News Day – EHR Workloads in Azure and AWS and is Cloud right for Everyone

News Day – EHR Workloads in Azure and AWS and is Cloud right for Everyone

Episode 329: Transcript – November 17, 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: [00:00:00] Welcome to this week in health IT. It’s news day where we’re taking a look at the news, which will impact health IT. Today, gosh, there’s so much going on. We have a bunch of stories. We’re going to talk a little cloud. We’re going to talk a little oh, we’re going to talk a little, biotech revolution around the vaccines.

[00:00:22] I think that’s interesting. We’re going to talk a little interoperability, things that are going on there. And my gosh, there’s a [00:00:30] hundred stories. We’re gonna talk some Zoom as well. If you’re wondering what’s going on with zoom, they’ve got a bunch of security patches and they were just sort of dinged for not being as upfront as they could be around their security posture prior to COVID. So we’ll see where that goes. My name is bill Russell, former healthcare CIO, CIO, coach consultant, and creator of this week in health IT a set a podcast videos and collaboration events dedicated to developing the next generation of health leaders. Speaking of developing the next [00:01:00] generation of health leaders, I want to thank Sirius for supporting that mission. Their weekly support of the show has allowed us to expand and develop our services offerings to the community. And we are very thankful for Sirius and all that they’ve done. 3xDrex is a service of Drex DeFord, a frequent contributor of the show, and sometimes cohost of news day. And one of the things that Drex does is he curates stories and he sends out three texts three times a week with three stories that he has [00:01:30] gone through his feeds and said, these are important for health it leaders.

[00:01:34] And it’s a great way to stay current. I use it for this show to receive these texts. The easiest way to do that is to text. Directs D R E X to four eight four eight four eight. All right. We’ve got a lot going on. Let’s get over to the conversation this week. Let’s go to LinkedIn over here. I’ll hit some of these stories, real quick.

[00:01:57] Hey, there was a lot going on. First of all, kudos to [00:02:00] CHIME. They did a phenomenal job. I love the virtual platform that they used it almost. I mean, clearly we’re all still sitting in our offices. We’re sitting in our, at our homes. It’s, it’s a time where COVID-19 is surging in a lot of markets.

[00:02:18] If you’re like me, I signed up, I attended four sessions. I struggled because my calendar was just getting hammered this week. I’m trying to land some consulting projects. I wasn’t able to do [00:02:30] that and attend all the sessions that I wanted to, but the four I did attend, really well done the virtual platform that they utilized also I thought was a really well done. I didn’t hit any of the, the keynotes. I wish I could give you more feedback on that. just, there’s a lot going on as there’s lot going on. And I think that’s one of the things that has been, sorta out there, which is we have record numbers of people signing up for these [00:03:00] events for the health event, for, for the various conferences this summer.

[00:03:06] and maybe even this chime conference, I have no idea what the number of signups were. but at the end of the day, I think we’re all struggling to carve out time. And if we are leaders for healthcare, we may want to help our staff to carve out that time and just dedicated, to go into some of these conferences. If we think there’s value in the conferences, because I know for me, Trying to juggle all those [00:03:30] things was extremely hard, but again, for four sessions, I did go to a really well, a couple of, guests of the show were on panels and they were excellent as always. So, I’m not going to go into too much detail on that.

[00:03:44] I just wanted to give the chime team just some applause for, for what they did last week. I thought it was really well done. All right. Let’s get over to LinkedIn where we are continuing the conversation with you guys. Now, you guys were busy this week. I get it. I understand. [00:04:00] Not a lot of back and forth, but I want to give you some of the stories that we shared.

[00:04:04] If you are interested in participating and going back and forth on some of the stories, I would be sharing a story on Monday, Tuesday, Wednesday, Thursday, Friday, every day of the week. I share one story out on LinkedIn. You can follow me at Bill J Russell. And then just put your comments in, what do you think of some of these stories?

[00:04:21] So for example, a week ago, I pulled Seema Verma’s article. She’s the administrator for CMS, and she wrote, [00:04:30] every patient has a right to know the price of their care upfront. Anything less is unacceptable. And I just posed this question. I’m curious if anyone disagrees with this. Price transparency, we have it everywhere else. Right. Before you buy anything else, you know how much it costs and you make a decision you should, right. Am I going to fly first class? Am I going to fly a coach? Am I going to buy a leather couch? Am I going to, but we don’t do that in healthcare. And we don’t allow [00:05:00] that to even happen in healthcare. And it’s something that I feel pretty passionate about that people should be given the option. They should understand what it, what it’s going to cost for their care and what it’s going to cost for their medications and those kinds of things. In fact, we’re doing a show tomorrow where we highlight a company that’s bringing that that information of what the medications are in the costs to the point of care.

[00:05:25] So the doctors can actually look at it, see what’s covered. What’s not covered how [00:05:30] much is covered in what medications will cost that individual that’s sitting right in front of them. So they could see this patient and say, this medication is going to cost us. The next patient needs the same medication. It could cost something entirely different based on their plan. That information is being brought to the point of care. I love those kinds of solutions. I think that’s exactly what we need to be doing, and that’s a great way for technology to play. And I also commented here, Scott, Becker’s been running some great posts on LinkedIn. He had, the [00:06:00] seven, seven or eight things that this election means and one of the things he pointed out. Was, he said a price transparency, which is supposed to start on January 1st may or may not be enforced. By the way, I agree with his statement. I don’t like his statement, but I agree with this statement. I think he’s right. That it may not be enforced. And I think that’s actually kind of sad. I wish it was enforced price. Transparency to me is not a. political stance in any way, shape or form. It really should be a [00:06:30] right of the patient to know how much their care is going to cost. I know there’s a lot of challenges around that, but at the end of the day, it’s my care, it’s my money. It’s my life and how I choose to live it and spend that money, really should be a choice that I get to make. And I’m not sure why we would push back, but we have pushback as an industry. We pushed back. We say, this is too much work it’s too hard, the healthcare systems can’t [00:07:00] possibly comply with helping people to know how much their care is going to cost. I don’t think that’s true. so I’m going to continue to, to hit that theme because I think it’s something that, I mean, I’ve yet to run across somebody who says no, no, the patient shouldn’t know what, how much they cost. I think some, we all agree on. I’m just not sure why we’re, we’re not pushing it forward.

[00:07:20] Anyway, that was the first article. Not a lot of back and forth on that one little disappointed. I was kind of hoping we get some back and forth, but you know, it’s a political time. People are worried about what they’re [00:07:30] going to say on posts and on social media, because they don’t want to get, canceled. I guess. So, the second post, I didn’t expect a lot of back and forth on, and that is the Zoom 5.0 upgrade. If you went to zoom, for whatever reason, you may have gotten it. Zoom is your platform for collaboration amongst the administrative staff, you may have gone to it for any various forms of your telehealth. You might be using it for a virtual consult. You might be using it for patient visits. [00:08:00] There’s a lot of different places we could use it. You’re going to want to look at this zoom 5.0, upgrade a bunch of encryption things, bunch of things to defend against zoom bombing and other stuff. so take a look at that. Just know that it’s out there and worth staying ahead of. 

[00:08:16] The next post just got a lot of, Hey, that’s really interesting. That’s really impressive. But again, a lot of back and forth, I’m not sure I expected too much back and forth. This isn’t really health it per se but Pfizer came out with a [00:08:30] vaccine, which is really fascinating to me.

[00:08:32] And I said, this isn’t your father’s vaccine. And, it really is new thinking for a new world. And I’m just going to read from the article. It’s another wondrous miracle of the biotech revolution in which knowledge of genetic coding will become as important as digital coding and molecules will become the new microchips.

[00:08:52] So we’re going to program molecules the same way we program microchips, vaccines work by stimulating a person’s immune system. [00:09:00] One traditional approach is to inject a weakened version of the dangerous virus. That is the way we now fend off measles, mumps, rubella, chickenpox. Another method is to use a version of the virus or a part of the virus that has been totally killed. Right? So then your body just generates the antibodies to that virus. Well, in steps, Pfizer in really changes the game. So the success of the Pfizer vaccine means that the plague year of [00:09:30] 2020 will be remembered as a time when traditional vaccines began to be supplanted by genetic vaccines instead of delivering tiny and safe doses of the virus itself, these vaccines deliver a piece of genetic coding that will instruct human cells to produce on their own, components of the targeted virus. These safe components can then stimulate the patient’s immune system. I just think that’s fascinating. I think it’s fantastic. [00:10:00] Again, most of your comments are just, Hey, this is, this is really interesting. So w we’ll just have to keep an eye on this and, this is one of the vaccines that is out there, and there’s a lot of, a lot of positive talk about this vaccine. So we’ll see, see where it goes. 

[00:10:16] All right. The next story. I pulled this, considerations for cloud-based EHR hosting hospitals, CA CIOs and CTOs weigh in. So I’m hearing an awful lot of talk of chatter of, [00:10:30] webinars of, different health systems, exploring this. We’re hearing of an Epic in Azure instance actually going for DR we’re also seeing, Epic workloads on AWS, or at least let me rephrase that. I don’t know anyone running Epic workloads in AWS yet but I do know that AWS is doing webinars on putting Epic workloads in AWS. We know that Cerner workloads in AWS is happening because Cerner signed the big deal with AWS.

[00:10:58] And, I [00:11:00] just asked, what are your thoughts on this? Great quote in here, Jeff Alpert, the former CIO at Valley Presbyterian hospital, recently retired, made this comment. Other industries identify their core values that they bring to the market and everything they do is in service to that. A lot of wisdom in that statement, by the way, what is your core business? What do you bring to the market? Why are you going to the cloud? What does this enable you to do? in going to the cloud? [00:11:30] And Jeff makes this distinction between large health systems and community hospitals. He says for community hospitals, I think it’s hard for, from a sustainability perspective to find a reason to host anything. That’s anything he’s saying it’s hard to host anything and think about it from a community hospital perspective. You’re probably you’re, you’re running a lean ship. I mean, cost is probably your number one driver. If cost is your number one driver then running Meditech [00:12:00] is your lowest cost EHR. You could run the Meditech in the cloud, but do you want to commit to those ongoing costs? Right. So you’re going to have an ongoing monthly cost, or do you just want to set it up in your data center, buy those servers with some capital dollars and then run that stuff really, as long as you possibly can, That has been proven to be one of the lowest costs routes to go in. And Jeff makes that distinction. He also goes on to say large [00:12:30] systems and integrated delivery networks. However, may have different requirements and greater need to manage locally. And I’m a proponent of the cloud, but primarily for agility. Right. Being able todo things, rapidly respond rapidly, like to say a pandemic or to a new reporting requirements or, to stand up AI capabilities or machine learning capabilities, to integrate in, in ways that you weren’t able to integrate before. There’s an awful lot of reasons to go to the cloud.

[00:13:00] [00:12:59] Most of them around agility, the ability to do things that you couldn’t normally do. but I often have to warn health systems about two things. one is cost. There’s an ongoing cost of moving to the cloud and for some health systems that that cost is not sustainable. The second thing I have to warn them about is lock-in. Right. So you to avoid lock and you have to put the right architecture in place, which is, some sort of abstraction layer so that you can move it from one cloud to the other. If you don’t put that as attraction layer in, you’re going to [00:13:30] end up with a contract that’s similar to your EHR contract.

[00:13:32] We don’t switch EHR every three years or five years because new features have come out in the other EHR. If you don’t do this, right, you’re not gonna be able to switch your cloud provider three or five years from now either. So, architecture around lock-in is really important. And I’m just wondering, we, now, we now live in an era where, EHR workloads, which are traditionally done locally are now being, advertised and capabilities being brought to [00:14:00] market where we can run those EHR, workloads in the cloud.

[00:14:04] And I’m wondering what your health system is thinking around that. Now this, this one hasn’t gotten enough time to really, to really, Get too many comments out there, but I’m curious if you have some comments that is out there on LinkedIn. Love to hear your comments. What are your, what are you thinking?

[00:14:22] Are you thinking? Or, are we in that era cloud first? We got to get to the cloud. I remember like four [00:14:30] years ago at chime, everybody was cloud cloud cloud cloud. First. We’re a cloud first health system. I’m not sure what that means, but, I guess it means that anytime you’re looking at a slow solution, you’re look at cloud first. It doesn’t necessarily mean you select cloud, but you’re looking at cloud first and again from an agility standpoint makes perfect sense. But from a, doing the best thing for your health system, you may have to step back and determine, what’s the right solution for, the direction that you’re going and for, [00:15:00] and I think Jeff is right for community hospitals. You may have to ask yourself if the cloud really does make. Since, and I think security plays a lot into that as well, but. I don’t want to get too lost in this one story. All right. Right. That’s the, that’s the LinkedIn conversation again, if you want to participate, follow me.

[00:15:16] Bill J Russell on LinkedIn, go out there. Go ahead and comment on some of the stories we’re going to get back to the news in just a second. There’s three things I want to make you aware of next year. we’re going to be adding articles to this week in health IT. That’s a big announcement in and [00:15:30] of itself, but we’re also going to be building out our contributor network. If you want to learn more about being a contributor to this week in health it by writing articles in 2021, please shoot us a note at [email protected] the second thing I want you to be aware of. the ClipNotes referral program is in full swing. I want to thank those who are who have already participated, for those who haven’t send an email to someone today and let them know about the show and about clip notes and [00:16:00] they can sign up by hitting the subscribe button on any of the pages on our website.

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[00:17:30] [00:17:30] Let’s get back the news. Let me tell you some of the headlines that are out there. All right. So first one, we’re going to hit. And this is healthcare IT news. Interoperability in cities is improving but small hospitals lag still behind. Of the 15 cities examined Cleveland had the highest rate of hospitals that are reported to have the ability to find send, and receive integrated electronic health information with sources outside their health system according to a new report from the ONC, And so they, they talk about [00:18:00] that, but they also go on to talk about a hospital and the 8 cities showed major improvements since 2015 was Chicago leading, the proportion of the facilities, engaging in the interoperability, improved in the windy city by about 140%. That’s fantastic. only but then they. They go on to talk about smaller hospitals, only 44% of small hospitals engaged in interoperability. According to the brief, compared to 58% of the medium and large ones. Similarly, independent hospitals [00:18:30] are less likely to engage in interoperability than system owned ones. Only 13% of small independent hospitals reported finding, sending, receiving an integrating data. And, a lot of that has to do with resources, right? If you’re a smaller system, you don’t have the resources, the financial incentives, aren’t there for them to share information. There just isn’t a financial reason for them to share their information with another hospital? There are [00:19:00] absolutely, reasons to support the health of your community, to, cut down on over prescribing drugs. I mean, there’s, there’s a million reasons to do it that are, it’s just the right thing to do. But again, from a financial standpoint, if you’re just trying to figure out how to keep your doors open as a small hospital, this isn’t going to be one of your top priorities sharing information.

[00:19:23] And so that really comes up in this and I’m wondering what we’re going to need to do there in order to make that happen. [00:19:30] And this could be one of the areas where we just see consolidation really change that metric and really move things forward. Dynamic partnerships, we know a lot of health systems are really pushing their community connect and their and and even their services to smaller health systems. And I think that will help to drive that as well. So that’s just something to keep an eye on. Very interesting. 

[00:19:57] All right. Another story. Why the US still has a [00:20:00] severe shortage of medical supplies. So we have a surge going on in, several markets. my, one of the markets I’m familiar with is, one that my daughter lives in my daughter and a couple of her friends have COVID right now. And they’re, on the tail end of that. And they’re doing well. But this is a story from Harvard business review. And it’s actually, it’s fairly old September 17th. I don’t know if I’m just now [00:20:30] getting to this or just picked it up cause it showed up in my feed. But at the end of the day, there is a strategic national stockpile and, which was created under George, the G W Bush. So W Bush administration, it was originally. Set up as a safety net in case of short-term threats, such as bioterror attacks was not designated to [00:21:00] handle APA DEMEC of this scale. So they go on to talk about the, the, SNS and that the profiles too low and how to expand it and those kinds of things. So Harvard business review article, if you’re interested in that, that is a that’s interesting. I think, that’s one of the things. We will see a lot of conversation over the next year. It’s just around public health and pandemic preparedness. And hopefully we will get in front of some of these, some of [00:21:30] these challenges. I think we have a manufacturing challenge for drugs that we have to take a look at. We have a, we have, obviously some PPE supply challenges that are going to be need to be addressed as well. 

[00:21:48] Let’s see what other articles do we have here? All right. Here’s an interesting piece of the press of ransomware. What security leaders need to know? Mitch Parker wrote this. Mitch has been on the show before [00:22:00] and, he is the chief information security officer for Indiana university health. And he gives a couple bullet points here. it’s in health systemcio.com. Again, it’s the price of ransomware. What security leaders need to know worth a worth taking a look at I, this one fascinates me, the Vermont governor deploys, national guard and response to the UVM cyber attack.

[00:22:22] Now, I don’t know if they followed through on this, but it looks like they were getting ready to the combined cyber response teams [00:22:30] will assist the university of Vermont health system. Health networks, sorry. In ensuring thousands of end-user devices are free of malware and viruses. So you have a governor deploying the national guard to help their health network, stay safe. I think that’s interesting. if nothing else, this is in healthcare IT news. I don’t know if they follow through on this, if they did. I think it’s. I actually [00:23:00] probably an interesting use of the national guard. And if the health system didn’t have enough resources to, to put up a good defense, I D it’s interesting. I never, I never thought of the national guard being deployed in that way and might be, something to keep in mind, in the future. All right, this one’s a little off the beaten path for me. A good win law.com department of justice announced, announced this [00:23:30] massive healthcare fraud. Take down, focus on fraudulent telemedicine schemes.

[00:23:35] Okay. On Wednesday, September 30th, 2020, the department of justice, along with the FBI department of health and human services and the, OIG. And drug enforcement agency. Wow. Announced enforcement actions involving 345 individuals across 51 districts. And what the U S government described as the largest healthcare fraud takedown in the agency’s history.

[00:23:57] Collectively the cases announced [00:24:00] in the nationwide enforcement operation, alleged more than 6 billion and false and fraudulent claims to private insurance and federal health programs, notably the largest portion of the alleged fraud. Some 4.5. Billion relates to schemes involving telemedicine. Wow. The provision of healthcare services remotely, rather than in person through the use of an internal or the phone, these, wow.

[00:24:25] That’s an awful lot of fraud. 4.5 billion in tele medicine fraud. [00:24:30] So anyway, Goodwin law.com is where I pulled that article up. And I just think that is fascinating that we’re looking at that level of fraud and that’s something, that I’m sure they’re going to continue to look at. moving forward.

[00:24:44] All right. I mentioned the Scott Becker posts, and I actually pulled one of those up. It’s not necessarily a news story, but, it’s, it’s an interesting post. So Scott Becker wrote, wrote a what to expect now, and this is post election, seven points. His first point was health systems, as well as the [00:25:00] state and local budgets have been hurt badly this past year, they can probably expect a little more support from DC.

[00:25:06] Number two, Biden, if need be, we’ll try to strengthen the ACA. Or parts of it via executive order. The most important parts of the ACA have been two-fold. One is preexisting conditions and two regarding Medicaid expansion. The other provisions while directionally important have not been had as much impact.

[00:25:25] Again, I love the fact that Scott’s writing this stuff. and [00:25:30] putting it out there. The third point, ACA concepts regarding behavioral health are also important and will be supported. I think that was going to be true regardless of the administration. but, that is absolutely true. Behavioral health has taken center stage.

[00:25:43] It is going to continue to move forward. So something to keep in mind. COVID will be a top priority in 2021 vaccines. and the logistics of that will be a huge priority. I think you may see a national mass mandate but I don’t think national [00:26:00] closed down policies more likely vaccines and mask takes center stage.

[00:26:06] I don’t think you’re going to see a national mass mandate because, if I remember correctly, I read an article where it is, they can’t do it and they, they just can’t do it. The States have the ability to override it. So I think what you’re gonna see is, Joe Biden really building a coalition of governors who are going to support the mass mandate and push it forward [00:26:30] in their, in their States.

[00:26:34] So, again, I’m not sure, but he’s absolutely right. And COVID is going to be the priority in 2021. Hopefully we’ll get through a significant majority of the pandemic. We will have a vaccine, hopefully early in 2021. And then we will start the task of trying to get that vaccine out, which will be, challenging in and of [00:27:00] itself.

[00:27:01] Number five, price transparency, that was supposed to start January 1st, which we talked about before. Number six, Medicare for all and public options and other issues may need to wait for serious discussion until 2022. However, lots of politics on both sides if becomes, it becomes a big item in the election year for Congress.I think what he’s saying, there is at least at the time of this writing, it was looking like we were going to have a, split, Congress, house of representatives and [00:27:30] Senate being split. By party, which means that, you weren’t going to have any major, legislation around healthcare. it was all gonna have to be done with executive order or they were going to have to get bipartisan legislation.

[00:27:42] I don’t know why we just write off the fact that we can’t do bipartisan legislation anymore. it’s just seems kind of counterproductive to me. It would be nice. If people started from the assumption that we can actually get things done. The next thing was a pharmacy drug pricing is very difficult problem because nation wants, the [00:28:00] new drugs being developed badly like president Trump, you may hear more noise than action. And I think that’s true. I think drug pricing is a significant issue but not an easy one to tackle. So let me check, let me check the time here. Let me check how many, all right. Let me close with this article. It’s a, I think it’s an important article for us.

[00:28:25] It’s an important topic for us as health IT leaders. Are you at risk of [00:28:30] burnout? Okay. It pros are spending more time working remotely. These tips can help you to keep calm and carry on during these times of change. other than people who are frontline medical workers, it has been the hardest hit when it comes to job stress and burnout said Andrew Schatte, S C H A T T E co-founder and chief knowledge officer at M equal me  M E. Quill Librium, a science-based resilience training program. Our provider, we saw many [00:29:00] experienced sleep disorders, a drop in their motivation. The best we can surmise is that a lot were put under pressure. When companies move to remote work, some it workers were expected to continue to show up since they were considered essential, that could put an additional strain to them worrying about their health and safety of the health and safety of the people they love. as it turns out, burnout is a as real as it is stressful in 2019, the world health organization named burnout as an official medical diagnosis. Okay. burnout [00:29:30] symptoms. Well, you heard some of them stomach ache, headaches, back pain, anxiety, sleeplessness, anxiety causes a downturn in quality of our sleep, but he said our sleep essentially, But sleep is essential.

[00:29:44] If you’re going to avoid burnout. Right. you may be experiencing anger, frustration, sadness. we’re also seeing a lot of spiking and shame with thoughts that we’re not beating our own standards in the world. for example, I’m not, I’m not doing [00:30:00] anything well, or I’m not a good parent partner or employee.

[00:30:03] These are signs because burnout symptoms are difficult to recognize it can, keep. it can help to keep a journal suggest dr. Ted, sun, organizational psychologist, and president of transcontinental university, a non-profit organization that offers programs. the human brain is brilliant at making up reasons to justify one’s decisions, even when they are poor decisions, sunset using a journal to note down certain thoughts [00:30:30] and behaviors, and then reading it to assess the major change is one self-diagnosis tool. look for people who are normally aren’t emotional, but who seem to be starting to flame out. He said, anxiety and frustration are understandable, and these emotions are normal. But if a person isn’t taking care of themselves or they’re coming late to a meeting, Or they’re procrastinating with their work. They may feel isolated. Disengage, a disengaging from work is a sure sign of burnout. So they go on to talk about us as [00:31:00] extinguishing burnout. Self care is the first step towards addressing work burnout. Make sure you’re getting enough sleep. You’re eating well and you’re exercising. Although healthy habits are always good. They don’t address the root issues. According to son who believes companies must therefore take responsibility as well. Leaders should help people develop positive responses to stress in the workplace and focus on empowerment as a mindset. I said son who suggests providing courses on empowerment to employees, as well as changing procedures to [00:31:30] give them more control over their environment.

[00:31:31] A development of emotional intelligence will be key. and they go on, business issues consider first, which tasks are actually value. Add for your in-house team to carry out and might require intrinsic organizational knowledge to complete. He said from there, consider outsourcing the tasks that are highly repeatable or might require less internal strategy. I used this, I mean, not necessarily that I would jump on all these things, but I use [00:32:00] this as a backstop for a discussion around burnout. This is a very real thing. We’re all handling this stress, just a little different, and we’re going into another season of surge, which means that we’re going to put added pressure on your team. They might have their children at home. Again, they might have a home stress that you’re not familiar with. We know that there have been hurricanes, there have been fires. There have been people displaced by fires. [00:32:30] A big part of being a manager today is organization and it’s being a psychologist. It’s identifying those people that are disconnecting. It’s having the conversations. it’s making yourself available. It’s having one-on-ones, it’s being able to be accessible, to discuss things, to give people. The the right amount of time [00:33:00] to encourage people to sleep, to, to take care of themselves, to exercise.

[00:33:06] Now you can’t force people to do any of these things. But it should be part of your thought process at this point as a leader. Now CEO’s get this, I’m talking to CEOs all the time. They have programs. They’re thinking about it. They’re encouraging people. It’s the next line of managers. It’s the next generation of health leaders who we’re talking to here.

[00:33:28] This is part of the, [00:33:30] part of the deal is how do you take care of your team? How do you identify those things that are going on in your team and how do you take care of your team? This is something you should be, reading articles about and something you should be really stepping forward and leading as strong as you possibly can in this area. This is a stressful time. We just had an election. There’s a bunch of people that feel disenfranchised. we have, we just mentioned that the fires, the hurricanes, the pandemic there’s home things [00:34:00] going on, the divorce rate is up significantly. during the pandemic, people are now talking about not being able to get together with their family for Thanksgiving, who knows what Christmas is going to look like. These are very trying times for all of us. And if we are leading a team in any way, shape or form, we have to be aware of that. And we have to be asking the right questions, promoting the right behaviors and encouraging, [00:34:30] encouraging people as much as possible to take care of all for this week. Don’t forget to sign up for clip notes. If, send an email, hit the website we want to make you and your system more productive. If you have somebody who’s told you about cliff notes, go ahead and put them in as a referral. we would like to, send them a gift and thank them for making you aware of clip notes.

[00:34:55] Special thanks to our channel sponsors. They have been phenomenal this year. And I [00:35:00] really appreciate all of them. VMware, StarBridge Advisors, Galen, Healthcare, Health Lyrics, Sirius Healthcare. Pro Talent Advisors healthNXT and McAfee for choosing to invest in developing the next generation of health leaders.

[00:35:12] This show is a production of this week in health IT. For more great content check out the website this weekhealth.com. Also check out our YouTube channel. We continue to do some really cool things there. If you want to support the show, the best way to do that. Sign up for clip notes, share it with a peer. Please check back every week we’re going [00:35:30] to be producing three shows. Stay Wednesday and Friday. Thanks for listening. That’s all for now.