November 10, 2020

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November 10, 2020: Welcome to News Day. What does the Intermountain Sanford Merger tell us about the future of healthcare? Can mergers get too big and unwieldy? There’s been a reported 10% drop in hospital admissions in 2020. What pre COVID behaviors were the most detrimental to health? Will our new habits change forever? Telehealth visits grew by 2000%. Now it’s time to step back and ask what did we really do? Did it improve our efficiency? Did it improve our care? And is Zoom the king of telehealth platforms?

Key Points:

  • What are the nuts and bolts behind a strategic merger? Is it as simple as a shared belief in how healthcare is going to be procured and delivered? [00:03:50] 
  •  We should be applauding 10% less hospital admissions but is it sustainable? [00:12:05] 
  • You really do have to rethink your security model [00:17:45] 
  • How much will health IT change as a result of the election? [00:17:55] 
  • One of the conversations that keeps coming up is telehealth [00:22:05] 
  • Don’t NOT solve a problem because you can’t solve a hundred percent of the problem [00:32:00] 


News Day – Intermountain Sanford Merger and Telehealth Video Winner

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News Day – Intermountain Sanford Merger and Telehealth Video Winner

Episode 326: Transcript – November 10, 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 Tuesday news day where we take a look at the news, which will impact health IT today. We’re not going to talk about the election or not a lot, to be honest with you, we’re going to talk about health IT. So I’m looking forward to it. we have a lot of, we have some merger, conversation to have, we have, Telehealth conversation.

[00:00:21] A bunch of interesting things have happened even though the election is going on. My name is Bill Russell, former healthcare CIO, coach consultant, and [00:00:30] creator of this week and health it. I said a podcast videos and collaboration events dedicated to developing the next generation of health leaders.

[00:00:37] I want to thank Sirius healthcare for supporting the mission of our show to develop that next generation. Their weekly support of the show has given us the ability to expand this year to provide new services to the, to the community. And we are incredibly thankful, 3xDrex, even though Drex isn’t here to remind us this week.

[00:00:54]3xDrex is a service of Drex DeFord and he is a frequent contributor to the [00:01:00] show and we’re so glad to have him. It was fun to talk politics with them last week. That will be the last time we talk politics for another four years. So hopefully you got enough out of it from that one show.

[00:01:09]But 3xDrex is where Drex sends three texts out three times a week with three stories vetted by him to help you stay current. I use it to do research for this show. And if you want to be a part of that to receive those texts, text directs D R E X to four eight four eight four eight. And that’ll get you signed up.

[00:01:28] All right. Well, [00:01:30] we’ve, I just want to be clear, we’ve gone to a little different format. I’m trying to engage with you guys directly and how I’m doing that as I’m posting every day of the week, I’m posting out on LinkedIn and, you guys have not disappointed. We have had a lot of back and forth, a lot of great conversations on LinkedIn.

[00:01:49] I have posted my larges t let’s see largest discussed post so far on LinkedIn. Let’s see how many, people have viewed this? [00:02:00] I’ve done a lot of posts. When you do one a day, it just starts to start to stack up here. It is 50,000 people have viewed this post. 395 likes or whatever else you can do on LinkedIn these days and 54 comments. And that is what does this merger tell us about the future of healthcare? Okay. So Sanford and Intermountain are coming together. And what I did is posted some of the facts of the deal. And asked you that question. What does this merger tell us about the future of [00:02:30] healthcare? Let me give you some of the facts on the deal. Combined it’s 70 hospital system with about 15 billion in annual revenue. The deal’s going to close in the summer of 2021, that’s if the regulators allow it to close that quickly. Sanford drew almost 7 billion in total revenue in 2019 and produced 3.1% operating margin which means that they are operating at a profit  Six months ended June 30th, 2020, which is this year. The system drew almost a hundred million in operating income in the first [00:03:00] half of 2020 on 3.1 billion in revenue. So they’re still profitable this year. Intermountain drew 374 million in operating income on 7.6 billion in revenue in 2019.

[00:03:11]Combined, they’re going to employ more than 89,000 thousand people across 435 clinics across seven States. Sanford operates in North Dakota, South Dakota, Northwest Iowa, Western Minnesota, while Intermountain is in Utah, Idaho and Nevada. The resulting [00:03:30] system would ensure 1.1 million people with systems, with the systems combined health plans and the proposed system is going to be called Intermountain Healthcare and it would be led by Intermountain CEO Dr. Mark Harrison. So and I made the comment, we expected mergers born out of operating distress, but this doesn’t appear to be that this appears to be more strategic, a shared belief in how healthcare is going to be procured and delivered. Wow. And then we got a [00:04:00] ton of comments. So let’s, dig into the comments.

[00:04:02] One of the first ones here is, from our friend Ed Marx, who says we will see continued consolidation and we’ll end up with four to five super systems just like most other industries, appliance, automotive oil, most industries have a four to five companies that make up 80% and Ed has a couple of fans here who agreed.

[00:04:23]I don’t necessarily disagree, to be honest with you that is the direction that we’re going. I just think the pace is going to [00:04:30] be an awful lot slower than what people think. So to predict that at this point, one of the things that’s going to happen is people are going to say, didn’t you say, we’re going to get to, a few major systems. It’s probably gonna take a decade for that kind of consolidation, for a couple of reasons. One is, healthcare just moves slower. Number two, the regulatory environment, having gone through a merger of two major health systems, the attorney generals in these States are really leery [00:05:00] of the monopolistic power that large health systems can wield, even though they really didn’t have much of a problem when the payers went down this path and they allowed that to happen pretty significantly. So, but when providers go down this path, there’s two things. One is the monopolistic pressure. The second is the loss of jobs. Remember that all these health systems are the largest employers in their market.

[00:05:23] And as such, one of the jobs of our elected officials in each state and understand this has to go through, [00:05:30] It’s crazy. These things have to go through each state. The attorney general gets to take their whatever, their pound of flesh, essentially from each system. And I say that because having gone through one of these mergers in California, that’s exactly what they extracted. concessions and other things that just, quite frankly, were not good for the overall merger and the, economies that we’re going to go into be gained. It just delayed them all. But at the end of the day it saved some jobs over a three-year period. So from that [00:06:00] perspective, they’re doing exactly what they were elected to do. Mike McSherry CEO of Xealth, a really cool digital app. We’ll have to have him on the show at some point, hospitals will need to consolidate to compete with payers United national. United and the others, national scale, 250 billion in revenue, 20 billion in profit, 250 billion in revenue. Think about that. All right. So that’s the largest payer, 20 billion in profit. Plus they’re trying to get into the provider space as well. [00:06:30] 25 times the revenue profit. Versus even this, fairly large mega system that just was formed with this merger, United buying a care delivery, optimizing telehealth, virtual health are relegating hospitals to ER, and acute surgery centers.

[00:06:43]This is a point that Jonathan Martinez has made as well. That we’re going to be, relegated to that health systems, health system providers are going to be relegated to, high risk, low margin, high acuity, services, somewhere down the road. If we don’t get ahead of [00:07:00] this, consumer and what Mike’s making, the point is a consumer driven model. And one of the points that Mike is making here is essentially that the payers are much better positioned to, to make this move because they have more revenue, more scale and, with, with that revenue, with that profit, with that cash. they can continue to make moves. And plus COVID was very kind to the payers, at least [00:07:30] at this point, Dale Sanders also frequent guests on the show. “Frequent,” he’s been on the show, I think three times and, somebody who I respect, significantly. Says, in keeping with my personality. I’ll celebrate. When I see these mergers turn into better care and lower costs for patients, stoic until then. So far, none of these M and a deals have had a major notable benefits to patients.

[00:07:52] In fact, there’s more evidence to the contrary across all industries, M and A’s underperformed the expectations about 90% of the time, [00:08:00] according to McKinsey and Deloitte. One thing that I observed having worked at Intermountain for eight years, my first step into healthcare, followed by broad exposure to us and international healthcare after that, the success of inner mountain is not easily easy to export. And he goes on to talk about, the homogenous nature of that community. there a statistic, a he’s, he’s a data scientist really by trade at this point, and just talks about the makeup of that market, which makes the services that Intermountain delivers [00:08:30] very distinct and sometimes the model that Intermountain would employ, would not work say in a Chicago or in a Southern California. 

[00:08:39] In fact, I had a hospital president major health system that just tells me that. Because I asked them if Intermountain does this well. And they do very well. Their margins are really high. We see those every year at the, At the JP Morgan conference, their margins are high, their operating, efficiency is very high. And, and so you just asked the question why wouldn’t we [00:09:00] do that in Southern California? And I get some variation of this, which is it’s a very different, community, very different model. These comments go on and on this is, these mergers are very, they’re again, positive and not positive Catherine Sullivan PhD. there’s going to be a big bubble that will burst soon. Remember the movie, the big short, the next movie will be about how the pharmaceutical insurance industry destroyed US healthcare.

[00:09:28] You have that range [00:09:30] this is bad for healthcare few players making decisions. We’re not going to get in front of social determinants. Although, to be honest with you, if we get this kind of scale, we might be able to get in front of social determines you have  stoic optimism from Dale Sanders. And then you have the,there’s a lot of potential here that could be unlocked. If the right health systems become the mega systems, with again, the right values and, capabilities and funding [00:10:00] behind them. Right. So pretty interesting and again pretty interesting back and forth. A lot of,  a lot of people.

[00:10:08] I’ve been through a merger. I had people are, people ask me, what do you think of this merger? I don’t, know the specifics to be honest with you. I think every merger has to be looked at in its own merit. I don’t think you just throw all mergers out per se. And I also don’t think, I also don’t think that you, just applaud all mergers because it’s a step in the right direction.

[00:10:29]I think Dale’s [00:10:30] right. We have not seen, the, benefits. I’ve made note on this show before, and I love the people at Providence and I think they do good work and they clearly, they have enough money on their balance sheet and they’re, doing just fine. but I have not seen them present an operating profit at, And not that it’s the only measure clearly it’s not the only measure, but they, since the merger with st Joe’s that I was a part of, I’m not sure they’ve posted a profit since then. And which is funny because when I left St Joe’s it was wildly profitable. [00:11:00] so. It’s just, one of those things that you just scratch your head and say, sometimes these things might get too big and unwieldy and, it’s hard to drive the efficiencies across the entire scale of the organization.

[00:11:14]Reduce the clinical variation, all the things that’s required to be an effective hospital, drive quality, drive down the, cost of care for the community. And that’s really what we’re looking to do. I’m trying to think if I talked about this one before, let me see. This was one week ago. No, I don’t [00:11:30] think it did. So let me share this one. So, the Kaiser Family foundation, 10% drop in hospital admissions, are reported that there was a 10% drop in hospital admissions in 2020. And, it was interesting. I saw a little back and forth on this and people were like, Hey, this, is bad for hospitals.

[00:11:49] I thought, wait a minute. Let me think about that one for a second, I think I’d like the data scientist is going to work on this. I’d like for them to, come back to me and tell me if this is a good [00:12:00] thing or a bad thing. Now, if people are deferring care, clearly that’s not a good thing. It’s a bad thing. We don’t want people to defer care that actually need care. But on the other side we should be applauding 10% less. People are being admitted to the hospital. That’s a, that seems like a good thing. Now, the question is, that a blip? Is it sustainable? What is, the cause? And I’d like the data scientists to really dig in on that, my, one of the things I started thinking is have habits changed. Right. And how have they changed? How has [00:12:30] the, how has the impact of COVID, impacted our health? Are we more aware of health during this time than we ever were before is wearing masks, helping us with other things that we don’t even recognize? The fact that I don’t travel on airplanes.

[00:12:44] Oh, heck I can’t remember. I haven’t traveled on an airplane since February. it does that make me more healthy? Does the fact that I get to see my family every day? Is that healthier? Is that healthier from a mental health standpoint? Is the fact that I’m getting outside more? [00:13:00] I know it sounds weird, but I’m actually doing more, like things in nature and walking and and playing golf and those kinds of things that I did in my normal schedule. Is that healthier? And, I, ended up with this question. What pre COVID behaviors do you think were the most detrimental to health that may change forever? And one of the, one of the thoughts I have on this is we may want to look at our assumptions going into next year’s financial year and other things based on [00:13:30] what, trends have changed. 

[00:13:32] And then I posted, I posted another story, which is the, there was a story on the real estate market in New York. And what will it look like next year? And I posted this with just that same question, which is, have we baked new trends into our assumptions for our 2021 operating models?

[00:13:51] Just something to consider out there. Let’s see. Did I get any back and forth on this 10%? I did. Let’s click on it. See what you guys are saying. Let’s see went back and [00:14:00] forth. Dan Howard MBA, C H C I O P M P a. That’s more initials than I have after my name, which I have. I’m always impressed with.

[00:14:11]I hope that the investment in efforts and education and patient engagement strategies over the last several years of resulting in healthier communities and populations. And I agree with Dan, I think it’s optimistic and I, hope that’s the case. I just want to make the point. Are we baking these trends into our 2021, numbers. All right, let’s see. [00:14:30] what two days before the major cyber attacks happened, I posted this post and I said, and Drex and I talked about it just about, ransomware attacks and, what’s going to happen. And so Drex and I went into these, we actually talked about some of the comments, so I’m not going to talk about, talk about them again. And we also talked about the breaches. Now, since then there’s been a couple more systems that are either under attack, have reported that they’re under attack or have been compromised. [00:15:00] These compromises are, serious deals. when you think about getting locked out of everything, if you’re not going to pay the ransom to get decrypted. And by the way, I technically, I guess paying the ransom is against the law. So, if you’re not going to pay the ransom and it’s encrypted, I have a feeling you’re not going to be able to decrypt a lot of this stuff. Let’s just play through this scenario a little bit of what that means to your health system.

[00:15:28]Essentially all those [00:15:30] boxes you have in your data center. they are just that they’re boxes. They are storage. They are, compute and they are, just, processing. That’s all they are. and so what you have to do is you have to rebuild, you have to rebuild from scratch and you start with, active directory. You have to rebuild your actor directory, you have to reestablish your accounts. You have to have people log in for the first time. All people log in for the [00:16:00] first time. and all right, so that’s where we’re starting. We’re starting from standing up active directory. Think about how far back that is. So what else was encrypted?

[00:16:09] If all of your CLA- hopefully your EHR wasn’t encrypted. And if you get by unscathed on your EHR, you’re, better off than, most. but then you start just meandering down the systems. How, has your ERP doing, how’s your PAC system doing? can you imagine if your PAC system has been encrypted and you lose all [00:16:30] your images and you don’t have access to your backups?

[00:16:34] Just play that out for you if, for yourself for a minute and think through what the ramifications of that are as you’re having, if as, you’re having these thoughts, start to think about your presentation to the board when you are trying to get money for next year. And they say, we really can’t afford to fill in the blank.

[00:16:54]You might want to ask the question if we lost all of our PAC systems, what would that look like [00:17:00] in terms of, you’d have to re-image everybody, who’s in the hospital everybody’s in active care would have to be re-imaged, you’re probably not going to get reimbursed for that. Right? The second thing is you’re going to have to- everybody who comes in the future is going to have to be re-imaged.

[00:17:14] Some of that will get reimbursed. Some of it won’t. You will likely have lawsuits. there’s an awful lot of things that you just go down the, you go down the list and by the way, we’re just not on the pack system. We haven’t even, we haven’t even opened up some of the other systems that you’re going to [00:17:30] have to rebuild the, amount of hours you’re gonna have to spend an it consulting dollars, a remediation, verifying that what you have, rebuilding your, security model. Cause it would really stink to stand it all back up and get. Get hacked, the week after. you really have to rethink your security model before you start standing all this stuff up again. I assume you’re standing at all up, as you’re unplugged from the from the network. 

[00:17:53] So anyway, next thing I posted, how much will health IT change as a result of the [00:18:00] election. Right. And so Drex DeFord and I dove into this last week. And, so we have a little bit more information. I told you I wasn’t gonna talk about the election, but I’ll. Talk about it from this perspective. the answer to that question is a little, and, not, as much as if we would have had a majority or if we’d had the same, party. And actually at the time of this recording, we don’t know who our president is going to be. I’ll just be honest with you. It is a I’m recording before the weekend, so that my production team get out [00:18:30] there and, So it really doesn’t matter which way this goes. the Senate is going to be a Republican. The house is going to be Democrat. whichever way the president goes, it’s going to be a split Congress, which means that, there’s going to be an opposition and oppositions are good. I’ve made this point on the show with Drex. and the reason they’re good is because it forces compromise somebody has to compromise.

[00:18:54] It means that the conversations have to happen. It means that, it, and if you’re not going to compromise, if you’re not [00:19:00] willing to come to the table and have the conversation and listen to the other side, then nothing’s going to get done over the next four years. Or the only things that are going to get done are executive orders.

[00:19:09] And, Gosh, and just the normal operation of the government. and, as I said last week on the show with Drex I’m okay. With that, to be honest with you, I, I, don’t like sweeping changes and, and radical movements. Cause I don’t think that’s what, America, that’s not where we’re at right now. The, electoral vote most in history [00:19:30] only split by about 3 million people. And to think that’s a mandate is kinda silly and to see it go, radically in one direction or the other, would be bad. And by the way, I feel that way, regardless of which party wins, what I really always want a split Congress.

[00:19:46]Let’s see. I did a, I did one on voting on the, voting day. Got, a lot of. A response. And I think it’s, I think it’s good by the way. Just the one comment I want to make from this one is, and I make this comment towards [00:20:00] the end of this thing where I say I’m concerned that so many people have started to identify themselves by their party in politics.

[00:20:06]We are  more than the candidate. We support you missing out on being friends with some great people. When you become so dogmatic that you can’t stand to be in the room with someone from a different political persuasion. And, someone came back to me and essentially said, when one person’s vote hurts someone else, it’s not being dogmatic it’s letting your voice be heard. That oppression of any kind is unacceptable. My comment back to that was, I would [00:20:30] imagine that everyone would agree with your statement that oppression of any kind is unacceptable regardless of political persuasion. I have not found that people from the opposing party, from the things that I believe to be unreasonable people, in fact, I think that’s the message. The message I want Washington to hear is, we don’t generally speaking, we are not that dogmatic. We are not that combative. we can have conversations, we have conversations with each other all the time. [00:21:00] and I’m really concerned about the next generation, to be honest with you, the younger generation who feels the need to put people into a category and then, brush them aside and, label them and brush them aside because at the end of the day, you know there’s people who vote Democrat who have very good intentions. And there’s people who vote Republican who have very good intentions. And I know you find that hard to believe, but if you take the time to have the conversations, I think [00:21:30] you will find that there are some very fair-minded and smart people on both sides of the aisle.

[00:21:36] So I, I did post, about some of the, medical ballot issues that were out there. I’m going to you, you have heard them all at this point, so I am not going to go into them. The next thing I post is a story about, TriHealth switches to zoom. Actually, I just used that story, because I wanted to talk about telehealth.

[00:21:57] And the reason I wanted to talk about telehealth is over the last [00:22:00] couple of weeks, I think I’ve talked to probably about 25 ish CIOs. And, and one of those conversations that keeps coming up is telehealth. And I just posed the question in which video platform was the biggest winner of the tele-health explosion.

[00:22:15] And it’s important- and every time I talk about tele-health, it’s important to note that there’s, there’s, tele-health as a broad category, there’s sub categories, which is virtual visits consults, and, remote patient monitoring. each sub category represents a [00:22:30] different set of use cases and a different set of technologies typically. There’s some foundational technologies. That might be the same across all of them, but generally they have some aspect of different technology. here’s what I’m hearing. I’m hearing that zoom was the big winner. And, and I’m hearing that- the reason I’m saying big winners, because first of all, I don’t remember zoom, even being a player.

[00:22:54] In telehealth, prior to COVID and now I’m hearing, Epic, Cerner, you name [00:23:00] it, whatever the Meditech, whatever the EMR is, I’m hearing people use Zoom, and I think they’re using zoom for the same reason. I use it to record our podcasts. It’s easy. It’s just easy to use. It’s easy to set up. It runs across low latency. it makes up for some of the, choppiness and those kinds of things. So from a just instantiating, the video communication. It’s easy for patients. It’s easy for providers and that’s why I think it’s winning. And by the way, that’s why I think most technology wins. I don’t think it wins [00:23:30] on speeds and fees. I think it wins based on its usability. the Epic Twilio solution is gaining momentum. but to be honest with you, it’s, half baked at this point is what I’m hearing. It still has. It’s still, it feels like it needs to go in the oven for a little bit. the other thing is it lacks some basic video capabilities, multiple participants on the same call.

[00:23:50] That’s what I’m being told. I’ve not used it. So if I’m wrong on that, please set me straight. I’m more than happy to be, be corrected. Which means it’s probably designed [00:24:00] for video visits and not really designed as much for video consults cause consults. And a lot of cases have multiple, clinicians on the call having a conversation. we’re also finding that MS Teams has made some inroads. I think it’s one of the reasons you’ve seen ms. Teams want to get on the app orchard, platform and be. A certified or, for the Epic platform. and I think the reason for that, to be honest with you is not that it’s an exceptional platform.

[00:24:25]it is, it’s a great platform. It’s being used by a lot of health systems, but I think it’s mostly [00:24:30] cause we’re already using it for, administrative collaboration and collaboration across the health system. So your physicians are getting used to using it. You already have the license for heaven sake. There’s no reason to fire anything else up and, If all you’re using it forced to instantiate the, the video call, then it, may work for you internally. My only warning on that, to be honest with you is having been somebody who has had to connect, from the other side to multiple different organizations MS Teams, it, is not, it is [00:25:00] like a quarter as good, from a connection, ease of connection standpoint as Zoom. So just. Just word of caution out there as you’re heading down that, or if you have, some saying that what Microsoft is doing, let them know that they can make that, that end user experience a little bit more easy and frictionless, as we say on the show, American well and Teladoc have done well. and I noticed that Cisco is absent. So back in the [00:25:30] day for us, the virtual consoles was all, our, our TeleSign and telestroke programs were all done on Cisco platforms. I’m not hearing Cisco all that much. And I don’t know what that means. if they have been relegated to the side, I know that WebEx is still out there.

[00:25:44] I still communicate with some health systems via WebEx. So that’s still a major platform, but that doesn’t seem to have made the. The jump WebEx didn’t make the jump as much as zoom and, ms. Teams did, into that, into that space. So I [00:26:00] asked the question, what solution is your health system using? And do you believe that solution will be the solution that you’re using a year from now? I find that to be an interesting question because, again, talking to a lot of CEOs, they are evaluating that right now. do we, this is what we did during COVID. So COVID. You had to respond and you responded quickly and you put something in there, kudos, you scaled it up, you did what you needed to do.

[00:26:23]You grew your telehealth visits by 2000%, but now it’s time to step back and say, what did we really do? [00:26:30] And did that improve our efficiency? Did that improve our, our care? Somebody made the point. I don’t think on this post, but before that, that he just measures didn’t move at all as a result of tele-health and is this really the right platform? and so it’s, I think that those are the questions that are being asked right now, as well as evaluating the technology, its integration into the workflow, integration into the process. And is that really working for your health system? [00:27:00] let’s see. So we got a bunch of responses and a little free advertising here. Jeff Carr, vice president of business development for let’s see, actually it doesn’t say I’m gonna have to click on something else to find out. I’ll tell you once I figure it out. I think it’s U R a let me tell you what Jeff said. Cause I thought it was pretty interesting. I re recommended looking at which telehealth providers in it platforms are accredited and certified following best practices. Standards matters. Good [00:27:30] medicine delivered on bad platforms is still bad medicine. To which I responded. I said I’m wondering how that really works. Clearly. There’s a security component that I understand why you would want to get certified, but what other things would, I need to have video platform accredited and certified for? Is the phone accredited and certified? Do we certify the platform or the workflow in the system that is using it? And he comes back and says, great questions. Here’s the standards at a glance. And so here’s the free advertising, if you’re wondering. [00:28:00] so I pop over here. To look at the tele telemedicine support services program that his company has out there. And they have, let’s see core section. They have business requirements, professional oversight, quality of patient safety, clinical workflows, risk management, consumer to provider, a provider to consumer, and then provider to provider. And, they have. I dunno, maybe about five or six points underneath each one of these that [00:28:30] you define.

[00:28:30] And really what it looks to me like is, our old policy documents that we had at the health system where it really defined all the aspects of the program. the clinical procedures, then usually technology, the proficiency of that technology, the patient to provide a relationship. you get an idea. It’s actually, it’s a pretty well thought out list. And, my, comment back is, I thought it was a great telehealth program checklist. So if you [00:29:00] are evaluating your tele-health program, you want like a checklist of things, go ahead and hit that post on LinkedIn and he gave a link to it but I do say to them, you’re going to have to sell me on using it unless it’s mandated. and the reason I say that is, I might use the list. To work with my team to make sure we have everything covered that we need to have covered. but, I’m not sure I would want to get my telehealth program [00:29:30] certified.

[00:29:30] It doesn’t seem, and again, I might be shortsighted in this, he comes back and says, and I said, I think it should be. you’d have to sell me on it. And he said, it’s selling itself since COVID employers, as part of their RFP process are starting to ask if their virtual benefit provider is accredited, independent validation matters.

[00:29:51] Some organizations may use telehealth standards to build their program while others, more so on cost avoidance, reduce risk, quality of marketing [00:30:00] promotion. The drivers that have. Tele-health accreditation are rapidly changing since COVID-19 when employers and payers are starting to ask the question.

[00:30:07] If telehealth providers are accredited, that’s a game changer and he’s right. If that’s happening. I, and again, I haven’t verified any of this stuff. I don’t know that’s happening but if that does start happening, then you may have to look at getting your tele-health program accredited. I guess it depends on what market you’re in and what kind of penetration and mind share that this is, this is getting, gee, Ben Braheem says the [00:30:30] lack of broadband access, was also a challenge for many solutions. Some require a minimum bandwidth. That simply is impossible. and in this post I focused on video of a specifically but the reality is a lot of telehealth was done across plain old telephone. In fact, I was surprised the, a couple of the health systems I talked to that was their primary method. They didn’t even try to stand up video. They just did. phone support because they’re like, look at the end of the day, the only thing we’re looking at doing with the video is [00:31:00] making eye contact but for the most part, most of the other stuff we’re just asking a series of questions, where does it hurt those kinds of things?

[00:31:07]There’s so it’s probably limiting in some, clinical procedures and clinical, evaluations but they were using the telephone. So that’s one aspect. The second thing I said is, I think a lot of these video solutions now work pretty well across 4G.

[00:31:24] And when you look at a map, a 4G has a pretty, pretty wide coverage. It’s not again, not [00:31:30] perfect. And I know there’s areas that still are. I, I’m not unaware that the broadband challenge exists. there’s also solutions on the horizon. You have space X doing what they’re doing and others but again, those are gonna be pricey who knows what’s going to happen. But here’s my thing on this solve the 80% problem, regardless of what people are saying to you, Oh, health disparities. And you’re doing this, solve the solve, the problem you can solve. And then don’t stop until you solve it for everybody, but solve the problem you [00:32:00] can solve.

[00:32:00] Don’t not solve a problem because you can’t solve a hundred percent of the problem. Right. Solve it for the 80%, then get to 81, then get to 82. Don’t stop. that’s how you, that’s how you. Take care of health disparities, and those kinds of things. But at the end of the day, don’t not do a solution because you can’t do it for everybody do for one, what you wish you do for everybody, is the general, principle there.

[00:32:25] All right, let’s go over to the, where are my headlines [00:32:30] here, there. Pull those up. Let’s see. What’s going on the headline front. Articles. So clearly this was a heavy, election cycle, which is where a lot of the, a lot of the discussions and a lot of the articles, focused on over the last, Couple, but let me give you a couple of the headlines that I’ve been, following. So a health evolution summit, and [00:33:00] I will probably cover this article at some point because it is a really good article, a health evolution summit. They did a two, a two part series. The open it hello. There it is. So they did a two part series on, that’s sorry, but they did do a two part series. Where is it? Health evolution? There it is. Our CEO’s obligated to address social determinants of health. the second of two parts [00:33:30] series, focusing on how chief executives can lead healthcare organization in advancing health equity, with data and community partnerships, I’m probably going to post this story.

[00:33:39] So, if you’re interested in having a back and forth on this, is really well done. they talk about, social health evolution forum, preliminary survey data illustrates how participating health care organizations are approaching the following social determinants of health. transportation currently do not address 33% partner with community organizations.

[00:34:00] [00:33:59] 25% use a combination of internal programs and external partnerships. Twenty-five percent running an internal program or initiative 70%. they do that for transportation, housing, food insecurity. it’s really well done. Article you have some, Some senior level people weighing in on it. Tom Sullivan does a great job.

[00:34:16] He is now writing articles for health evolution and, it is really a really good article. let’s see. Damo Consulting. Healthcare gets ready for its starbucks moment. All right, I’m gonna open this [00:34:30] one up. So this is a Patty who was on the show. Damo consulting. this is a good article. Patty writes some good articles. There they’re generally short, which is which I appreciate trying to read as much stuff as I do.

[00:34:44]But when he goes into his, this whole concept of  creating these, seamless care experiences, combining the digital with the physical, and he talks about drive-throughs and Starbucks bought buy online, pick up in [00:35:00] the store, creating those, that safe distance, if you will to receive care and low contact and contactless experiences.

[00:35:10] These are all really important concepts as, we move forward, especially this low contact and contactless experience, the whole thing. He goes, he said, according to Richard Isaacs of the Kaiser Permanente medical group in Northern California, they’re transformative, transformation underway.

[00:35:26] Could move more care out of the medical facilities and [00:35:30] into homes and specialized centers. It may well be the Amazon like e-commerce experience where you order online and have it delivered to your home to overnight is coming to healthcare. Again, I think that is a phenomenal statement of really thinking through the physical and digital and how they’re going to interact.

[00:35:48] I imagine ordering your healthcare. Right. I order the nurse, comes to our house order, the fill in the blank, and they come to their house. It really should start with a telehealth visit. The, [00:36:00] in-office visit should be, pushed down and prior to, we need to think through what the priority. What is the best way to service certain, certain conditions in the safest most effective way?

[00:36:14]There’s a good story in healthcare. It news CIO, his perspective on the promise of digital transformation. So, some good, some good back and forth there. They talked to a Penn medicine, chief information officer Mike  or Sushiya, [00:36:30] says strong leadership is needed to capitalize on technology’s potential, but people are the real enablers, having talked to.

[00:36:36] Again, I just completed a consulting project, talked to a bunch of leading CEOs across the country, and it’s amazing how they keep coming back to this concept of how important their people are and how important it is to take care of your people. How important it is to create the right culture, how much time they spent on building the right culture.

[00:36:56] On cultivating the right environment on [00:37:00] providing the resources that there are people need to be successful on encouraging them. just, it was, really, it, was really I don’t know, I wouldn’t say the word encouraging again, but I don’t want to be repetitive, but it was encouraging to me.

[00:37:14] It was encouraging to me to, to listen to these great leaders. Just talk about, how much time they spend just, building a great team. they are the bill Belicheck of, health it across the, across the country. And some of you work for great leaders. Some of you are great leaders. [00:37:30] And, I think that’s what makes it so exciting to do, the show and to do what we do.

[00:37:36] And, we really appreciate you and that’s all I’m going to cover looking at the time. I am really at the end of what I can do. Hey, don’t forget. We have the, CliffNotes referral program out there. Love for you to be part of that. you can have a win the chance to have an opportunity. The person who gets the most referrals has the opportunity to come on the show and do this week in health IT that [00:38:00] Tuesday news day show with me, which I think is going to be fun, for anyone who does a referral, you get entered in drawing to win a work at home. Work at home kit, a bunch of stuff from this week in health it, and if you get 10 or more referrals, you’re going to get a This week in Health IT moleskin notebook. So participate easy to do. Just go send people out to this They can click on subscribe have them put your email address in as the referral and, And we have [00:38:30] a bunch of people that already have multiple referrals out there and not too late, we just started a couple of weeks ago. So hope you guys, this can be a part of that and I’d look forward to, talking to you on the show. If you happen to win the, the most referrals special. Thanks to our channel sponsors, VMware, StarBridge Advisors, Galen Healthcare, Health Lrics, Sirius Healthcare, Pro Talent Advisors, HealthNXT and McAfee 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 [00:39:00] content check out our website or the YouTube channel. If you want to support the show the best way to do that is to share it with a peer participate in the referral program. Easiest way at this point. Please check back. we really shows every Tuesday, every Wednesday and every Friday. So thanks for listening. That’s all for now.

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