April 6, 2020

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April 7, 2020: It’s Tuesday, and you know what that means: It’s news day. Today, Drex DeFord joins us to walk through some of the latest stories making headlines. Bill kicks off this episode by reflecting on some of the field reports he has done over the past week. He has spoken to CIOs around the country and has seen some incredible, varied responses to the pandemic. As demand for the show continues to grow, Drex has come on-board to interview CISOs, so that we can get a clearer idea of the progress being made as well as the challenges that lie ahead. Drex shares some of the difficulties in the security space, from email phishing to how the fast-paced development could leave gaps in many organizations. We then talk about furloughs and discuss how several hospitals around the country are dealing with the issue. While it is disconcerting to see hospitals letting so many people go, they are businesses and have to make tough decisions. There is a clear tension between smooth business operations and optimal public benefit, which will continue to unfold as the crisis progresses. Finally, Drex and Bill talk about field hospitals. As a veteran, Drex has extensive knowledge of the subject and provides some excellent insights from how they are set up for sharing information and more. Bill and Drex also touch on the positive long-term changes they hope the crisis will bring. We need to use this as an opportunity to rethink so much of what we’re doing and hopefully change for the better. Be sure to tune in today!

Key Points From This Episode:

  • Find out how Drex has been keeping busy and what he’s doing to facilitate dialogue.
  • A recap of who Bill has interviewed over the past week and his main takeaways.
  • Some of the main security issues and concerns that Drex discovered during interviews.
  • The long-term dangers of laying healthcare workers off or letting them go on furlough.
  • Positives that have come from coronavirus should be built on for public health benefit.
  • Why Bill believes that post-pandemic there will be a great deal of IT innovation.
  • Learn what it takes to get a field hospital to stand up and details of the one in Seattle.
  • Additional accommodations COVID field hospitals have made that aren’t used in combat.
  • What Drex thinks will happen with getting data to the field hospital.
  • How CIOs can maintain the digital innovations in healthcare post-pandemic.
  • Some changes Bill and Drex believe are likely to last once the pandemic has tapered off.

News Day – Field Reports, Field Hospitals and Furloughs

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News Day – Field Reports, Field Hospitals and Furloughs

Episode 219: Transcript – April 7, 2020

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

[0:00:04.8] BR: Welcome to This Week in Health IT, it’s Tuesday news day where we look at the news which will impact health IT. Today we talk furloughs, field hospitals and field reports with Drex DeFord. My name is Bill Russell, healthcare CIO coach and creator of this week in health IT, a set of podcasts and videos and collaboration events dedicated to developing the next generation of health leaders.

This show has channel sponsors and we have episode sponsors. Our channel sponsors have been fantastic Galen Healthcare, VMWare, StarBridge Advisors ProTalent Advisers and Health Lyrics have stepped up to support a Slack channel for health systems to collaborate and they have also connected us with numerous health system leaders who have provided us field reports from the frontlines. Many thanks to our channel sponsors. 

This episode and every episode since we started our COVID-19 series has been sponsored by Sirius Healthcare. They reached out to me to see how we might partner during this time and that is how we’ve been able to support producing daily shows for the last four weeks.

Special thanks to Sirius for supporting these shows and our efforts during the crisis. It’s Tuesday news day and Drex Deford is on the line and we’re going to talk a little health IT news. How’s it going, Drex?


[0:01:17.4] DS: I’m good, thanks. Man, I’m telling you, you are killing it right now, the content has been terrific. I watched a bunch of episodes this weekend, they’re short, they’re sweet, they’re like compact, loaded with stuff and the Slack channel’s been great too. I have the Slack channel up on my iPad over here all the time, all day, watching the conversation. Thanks for doing this, it’s really been awesome. I think it’s great for everybody.


[0:01:47.4] BR: You know, I appreciate you saying that and how have you been keeping yourself busy? I have the Slack channel, the shows, and you’re now recording some shows as well and you’re doing the Slack channel. What other things have you been doing? 


[0:02:00.9] DS: Yeah thanks, you know, we have – I’ve been doing some work with David Chao on a couple of different things and one of the things is we setup a Wednesday call, we have about 16 health systems, we open up a Zoom meeting and we let it run for about three and a half hours. So, basically just sort of put the offer out there for several participants to say, ”Just drop in and unload on us, right? Come in and tell us what you’re working on and what you haven’t figured out with somebody would come up with and whatever,” and then we write those and also dump them into Slack channel for the people who are participating.


And then we burn those episodes, we blow those episodes away, we don’t record them for notes. But we don’t actually keep them to broadcast. 


It’s just you know, anyway that I can and like you, although I don’t have it figured out, I think as well, you haven’t figured out but any way that I can help to facilitate cross talk, I’ve tried to do that.


 Actually, was on the phone with Russ Branzell this weekend because I was getting calls from CIO’s who were saying, “Do you know so and so’s phone number. Because I’d like to talk to them?” 


And so I’ve tried to make some of those connections but for the listeners, just know that you can always call CHIME and they have probably 80% of all the contacts, CIO contacts that are CHIME members they’ll always help you make that connections. If they call CHIME and they can’t help you call me or call Bill, we’ll figure it out. We’ll help make those connections for you.


[0:03:31.9] BR: Yeah, absolutely. I appreciate your help. We’ve been doing field reports, I’ve been interviewing CIO’s for the last couple of weeks. And this week, I’ve been asked to expand and I’m like, “Well, I can’t expand anymore, there’s only one of me, there’s only one microphone, there’s only so much time.” 


And so I reached out to you, you’re going to be interviewing a bunch of Chief Information Security Officers and doing those field reports and I’m going to continue talking to some CIO’s.


Actually, what I’d like to do is start off the show, I’m just going to do highlights of just a handful that I’ve done and for anybody who has been on, I’m only going to go back to the last seven days, I’m not going to go way back. 


And if you talk about your CISO interviews or even the conference about what you’re learning, that would be great.


We had Steve LeBlond, CTO for Ochsner on and it was a really good conversation. The thing I appreciated about him is he talked about being in it for the long-haul, seven days schedules for IT, planning for backup IT staff in case they get sick. And caring for the IT staff that is required to be on site. Really good conversation. 


Dan Nigrin, your friend, your friend Boston Children’s. He covered telehealth in detail. The use of really telehealth to reduce the amount of contacted nurses are having with COVID-19 patients in the room. I thought that was fascinating.


Nader Marabi the CIO for NYU Langone. I think the thing that was interesting from him for me is even though this crisis is distinct, the talked about how each crisis has prepared us for this. Going back to 9/11, talking about Sandy and how he really was prepared and I also talked to him. Ray Lowe and Eric Lee from AltaMed and I though the fascinating thing with that is they’re with a federally qualified health clinic that does a lot in ambulatory settings.

They didn’t have a lot of cash sitting there to just start throwing, “Hey, let’s telehealth up. Let’s throw this.” They had to be judicious with the money but they also have had the move equally fast to serve their community. Those are just some quick highlights of four of the most recent field reports that we did.


And so you’ve done your first CISO report. What are you hearing out there from the security standpoint?


[0:05:52.1] DS: Well, you know, I had the opportunity and I’m assuming it will probably come out this week that I had a conversation with Mitch Parker, he’s the CISO at Indiana University Health. You know, Mitch is great, I follow him on Twitter, we are constantly – not constantly, regularly are DM’ing each other about things that we’re seeing. 


You know, like most organizations, and a lot of CIO’s that I talk to right now, they have some underlying concern about all of the changes and how fast we done so many things in the last few weeks whether it’s telemedicine or work from home or you know, analytics stuff, all the things that we’ve done to make sure we can support their mission. And a lot of that comes with sometimes when you go really fast, you accidentally leave yourself landmines that you step on later. 


And so I think they’re sort of this process now of everybody’s trying to keep really good track of all the things that they’ve done and how they’ve done them so they can go back and make sure that they haven’t left any booby traps. But that’s going to be I think a process that folks are going to get us through. 


The other thing you talked about was just the amazing amount of spear phishing that’s going on right now from an email perspective .Folks that are sending emails that have really good, great detailed information and email that really makes it super tempting to click on for employees. The complications sort of come from that, come with that is that you have folks working from home now, the dogs barking, the kids are yelling and there’s music playing in the background and you’re distracted and maybe there’s a tendency to click on something that you shouldn’t click on.


You know, that regular drum beat of, “Be careful, there are bad guys still out there trying to get to you no matter what they say.” Because there’s actually some good messaging out there now from some of the hacker organizations saying we’re not targeting healthcare, we’re not targeting healthcare. But we know that that’s happened. 


Just be careful and I’m looking forward to some of the other ones that are coming up too – I won’t say who but I know we’ve got some folks on series.


[0:08:06.7] BR: We’re allowed to let the cat out of the bag for some of the stuff. But let’s get to the news really quick. Actually, I’m getting a bunch of these – two of these stories I’m getting from 3xDrex so I appreciate your service 484848 to Drex. No, that’s backwards. Drex to 484848. Because if you do the other way, it doesn’t  really work and you get those three text messages during the week, Monday, Wednesday, Friday. Actually, you say three news stories but invariably it’s four or five – 


[0:08:39.3] DS: It’s always more than three, yeah. It just depends. I try to cram in as much as I can. I’m limited to 1,600 characters so you know, can only be so big. There’ s only so much I can cram in there. I do my best to get as much in as I can.


[0:08:52.7] BR: yes, I saw the first story is about hospital furloughs it’s Bon Secours story and I’m just going to highlight a couple of them. 


Bon Secours  talked about – they’re going to furlough any staff that aren’t directly supporting the 43 hospital system response to COVID-19. And Bon Secours is – they actually say Cincinnati based organization. I guess they decided that they’re going to take the Mercy headquarters and not the Bon Secours headquarters which is in [inaudible 0:09:22], I believe.


Boston Medical Center is putting about 700 employees or about 10% of its workforce on furlough. St. Claire healthcare out of Kentucky, it’s putting 300 workers. Appalachian Regional Healthcare, also in Kentucky, 13 hospitals, 6,000 workers. And then Baptist Little Rock.


You know, I brought this story up because I think there’s a lot of misinformation, a  lot of concern. I know that Intermoutain said they were going to do some either staff reductions or reduction in pay and then you had the CEO come out and clarify that that was not the case, that they were not going to be doing that. 


You know, what do you make of this, what do you make of this story and the reductions that are going on?


[0:10:14.5] DS: Yeah, I would say my initial reaction is surprise. And you know, it’s just frustrating that given the situation that we have right now, we need all hands on deck. I understand that not everybody is involved in direct patient care and that maybe you have to let some of those people go on furloughs so that you can have the resources that were assigned to them to put in other places. I think in 3xDrex today, I said something like, “When you treat healthcare systems like businesses, they’re going to act like businesses.” And that’s exactly what’s happening right now. That isn’t necessarily the best thing for patients and families over the long term.  


I’ve had a CIO you know, call me and tell me that basically they had to let their project management office staff go. They basically kept their whole PMO and that’s a frustrating, dangerous, long-term problem that we’re going to have to deal with down the road. And it’s just – I don’t know, it’s a challenge. I think it’s a real challenge for health systems and for cultures too when they start letting people go on a layoff or a furlough.


[0:11:36.2] BR: Yeah, you know, it’s interesting. I don’t have any problems with them making these decisions because they are businesses today. They’re making decisions as businesses because they are businesses. And there’s risks, you let your entire PMO go, good luck getting them all back. Now, we don’t know the whole story, maybe they were looking at the PMO saying “This is pretty ineffective PMO.”


I have no idea.


[0:12:00.9] DS: True, there’s always more to the story.


[0:12:03.4] BR: There’s always more to the story. But you know, – healthcare is interesting you know? We – can we afford to have losers in healthcare, you know, if we – if Macy’s fails and they close up all those stores, it’s not really going to have much in a way of an impact, although my Macy’s credit card bill will be less. 


But when a local hospital fails because of bad leadership, it really impacts the community. But you know, what is the answer to that? Is the answer – I was talking to somebody earlier today and they said, “Wow, it’s interesting how all the New York hospitals have come together and the government’s really running that thing. Do you think New York will take the lead and become you know, a state run health system cross the board?”


I was like, “Not a chance. No.”


[0:12:50.1] DS: I agree with you. 


[0:12:51.4] BR: But from a public health standpoint, what they’re doing today needs to stay in place and then be built upon which is they’re sharing information on inventories. They’re sharing information on beds. They’re sharing information on research.


 I mean, just across the board for the good of the community by all means, let’s get that done but if we don’t do this on a national basis, you know, people in New York, if they want different care, they’ll just go to Pennsylvania, you know? 


You can’t do it on a state by state basis. It has to be national basis but today, it’s still business and you know, I would be speaking out of both sides of my mouth because the first episode this year, I did the JP Morgan conference and I said, you know, I really appreciated the Bon Secours Mercy CEO who has done a couple of mergers just amazingly well.


Really well run business, he’s really running it well as a business which gives him the ability to grow and those kind of things. And then to turn around and he does this reduction if I were to say, “Well, how dare he act like a business?” He’s doing exactly what he should be doing as a CEO, I think.


[0:14:02.2] DS: Yeah, I mean, this is an unusual situation, right? I’ve served on public company boards and there are times where I know I’ve talked to friends on other public company boards who have said, “We have made a decision to send everything to China. Which probably wasn’t the best decision for the country but it was the best business decision that I had to make as a board director because my responsibility is to make sure that shareholders maximize their value.”


We wind up in this weird situation sometimes where what we are supposed to be doing and what we want to do are diametrically opposed. And I think we’re facing some of that right now in healthcare, well, we know we have to compete, we know we have to be businesses but there are times where we’re going to need to link arms and say, “To hell with all that, we have to beat back this virus,” and we’re seeing some of that.


Unfortunately, the business acts aspects of this are causing us to lay people off. May eventually cause hospitals to close. Certainly, will put some hospitals and some organizations in positions to be acquired because of the financial stress that they’re going to see.


There’s a lot of shakeout still to come from this. 


[0:15:16.7] BR: Do you think I would suspect that a lot of bail out money is going to go towards hospitals. It will be a lot of different forms, one, look, I’m sitting here as a small business owner, I got my little thing in the mail today from Chas which said hey. If you want to apply for the corona virus relief, I forget what it’s called. But essentially, you know, they’ll help me to pay for payroll, health insurance and a bunch of other things during the crisis with a 10 year low interest loan which could potentially be forgiven at a future date.


I’m sitting here going, “Okay, if they’re doing that for me, they absolutely are – the largest employer in every city is the hospital. They’re absolutely going to figure out a way to make sure that the hospitals hire.” 


And then eventually what you’re going to have is a whole bunch of money coming in from a public health perspective and a whole new series of IT projects be built around this for sharing this information, creating an analytics framework that supports public health.


I mean, I see just a ton of government money coming towards healthcare. Maybe not right now, but soon. 


[0:16:32.2] DS: Yeah, I think that if we look down the road and you have another item on our list, it’s sort of the post-pandemic – what do we do, how do we go through the different phases and eventually come out the other side of this?


 I think that in that article when we talk about it, there’s some good reasoning behind new capabilities that we’re going to need to create to be able to face this when it happens again. And a lot of that is going to be analytics and infrastructure and those kinds of things. 


The challenge right now I think in the near term is – That when I talk to a big health system in the Midwest who told me that they are losing a $150 million a month because they are cancelling elective surgeries. They are a small hospital in the middle of Ohio that says that they are losing $15 million a week because they cancelled elective surgeries. A lot of these organizations don’t have big war chests. They don’t have a lot of money in the bank. They just have cash on hand isn’t really a thing for them in any significant volume.


So they only have to go on a really short period of time in this situation until they start looking at each other like, “I don’t know what we are doing. I don’t know how we are going to get money on whatever it may pay. “That’s why you see some of these hard decisions coming now. These are CFO’s who are being proactive and saying, “I want to make sure we don’t get into a situation where we don’t have any options.”


[0:17:56.5] BR: Yeah it is interesting –  I’ve call this a reset a couple of times and people have started to – that start to resonate with people of saying, “Hey you know what? When we come out of this, we are going to look at our entire project set that we have.” And I think there are some people they’re still sitting there going, “Hey, eventually we’ll come out of it so we’ll just start up all the IT projects again.”


 I’m like, “No. I think you erase the board. And you start putting projects up again,” And say, “Okay based on what we now know, based on what just happened are we doing the right things or have certain things taken a new priority?” 


And my guess is towards the second half of this year we are going to see a whole new set of IT projects and a whole bunch to just sort of go off to the way side. But that doesn’t answer your – yes, small hospitals, rural hospitals, I would guess that the federal government is going to have to step in here. 


Because there is not a quick enough bail out and there is no buyers during this timeframe. They are going to have to prop up a lot of these health systems. There is no doubt about it. 


[0:19:06.3] DS: Yeah.


[0:19:07.6] BR: I wanted to talk to you about a story you put in there as well. Standing up and maintaining a field hospital because you have experience doing this. And this is actually on the Army military site and it is about them standing up to 250 patient Army field hospital in Seattle. What does it take to stand up a field hospital? 


[0:19:29.7] DS: So Army field hospitals, Army medical units, Air Force has a version of that called Expeditionary Medical Systems. These are pre-packaged. They’re usually on a fairly regular basis opened, up exercised, all the expired material or the material that has a life span is refreshed and replaced and they make sure everything works and that it all goes back together and gets repackaged to be able to ship out, right? 


Whether it ships out on a C-130 or a C-5 or whatever the aircraft maybe or it is loaded on trucks and moved across the country in the case of a disaster. In this case that is exactly what’s happened. The Army field hospital components of it are coming from Colorado, major components of it are coming from Joint Base Lewis-McChord, just South of Seattle. And they are setting up in the CenturyLink Field, the home of the Seattle Seahawks and it’s just crazy to think that that is happening in my hometown right now. 


Their intention is to take non-COVID patients as it stands today, although we see even in New York right now a lot of controversy over whether or not some of those field hospitals would take COVID patients or non-COVID patients. On the Army core of engineers is certainly here too and they’re involved and making sure that they have all of the stuff they need to be able to run the utilities, do all of the things they need to make sure that they can run a field hospital.


And they can actually do this pretty quickly. I mean I have deployed, 50 men are transportable hospitals and 250 med contingency hospitals all over the Middle East and you can get up and running pretty quickly. In the case of using a building of opportunity like CenturyLink Field, you don’t have to put up tents. You don’t have to do that part of the infrastructure so they can go even faster. 


They’re making some actually making some really interesting modifications in the field hospital to put up privacy walls between the patients, which is something that we don’t have to worry about in a combat situation. But they are making a lot of additional accommodations including just making sure there is plenty of spacing between the beds, which again is something we didn’t necessarily have to worry about in real field situations but we’re making great progress. I mean they’ll be up and running probably in the next few days. 


[0:22:09.5] BR: So let me ask you a health IT question. So you’re dropping in CenturyLink Field. So you have my gosh, it’s Paul Allen’s home so you probably have a massive network going into that thing, fiber optic and all so that is not going to be an issue. But what – from a data sharing standpoint so you have let’s say a patient gets transferred from UW or transferred from Swedish into this thing because they are seeing too many COVID patients, how does the medical record follow and what EHR with the military be using in that facility?


[0:22:44.4] DS: This is a really good question that I don’t think I know the answer to yet and I have been asking the same question. So the DoD selected Cerner as their electronic health record a year maybe more or so ago. And Joint Base Lewis McChord was one of the first deployments of Cerner. And so, I am making sort of a theoretical assumption and if anybody knows anything differently we’d love to hear it that they are deploying some version or some connectivity back to JBLM to ride on a Cerner infrastructure or on a Cerner EHR. 


We’ll see then how the communication happens between the hospital who may have a patient that’s non-COVID and they discharge to the Army hospital, what comes with that patient and how does that data get there? I am assuming that worse case, they are printing a bunch of stuff and they’re going to lash a paper record to the top of the patient and that’s all going to move with them. Hopefully in a better case than that they are going to somehow figure out how to get an electronic data over to the Army. So I am going to stay on that one because I really want to know the answer to that question too. 


[0:24:01.7] BR: The other aspect of it is DOD doesn’t have any billing functions whatsoever built into the EHR is my understanding because they don’t have to. There is no one to bill. So that whole mechanism really probably doesn’t exist in the build itself. I mean anyway it is bad intimate interesting question.


But we were seeing these field hospitals I think one of the things we’re going to have to work on before the next pandemic and hopefully that will not happen in our lifetime but it probably will. The coordination of these field hospitals, how they get stood up, how they get connected in, how information flows around because in New York there is a whole bunch of them and you know some of them have been stood up by the military, some of them have been stood up by human rights organization – not human rights, humanitarian organizations and whatnot and there’s just coordination of that like with.


 I mean the story I just read about the ship, it’s the Mercy or whatever that is in New York harbor that some COVID patients went there and there wasn’t supposed to be any COVID patients going there. So that is one of the things that slowed down the whole process of that really coming up to speed. 


[0:25:18.4] DS: So, just so you know that military does bill. So they’re definitely patients who are seeing in military facilities who have third party insurance so they definitely have a billing function built into that. 


It will be interesting to see so many of the rules that we’ve been granted exceptions to now like cross state reciprocity for physician licensing and things like that. Does that ever go away at some point down the road? How do they take it back? 


That is going to be a challenge and when you think about all of these patients moving around to all of these different places and being discharged to Army field hospitals, I mean who would have imagined? You know this is wouldn’t it be great if there was a single patient ID? Whatever that looks like? Wouldn’t it be great if there was a single patient ID to be able to keep track of all of these people?


And in the context of an epidemiological sense too, this would be a good time for us to think about how are we going to deal with that in a few months or however long it takes, it should be on our agenda for the near term.


[0:26:34.7] BR: Well let’s do this, we’re going on a long time but the last story I had here was on the American Enterprise Institute and I have no idea who they are and what they stand for but it was an interesting story. National corona virus response: A roadmap to reopening it. It had four things, slow to spread, state to state reopening, establish immune protection and lift physical distancing and then rebuild our readiness for the next pandemic which was in there at sub-points in each one of those. 


Instead of going into that story because we’re not physicians, I do want to talk about how we’re thinking about from a health IT standpoint, how are we thinking about moving forward from here, right? So eventually things will slow down and this might be too early to really project some of this, it will slow down. How much of this – it is interesting. We have been talking about the need for digital in healthcare for years, literally. Probably almost a decade the need for digital. 


Well, it just happened in four to eight weeks. I’ve now seen charts from CIO’s who have shared them with me of their usage for telehealth, for their usage on their portals, their usage on just a whole host of digital – 


[0:27:54.8] DS: 30 times, 50 times increases in a really short two week periods of time. 


[0:27:59.6] BR: Yeah it is not even a good hockey stick. It is like an uncomfortable hockey stick it is going up so fast. And so that’s what we have been able to do is part of the role of the CIO moving forward to figure out how to sustain some of these things? Are we going to have – clearly we are going to have to see what the federal government does. If those barriers come down, if they continue to reimburse telehealth, are we going to be able to sustain these kinds of telehealth gains that we’ve seen and these kinds of digital gains that we’ve seen over the last couple of weeks? 


[0:28:35.3] DS: You know I hope so. I think there is – I had a conversation with a couple of CIO’s the other day and the conversation was sort of within the context of how are we going to get all of the kids to come back to the farm now that they’ve been off the farm for a while? In the context of work from home and the context of Telemedicine and that was really quickly followed by sort of the, “I am not sure we want them to come back.” 


“I mean in fact, maybe I am pretty sure we don’t want them to come back, right?” Now when you think about Dan Nigrin talk about this in your episode too that we’re not really exactly sure there is a lot of telemedicine right now and some of that maybe just a brief check in to sort of hold somebody off from coming in but they still really need to do an in person appointment and so we count that as a telemedicine visit but it’s not fully a replacement for what they really would like to do with the patient. 


There is some number of those in this telemedicine ramp up too. The hold on and don’t come in, you’re good enough just hold the fort, we’ll talk to you again in a couple of weeks. 


But man, we’ve seem to have, and I think that it is changing a lot of people’s habits. Not only the doctors and not only the people who are in the health system, they are working from home now but a lot of patients too who become really clear about, “I am not sure I want to come to the clinic.” 


“I mean that is where you get sick when you go to the clinic or you get sick if you go to the hospital.”


“ Let’s do telemedicine visit that’s better for everybody.” I think we are going to get a lot more consumer demand and we have already been talking about consumerization for a long time too. This has also pushed the button on that part of our business. 


[0:30:11.4] BR: So there’s two things, work from home. I think it would be interesting to do a study. Well actually you don’t have to do the study. We have been working from home and we’ve stood up just incredible amounts of stuff over the last eight weeks, right? So IT has been more productive over the last eight weeks than it probably has been over the last year and a half and that just comes from a focus. Yes focus, it’s just a fine-tuned focus and we’ve taken away the – 


There was sort of a – you know the regulatory burden is lifted obviously and then the money issue was raised, was lifted. They just said, “Do what it takes to get everyone working from home. Do what it takes to get every doctor set up with telehealth,” and in eight weeks we did that. So we can be incredibly productive working from home. Why would we put people back into a situation where they’re going to commute for an hour in some of these cities that would be nice if it was only an hour, but if they are going to commute for an hour and they’re going to take up really expensive real estate in some building, if we have proven that they can work this way? 


[0:31:22.2] DS: Yeah, well you did a – so the tables were turned on you the other day and Ed Marks did an interview with you and I watched that and at some point, Ed said something like, “Why in the hell would people drive to use a computer? That doesn’t make any sense to me.” And that really has stuck with me. That makes a lot of sense, why would you have somebody drive for an hour to come in to an office to use a computer because they’re a knowledge worker and that’s mostly what they are doing all day? I am with you. I think in the last couple of weeks and this is going to go on for a little while longer, it’s going to change everything. 


[0:32:01.9] BR: Yeah, Drex thanks for coming on the show. It’s always easier to talk through this stuff with you than to just pontificate for certain things on my own. I love doing this. So thanks for doing it. 


[0:32:12.4] DS: Thank you. You bet. 




[0:32:15.1] BR: Special thanks to our sponsors, our channel sponsors, VMware, StarBridge Advisers, Galen Healthcare, Health Lyrics and Pro-Talent Advisers for choosing to invest in developing the next generation of health leaders. 


The show is a production of This Week in Health IT. For more great content, you can check out the website at thisweekhealth.com or the YouTube channel. If you want to support the show, the best way to do that is to refer it to a friend and share it with a peer. We are going to be back again every day this week, you’re going to hear some from Drex this week interviewing some Chief Security Officers, Information Security Officers and we’ll continue to do field reports as well with the CIO’s. 


Thanks for listening. That is all for now.




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