News Day – Chief Telehealth Officer? CMS Crackdown on Reporting


Bill Russell

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October 27 2020: Who will lead telehealth in your health system? Is there a perfect point person? What strategies are health systems utilizing to move beyond the four walls of the hospital? What are the unintended consequences of remote work? What will it take to bring people back? We explore the hybrid work model versus working from home. How do we get better at automation? And better at efficiency? How can we utilize tools that are not as labor intensive? How do we get better at management structures within IT so that we can create margin and capacity? Focus and funding is the answer. We saw that during COVID. We got so much done when we were laser focused and funded.

Key Points:

  • CMS requires reporting on COVID and the flu [00:04:45]
  • BayCare Health System and Tampa International Airport announced the launch of the country’s first airport testing pilot [00:07:30]
  • What does it look like to get back to work? What is a safe work environment? [00:08:33]
  • CMS will now pay for certain cardiac and pulmonary rehabilitation services [00:21:35]
  • Children’s Hospital Los Angeles launches 26-hospital pediatric digital innovation accelerator [00:22:35]
  • Mayo ramping Google partnership back up and plans to open AI factory [00:23:50]
  • We often joke that most health visits start with Dr. Google [00:27:03]


News Day – Chief Telehealth Officer? CMS Crackdown on Reporting

Episode 320: Transcript -October 27, 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] [00:00:00] Bill Russell: [00:00:00] Welcome to this week in health IT. It’s Tuesday Newsday, where we look at the news, which will impact health IT. We’ve got a lot of great stories this week. I posted a bunch out on LinkedIn. Who’s going to lead telehealth, a Trump administration crackdown couldn’t come at a worse time for hospitals, a little back and forth on that. Very interesting conversation. We have some voice stuff, Telehealth stuff, some HCA, returning their cares act money. There’s a bunch of interesting things to talk about this week. My name is bill Russell, former healthcare CIO, coach [00:00:30] consultant, creator of this week in health IT. I set up podcasts, videos and collaboration events dedicated to developing the next generation of health leaders.

[00:00:38] Thanks Sirius Healthcare for supporting the mission of our show to develop the next generation of health leaders, their weekly support of the show this year has allowed us to expand and develop our services to the community special.

[00:00:49] Thanks to them for supporting the show’s efforts. 3x Drex. If you’re not signed up yet, Drex DeFord has a tech service. He sends out three texts, three times a week with three stories vetted by [00:01:00] him to help you stay current, to receive these texts, text Drex: D R E X to four eight four eight four eight. If you don’t know, Drex DeFord is a frequent contributor of the show.

[00:01:11] Don’t forget to join us next week, Drex DeFord and I are going to do a special election day. Get out to vote kind of Tuesday news day. And we’re really looking forward to that conversation. Love for you to join us.

[00:01:22] All right. Man – I have 35 stories in front of me. We are not going to get to all of them, but, Hey, we’re going to [00:01:30] start out on LinkedIn. You guys have been engaging with the posts and it’s been a lot of fun to, to go back and forth with you.

[00:01:37] Ah, let’s see. Let’s start back here. This was about a week ago now. And I asked the question who should lead telehealth at healthcare providers. I set it up as a poll and I asked, these are the options, CIO, Chief digital officer CMIO, COO CMO, VP of Telehealth, Chief telehealth officer or other. And, wow. we got a bunch of [00:02:00] comments on this, a lot of views on it. One of the first ones was cracked me up was, I had my friend Sherri Douville whose been a guest on the show throw back at me a show that I just recently did with David McSwain, where he actually answered this question. but we’re going to assume that David McSwain does not all knowing and omniscient, although he did comment here as well, and he is extremely knowledgeable on the telehealth front. In fact, he says, it really comes down to the culture of your organization and the willingness enthusiasm of those leading the effort to work collaboratively [00:02:30] across the organizational structure, regardless of their role or title. Bottom line, as many as many have mentioned, is that true? Telehealth is healthcare as such integrating it effectively requires expertise in many areas, compliance, billing, operations, clinical, technical quality, et cetera. And no one person. In fact, no one team can do it effectively alone. I agree with that. No one team could do it effectively alone.

[00:02:54]My point here, I think in asking the question is it would appear to me that someone [00:03:00] has to be the energy. Somebody has to be focusing the energy of the organization and the efforts of the organization, because you could be doing telehealth, telemedicine, you could be doing teleconsults.

[00:03:10] You could be doing a lot of different things in a lot of different ways. how do you prioritize what’s going down? I guess if you have really good governance within your organization, that’s easy. but at some point, even some of these smaller organizations, aren’t going to have this choice of “who do you give it to?”

[00:03:23] It’s going to have to be somebody’s other job, John. let’s see, what did John say? CEO, ProTalent [00:03:30] advisors, “I like your idea of creating a telehealth officer, likely adding another CMIO CNO type to your overhead and would pair them up with a stirring committee-steering committee made up of clinicians, business operations and specialized.” And I agree with that. the, again, I just come back to, it feels to me like someone needs to lead it and I don’t know who that is. but, it really, it can be the CIO. And I think in smaller organizations, it will probably be the CIO. Chief digital officers, interesting, because they’re thinking [00:04:00] of new venues and new ways to generate revenue.

[00:04:02] So perhaps it makes sense there. No, VP of telehealth, chief Telehouse officer is actually one of my least favorite, ideas. We don’t need any more administrative overhead. I don’t think unless your organization is really highly focused on this. And, sees it as their next major move. Clearly American well or Teladoc would have someone in that type of capacity or type of role.

[00:04:27] And if you’re health systems making that kind of major move, maybe it [00:04:30] makes sense to do that. Yeah. Again, a lot of good, a lot of good comments you should take out that post a lot of great back and forth. I can’t stay on that one post the whole time. Otherwise I get lost. let’s see. Trump administration crackdown couldn’t come at a worst time for hospitals, and this is the story of they are, requiring, so the CMS is requiring a reporting on a COVID and flu.

[00:04:51] And if you don’t report, there’s a risk of your CMS funding. Great. And I think there’s some aspect of this that has to be reported [00:05:00] electronically. And, I started this with a little bit of a Snarkey comment. I’m sorry. I don’t want to be admitted to your hospital if you can’t do basic reporting with a 14 week lead time.

[00:05:10]Now I also understand, like I have empathy. I understand there’s a lot of things coming your way. There’s also 11 new codes. We’re recoding things, there’s a massive amount of requirements on this same team. but at the end of the day, we already collect the flu information. The COVID information we’ve had since July.

[00:05:28] It just feels to me like if you can’t [00:05:30] do this high priority item, make room for it, that there’s other issues at play there. And I would be concerned of being actually admitted into your hospital and I’m not, I that’s, I say it’s snarky, but at the end of the day, I would be concerned. And I have been in hospitals where I’ve taken my father-in-law in the hospitals and those kind of things, where the administration was so bad, it made me question the quality of care.

[00:05:53] And I don’t think I’m the only one I think, I think we equate, the cleanliness of the hospital and the hospitality of the [00:06:00] staff. And we equate that with, are we receiving good care? And all of those things become important and, and if you have a outdated, if you’re handing me a lot of papers, I immediately scratch my head.

[00:06:12] If you’re handing me an app, that’s really outdated, it looks silly. if you have a URL that is not secure in any way, all that stuff drives home a brand problem that’ there. Now, I did make a mistake in this post, so I will correct it here. One of my physician friends reached out to me and [00:06:30] said, Hey look, we haven’t, we, the reporting of the flu stuff was voluntary and it was a lot of, it was retrospective. It was done at the end of the flu season. So this does represent a change for that. Although he did go on to say that, That, my concerns are still valid, that not being able to produce this information is a cause for concern about that health system.

[00:06:51]Again, a lot of good back and forth really appreciate everyone. All the comments, And, all the things that you guys are talking about, I’m just, I’m sorry, I’m reading them as I’m going [00:07:00] through this and some of them are really good. Alright. Next one. What strategies are health systems utilizing to move beyond the four walls of the hospital?

[00:07:07]So anytime there’s a, any time there’s an event like this, like COVID, there’s a significant change in behaviors and habits and in ways people consume services. Now we’re seeing that all over in the way people are shopping. Absolutely. And the way people are traveling, we’re seeing it absolutely.

[00:07:25] But I think we’re going to see it in healthcare as well. And, I call out to this article calls [00:07:30] out one, and that is a BayCare Health system has partnered with Tampa international airport and they’re offering a screening at the hospital. So COVID testing at the hospital while you wait, when you come in those kinds of things.

[00:07:43] And now before you’re to flippant on this. I live in a community where, it, before you come back before you, cause a lot of people I’m in Florida, a lot of people come North, from the Northeast back and from the Midwest back down to Florida. But before you can start participating in some of [00:08:00] the events here, you have to get a COVID test. You have to show a clean bill of health. So having this done at the airport is not the worst thing in the world. And by the way, you can’t do it in your home state. And then come down here, you have to come down here and test. Down here before you start participating in events. So some of this stuff, we could see some of these other things as some of these testing I think, I guess the most obvious that’s going to pop up. Another one I point out is a, an article Southwest airlines mentioned their collaboration with Stanford university. School of medicine mentioned that last week on the show. I think there’s an [00:08:30] opportunity for academic medical centers to step into this void of how do we get back to work?

[00:08:33] What does it look like to get back to work? What is a safe work environment? I think is a service that a lot of AMCs can offer to the community. I point out that. we have the national football league and major league baseball colleges. They’re really demonstrating how to do this.

[00:08:47] We talked about some college programs and how they’ve been able to keep students on campus through the entire semester. And my daughter’s one of those at a major university in Texas. And all indicate [00:09:00] I have a dashboard that is phenomenal that they have given all the parents, not only statistics of the campus, but statistics of the community in which they serve so I feel pretty well-informed. I get a weekly letter from the president, updating us on the services, the, changes they have made to the testing schedule. Tere’s a lot of things going on for how do we get back to it? How do we get back to work? And I think that’s the question that drives all these things.

[00:09:26]And it is what do we need to do to get society moving again? [00:09:30] I know, and some other obvious ones I think are, the movie industry needs to get started again. So first they need to start filming. And at some point we’re going to get tired of seeing reruns. We’re going to need to start seeing movies in theaters, and those kinds of things.  And, we’re gonna have to do testing. We have to do testing of actors. We’re gonna have to do testing. I don’t know, we just got to figure out how to get industries whole industry’s moving again. like we did with the food industry and the, in the meat packing industry and other things.

[00:09:56] So a little bit of back and forth here, let’s see six [00:10:00] comments on this. This didn’t get a lot of play, to be honest with you, only about a thousand views of this one. What happens? I think I told you this last week, what happens is some of these get a lot of play, this one about the, The Trump administration crackdown couldn’t come at a worse time.

[00:10:14]You got a significant amount, so it steps on the next days just based on how feeds work in social media. And let’s see Hollywood. What about home testing? Of course, the article referencing a study, but this would be an interesting method to try to manage the spread of the [00:10:30] virus. and I agree with that.

[00:10:31] That is a, it makes sense. And my question is who’s going to do that, is that healthcare providers, is that a CVS, Aetna kind of thing, where they’re going to start doing home testing? Is it a home-based care organization? That’s going to do that. So a lot of opportunities and I think it’s, it’s good to be having those conversations.

[00:10:49] All right. I don’t do this often, but I actually reposted somebody else’s posts, Josh Sol, who is a guest of the show, Digital and Clinical innovation leader at Houston Methodist [00:11:00] highlighted a talk that was done by Roberta Schwartz. The chief innovation officer for Houston Methodist and a Phoebe Yang.

[00:11:08] Healthcare general manager for AWS, and they talked a bunch about voice and ambient listening and what is going on. And I decided to, to repost that and the reason I decided to repost it, because I think it’s worth watching, what they are doing. And, is they’re doing ambient listening in the OR which I think is a perfect location for ambient listening, [00:11:30] right?

[00:11:30] You guys, you’re all scrubbed up. You’re all, whatever. we’ve, we were actually struggling with this back in 2014 of, the doctors still need to get information, potentially navigate the screens and see what’s going on and scans and those kinds of things. And there’s been some creative things I pointed out in 2014 with Mostafa Khairzada who’s also been on the show, used to work for me at St. Joe’s and he went to work on, using X-Box connect controller to do hands-free navigation to the medical record. And it was a little, cloogy a little clucky, he had a couple of doctors using it [00:12:00] and they were, they were navigating the record but voice is so much more elegant and I think it’s going to be really fascinating. The reason I highlight this story is at the end of the day, the complexity of voice cannot be overstated. It’s not just as simple as taking that Alexa putting it in the OR and away we go. there’s a distinct distinction in language, right? There’s dialect of course, there’s healthcare vocabularies that have slowed progress, right? The different types of documentation that’s required for an orthopedic visit versus an oncology [00:12:30] visit.  is significant in nature. So you have to get those vocabularies into the system and that is no small task.

[00:12:38] So I think any one of these announcements that come out are exciting to me because it shows that we are making progress in this important field. And I think quite frankly, I think this is going to be one of the areas where we really make a difference in the clinicians lives. They’re going to be able to walk around and say, before they walk into a room, there’s going to be an iPad there said, and they could [00:13:00] say, give me the vitals.

[00:13:01] It’ll give them the vital information or what’s going on. when’s the last time this doctor visited just a whole bunch of information at the not necessarily touch, at the tip of your fingers, but at the tip of your tongue, I guess is your voice. So we’ll say, Hey, next article, pretty important article, right?

[00:13:19]Let’s see, CMS has started correlating all their information on telehealth visits and they said there were 35, 34.5 [00:13:30] million telehealth services delivered in March through June. That’s an amazing, but still unsustainable, 2632% increase in telehealth visits compared to the same time period a year earlier.

[00:13:43]And I asked the question, what level do you think this is going to settle in? And, the I’m a driver for telehealth was safety clearly, right? We had to keep the caregivers safe. We had to keep the patients safe. And so care to distance was huge. the enablers for this were a [00:14:00] reimbursement and there’s still questions about where reimbursement is going to go.

[00:14:03]There was relaxation of federal guidelines and funding of infrastructure. Yes. MFCC money that went out and that was helpful as well. and, things are starting to change now, right? So CMS has the data. They’re looking at a third adjusting reimbursements. They’re being more targeted.

[00:14:16]I don’t think CMS is, if you’ve read anything, CMS is all in on telehealth. So when you see that in pulling back some funding and putting funding towards other things, it’s because they are being strategic, they are looking at it and saying, where are we making a difference? [00:14:30] Where is this actually impacting outcomes  and driving better care, getting to that point. Valerie Leschber. Dr. Valerie Leschber: Bill Russell. Yes. I agree. Virtual care should be a key enabler for pop health initiatives to scale and succeed in their mission. And at least to extend, that I am aware of telehealth as a mode of care has not yet shown specific measures, measurable impact on Hetus performance or change [00:15:00] clinical outcomes for chronic conditions during this COVID fuel Tel pilot, without proof of value, it will be hard to lower our payers to support or better to prefer, recommend. Telehealth modality of care over in real life care. it’s a new flavor of our old circular argument of fee for service versus value based care models. we’ve had for years, Yeah.

[00:15:22]There’s a lot of wisdom there. This is what I’ve been saying all along with this, it’s a huge pilot. We got a ton of information. we may have done some [00:15:30] things, right? Some things wrong. We will find that out. We will also find out where we can actually move the needle where we can’t move the needle.

[00:15:36] And, I think you’re going to see CMS leading here, as long as the, under this administration, which could go on, may not go on. We will know that in a was it two weeks? A week. Wow. Coming up it’s right around the corner. so after the election we’ll know, but if it’s Seema Verma and Azar in the, in that group stays in, what you’re going to [00:16:00] see is a continued push on telehealth on electronic delivery of care, because it drives their costs down.

[00:16:07] And, but again, fee for service, it does not help the health systems who rely heavily on fee for service. And so that’s one of the things that’s going on. John Moore CEO, founder of chilmark research, says it’s likely to sell at about a 15 to 18% of all visits, will certainly be higher for providers in value-based care, capitation versus fee for service, as [00:16:30] we are already seeing, more payers pulling back on tele-health reimbursement and I think that is yeah, 15 to 20%. yeah, that feels about right. regardless of the reimbursement, I think there’s areas where we’ve looked at it and said, Hey, look, this just makes more sense. plus I think you’re going to see the reimbursement continue in some areas.

[00:16:49] All right. I asked the question, ACA returned $6 billion in cares act funds, and accelerated payments. And I just asked the question, what does paying back the cares act money indicate about a [00:17:00] health system. This hasn’t gotten a lot of back and forth yet. And, I really stepped on it pretty quick by putting another article out there, but I’m just curious. so ACA returning the cares act money, it got me to thinking, which first of all, what other health systems return, the cares act money.

[00:17:14] I know that Mayo talked about it. I don’t know that they followed through on it or not. I haven’t seen an article to that effect. And then I started wondering, do I really want health systems to return the cares act money? I’m not really sure at the end of the cares act money was to provide liquidity at a time of crisis. And, [00:17:30] the revenue dropped by almost 40, 50% at a certain period of time. There was a lot of unknowns, we were worried about the liquidity of those health systems for obvious reasons, right? healthcare’s largest employer in most communities. They’re the frontline of the pandemic and they were facing some really dire choices. Let people go at a time when they are needed the most. And so I just threw that out there. Thought I would, just ask the question again. It didn’t get much traction because I dropped another story, which is, Kaiser [00:18:00] Foundation, hospital admissions projected to drop 10% in 2020. Now this one, this one got a little more traction. A 10% drop in hospital admissions. And I ask isn’t that a good thing, right? When we normally consider that a good thing, 10% drop in admission. So 10% less people are going to hospitals. Now clearly if this is people deferring care, that’s not a good thing. And that’s not what I’m saying here, but what I’m saying here is that should be one of our goals, right?

[00:18:26] A 10% drop in people actually being admitted to hospitals. [00:18:30] That’s good. I’d really like data scientists to dive into this number. there’s this sort of theory that, that the, there, the mortality and the sickness is the same year in and year out. I’m pushing back on that theory and saying, look my habits have changed pretty dramatically. And I’m wondering if everybody else’s habits have changed dramatically. And if they’re healthier, right? I, if working from home is healthier. If not driving everywhere is healthier. If I’m not going to the football game and getting a Coke, a hot [00:19:00] dog, and a pretzel is healthier for people. Now I understand there’s ramifications of being at home and mental health and all those things.

[00:19:09] But I guess what I’m pushing on is, are our assumptions correct going into 2021? Are we, is the 10% drop a permanent drop or is it a blip that we’re just going to see it come back because mortality and, and sickness is constant and it doesn’t change even though a lot of things have changed.

[00:19:28]Dan Howard commented on [00:19:30] this. Dan Howard’s a, friend who, we interact a bunch on social media. “I would hope that the investments and efforts in education and patient engagement strategies over the last several years is resulting in healthier communities and populations. yes, need for deeper dive into the details of this sort out deferred care versus healthier populous. Many pre COVID behaviors that are negative health multiplier smoking, and drug abuse, poor diet, exercise habits, et cetera. Will those change moving forward. I like to think so and believe, one [00:20:00] of the silver linings of COVID is that it puts a spotlight on personal health and personal responsibility.”

[00:20:05] I love that optimism and, agree with it, an awful lot of that in, from this perspective, We have done a lot of patient engagement strategies. We’ve done a lot to get people thinking about health. We put a lot more tools out there. We have texting tools. We have apps out there. we have tech partners who are putting apps out there.

[00:20:23]I know if you do individual studies, you’re like, Hey, that’s not taking hold. That’s not taking old. Maybe all of it’s starting to take hold. [00:20:30] I, I tend to be optimistic about this stuff and, if you hammer on a on a problem long enough, it, you tend to make some money progress.

[00:20:39]We’ll start last comment and then I’ll get to some other news headlines, Will Stewart. I sometimes feel like healthcare is like the auto industry. Imagine if I had an insurance plan that said that allowed for a mechanical coverage on my car. Every time I took it to the shop for maintenance. I would bet that as long as it was covered, something would need to be replaced.

[00:20:58] I think our financial model [00:21:00] sometimes rewards unnecessary interventions, and that could be, right? we’re not showing up for appointments because we’re not showing up for appointments. We’re not being admitted to hospitals. And it could be the case. I’m sure if we go back in history, look at some of this stuff, we will see that, history will show that, this would not be, an unprecedented thing to have that be of that occurring within healthcare.

[00:21:24]Some of the headlines. So let me check my time real quick. See how many headlines I can get to. [00:21:30] All right. 24 minutes. I’ll do about five minutes headlines. Here we go. CMS will reimburse 11 new telehealth services during the public health emergency. this is aged a little bit. I didn’t get in front of this one.

[00:21:41]You probably already know about it, right? So there’s, and if you don’t, this is from healthcare finance news worth hitting the story. but there’s a lot of it out there already. So CMS will reimburse 11 new telehealth services, during the public health emergency key and operative word being there during the public health emergency. So this is what people are talking about. [00:22:00] Is this stuff going to continue? I don’t know if it’s going to continue. I would suspect that, this is a major issue in this election and I would imagine that if the money is there, this will continue. It’s a bunch of stuff. They’re also providing support the, so there’s 11 new services they’re also providing support, for state Medicaid, children, health, chip agencies and their efforts to expand access to telehealth through the lease of new supplemental, to its state, medicated chip telehealth toolkit. All right. So there’s a [00:22:30] lot going on there. So let’s take a look at some of the others, children’s hospital, LA launches accelerator for pediatric digital health. I always love these stories and I may have touched on this before as well. Now that I think about it, sometimes my headlines, I get a bunch of them, but I’ll hit on it real quick, just in case I didn’t, I liked these things. So children’s hospital LA incubator 30 hospitals across the US and UK Australia, with technologies companies focused on increasing digital innovations on [00:23:00] pediatric patients. Again, fierce healthcare article. I just like it. I like bringing all these, like-minded, similar problems together.

[00:23:09]it focuses the energy of the innovation community. It gets, some, visibility into, some of the things that, these tech startups are doing. If you’re doing anything around pediatrics, I would, I would get into this and participate. This is it looks like something. I would love to be a part of if I was in a children’s hospital that is [00:23:30] launched by children’s hospital of LA, 30 hospitals participating, I’d imagine it’s a fair amount of good, good participation and, interaction from all those health systems. Next article Becker’s I have a bunch of Becker’s articles here. I went through their, their print issue, September print issue, this week and pulled out a bunch of articles.

[00:23:50] So Mayo ramping up Google partnership, and plans to open AI factory worth a read. This is Chris Ross. Again, previous guests on the show. And, he [00:24:00] goes into, how the pandemic has affected their, efforts with regard to, moving forward with Google and how they worked with Google through that. And he also talks about some of the IT investments they’re planning for next year. if you want to, I always keep an eye on, I keep them keeping an eye on Cleveland clinic. I keep an eye on Mayo clinic. Keep an eye on, just a handful of health systems out there that have the funds and the wherewithal to let me know, figuring out the future, isn’t all that difficult.

[00:24:28] You just have to keep an eye on [00:24:30] somebody who’s ahead of you. And Mayo is generally going to be ahead of most health systems just in terms of how they operate and how they organize. And you can, take a close look at that and determine which of their initiatives and they’re very vocal. they’re out there, they’re in the market space.

[00:24:46] They’re talking about all the things that they’re doing. so keep an eye on them. Keep an eye on Chris Ross, keep an eye on, John, Halamka keep an eye on, I keep an eye on what’s going on at Cleveland. and actually the New York hospital there’s disrupt a bunch of great hospitals out [00:25:00] there. They’re doing good stuff to stay ahead of.

[00:25:02] Let’s see suit dismissed over patient data, sharing by Google University of Chicago. All right. So this is news because I think as people start to dig into this, and you can go after Google with, Google and their partners for the medical records stuff. But I think as you start to dig into this, what you’re going to realize is they’re following all the right procedures and protocols.

[00:25:26] They knew this was going to happen. there’s people when you generally say, Hey, my health [00:25:30] system since sharing data with Google, you have this immediate visceral reaction, Oh my gosh, somebody’s going to be able to search for fill in the blank disease. And they’re gonna, a picture of me is going to pop up in the search.

[00:25:41]Those two data stores couldn’t be further apart if you tried. there, if any of that Google data, if any of that medical data shows up in a Google search, more than likely it came from the health system, there was a breach of the health system and it’s being shared that way. There’s very little chance that the stuff that’s being shared with Google [00:26:00] Health is going to end up in the search. So anyway, this suit was dismissed. I would imagine this will push back on anybody else who’s thinking about, going after them saying, Hey, I didn’t give them permission to share my data with Google. we’ll see. We’ll see what happens. We’ll see how this pans out. Other big news for Google is the push by the federal government.

[00:26:19]I don’t know if I have a story in here on that. I don’t but anyway, so the federal government, going after Google for anti-competitive practices, I [00:26:30] believe again, this is Bill Russell’s opinion, but I believe we’re going to see at least one tech breakup in the next five years. And the next four years, four or five years, we’ll see a tech breakup. And I think Google is the most likely candidate for that. Their search capabilities at this point, make them a, a likely target. they are the Rockefeller of, search, right? So John Rockefeller had a monopoly on oil back in the day when oil was [00:27:00] everything and search and data and information is everything today.

[00:27:03] And we joke about Dr. Google, most health visits start with a, With a visit to a Google search. And, that’s true across the board. Somebody once told me, I think it was Aaron Martin once said to me, the check that Amazon hates, that Jeff Bezos hates writing the most, every time he turns around is that check to Google, because he has to get positioned on Google for the placement of Amazon goods [00:27:30] and services, Amazon doesn’t stand on its own, even as big as Amazon is, they have to, put money on the altar of Google, to make sure that they are not forgotten. And Google has that kind of power right now. So it’ll be interesting to see how this, federal government, going after and really looking at the competitive practices of Google.

[00:27:47]Let’s see, consequences, roadwork, the unintended consequences of remote work three health  system, CO’sS on new challenges and what lies ahead. I’m actually hosting this week. I’m [00:28:00] actually hosting two event with CIO, CTOs and others, for vendors and, people who’ve pulled me in to be really a moderator facilitator. And I think this is going to be a significant topic. I think this, in fact, I know it is, how what is, what does the model look like to bring people back? And these are three people. I highly respect, Andrew Rosenberg, MD CIO, Michigan medicine, Reed, Stephan vice president, CIO st. Luke’s health system in [00:28:30] Boise, Idaho, and Joel Vanko, senior vice president, chief information and digital officer Baystate health.

[00:28:34]And two of them have been a guest on the show and I know Reed, pretty well. this is a Becker’s article worth a read. If you are trying to figure out the, the, hybrid work models versus the work from home, when you’re gonna come back, what culture looks like, how you train your employees, how you train your managers to work with your employees.

[00:28:56]Yeah. And how people are thinking these are three good minds on, on [00:29:00] this subject. Again, I just do headlines in this section. So if you want to check that story out. It is worth checking out. let’s see. One or two more Intermountain health here to cut 250 business positions. I think it’s interesting that they focused in on business positions. So it’s administrative type positions that were, that were cut. And, that goes along with a significant amount of cuts and furloughs over the previous year. I think there’s just underscores. We have to get better at automation. We have to get better [00:29:30] at efficiency. We have to utilize, tools that don’t require as much labor and are not as labor intensive.

[00:29:37]We have to get better at our management structures within IT so that we can create margin and capacity, where there is seemingly none. today we’ve got to be always looking for those, those ways that we can, create focus. And that’s one of the things I’m talking to people about is focus is so important. We saw that during COVID. We got so much done when we were focused and [00:30:00] funded. And so that the role of CIO is to get a funded. and to really create that focus of the team always knows what’s the most important thing to be working on and to be moving towards getting that done. let’s see. So Cerner unveil some stuff at their conference, unveils new interoperability tools as CEO, Brent Shafer says  and I think that’s true.

[00:30:23] And I think that’s true for, For Cerner, I did not comment. I didn’t bring this to the LinkedIn, [00:30:30] community. And, again, I like the stuff that Cerner’s doing, their, their partnership with AWS, I think gives them the ability to tap into things and really move this moves the needle forward quicker and again, a lot of this stuff is good. And I really have, They’re they’re utilizing, the voice technology. So you have, Hey, Epic. Now you’re going to have, Hey, Cerner, that’s a me too thing, but you would expect that, it’s also in a partnership with nuance. I don’t expect any, ground breaking, [00:31:00] types of things, from them that you won’t get from Epic, to be honest on that.

[00:31:05]I think the area where they’re going to be able to really make a difference is in the analytics space, the machine learning and AI space. And so that’s the place. If I were Cerner right now, I’d be stepping on the pedal. and, and also the, clinical usability, if I can make my EHR that much easier, where you finally have Cerner, users at conferences saying, I got my life back it [00:31:30] they’re utilizing, AI and machine learning in ways that, are giving me time back. it’s searching massive amounts of information. It’s calling that information. It’s putting the most important information in front of me so that I am actually saving minutes of my day. And, I’m actually practicing medicine at the top of my license because of the way that the machines are helping me to practice.

[00:31:53] I think that’s the opportunity that Cerner has. I’m not sure anybody else really has a Meditech may have that in the smaller health [00:32:00] systems. I don’t hold out much hope for, Metatech being the innovation arm, but I do, continue to be a Meditech fan. just. some of these systems are getting very expensive. It’s expensive to run Epic. It’s expensive to run Cerner and Meditech just is a, is a nice self-contained runs a hospital. gives you the, compliance reporting and things you need, but I don’t expect, I don’t expect to see the major innovation. From them now, hopefully, Hey, if somebody from Meditech [00:32:30] wants to come on, talk about those things more than happy to do that.

[00:32:32] If somebody from Cerner wants to come on and talk about some of these announcements, always happy to do that and Epic as well. Let’s see, is that the last one I want to talk about? Hey, a lot of activity on cyber. I decided purposefully not to talk about cyber today, although I should be it’s like cyber awareness month or something to that effect, but I’ve been talking about it for the last five or six weeks.

[00:32:52] So I decided not to, but again, a lot of activity there, visual is important. keep an eye on that. Wow. I hit a [00:33:00] lot of these stories. Those are the headlines I give you the headlines to tell you what’s going on. Hopefully you’ll go out and, read some of these and, stay current on what’s going on, which is one of our, one of our goals.

[00:33:13] Hey, we, that’s about all for this week. We want you to participate in the conversation. follow me on LinkedIn. Bill J Russell. Now you can follow the show at this week and I’ll have it, but follow me on Bill J Russell and I post a story every day and you can participate and go back and forth with me on those, on those [00:33:30] stories. If you think I missed the mark, send me a story [email protected] Say Bill,. I don’t know why you’re not covering this story. This is the most important thing that’s happening in health. It more than happy to give it a look and a covered on the show. that’s all for this week. Don’t forget to sign up for clip notes. Participate in the, in the clip notes referral program. And if you don’t know what that is, go ahead and listen to one of our episodes from last week. I shared a bunch of information. There’s also information on our website about the referral program. You can win an opportunity to be [00:34:00] sit across the table while sit across the zoom call with me and discuss health IT news, on this show.

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