuesday News Day! This episode, host Bill Russell challenges himself by giving you ten news stories in 20 minutes. Along with detailing each story, Bill adds his insights to each article, ensuring that you are on top of the latest health IT news. A subject that’s on every healthcare professional’s mind — the future of telehealth is discussed in a few of today’s articles, with two articles focusing on how telehealth might be funded under Medicare. Another critical topic is the financial stresses that have been placed on the healthcare system by COVID-19, along with a few pandemic silver-linings. While many are hyping the potential of 5G, Bill provides his take on why it shouldn’t be your immediate focus. Looking at an article about how a COVID-19 survivor was charged over one million dollars, Bill talks about why hospital costs are a political issue and why it’s been an odd election year. In industry news, Cerner has a new CFO — hear why Bill feels uneasy with their choice. A lot is going on right now, especially in the world of telehealth, and as Bill says at the close of the episode, “It is going to be an exciting time in healthcare. Isn’t it always?”

Key Points From This Episode:

  • There are many COVID-19 silver-linings, including a new focus on telehealth. 
  • Health systems have faced resource strain as a result of the pandemic. 
  • Why Bill reserves his to comment on Cerner’s new CFO.
  • While 5G is exciting tech, there’s no reason to rush into it. 
  • The predicted rise of contactless experiences.  
  • Why contact tracing won’t be adopted in the U.S.
  • The importance of remote monitoring and remote communications in the future.
  • Increasing calls for expanded Medicare telehealth access. 
  • Where the money for increased telehealth access may be coming from.
  • Why healthcare cost is still a political issue — particularly in an election year.
  • Bill highlights that it will take time for healthcare systems to recover. 
  • Bill shares more ideas on how telehealth can be funded. 

News Day – 10 Stories in 20 Minutes

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News Day – 10 Stories in 20 Minutes

Episode 266: Transcript – June 15, 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.

[00:00:00] Welcome to This Week in Health IT. It’s Tuesday news day, where we look at the news, which will impact health it today. Job losses, telehealth 5G and much more. My name is bill Russell, healthcare, CIO, coach, and creator of  This Week in Health IT a set of podcast videos and collaboration events dedicated to developing the next generation of health leaders.

[00:00:22]The country is transitioning. And so are we, we are now doing three shows per week instead of the five we’ve been dropping. we’re going to have a show on Tuesday and Friday as we did prior to the pandemic, and we’re going to drop another show every Wednesday. we’re going to continue to do a live show a once a month at the end of the month.

[00:00:39]we will only do a few more episodes of the COVID series, and then we’re going to, put a bow on that and call it a series and put it into the archive. as part of that, we’re introducing new cards. That’s going to match the website redesign that we did a while ago. We just decided not to re do the cards in the middle of the COVID series.

[00:00:58]we’re launching a thing called [00:01:00] clip notes that I’m really not allowed to speak about yet. We will talk about that the next couple of weeks. I’m also, I wanted to make you aware, I’m speaking at the atmosphere of digital conference for Aruba and hosting a panel discussion with, Dr. Chaudri  CIO from, Seattle Children’s and Rick Allen.

[00:01:15] The CTO from Navicent, we’re going to be doing a session called healthcare at the edge, the convergence of devices, data, patients, providers, and care. I hope you followed all that. you know, works extremely busy at this moment in time working to develop great content. For the next generation of health leaders this episode, and every episode since we started the COVID-19 series has been sponsored by Sirius healthcare.

[00:01:36] It is their commitment to making this content available that has made the daily episodes possible. A special thanks to Sirius for supporting the show’s efforts during the crisis. Okay. Let’s get to the news. Here’s one of my promise to you. It is a, I’m going to do 10 stories in 20 minutes. I promise. Set the timer here goes, I’m looking at the timer.

[00:01:56] Okay. 10 stories, 20 minutes with a So What? For [00:02:00] each one. Here we go. over 10% of healthcare CFOs expect digital transformation, to cut digital transformation spending. It’s interesting that article title over 10% of healthcare CFOs expect to cut digital transformation spending. When in rally, what they’re saying is 90% don’t expect to cut it.

[00:02:16] So here’s what the article says. It would seem most CFOs understand that the pandemic has proved the need. To speed up digital transformation initiatives, to not only survive, but to prosper in the new normal Doug Brown president of Blackbook research said in a statement for CFOs eager to exponent their organization’s digital transformation, the standardization and simplification leaders want their backend processes.

[00:02:42] Are allowing for less complicated, faster adoption. Despite the times, additionally, the survey found that 90% of the providers have embraced virtual care solutions. 75% have initiated high, highly, Highly patient positive experiences and over half have had to commence [00:03:00] with layoffs and process changes.

[00:03:03]you know, what’s the, so what on this? The, so what on this is absolutely, you know, there’s, there’s a whole host of things coming out of this pandemic, which are going to be silver linings. And some of that is going to be essentially that, the patients have experienced new, new modalities and, providers have we’ve educated a whole.

[00:03:22] Host of people, huge amounts of people on the value of telehealth on the value of a remote patient monitoring, the value of, online scheduling the, I mean, you name it, it’s a, quite frankly, we had, we were forced to do it and now everyone’s experienced it and they sort of stepped back and said, Hey, I actually liked that meal.

[00:03:44] That was actually good. I actually enjoyed that. Let’s do more of that. So I think you’re gonna see that. In light of some of the other stories that are coming up. So COVID-19 story number two, COVID-19 impact on hospitals, worse than previously estimated healthcare finance news. [00:04:00] A Kaufman hall report.

[00:04:01] Looking at April hospital, financial performance showed that steep volume and revenue declined, strove margin performance so low that it broke records. despite $50 billion in funding allocated through the cares act operating EBITDA margins fell to negative 19%. They felt a hundred or 74% or 2,791 basis points compared to the same period last year.

[00:04:26] And 118% compared to March. This shows a steady and dramatic decline as EBITDA margins were as high as 6.5% in April. so what the, so what of this is, it’s bad. It’s not uniform, but it’s bad. And a mitigating factors as we’ve talked about on the show before, if you had a lot of, managed care patients, you would, whether this better than, organizations that didn’t have managed care patients, there’s going to be hospitals and health systems that have a billion dollars in investments.

[00:04:59]even though [00:05:00] the investments didn’t do all that well during the pandemic, they have rebounded nicely. And, they’re going to have some reserves to. Play with, to come out of this. some of the other health systems are going to struggle mightily. I don’t suspect that we will see it budgets increase.

[00:05:16] In fact, I think we will see pressure on it, budgets to contract, but we will see digital transformation, digital, very targeted, digital consumer experiences, investments continue to grow. All right. Number three, story. Number three, Cerner hires, a new CTO. Jerome Labatt Labatt, L a B a T healthcare it news.

[00:05:37]Labatt has. Deep experience with cloud and software as a service. Most recently, he served as CTO for micro-focus international, a British pure play enterprise software and information technology business. Before that he served as CTO for HPE software leading the cloud automation business. Prior to that Labatt served 20 years at Oracle, where he led [00:06:00] infrastructure automation and development operations.

[00:06:03]among his goals at Cerner is to build out cloud capabilities while integrating cognitive computing capabilities, according to the company. So what, I don’t know what to make of this, to be honest with you, I wish I could give you a definitive. I was pretty high on Cerner last year. I thought their move to the cloud was good.

[00:06:21]I thought the partnership with AWS was pretty smart. I saw some, I saw some, a light there. I saw some, some things to get excited about. I, I’m never excited when you’re replacing the CTO and, you know, and quite frankly, 20 years at a. you know, 20 years at Oracle and this, this announcement does not excite me as much as it maybe should.

[00:06:46] I don’t know. I don’t know this person, all that. Well, I know that the Oracle background doesn’t really excite me. The HPE background. Doesn’t excite me the micro-focus background. Maybe. maybe this is the kind of person they need. I would hope for, you [00:07:00] know, the direction they were heading with AWS.

[00:07:01] And the cloud seemed to me to be a forward leaning forward looking, and then you just hire somebody with, you know, 30 plus years of experience in the industry. I just, I don’t, there’s something about this that doesn’t sit right with me. I’m not sure what it is yet. I have no show what for this, I reserve the right to comment on this later, a 5G revolution unlocking the digital age.

[00:07:22]this was a. This is, you know, visual capitalist comes out with these things and every now and then I’ll click on them and look at them. This was interesting to me and I pulled this out for one reason. From 1982 to 1990, you had one G. From 1990 to 2000, you had to G from 2000 to two 2010, you had three G from 2010 to 2019, you had 4g and 2019 to present.

[00:07:48] You have the advent of 5g. My S my, so what on this is read through the hype. This would decade. This is going to evolve over a [00:08:00] decade. There is no reason to rush into this. I mean, yes, there’s going to be, this is an exciting technology. It it’s an important technology, but for healthcare, it’s probably an important and exciting technology for 2022 and 2023.

[00:08:14] That’s my, so what on that, beyond telehealth, the virtual care technology trends that will transform healthcare. This is healthcare it news. Patty wrote this art, Patty Padmanabhan who, does consulting in the industry whose stuff I like you as a podcast as well. It’s with Dame-o consulting. let’s see, he wrote.

[00:08:34] A handful of thing. So I’m just going to pull out the, you know, 20, 20 or 10 stories in 10, 20 minutes. three main points. The rise of contactless experiences as is often happens in major catastrophic events, natural or human made. Many societal practices change irreversibly. The pandemic has made us all afraid to touch any surface exposed to the public.

[00:08:57] So there’s going to be a rise of contactless experiences. [00:09:00] Isn’t first point second, one contact racing inspired by the success of Singapore and South Korea. Contact tracing applications on Bluetooth enabled devices have been positioned as an effective means to track and trace infections, to reduce the spread of COVID-19.

[00:09:13] And his third thing is remote monitoring and automated communication. Health care executives are more motivated than ever to keep their populations healthy in their homes. The rise of telehealth and intelligent remote monitoring devices now allow patient populations to stay at home and manage their chronic care conditions.

[00:09:30] Avoid visits. Two hospitals and communicate on realtime basis with their caregivers. Here’s the, so what. Absolutely. Yes. On the contact, less experience. I’m starting to experience that. I had some furniture delivered. we moved into a new house, we got a new chair and they delivered it. And the whole experience was contactless.

[00:09:49] I mean, they took a picture, in the house of the thing. I didn’t have to sign anything. I didn’t even have to do the finger thing on somebody’s phone, which has a, you know, a [00:10:00] phone is one of the, just the complete carrier of a. Of, you know, germs and viruses. So, you know, I think that contactless experience is going to be a new thing in our, in our culture.

[00:10:11]contact tracing, I think is going absolutely nowhere. I think it’s going to be swallowed up in the political abyss. again, not a technology problem. I think it’s a, it’s an adoption problem. And I think it’s a politics problem. And again, not stating whether we should or should not be doing it. I’m just saying it’s going to get swallowed up.

[00:10:28]we are not South Korea and we are not Singapore. We don’t have, the same culture. And so I think that’s going to get swallowed up, remote monitoring and automated communication. Absolutely. I think we’re going to see that the rise of the home as the new. A locus for caring for the aged. I think we’re going to see, people really try to stay away from, going into longterm care facilities, stay at home more.

[00:10:53]I think you’re going to see chronic patients start to wire up their homes with, internet of things, devices, [00:11:00] and you’re gonna see a whole host of things happen around that. I think that’s the thing to keep an eye on. It’s really going to be interesting. Okay. Next story. Medicare leaders call for expanded telehealth access.

[00:11:10] After COVID-19 president Trump’s top Medicare officials said Tuesday, that expanded access to telemedicine should continue after the coronavirus. Excuse me, pandemic proceeds. And that officials are examining ways to act without waiting for legislation from Congress. I can’t imagine going back said SEMA Varma, administrators of CMS and Medicaid services told stat during a live virtual event, people recognize the value of this.

[00:11:38] So it seems that it would not be a good thing to force our beneficiaries to go back to in person visits. Absolutely. Here’s the, here’s my, so one on this. SEMA verb. Vermont is arguably one of the most powerful people in healthcare. There are 64 million people on Medicare. and she is speaking as someone who holds significant influence.

[00:11:59]I wouldn’t [00:12:00] take this to the bank because she needs money to make this happen, but they’re very creative, right? So people recognize the value. So it seems it would not be a good thing to force beneficiaries to go back. That actually was, that officials are examining ways to act without. waiting for legislation from Congress.

[00:12:16] Interesting. Okay. So I’ve made this point last week on the show that, Congress is where you go to get money schoolhouse, rock taught us that that’s where you go to get money. So that takes it to the next story. there are buckets of money. You just have to find them. There’s so much money flowing around DC that you just have to find them and, attach into them.

[00:12:38] So a step in the right direction for telemedicine, Medicare advantage, a bipartisan budget act of 2018 allows Medicare advantage plans to include additional tele-health benefits, still health bonuses beyond what the original Medicare allows. In their bids for the basic Medicare benefits starting in plan year 2020 under this final rule, ma enrollees.

[00:12:59] Medicare advantage. [00:13:00] Enrollees may have a great opportunity to receive healthcare services from places like their homes, rather than being required to go to healthcare facilities. Ma plans will now have broader flexibility than is currently available in how they pay for coverage of telehealth benefits to meet the needs of the new Orleans.

[00:13:15] These changes will provide ma plans with the ability to offer expanded telehealth coverage. To meet the needs of their patients. Patients in ma plans have always been able to receive you get the idea. as I said, Medicare covers 64 million Medicare advantage covers 22 million. So essentially Sima, Varma and team have figured out a way to tap into this money from the 2018 bipartisan budget act so that they can fund a third of Medicare beneficiaries with telehealth.

[00:13:45]So telehealth is isn’t going away. Love it, learn it, integrate it, figure it out. next story who got get gotta get moving here. Seattle coronavirus survivor gets one point $1 million bill, 101, one 181 [00:14:00] pages. Long, Michael Flor, the longest hospitalized COVID-19 patient who, when he unexpectedly did not die was jokingly dubbed the miracle child.

[00:14:08] Now that he, he also, you can also call him the million dollar baby total to have 1.1 million, a one, a little over 1.1, all in 181 pages. Bill is technically an explanation of charges. And, in fact, because it’s COVID-19, he will likely not pay. Anything, that will be picked up by various things, including, money that was put aside for the cares act and other things.

[00:14:34]why do I cover this story? It’s just a reminder. It’s an election year. She’s telling somebody the other day, this is the oddest election year ever. You just don’t even hear about it. Normally you’d be the, the sound would be so high on this election year stuff. but there are so many things going on in our world.

[00:14:51]it is an election year. Healthcare costs are an issue. This normally would be a massive story in an election year and it would become [00:15:00] an election year issue. And it may still, the cost of healthcare. 20% of GDP is still too high. approaching 20% of GDP is still too high. A cost to individuals, cost to businesses still too high.

[00:15:13] So, it’s an election year. It’s an issue. Just keep that in mind as we move forward. Next story hospitals continue to struggle with job losses as other areas of healthcare rebound, healthcare finance news, overall education and health services employed, employment increased in may adding 424,000 jobs after suffering a decrease of 2.6 million in April.

[00:15:34] However, the numbers also show that hospitals have yet to recover financially from the surge. Of COVID-19 patients and the loss of revenue from Posto postponed or canceled elective procedures, many were forced to furlough or lay off staff because the billions earmarked for hospitals in the coronavirus aid relief cares act, sorry, was not enough for most hospitals to operate at previous expense levels.

[00:15:58]you know, to do [00:16:00] a search. So one on this is, you know, these are tough times for hospitals. We are going to tighten our belt across the board. some, some health systems are really doing okay coming out of this. It’s been interesting. I think some of it has to do with your, market share. Your sensuality in the markets that you serve, some of it may have to do with the amount of money you decided to spend going into it.

[00:16:22] Some people really drug their feet, going into the preparedness saying, you know, we know we can sort of make this transition when we need to, we’re not going to, you know, clearly they, they follow the state guidelines and whatnot, but they didn’t. Spend a ton of money standing up additional facilities, or even transitioning a ton of, of space.

[00:16:44] And so they didn’t incur those ex excess costs. They did have the decrease in revenue. I’m just saying it, it hit health systems unevenly. The, so what on this is, that it’s going to take a little while for healthcare to recover. Some people are saying. you know, the, that [00:17:00] actually some people I’m talking to the numbers have recovered somewhat we’re at, it seems pretty simple for people to get back to about 80 to 85% of their run rate.

[00:17:10] But when you hear that run rate, keep in mind it’s different run rates, right? A percentage of ed visits, percentage of procedures, percentage of office visits, percentage of. clinics and whatnot, the percentages are different and they mean different amounts of revenue and different amount, different amounts of money to the health system.

[00:17:30] To keep that in mind, as you hear these numbers, you got to sort of balance them out. But I think getting back to 85% in general is something that is happening pretty quickly across the board. But keep in mind, 85% is not enough. They have to cut significant. We as a health system will have to cut significant amount of costs to stay into that.

[00:17:49] Okay. And final story. And I’m almost delivering on my promise at Stanford children’s health, the telehealth bubble won’t burst. now the, Hagler [00:18:00] M D chief medical CMIO of Stanford. Children’s health time will tell what the future holds. And I expect some drop in telehealth numbers as we go forward, but clearly we won’t return to the baseline we were before the pandemic.

[00:18:12] There are so many stories of both patients and providers who have discovered unknown value in telehealth. And in many cases tele-health may be the more optimal method of delivering care. We have had cases where. Our development and behavioral pediatricians are seeing children in their home environment and getting much more information about the development of the natural environment compared to the clinic setting.

[00:18:35] It’s actually gotten to the point in which our division chief for development and behavioral pediatrics has said that going forward, the at-home assessments will be standard part of these evaluations. you know, there’s so what on this is, I agree wholeheartedly, although it is. Primarily going to be a numbers game.

[00:18:53]it depends how much of this is going to get, there’s two aspects of this really. It’s got to get funded. We [00:19:00] all know that. So I should just stop saying it. It has to get funded in some way. It’s a zero sum game. You cannot, you know, all of a sudden create all these new capabilities that doesn’t get funded, but there’s different ways to fund it.

[00:19:10] You can get actually paid for it, or you can drive out costs by doing things in a different way. now, if, if it doesn’t get funded, I mean, there’s. Case to be made, that is going to be hard to sustain these gains. But as you saw an earlier story, Medicare advantage is a funded. I think you’re going to see Medicare get funded.

[00:19:30] I think you’re going to have a new plans get developed by the payers, by the commercial payers, which have tele-health only type options. It’s going to be an exciting time in healthcare. Isn’t it always a that’s all for, for now for the news special. Thanks to our sponsors. VMware Starbridge advisors.

[00:19:50] Galen healthcare, healthcare, Sirius healthcare and Protel and advisors for choosing to invest in developing the next generation of health leaders. The show is a production of this week in health. It for more great [00:20:00] content, check out the website this week, health.com or our YouTube channel. If you want to support the show, the best way to do that is to share with peer or send an email, let them know that you’re getting great things out of the show.

[00:20:12] Please share back. Every well, let’s see, Tuesdays, Wednesdays, and Fridays now for new content. thanks for listening. That’s all for now. .

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