This week in Health IT News Day
August 25, 2020

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August 25, 2020: Bill was wrong! About the CDC HHS stuff. He explores the rocky transition and why he’s glad he was wrong. You get cars from Uber, food, even a helicopter. Now they deliver drugs too. We can’t afford to lose billions in a crisis again. We have to focus on speed and agility. How fast can we launch new business models? How good are we at improving productivity? How fast are we developing new products? We also look at the startling UCSF hack ransomware story, REI going remote and selling its corporate headquarters and the scary Orwellian future of health passports. Big brother really is watching.

Key Points:

  • Health passports [00:11:50]
  • Kaiser terminates employee that inappropriately accessed 2,756 patient records [00:13:50]
  • COVID-19 to cost hospitals 323 billion [00:15:10]
  • COVID-19 data will once again be collected by the CDC in a policy reversal  [00:17:10]
  • In this ransomware era you really must look at all of your backups [00:27:50]
  • McKinsey article: Ready, set, go: Reinventing the organization for speed in the post-COVID-19 era [00:28:50]


News Day – HHS 180, How Agile is Your Health System?

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News Day – HHS 180, How Agile is Your Health System?

Episode 294: Transcript – August 25, 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: During the peak of COVID-19 in New York city, we were doing a thing called Field Reports where I was interviewing as many CIO, CTOs CSOs, as I could around the industry. We were releasing shows five days a week and I was interviewing one of the CEOs. And when we got done, he said, I’ve listened to a couple of these, these have been fantastic, but I don’t have time to listen to all of them. Is there any chance that when you hear something interesting, you can shoot me an email or can you shoot me an email with a bunch of the interesting episodes that you’ve done so far [00:00:30] and, that was the Genesis for this idea of clip notes and clip notes is an email that you receive.

You sign up for this, newsletter, and you get a one paragraph summary of the show. It’ll give you an understanding of what went on. We have key moments in bullet point format with timestamps. So you can go right to that part of the episode if you see something that’s interesting.

And we give you one to four video clips, short segments of the show that make it easy for you to share with your staff, with your peers, with others. it’s a great way [00:01:00] for you to stay current. Just get that email quickly, scan through what was talked about, who’s on the show, what was talked about, what was important, and then you can determine, am I going to download that to my, to my iPhone or to my Android device, for listening on the way home.

And we designed it based on your input and, and we believe that it’s something that is really going to help you to, to stay current, keep your key team current and again, to really help to get [00:01:30] these great interviews and conversations out into more hands so you can sign up.

It’s real easy. Sign up one of two ways. Go to any episode page on our website this week, And you can click the subscribe button in the top, right? Or you can send a note to clip notes, CLI P N O T E [email protected] And it will kick off an automated workflow. Now onto our show.

[00:02:00] Welcome to This Week in Health IT. It’s Tuesday news day, where we look at the news, which will impact health IT today, I was wrong. Yup. I was wrong. about the CDC HHS stuff. And I can’t wait to talk to you about it. And the second half of the show, I’m going to talk to you about it. We’re going to take a deep look at that, why I was wrong and why is a really good thing that I was wrong.

my name is Bill Russell, healthcare, CIO, coach, and creator of This Week in Health IT a set a podcast videos and collaboration events dedicated to developing the next generation [00:02:30] of health leaders this episode. And every episode since we started the COVID-19 series has been sponsored by Sirius Healthcare.

Now we’re exiting the series, but Sirius has stepped up to be a weekly sponsor of the show through the end of the year. Special thanks to Sirius for supporting the show’s efforts during the crisis and beyond. Alright. Oh, one last thing. If you haven’t signed up for Three Extracts yet you’re missing out texts directs DREX to four eight, four eight four eight, and received three texts every week.

With stories that will help you to [00:03:00] stay current, it helps me prepare for the show and I think it’ll help you to stay current. This is a service of Drex DeFord. He’s a frequent contributor to the show and someone I’m looking forward to having on the show shortly to discuss the news. Alright. we started something a couple of weeks ago and we’ve gotten good feedback.

So we’re going to continue to do it a little more structure around it than, than before. And that is, we are going to look at four main sites. And these are the four sites that I get a majority of my news [00:03:30] from, modern healthcare it news Becker’s and a healthcare innovation group, HCinnovation

Those are probably the four places. I get the majority of my stories. Now I get others from other places and we’ll continue to do that. but this is like the quick headline, view. And now, remember, I’m not talking about healthcare specifically. I’m not a doctor and I’m not talking about politics in general.

There’s a bunch of political stories in here. We try to focus in on healthcare. It, if technology can solve the [00:04:00] problem. That’s a topic we want to talk about. Alright. So we also talk about the business of healthcare and because there’s a bunch of that here, because a bunch of organizations have announced their Q2 earnings, right?

So the lead story in modern healthcare is Mayo clinic’s margin slides in Q2 and volumes back to normal. I think that’s the, that should be the lead volumes back to normal at Mayo. That is a very encouraging sign. so if we are seeing that kind of snap back [00:04:30] then, that bodes well for Q three Q four with a lot of health systems.

But with that being said, Mayo slide is a little different than other people’s slide. Their margins usually run at about nine, 10% for this quarter. I didn’t, again, I’m looking at the headlines. It doesn’t tell me the headline. I’m just remembering back to the JP Morgan conference. Somewhere between nine and 12% is where they run.

And they slid back to about 4%. So they were still on the positive side of the ledger. And that was a bad quarter. [00:05:00] Second quarter was a bad quarter for healthcare. In fact, I think if I go down here further, yes, here it is. So Sutter Health announced their earnings and their margins hit negative 11% amid the pandemic.

And that just goes to the point of, you really have to understand the business that you were in. Healthcare IT is about supporting the business of healthcare and the outcomes of healthcare health within your community. And so we have to continue to expand [00:05:30] our knowledge. If you are a technologists, we have to expand our knowledge into the business of healthcare and into the practice of healthcare.

If you’re a physician who to be, brought into technology, the, hopefully you’re listening to this show to get more grounded in some of the technology as we geek out from time to time. And, that helps you. But for those of you who are technologists, I want to keep encouraging you to understand the business.

Do you know what case mix index is? Do you understand the competitors that are coming to your [00:06:00] market? What does it mean? Do you know what a low asset strategy is going into your markets? Do you understand what a platform is and how a platform is going to help your organization to operate as a more seamless, entity as they interact with, the various health providers within the community?

So there’s a lot of things. that’s the reason we talked about the business of health care, cause it’s important to understand. All right, let’s keep going down. Modern healthcare. Wow. Lot of political stories. Lots of [00:06:30] financial stories. Here’s one that might be of interest. Yeah. It’s not overly interesting to me, but I will share it with you because I know it probably will. Epics $420 million trade secrets damages win gets slashed.

The reason this is not of interest is because this happened back in 2000 early, two thousands. Tata consultancy services, lost this lawsuit and the reason they lost this lawsuit, Epic gave Tata back when Epic wasn’t Epic. They weren’t the behemoth, they weren’t the intergalactic world [00:07:00] headquarters in Verona.

They were in Verona, but a little different back in the early two thousands. Tata was the consultancy services that provided support for Kaiser, which was the largest client for Epic. And they actually gave Tata consultant consultancy full access to the source code. And, obviously there’s safeguards and caveats around that.

And Tata went way overboard on that stuff. They have emails showing, they’re consultants sharing source code with people that [00:07:30] shouldn’t have had access to source code, they then went on to develop a competing product to Epic. So anyway the initial award was, close to a billion dollars and has been slashed the 420 million, which is considered to be more in line with the crime.

I don’t know if it is or not b ut what Tata did is bad. And wrong, you gotta keep those, even though you make an agreement in 2004 and you get to 2008, you’re still under that agreement. So you’ve gotta put the, the controls and the measures in place. Alright. Florida hospitals [00:08:00] lose billions due to pandemic measures.

This is something where to come back to, I’m going to look at a McKinsey article a little later in the show. and I’m going to talk about agility and business agility. We have lost billions due to pandemic measures and those kinds of things. But part of it is we are not agile as organizations. So anytime we have to make a major move, we have to spend a lot of money.

We have to exert a lot of energy and force. And once you put platforms in place, once you have agile as a, an operating [00:08:30] model, you’re able to move a lot quicker. so that’s, that’s something. And then the other thing is I’m reading too many of these stories. To be honest with you. We did lose billions.

That is true, but we all so got corresponding billions in the Cares Act money. Now, before everyone flips out and says, that doesn’t compensate for the full amount. I understand it. Doesn’t compensate for the full amount. But we had a okay first quarter, we had a horrible second quarter.

We received a bunch of money to cover that. Not all of it, but a bunch of it. we also have [00:09:00] endowments. We have other sources of income. We go into third quarter and the thing bounces back to about 90% of our revenue. And if the Mayo thing is true, we’re going into the third quarter with potentially almost 100% of our revenue back.

I’m not sure we should be crying in our milk, all that much. Let the hate mail begin anyway. that’s just my personal opinion. I think we should have been able to bounce back from this just fine, based on what we’re looking at. post pandemics. Now I will [00:09:30] have some other people on the show who can correct me a little later.

Let’s see. Anything else here? No, not, probably the last thing. So Uber enters RX at home delivery market. I think that’s going to be the new norm. Quite frankly, I think, at home delivery of drugs, express scripts has been doing it for years as have others. And, I, while I think people enjoy getting out of the house and all that other stuff, going through the process of, putting the [00:10:00] prescription in, getting it over there, waiting, getting the phone call, come get it.

that’s something we could do without in our lives. And I think we will do without in our lives. I think we will, have those prescriptions written at the doctor. They will be submitted to somebody who’s going to deliver into our house. It’s going to be more the norm 

Let’s see health care It news. :Less and less becoming a go to site for me, mostly because there’s so much advertising, intermixed, a lot of sponsored [00:10:30] stories and those kinds of things. So it’s getting harder for me to pick out which ones are, which  Many children respond better to therapists on telehealth screens than face to face.

That’s probably something that would interest me. As a CIO, I’d want to understand that more, because there’s people that are not excited about telehealth. So why did it work for, children and how they reacted to therapists? That would be an article I’d probably want to delve a little deeper. Health passports and distancing tools among COVID-19 tech climbing, the Gartner [00:11:00] hype cycle.

this is the July release. It looks like, is that right? July release of the Gartner hype cycle. I always keep an eye on the Gartner hype cycle. I think it’s worth looking at it gives me an idea of what I’m going to be talking about pretty predominantly in two years, not just on the show, but if I were the CIO, I’d be keeping an eye on that.

It’s also going to give me an indication of what people are gonna start coming up to me and asking questions about. THere’s a bunch of AI things on this. There’s a bunch of machine [00:11:30] learning things on this. We’re going to have to understand general machine learning or, artificial intelligence, you’re going to have to understand the distinctions between artificial intelligence, how they get utilized, how they get brought into the health system, all that stuff’s really true.

Also understand the curves and how they work. Health passports. Gosh just the concept scares the crap out of me. I don’t know what else to say about that other than, when I have to bring my health passport to go to a baseball game. Or, or send my kid to a certain school, we’ve entered an [00:12:00] Orwellian future.

I’m not, again, I’m not excited about it. You might be. So I’m not going to comment on that. any other stories here? Yeah. Again, not harder to healthcare It news, the name says it all. we really should be pretty easy to find the stories that we want to find on that site and it’s getting harder.

All right. August print edition for Becker’s state-by-state breakdown of 130 rural [00:12:30] hospital closures. That was one of the things that we have to keep an eye on for the pandemic. Yeah, if you’re in a Metro area and you’re a fairly well funded health system, you’re going to be asked, how do you extend beyond the four walls of your health system?

How do you. create connections to those rural locations, provide a level of care to those rural locations. I think that is going to become a common, conversation, probably pretty soon if not already happening. they have 12 key comparisons for Epic, [00:13:00] Cerner Allscripts and Meditech. Interesting.

Thien is not on there. That’s interesting as well. Yeah. Anyway, so probably worth like the Lance, although I don’t think too many of us are thinking about changing our EHR at this point. Cleveland Clinic is advising United area airlines, who CEO says airplanes don’t have social distancing.

The reason why United is one of the worst airlines in the country, followed closely by American airlines. And, they have gone back to booking flights at full [00:13:30] capacity. What can you say? I really have nothing to say there’s I’m not sure there’s a technology solution to it. I just wanted to tell you that I thought United was one of the worst airlines in the country. 

Say 29 hospital bankruptcies in 2020. Again, something to keep an eye on. It’s gonna be an opportunity for some, and it’s going to be a challenge for some communities. Kaiser terminates employee that inappropriately access 2,756 patient records over eight years. Wow. [00:14:00] Yeah. just, wow. But anyway, we’ve got to keep an eye on those controls and if you are a health, if you happen to be a practitioner, who’s listening to this, just to understand health it, every click, every screen, you look at it and the EHR is tracked.

Period. end of conversation. And it’s track for a lot of good reasons. and this, yeah. Inappropriately accessing, we’re required to, understand, are people reaching beyond their rights and looking at patient records, they shouldn’t look at  This typically comes up [00:14:30] in, the Hollywood kind of locations where, you know, Brittany Spears checks in and somebody’s gonna make a lot of money selling it to access Hollywood or whatever but it also happens in our communities and it’s one of the reasons that we have those security controls. Let’s see, Kaiser returns $500 million in Cures Act payments. And that’s great cause Kaiser made a lot of money. I think we read that, their, investments bounce back. They’re they’re a payer provider.

So their mix was a lot better than [00:15:00] somebody else’s mix. They probably didn’t need all the money that was allocated to them. Good for them. Fantastic. again, it’s probably appropriate for them to return money that they don’t necessarily need or, yeah. Don’t necessarily need. COVID-19 to cost hospitals 323 billion American hospital association.

 Yeah, I guess you can make numbers say anything at the end of the day, but, you just go down a couple of things. Eight nonprofit health systems got $1.7 billion bail out and furloughed more than [00:15:30] 30,000 workers.

Anyway, there’s a lot of competing things. You have to understand them in the context of, what type of health system, what was going on in the community? What is their primary, group that they’re serving. there’s so many things as you read these articles and you also have to understand people’s interests. 

More and more, when I read articles, I’m asking myself whose interest is that player. When the American hospital association says, Hey, hospitals lost 323 bill billion, [00:16:00] they’re lobbying for something. They’re lobbying for more bailout and you have Kaiser returning 500 million. So you’ve got to ask, whose interests are, do they represent?

All right. Last one, healthcare innovation group, Aetna Cleveland clinic launch, new model ACO co-branded insurance plan. I think more and more health systems are going to look at COVID. And see that the payers did better through COVID than they did. It will be a risk mitigation strategy [00:16:30] moving forward.

It’ll probably be a must for a lot of health systems to get back in that. So you’re going to see a lot of partnerships and plays, where providers become payers. We are also seeing payers become providers. I think the distinction is going to become hard to figure out in the, not too distant future.

All right. So that’s the quick hits on the four major sites that I normally go through. [00:17:00] Alright, let me tell you why I was wrong. Let me see if I can find this story. And the story is essentially that the COVID-19 data will once again, be collected by the CDC in a policy reversal. All right. Hospitals are going to return to reporting new cases to the CDC and prevention.

Trump administration says after a shift from HHS led to delays and data problems. Alright, so this is [00:17:30] interesting to me, because of this is going to play out in a lot of different ways, right? It’s very easy to step back and say, this was a mistake of Epic proportions. We can use it for political gain.

let’s trash them. And we’re going to hear a lot of trash talk about this. It was   a debacle. Don’t get me wrong. They didn’t get gain enough input from the people who were actually providing the information. they, implemented it pretty, it felt like pretty swiftly,pretty quickly in the middle of a pandemic, it felt to me [00:18:00] early on, like they were doing that because there were significant problems to the CDC database. They didn’t communicate real well. We don’t. we have a general idea of what we were going to get. We were going to get a more, thorough reporting and those kinds of things from the new HHS database, but there’s a lot of problems with it and they didn’t address a lot of those problems.

So it was handled pretty poorly from beginning to end. It’s a case study in what not to do. We talked about that last week. there’s, there’s ways to do this correctly, gather the input, from your [00:18:30] constituents, especially with people who are going to put the data in and use the data, they didn’t do that.

They didn’t communicate real clearly on, what the benefits were going to be to people. they could have piloted this very easily. And, there’s a hand full ways that could have piloted to be honest with you. They could have had people continue to report to the CDC and create a secondary feed that would have come to HHS.

That would have been a nice, easy way to do that. another thing they could have done is they could have contacted. [00:19:00] they could have taken the academic medical centers in, who are, fairly well funded, have pretty advanced data and analytics skills, would probably have had the ability to create the extracts pretty easily and just said, look, we’re going to run a pilot.

And we need you in very short order to start to create this extract and start sending it in both directions. And they could have done that very easily. They could have seen, what works, what doesn’t. Now they would have done a secondary pilot as well, that would have given them some [00:19:30] information about, does their model work?

Does the collection work? Does the tools scale like it should scale, then they have to figure out how they’re going to get it from all these ancillary locations. States and other things, but there was ways to do pilots. There’s ways to step into this. And sometimes when we’re trying to move fast, we skip a lot of steps.

It’s a huge mistake. We’ve all made it. we really have all made it. And, so anyway, We’ll chalk this one up [00:20:00] to a very poor implementation on HHS as part. Here’s what I’m going to say about this though. I’m impressed. Here’s why I’m impressed. A lot of times when we make a mistake in it in health, it in other places, we don’t own our mistakes.

We, in fact, we fall in love with our mistakes and we, we ride them as long as we can. And we try to our initial mistake. We try to make better by. doing something on the back end, CDC, I’m sorry. HHS could easily [00:20:30] have said, we’re going to continue down this path. We’re going to figure out, how to make this work.

They could have, doubled down on it. They could have thrown more resources at it. A lot of health systems do this. a lot of it projects have notoriously done this in the past. they failed fast, right? This is what we want them to do. They failed fast and they said, Nope. Our one month experiment and going this direction was a mistake and yes, it created a lot of angst [00:21:00] but we are going to do the right thing. We’re going to own our problem and they knew full well and yeah, election year that this is going to be used over and over again. But at least they went down the path of the right of the, the, that what was right for the country, what was right for the patients.

And we can argue, a lot of different things here. Let me tell you why I take this approach, early on in my career, I was in a. Fortune 500 company. And I [00:21:30] was  an Executive Director. I was over a large swath of the country, delivering services and those kinds of things. And I was highly critical of the person who was in the VP role, just above me.

And, I was critical that they didn’t do a good job. They didn’t understand what was going on in the branches. They didn’t understand what was going on in our clients. And, I was young. I was, late twenties, early thirties, somewhere in that timeframe. And I was highly critical [00:22:00]  And in a humorous twist of fate, the company filed chapter 11 and, the person who was in that role left and I got the job, So I stepped into the very role that I was highly critical of how they handled the role. And what I learned in that very short period of time was it was a hard role. And it was a lot harder than I thought it was. And the decisions were a lot more nuanced and sophisticated than I thought they were.

And I thought they were easy black and [00:22:30] white decisions and they weren’t. There was a lot more factors at play. And, that was one of the learning experiences for me and from that point on I’ve given leadership a lot more leniency and a lot more leeway. Because I know that what I’m reading in the paper and what I’m reading online and stories and tweets and those kinds of things a lot of times don’t take into account what they’re actually facing. I’m only reading half, if not, if not a lot less of the story. I think there’s stuff here to be [00:23:00] learned for us in health. It don’t fall in love with your mistakes. the whole concept of fail fast, build a culture that’s accepting of, A failure as part of the process to getting better.

So again, we’re trying to create that in our organizations, I’m going to give a HHS, not a pass, it was a debacle. They handled this really poorly but I am going to give them a little bit of grace here and say, learn from this mistake, figure it out, do it better the next time. And just like we would within our [00:23:30] own organizations.

All right. I’m going to hit a couple more stories. Let me check the time. Wow. The headline stuff really takes a lot of time. Alright. let me hit on this one. REI is going remote and selling its corporate headquarters. So REI is a. a great company, a good reputation, a good culture. And they’re essentially the company that sells outdoor sporting equipment, [00:24:00] that kind of stuff.

And they are getting rid of their corporate headquarters. Well their corporate headquarters is not a small building by any stretch of the imagination. I hit this one real quick only to say, how serious are we about work from home? And if we are very serious about work from home, how ready are we to get rid of our buildings, for healthcare and health it or to redesign our buildings?

Our building designed for, for everybody working in the office is probably, should be very different than our building [00:24:30] design. For, even a hybrid approach of people only coming to the office two days a week, or those kinds of things. If we’re serious about this, we’ve got to start thinking about what this means from a real estate standpoint.

And then the second thing is don’t sell your real estate right now, especially the commercial real estate goodnight. but, yeah, cause the market is not going to be that great I wouldn’t imagine in most locations for commercial real estate. But with that being said, I bring that up to say there’s a significant ramifications to work from home for [00:25:00] us.

Probably not right now, but we’re probably going to have to continue those conversations and consider it, moving forward. Let’s see other stories. Man. I got 15 stories here. Microsoft joins court battle between Apple and fortnight maker Epic. Now, why did I pull that one out? I pulled that one out because I think this is a precursor to a larger battle that we’re going to see, in healthcare maybe a year or two out.

And that is, so fortnight maker of [00:25:30] the. Massive. Our Epic is the maker of the massive game. Fortnite. They were delivering it on the Apple iPhone. They violated Apple’s, store policies and because they add the violated apples, app store policies, they were kicked out. They were given some notice, but then they were kicked out.

And it’s interesting because Microsoft joined the battle on Epic side, on the Fortnight side. Saying that, essentially Apple extracts more than a fair price for [00:26:00] access to, to their, to their app store. And, and that there are different technologies that would benefit the users that are being thwarted through that app store.

This is going to be an interesting case. I think it’s worth keeping an eye on because in healthcare we may have this same thing. I know that we have 21st century cures, which is saying that the data is going to get to the patient with little inroads, special effort or excess costs. But if it doesn’t happen that way, if it doesn’t just come down that [00:26:30] way, I think you might see a similar court batt come up.

I don’t know what it will look like, but that’s why I pulled that one out to take a look at, UCSF hack shows evolving risks of ransomware in the COVID era. This is a Bloomberg story. And the reason I pulled this one out was it’s. again based on the emails, it’s startling.

That the, essentially what UCSF is saying is look, they [00:27:00] tried to haggle with   with the ransom ransomware, what are the extortioners extortionists, whatever it is. They tried to haggle with them and essentially said, Hey, this is being used. This data is being used for to develop a treatment for COVID 19, develop a vaccine.

We need this data back, can you help us now? We don’t know if this was just any negotiating tactic or what it was. but at the end of the day, you CSF was not prepared. They clearly didn’t have a backup of this [00:27:30] data, or they didn’t have ag. They couldn’t recreate the data. Let’s just say it that way.

Or  the recovery point objective was it was so much that they would lose too much data either way. It wasn’t well thought out something to consider in in this era that we’re in. And this ransomware era that we’re in is to really go back and look at all of your backups.

I remember when I did that as a CIO, I had them do an audit of all of our backups and it was alarming where we’re at, this is [00:28:00] one of those areas that if you don’t keep an eye on and don’t keep good sound operational practices around, you will, you’ll fall behind and you’ll start missing things.

Ah, here’s a, another security one US charges, former Uber security chief with covering up massive 2016 hacking. I’m not going to go into the story. I think that the title says enough, right there. bottom line, they should go after him. we should not be covering those kinds of things up.

I think we know that in healthcare, [00:28:30] but, it is, it is worth mentioning that when a breach happens that we need to report it, I think we all know that. I think we know we’re all responsible for doing that. I don’t know of any health systems that are getting caught for that. And a startup is probably more prone to that kind of decision-making but, just a reminder, last story. This is it. McKinsey wrote an article. Ready, set, go, reinventing the organization for speed in the post COVID-19 era. And this is one of the things I wanted to focus in on [00:29:00] speed and agility. We have to get faster. And how do we get faster?

We have to look at how do we deploy talent? How do we redeploy talent? How can we launch, how fast do we launch new business models? how good are we at improving productivity over time incrementally or, or more broadly, how fast are we developing new products? Shifting operations? Clearly McKinsey wrote this article, not specifically for healthcare, but for businesses in general.

And what they’re saying is COVID has changed. [00:29:30] Everything. It didn’t really change everything we were already here. It just made it obvious to everyone else. There’s a need for speed and we’re not turning back. And so they go into reinventing the organization for speed. rethinking the ways we work.

Re-imagining the structure, reshaping, the talent who we hire, how we deploy them, where we put them, the, we need to speed up and delegate. Decision-making. So decision-making can be made faster with people who have the information who are more [00:30:00] in contact with where the decisions will do the most good.

We need to get them the information, give them the right structure to speed up. Decision-making, step up execution, excellence. and they go on to say, just because the times are fraught does not mean that leaders need to tighten control and micromanage execution rather than the opposite.

Because conditions are so difficult. Frontline employees need to take on more responsibility for execution action and collaboration. And I want to echo that is great words to live by a [00:30:30] lot of times when we get into these things, we think, I know what to do, but no one else knows what to do.

Do, therefore I’m going to bring more control, land, worst thing you could possibly do. and, Stanley McChrystal had a great story of, how they were so far behind. In, battling the, Taliban and others, they had distributed control and command and control type of decision making and everything for the US was centralized.

And it wasn’t until they distributed that command and control that they started to [00:31:00] make. The decision making. I keep saying command and control, just the decision making that they were able to work and actually make progress in that, in that battle, cultivate extraordinary partnerships, working with partners is routine, but the speed of action only goes so far if other players in the ecosystem failed to move just as fast.

Okay. And I think the other thing is, cultivating extraordinary partnerships at scale and at speed, one of the things we did, when I was a CIO [00:31:30] is we looked at, Hey, we need to bring in all these potential partners, but we set them up for a legal process that takes, three to six months to get through the gauntlet.

And so what we created was a short, repeatable contract for, new partners, where they could get into a sandbox work with not even de-identified data, just fake data and prove out their systems. And so that contract was really easy to get signed. Really easy to get people up and running. They were working [00:32:00] on our systems with fake data so that they can prove out that they’re, that their solutions worked.

And then over time we could then move them into more structured contracts. Cause if their stuff didn’t work, there was no reason to go through the big contract anyway. And if their stuff did work, then, it would take them some time to prove it out. We would get to see that and we could get the true contract to get to de-identify data and then potentially. live data, flattened the structure, unleashed nimble empowered teams that [00:32:30] pandemic has seen it. Large scale deployment, a fast agile teams, small focused cross functional teams working together towards a common set of objectives. This is a make hybrid work feel tomorrow’s leaders today learn how to learn.

These are all great concepts. This is a really well done article. I say this to say, we need to do this in healthcare. This is how we need to be thinking. We need to be thinking agility is the most important [00:33:00] attribute. I think we’re going to ascribe to a health system moving forward. the story is ready.

Set. Go. Reinventing the organization for speed in a post COVID-19 era. if you get the chance to hit the McKinsey site, download that, read it, share it with your team. it is a great conversation piece for your team to go through. That’s all for this week. I rambled a little bit getting used to this new format.

W e’ll continue to get it down a little tighter as we go. don’t forget to sign up for clip notes, send an email, hit the website. we [00:33:30] want to help you to be more productive and to maintain your commitment to your staff, to keep them current. Special, thanks to our sponsors, VMware, Starbridge Advisors, Galen Healthcare, Health Lyrics, Sirius Healthcare. ProTalent advisers and Health Next for choosing to invest in developing the next generation of health leaders.

This show is production of This Week in Health IT. For more great content. you’ve got the website  this or the YouTube channel. If you want to support the show, share it with a peer. Please check back every Tuesday, Wednesday, and Friday for [00:34:00] more great content. Thanks for listening. That’s all for now.

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