December 1, 2020

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December 1, 2020: The vaccine is coming. It’s coming fast and furious. How will it be distributed? Will it be mandatory? Who gets it first? How will we market it? How can we track it? One thing is for sure, it’s going to be an interesting debate. Amazon pharmacy pricing versus GoodRx pricing. Which do you think is lower? CMS made some stark law changes. We know they’ll protect against fraud and self-dealing but will they help boost value based care? What does it look like to respond to the next pandemic? We know data is important. We know tracking is important. We know PPE is important. There’s a whole bunch of solutions but how do we make them national? And what does the data and technology infrastructure look like at the state level around public health? How challenging was it to connect to your local state? Were they able to receive the data you were sending them? What was the interaction like? How advanced is their technology?

Key Points:

  • Did you ever wonder what your information is worth on the dark web? [00:04:20] 
  • Why would people want to steal medical records? [00:06:02] 
  • CMS interoperability and patient access final rule compliance is right around the corner [00:12:51]
  • The Ohio Department of Health’s COVID-19 data has been skewed by technical issues related to lab reporting [00:24:00] 
  • AWS resumed operations after hours of outage [00:26:25] 
  • Novant Health, UNC Health and UNC School of Medicine announce partnership across North Carolina with a focus on finding innovative solutions to enhance care in rural areas [00:26:45] 
  • COVID-19 vaccine distribution [00:27:25] 


News Day – Vaccine Distribution, Stark Law Changes

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News Day – Vaccine Distribution, Stark Law Changes

Episode 335: Transcript – December 1, 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 going to take a look at the stark law changes. We’re goijng to take a look at vaccine, state public health technology, and a couple of other stories that are going on. My name is Bill Russell, former healthcare CIO, CIO, coach consultant, and creator of this week in health IT a set of podcast videos and collaboration events dedicated to developing the next generation of health leaders. I want to thank [00:00:30] Sirius Healthcare for supporting the mission of our show to develop the next generation of health leaders, their weekly support of the show. This year enabled us to expand and develop our services to the community. And for that, we are extremely thankful. I just want to mention 3XDrex. Once again, Drex DeFord frequent contributor to the show has a service. He will text you three texts three times a week with three stories vetted by him to help you to stay current, to receive those texts, you can text Drex D R E X to four eight four eight four eight.

[00:00:59]Before we get [00:01:00] to the news, I want to make you aware of some of the changes for 2021. We try new things each year, so that we can try to get closer to our mission, which we talked about earlier to develop the next generation of health leaders and also to amplify the best thinking to propel healthcare forward. Those are the two things we’re really about. Next year we are changing this show just a little bit and we’re launching a new channel. Over the course of this past year, we introduced Drex DeFord as a recurring guest on the news day show. And, for [00:01:30] 2021, that is going to be the new format.

[00:01:32] We are going to have two people on every week, Drex is going to continue to do it. And we’re going to, we’re going to set up, a round robin of about six people. Right now. We have three people committed. Drex is going to continue, Anne Weiler, former CEO of Wellpepper who has been on the show. brilliant, wonderful, really understands the startup space and she’s going to be coming on every six weeks.

[00:01:53]Sue Schade, Principal at Starburst advisors has agreed to come on as well. And a former CIO of the year. we [00:02:00] have a ton to talk about and she’s been on the show several times. So I’m looking forward to having those three on. We have some, other invites out and people are checking their schedules to make sure that they can make that kind of a commitment, but the six-week rotation I think will be fun.

[00:02:13]We have, we’ve had a lot of good feedback and quite frankly, it’s a little easier for me to go back and forth with somebody, then to just talk about the news myself. For those of you who are saying, but I like when Bill talks about the news that really helps me to stay current, for you, we’re launching a new channel. [00:02:30] And starting in January, we are going to have Today in Health IT, which is going to be five to seven minute episodes. So five to seven minute podcasts that we produce every weekday, five days a week, we are going to be dropping a single show that discusses one news story. You can subscribe, listen to, five to seven minutes a day and you and your team can stay current on, what’s going on in the news around health IT. The and actually, I’m excited about that. That’s a pretty big commitment for [00:03:00] us going to a, a daily show like that. We did it during the COVID series, gave us a little experience with it. this is going to be a little different cause it’s going to be current. We’re going to be doing something every day of the week. So it’s going to be, it’s going to be fun. 

[00:03:12] VMware and Sirius have already stepped up to be show sponsors for Today in Health IT. We’re still looking for three more show sponsors for that. And, we’re excited to have them on board. They’ve been great in supporting all of our work over the last year. And VMware was our first sponsor. So they, took a chance on us back in [00:03:30] 2018. And, we are really thankful for having them on board. All of our sponsorships are annual if you don’t know. So we’re renewing all of our sponsorships right now for 2021. And we have some new sponsors to introduce to you in the new year. So we’re looking forward to that some exciting times. 

[00:03:47] All right, let’s get to the news. So what we’ll usually do is we go over to LinkedIn. We post a bunch of stories. We get a little back and forth going with you guys, to be honest with you. I think I only posted three times last week. Well, that would make sense.

[00:03:59] Monday, Tuesday, [00:04:00] Wednesday, Thursday, we posted, our Thanksgiving. Thanks for all of you in our community. And we are thankful for all of you in our community. And then I dropped about four for a post this morning, cause I have a lot of pent up stuff to talk about. So we really only have three things out on LinkedIn.

[00:04:17] So let’s take a look at the back and forth on that. The first is, did you ever wonder what your information is worth on the dark web and will it change your behavior if And this is from a, from an article [00:04:30] in privacy affairs. And the post had a couple of prices, which I thought were interesting. Clone credit cards with a pin. This is a credit card with a pin, so you can make a purchase. It goes for 15 to 35 bucks. Which shocked me. I thought it would be much higher. A Solon online banking details. 35 to $65. Depends on the balance. It’s that interesting. PayPal credentials are $200. A transfer from a stolen paypal account is 150 to $320.

[00:05:00] [00:05:00] So you can have the PayPal credentials. And then you could have somebody else actually transfer money out of that account. And that costs you a little bit more money to do that. A forged driver’s license, 800 or I’m sorry, 80 to $550. That’s kind of pricey. not what I remember in high school when we were trying to, get a forge driver’s licenses so we could drink.

[00:05:22]I never actually did it successfully, so I can’t tell you what we were paying back in the eighties for, forged driver’s licenses. forged [00:05:30] passports, 16, 1500 1600 bucks. I should get my glasses 14, 15 to 1600 bucks a hacked Twitter. Instagram or Facebook account? 50 to 75 bucks. Okay. So not in this report, but, reported elsewhere.

[00:05:45] A medical record can be sold for $250. I was at a dinner last night where I was talking to somebody and we were talking about medical records being stolen. Yes. I know it’s not that interesting. I’m meeting new people and they asked me what I do. [00:06:00] And then we talk about things and then they ask me questions.

[00:06:02] They’ll ask me questions like people are stealing on the medical records. What do they want my medical record for? And the reality is a medical record is loaded with great financial information. I mean, you can, think about it has like, the, maybe the two or three most recent places that you lived. It has your mother’s maiden name has medical history as it’s just a ton of information that we use every day to validate financial information for starters, let alone the, the potential medical [00:06:30] ramifications for having that information. But most of it is really it’s a great base to steal someone’s identity.

[00:06:36]And so they’re saying 250 bucks is what those were being sold for. And I just posted a question. I’m wondering, if it matters what I do, if I wonder if it matters what I do to protect my information. If my health system can’t protect my medical record, and I made the note that I have for, credit notices in the past five years, two of them are from healthcare providers, one from a credit Bureau [00:07:00] and the others from a retailer.

[00:07:01] And, and I just asked the question, have you received a credit protection notice and who was the cause of that? we had the, a large financial credit, I guess was that Equifax. It was Equifax. We had the Equifax breach. That was huge. We had the, a huge payer breach, as well.

[00:07:19] And that was a lot of information as well. not a ton of comments on this. But, generally somebody,  Matthew Swan said, Hey, you know it, well, let’s [00:07:30] just take that as a starting point 250 times the lives managed under contract should be the minimum security budget.

[00:07:37] And, I just did the math quickly in my head for the health system that I was a part of. And I said, we had about a million lives under a contract. So 250 times a million would be $250 million for a security budget. That was not going to fly. our security budget was not small, but it wasn’t, anywhere I wouldn’t remotely close to 250 million.

[00:07:59] If I remember [00:08:00] the last security budget for the year when I left was, probably between five and $6 million, which included labor, And my guess is that is only going up. It only increasing as I’m hearing from other CEOs in the history. So I thought I’d share that, the numbers, I think are interesting, the value of the information we’re holding, I think is interesting.

[00:08:21] And the comments, around that, didn’t have a lot of comments around that, but I think it’s an interesting conversation to have of what should the starting point [00:08:30] be for a good security budget for a health system. 

[00:08:33] All right on Tuesday, Amazon pharmacy pricing was compared by, Eric Bricker, dr. Eric Bricker, who was on the show and he does a thing called AhealthcareZ. And I just found this interesting. So Amazon announced their pharmacy and he compared the pricing of a bunch of drugs off of the Amazo n price list, the Amazon site and a good RX pricing. And I thought that was a really interesting way to go.

[00:09:00] [00:09:00] And, I started this by saying, which do you think is lower? I mean, just think about it right now without even knowing what’s going on. Which do you think is lower? The Good RX pricing or the Amazon pricing and I posed the, the, concept of this could be like a, a Myers-Briggs or a disc test for your, for the, digital leaders, a lot of digital leaders, think that they’re, they’re heroes can do no wrong, right?

[00:09:26] So Amazon obviously is going to be better. Whereas digital [00:09:30] pragmatists are people who are always looking at the facts. All right. So let’s see, did this digital solution actually deliver on the results, the business outcomes that we were looking to. So I call those digital pragmatists and, and I really respect digital pragmatists.

[00:09:44]Not everything that Apple does is perfect. Not everything Amazon does is right. Not everything Google does is right. And so we have to step back and say, is this delivering on what we need? Regardless aside, that’s a tangent and I’m very tangential today. I guess it’s, it’s taking four days off in a row. [00:10:00] My mind hasn’t really. Focused yet. So we’ll see what happens. the facts would indicate that Amazon is using basically a loss leader approach. They have lower prices on the most common generics, but they have significantly higher prices on psychiatry, psychotropic drugs, in this review.

[00:10:17]You would expect that Amazon’s buying power is going to catch up, but realize, I mean, you’re talking about Amazon’s buying power against CVS, Walgreens, Walmart, I mean, these are organizations with significant buying [00:10:30] power. I’m not sure when you get to a certain point, I’m not sure that Amazon’s buying power is, that much better.

[00:10:37]Their, Their distribution engine is that much better and that’s where they can, they can make up some of the things. So we would expect that their pricing could come down in some of these areas as they, As they step into it. I mean, they’re just stepping into it and they’re pricing on a large swath of drugs is not dramatically lower, but lower, lower, enough for you to consider doing it. You might consider doing it for all [00:11:00] drugs, thinking that the price is lower and that’s what this, this, information really shows. I think the, the Amazon, introduction into the market is going to have a significant impact. There’s no doubt about that actually in my mind. The, and what I, what I think is you look at gas stations at Costco and Walmart, and I think it’s that same sort of approach.

[00:11:22] We’re all Prime members or a significant number of us are Prime members. there’s value and there’s value in the loyalty program. people are [00:11:30] already going to Amazon on a daily basis. I mean, our things are showing up at our door from Amazon, literally on a daily basis.  So if that’s a store that you visit more frequently than you visit a CVS or a Walgreens, and you start to realize, Hey, I can just get these drugs delivered to my house.

[00:11:46]I think they’re, they’re banking on loyalty and convenience, and I don’t think that’s a bad, bet to be honest with you. A couple of comments on this, Dre McQueen. I think that Amazon’s approach will be interesting to [00:12:00] monitor over time. I think it would be naive of us to think that they’re doing this just to improve access, to make money on medication sales.

[00:12:07] A former colleague of mine who is also a pharmacist pointed out the huge opportunity that we’ll bring to Amazon to suggest supplemental over the counter products to consumers that are on the site to fill prescriptions. Just imagine how many great deals on vitamins, diet supplements, low sugar foods, fitness goods, might appear for diabetic [00:12:30] patients or soup and cozy PJ’s for someone filling a script for antibiotics. You don’t have to be, you don’t have that kind of targeted, suggested marketing in a traditional pharmacy, or even with some of the current online distributors. Absolutely true, great point. Yeah, it’s just, Yeah, there’s a lot of ways for Amazon to make money.

[00:12:51]The last article I’ll just hit on this real quick, CMS interoperability and patient access, final rule compliance is right around the corner. what do you think the impact will be and how, [00:13:00] how goes the work on compliance? I use an article InterSystems, updates, health share to with expanded, FHIR capabilities.

[00:13:08] And I found this interesting InterSystems is one of those things. If you are not going to go with the straight up. EHR solution. InterSystems is one of those third parties that you can, funnel the information out of the EHR and other systems into, at the inner systems platform, and then utilize them for your compliance.

[00:13:27] So here’s what the article said. InterSystem system [00:13:30] says health shares, data model maps to FHIR profiles from Karen alliances, blue button, 2.0 implementation guide and supports the United States core, data for interoperability, USCDI version one standards. And eventually patient data exchange plan met standards for search and retrieval.

[00:13:48] In addition to the new release has been tailored to meet the needs of health systems during the pandemic, including COVID 19 analytics dashboards while, its clinical viewer adds cOVID-19 specific tests, stay at status [00:14:00] icons, and chart options to help care teams, better track and monitor COVID-19 patients.

[00:14:05]I obviously, and I talk about, this is one piece of the puzzle, but here’s the thing I will say. This is an interesting strategy. It’s the strategy we took at the health system I was at, because we had multiple EHRs and there was no way to really consolidate them based on how the foundation model works in Southern California. So we had to go with a third-party. We chose the InterSystems model. We funneled all the data into that. and we utilized it for [00:14:30] interoperability across these disparate systems. I actually like this approach better than the EHR only. Obviously if you’re a small system, small budget, if your EHR does 90% of it, you’re just going to go ahead in that route.

[00:14:43] But if you’re a larger system, this kind of approach, I think makes a lot more sense. And part of the reason is because all your information isn’t in the EHR for starters. And second of all, you’re always going to have partners and those partners, aren’t all going to be on Epic and they’re not all gonna be on Cerner.

[00:14:57]And you’re going to have to figure out a way to bring it in. [00:15:00] So, when somebody says my interoperability strategy is my EHR, I scratch my head because, it’s interoperability has to be bigger than that has to reach across a larger, segment of your population or of your  application mix.

[00:15:14] And so I sorta like these things. I brought that new story up, not a lot of back and forth that went out on Wednesday. I would assume all of you went home for Thanksgiving and had a good Thanksgiving. All right. That’s that’s all we did on LinkedIn. I posted about four [00:15:30] this morning. It’s Monday, I’m recording this on Monday.

[00:15:33] For, this morning, if you want to comment on those, that’d be great. We only have two more, News Day episodes, scheduled, one for next Tuesday. I’ll do that. And then the final one for the year I’m going to do with Drex. I’m not sure you could really call that a Christmas episode since that’ll be the 15th of December, but we will start the festivities.

[00:15:55]And if you’re wondering over the holidays, we take a two week break, but over those two weeks, we release [00:16:00] our best of shows. So we’re going to release a best of COVID series. We’re going to re that was a series we did over the course of three months, where we interviewed people on the front lines and we’ve pulled out some segments from that that we want to share with you.

[00:16:12] And this is best of series. We have the best of the new stage show. So we have. from this show, we have a bunch of news stories, which sort of defined, the year, obviously COVID was the big story this year, but a bunch of stories, from that. So we have a best of that. And then we have  the countdown, the [00:16:30] top 10 shows from this year, top 10, most list do shows for this year and we’re going to do that countdown.

[00:16:36] We’ll do it on social media as well. So that’s what we’re going to do over the last three, three, our last two weeks of the year, as we go into the new year, we take a little break and then we come back, but we don’t take a break, from the content. We’ll keep, dropping stuff out there for you.

[00:16:51] All right. So let’s hit a couple of these stories. I’m using a new, set up here. So I have a monitor over [00:17:00] here that’s working a monitor over here. but since this is also a, This is also a video podcast. I don’t want to be looking in another direction and lose you guys. So, all right. So, the stark law changes, so there’s, there’s a bunch of different articles.

[00:17:19] Let’s see. Here’s one. This one is a conversation between secretary Azar and Hargan who’s Hargan wish I knew. But they’re talking about [00:17:30] anti-kickback changes. that’s going to boost the value based care, from the article Azar says these whelming rules, we’re talking about the stark laws and the anti-kickback laws. These well-meaning rules are there for a reason to protect against fraud and self-dealing. And unfortunately they froze in place a dis-aggregated care model. When we know that what we need is a coordinated care built around the patient. And so these reforms will in a sensible way, enable value based [00:18:00] arrangements that let providers coordinate them and share risk, let them help patients to improve outcomes, inadvertently the stark laws and anti-kickback statutes. Again, inadvertently created an incentive to force consolidation and enhanced provider market power in localized areas. And so we believe that this ancillary benefit of these rule changes is to enable virtual collaboration that is built around the patient without essentially requiring consolidation in common ownership. So I’m going to [00:18:30] hit a story here. There’s another story, Midcity news has a story on this. So one of the, when they talk about inadvertently, what it, what it has done is because you couldn’t create these value based care models and these networks to deliver coordinated care a lot of times what, these, small providers, independent providers and others that were a part of that value chain had to do was they had to become a part of the health system. Or they had to become a part of what, whoever the largest entity was, that was, that was delivering. And [00:19:00] so there was a indirect, drive to, consolidation within the industry, that wasn’t considered good.

[00:19:07] The, so what for us though, is going to be around technology. As the stark law most often came up when we were talking about technology are, what can we actually give these, independent providers, because you didn’t want to encourage any fraud or any kind of self-dealing so it was really around referrals and locking in referrals and those kinds of things, right? So we can’t give them [00:19:30] technology in exchange for them giving us all the referrals. and so they loosened some of these laws, around the EHR that really came up around cybersecurity, came up around analytics that came up.

[00:19:41] Anytime we were, giving out things of value to those, to those, independent providers, we had to be careful that we followed the law to the letter, otherwise. I mean there were significant, serious ramifications to, violating this law. Obviously, if you’re trying to [00:20:00] avoid fraud it’s pretty important. 

[00:20:03] All right. So let’s get the med city news articles. CMS changes the stark law appear largely positive experts say CMS has finalized changes, to the physician self-referral also known as stark law. Healthcare law experts say that these changes will generally make it easier for hospitals and physicians to remain in compliance with the statute. CMS recently finalized that. stark law also known as the physician self-referral law was initially enacted in 1989.

[00:20:28]it prohibits [00:20:30] physicians from referring patients to an entity for certain health care services. If the physician has been financial has a financial relationship with the entity. In other words, if we are giving them equipment for free cybersecurity for free, advanced analytics for free, that was considered a financial arrangement.

[00:20:46]The government has recognized. And so those independent providers had to pay for all that stuff, themselves up to a certain percentage. I think it was 75%. I don’t remember the exact number. the government has recognized that the need, to update the stark regulations that were originally developed at a [00:21:00] time when unnecessary volume of services was of primary importance. Phil sprinkle a health care partner at Akerman. LLP said an email, the concept of value added services, cost savings, systematic, systemic efficiencies and overall, quality outcomes were just in their nascence. according to CMS, the changes finalized November 20th, aimed to alleviate the administrative burden of complying with the law.

[00:21:25] The reforms will modernize the regulations that interpret the stark [00:21:30] law while continuing to protect the Medicare program and patients from bad actors makes perfect sense. Tina fry, a healthcare associate at McGuire woods LLP, said in a phone call that the changes updated stark regulations in three primary ways.

[00:21:45] Here we go. Number one, CMS has adopted new exceptions for value based enterprises and goals. If a healthcare provider has a value-based or care coordination goal. And there are certain hallmarks in place, such as governing board and contracts. They can [00:22:00] share revenue in novel ways, in ways that are not based off of fair market value for fee for service model.

[00:22:05] Fry said the exception will allow physicians and other healthcare providers to design and enter into value-based arrangements without fear of legitimate activities to coordinate and improve the quality of care for patients and lower costs would violate the stark laws. The second thing. The changes include new exceptions to protect non-abusive beneficial arrangements between physicians and other healthcare providers.

[00:22:29] These [00:22:30] include exceptions for sharing technology, providing cybersecurity. Frysaid, for example, a hospital would be permitted to help provide cybersecurity provisions to physician groups. They share EMR with, they may not have enough resources to protect against cyber crime on their own. That is absolutely true.

[00:22:47] And a huge win, CMS has also provided helpful clarifications and guidance on various parts of the law. Many of which have led to providers in the past to think they violated the statute. Frye said, this [00:23:00] includes guidance on how to determine if the compensation being given to physicians is at fair market value and that’s also part of the CMS fact sheet. You can also hit the CMS fact sheet. If you want more information on this, this is generally a significant positive something. We want to determine what that means for the clinically integrated networks that we’re building out, the partnerships that we’re building out.

[00:23:22]What kind of things can we now do that we couldn’t do before? Specifically I would focus in on cybersecurity. I [00:23:30] would focus in on, maybe some of the advanced tools that we have, some of the analytics that are built into the workflow and being able to do, I know some really neat things across that, coordinated continuum of care.

[00:23:42] And so this is, this is good. This was a long time coming. It seems to hit the mark of what people were saying is the, the downside of this. I have two stories here. On, well, actually, I’m just, I’ll just focus on one just for time sake. Ohio [00:24:00] lab tech issues delay COVID-19 data virus spread dramatically affects health system’s ability to care for patients.

[00:24:05] The Ohio department of health COVID 19 data has been skewed by technical issues related to the lab reporting. Although Ohio governor Mike DeWine noted that the virus is spreading quickly across the state, according to local ABC news affiliate. Only reason I brought this story up. To be honest with you is to have a conversation around what does the, the data infrastructure and technology infrastructure look like, at the state level [00:24:30] around public health?

[00:24:31]I’ve, off the air been having conversations cause no one wants to speak about these things. On the air, with CIOs, how challenging was it to connect to your local state? Were they able to receive the data that you were sending them? how was it to, interact with them? How advanced is their technology?

[00:24:49]How much of the work was pushed down on you? And generally speaking, as you, I would imagine it’s different depending on the state. Some States are more advanced than others, but advanced is the [00:25:00] wrong word. Some States are adequate. And some States are really behind the times. and so my hope is that, that, we, as a health system, community and house health care providers, any payers for that matter, can look into what we need from a public health infrastructure moving forward. I hear people, shouting from the tree tops, we need to do this and we need to do this. A lot of those things are probably right. 

[00:25:29] We just need to step [00:25:30] back a little bit and say, all right, what does it look like to respond to the next pandemic? I know we’re not out of this one yet, but keeping an eye on the, on the future and, based on the experience that we’ve had as a result of this pandemic, We know that data is important. We know that tracking is important. We know that, PPE, that quantities of, PPE, vaccine distribution. There’s a whole bunch of stuff that we have solutions, but they’re not national.

[00:25:57] The ones that are state-based are supported [00:26:00] by maybe lackluster technology and programs. And so there’s a lot of work to do here. And the, so what is, there’s a lot of work to do here? I think we could weigh in and I think we can, knit some things together. One of the challenges in healthcare is we have, a lot of interested parties. Let’s just say that a lot of interested parties and, and to a certain extent, they’re all gonna want to have a say in how, how this goes. AWS resumed operations after outage and [00:26:30] AWS had an outage right around the, Thanksgiving holiday. And it didn’t last that long. They, they took the code out of production that caused the issue.

[00:26:41]So just something to keep an eye on as we continue to move to the cloud, Novant Health, UNC health and UNC school of medicine announced agreement to partner across North Carolina. So, You had a atrium try to step in there with UNC that did not work out. and now you have a, partnership with Navon. [00:27:00] This was worth a read. It’s pretty interesting. Nevada is going to get some, school, capabilities in Charlotte. so it gives them the, some academic medical center, credentials, by partnering with, with UNC. And so, Navantia player in that space and we’ll see, and obviously UNC is a player, so, we’ll see how that transpires again.

[00:27:22] I’m just focusing on the headline at this point. COVID-19 vaccine distribution. So [00:27:30] there’s a couple stories on this. the, the first is healthcare finance, healthcare finance news COVID-19 vaccine distribution will begin within 24 hours of an emergency youth use authorization. So we are this December 1st.

[00:27:43] This is airing. we are being told that a lot of, vaccine, doses will be going out in December to start. and so I have seen some health systems start to talk about what they are doing. So let me hit that story. We have Providence in [00:28:00] Intermountain, how Providence and Intermountain CIO’s are preparing for COVID-19 vaccines.

[00:28:05]25 States have immunization data systems in place, but most aren’t prepared to track COVID 19 vaccinations or work data to the federal government. According to the report by the Kaiser family foundation, health systems are stepping up to coordinate vaccine distribution in the future. Okay. If that goes to the public health thing, I just talked about, our it organizations have responsibility to provide the technology, and data, by the way, this is Becker [00:28:30] story and data needed to track virtually all aspects of distribution and administration of the COVID-19 vaccine said Ryan Smith, newly minted, vice president and CIO of salt Lake city, Utah based Intermountain healthcare. This entails a significant amount of collaboration and coordination with many different functions within the external, within an external to Intermountain to ensure.

[00:28:53] Our response scales, Intermountain coordinates with Utah’s immunization registry to ensure clinical systems [00:29:00] have updated immunization data from the state in near real time. The health system also developed an interface between the state and Intermountain’s EHR to coordinate between doses. both parties can see which vaccine the patient received.

[00:29:15] For the first dose, they make sure that the correct second dose is administrator is ministered. This type of interoperability will be essential throughout the vaccine distribution process next year. All right. So that’s that’s, what one health system is doing, [00:29:30] which is fantastic. Providence, executive vice-president CIO, PJ Moore told Becker’s the Renton Washington based health system also is taking steps to prepare for the vaccine.

[00:29:40] Our information security works closely with our clinical teams to ensure that EHR tools are ready to go and our caregivers are supported so they can support our patients. He said, yeah. we stood up teams to focus on multiple vaccine distribution work streams are looking ahead          providence is considering acquiring additional iPads and laptops to make the documentation process [00:30:00] more efficient, the vaccine distribution, or acquire many aspects of AIA services, including tracking documentation reporting and supporting multiple methods of delivery delivery.

[00:30:09]Providence is also working closely with federal agencies to track and share data. Mr. Morris said, in addition to his it role Mr. Moore oversees real estate and operations for the health system areas that are integral to the vaccine, storage and distribution, the health system may buy more freezers and build a traditional and alternative vaccine delivery sites.

[00:30:29]I [00:30:30] actually I think the most interesting thing about that sentence is that, BJ Moore of the CIO oversees real estate and operations for the health system. Something to, something to consider. But anyway, the vaccine is coming. It’s coming fast and furious. Just had this conversation with a couple of CEOs.

[00:30:45] You’re going to hear it, this week with, actually tomorrow with Tressa Springmann we talked a little bit about the vaccine distribution. It’s coming it’s fast and furious. And, we have a role to play. We have a role to play not only in tracking, [00:31:00] updating the registries and making sure that people are getting the, the right vaccine. But  as we talked about before on the show, the, Pfizer, storage requires a cold storage. So we’re going to have to make sure that that’s coordinated. I’m sure there’s technology aspects to that. The Moderna, vaccine does not require that kind of cold storage. but again, it’s as PJ Maura was talking about, it’s a logistics, we have to have the registries, we have to have the reporting.

[00:31:26] We have to have the information into the workflow, at the point of care, which [00:31:30] is, which is important. There’s also a lot of other stuff going on around the vaccine. There’s a conversation going on around mandatory vaccines. And, are employers going to require vaccines? The vaccine being taken before people come back to work and those kinds of things in healthcare, we don’t really, consider this problem because we had to do, we had to do the flu shot and vaccine every year.

[00:31:52] And, it would be updated on our vaccines, to work in healthcare IT. It didn’t matter at least where I was. It didn’t [00:32:00] matter if you were in administration or not. if you were related to the hospital in any way, you had to have these things. So I would imagine our frontline workers will be some of the first people to get vaccinated. Our pro sports teams will probably be second. Our third will be probably our administrative staff. I know that shows our whacked out priorities, but for the most part, this is coming, that will be an interesting debate. right now one of the challenges is that only 47, some odd percent occurred according to a Reuters poll, say they intend to take the [00:32:30] vaccine. which means that we have work to do, we have to build up trust in our communities. And we are one of the trusted providers of information. And so the, so what on this is, what are we doing with our marketing departments? What are we doing on social media? What are we doing to promote, the use of vaccines?

[00:32:46] I thought we were late to the game on masks. The masks cup thing was great. And I appreciate the health systems, that started hitting social media. in the beginning we just used the shaming. protocols in order to, to try to get people to wear masks. [00:33:00] I like the mascot program. I think it’s positive.

[00:33:02] I think it makes sense. I think we need to do the same thing around vaccine. Some way shape or form. Hey, marketing works. It just flat out works. And, when trusted people tell you that the vaccine is safe, like your doctor, your family doctor, someone who you’ve been going to for years, that has value. And that has the ability to change behavior. And so I think the health systems do have a role to play here, with regard to getting the word out, getting our physicians front [00:33:30] and center on social media, promoting the vaccine. There’s no way for us to get to the percentage that the epidemiologists are talking about, to really control the spread of COVID.

[00:33:40]it’s upwards of, I’m going to get this wrong and I’m not a physician, but I it’s high. It’s like 80%, 70, 70 to 90% either vaccinated or, with antibodies in order to really slow the spread of this virus, because of its nature, because of, of how it spreads [00:34:00] and, and those kinds of things.

[00:34:00] So, yeah, so I think we have a, we have a role to play. There’s a couple of other great stories. I’ll save some of these to next week. There’s a, a whole, home health, really acute care home health, going on right now. And we see a Vera health doing some stuff there. We see, obviously Mayo’s doing some stuff there and there’s, there’s, a lot of really cool stories around that.

[00:34:24] So I may, I was doing it. Intermountain’s doing it verus doing it. so w we’ll talk about that next week. I think that’s, [00:34:30] an interesting thing. All right. that’s all for this week, a to participate in the conversation, just go out to LinkedIn, follow me, bill J Russell on LinkedIn. And go ahead and start commenting on those stories.

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[00:34:59] And you, and I will [00:35:00] get on the show and we’ll talk news for, for a half hour or so. and I think that’ll be a lot of fun. So I don’t forget that goes through the end of this year. And, and we are excited about everyone who has signed up. We are sending out well over 1500 emails a week to our subscribers and, and helping them to stay current on what’s going on in the, in the end special thanks to our channel sponsors, VMware, StarBridge Advisors, Galen Healthcare,  health Lyrics, [00:35:30] Sirius Healthcare, Pro Talent  Advisors, healtNXT,t McAfee and Hill-Rom Digital for choosing to invest in developing the next generation of health leaders along with us. This shows is a production of this week in health IT. For more great content, check out the website this week, or the YouTube channel. If you want to support the show best way to do that is participate in the referral program. we want this to get this content in the hands of as many. people as possible.

[00:35:55] Please check back every week as we drop three more episodes, [00:36:00] news day, solution showcase when we have them, if not, we just drop a second influencer show. So over the next couple of weeks, we have a bunch of influencer shows. We have Tressa Springmann this week. We have Darren Dworkin on Friday the  fourth, and that’ll be a good episode.

[00:36:14]Next week we have Amy Compton Phillips and Diana Nole. From a nuance, talking about the partnership between Providence and nuance. we have Marty Paslick who is the CIO for HCA on December 11th. So [00:36:30] we’ve got a lot of great shows coming up in H opefully, you’ll get a chance to drop in as many of them as you can. Thanks for listening. That’s all for now.

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