News Day – Vaccine Logistics, Amazon Outage, Imprivata and FairWarning

News Day – Vaccine Logistics, Amazon Outage, Imprivata and FairWarning

Episode 338: Transcript – December 8, 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 I It’s news day. Today we’re going to talk about the vaccine. We’re going to talk about that later in the show. We’re going to take a look at AWS outage. We’re going to public health data, 21st century cures and information blocking rules, some CMS home flexibilities as well. some, interesting, stories out there this week.

[00:00:25] My name is Bill Russell, former healthcare CIO, coach. Consultant and creator of this [00:00:30] week in health. I I want to thank Sirius healthcare for supporting the mission of our show to develop the next generation of health leaders. Their weekly support this year has allowed us to expand and develop our service offerings to the community.

[00:00:41] And for that, I am extremely thankful, starting at 2021. I just a little update before we get to the news, starting in 2021. We have a new channel. we have three shows today and those will continue. We have news day, we have solution showcase and we have influence. [00:01:00] the only change you’re going to see on the channel is that news day is now going to be with two people.

[00:01:04] I’m going to have a revolving group of about six people that come in. every six weeks they’re going to come in and, discuss the news with me sorta like what I do with directs today and directs, we’ll continue to do that. we’ve added sushi and I’m in conversations with a couple others, to join the show, to talk about, the news from various perspectives.

[00:01:24] I’ve I find that’s a, that has resonated with you and you’ve given me good feedback on that. So we’re [00:01:30] going to continue to do that. But, what’s going to happen is, this, show where I talk about the news, is really going to go away. And so to, in its place, what we’re introducing is today in health, it, and it is a whole new channel.

[00:01:49] You’re going to pick that up on a different channel within, within Apple podcasts, Google podcasts, and Spotify, all the places that you get, your podcasts, we’re going to drop a show. Every day of the [00:02:00] week where we cover one news story, the is going to be about five to seven minutes in length. and we really feel like this is in support of our mission.

[00:02:08] And in response to your feedback, this is a great way for you to stay current. you can listen to these every day for five to seven minutes and, get up to speed on one news story that we’ve hand picked and we talk about, or you can batch them, listening to them all on the weekend. It’s really entirely up to you.  This is actually a major [00:02:30] undertaking for us and something I’ve wanted to do since the beginning of the show, but a daily commitment to doing a show is, kind of daunting. but I’m looking forward to it. I think we’ve learned a lot over the last three years and we’re ready to do it. So, we are also excited that, serious healthcare and VMware have stepped up to sponsor the new channel.

[00:02:49] We still have a couple of sponsor shot spots available. If you’re thinking bio, it would be great to have our company be highlighted on that show. feel free to reach out to me [00:03:00] [email protected] to subscribe to this, you’re going to go to a, this week in health, it click on the subscribe button and we put the little section in there for the, for the new show so that you can subscribe that way. we’re still working through some of the logistics, but you’re gonna be able to find this on iTunes, over the next couple of weeks in, in December, it will start showing up. It’s already in Spotify and the others. It just takes a little while for them [00:03:30] to, to, approve the show, to be, published on the platform.

[00:03:34] So, so go ahead and get signed up as soon as you can. And we’ll start dropping one show a day, starting on January 4th. We’ve already dropped a sort of an intro show out there. so you can listen to that and know that you’re subscribed. All right. Let’s get to the news. As we, we start with the, stories that I’ve posted on LinkedIn, and we do this so that you can engage in the stories and we can go [00:04:00] back and forth.

[00:04:01] if you want to participate in that conversation, go ahead and follow me on LinkedIn at Bill J Russell and, just follow me every day, go out and see the story and go ahead and post. 

[00:04:11] All right, the first story, let me go over here to LinkedIn. There we go. first story is AWS had an outage. And the question I ask is, does your health system have a mission critical, have any mission critical workloads on AWS? And what is your uptime performance that you have [00:04:30] had thus far? I think one of the things is when AWS has an outage, the world knows, right? It’s a huge deal. when your health system has an outage, the world doesn’t know.

[00:04:42] But, your doctors know, obviously your clinicians know and so it’s, a big deal and AWS goes down and it’s, the people who are against the cloud will say, hey, look, here’s what happens. The reality is, AWS is, [00:05:00] a really tightly run ship really well done and all those things.

[00:05:03] But at the end of the day, it’s still technology. It’s still software. it’s still processes. And even though those things are buttoned down pretty well, within the AWS platform, there, will be outages. All right. So here’s, some of the things from the article. the outage began on November 25th and lasted four hours as Amazon team worked to restore functionality by the early morning on November 26th, the company returned to normal [00:05:30] operations.

[00:05:30] Amazon warned customers via Twitter that the outage could cause product disruptions operations at the wall street journal were affected by the outage as well as the Chicago Tribune. The programming interface for kinesis data streams product was affected by the incident and customers weren’t able to write data tie to the streams, according to the report.

[00:05:51] Amazon said it identified what caused the issue and is working to prevent it from happening again. And I’ve actually watched these [00:06:00] Amazon outages, almost for over a decade now, to be honest with you. And, the thing that impresses me is if you really want to see how to handle an outage, go ahead and watch Amazon.

[00:06:11] They’re incredibly transparent. They’re, producing information, highly detailed information and they’re, making it available to the world. Essentially, because I’m able to read it and I’m not necessarily, I don’t have massive workloads on AWS. and so they make it available. [00:06:30] It’s available to the press, it’s available to the public it’s available to, to their customers.

[00:06:36] And, they really, they handle this really well. So, not only is it a good model, so that’s one of the, so watch for this really good model to look at is how Amazon handles their outages. but another thing is. what are your expectations of a cloud provider? Right for uptime, recovery time and data loss, in really communication during the outage.

[00:06:56] What’s your expectation of them? is it higher than you have for your [00:07:00] internal systems? is it the appropriate level of expectation for that? you, should probably figure that out. Now, if you have any workloads in the cloud, what’s your expectation? What do you. it’s one thing to have those expectations as a state of up-front, it’s another thing to, state your disappointment in how the cloud provider, performed. but the reality is, from our perspective as a user, our job is to ensure that, we are communicating well with [00:07:30] our vendors for starters. And then the second thing is, that, that we are. identifying any potential issues before they happen. 

[00:07:38] Right. So, next story. And, this one I’ve been talking to a bunch of people about how good or bad are public health data systems at the state level. the Ohio department of health, this from the article, the Ohio department of health COVID 19 data has been skewed by technical issues related to lab reporting. Although Ohio [00:08:00] Governor Mike DeWine noted, the virus is still spreading quickly across the state. According to local, ABC affiliate news five Cleveland, the state reported COVID-19 cases were artificially inflated so forth and so on, you get the picture. these state systems, I, talked to a bunch of CEOs just, just last week on a panel. And we were talking about this. the States are not getting high grades for their ability to receive the data. They’re asking for the data. The data is required by the CDC it’s required by, [00:08:30] well, at one point it was required by HHS and CDC, but it’s required by the CDC.

[00:08:34] It’s required by the state. They’re saying we need this data and then they send it and they really don’t have great mechanisms for collecting that data and correlating that data. And, and that’s pushing the burden down to health systems. Which is a pretty interesting, one of the things I talk about a lot, people say, why don’t we have interoperability in healthcare?

[00:08:57] And one of the things is, I go back [00:09:00] to a story when I was the CIO for health system and I sat in a meeting and I think it ended up going about three hours. It was ridiculously long where we were trying to define it something that I thought was like a pretty simple, pretty simple definition. It was, something like discharge or something like, something, so it was a simple definition. I really wish I could remember which one it was. but anyway, The, the, [00:09:30] process went on for three hours and we ended up with six definitions. Now, the problem with that is, with six definitions and the information showing up on onto the better part of a hundred to a thousand reports within our health system, we have to be real clear what the definition of that data is on each report, because of it can be six different things. It will be six different things and it will be based on whoever’s seeing it and whatever the lenses, that’s a problem for another day, a discussion for another day in terms of [00:10:00] governance and, the work, the hard work that we have to do around governance.

[00:10:04] But with regard to saying, Hey, the federal government should define these things more clearly, or the state should have defined these things more clearly. When I hear that argument, I sorta, laugh, because we can’t do it within our own health system to define the data. And now, essentially what we’re saying is, Hey, let’s pass the buck.

[00:10:21] Let’s get the federal government to say, Hey, the definition of this are the definition of things that we can’t even define within our health [00:10:30] system without nuance and other things. The federal government is going to define for us. I don’t think we really want that to happen. we do want, a standard way of reporting a standard set of definitions for certain reports.

[00:10:44] And for that, I think, I hope that the state and the federal government can come together. Question, a question that often comes up is, do we federalize this right? Do we, allow the States to continue to do the [00:11:00] collection, which is, I think as it should be. but we provide them a lot more guidance, not only around the data and the terminology, the ontology, but also the technology.

[00:11:12] That’s going to be used and, and, how effective it needs to be. Just a interesting story that was out there. I just use it as a backdrop to talk about, how ready are the States for this information? Te next one, 21st century cures [00:11:30] information blocking rules are set for April 5th, 2021 and API functionality on December 31st, 2022.

[00:11:37] That seems like a long way away. It’s not, are you banking on your EHR provider or someone like Google? So this is a story about Google, cloud intro’s new program to help 21st country cures API regs. This is interesting to me. Let me tell you a little bit about it from the article. components of the program include Google’s health.

[00:11:56] API X accelerator, which offers [00:12:00] pre-built templates and best practices and other implementations to help app developers and others create new, create new build fire and AP I based tools. The Google cloud healthcare API, meanwhile, offers methods for ingesting transforming, harmonizing, and storing your data.

[00:12:18] In the latest fire formats, as well as HL seven V2 and DICOM, and serves as a secondary lunch tuneable data store to streamline data sharing, application development and analytics with [00:12:30] big query, according to the company and the cross-cloud Apogee API management platform helps with security and governance for delivery and management of scalable APIs and enables more robust API analytics for faster digital rollouts.

[00:12:48] it’s, I asked them, I asked the question and, is your, are you banking on the EHR provider or someone like Google to do this? I will tell you that, Google probably run circles around your [00:13:00] EHR provider. Google is making some huge strides in this, in this space, in the life sciences space, in the pharma space. they are starting to really hit their stride and is someone to, keep an eye on, as, we’ve talked about on the show before, just this whole idea of ingesting, transforming, harmonizing, and storing your data, to the latest fire formats. That’s a huge deal. And that’s a, that, was the Ascension deal.

[00:13:27] And everyone’s got a little skiddish [00:13:30] because essentially took some flack on that, for what they’re doing. But if you got a chance to look at some of the, the interface that they were able to create on top of the harmonized data, across many, EHR, That’s right. So this isn’t a single EHR and they harmonize the data. It made a new user interface for it. This is a lot of different HRS. They pulled that data in and they created a new front end. I’m going to see if I can reach out to somebody from Ascension, get them on to talk [00:14:00] about that a little bit, because I think the dust has settled, settled on that. And, they probably made a fair amount of progress on that.

[00:14:07] I think it’s an interesting, model. Four, if you don’t want to spend, two and a half, three, $4 billion on an EHR modernization project, it’s a way to modernize the user experience, user interface. Without doing that. So I think that’s interesting. I think Google is somebody to keep an eye on. I, this is a, the other thing is I think [00:14:30] the, aggregation and consolidation of that data, if you’re banking on the EHR to do it, just understand that we never have a single environment, right? So it’s never across your entire, health system. It’s never all Epic. It’s usually multiple instances of Epic it’s. And if you have a clinically integrated network or partnerships, you’re usually dealing with multiple EHR. Now, if you have a CIN and you’re trying to, create [00:15:00] reports, now you have to, pull in disparate data and create something.

[00:15:04] So you still have to solve this problem, even if you’re like, Hey, we’re all on Epic. You’re still going to have to solve this problem one way, shape or form, your HR providers. One way to go. it’s not the direction that I would go, but, just, just something to consider. All right. CMS launches, unprecedented hospital at home strategy to manage latest COVID 19 surge.

[00:15:27] I like this. This is really interesting to me. And I [00:15:30] ask, is this the future? So if they’ve announced these flexibilities, let’s take a look at some of this, stuff. So from the article, where’s this article from actually, let’s see home health. Home health care news.com. The first time I’m quoting this one, or that source, So under the program, participating hospitals will be required to implement screening protocols prior to delivering care in the home.

[00:15:58] Participants will need to screen [00:16:00] for both medical and nonmedical factors, including working utilities, assessment, physical barriers and screening for domestic violence concerns. So social determinants data as well, I would assume. I mean, that is some. So some of the social determinants data, I, it makes perfect sense.

[00:16:14] Participating hospitals will also need to provide in-person physician evaluation before starting care into the home. Also makes sense. Additionally, a registered nurses are required to perform evaluation on each patient in-person or remotely daily. That’s interesting. in addition to building new [00:16:30] capacity, CMS has program is also.

[00:16:33] also a means to support established hospital at home programs, which have mostly had to rely on payment mechanisms outside of the Medicare fee for service world. CMS believes that with proper monitoring and treatment, acute conditions such as asthma congestive heart failure, pneumonia and COPD can be treated in the home setting.

[00:16:53] and I just noted that this seems like the future to me. Right. this is a great [00:17:00] way to not expose people to unduly, to, to potential viruses and other things, which are more prevalent at a, aggregation point, like a hospital or a. emergency room or a waiting room and, getting this kind of care out of the home is, is pretty interesting.

[00:17:19] It’s a, great way to expand the number of beds in the community. and, we’ve seen this a lot with COVID. I mean, we’ve seen this, in a lot of different markets. I talked to CEO’s who are doing this at least on a [00:17:30] trial basis, a handful of, a handful of, potential, maybe a hundred or 200, we’re not seeing massive uptake of it, but we’re seeing, peop people, or organizations start to go in this, direction.

[00:17:49] All right. Next story. States can make a difference in long-term telehealth policies. I read this report and I thought it was really interesting. And it’s the [00:18:00] national governors association. And it’s really, it’s for the governors it’s to inform them on what’s going on around tele-health and, they, talk about the considerations that can help governors and their teams assess the potential implications of different policies.

[00:18:16] and they have one, two, three, four, five, six, seven, seven areas to consider licensure policies, can be used to facilitate interstate practices. we know that’s a huge issue. Are huge, opportunity, coverage of [00:18:30] service services provided via telehealth may be narrowly or broadly defined to allow providers flexibility, that has also helped during COVID, pairing payment policies and incentives to move towards more value based models that is also being done during the pandemic, as well as fee for service models for that matter, establishing policy.

[00:18:50] But I think those fee for service models will start to get a contract. post COVID and I think you’ll see this, idea of moving to value based models, make [00:19:00] a ton of sense, with integrating tele-health establishing policies that narrow the digital divide will increase accessibility to those who may have difficulty engaging in services via telehealth.

[00:19:14] so, and, they talk about those people that, struggled to get around, struggle with, visibility with the, all the things around accessibility, encouraging [00:19:30] interoperable tele-health platform, streamline processes, and improve information sharing, and sharing policies, account for appropriate privacy protections without limiting access to care and engaging stakeholders.

[00:19:40] can be an important process to inform telehealth policy development, telehealth isn’t going anywhere. It has, it has made a major leap during COVID a lot of talk around how much it is receded and we, almost expect expected it to recede. If we have another surge in which we are having we’re in the middle of another surge, [00:20:00] I think we will see tele-health go back up again. and, again, not to the, may. April mate, levels, but it’ll go back up again because people will be a stay in place and those kinds of things. but the reality is it is, it has entered into, the mainstream, right? It’s the mainstream of what we expect is patients. It’s the mainstream of, what we can deliver now as health systems.

[00:20:30] [00:20:30] And it’s a matter of baking those things in to our, normal everyday, Processes and procedures. let’s see. Last one on LinkedIn. Well, I’ve already gone 20 minutes, hard to believe. well, let’s deal lead to less breaches in 2021 and 2022. And that is Imprivata acquires fair warning, bolstering the threat detection, intelligence. And, I’ll just suffice this to [00:21:00] say. I’m a huge fan of fewer solutions and integrated toolsets, especially in the security area. I find that people are overwhelmed. They’re overwhelmed with the number of alerts. They’re overwhelmed with the number of tools, and when you’re overwhelmed in defense, it just creates opportunities, for the attack, and provide us around a identity, and, And FairWarning’s really around privacy, using AI tools to really look at the behavior of, people [00:21:30] that are utilizing the data.

[00:21:31] So I think. Identity and behavior seems like a really good match. I like this. I like this, merger, no, acquisition. I like this acquisition. I like this partnership. I like these two organizations coming together. I think this is a really good, opportunity if you’re an Imprivata user and aren’t using FairWarning, I think it’s a good match to bring the, second end.

[00:21:56] And if you’re a FairWarning client and aren’t using Imprivata [00:22:00] for identity, then I think that’s a good match as well. I think this is a really, good, partnership for healthcare. alright, let’s see. Let’s go back. See what other stories are out there. again, to participate in the conversation, follow me at bill J Russell on LinkedIn.

[00:22:20] Actually, I didn’t go to the comments. I apologize. Moving a little fast this morning. we’re gonna get back to the news. And just second, I just want to remind you that we’re in the middle [00:22:30] of our clip notes referral program. We’ve had, gosh, we’ve had close to a hundred people sign up for notes. since we started this, oddly enough, a bunch of people don’t put in a referral, name.

[00:22:40] so a lot of those people who have signed up don’t have somebody that has referred them. even though the form, the fourth line is who referred you, where they can put your name in, some have not done that. and to be honest with you, the, it, this is really widespread in terms of the people who’ve gotten referrals.

[00:22:59] Nobody has a [00:23:00] significant lead, like. but an awful lot of people have referred their friends. And for that, we are incredibly appreciative. don’t forget, you can win some great prizes. We have a work from home kit that we’re going to draw a, we’re gonna draw a, we’re gonna have a drawing January 1st. and we will draw somebody who’s going to receive that work for home kit. If you got up to 10 referrals, you get the black moleskin notebook from this week in health it, and for whoever gets the most, we have an [00:23:30] opportunity. We’re not going to force you to come on, but if you’d like to come on and discuss the news with me, you’re gonna have the opportunity to do that.

[00:23:37] And, all you have to do is be the one who refers the most people to the ClipNotes program. I’ll tell you, we really believe in this content. We believe in what we’re doing over here. We’re excited about it and your emails and your, comments to me on LinkedIn and on Twitter. tell me that, we are meeting a need within the industry.

[00:23:58] We want to get this content [00:24:00] into as many hands as possible. I wish I had this content when I was a CIO, I just, I would have had my entire team listened to it. so that we could have been talking about it. Not necessarily that I’m right, but that I’m starting the conversation. And then you could have much deeper and better conversations within your health system.

[00:24:21] And so that’s, that’s why we want to get it out there. That’s why we’re doing the referral program. thanks to everybody who participated. And, we [00:24:30] really appreciate it. 

[00:24:31] All right. Let’s take a look at the headlines. As when I get to the second section, I really just look at the headline itself. I don’t dig too much into the story unless it’s something I really want to pull out. but the first thing I want to talk about is vaccines. So there’s a, Oh my gosh. There’s so many vaccine stories at this point. It’s they’re everywhere. All right. So we are, pretty close to the, the Pfizer and Moderna [00:25:00] vaccines showing up at health systems. Right? So, it’s going to be limited quantities in December. It will grow a little bit in January, probably full supply chain and everything by, February. so we’re looking at, some. it, some interesting decisions to make in December, like who gets it right? Who, gets the, who gets the vaccine now?

[00:25:28] The [00:25:30] instructions from, from the CDC is, somebody referred to me as vague. I don’t think it’s overly vague. I just think it’s, there’s a lot of, room to maneuver within the. Within the, recommendations. And so, obviously frontline workers, hospital workers, are in that first category. But if you only get, let’s say you only get, I don’t know, [00:26:00] 2000, doses of the, of the vaccine. And by the way, the vaccine is a, initial vaccine plus a booster. So you have to get the second thing and we’re gonna come back to that in a second. so you have the challenge of, Hey, we have more workers, more frontline workers, then we have vaccine. So you have to decide who’s going to get it. I know a lot of health systems right now are doing surveys of their frontline workers of their, healthcare [00:26:30] workers, to determine who wants the vaccine. And, this is a highly politicized thing. It’s, I’m hearing everything from, people are lining up to, not even all the.

[00:26:44] People who are, donning and doffing, their PPE every day, want to get the vaccine. So, interesting challenge right now around this. First of all, I think the survey makes sense, figure out who, wants to get it. Second of all, you have to [00:27:00] determine who’s going to get it. you have to determine who’s paying for it, right?

[00:27:03] I think in some cases, it’s mandated that you can’t pay for it. In other cases, you may need to pay, charge insurance or something for it. I think those questions need to be answered. the logistics of this are pretty interesting as well. just in terms of, the, two, having to administer two doses of the vaccine for full. for [00:27:30] full, I dunno, efficacy for full, and that’s not the right word either anyway, struggling with my words this morning. but for the full potency of it, yeah, creates a challenge because you’re going to give the first one and then you have to determine, you have to ensure that they’re going to come back for the second one.

[00:27:47] So there’s going to be a follow-up mechanism. at some point you’re gonna have to determine. are you, going to have walk-ins? Are you going to have a scheduling, situation? Are you going to integrate this [00:28:00] scheduling into your digital platform? in order for people to just go in there, see schedule to get the vaccine, make the schedule, the appointment. Are you going to deliver that in the home? Are people actually going to go out to the home to deliver that? Is that a safer way? Are you going to bring them into the clinic, are you to do through, there’s an awful lot of logistics to be done around this vaccine. And, and it, it’s come at us pretty fast and furious, but we knew it was coming.

[00:28:27] I hope we have that, [00:28:30] those plans in place. And then the other thing I’m talking to CIOs about is, is marketing. we, just, yesterday we had the three former presidents, I think it was three, maybe four. Now I think it was three former presidents, said that they were gonna take the, the vaccine right upfront. and I think we need more moves like that. The reality is the most trusted source of health information in the community, is, [00:29:00] not, CNN or Fox. It is, the local hospitals and the doctors in those hospitals and your primary care physician. so I think our marketing groups are going to have to flex some new muscles to really lead the charge in, changing the perception of the vaccine and driving those numbers up.

[00:29:19] If, if we. If we have a vaccine and can only get, 30, 40% of the people to take the vaccine, we’re going to be fighting this thing for a long. [00:29:30] Long time. We have to figure out how to get a majority, how to get 60 some-odd 70% of the people, to take the vaccine as well as those that have developed antibodies around it.

[00:29:44] So a lot of vaccine news, a lot of stuff going on out there. hopefully you guys have a plan in place. Hopefully you’re, talking through this, with your, incident command centers and whatnot. So, let’s see. [00:30:00] There’s still a lot of talk about Amazon pharmacy, how it’s going to disrupt healthcare.

[00:30:04] So we talked about that a couple of weeks ago. And, worth just keeping an eye on, Amazon is bringing Mac OS to the cloud in a boost to Apple app developers. I think that’s great. I don’t know how applicable it is to healthcare, but, we did a lot of, development on cloud prep platforms because you could stand them up.

[00:30:25] Now you can instantiate the platform and break them down pretty easily. Having the Macco S. [00:30:30] I dunno, interesting, to create some, native apps, potentially some iPad apps and those kinds of things. So I think that’s, I think that’s a good move and could save us some money, move something into operating that used to be capital.

[00:30:43] So, interesting, interesting play right there. let’s see. patients at Vermont hospital are left in the dark after cyber attack. this is a New York times article. This was shared with me by, David monsoon. Who’s been on the show. this is actually a really good article [00:31:00] and one that’s. worth reading it’s really about the human side of these cyber attacks and how it impacted specifically the oncology patients it’s kinda heart wrenching. I, it also reminds me of how often they drop political statements in here that are irrelevant, to the overall story. And, I just wished they would not do that, but they do so, it, I would, just encourage you to [00:31:30] get past the political statements, that are irrelevant and really focus in on, the human side of this.

[00:31:36] so that, I think these are great stories to have. When you are talking about your cybersecurity budget and what you’re going to be putting together, these are great stories that you cut out and you send to your board members, so that they understand the human aspect of the cybersecurity budget and how you’re spending the money. so I, if, I were a CIO right [00:32:00] now, I would take this story. I’d forward it to I’d put it in the next board packet and, share with them. a handful of things. One is the number of attacks that you are fending off on a pretty regular basis. The fact that, university of Vermont and some of these other health systems were all targeted, but it wasn’t isolated.

[00:32:20] They targeted, upwards of about three to 400 hospitals across the country. And so this is an opportunity to say, Hey, look, we, are, defending [00:32:30] against these, These ransomware attacks and, vigilance is, key. but we are, at least for now staying ahead of this, but we’ve got, to remain vigilant.

[00:32:43] So anyway, that’s how I would use one of these stories. I, also, it’s good to remind me. Of the, we talked a lot about technology. We talked a lot about cybersecurity and those are kind of, disinfected terms. and when you read about, [00:33:00] people that are having to, delay lifesaving treatments, over weeks, that they’re counting on it is, it really brings it home.

[00:33:11] It really may, it humanizes the whole work that we do. So interesting, interesting article. I highly recommended again, it’s a New York times when it was published. I just got it yesterday. I don’t know. They don’t put a date on it. Other it [00:33:30] is November 26, 2020, updated on November 27th. So, again, worth a read New York times. And the title is, patients of a Vermont hospital are left in the dark after cyber attacks. So worth taking a look at. there’s a couple other things in here, nothing, exciting. And I will be talking to Drex next week on the show where we’re going to do our last Tuesday news day of the year.

[00:33:59] And we’re going to [00:34:00] do, I don’t know what we’ll call it. Our holiday show. We’ll figure out a way to make it a little more festive. Maybe we’ll both wear, some hats or something. We’ll see. We’ll see what we do. So I’m going to leave some of these stories for next week for Drex and I to talk about. 

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