September 29, 2020

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September 29, 2020: Cyber threats, ransomware, the addictive nature of Facebook and the biggest tech retail disrupters in healthcare. Why isn’t big tech just swooping in and changing the industry? What makes the Microsoft healthcare plate different from Amazon or Google or even Apple? How will healthcare delivery change over the next 10 years? Is it all still local and will it remain that way? Or are you ready to go into other States to offer services? Is your strategy thought out before you advocate to bring down some of those barriers? Also can patients be trusted with their health data? Can they understand it? Will they use it correctly? Is there a support system that comes with it? 

Key Points:

  • Microsoft will continue to do well in healthcare because they are on the side of healthcare providers [00:06:05] 
  • We Chat is fast becoming the number one online healthcare destination in China [00:07:35] 
  • To become consumer centric, what will enable and empower the patient? [00:12:30] 
  • Only 44% of healthcare institutions met national cybersecurity standards in 2019 [00:14:20] 
  • Blackbaud Philanthropy Database Security Incident [00:19:20] 
  • Epic was taken offline for precautionary hacking reasons [00:21:35] 
  • Microsoft: Attackers Exploiting ‘ZeroLogon’ Windows Flaw [00:22:45] 
  • Beckers: 10 hospital execs predict the biggest tech retail disruptors to healthcare [00:26:45] 
  • We made Facebook as addictive as cigarettes on purpose [00:33:45] 

Stories:

News Day – Why isn’t Big Tech Fixing Healthcare?

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News Day – Why isn’t Big Tech Fixing Healthcare?

Episode 309: Transcript – September 29, 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] We want to thank you for your feedback. For those of you who went out to this week, health.com/ 300. We want to thank you for the amazing amount of feedback that you gave us. And for those of you who signed up, you’re going to be receiving your free black logo, moleskin notebook. If you haven’t, we’re going to leave it open for one more week because the feedback has been so helpful for us.

[00:00:20] As we try to shape the show for the coming 2021 year and set our strategy for that. So you can go ahead and hit this week. health.com/ 300. And let us [00:00:30] know how we can serve you better. Now onto the show.

[00:00:34] Welcome to this week in health IT. it’s Tuesday news day where we look at the news, which will impact health it today. We are going to look at a bunch of things. We’re gonna look at the stories we posted out on LinkedIn, and we’re going to look at security. We’re going to look at, the addictive nature of Facebook and other things.

[00:00:55] We’re gonna look at some quotes from industry leaders around, where, disruption is going to come [00:01:00] from. And. A couple of quotes from Matthew called the, CIO at Cleveland clinic, which I thought were insightful and interesting. And I’m looking forward to sharing them with you. My name is Bill Russell, healthcare, CIO, coach, 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. This episode, every episode, since we started the COVID-19 series has been sponsored by Sirius Healthcare. Now that we’re exiting the Sirius has stepped up to be a weekly sponsor of the show and they will be through [00:01:30] the end of the year.

[00:01:31] Special thanks to Sirius for supporting the show’s efforts during the crisis and beyond. If you haven’t signed up for 3XDrex, yet you are missing out text directs, D R E X to four eight four eight four eight. Received three texts. three times a week, from Drex on the stories that he thinks are most important.

[00:01:49] Now it’s limited because when you text somebody, you can only have so many characters. So you’re going to get three or four stories that, that directs his monitoring in his feed that he thinks are going to be helpful. It helps me [00:02:00] prepare for it, the show, and it’s a one, the full service. It’s a service of Drex DeFord, who is a frequent contributor of the show.

[00:02:07] All right, let’s get to the news. we’re going to start with, actually, here’s what we’re going to do. We’re going to go to our LinkedIn conversations as you guys remember, I post a story every weekday on LinkedIn and invite you into the conversation. and, and really,   conversations have been great and I’m really enjoying the back and forth with y’all.

[00:02:28] And here are some of the things [00:02:30] I posted this week. Should I go in reverse order? I’ll go in reverse order. Here’s what I posted on Monday yesterday. So why isn’t big tech fixing healthcare. Again, this one hasn’t had enough time to really simmer out there. As we’re recording on Monday for Tuesday’s show.

[00:02:46] This was an interesting article was in the Washington times. And the article talked about, why isn’t big tech just swooping in and changing healthcare. Like they swoop in and changed all the other industries that they, have [00:03:00] served. and really what they talk about is the fact that the healthcare benefits don’t accrue to the users of the technology.

[00:03:07] In the  case of, Amazon, the benefits of personal economic benefits accrue to me. But if I use Fitbit, Amazon or Apple watch or a, Peloton, I get health benefits, but I don’t get any health care economic benefits. And, when, when, a tech startup is, trying to fund, or they’re trying to find some money, or they’re [00:03:30] trying to.

[00:03:30] Get started. One of the first things they’re asked is what your, business model is. And these, VCs are very savvy and they say, you can either make money from the insurance company. You can make money from the employers, or you can make money from the health systems. But if you’re going to go after the individuals, it can’t be something that they expect to be covered by insurance, because if they expect it to be covered by insurance, they’re not going to pay for it.

[00:03:51] So one of the things we’re missing out on is that the benefits of these health technologies are not accruing to the masses. So that’s one of the [00:04:00] challenges. And I, I thought what would be a more interesting title to be honest with you would be, what does it take to unleash the power of technology in healthcare?

[00:04:09] Because there, it really does require a change in the economic model in order for that to happen. And the economic benefits have to accrue to me the individual. Who is making the choices, which impact my healthcare. Do I eat at McDonald’s today? Do I exercise today? Those benefits accrue to me this is the individual health is going to continue to be a really struggling and stagnated. And [00:04:30] I think it’s an economic problem. I don’t think it’s a technology problem. The next question I asked was what makes Microsoft healthcare plate different from Amazon or Google or even Apple? And, I think that the major thing about Microsoft to understand is they have a, huge healthcare play.

[00:04:46] as a healthcare CIO, I had a huge budget that went to Microsoft every year. but I, it wasn’t like Microsoft health. It was just Microsoft, They just, it was my SQL servers. My, My, storage, my servers, [00:05:00] it was just proliferating. It was the, the productivity suite. it’s now teams and other things that are out there, all great tools for healthcare, and a major part.

[00:05:10] But, one of the things I think that may Microsoft so good is that I believe they are an arms dealer. And they know that they’re an arms dealer. In other words, they provide the tools to anyone that wants to buy them. They don’t even care if you’re competing with the health system across the street from you, they’ll sell to both of you.

[00:05:27] they don’t pick sides. they just sell, [00:05:30] access to a broad set of advanced capabilities. they also know not to get into the war. There’s no talk of Microsoft, getting into insurance, offering telehealth, hiring doctors when they came out with their telehealth. announcements, which was over the last week and a half or two weeks or so it was in partnership with health systems in partnership with Epic integrated, into Epic, and Nuance and whatnot. It was not, Hey, we’re offering telehealth or we’re offering a [00:06:00] direct access to doctors. very interesting. I think that’s one of the reasons that Microsoft, will continue to do well in healthcare is because they are providing they’re really on the side of healthcare providers.

[00:06:10] And as long as healthcare providers do well, they are going to continue to do well. all right, next question. How will healthcare delivery change over the next 10 years? I thought this was an interesting article. The Chief Digital Officer for Mayo Clinic put out there, Rita Khan she, gave us a couple of, windows into how she’s thinking about it.

[00:06:29] A lot of [00:06:30] stuff around. home-based remote patient monitoring, remote diagnostics six. she believes that a lot of the technology is going right, enable us to rethink and reinvent the whole system. Now, if we’re just going to tuck technology in, we’re not going to see the overall benefit, but if we are able to step back and rethink workflows and rethink processes and how they can be knit it together to better facilitate care, that is going to lead to something.

[00:06:54] So that was a, that was an interesting conversation. As well. [00:07:00] I thought that this one was interesting, is all healthcare still local and will it remain that way? And, the reason I highlighted this article, this was in the healthcare blog, which is a good blog to follow by the way, Matthew Holt’s blog, a lot of good things in there.

[00:07:18] A lot of things that are very specific to digital health. so if that’s not your, game, then it’s probably a little heavy on that side, but, from time to time, I pick up [00:07:30] some really good things. And this is one of those articles where I picked up, some information on what’s going on in China.

[00:07:35] So We Chat is according to CMI media fast becoming the number one online healthcare destination in China, it offers among other things, health content. In some cases through partnerships with us firms products, telehealth, a network of trusted doctors, a form of health insurance, and We Doctor sure the latter provides online health  services, psychological support prevention, guidelines, and realtime pandemic reports [00:08:00] and is free to the user.

[00:08:02] It is available 24 seven for people all over the world. it’s interesting when I talk about tele-health, it’s one of the things I say to the providers and systems is, before you want to bring down all the barriers to make telehealth available across, across the, across your state and accessible for you and to other States, are you ready for that?

[00:08:22] Are you ready to go into other States to offer those services, to pull those in? Do you have a defined strategy around that? Because I believe those [00:08:30] barriers are going to come down, but those barriers are going to come down and then there’s going to be awfully large players coming into your markets who are going to be, redirecting services.

[00:08:39] So it’s just something to consider. Is your strategy thought out before you are advocating for bringing down some of those barriers. One of the ones that got a fair amount of feedback, 34 comments on it. Can patients be trusted with their health data and can they understand it? And will they use it correctly?

[00:08:58] And this is the, [00:09:00] there was a survey commissioned by the Pew charitable trust that found the majority of the patients want easy access to their health data, via applications, which, we know this, is not, not really rocket science. And it’s interesting where the comments went.

[00:09:16] 37 likes or whatever. there’s a lot of different options down. there’s six different options. You could applaud it. You can like it. You could think it’s a good idea. Anyway, 37 of those and then 34 comments. [00:09:30] and, some of them are interesting, somebody who’s a department of, podiatry medicine and surgery commented. No, they shouldn’t have access. They will, won’t be able to read it correctly and will trigger an avalanche of calls to the physicians. for explanation and, to a certain extent, I, hear that and I understand that. And I agree with the aspect that we should not. One of the things we have to take [00:10:00] consideration is the unintended consequences.

[00:10:02] So we provide the information, the patient, which I think we all agree is the patient’s information in order to activate the patient, to engage the patient, they’re going to need to have access to their information. And, but at the same time, we do not want doctors to be tech support. it’s, a poor use of their time, it’s under way under their license. and it’s not something that they should be doing. And so we have to be thinking through [00:10:30] the, mechanisms that we need to in place to make sure that the physicians aren’t that. We’re going to do open notes. Great. How are they going to get information? Is there a support line?

[00:10:37] Is there now a service desk where they can call and get information on their medical record information on how to use the portal, effectively information on how to do online scheduling correctly. And that seems to be the number one. number one, let’s say, yeah, push back on this whole concept of providing the patient a patient information [00:11:00] to the patient is that they don’t know what to do with it.

[00:11:03] And I think one aspect is. Are you going to provide a service where they can call in and talk to somebody, talk through their record, not necessarily their doctor, but just talk through their record with somebody. Is this right? Does this make sense? Am I receiving the right care? Is there a better way for me to receive care?

[00:11:19] Is there a more cost effective way for me to receive care? This is the area. I think that CVS is trying to step into where they’re going to help you to navigate healthcare. And if they are able to get [00:11:30] in between you and your patient. If you’re a health care provider, then you’ve lost the game, right?

[00:11:35] Because now they control and direct the care to where they want to direct it to. And if they can, help, if, they essentially helped me to understand how I can navigate it better, save me co-pay, save me actual dollars. Give me a financial reward on that. Then that is going to be a huge win and they are going to be very effective at doing that.

[00:11:59] Anyway, [00:12:00] this, post got a lot of, a lot of back and forth on it. I highly, highly recommend you’re looking at it by the way. The other side of this is I love. what a condescending question can patients be trusted? Their health data is my personal data and I should be able to do whatever I want with it.

[00:12:17] And I think that’s generally what we’re hearing from patients. So if we’re going to become a consumer centric type of industry and organization, We’re going to have to think through what it’s going to take to enable the patient, to [00:12:30] empower the patient, to give them the information, but then also have the systems in place, the processes and the systems in place to provide them the services, to understand their medical record.

[00:12:40] Not necessarily the doctor doing that. One-on-one. But also, the, the support to, use the technology. Now, when a lot of people will tell me is, I use Apple apps all the time. I never call tech support. They’re just intuitive and easy to understand, and yes, we should be striving for that level [00:13:00] of user centered design so that we, are, really designing it in a way that is intuitive to the end user.

[00:13:07] And I would say we have to keep into consideration that a significant portion of our population. that utilizes our services are older. And, I’m thinking of, those phones with the big buttons and only four or five options. And I was commenting with somebody and I said, for seniors, we should have that option for our portal.

[00:13:26] Five buttons, five simple buttons that they [00:13:30] do. And if you think about it and you can break it down, what are they, looking for? They, need to refill a prescription. They need to text or talk to their doctor. they need to schedule an appointment. They need to. A check a result. there’s five that you get, think through what your senior culation is looking for from a portal.

[00:13:49] And you should develop an app that has just five buttons, simple navigate, not this. if you’re providing the same app to a young invincible, And a [00:14:00] chronic, a chronic 80 year old then, then we’ve missed the mark. There’s very few applications that are going to be utilized and thought through the same way.

[00:14:11] Next thing I posted, is, leaving my data with a health system, leaving it with a bank that doesn’t lock its vault. And this was a result of a, Survey that said only 44% of healthcare institutions met national cybersecurity standards in 2019, according to an annual report from the consulting firm [00:14:30] synergistic, that’s a slight drop of from 45%.

[00:14:34] But thinking about that’s just, that’s drop from 45%. So we’re at 44%. that’s, a failing grade, right? A hundred percent being an a or an a plus 44% being an F. maybe an F plus, but an F none the less. And I just make the case of, is there another way to do this? And I’ve made this case of something a couple times it gets me, interesting [00:15:00] feedback from the audience and I, welcome it. Let’s, keep, the conversation going. So I just pondered this thing. I wonder if there’s a better way. How about a health system? The health system doesn’t store my data. And I bring it with me. When I seek service, I have a phone with access to the cloud that I can easily store my health record in.

[00:15:19] How about the health system? Give me my entire record. When I present for care, I can provide my entire or a portion of my record for a period of time that I specify. And when I leave, I take that [00:15:30] entire record with me. And the question obviously comes up. What if I’m unconscious? we have to break the glass.

[00:15:34] This is a common concept. We use it with him all the time today. What about, and so I’ll know in order to care for me. Great. Yeah. Okay. And if, you’re carrying for me, I’m going to say, great check the box. That’s good. I appreciate you breaking the glass in the, in my time of need. what about public health research?

[00:15:53] And my comment to that is, just ask, make the case for the work that you’re doing is good. And I’ll give it to you better yet. [00:16:00] you could pay me for it, but you don’t have to pay me for it. Cause if I feel compelled to give my information to the. American health heart Institute, or, fill in the blank.

[00:16:09] if you make the case, I’ll give my information to eight ton of people to use for research. if that’s, my bed and it is my bed, more institutions will probably have access to it or more. Researchers will probably have access to my, to, my information than, normally do today.

[00:16:26] And they would stop having to pay. [00:16:30] Whatever entities they’re paying to get that information today. and, somebody also asked me in this about, what about the people who can’t afford phones? And I, I was getting that question back in 2011 and, the research would actually show that number is probably lower than you might think.

[00:16:52] however, my, comment on that after thinking about it now for about nine years, if the government wants to fund something, they can fund [00:17:00] cloud storage and a simple phone for the underprivileged. And I know that brings chuckles from time to time, people are like, are you going to give everybody a phone?

[00:17:07] And the answer is, yes. have you tried to live a week without your phone? Or even a day for that matter, it’s harder to function on our society than you might think without a phone these days, pay phones are gone. Phone books are gone, maps are gone. Newspapers are no longer where you go to look for a job. How am I supposed to function in this society? There is a digital divide that gets created, but that digital divide leads to an economic [00:17:30] divide, leads to an access to healthcare divide. And so you really do have to address the, the digital divide. If you’re going to do anything in healthcare.

[00:17:40] All right. That’s probably enough of those. You can go out and read those. In fact, I would strongly encourage you to, that those are on my personal LinkedIn. So if you want to follow me, Bill J Russell out on LinkedIn, I’m going to continue to post one a day and, really enjoying the back and forth with you guys.

[00:17:57] Some of it, we get some interesting [00:18:00] troll comments, from people. who are not fans of what we are doing in healthcare, which is, which is good. it gives us the other, opinions that are going on there so that we can stay current on those. don’t forget also to follow the show on LinkedIn as well.

[00:18:16]The show is @thisweekinhealthit out there and you’ll get the posts on all the, stuff we’re doing like this show or, the industry influencer shows or the. A solution showcase [00:18:30] shows that we do. So you’ll keep current on all those things. Plus we’re posting those short clips out on the This Week in Health

[00:18:37] IT show as well. Also, if you like those short clips where I take the, two, one to three minutes segments on the interviews, that’s great. The way to get those as well. Plus you could sign up for Clip nNotes. That’s the other way to get those. All right now, let’s just head over to my feet. We get to a few more stories.

[00:18:58] What time is it? [00:19:00] 20 minutes in. Alright. I will try to, I’ll try to close this out in another 10 minutes. and I may post some of these stories this week. Security is, top of mind today I’ve received a couple of phone calls and talk to some people over the weekend and, looking at some things, the first is obviously there’s been a bunch of security activity. There’s the, the Blackbaud incident, which, has been out there for a little while, bunch of healthcare systems it’s, [00:19:30] have been, hit by this. let’s see if I can open something up here. One of them is Atrium Health. Atrium alerts patients of ransomware data breach on one of its hospital vendors.

[00:19:41] So these are BAA covered systems. there’s a. it really wasn’t access to the medical record per se. So in recent weeks affected patients, philanthropic donors were notified by atrium and posted a notice of [00:20:00] the ransomware attack on its website. Atrium health officials said that notice, in the note of some information possibly, including the person’s name, birth date and doctor’s name was accessed by cybercriminals started in one of its vendors. Blackbaud. The hospital system says no medical records or information about the medications or test results were compromised. Yeah. This is a separate system. It provides donor management software for many institutions. And I think there’s another story over here.

[00:20:24] And it did hit a bunch of healthcare solutions. This is one of those, again, a lot of [00:20:30] health systems have, charitable arms, they’re raising money. They keep track of those donors. Blackbaud was a significant, piece of software for a lot of organizations to utilize. Let’s see, Blackbaud, there we go.

[00:20:48] Some other Guthrie was, compromised as well. I’m not seeing any others in this right now, but I’m pretty sure there’s some others that have been [00:21:00] compromised. Another thing on the security front, Equinix discloses ransomware attacks. So if you don’t know, Equinex is one of the large data center providers.

[00:21:09] In the country and they were attacked as well with a ransomware. They said they responded very quickly and got in front of that. but I wouldn’t be surprised if there’s some healthcare organizations that were impacted by that. I don’t know those specifically, Nebraska Medicine has been down for several days and I, watched a local report on [00:21:30] that and it’s believed that it was a cyber attack.

[00:21:34] The news story that I read reported that Epic was taken offline. And had been offline for a couple of days. So users were not getting their test results and other things. I don’t know if Epic was taken offline in a, precautionary, or if Epic itself was down, my guess is it was taken off for precautionary reasons.

[00:21:53] If they were compromised by ransomware, they’d probably want to make sure that critical system doesn’t [00:22:00] get attacked. So Microsoft attacks have actually escalated in since September. And we’re seeing that we’re hearing that and side, I sent a note to, to Drex DeFord mentioned earlier, a friend who does a lot of work in cyber security, and he shot me over this great article in, on the website, dark reading, is a, a site dedicated to security and security issues.

[00:22:29] Let me see what I can [00:22:30] blow this up a little bit. I am wearing glasses today. I’m doing a lot of reading and, And I’m getting older. My birthday is this month. So getting older, a lot of reading glasses become mandatory. So here we go. Six things to know about Microsoft zero login flaw, by the way, this is a big one, right?

[00:22:47] And Microsoft made us aware of this thing in August. And a activity has picked up since Microsoft has released its patch. So this is one of the things that happen. So Microsoft says in August, Hey, we’ve got this big, [00:23:00] flaw. And we’re going to release patch. So they released the patch, when the patch is released, it’s signals to people, Hey, here’s what we’re actually patching in a system. So the hackers go to work, they get the patch, they know that you’re not going to patch as quickly as they’re going to look at the information. So they look at it and they say, Oh, here’s what this thing actually is, about. And they start to generate payloads while those payload payloads started getting delivered in September.

[00:23:25] Let’s talk about what it is. So net log on zero login or log on vulnerability. [00:23:30] Is an elevation of privilege, vulnerability that exists and M S N R P C a net log on a core authentication component of Microsoft active directory. This is why this is a big deal net log on is a service provided by the domain controllers to give secure channel between the computer and the domain controller.

[00:23:50] So it normally requires previously established credentials or other authentication methods in order for the channel to be used. The net log on zero log on flaw has been [00:24:00] assigned a CVSs based score of 10, which is the maximum possible severity rating for a software flaw under a widely used vulnerability scoring system. Why is there so much concern? The net log on zero log on flaw allows an unauthenticated attacker to use MSN RPC, remote procedure call to create a domain controller and gain full administrator access to Microsoft services. Okay. So that’s domain level. [00:24:30] That’s the main level access, at your, at your domain controller, which means more than likely depending on your architecture, it is going to be, give them access to your entire network. again, take a look at this. keep a close eye on this and let me tell you that the, so what on this is, is, [00:25:00] is it’s pretty obvious. No, we were busy during COVID. but the, the, cyber threats didn’t stop and they didn’t stop advancing and the main thing is vigilance is key. So you have to make sure everything is packed, patched, make sure remote workers aren’t bringing in payloads, which can compromise your system, which is by the way, the most used, mechanism or attack mechanism at this point is just delivering the payload through email.

[00:25:31] [00:25:30] And, make sure that you have a way to restore systems in the event of a ransomware attack. We touched on this on one of the shows. one of the first things they look for is your backup files. If they find your backup files, they will compromise your backup files first, and then they will lock down your stuff with ransomware.

[00:25:48] These people are smart. They’re not. There. these are, in some cases, these are nation state attacks, and these are, highly sophisticated attacks. And if they’re not nation state attacks, [00:26:00] they’re, crime families they’re, organized. they’re organized crime families is probably not the right word, but they’re organized crime syndicates that are looking to make money.

[00:26:10] And this is one of the ways that they have, I identified to extract money from the healthcare system. So visual is key. This is going to continue to be a. Very, important, topic. So if you haven’t patched, look that up too. Hey, make sure that your patch across the board, that’ll [00:26:30] give them access to gosh, just about everything.

[00:26:33] That’ll be the keys to the kingdom. I think, three quick hits to close. Let’s see. Yeah. Three quick hits the close, comments from industry leaders. I found this one. Interesting. So Becker’s went out and asked 10 hospital executives from Amazon and Google to Walmart and CVS retail giants are transforming the healthcare industry and fueling new needs [00:27:00] for innovation. Here, 10 chief innovation and digital officers from health and hospitals and healthcare systems across the U S share their predictions of what companies will become the biggest tech and retail disruptors to healthcare.

[00:27:13] And, again, we talk about this topic a fair amount. and let’s see, who do I want to quote, Daniel Duran, MD chief innovation officer for Life Bridge Health. I think there’s a difference between what the intention of the different [00:27:30] groups is versus what they seem to be achieving in real time.

[00:27:33] But I would put my money on Amazon. Amazon gets a lot of kudos here. So Owen Alon, chief digital, and chief data and digital officer Atrium, Amazon, and Walmart, how our best buy and Comcast can disrupt any major way as well. I would agree with that list, by the way. Not necessarily in that order. I think Walmart is going to be the biggest disruptor probably first, just because they’ve been, methodic lead, moving in this direction and are [00:28:00] getting ready to ramp, Amazon, it will be a disruptor to don’t hear me not saying that. I just think Walmart will get there a little quicker, best buy. We have noted several times the show. I believe it’s going to be a huge one.

[00:28:13] Lisa Prusaud, Chief Innovation Officer Henry Ford health system, Apple. let’s see, Aaron Martin, I think it’s going to be a tie, with different markets in the millennial commercial market. It’ll probably be Amazon and in the Medicare market, it will probably be [00:28:30] Walmart. Yeah, that’s probably a good distinction.

[00:28:32] I would agree with that decision. Good distinction to make, between the different markets, Peter Fleischer, doctor, New York Presbyterian, Chief transformation officer. I think Microsoft has pretty impressive technology. Giant and the work takes on a is pretty impressive. I agree. We’ve talked about that earlier and a couple more here, Amazon, Optum, CVS, [00:29:00] Amazon.

[00:29:00] Google, actually there was only one Google. That’s interesting to me, only one Google on the list. that might be an oversight, but anyway, what’s the, so what on this, keep your eye out for your potential competitors. They’re not all gonna be the same, just because somebody you respect out there says, Hey, it’s going to be Walmart or it’s going to be Amazon or.

[00:29:19] Think about the different markets. Think about the markets you serve. Think about the people that are already in your market. Think about who you are, patients and who your con consumers already interacting with. [00:29:30] Those are your potential. the people you’re not going to have time to respond to. So if they’re already going to Walmart on a regular basis, and Walmart really comes through with an insurance product and a new clinic and whatnot, it’s gonna be, you’re gonna be hard pressed to respond to that. Cause that’s going to happen very quickly. It’s going to be. six months you have to respond but if somebody has to come in and actually establish a market, you’re going to have a little bit more time to respond and come back with, if somebody comes in with telehealth. And you have no telehealth [00:30:00] competitors today and they don’t really have a market for you and they come in and they’re gonna cut undercut your prices and whatnot.

[00:30:06] You can actually do a pricing strategy to support that a little bit and then, fill in the, things that you need to do. So again, I’m just saying everybody’s going to be looking at a little different landscape. Matthew Cole. Let’s see, I’m going to pull that one up five quotes from Cleveland clinics.

[00:30:23] Again, Becker’s so I think what Becker’s does, actually, I know this was Becker’s does and emails to these people who are [00:30:30] extremely busy and they say, Hey, let’s do an email interview. Here’s five questions. I’d love for you to answer. And they go ahead and answer them in whatever timeframe that they’re able to do.

[00:30:39] That it’s actually a pretty good method. I’m might start to, employ that next year. We’ll see if that, makes sense. Here’s five quotes from Matthew Cole on digital transformation. I’m not gonna share all of them. On Cleveland clinics, digital transformation management from a digital perspective, honing in our telemedicine and telehealth, especially as it’s becoming [00:31:00] more accepted as a care pathway his job number one, I think that’s a, that’s important. what I like about that they’ve really identified. This is job. Number one, this is the most important we’re going to try to figure out how to leverage this delivery vehicle to the, to its maximum potential. his advice to detect leaders. Don’t under underestimate the amount of research that your physicians and other administrators, or even your nursing staff are doing.

[00:31:26] And into some of these advanced technologies, when I [00:31:30] get a call out of the blue that says, Hey, Matt, I want to talk to you about deep data mining technology. when can we sit down? And have that conversation three years ago, three years ago, I would never have thought of that happening. It’s it was just not that common.

[00:31:43] I love that a comment. I think that’s true. I think, we are seeing, physicians more and more physicians and nurses doing their research coming back with well, thought out technology plays and well thought out data, plays. [00:32:00] and, and they want to be a part of, co-creating the future, the technology future.

[00:32:04] So you have to figure out how to bring them in as co-creators that’s a, so what on that, on new avenues for innovation technology is ubiquitous everywhere. And I think we’re going to start seeing a lot of innovation occurring much closer to the edge. I agree with them on that. the edge is where a lot of things are going to start happening.

[00:32:21] You’re going to see processing happening at the edge. You’re going to see. a lot of devices at the edge obviously is starting to proliferate on [00:32:30] organizing cloud capabilities. I think that defining your cloud strategy and providing a curated list of services is really good way to tighten that innovation framework, and that when great ideas happen on the edge.

[00:32:41] So they become interoperable with the things that are happening in potentially other divisions. In fact, that’s the way I would think about the cloud. The cloud is your platform for bringing all these disparate edge strategies together. The, cloud should have a platform. There should be, it doesn’t have to be a platform, but it has to be a well thought [00:33:00] out, set of technologies that interoperate inter-operate well, so that as you do these different things on the edge, you can bring that data together.

[00:33:08] You can bring that information, you can make it flow, you can create workflows across it and, enable your organization. he goes on to say some good stuff, Matthew has a lot of, great insights here. I, agreed with four out of the first five and I didn’t even read the fifth one. I’m sure I agree with that as well.

[00:33:29] So a [00:33:30] great insights from him really appreciate it. I’m going to close with this last one, which I think is just interesting. I think it’s, I think the, the intention of this is to trash an old company, but former employee, we made Facebook as addictive as cigarettes on purpose. Tobacco companies initially just.

[00:33:49] Sought to make nicotine more potent. He said, but eventually that wasn’t enough to grow the business as fast as they wanted. And so they added sugar and [00:34:00] menthol, to cigarettes. So you could, hold the smoke in your lungs for longer periods. And at Facebook we added status updates, photo tagging, and likes, which made status and reputation primary and laid the groundwork for a teenage mental health crisis.

[00:34:17] And, I, the reason I close on this story, the reason I close on, I didn’t plan to close on it. But the reason I’m talking about this story is, there’s an all, we talk about the gamification of healthcare. One of the things that happens when you [00:34:30] open Facebook is, it’s, it releases dopamine to have people tag my stuff, have people like my stuff.

[00:34:35] It’s one of the things I hate the most about my job being out on social media, it requires me to be on social media and it is an addictive platform. Did they like me? Did they follow my story? Did they comment on my story? All those things are releasing dopamine in your system, whether you want to, or not, whether you’re a 53 year old sophisticated person who even knows what they’re doing to you, it’s still doing that.

[00:34:57] That same thing can be released [00:35:00] in, how we think about healthcare. Why not? Let’s make health addictive. Let’s make things that people do addictive, that is eating well. That is exercising. That is conversing with family members that is making friends, that is being social, all the things for mental health or physical health level, make that addictive.

[00:35:24] Let’s think through it in the same way that we can make people hooked on those kinds of things. And I know a lot of [00:35:30] people are thinking that way, and I think that is a. A good way to be thinking, heck it’s being used to make, we eat, eat more ice cream. Let’s start to use it to, make me exercise more.

[00:35:44] I think that would be great. That’s all for this week, don’t forget to sign up for clip notes. You’ll get an email, with a short clips from each one of our episodes. Great way to share it with your peers and share it with other people in your organization. If you’ve heard anything interesting, easiest way to share it, sign up [00:36:00] for clip notes, send an email to clip notes.

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