News Day – Amazon, Google, Privacy

With

Bill Russell / Drex DeFord

News Day This Week in Health IT

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September 1, 2020: Drex DeFord joins Bill to bring you the news. They tackle the big topic of going back to school. How are different colleges and universities handling it? Sharp Healthcare is the first to deploy Amazon’s new Halo health wearable which tracks activity, body fat and emotions. We can’t wait to see the results and how it will help their clinicians. Contact tracing, Google and issues of privacy. We simply don’t know where our data is going or how it’s being used. Ascension Michigan health system is laying off and outsourcing 223 IT jobs. Yikes. And a Tesla employee was offered $1M to install malware. How worried do we need to be about internal cyber attacks?

Key Points:

  • Abbott labs came out with a $5, 15 minute test [00:20:20]
  • University of Illinois mandatory testing plus health passports required to attend class [00:21:00] 
  • Health style TSA for football games [00:25:30] 
  • Contact tracing and issues of privacy [00:24:15]
  • Further discussion on HHS back to CDC [00:30:10]
  • Google Cloud and Amwell partner on telehealth [00:30:55]
  • In person in clinic visits are back to around 95% of where they were [00:34:10]

Stories:

News Day – Amazon, Google, Privacy with Drex DeFord

Episode 297: Transcript – September 1, 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] Bill Russell: Before we get started. I want to share with you something that we are extremely excited about here at This Week in Health IT and that is Clip Notes. Clip Notes is the fastest growing email list that we’ve ever put together. If you can’t listen to every show, but you want to know who was on and what was said, the best thing to do is to sign up for Clip Notes.

One paragraph summary, key moments in bullet point format with timestamps and one to four video clips from the show. It’s a great way for you to stay current, share insights with your team and maintain your commitment to their development. During these [00:00:30] extraordinary times, the best way to sign up. The easiest way to sign up is just send an email to Clip Notes.

CLI P N O T E S @ thisweekinhealthit.com and it’ll kick off an automated workflow. You’ll get an email back from me, click on that link and you are off to the races. So don’t delay, send that email, get signed up today. Now onto the show.

Welcome to This Week in Health IT. It’s Tuesday news day, where we look at the news, which will impact health IT. [00:01:00] Today Derx DeFord is in the house to discuss the news. And I know you guys look forward to that. And so we’re going to do a little back and forth. It should be fun. My name is Bill Russell, healthcare, CIO, coach, and creator of  This Week in Health IT a set of podcasts, videos and collaboration events dedicated to developing the next generation of health leaders. This episode, every episode, since we started the COVID-19 series has been sponsored by Sirius Healthcare. Now we’re exiting the series and Sirius has stepped up to be a weekly spot for the show through the end of the year.

Special thanks to Sirius for supporting the show’s efforts. [00:01:30] Alright. Hey, good morning. Welcome back to the show. 

Drex DeFord: Good morning. Good morning. Thanks for having me. You got to love those Sirius guys for continuing to 

Bill Russell: Oh, they’re fantastic. 

Drex DeFord: Put wood on the fire right? 

Bill Russell: Yep. And I’m going to be hosting  one of their healthcare events coming up here shortly. I’m going to be moderate. MCing, I think is what they said. I don’t know what the difference between a moderator and an MC or a speaker. I think an MC is somebody when you don’t really want them to speak, but you [00:02:00] just want them there. 

Drex DeFord: I don’t know. I think MC requires you to tell jokes. I’m pretty sure you have to have some jokes.

Bill Russell: Oh man. My kids are just cringing right now 

Drex DeFord: I’ll work with you on that. How about some dad jokes right in the middle of the audience. It’d be fine. 

Bill Russell: Hey you doing every now and then new show, I usually give a shout out to 3X Drex. And, how did you come up with 3X Drex? Why did you come up with 3X Drex?

Drex DeFord: That’s a very interesting question. [00:02:30] I, and so I should be at burning man right now but it was canceled last year at burning man. I happened to run into somebody that I knew who s aid, I follow you on LinkedIn, you post really good stories. I always whatever you post, I always read that and I avoid everything else.

And like you’re giving the, giving me some curated content. And so I sorta thought about that. it was one of those things that was in the back of my mind, the rest of the week, while I was there. And when I. Came back. I started thinking [00:03:00] about why doesn’t somebody do something by text, because it’s limited to 1600 characters.

You can’t overwhelm anybody, maybe it’s one or two or maybe three stories. and you just talk about the stuff that you know, is the big stuff to you. The stuff that you find most interesting or most important, and that turned into figuring out how to do that. text-based blast and, Signing people up and, it started with two or three or four and, we’re just keep growing and keep growing. And so that’s the story. It was born of, of burning man and keeps on going. [00:03:30] 

Bill Russell:  Got to love every answer that starts with, I should be at burning man right now. And the whole concept happened at burning man too. There’s 15 followup questions that I’m not going to ask but it is a great service.

I love that you could just click on them. Easy for me to pull them up. Then I just, file stories away to talk about. And the good news is you found them for me. I don’t have to go find them, which is wonderful. 

Drex DeFord: I think that’s the, that’s the, I have time right now. I have a bunch of [00:04:00] feeds from a bunch of different places.

So I read tons of stories and I really do try to just figure out like, this is one that’s probably the most interesting, or, these are the two or three that are most interesting today. Those are the ones I’ll punch out. And then sometimes I find something that’s oddball or weird or interesting, and, I’ll do that as a bonus post.

And, but yeah, sign up. It’s a really easy text the keyword directs D R E X to four eight four eight four eight. And, and we’ll start hitting you with 3 texts messages, [00:04:30] three text messages a week, and a pretty easy reads, 

Bill Russell: Well Drex best radio name. for people who don’t know what radio is, it’s like the precursor podcast anyway, Drex though, man, that is such a great name.

I wish, Bill is just not quite the name that really gets it going for a. I need a new radio personality name. That’s what we’ll do. Start sending me a [email protected] I’m going to rename, I’m going to get a new name. That’s going to be my radio personality name. Feel free to send me some, some [00:05:00] ideas 

Drex DeFord: You need a handle, right? Like a UFC fighter fire fighter. So it could be Bill something, and then we’ll get an announcer. Maybe I’ll do it. Come on and do like a UFC kind of announcement. Yeah. and that’s step into the ring. 

Bill Russell: This probably shows how old I am. I’m thinking of like George, the animal Steele, Jimmy Superfly scnucka risers.

These were the professional wrestlers back when I was a 

Drex DeFord: Yeah a  professional wrestling introduction. Yeah. Yeah, exactly. Same [00:05:30] thing. 

Bill Russell: All right. Tune in for this, although I don’t know, maybe they did. Here’s what we’re going to do. We started something new a couple of weeks back. We just hit the headlines on a couple of things real quick, and then we go a little deeper into some of the stories that are out there. First thing let’s take a look. People have been busy app, Amazon launched a new wearable. I think it’s interesting. The modern healthcare story is that Sharp healthcare first to deploy Amazon’s new health wearable. There’s a, a couple of stories out there on this.

Let me see if I can find the [00:06:00] other one. So they had to be working with sharp. I would assume they had to be working with sharp ahead of launching this stuff. When you think in order for them to announce and be at sharp already. 

Drex DeFord: Yeah. As part of the, sort of the scoop of the product you would think, so they have some kind of a relationship that they built in advance of this and whether it’s around the specifically the wearable or something else, it’s definitely, an early adopter program and innovation program of some kind, it would be, it’d be interesting to dive in and [00:06:30] find out the details on that.

 So yeah, they must’ve been tied in. 

Bill Russell: Yeah, let me give you a couple of the details on Amazon unveils, Halo to battle Apple watch and Fitbit tracks, activity, body fat emotions. Amazon is interested interesting to wristband. You got that. It brings new offerings, including technology to track people’s body fat per head.

Anyway, it’s just a recap here. Amazon’s first significant move into wearables, which gardener estimates will be a $52 billion market this year alone. Are there really that many [00:07:00] wearables? I guess if you’re putting the Apple watch into that category, you’re putting the Fitbit into that category.

And then there’s just a whole host of other things that fall into the wearable category. Like some clothes and some others. 

Drex DeFord: this one was, interesting. I think I remember seeing something maybe this morning or last night about how it records temperature. And If that’s the case. there were some really interesting reports early on in the COVID outbreak [00:07:30] where people were taking their temperature with smart thermometers and based on the geo locating data that they could do with those temperatures, they were able to like, Unfortunately, it was after the fact, but go back and look and say, wow, yeah, we could have maybe predicted the outbreak in New York because a lot of people were taking their temperatures and their temperatures were elevated and maybe that’s, correlated.

So I find that interesting because if people shared data [00:08:00] and that became a public  public health resource, maybe it’s, another thing that could help predict pandemic outbreaks or, new blooms of Covid. 

Bill Russell: And that’s the pro that’s the promise of wearables. Here’s a good article on this. Becker’s hospital review did a good article, 60 details. You need to know the halo band, advanced sensors, as you would guess, and a temperature, heart rate, sleep fitness activity. I’d say also equipped with two microphones. [00:08:30] Interestingly, we can talk about privacy on that. which be turn on or off at the user’s discretion, I’m sure by default they’re on, to analyze energy and positivity in their voice.

That’s new halo. Yeah. That’s interesting to me. I guess that’s how they’re getting moods and yeah, and an important part of health. So that’s

Drex DeFord: Back in our day, we just had one mood rings, right? Exactly. When they turn 

purple  

Bill Russell: Until you had them for a while, in which case they were black at all times, [00:09:00] who knows what was in there.

The halo band tone feature aims to help users understand how their voice may sound to others. For example, tone may identify that it’s, that a difficult. work call leads to less positivity and communication with a customer’s family. Again, this is interesting. they’re listening into our conversations, so there’s going to be, do you want them allow them to do that?

And if you don’t, you miss out on some of the core capabilities of this thing, which sounds [00:09:30] interesting. the other thing that’s interesting, Amazon’s really using their expertise in voice they’ve collected a lot of just experience. 

Drex DeFord: Yeah, it’s a, it makes me, so from a funny perspective, it’s, you, it makes you wonder if, you sound very aggressive right now.

Would you like for me to turn on all caps, for your, but the, and maybe there’s a connection there, but maybe not, but it might be something that gives you a little buzz and, says you’re. Sounds like you’re [00:10:00] irritated. Would you like to do a breathing exercise or something like that?

I wonder how they’re going to connect all this and make it, useful to a person. I know that some, applications now have we’ll run a microphone and listen to the sound around you to give you some feedback on you are in a really noisy environment and you need to use hearing protection at this point, but, it’s interesting to see how it’s going to work with mood.

Bill Russell: Yeah this is, the reason I’m smiling and [00:10:30] laughing is because, you could actually put this on a whole bunch of people’s arms and, as they’re speaking in a meeting, I can see it saying it’s time for you to. Shut up. It’s time for you to step out of this meeting. You’re saying too many dumb things you’re going to get fired.

Cause I’ve been in those meetings where somebody is talking and I’m like, Oh man, you should stop talking right now. Obviously you’re angry and this is not the place 

Drex DeFord: You want to kick them under the table or something. Try to send them some kind of a sign. 

Yup. Absolutely [00:11:00] throw them a life preserver

Bill Russell: But yeah, I’ll tell you here’s what I like about it. Halos integrated with Cerner at this point. and there’s also this labs feature which are health challenges, experiments and workouts designed to help users build healthier habits, such as, improving sleep quality and finding more effective workouts.

The beautiful thing about the Apple watch and the beautiful thing about Apple is it is a walled garden. The awful thing about Apple is it is a walled garden. And I like this. It seems like they’re putting in a little [00:11:30] opportunity for you and I to create habits together or a family to create habits together.

I also like that this is not me too. There, it is going to have a lot of the same sensors and those kinds of things. But it’s interesting what they’ve done with voice and some other things, if I were see, I’m curious your take, if you were a CIO, would this, or are you still looking pretty closely at some of these devices?

Drex DeFord: I think I would probably think of this in the context of what’s my longterm strategy around [00:12:00] care at home and remote care and those kinds of things are there ways that this ties into giving us another piece of data that might be useful for our clinicians? So there’s a lot of clinician collaboration that has happened around us, I think really understand what’s useful.

And what’s interesting. because you, and I both know when you talk to clinicians about EHRs today, a lot of them continue to say that there’s so much data that it’s overwhelming and it doesn’t give them the things that they really want. But it’s hard to say what those are sometimes from patient to [00:12:30] patient.

More information out of context isn’t necessarily better. I think it will take a lot of collaboration to really understand how these things are gonna play into helping physicians or clinicians in general. Do their work more effectively. I think there’ll be pockets of things they’ll figure out.

But that’s how a lot of this stuff works. It’s little experiments, a little experiments, things turn into a routine that [00:13:00] becomes something that everybody does. And then, you continue to expand from there. 

Bill Russell: All right. So here’s one, that’s more close to home Ascension to lay off  230 223 IT workers in Michigan. So this isn’t just healthcare workers in general, this is specifically IT workers. And the short snippet here is Ascension Technologies. The st. Louis based hospital, giant information technology services, arm, outsource network operations and service desk jobs as part of its digital transformation [00:13:30] efforts.

Interesting. when we talk about digital transformation, a lot of times we’re talking to about tools and the ability to take in this information from sensors and to take that sensors and follow it through another layer so that we create meaning and context for the clinicians. And so we’re talking about all the fun things, but there’s also an aspect of greater efficiency that comes with digital transformation, that can lead to. reductions in the IT staff, is it [00:14:00] disingenuous to not if you’re the CIO to not be talking about this potential, 

I’m going to give you, I’m going to give you the hard questions instead of training for myself. 

Drex DeFord: yeah, no, we’ve talked about some these things before.

My brain works in, Maslow’s hierarchy of needs kind of way. And so when I look at some of this stuff and they tell me that they’re outsourcing, network operations, what else did you say? 

Bill Russell: service desk. 

Drex DeFord: service desk. So this isn’t, these aren’t super [00:14:30] surprising.

There are a lot of companies today that do service desk for health systems. There are a lot of companies today that will provide, network operations as a service, for health systems or other organizations. These are things that are absolutely necessarily to run that you have to run them well.

To be able to do the things that are higher on Maslow’s hierarchy of needs. So if you want to do business intelligence or other things, the network has to run really well. The power house. Just to stay on in the data center. All those things have to work really well. [00:15:00] And if you’re having a hard time hiring good people to do that and running it really well, because maybe where you are geographically, or maybe healthcare isn’t the most exciting place in the world for some of these people to work.

And I think you have to be looking all the time at what are the things. With the right structure of contract and support and, SLAs and everything else, what are the things that I could outsource so that I can refocus my energy on the things that are really unique and hard and different about [00:15:30] healthcare that we really want to do.

So I think the things on the lower end of a Maslow’s hierarchy of needs for healthcare, it, probably get looked at pretty regularly and should.  

Bill Russell: I did a monthly town hall and I was asked this question all the time. I would say at least nine out of the 12 town halls that I did, are there going to be reductions?

Are you, and those kinds of things, and that’s a difficult question to answer and you can never answer absolutely positively. No, coz COVID could hit, you have no [00:16:00] idea what’s going to come down the pike. but the other thing about it, I always used to say is. I’ll make a commitment to you every day.

You’re here. I will make you more valuable. I will give you opportunities to learn new opportunities to do things. That’s my commitment. I’m not guaranteeing you a job, but I’m guaranteeing you. You will be more valuable for having worked at this organization. But the next thing I would invariably talk about is some aspect where I say, look, three years ago, we used to provision servers.

And when we did that, we would go online. On a Dell [00:16:30] website we’d order servers, the servers would arrive. Somebody would unpack them. Somebody would take them into the data center. We would then, we would then coordinate the activity to actually put it in there. Then we’d bring in a different networking person who would connect up the networking and do all those things.

And that’s before we even installed the operating system or had anybody come on and define the VPN, the routes and all that other stuff that needed to be done in order for that to be to happen. And then I pick up my phone. I go, I can now provision an [00:17:00] entire data center from this phone and the next three minutes.

literally I can go on and provision as much compute and storage as we have downstairs in this, in our core data center with a credit card in a couple of minutes. And it didn’t require me to go online ordering. So if I can do That shouldn’t that be the model for this organization? If we were about the, and the answer is yes, that should be the direction we’re going.

And I say, okay, if that’s the direction we’re going, then we still need some, do we still need a data center? Do we still need somebody [00:17:30] to clean below the floors? Do we still need somebody shipping and receiving for that stuff? We, while I was at CIO at St. Joe’s, we ate, we emptied this massive room of parts. I walked in and I was like, what is all this stuff? They’re like, this is parts in case something 

Drex DeFord: Spare parts. Yeah. 

Bill Russell: Wow. This is, it was a big room. It represented, hundreds of thousands of dollars worth of IT, equipment, an inventory management system, a person [00:18:00] dedicated to it. and I walked out of that room. I looked at my CFO for the it organization. I’m like, okay, we’re getting rid of that room. And everything it represents. We’re getting rid of it. Yeah. 

Drex DeFord: I think it’s, you’re always going to, we looking for efficiencies and you should always be looking for efficiencies and you should tell your team that it’s part of your expectation, that they will always be looking for efficiencies and you’ll do the best to, not make that turn into something where somebody loses their job.

We’ll do our [00:18:30] best. If somebody loses a job to try to figure out another place for you or a way to retrain you, or a way to use you in a different way in the department. But. efficiency. These are how we are going to continue to be able to do more with less. You do more with less, not by working harder, but by finding waste and taking it out of the process by finding efficiencies and implementing those efficiencies as a way to do your work better.

And it is a thing that I [00:19:00] think, like you said, you have to be really careful about ever saying, I promise that we’ll never lay you off and that you’ll always have a job because you just don’t know what’s going to happen tomorrow. Something crazy could happen. And we, could change computing forever.

It can change what we do forever. So you can’t really make that promise. But I love what you’ve said. I’ll always work my promise to use it. I’ll always make you better than you are. I’ll work to make you more valuable either to me or to someplace else. And if you have to go someplace else, [00:19:30] that’s also something that I’ll do very graciously.

I’ll help you make that transition if you need. 

Bill Russell: And the best people to work for by the way is if just watch when they have to do, because every organization has to do cuts at some point, watch how they do it. If it’s just, if it’s just a day event where hey, people came in, they were told they were let go.

They walked out with a box that’s that doesn’t say much for the organization, but if they go out of their way to write references, to make phone calls, to [00:20:00] make connections, to utilize their network on your behalf, that’s probably an organization you want to be a part of. Cause. You just, it just communicates a better culture.

They care about the people while they’re at the organization and beyond, right? 

Drex DeFord: Yeah. Yeah, no doubt. 

Bill Russell: A rapid $5  test doesn’t need specialty equipment. So Abbott labs came out with a $5, 15 minute test. for coronavirus, this is, this is a significant move. And actually, I’ll talk about this in the [00:20:30] context.

Cause you’re one of the people I’d want to talk to about this. Let’s see. So NPR. Yeah. 

Drex DeFord: I don’t know though, for five bucks I get a subway sandwich or do I want a coronavirus tests? I don’t know. I’ve dealt with that long. 

Bill Russell: Yeah. So my wife called me today. She goes, Hey, you should cover this on your show.

I was like, all right, storyline. And it was an NPR story. So I went out and it’s a, if you hit the NPR website, you can actually listen to the story. And they have a reporter at the University of Missouri and a reporter at the University of [00:21:00] Illinois. And they talked about how university colleges and universities are handling this differently.

So university of Illinois has mandatory testing. And it’s a saliva based test that they developed at university of Illinois or Brianna smart people go to go there and work there. And they develop this test. They administer 10,000 tests per day on the campus. They had 300 positive cases when people came back and they said they [00:21:30] anticipated that.

they thought that was going to happen. There’s people that didn’t know they had it. There was people, 300, 300 out of a, I don’t have the total number of students, but I would imagine it’s a state college. tens of thousands. So that’s probably a pretty good percentage.

70% of their classes are online. So here’s what they did. you’re required to test before you come back on site, you’re required to test during the day. And the reason this is a technology project is because they’re implementing a health passport. Okay, so you [00:22:00] can have the test results on your phone, or you can have a piece of paper, not as techie as we would like, but essentially you have to show that before going to class, it’s a health passport.

Which I think is interesting. So the second they talked to the university of Missouri, no mandated testing to come back onsite. no testing. you can get a test if you have any symptoms while you’re at the university, they’re doing in-person classes for freshmen [00:22:30] and a lot of the other classes are online, but a majority of the freshman classes are in person.

the people, and what’s interesting is that they interviewed people at both universities, they interviewed people at the university or a student at the university of Illinois. And she’s I don’t mind the lines. This is great. I know that the person sitting next to me, doesn’t have COVID they interview the person at the university of Missouri and they’re like, Hey, I appreciate it.

I’m getting the full college experience and those kinds of things. It’s a, I almost don’t want to [00:23:00] comment on this because this will get us into a really grey area. I thought it was fascinating. That, the different approach. And my daughter goes to college right now. I had to decide whether I was going to send her back.

And I think it’s fascinating, these colleges, I think they’re, you can tell which ones have academic medical centers. You could tell which ones are partners really well with the healthcare community. My daughter’s university is really well connected. She goes to Baylor. [00:23:30] A great academic medical center.

They partnered, they did a lot of great stuff. And, I talked to her a couple of times now and she feels really relatively safe on site. They’re wearing masks everywhere. university of Illinois, they’re wearing masks everywhere. I didn’t pick up the university of Missouri if they’re wearing it or not, but this is a, this is an interesting.

I just thought it was an interesting story. I don’t know if you want to comment, go ahead. But if it gets too political, I want to throw up my hands. 

Drex DeFord: you and I have had a little bit of this debate [00:24:00] online on LinkedIn, along with several other people who have commented on some stuff that you have posted about this on LinkedIn.

So I actually really liked the idea of being able to do. Part of this, Is ultimately not just being able to do a test, but it’s, do you have a whole infrastructure program in place to do contact tracing and everything else? And if you don’t then, one part of it, it’s one leg of a stool, stool only has one legs and not the other two it’s going to fall over.

So all of that sort of has to be taken in context, but if you [00:24:30] do have a comprehensive program. At the university, then you also have to look and see, do you have a comprehensive program in the community? Because it’s probably unreasonable to expect that those kids are only going to stay on campus and they’re not going to interact with anybody from off campus.

And that also then gets to other issues like. Is the health system in that community already overwhelmed with COVID cases and other things. Then maybe those schools shouldn’t be back in session until, things get squared away. So some of it’s common sense. [00:25:00] I love the idea of having.

Some kind of a passport on the phone, I get tested every three days and yeah, it’s updated on my phone and I’m working with an early stage company right now. Who’s doing something like that right now that would allow you to do things like show up, eventually show up at a football game and say, Oh, I can show that.

I’ve been tested so I can bypass the line. That’s the temperature check and the question set and all of that, I get the 

Bill Russell: A TSA for football games, [00:25:30] is that what you’re telling me? 

Drex DeFord: Or for thing that, that people would wind up. I’m going to even going to class, You can show your code walk right in, or you could do, you don’t have, if you don’t have a code, you have to get the temperature tech and check in the question, set and set on a different, in a different part of the room or something like that. There’s probably a hundred ways to skin this cat, but, yeah, definitely been a big topic of conversation about going back to school, going back to university.

Yeah, 

Bill Russell: I [00:26:00] hope nobody’s developing a health passport app. It makes no sense they should. We can just put it in Apple wallet or whatever Android thing. If I can put my movie tickets, my plane tickets and everything else, I can put my health passport in there. And so I just hope no one is spending millions of dollars pursuing a health passport specific, unless they have ideas for how it’s going to expand.

But. No. I just find that interesting that the article that you and I [00:26:30] disagreed on, if people are wondering. So I now post, I take one of the stories we’re going to talk about. I posted that on LinkedIn every day, I put a little commentary. And right now they’re getting a lot of back and forth.

In fact, I’m going to go over here. The one you and I disagreed on was, I think the school one or the contract racing one, one of the two. 

Drex DeFord: I don’t know. So for everybody who’s listening right now, I know sometimes you think Bill and I agree on everything, but. That really not to be the case, which is actually why I [00:27:00] love the guy we get to talk and debate about a lot of stuff and we do it reasonably there’s never any shouting or hand waving.

Bill Russell: You’re left of center. I’m right of center. I happen to be an environmentalist who’s right of center. I don’t know if that’s, if that even makes sense to people but anyway, so I put the thing out on contact racing, you and I went and did deep dive into contact racing a while back, but there’s still a lot of back and forth of other countries have done this and they’ve done it big time.

[00:27:30] And I’ve seen some CIO saying, Hey, we’re doing this across our campus, but generally speaking, bringing the patients or even, a school population of students into it just feels like it’s asking a little bit too much for our society right now, our society in the United States

Drex DeFord: We’re super suspicious from a privacy perspective in some ways, right?

So on this topic, everyone seems to be really concerned that [00:28:00] I’m not sure I want somebody tracking where I’ve been. And even if it’s the identified, will everybody do what they’re supposed to do? And if everybody is a participating, does it really make it worthwhile? And so I’m really scared, but we’ll use Facebook and Twitter and Amazon Alexa listening on all of our conversations and all of that.

We don’t seem to have a problem with. So there’s some, probably the wrong word, but there’s some bipolar problem that we have around privacy. when it comes to something like this, I’m like, dude, come on, this could save your [00:28:30] life. It could keep you from getting your grandma infected, but the people are really skeptical about it. I understand why 

Bill Russell: You knew gave me the They asked, Bill Gates, why aren’t we more effective on the whole response to COVID-19? Why are people buying in those kinds of things in a one word answer? You know what? It was freedom. He said, this country is more free than other countries, in other countries you don’t have a choice, but to do contact tracing, you don’t have a choice what to do, wear a mask. And, in our [00:29:00] country, we’ve been brought up that, no one gets to bully you. No one gets to tell you what to do. And unfortunately, That stuff equates to, Hey, you have to wear a mask or no one gets to tell me what to do. Wait a minute. there’s a rational argument here for wearing a mask and protecting each other and those kinds of things, but there’s just this knee jerk of freedom.

We were taught, what was the old thing don’t tread on me and actually, yeah. Yeah. Those revolutionary war flags. Yeah. You know my rights are [00:29:30] my rights, All right. Anything else on that? th the other thing I put, the, CDC I talked about last week, the change from HHS to CDC, I don’t really want to talk about that anymore, but it did remind me of that Saturday night live skit member, where they used to have Roseanne Roseanna, Danna.

She would go off on something and be really adamant on something. And then somebody would say, Roseanne, It’s, she’d have a word wrong or something. It’s we’re saying it’s actually this and she’d go, Oh, nevermind. That’s what it felt like. It felt like they were like, [00:30:00] we’re going to do this.

This is going to be good. We should do this. Then all of a sudden they just go, nevermind. Back to what we were doing. 

Drex DeFord: There’s a. It’s definitely, it continues to be interesting to watch happen. It whats watch what happens between the CDC and HHS. it’s the classic right hand, left hand, challenge.

And, even the issue of, they’ll issue guidance, CDC will issue guidance, and then even the CDC will come back the [00:30:30] next day and say, nevermind, we didn’t mean it like that. and so it’s, it makes it hard, right? it creates a general purpose trust problem that I think makes the dealing, figuring out how to deal with the pandemic even harder.

Bill Russell: Yeah, absolutely. I agree. You need clarity to address a problem. You need clarity. And, that’s, it’s welcome to have clarity that I am curious on this, Google cloud Amwell coming together. [00:31:00] Oh yeah. A hundred million dollar investment and they’re going public. are you worried at all? with Google there’s, we talk about the surveillance economy that exists, If people. I think people are just ignorant of the amount of surveillance that is actually going on. 

Drex DeFord: Yeah. 

Bill Russell: Yeah. So when we say, Hey, we’re going to, we’re going to track you for COVID. They’re like, no, you don’t get to track me. It’s like you realize if you’re carrying an Android phone, you’re being tracked every which way but Sunday.

[00:31:30] Drex DeFord: Stories that sort of show. Oh, here’s where all the cell phones that were located at the Sturgis motorcycle rally went to after they left Sturgis. Now none of those people consented to be monitored on their cell phones and where they’re going, but it happens and it’s a de-identified and it’s publicly available and you can go look at it. It’s. Yeah. You’re exactly right. we’re being monitored all the time. They’re folks always tracking us. They may not really know who we are, [00:32:00] but we’re being tracked. 

Bill Russell: What’s. Google’s why I won’t to ask you that question because you have no idea what Google what’s in their mind here, but does the privacy aspect concern you at all?

Google has the deal with Ascension, the deal with Mayo. They have the, now they have to deal with Amwell. They just did a deal. Fairly, did a deal. I saw on the news on stop loss insurance as well. Google’s making their bets, they’re making their place right now. Are you worried about that [00:32:30] privacy aspect as Google searches step in, would you like to see more from them in terms of a, I wouldn’t mind if Google themselves came out with a patient bill of rights that said we won’t use your information in this way, we will only use it in this way. That would be interesting. 

Drex DeFord: Yeah. Yeah, I think, for all of the companies and honestly it doesn’t matter who it is, whether it’s Microsoft or Google or Amazon or whoever. TRansparency is probably most important being readily able to, [00:33:00] and willing to ask, answer questions about how you’re using the data that you’re getting.

An  having those conversations turned into, like you said, a bill of rights or clear places where you draw a line and say you can’t use it like that. because a lot of people are putting, getting data put into the use. Big data machines, these big data companies, and they don’t really know where it’s going or how it’s being used.

And they’re trusting that it’s being de-identified, we’re not totally sure. Which means in a lot of [00:33:30] ways you’re operating in the blind and as a consumer, you don’t know where your data is going and what it’s been. I think it’s interesting too, to see Google and Amwell come together.

There’s a little bit of a hurry up and get in the telemedicine game while it’s hot, issue. And then, I don’t know if you saw the article from CT Lynne at the CMIO at the university of Colorado Health, I recently did a blog post be talked about how telemedicine skyrocketed. [00:34:00] And then now it’s trailed back off and they’ve gone from a hundred visits a week to something like 8,000 visits a week.

That’s where they are now. But. In person in clinic visits are back to sort of 95% of where they were. So overall they’re seeing more patients and maybe more efficiently because they’re using telemedicine for some of that. But the idea that telemedicine was going to change everything. I still think it’s, we’re on a slow plotting course to get to the point where as much [00:34:30] stuff as we can do by telemedicine, we will eventually do. we will do virtually, but, but it’s interesting to see from his notes and his diagrams that like things really turned around for them. they still do a lot of telemedicine visits, but in person visits went right back to where they were pre-COVID.

Bill Russell: Here’s my take on telemedicine at this point, it’s going to snap back. There’s no doubt it’s going to snap back because you just have to follow the money. And, that will dictate that people are going to come back into the office. They’re going to get [00:35:00] higher reimbursement and those kinds of things.

And generally speaking, if a doctor says, Hey, come into my office, you’re going to go into their office. That’s one, one aspect. But the thing that the expectations have changed, so the consumers are more readily open to telehealth. So if you would have said. Six months ago to people, Hey, we want to see you via telehealth. They’d be like, ah, I don’t know. But now almost everyone has experienced it and they’re like that wasn’t bad. 

And so if you, now, some people mess it up a little bit and the first impression wasn’t [00:35:30] that good, that’s bad. some people, the scheduling was a little off and whatnot.

We threw some things together, but generally speaking, not that bad. So there’s going to be things where they go. Hey, you know what, for my followup visit more than happy or for a visit where I already know I’m sick. I just need you to prescribe something. You want to do a telehealth visit? Sure. Yeah, let’s do that.

So I think that’s going to be one aspect. The other thing is the health systems that [00:36:00] really have thought are starting to think through where video and, in virtual care. Start to bake in. And there’s a bunch of them. There’s a lot of conversation going on in this, whereas virtual care that going to be baked into our normal care processes and whatnot, they are, they’re going to position themselves for the future.

And there is going to be this future of aging in place, out of the home, that kind of stuff. And so a lot of conversation going on there. [00:36:30] And then quite frankly, I think there’s an opportunity for significant. Efficiencies to the health system that brings their smart people together and starts to look at, where they can insert a video between clinicians and consults and things that may be round rounding that weren’t as that they were forced to do in COVID.

Maybe they can step back and say, Hey, you know what? That actually worked pretty good for us. 

Drex DeFord: A lot of that is like in [00:37:00] house telemedicine sort of stuff. when it came to things like rounds or somebody just couldn’t be there physically, but they brought them in, by video because you know that the doc had some preexisting condition and didn’t want to be in the hospital, but was able to be on rounds, using, A cow or something like that.

A lot of those things going in preserving PPE by being able to do a tele ICU thing with a patient, as opposed to. putting all the gear on and going in to do [00:37:30] one little thing and then coming out and having to trash all of that, the gear that you just put on, all those things, or turn out to be like really good habits and probably good for the patient too.

and definitely protects, in some cases protects the clinicians. So it’s, there’s a lot of, we, we learned a lot of stuff I think, and we’re still learning a lot of stuff that, that we shouldn’t throw out. we should. Keep using, keep leveraging these ideas. 

Bill Russell: So let me, so one of your, you’re my cybersecurity guy, [00:38:00] you’re one of my cybersecurity guys. The, so I love this story. So I highlighted today. It’s probably the one that got the biggest uptake of all the stories I’ve done over the last two weeks. And it is based on Tesla. There’s a Tesla employee that was offered a million dollars to implant malware. And instead of doing it he actually worked with the FBI.

So it was worth the cyber attack. And I just posted this question. if I had a million dollars in some malware, could I [00:38:30] entice someone at your company to insert code, to gain access to critical information? And I guess my question to you, cybersecurity expert is how worried do we need to be about internal attacks about our employees being. I don’t know, being coerced in some way to a plant malware or ransomware or those kind of things. Is that a common thing? 

Drex DeFord: I think. in a nutshell, in a simplest form, that’s what fishing is, That [00:39:00] you send somebody an email and you ask them, something, you give them some piece of information that they’re really interested in and they click on a link and they accidentally install malware. And you’re not even paying them for it. You’re giving them something that they think they want and that, and then they accidentally missed step. I think we saw it with, the. Twitter breach a couple of, a month or so ago where, the kid from Florida. Went in and had some kind of conversation with a Twitter employee who had some kind of super [00:39:30] user access to Twitter accounts.

And, he gave up the username and password or something, and suddenly the Bitcoin kid was out there posting under, all kinds of celebrities names. Hey, send me a thousand dollars in Bitcoin and I’ll send you $10,000 back. And, he rounded up a lot of Bitcoins cash. so I think if. you have employees who will do it accidentally. There’s certainly the possibility that you have employees that would do it for. [00:40:00] Payment. It’s probably just a matter of, what’s the number and then the individual, I don’t know. this is like everything else, right? People are just doing some kind of calculation in their head about the risk of being caught, the amount of damage that it might actually do if they took part in it.

And how much do they want a million dollars. yeah, I think the risk is there and it’s something we have to look out for all the time. 

Bill Russell: So it’s probably not common that somebody is going to knock on your door and say, let’s go out for lunch. And, [00:40:30] I’m willing to give you money to put this malware in it because it’s just as easy at this point to get you to click on an email.

Drex DeFord: You’re out another way to do it. Yeah. this is the, the problem with these, With these kinds of cyber crimes is that once you bring one more person into it or two more people into it, that you’re way more likely to be caught. So if you can figure out how to maintain your anonymity and get somebody to do it accidentally, then.

Your odds of being caught are [00:41:00] very slim, but if you’ve got to pay somebody for it, now that’s another person that’s in the conspiracy. And once they’re caught there, 

Bill Russell: We’re not trying to train the hackers here. 

Drex DeFord: Oh no. 

Bill Russell: Be as blunt as you can.

Drex DeFord: This is. I think this is a, I have a friend at CA security who does a Facebook live every week. And, the same conversation comes up. as when we may be talking about things, there are times where I’m just. Oh man, don’t say that out loud because he like, bad [00:41:30] guys are listening, his opinion about this, he’s a CISO. is that anything that I’ve thought of? There’s tons of people that have already thought of it. So even if you think it’s a genius idea and nobody’s come up with it, people have come up with it. 

Bill Russell: yeah. Yeah, gotta stay one step ahead. yeah. Hey, thanks again for hosting the show a couple of weeks back. I appreciate it for sure. 

Drex DeFord: That was great fun 

Bill Russell: The ratings were so good. I’m thinking of having you do it every week, you have a real job, 

Drex DeFord: okay. I’m sure we can figure something out, but it was great fun. I appreciate you trusting [00:42:00] the brand to me for a week, cause I surely could have wrecked it but unfortunately I didn’t.

Bill Russell: it’s a recorded show. So you couldn’t wreck it too much. Y

Drex DeFord: You wanna review it before it goes out anyway 

Bill Russell: I was on vacation, but my staff wasn’t so they still reviewed the, all this stuff. I do trust you, Drex. I’m just saying there’s checks and balances in place. Anyway. Hey, thanks.

Thanks again for stopping in this week, [00:42:30] we didn’t really get to dive into anything too deep, but it’s always fun to just go through the headlines with you and, and see what’s going on in health. It, yeah, 

Drex DeFord: I get a kick out of it. Thanks. And anytime I’m happy to come on. 

Bill Russell: Fantastic. All right. That’s all for this week.

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