December 15, 2020

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December 15, 2020: Drex DeFord and Bill are at your service. What predictions do they have for 2021? Will AI go to town? AI in the pharma space, AI automation around communication, AI robotic process automation. Will there be so much AI that people are going to say, I’m tired of hearing about AI? How will Providence bring back remote employees? Is 5G’s day in the sun still a couple of years away? It’s the starting gate for the vaccine distribution. We know healthcare workers, frontline responders and long-term care facility individuals get the shot first. Who gets it after that? How will we track the immunity? And SpaceX’s first high-altitude Starship test could happen as soon as today. 

Key Points:

  • It might be the most important vaccine that you will ever take in your entire life [00:06:25] 
  • You’re going to need a queuing mechanism to let people know they can get the vaccine. Either digital queuing or email or text. Maybe even a fax. [00:11:55]
  • The paper vaccine passport is worrisome because it gets into the fraudulent activity space [00:21:30] 
  • Vaccine logistics are super complicated. Even simple things like the glass vial problem. [00:25:50] 
  • Providence released their strategy to bring back remote workers. It will modernize how employees work in public health post the public health crisis [00:31:35] 

Stories:

News Day – Vaccine Distribution, Return to Work Plans and SpaceX

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News Day – Vaccine Distribution, Return to Work Plans and SpaceX

Episode 341: Transcript – December 15, 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] All right Welcome to This Week in Health IT.  It’s Newsday. Our last episode of the year. Today we’re going to talk about vaccine distribution, which has really dominated the news cycle. We’re actually gonna do a little predictions for 2021 Drex and I you know, why not? Since none of the predictions for 2020 were correct. We’ll try it again for 2021. And then maybe we’ll be a little more accurate this year. My name is Bill Russell, former healthcare CIO, CIO, coach consultant, and creator of this week and [00:00:30] health IT. I want to thank Sirius healthcare for supporting the mission of our show to develop the next generation of health leaders.

[00:00:35] Their weekly support of the show has allowed us to do, an amazing amount of stuff this year to expand our service offerings and to develop new content for the community. And for that, we’re incredibly thankful if you haven’t signed up yet for 3xDrex, DrexDeFord, our co-hosts for today’s show as a service three extract, three stories, three times a week, vetted by Drex just texts DREX to four eight, four eight, [00:01:00] four eight directs is in the house. Good morning, Drex. How’s it going? 

[00:01:03] Drex DeFord: [00:01:03] Hey, how’s it going? How’s how’s everything down in Florida? 

[00:01:08] Bill Russell: [00:01:08] Florida is nice, you know how hard news to say 3xDrex, text Drex to, all that. I mean, it, it just sorta, from a tongue twister thing, it’s I’ve said it so many times now it just comes out. But. how’s that, how’s that service going? I mean, I looked at it this morning. You had, [00:01:30] you had a story about vaccines and a couple other things, a bunch of security stuff. So, yeah, how’s the service going? 

[00:01:39] Drex DeFord: [00:01:39] It’s going good. I mean, I think, it’s, it’s something that I started really about a year ago now. And, no, it did it just, without any sponsorship really kinda just wanted to try to get some stuff out there. I had originally been told by some folks that I was posting a lot of stuff on LinkedIn and [00:02:00] that they were really honing in on that, skipping a bunch of other things.

[00:02:03] And so I said, let me try to do something by text because nobody else does that. And you know,  it’s going well, I get good feedback. Every issue that I send out, somebody winds up or more than one winds up, either sending me an email or send me a text back and telling me that something in there was really surprising or good or interesting or whatever. So it’s fun. And it’s really, [00:02:30] I don’t know that it’s going to turn into anything big. It’s mostly just a way for me to communicate to folks who like to., like to hang out. 

[00:02:38] Bill Russell: [00:02:38] Yeah. I was going to launch 3xBill but it just didn’t go. So we’re just going to keep referring people to your service. Actually, it’s a phenomenal, phenomenal service. I pick up one or two stories for, this week, every, or for this show every time. So you’re signed on for 2021. We are going to, this format [00:03:00] has actually, a lot of people like this format, so we’ve, I’ve found a couple of your peers.

[00:03:06] So Sue Schade’s going to join me every six weeks. You’re going to join me every six weeks. I have two others that I can announce yet because  they’re getting permission, but they’re pretty sure that they’re going to do it. So we’re going to, we’re going to get the news from a lot of different perspectives. We’re going to have six different co-hosts next year. I didn’t want to overwhelm any one of you with preparation, but we’re gonna, we’re gonna do this format for the show all [00:03:30] next year. So it’s gonna be, it’ll be like, I didn’t actually, I enjoy this more. I enjoy the back and forth. It’s a lot easier.

[00:03:35] Drex DeFord: [00:03:35] I think it, I think it works really well too. And you found some folks that you work really well with. And can have really good conversations with. Sue Schade is ridiculous. I mean, she’s amazing. I mean, first of all, just her background and the skill and talent that she has and all the interim stuff that she’s done since she’s kind of pretended to hang it up. Yeah she has so much experience and [00:04:00] insight and she’s going to be a great co-host. You’re gonna have a great time with her. 

[00:04:05] Bill Russell: [00:04:05] Yeah, we’ve had several conversations, over the years. She’s, it’s interesting because there’s there’s some things that we don’t necessarily, and this is what I like, and I’m going to really try to push this more next year is, is the areas where we don’t see eye to eye. People I think, listen to the show and think we agree on everything and we don’t. Necessarily agree on everything, in terms of approach and those kinds of things. I mean, there’s some things, obviously we [00:04:30] believe in, project governance and intake and different ways of doing that and how important it is.

[00:04:36] And, we believe in a digital foundation for health. I mean there’s, there’s a whole host of things that we’re like, yeah we fundamentally agree on these things, but there’s ways of going about things that I think we spark each other’s thinking and ideas towards. So. 

[00:04:52] Drex DeFord: [00:04:52] I agree. 

[00:04:52] Bill Russell: [00:04:52] Towards that. Let’s talk vaccine. One of your stories from this morning was vaccine. I highlighted a couple on LinkedIn. [00:05:00] The vaccine rollout is, we, I guess we are at the starting gate. I think a lot of health systems are saying by the end of this week, they’re either going to get the, well, I think the Pfizer vaccine is going to start going out this week and then the Morderna vaccine will be following in the not too distant future.

[00:05:22] So, we, we’ve actually had a little bit of a conversation about this before, how [00:05:30] I don’t even know how to, I don’t have a tee this up, because it’s interesting to me because we’ve known this was coming. This is not a surprise. We’ve known this was coming for a long time. You would think we were flat out ready.

[00:05:46] We’re prepared. We’re, Hey, we’ve done flu vaccines for years and we’ll just take that module and away we go, in your story, the new highlight today is about using paper to track the [00:06:00] vaccine usage. I mean, it is that, is that really going to be the best method with given the amount of money we’ve invested in technology at this point?

[00:06:09] Drex DeFord: [00:06:09] That’s  the point that I made in 3xDrex this week, was the idea that we spent 35 or 50. depending on what numbers, you see, $38 billion in the meaningful use period to build electronic health records and all this stuff. And now we have a vaccine. It might be the most important vaccine that you will [00:06:30] ever take in your entire life.

[00:06:32] And we’re going to keep track of it on a little paper card that they’re going to give you when you get your vaccine. Here, sir, please take this, fold it up, put it in your wallet. And then when you come back to get your next vaccine, we’re going to need for you to produce this again so we can make sure that everything matches up.

[00:06:47] And I mean, there’s a whole bunch of things in this. I mean, first of all, does anybody carry a wallet anymore? That’s just start right there. That could be a problem, but just the, [00:07:00] I think this is why we have, why we still have fax machines in healthcare right. We built big, complicated digital, electronic health records. We’ve discovered surprisingly that they don’t inter-operate very well. And we’re working on all that. Don’t get me wrong. People are bending over backwards. They’re working really hard to try to fix this stuff, but, man it’s a, it’s painful to think that we’re going to go into this with paper records.

[00:07:29] And I [00:07:30] sort of jokingly called it the other day when, you and I, and a bunch of other IT people were on the phone. 

[00:07:36] Bill Russell: [00:07:36] You did 

[00:07:37] Drex DeFord: [00:07:37] I said, I bet you, we wind up going to some kind of a paper record for this. Like, I spent 20 years in the military. We had a paper shot record. If you’ve ever, if you’ve been in the military, you know what I’m talking about?  It’s this little yellow form and you carry it around. It’s gold .

[00:07:52] Bill Russell: [00:07:52] We used to have that with vaccines as well. When we were kids, we had this little vaccine record and I mean, I guess no one thought about, hey, you can usually forge [00:08:00] that but we had that record. We’d take it to our school and say, look, they’re little checks next to these vaccines. We’ve got them. And then they would accept it. It’s crazy. Yeah. 

[00:08:10] Drex DeFord: [00:08:10] Yeah. So I worry about this, but you know, the other part of me is keep it simple stupid. And if it’s, if paper will work and we can figure out how to make it work, then maybe that’s the, maybe that’s a good route. I know I’ll, if I, when I get mine, I will immediately take a [00:08:30] picture of it and store it on my phone. And that’s probably how, I’m how I make sure that I keep track of it. But. 

[00:08:36] Bill Russell: [00:08:36] I’m probably going to get a tattoo just to let people know. Well, I mean, how else are they going to know? Other people are going to be walking around going, Hey, that guy doesn’t have a mask on tackle him. I would be like, no, no look at my tattoo.

[00:08:49] Drex DeFord: [00:08:49] I have my card. It’s going to be interesting as we go through this. And I just was on a call with some friends from London this morning, and they were saying that, they have started giving [00:09:00] out vaccines there and the conversation very quickly evolved into exactly where you’re going, which is some people are going to get vaccines early.

[00:09:10] They’re going to be people who are in long-term care facilities and healthcare workers. And so healthcare workers are probably going to be able to start doing things that the rest of us are going to have to continue to be hunkered down for, for the next six months or eight months until everybody gets their vaccine.

[00:09:30] [00:09:29] Bill Russell: [00:09:29] Right. 

[00:09:30] Drex DeFord: [00:09:30] So how’s it. How’s that going to work? Are they going to have some kind of a special ID? You know that they produce another paper document that they have to carry around their shot record, proving that they got there so they can get into a football game or a you know. 

[00:09:44] Bill Russell: [00:09:44] Here’s what I want to do. I want to structure this conversation a little bit. So you and I both have experienced a CIO, so, and I want to, I sort of want to break down the challenges that are associated with this. The, yeah, I mean, we were on the same call and when we asked some [00:10:00] doctors, when do you think we would get it. So I’m in my fifties, fairly healthy and those kinds of things.

[00:10:05] And they said, yeah, at the earliest March at the earliest, because that’s just the pecking order of who will be getting this and more than likely it’ll be later in the spring that we would get it. So let’s break this down into a. Some of the challenges that we face. First of all a two dose vaccine a two dose regimen.

[00:10:29] So [00:10:30] you have the initial shot and the booster, and that’s where we’re talking about the card, right? So if you get the first one, you get the card, they carry the card with you, which we all hate. I mean none of us like to go to stores that require receipts for returns anymore. Amazon’s changed all that. And so we’re going to have that card which is, which will mean in theory, which will mean I can go to one health system for the starter shot and another for the booster shot and have my little card and it will, [00:11:00] it will indicate. Now the problem with that, but I mean, let’s just, let’s start with that two dose regimen and say, all right we need a way to notify people that they are eligible for the vaccine, right? So it’s going to start with, first responders, frontline workers. It’s going to go to, those who are at risk of maybe the nursing homes and other places and those kind of things. And it’s going to move through. those [00:11:30] channels. As we move through those channels, we have to keep track of the people. who’ve gotten it the first time and who are, who need to come back the second time. And follow up with them and make sure they come back the second time. But we also have to have a mechanism for scheduling this. So my parents are already saying, Hey, how do I get on the list? How do I get scheduled? 

[00:11:53] And that’s going to be health system by health system, kind of. Basis. Right. And you’re going to need some [00:12:00] queuing mechanism, either a digital queuing mechanism or some other mechanism. I, I mean, maybe it’s an email mechanism. They use a fax, maybe it’s a text. and actually, I, I don’t really care which one it is, but you need a queuing mechanism to let people know, that they are, they can get the vaccine.

[00:12:20] Otherwise people are gonna start showing up at the emergency room. I think. What mechanism are we going to use to let people know? Because to be [00:12:30] honest with you, there’s part of me that feels like we’re going to have to convince people to take the vaccine. But I’m really more in the camp of, I think people are kind of tired of the way we’re living right now and they’re ready to be beyond it. I think there’s going to be a line at least upfront. I think there’s going to be a line of people going. Yeah, let’s get to the other side of this. Sign me up and they’re going to be asking the question. How do I get in line? How do I get mine? 

[00:12:57] Drex DeFord: [00:12:57] Yeah. Yeah. That’s a great [00:13:00] question. And hopefully there are some analytics, people that are working over time right now that are sort of figuring out what is the, what is the shot protocol? What is the vaccine protocol for first, we’re going to do this group, then we’re going to do this group. And I mean, we’ve, they’ve tried to lay it out a little bit already saying healthcare workers, frontline responders, and a long-term care facility. individuals get the shot first. And then who gets it after that?

[00:13:26] Well, there, there are a lot of protocols that have been laid out and [00:13:30] like you I’ve gone. I think it was the New York times that had a, a pretty interesting little tool that they published maybe last week that let you put in your age and whether or not you had comorbidities and ask you if you were a healthcare worker and then it told you your place in line locally compared, if there were only a hundred people online, where are you? And I was like 96. I was way in the back of the line. but [00:14:00] there’s there’s I mean, comorbidities, right? That’s another thing that you’re going to look at. These are people who have other healthcare problems that we want to make sure get the shot, because these are the kinds of co-morbidities that are most likely to have a very negative outcome if they get COVID and they have this pre-existing condition. So that has to be part of it. Like I said, I hope somewhere in your health system, there are some analytics folks who are working through this, [00:14:30] searching through your. Electronic health record, finding people, building some kind of an order.

[00:14:35] And then the conversation comes down to how do you contact them? And where do you contact them? Are these people who live local? Do we have, or the right phone number? For the folks who have Salesforce and are probably doing some at-risk contracting and are in regular. Contact with our customers cause they’re, always trying to make sure that they’re doing all the things they should do from a preventative health perspective and [00:15:00] staying healthy. They’re probably going to have a lot better luck than a lot of others who I think are going to struggle with the who’s who’s on first and who gets it first.

[00:15:10] Bill Russell: [00:15:10] So here here’s some of the questions I think we need to answer, and it actually, we can even make this easier and just say, who gets it first within the health system? Right? So a lot of health systems are doing surveys right now, their staff to ask the question of who wants to get the vaccine. You have determine if the insurance is going to cover it.

[00:15:25] If the health system is going to cover it in terms of the, the costs. [00:15:30] you have to have a tracking mechanism, right? So I guess all EHR has have a tracking mechanism for tracking vaccines in that we’ve done the flu for years. I don’t know how much more, different the bills will be for COVID or if we’re just going to use the flu, whatever the flu workflow is and just mark it as COVID somehow or whatnot, I would imagine that’s going to be a pretty easy, [00:16:00] pretty easy workaround. The other challenge, to be honest with you, I know in the state of Florida, or at least I’m being told in the state of Florida, only five health systems are getting the first supply of vaccine and, in the month of December.

[00:16:15] Right. So. First of all, not all health systems are getting it. Second of all, they’re not even getting enough to cover their workers. and so there’s a communication process here. We keep talking about how do you get in [00:16:30] line? That’s a question that needs to be answered like today. If you’re, if you’re listening to this show, this needed to be answered actually last week and needed to be answered last week.

[00:16:40] That your community, there should be news stories on all the major news you should be posting on social media. This is how you get in line in Southern Florida. This is how you get in line in Seattle to get the vaccine. And Oh, by the way, here’s the CDC guidelines. There’s nothing magical about that New [00:17:00] York times list. 

[00:17:02] Drex DeFord: [00:17:02] It’s a super simple tool.

[00:17:04] Bill Russell: [00:17:04] Yeah. I mean, you and I, you and I probably with somebody with a little more programming skills than us these days, but could probably have that written up by this afternoon and put on our website to says, do you want to know when roughly, when you’re going to get the vaccine and, Oh, by the way, when you’re done taking that click on this button, if you’d like to schedule an appointment for that for this range of times, and we’ll contact you via text or [00:17:30] those kinds of things.

[00:17:30] So we have that aspect, but then we also have the public health aspect Drex. I’m looking at this going, how are we going to track the immunity, right? W we need to get to eight, I’ve been told numbers that are really high, and I don’t know if this is the case or not, but given how, how, how this thing really passes from individual to individual, it [00:18:00] appears to me, they’re saying, look either, either people who have had that had COVID. Or people who have the vaccine has to get upwards of 80, some odd percent to really slow the spread. 

[00:18:13] Drex DeFord: [00:18:13] That is the herd immunity number, right. That is the point at which if 80% are immune or have had the vaccine then yeah. You, you’re at the point where the virus has so few places to attach that it really starts to become insignificant.

[00:18:30] [00:18:30] Bill Russell: [00:18:30] So am I going to have to report that information to the CDC? 

[00:18:38] Drex DeFord: [00:18:38] As far as the number of vaccines that you’ve provided, I’m sure that there’s going to be a reporting requirement. There has to be.

[00:18:46] Bill Russell: [00:18:46] Has to be. So what if I’ve, what, if I’ve done 75% more of the first shot than the second shot? 

[00:18:56] Drex DeFord: [00:18:56] I definitely worry about that. Right. Cause people will come in and get the first shot and feel [00:19:00] like they’re probably going to be okay or they’re going to come in and they’re going to get the first shot. They’re going to feel like crap because that may very well be a side effect. And then they’re going to decide that they’re going to decide that they’re not going to go back and get the second shot. What’s that effect going to be? How many of those people are going to fall into this bucket? What does that do for immunity? Right? Because we know. For other things like taking a antibiotics, you got to take all the antibiotics or you might just [00:19:30] supercharge but. I don’t know if it works the same way for a vaccine. We’d have to get a public health person on it.

[00:19:35] Bill Russell: [00:19:35] Alright so let’s move beyond let’s. So people start getting it. And actually the timeframe to me, I’m not worried about the summer. Cause, as we’re seeing in like Australia and other places in the summer, this thing did not really take off, it is for whatever reason, when we are outside,  more ventilation w whatever the reason is, I’m not a doctor. Don’t, don’t hammer me on these things, but we’re seeing this in the Southern hemisphere right [00:20:00] now. It’s summer. It’s not spreading as much, but we’re in winter. People are indoors. It’s, we have, we have a surge going on all over the place, but in the spring, I’m worried about. a certain amount of people are going to have gotten the vaccine. Certain amount of people will have had COVID. And my guess is it’s going to start looking like normal come March or April. And it really probably shouldn’t yet look like normal. So how do we [00:20:30] go back to normal safely? And is it a passport? Is it, is there a technology solution? I joked about the tattoo.

[00:20:40] But how am I going to know that Drex has had the vaccine and this person hasn’t had the vaccine and we get to let’s next major holiday would be Easter or, Memorial day. That kind of stuff. When we start to, start to get together again, how are we going to [00:21:00] know we’re safe? 

[00:21:01] Drex DeFord: [00:21:01] Hmm. Well, I mean, I think it’s the same, the same kind of thing we do now. And I think this is going to go on for a while. You’re going to have your bubble. You’re going to, probably a lot of people are going to continue to wear masks no matter what, even if they’ve had the vaccine, I think we’re going to find out that people are going to say you should continue to wear the mask just because it’s hard to say somebody not wearing a mask did they have the vaccine? Right. You get into this whole issue that you were talking about earlier. The whole passport thing. [00:21:30] worries me a little bit, because then that gets into the, the ability to do fraudulent stuff. I know that there were several companies that looked early on into this idea that, you could go to NBA games. If you. Took the survey about feeling, not feeling well, or if you had the vaccine or, whatever. And then 

[00:21:54] Bill Russell: [00:21:54] Trust me

[00:21:56] Drex DeFord: [00:21:56] Show up, show up 15 minutes before the game and you can get in and [00:22:00] otherwise you have to go through this sort of the line where they give you all the, you have to pass through all the protocol tests, but, man, it’s yeah, I think it’s still pretty messy. I think we’re all very hopeful about the vaccine. We know that it’s coming soon. You have some vague idea where you are in line but there’s, there’s all the messiness that’s around us right now. And that includes, I mean, all the logistics stuff, right? The, the cold chain for [00:22:30] some of these vaccines are really hardcore and you don’t want to get, I mean, if you get a shot from a spoiled, batch of vaccine, because it warmed up, you wouldn’t know that and what’s that effect going to be? So there’s a, there are a lot of things. I mean, even buying refrigerators, I’m talking to friends at health systems and their health systems are buying refrigerators now.

[00:22:53] And then I’m talking to friends with smaller health systems in rural communities who are like, we can’t afford those refrigerators. So how are we going [00:23:00] to get the vaccine? This whole thing is really sort of continue to amp up the haves and the have nots and healthcare, bigger health systems and rural health systems and smaller communities. And, I think, I think we’re going to continue to see this exacerbated a little bit as we get into the vaccine march. 

[00:23:20] Bill Russell: [00:23:20] Yeah. well, I think we’ve done our duty here. We, we did, we had a couple people that were on the phone with. earlier last week where they said they were going to do a [00:23:30] drinking game and drink every time we said the word vaccine in the show, at this point they’re underneath the table. We have said the word vaccine a fair amount. Hoof!  These are, these are some interesting questions and IT clearly is not answering these questions by themselves, but there’s, there’s an awful lot of, data challenges. there’s a scheduling, there’s follow up messaging. There’s a reporting. There’s, there’s an [00:24:00] awful lot of, challenges associated with this that will fall squarely on the health IT leaders and it will be interesting. I have not heard of a system yet that I’ve talked to who said, yeah, we’ve got this wired. We feel pretty good about it. There’s, it’s, it’s new. There’s a lot of unknowns. 

[00:24:21] Drex DeFord: [00:24:21] Yeah. It’s it’ll be interesting to see as are you going into January, how this [00:24:30] evolves and whether or not we have a national plan that is then duplicated by the States. I mean, the challenges vaccine is coming. Like you get it, somebody’s getting it next week. So if we have a plan, it needs, we need to know what theplan is. I’m totally with you Bill. And I’m not, I don’t have my, I don’t, I don’t have my head wrapped around it yet. I’m not seeing it. 

[00:24:55] Bill Russell: [00:24:55] Yeah. I’m not seeing it. And I actually talked to somebody in Florida yesterday. I [00:25:00] said, what are the five health systems that are getting it? And they’re like, they can only name four of them. And when they were done, I’m like, okay, you didn’t name any in Jacksonville and you didn’t name any in Southwest Florida. They’re like, Yeah. I mean, it’s going to Miami, it’s going to Orlando. It’s going to the major metropolitan areas because that’s where we’ve seen a significant, outbreak.

[00:25:23] And, and I understand that look, the supply chain, it’s not like they can, they can pump out, 50 [00:25:30] million doses in December. They’ve got a ramp up the supply chain. They’ve got to make sure that the supply chain lasts as long as it needs to last, which is a fairly long time at this point in order to, because we’re, we’re not only talking about vaccine vaccines in the U S we’re talking about vaccines around the world, around the world.

[00:25:50] Drex DeFord: [00:25:50] Yeah. I mean, even the simple things like the glass vial problem and, on and on and on it’s it is a, is a super [00:26:00] complicated, logistical. challenge to resolve and, hopefully we have some good people. 

[00:26:10] Bill Russell: [00:26:10] Yes. And I think we do. And so you’re, you’re a space geek. We’re going to talk about space X high altitude star ship. We’ll talk. Providence has actually announced their remote work, back back from COVID. So we’re going to, we’re going to hit those. In a minute. 

[00:26:27] But I do need to, [00:26:30] discuss the clip notes referral program because my, my team will be mad at me if I don’t, the Clip Notes referral program. If you’re not familiar with clip notes, you get, an email 24 hours. After each episode airs, it’ll have four video clips. We’ll have a summary and I’ll have bullet points. Of the key things that were said, this is a great way to stay up to date. Great way to hear from great leaders. We just had Darren Dworkin and on, this, this week, actually this Friday, and last Friday, we had [00:27:00] Marty Paslick.

[00:27:00] Drex DeFord: [00:27:00] He was really good. I, Darren, because I loved his background with all the old Mac computers and things sitting back there. Yeah. 

[00:27:08] Bill Russell: [00:27:08] Yeah. I’ve been I’ve, I’ve been in there a couple of times. He, he has fired, he fired up the trash, Amy. The TRS 80, rate it’s a radio shack machine back in the day, he did fire it up and he said, and the, you could smell that sort of a burning Silicon smell. And he goes, I, I thought it might be smart to power it [00:27:30] down before I burned down a building in Beverly Hills. So, you can imagine, I, it amazed me that those things run, but he swears that, almost all of them will, will power on if you, yeah. 

[00:27:43] Drex DeFord: [00:27:43] He has quite the collection in his office, in that outer area. And then in his office too. old computers. Yeah. That’s a hobby of his, 

[00:27:51] Bill Russell: [00:27:51] It’s, it’s pretty amazing. Well, yeah, you’ve been down there to help with the accelerator as well. Haven’t you? 

[00:27:56] Drex DeFord: [00:27:56] Yeah, yeah. He’s they, [00:28:00] they, they have quite a, I mean, Darren just on his own super smart guy has, does everything from, investments to being the CIO at Cedar Sinai, pretty, pretty incredible career but the accelerator just on its own, was, one of his and the teams, brainstormed down there to be able to bring companies and that, that have opportunities to change healthcare. And they’ve actually been really successful. Many of the companies that have gone through this [00:28:30] accelerator, The accelerator I’ve gone, I’ve gone on to the, really successful.

[00:28:34] Bill Russell: [00:28:34] Well the thing I like and I’ll get back to ClipNotes referrals sidetracked, but the thing I love about talking with, with Darren on the show is, I send the guests like, Hey, here’s, here’s, here’s the topics. Here’s some questions I’m thinking about asking. And for the most part, I stay on those. And when I get on with Darren, he essentially looks at me and says, yeah, you can ask these questions, ask me anything you want, plus, let’s sorry, let’s talk about [00:29:00] whatever you want to talk about. So he’s one of the few people that I can just go, hey, I have this question and he’s been great to answer them and ensure, the things they’re doing. 

[00:29:12] Clip notes, referral program. If you’re not participating in the easiest way to do that, just go to a. Go to our website, you can hit subscribe and you can subscribe to clip notes. If you want to recommend it to somebody. right now we have this referral program going on. If [00:29:30] you, if you get one referral, which directs you to have a referral, by the way, if you get one referral, you’re entered in the, in the program. So you can receive a work from home kit, and we’re going to do that drawing on January 1st. if you had 10, you get the black mole skin notebook would just sitting over there on that table where I, where I was journaling this morning. And, if you are the number one vote getter, I’m not going to force anyone, but you get [00:30:00] the opportunity to come on this show and discuss the health IT news. with us. And if you’re wondering if it’s too late, it’s not too late. Where did this goes all the way through the month of December? And the leader on this only has about four or five referrals. So nobody’s gone out and gotten 20. We’ve got a whole bunch of people that got you know five, four, three. So it’s actually a pretty close race. I think people send it to a bunch of their friends, they signed up and, I think the [00:30:30] best way for this is if a CIO, where to send it to their staff, the whole staff, the whole staff, and say, Hey, you should sign up for clip notes that they would flat out be the winner.

[00:30:41] Drex DeFord: [00:30:41] For sure 

[00:30:42] Bill Russell: [00:30:42] I think it would be interesting actually. If I were a CIO, I would do that. And here’s why I would do it. If nothing else view, set the foundation for your team, staying current and having good conversations. So yeah, that’s why I would 

[00:31:00] [00:30:59] Drex DeFord: [00:30:59] Do that. Yeah. Send them an email and tell them to sign up for clip notes and 3xDrex. And you do that. You got the old double whammy going and, your, your team’s going to know what they’re talking about. They’re going to, they’re going to be in the know. 

[00:31:15] Bill Russell: [00:31:15] Yeah. So, I’m going to save the space X ones for the end. That’ll keep you, tuned in to the show. Cause I know you’re a, you’re a huge space, a X space space fan. All right. Providence, how [00:31:30] Providence will bring back remote employees. So Providence is in your neck of the woods, 51, the hospitals, and, an awful lot of people working from home. There’s this, see with the vaccines closer to reality. Providence has finalized post COVID 19. virtual work strategy for administrative employees to modernize how work will be performed in the public health, post public health crisis.

[00:31:54] What we will be doing in the future is giving employees the ability to have more flexibility, collaborative, [00:32:00] engaging work experiences. Mr. Till said, a lot of that is accelerating plans that have been working. we’ve been working on for the last several years and we’ve projected, what the future will look like. Mr. Till by the way, is. Has to be in this article earlier, Greg Till Chief People Officer. There you go. There you go. July 1st will be the earliest that remote administrative employees can return to facility facilities and offices unless they can’t work productively from home. Mr.  [00:32:30] said a few employees will work onsite daily and a few will work from home daily, but most of Providence is administrative workforce will work anywhere from two to four days a week from home, where an employee works day-to-day will be based on the individual and their role.

[00:32:45] He said, based on what we’ve seen so far during the pandemic, we believe that it’s going to be something that improves our employee experience and their productivity, our indicator that gives us confidence in this approach is our recent employee engagement [00:33:00] survey. Showing that seven point improvement from those who have been able to work remotely, Providence will replace personal offices and cubicles with flexible, open and shared hotel work and collaboration spaces to support the hybrid model.

[00:33:14] So you know, the reason I pulled this story up is because. I’ve talked to a lot of CEOs about it, and this is the first one that’s just out, coming out and saying, Hey, this is what we’re going to do post COVID. Have you seen any others at this point? 

[00:33:28] Drex DeFord: [00:33:28] No. I think there are a lot of [00:33:30] folks who are thinking about it and considering what the, what the process is going to be to bring people back. Or even if in some cases they’re going to bring people back. Because I think there are a lot of folks who are thinking long-term this work from home thing may be a thing that at least some subset of employees are going to be. Very well suited for but this is the first one that I’ve seen sort of publicly announced. This is our process and, up until July 1st and probably going to change the [00:34:00] date, but up until July 1st, if you want to work in the office, you’re going to have to get permission kind of is how it sounds? 

[00:34:07] Bill Russell: [00:34:07] Absolutely. 

[00:34:08] Drex DeFord: [00:34:08] Yeah. So it’s the first one I’ve seen and it’s good. I’m glad again, people are kind of thinking over the curvature of the earth. This is going to ultimately get resolved and you’re going to have to figure out what you’re going to do post vaccine administration, post pandemic. How are you going to run the show? 

[00:34:26] Bill Russell: [00:34:26] A curvature of the earth? What are you talking about? It’s not flat. [00:34:30] Anyway. The thing that strikes me about this. Is that, not everybody can work from home and,  there’s aspects of this. I’m not sure we’ve thought through completely. And we will eventually as situations come up, but let’s assume an employee starts to struggle working from home. They miss a couple of meetings, they, for whatever reason, it is the is the follow-up is the, is the performance plan to bring them into the [00:35:00] office so we can watch them more closely? It just, I’m wondering, I mean, you’ve worked out of your home. I’ve worked out in my home. I’ve said this on the show before. It’s not the easiest thing in the world. I think everybody thinks it’s Oh, this is great. And I understand why the employee satisfaction went up, because it is great, but at some point it does take a fair amount of discipline to keep that door closed, to stay at work, to not, [00:35:30] go play with the kids, go play with the dog, go, whatever it takes some discipline. So I’m wondering what the are we training people to work from home and, what are, how are we going to address people who struggle to work from home?

[00:35:48] Drex DeFord: [00:35:48] Yeah. I think if you’re, As you have people work from home, the companies that have done this well, I’ve done a lot of sort of training for those folks. Here’s how set up your work [00:36:00] environment. Here’s the things you can do. These are things that you shouldn’t do as far as distractions. And then a lot of it is, definitely the person. I’m a great morning person by the time I get to early afternoon, my ADD kicks in I start to get really super distracted with everything and I have a hard time getting things done in the afternoon. I have a lot of friends who are, they’re co they’re sort of chronic complaint is I don’t have any rituals about.

[00:36:25] I used to have to get up in the morning and take a shower and then get in the car and drive to [00:36:30] work. And that’s when work started. And then I left work and I drove home and I saw my dog and took him for a walk. And that’s when the day ended. And it’s a much more difficult thing. When you work from home, everything runs into each other.

[00:36:41] People are finding themselves working 16, 17 hours a day because. It’s just, they don’t, they don’t have a clear break point in their day. So you definitely need a lot of sort of ongoing training and coaching about what you expect from employees working from home. And then the other problem is, not everybody has a place, not everybody [00:37:00] has a workspace like you and I do. A lot of people have roommates and two or three of them, if you live in an expensive place like Seattle, and so trying to get work done when you have two or three people trying to work from home, that’s a whole challenge in, in and of itself. And then of course you have kids and all the other issues that go with it. It’s not the easiest thing in the world. 

[00:37:22] Bill Russell: [00:37:22] Yeah. But even just the stuff you just said had so much wisdom in it, right. It’s, it’s a understanding your work. So I get up at [00:37:30] roughly around 5:30 every morning. And the reason I do is because I know I am almost worthless after noon, so, and actually I knew this when I was the CIO as well. I planned all the really important meetings in the morning. And in the afternoon I did my, walkabouts, right? Yeah. Right. So I either went to a hospital and walked around. I walked around my staff. I mean, because I have energy to have conversations, I just can’t sit in front of a computer and type a, [00:38:00] create a presentation or anything creative after working, six or seven hours already by lunchtime.

[00:38:08] I don’t have that creative energy left. To really do it. There’s a lot of wisdom in that. I have seven things every morning. I come in number one, clean off your desk. It’s crazy. But I will, I will tank as an individual. If my desk is dirty, like I just can’t. [00:38:30] function. And so the first thing I have to do is clean my desk. I do that every morning. I create a daily planner. One of the things I need to get done today, I read and journal. I do a daily post. I have one problem that I get out of the way before I eat breakfast. And it could be write a difficult email. It could be whatever, but you know what that represents Drex and the stuff you just said represents, it represents decades of working from home. 

[00:38:56] Drex DeFord: [00:38:56] And being self-aware and really thinking about [00:39:00] not being mad at yourself because you can’t focus as well on the afternoon as you can in the morning, but consciously building a program for yourself that says I’m going to take advantage of what are my natural strengths.

[00:39:17] So if I’m good in the morning, let’s do all the hard stuff in the morning. Let’s do all the socialization in the afternoon. It still takes energy, but not nearly the same kind of focus and. For me. I mean, I was the same way. Great. In the [00:39:30] morning, a little weaker in the afternoon when it came to focus. But what I had in the afternoon was a real ability to sort of be empathetic and listen and sort of process that kind of stuff.

[00:39:40] I was better at that in the afternoon that I was in the morning, because in the morning I was trying to figure out how to get through a pile of work. So, yeah. And as a leader, I would say the same thing. It’s not only knowing yourself. It’s knowing your team. So you have to not only figure out these things about yourself, you have to figure out these things about your team, because you want to take [00:40:00] advantage of their natural strengths.

[00:40:02] Bill Russell: [00:40:02] All right, next year, you’re going to be my person to go to for a space, a story. So space X first high altitude start ship test. Could happen on Tuesday? What does this mean? Do I mean, first of all, what is the Starship? Why should we even care and what I altitude tests? I mean, what, w w w they’re gonna take this thing higher and then do what?

[00:40:24] Drex DeFord: [00:40:24] Yeah. So, I’m definitely not a space X expert, [00:40:30] but, I’ve become a pretty big fan of the many of the programs over time. Starship is sort of the, exactly that’s the deep space. That’s the going to Mars spaceship. And there’s a lot of work and a lot of testing that’s going on with the starship right now. And if you’ve seen, they’ve done some short hops with star ship, right? This is just the ability to make sure that they can land components. How is this going to work? And [00:41:00] basically it looks like a giant grain silo and they sort of take it off, take off and they move it, 50 yards across the ground. And then they set it down again. Well, this is going to be, if they, if they get it done today, they’ll do about a 50,000 foot test. So they will launch this thing 50,000 feet in the air, and then they will bring it back down and try to land it. And so for every one of these, there’s a lot of systems.

[00:41:23] I mean, these are super complicated machines and I’m trying to get one back. And not break [00:41:30] it as a super complicated task. And so it’s going to be kind of fun to see, as, as we saw with the, the Falcons, the, sometimes you gotta break some eggs before you sort of figure it out. So, I fully, I fully anticipate that this will not go well and they’ll learn a lot from that. And then they’ll do it again and again, until they get it perfect. 

[00:41:55] Bill Russell: [00:41:55] Yeah. So, it’s, it’s hard not to root for Elon Musk [00:42:00] and he does some goofy things. He says some goofy things, but at the end of the day, it’s hard not to root for the guy. I mean, he gave us Tesla and he’s given me a space X and, there’s, there’s such promise in both of those things. It’s just fun to root for him. 

[00:42:15] Drex DeFord: [00:42:15] Yeah. I mean, you look at space X and I mean, you look at the Star Link program that he has going on right now, or he’s just dumping satellites. I mean, almost on a weekly basis now going up and dumping high speed internet satellites, into the atmosphere, [00:42:30] into the the space atmosphere and, the idea for that would be that a lot of places that can’t get high-speed broadband today would be able to get it and have good, solid high-speed connectivity.

[00:42:42] And that has all kinds of implications for us. And we talk a lot about 5g and how 5g is going to change everything. But I really think now we’re getting into predictions maybe, but I really think that, Starlink, once Starlink is really up and running. That a lot of rural facilities [00:43:00] and, rural healthcare organizations that don’t have access to that kind of broadband, it’s really gonna change the world for, a lot of people who just don’t, we take it for granted because we live in a city, but a lot of rural places it’s, it’s dark out there.

[00:43:15] Bill Russell: [00:43:15] Yeah. And we might as well just go into predictions. And by the way, I agree with you on this one specifically, I think 5G’s day in the sun is a couple of years away still. first of all, the build outs, not there. Second of all, [00:43:30] to be honest with you there, there’s still some, there’s still some hurdles in terms of coverage and, and some other things that they’re going to have to get through, getting through buildings.

[00:43:41] And so we still have, we still have a bunch of hiccups to get through before we get to where we wanted to get to. And second of all, we already. How about a fair amount of bandwidth with, with, with 4G and most of the time you’re on an edge network. Anyway, we’ve proved that people can work remotely, which means that people can work remotely.

[00:44:00] [00:43:59] We ‘ve proved that almost everywhere, where we can reach with this computer, we can do remote, remote patient monitoring and do all sorts of, we can start to stand up acute care facilities in the home. but I do believe that what you just said is probably going to be the biggest thing in the network. And that is a Starlink and some of the other competitors that are out there and we’re going to start to see maybe another billion people be brought onto the internet and at a pretty high speeds and the ability to do some [00:44:30] things in those rural communities, in those remote communities. That are really a transform healthcare. It’s going to be interesting. 

[00:44:37] Drex DeFord: [00:44:37] Yeah, no, I’m with ya. I’m with ya. I mean, I’m excited about it. Telemedicine, telehealth, like you said, being able to do care in the home, all those things really depend on having access to broadband. And there’s so many places in the U S that don’t right now that that’s gonna, that’s going to change 

[00:44:56] Bill Russell: [00:44:56] Any other predictions for next year. As you look at this? 

[00:45:00] [00:45:00] Drex DeFord: [00:45:00] I, so there are things that, that I don’t even know about, that I, it makes me wonder, like, so for example, going back to the vaccines, take another drink. Going back to vaccines, one of the vaccines. So usually when you do vaccines, you inject some weakened version of the virus or some damaged version, dead version of the virus and your body reacts to [00:45:30] that and builds antibodies. One of the vaccines this time actually does something, uses a technique called MRNA, which is, I mean, it can get super complicated, but essentially what it’s doing is you’re in jail. You’re being injected with a piece of DNA code that is going off to yourselves and saying, you need to build this kind of, this kind of antibody and then you’re building antibodies.

[00:45:57] So, so your chance of getting [00:46:00] sick at all from that vaccine is. it’s, it’s not like they’re injecting a dead vaccine in you. it’s I mean, so there are things like that, that I, I think we, we, don’t just generally purpose, regular people like you, and I don’t even think about it. I think there’s going to be more of them kinds of inventions, more of those kinds of discoveries that are going to be done next year that it’s hard to even predict. I think back to the old, [00:46:30] trials back in the day with OJ Simpson and DNA and, people didn’t, people were like DNA, what are you talking about?

[00:46:38] That’s not a, that’s not a thing. They’re just making this up. It can’t be a real thing. And now everybody knows about DNA and now we have this MRNA a thing going on. Amazing ridiculously cool capability that I dunno, probably just only a tiny fraction of people could really even understand that this is something that could be done. There’s going to be a lot more of that kind of [00:47:00] stuff is in 2021. 

[00:47:01] Bill Russell: [00:47:01] Yeah. I agree. the DNA, the messenger RNA to proteins. And just, if you watched anything on how this vaccine was created, they’ve generated one of the 29 proteins, which is the spike protein. And then, and essentially they have to get it to come into your body so that it’s, it’s, it gets accepted, but once it gets accepted, then your body’s immune system sort of goes to work.

[00:47:28] I mean, just [00:47:30] listening to all this stuff is like, it just really drives home your point, which is we’re doing things now. That has really been set up by great work that has come up until now. But I agree with you. I think it’s going to accelerate. I think, we saw the, DeepMind protein folding AI, which is unbelievable, in terms of how fat, how much that’s going to accelerate that solves a 50 year old problem.

[00:47:58] And, [00:48:00] and really it takes what we just saw with this vaccine. And accelerates it even further, as well as some things I don’t even understand at this point. And I think we’re going to see, one of the things coming out of COVID and out of this pandemic is going to be the acceptance of digital at the acceptance of AI and really watch it, just go to town. And I think it’s going to start next year. I think it’s going to be. AI in, in the pharma space. I think it’s going to be [00:48:30] AI automation around communication, around, robotic process automation and, and those kinds of things. I think there’s going to be so much that AI people are going to say, I’m tired of hearing about AI.

[00:48:43] But we’re finally gonna, it’s not going to be, just the terminology being, thrown on top of a product. I think we’re actually going to see some real use cases around AI and some really interesting things happen, in 2021. I mean, I think [00:49:00] it’s that close. It’s going to be really fun to watch 

[00:49:02] Drex DeFord: [00:49:02] There’s the thing about AI that I think at least in my head, AI is something to me that is always aspirational and we always are looking forward to some AI solution for something. There are a lot of things like Siri or Alexa, that probably fall into the AI category but once it becomes common use [00:49:30] and we just, that’s not AI anymore. AI is this thing that we don’t have. So I wonder if, we’ll continue down that path. There will be lots of ML, lots of that kind of stuff that becomes part of our daily lives that we will continue to aspire to something that doesn’t exist yet. 

[00:49:47] Bill Russell: [00:49:47] Well, Drex, this has been great. I’m looking forward to 2021. We’ll we’ll keep doing this every six weeks or so, or. We’ll come together. I think it’ll be fantastic. Thanks. Thanks for this year and hope you [00:50:00] have a hook. You have good holiday. It seems early to say this. I hope you have good holidays. 

[00:50:04] Drex DeFord: [00:50:04] Thanks. Same. Same to, ya. 

[00:50:05] Bill Russell: [00:50:05] All right. That’s all for this week. Don’t forget to sign up for clip notes. Hit the website, just hit the subscribe button. The easiest way to do that special. Thanks to our sponsors. Channel sponsors. VM-ware , Starbridge Advisers, Galen Healthcare, Health Lyrics, Sirius Healthcare, Pro Talent Advisors,  Health NXT, McAfee and hill-Rom for choosing to invest in developing the next generation of health leaders. This shows is a production of This Week in Healht IT. You can check out the website, check out the YouTube [00:50:30] channel. The only other thing I want to make you aware of, and I can’t even remember what it is right now. It’s, by Drex, cause it’s 12:53 where I’m at and I don’t function anymore. That’s what I have. I know what it is.

[00:50:47] I know what it is, we have our End of Year shows. So we have a best of this week in health IT, this show, we have a best, the news day show. We have a best of the, the, COVID series, which [00:51:00] I think is interesting to hear how all the different health systems were addressing COVID and then we have our top 10 countdown. So the last two weeks of this year, we’re going to be dropping those shows and, you’re going to want to tune into those things. So that’s a wrap, as they say, thanks for listening. That’s all for now.

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