This Week In Health IT Bill Russell Drex DeFord
July 28, 2020

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July 28, 2020: Drex DeFord is behind the wheel today to share the news with you so buckle up. Big stories, CHI Franciscan and Virginia Mason come together with CommonSpirit, 10 ways COVID has changed healthcare, the telemedicine revolution deferred and hackers … dude your phone’s on fire. We’ll also talk about Zoom shirts and concerns over data security and privacy when working from home.

Key Points:

  • Washington-based health systems, CHI Franciscan and Virginia Mason come together with CommonSpirit [00:05:00]
  • The techniques and methodologies for patient’s safety [00:06:45] 
  • Steve Shihadeh’s blog Chiefly Commercial [00:07:30]
  • Top 10 ways COVID-19 is changing the US healthcare system  [00:07:35] 
  • More CMS mandates [00:07:55] 
  • Politico article “Telemedicine Revolution, Deferred”  [00:10:30] 
  • WFH concerns over data security and privacy [00:15:05] 
  • NY Times article “The Video Call is Starting, Time to Put On your Zoom Shirt”  [00:16:20]
  • Hackers using USB chargers to destroy your phone [00:17:25]

News Day – Telemedicine Revolution Deferred – Really?

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News Day – Telemedicine Revolution Deferred – Really? with Drex DeFord

Episode 284: Transcript – July 28, 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: Welcome to This Week in Health IT where we amplify great thinking to propel healthcare forward. My name is Bill Russell, healthcare, CIO, coach, and creator of This Week in Health IT a set  of podcasts, videos and collaboration events dedicated to developing the next generation of health leaders. This episode, every episode, since we started the COVID-19 series has been sponsored by Sirius healthcare.

Now that we’re exiting this COVID-19 series, Sirius has stepped up to be a weekly sponsor through the end of the [00:00:30] year. And I want to give a special thanks to Sirius for supporting the show’s efforts during the crisis and beyond cliff notes is live. It is available if you can’t listen to every show, but you want to know who was on the show and what was said.

Then you should sign up for clip notes. You get a one paragraph summary key moments in bullet point format with timestamps and a one to four video clips from the show. This is a great way to stay current share insights with your team. It’s comes in an email format. You could easily forward it out, whoever you want, and it’s [00:01:00] a great way to maintain your commitment to development during these extraordinary times.

Invitations for guests for the fall shows have gone out and I’m looking to cover the following topics this fall, telehealth. I want to take a look at the impact. If you have numbers, I’d love to hear some numbers. I’m looking for new modalities impact on current outcomes, those kinds of things. We’re gonna have a whole section on 21st century cures.

We’re going to kick that off with a great interview with a Anish Chopra who is, I think one of the, one of the great evangelists [00:01:30] around, sharing the patient record with, patients and with the, innovative the community of developers that are out there, who are looking to innovate.

Work from home. I want to see how work from home evolves. I want to hear how you’re thinking about bringing people back to work. There’s a lot of topics around this, a priority. We’re always looking at priorities. What are your priorities today? How have they shifted due to COVID? What are your priorities heading into 2021?

What are your top of mind projects and has that shifted at all? I always looking at digital initiatives, front door investments, [00:02:00] new approaches to old problems, RPA voice, you know, a lot of digital initiatives out there. Love to talk about those things, infrastructure and operations. We’re going to look at automation, AI, and INO, cloud edge computing software to find.

A security, always going to have a handful of security, topics, a zero trust, identity, and access management. continue to be top of mind, securing the cloud also we’re always looking for if you’re optimizing, clinical workflows, your clinical systems, your [00:02:30] EHR, we’re always looking for how people are doing that in innovative ways that are really impacting.

The clinicians and their workflow and their quality of life, quite frankly. So, we are going to be talking about all those topics. As I said, invitations have gone out, but if you’re an executive right, with a health system, not only the CEO’s, do you have a story to tell about these topics, please shoot me a note [email protected]

if you happen to be a healthcare partner, i.e. A company trying to sell a product, to [00:03:00] healthcare, you could still reach out to me, bill @ thisweekinhealthit.com but almost all of our vendor spots are paid spots these days. this helps us to fund the show’s growth and to fulfill our mission, to develop the next generation of health IT leaders.

And we love our sponsors and we appreciate, them really funding this effort. This week I’m on vacation. You’re hearing my voice is actually an optical illusion as I recorded this intro prior to my time off  Drex DeFord, isn’t that a great radio name [00:03:30] anyway, Drex DeFord is stepping in today to share the news with you.

Drex shares a commitment to keeping people current and sharing his experience with the next generation. He developed a tech service called three extracts. If you haven’t signed up, it’s a great service. I’m signed up to it. It helps me to do research for specifically the Tuesday show. This is where you get three handpicked stories texted to you in one text three days a week, to sign up.

All you have to do is text, Drex D R E X to four eight four eight four eight. Okay, here we go. [00:04:00] Onto today’s show with Drex. 

Drex DeFord: I am Drex DeFord. I’m  substituting forBbill Russell this week for This Week in Health IT. This is one of those things that Bill and I have sort of talked about for a while.

And today, or last week, I guess he sort of came to me and said, Hey, I’m going to take a vacation. And I was like, that’s amazing. He said, do you want to drive next week? I said, sure. Do we have insurance? And he assured me that we did so buckle up. This should be a good, hopefully at least an okay show. And I’ll be a suitable substitute for Bill [00:04:30] a while he’s gone.

We’re going to cover a lot of different stuff. CHI Franciscan and BM coming together. 10 ways COVID changed healthcare. the telemedicine revolution, deferred. According to this article, although I’ll disagree a bit  A. visual capitalist story on working remotely, which I think is a pretty fun story and pretty interesting.

We’ll talk about zoom shirts and, dude, your phone’s on fire. That’s all coming up right now. Okay. So [00:05:00] first let’s talk about CHI Franciscan. Let me flip over to my. To the tabs that I have opened on my computer. There was an announcement last week, 12 hospitals Franciscan and Virginia Mason system would become part of Common Spirit.

Under new deal says they’re going to work together to explore a combination, and create a joint operating company that will become part of common spirit health, and interesting situation, right? Because Virginia Mason has, for the longest time been a terrific standalone [00:05:30] smaller health system here in Seattle.

Brilliant at Toyota production system and lean methodologies. really one of the best in the country and, a super safe place to go regularly. Getting A ratings, from leapfrog. So it’s interesting to see that there were a lot of M and A’s happening before COVID a lot of things sort of locked up as we got into the COVID throes of, you know, all the, all the work that was happening. [00:06:00]

and now things are starting to loosen up again, and we’re starting to see some of these M and a, Some of these MNA deal flows, for the Pacific North West. I think this is going to be a big one. And what I really hope. I mean, my takeaway from this is that hopefully the Toyota production system stuff that Virginia Mason has done and they have been terrific.

Again, I’ve been a fan for years. They’ve been terrific and sort of reaffirming this idea that it’s people process technology. When you try to do new things, things in health [00:06:30] system, the people in the process parts are the hard parts. They are not the easy parts. It turns out the technology in many cases, turns out to be the easiest part.

They’ve done a really great job of sort of putting that together and making it work. And, and I hope that flows over into the new entity. And then the other thing is the patient’s safety. Hopefully the patient’s safety, the techniques, the methodologies that they’ve built, a lot of them using Toyota lean production methods, flows over into the new organization.

So, I’m excited for everyone involved there [00:07:00] and think that will be a, that will be a. A good merger, continue to just keep her eyes open. Cause I think we’re going to see more and more and more of these, Steve Shihadeh, a friend of mine from, back in his Microsoft days. Originally I was the chairman.

I was the chairman of the Microsoft healthcare users group back in the day. And Steve and I worked together, when that was happening, He is a independent consultant now doing a lot of different kinds of work and he writes a blog [00:07:30] called chiefly Commercial for his company Get To Market Health. And, the blog that he writes, last week is the top 10 ways COVID-19 is changing the US healthcare system.

And there’s a lot of really good stuff in here from the greater acceptance of telehealth. And I’ll talk more about that and another article, excuse me, in just a moment, but. He also talks about more CMS mandates that are coming as a result of the work that, healthcare organizations have done, with [00:08:00] COVID there will be more state mandates.

the bigger will get bigger. This ties back to the, you know, the conversation we just had about Virginia Mason, that you will continue to see more and more M and A, and I think. Probably what that means is that organizations that have logically bigger checkbooks, bigger war chest are going to be the ones who are acquiring health systems.

And a lot of them who are barely making it on margins. So continue to watch for that. He talks about [00:08:30] increased centralized control. I think that when you see those mergers, what has happened in a lot of cases is that when a merger happens between one health system and another they never really completely come together or it takes them a really long time to come together.

There’s sort of this lagging process where there’s a lot of decentralization that’s left to the hospitals or left to the other health system that is coming together for some period of time. You know, Steve makes the point that he thinks this will happen a lot more quickly now. And [00:09:00] honestly, I do too.

When there’s a merger, you’ll probably see the increased centralized control happen fairly quickly. That’s also tied to this idea, a point that he makes around increased pressure to reduce variation that also ties to this Toyota production conversation that I had earlier. ironically. Wait. but you know, this is a thing that no matter what we do this, this, this is going to be around controlling cost and better managing costs.

And the more variation we have around any process that we do in a health system, [00:09:30] the harder it is to make adjustments to control costs or safety. Or timeliness or any number of control measures we might want to, I have, on our systems. So I think you’ll continue to see Steve says, she thinks you’ll continue to see increased pressure to reduce variation.

He has a lot of other great points in here, including bringing care to the patients, meaning that in our recent situation, we’ve had a lot of COVID patients on ventilators and trying to get. Them two [00:10:00] MRIs or get them to CT scanners or get them to other monuments that we built in the hospital has become a lot more difficult.

And so we’re going to have to rethink our whole process around how do we get care to patients even when the patients are in the hospital, but it’s a great article. It’s pretty short, pretty easy to read. again, it’s on a Steve Shahada, his blog called chiefly commercial. One of the articles that, that I’m bringing this week, is from Politico and it’s [00:10:30] a titled telemedicine revolution deferred.

And, you know, I think Bill talked a lot about numbers last week that were pretty insightful. The idea that we’ve got, we’ve taken telemedicine from sort of like a few thousand visits a week to like over a million visits a week. but what the article here sort of talks about is that we’re starting to see those curves flex down now.

So telemedicine, fewer and fewer visits over time. And I think it’s logical, right? There were a bunch of. Basically [00:11:00] other care that we may have put off, during the early stages of the pandemic so that we could, create capacity and create more bed space and do other things to make sure we can take care of COVID patients.

that meant we pushed more and more things either off the plate. Postponed them not going to do them now, or we push them to telemedicine telehealth visits. so there’s a logic to the idea that tele-health medicine, telehealth visits are going to fall off. I don’t think that’s really a big deal or a big surprise.

So when you read [00:11:30] articles like this, my point being don’t be dismayed, don’t be disappointed. I think a n amazing thing happened at the beginning of the, of the pandemic and telemedicine really became medicine. And I think we’re going to continue to see telemedicine, telehealth, expand and grow in ways that we really haven’t thought of up till now, home care, home monitoring, lots of other stuff that we’re just starting to kind of get our arms around.

And I think it’s going to be pretty interesting to see where this goes and, and how it continues to [00:12:00] grow and expand. Don’t be frustrated. Okay. There’s a lot of folks who are probably saying, or thinking that, we’re going to have to back off on telemedicine. It’s just not going to hold up. I think no matter where this goes, As we move into future healthcare, whether it’s at risk, healthcare value, best value based healthcare, the digital front door patients and families want tele-health.

They want telemedicine and we’re going to have to give it to them. So, stay the course, [00:12:30] keep on the path that you’re on. Cause I think it’s a. It’s really a good one. There’s a, there’s a really interesting article. One of the sites that I, am a big fan of is visual capitalist. And the reason I’m a fan is that I’m kind of a data nerd.

And so, and I’m probably a data viz nerd cause sometimes things that are really complicated, you know, a picture’s worth a thousand words. So when things are really complicated, if somebody can draw a picture for me, it makes it a lot easier for me. It makes it a lot easier [00:13:00] for me to understand. So I like the visual capitalist site and one of the articles they wrote a couple of months ago, which is still sort of stuck near the top of the list of the articles that they’ve published recently is how people in companies feel about working remotely. There’s some really good stuff in here. I mean, it’s a fun article. It’s a really interesting article to read and it totally there’s stuff that I’ve published over the last few weeks in three X Drex about, the sales of sweatpants, being up, 80% and the [00:13:30] sale of a dress pants falling off a cliff that people love to work remotely.

It gives them flexible schedules. The article talks about, you know, being able to work from any location, being able to avoid the commute, which a lot of people really hate. And then of course spending more time with family. But the really interesting part of this that I think we saw over and over again.

Early in the pandemic was that, if there were challenges getting a company culture, there were a lot of companies and a lot of health [00:14:00] systems who had up til then had a there’s no way people are working from home. Everybody needs to be in the hospital or in the building or whatever. That’s, that’s how we, that’s how we run things here.

And, overnight we saw people say, you know, Starting tomorrow 3000 people need to work from home. And fortunately it was really fun to see, CEO’s and CISO’s and chief technology officers being able to bend and flex and scale and, and being [00:14:30] agile and being able to that happened. And I think there were a lot of things that we had to do to sort of.

Make that make that process occur and we’re going back and cleaning those things up now. But, but the culture changed really quickly. And I think a lot of organizations are now realizing that maybe that culture that they originally had, that nobody could work from home is a little outdated, but that turns out to be the biggest obstacle.

And once you get past that, there issues around privacy [00:15:00] and understanding, you know, the technology requirements. There are certainly concerns over data security and privacy. I think, I think I said privacy earlier, but data security and privacy. So, we’re getting there. The, the big benefit that I see coming for many of us, if, if we continue to kind of hold the fort on this work from home idea or work from anywhere idea is that there’s some really great people with really great talent who want to live, where they live, but they want to work where you [00:15:30] are.

so they may want to work for your company, but they may have a hundred different reasons why they don’t want to live in the city where your company is located or where your health system is located. If we can get over that, you can probably get some top notch, talent. You might be able to get some top notch, top notch, talent, relatively cheaply, because they want to live somewhere where costs aren’t astronomical.

So think about that. Talk to your HR folks, continue to push the button on that. I think that’s a [00:16:00] big one for us. It could be a big win, especially in healthcare. It finding a really great staff that doesn’t necessarily need to be in the same building where you are. which leads me to my next article, which is, a little bit of fun.

It’s from the New York times  it’s called The Video Call is Starting it’s Time to Put on your Zoom shirt. So, they’re definitely have been times where, for me personally, I have a, had a shirt hanging on the back of my door [00:16:30] and, I have put that shirt on for Zoom calls and, since sometimes it’s a recognizable shirt.

I’ve had people call me out on that, like, Hey, do you ever do laundry? That looks like same shirt you were wearing a couple of weeks ago. So yeah, I do laundry. And, the point being, maybe you need to think very carefully about what you use as your zoom shirt, because I know I’m not the only person doing it.

I see you doing it too. So, just hang in there and take care of your Zoom shirt. It’s [00:17:00] very important. and finally, you know, dude your phone is on fire. It’s it’s kind of interesting, man, from the security perspective, there are so many things that happen, that are frustrating and maddening, right?

And this one has to do with hackers having now figured out how to go in and do something to your USB chargers so that they will destroy your phone by giving them too [00:17:30] much power. We’ve already had this other power problem with USB, in that you would, go to a hotel or, you know, on it on a plane or someplace else, and you would plug into USB to charge your phone.

And it turned out that that also could be a situation where bad guys were getting to your data. So, organizations, businesses came up with these little adapters that allowed you to plug in that only allow power to flow. So that was good. Now they figured out the bad guys have figured out how to take those high speed, [00:18:00] high speed charger, USB, units.

Unfortunately, everything is a smart device. These days. They figured out how to, how to hack into those overwrite the firmware and make them burn up your phone. So. The point being man, just be careful. Okay. It’s a little, it’s a little crazy. Yeah. There, you never know what’s going to happen. take care of your phone and be very thoughtful and careful about when and how you charge, you know, bring your own stuff.

That might be the best advice that [00:18:30] I can give you. Hey, hopefully that worked out. Okay. This Week in Health IT Bill Russell will be back next week. There aren’t any the other shows this week, as I understand. So, you know, take the rest of the week, hit the YouTube channel, catch up on past episodes.

There’s a lot of great stuff out there. It never goes. Never goes stale. I’m Drex DeFord again. Thanks very much. See drex.io or  three extracts.com. You can sign up for my text updates at text [00:19:00] Drex D R E X two four eight four eight four eight. I’ll give you three articles a week that have a lot of the same kind of stuff in it.

Thanks. And, I’ll see you next time. Bill gives me the keys. 

Bill Russell: That’s all for this week. Thanks to Drex for stepping in no insurance necessary. As Drex is always a welcome voice in the community. Special. Thanks to our sponsors vMware, Starbridge Advisers, Galen Healthcare, Health Lyrics, Sirius Healthcare, and Pro Talent Advisors for choosing to invest in developing the next generation of health leaders and stay tuned because we have some [00:19:30] new channel sponsors joining us in August.

if you made it this far, you are a fan of the show. Please do me a favor and send an email to one person who you think would benefit from the show and share it with them. We will do our best to honor your support by producing great content with industry leaders to propel healthcare forward. We’re going to be back next week with shows on Tuesday, Wednesday, and Friday as we kick off our fall schedule.

Thanks for listening. That’s all for now. [00:20:00] .

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