Newsday – 2021 IT Predictions, Trends, Advice and a Tribute to my Father-in-law

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Bill Russell

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January 4, 2021: What are health leaders predicting for 2021? Welcome to a future where the patient, not the site of care is at the center. This is healthcare’s Amazon moment. Can you provide a seamless patient experience? Keep up or you could end up out of business. COVID-19 has reshaped our technology culture and policy. What used to take a decade can now be done in days. Look out because 2030 is going to arrive in 2021. Plus what my incredible father-in-law taught me about life … and healthcare.

Key Points:

  • Looking from the patient perspective and the family perspective helps us to see how our work is really impacting people [00:11:35] 
  • Simplify. Modernize. Innovate. [00:14:50] 
  • Walmart’s retail exposure in remote communities enables it to scale developing markets, lower consumer healthcare costs and expand access to primary and urgent care [00:21:10]
  • It’s important for the healthcare industry to recognize that AI algorithms trained on insufficiently diverse data can lead to AI bias [00:23:15] 
  • We know that social determinants of health play a critical role in health outcomes [00:25:05] 
  • Have systems really thought through building and maintaining culture across a virtual environment? [00:30:35] 
  • Focus was the key word in 2020. In 2021, our focus will get even more fine tuned. [00:32:00] 
  • One of the most helpful technologies to engage patients on their journey is the use of real time information [00:32:15]

Story:

Newsday – 2021 IT Predictions, Trends, Advice and a Tribute to my Father-in-law

Episode 347: Transcript – January 4, 2021

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 news day, our first one of the year. Today, a personal experience attribute and what health leaders are saying going into 2021. My name is Bill Russell, former healthcare CIO for a 16 hospital system and the creator of this week and health it a channel dedicated to keeping health it staff current and engaged.

[00:00:25] Special thanks to Health Lyrics. Our news day show sponsor for investing in our [00:00:30] mission to develop the next generation of health leaders. If you want to be a part of our mission and becoming a show sponsor, send me an email [email protected] A quick note, we did launch a new podcast Today in Health IT where we would look at one news story every weekday morning. In fact, check it out. Subscribe anywhere you subscribe to podcasts. Also we have a new schedule for the, for the year, we’re ticking it off this week. We have Newsday on Monday influence or showcase on Wednesday and an influence again on [00:01:00] Friday.

[00:01:00] So be sure to check back. In fact, this is a shortened episode of our Newsday show. As this year, we’re going to be doing news day back and forth with a round robin group of about six co-hosts I guess we’ll call them moving forward to call them co-hosts. However through scheduling snafu, didn’t really think this through.

[00:01:22] We took off the last two weeks of the year and did not schedule to record this show, but I wanted to put one out there because [00:01:30] there’s a fair amount going on. And I sort of want to catch you up and give you a little bit of what’s what’s been going on. All right. So before we get to the news today, I want to give everyone a little bit of an update.

[00:01:41] We’ve been doing this show now for about three years and I’ve used my father-in-law as an example, and really our experience in providing care for him. We, at first we provided care for him. We were in California, he was in Pennsylvania. And I was talking about care at a distance and just how hard it was and how technology could really fill [00:02:00] that gap.

[00:02:00] And that was the experience early on while eventually he moved in with us in Southern California and we became the primary care provider. And he was a a different experience at that point. Well my wife’s father, he passed away two weeks ago from what was essentially complications from COPD and CHF.

[00:02:22] And I wanted to give a little a little tribute to him. He has been a part of the show and I’ve [00:02:30] shared his experience. We shared his experience with going to the ED that medical record, not transferring. And since we’ve talked about it as much, I thought I’d give you guys a little very short a tribute to him. He really was a wonderful man. It just give you a little perspective here. He left the military to care for his family. Once his father became ill. His father later, later died in his arms to give you an idea of how much of a caring person this guy was. He cared for his son who was born with with brain damage. And never learned to [00:03:00] walk or talk. Never really progressed past an infant mindset. But he cared for him in the home for 44 years until he died. And all that, that entailed. He was the, we used to joke. He was the executor of so many wills of, of the people who lived around him. And then part of that was, he was such a trustworthy person.

[00:03:19] He said what he meant, and he did what he said. He lived pretty much by routine. He was a bookkeeper by trade, so he was very methodic. In [00:03:30] fact he would when he come out and visit early on in our marriage, we’d go out for dinner and I would do everything I could to try to pay the bill and I would leave the table, I’d pay whatever.

[00:03:42] And invariably, a week later I would get an itemized checklist of all the things that he felt like they should have paid for with a check in it. Just to give you an idea of his bookkeeper mindset he lived by routine prices, right? Let’s make a deal. Sit out in the sun. Happy hour was every day at four [00:04:00] o’clock dinner and a, a game of gin every night, a wheel of fortune, jeopardy, and then a good Clint Eastwood movie would round out his day.

[00:04:08] And that pretty much described a lot of his days. That’s what he was doing the last couple of years. He was with us. In his finals, in his final days he could only get a few words out. And I think this says a lot about who somebody is and the few words he could get out, all of them were, I love you to his [00:04:30] daughter. And a friend of mine once said to me that when you get squeezed by life, you get to see what’s really inside of a person.

[00:04:37] And in his dying days, we got to see what was inside of him. He loved us well, and we will miss him. Just to give you a tie this in a little bit. Here’s what we learned about healthcare in his final years, but really in his final days. 

[00:04:52] I already shared about the medical record movement. It was challenging going from Pennsylvania to Southern California, but then Southern California to Florida was not as [00:05:00] challenging, mostly because we knew what to tell them to do in order to get the medical records. So we were really telling them not something that everybody’s going to have the advantage of the knowledge of how the EHR works and how interoperability works, how to get the records from one place to another. And it’s, it’s really a shame but it’s still the case that you have to help the health systems. To provide the best care for you. It’s just, it’s not it’s not wired. It’s not it’s not synced up yet.

[00:05:30] [00:05:30] Finding doctors is hard when you move to a new location. That’s one of the things we found. We moved to moved him a couple of times and getting that right mix of doctors is is challenging. And it’s. And the information is not that great. We’re still doing it by word of mouth for the most part.

[00:05:45] Choosing insurance is really hard without a coach. If you think about this, a child trying to care for an aging parent coaches, and you’re really looking for a coach who’s and connected with the insurance company and when you find them they’re invaluable. And we did find a, a woman who walked [00:06:00] us through all the different options, what to consider what was paid for, what wasn’t, which was really helpful.

[00:06:05] Technology was not really helpful in caring for him. And perhaps that’s a little over the top, to be honest with you. He is, his care was coordinated. Well, that was obvious and many care providers he saw were informed. So the information was flowing from one care provider to another, but outside of that, there were, there were a ton of phone calls, a ton of faxes and papers flying all around. Almost [00:06:30] no online scheduling and even texting was not something that the doctor’s office wanted to partake in.

[00:06:37] His home care nurse was exceptional. And it was a great program. Once a week in the house, she also acted as the quarterback for the care team and it was really effective. I mean, she would come in and say, now what’s your next doctor? Well, that’s not the next doctor. You should see, you should see this one.

[00:06:52] And then she would make the phone calls and change the appointments for us and do all that stuff. That was a really good program. If if your health system is doing [00:07:00] that and I put some money behind that. That’s very very effective, great experience from our perspective. It’s, it’s interesting because we talk about experience a lot. Right. And the experience is interesting. So same hospital, same course of two weeks. His, care in the ICU was phenomenal as you would expect, it’s expensive. There’s a lot of nurses the the patient per care providers is pretty the ratios, the right ratio. And on the fourth floor [00:07:30] exceptional care.

[00:07:31] I mean, the nurse was constantly coming in. She was kind and those kinds of things. On the second floor, couldn’t find anybody. It’s just interesting, like nobody would come into the room, his food would sit there. He needed to be fed towards the end and he wasn’t fed and those kinds of things we’d have to go out and find somebody.

[00:07:49] So it wasn’t uniform around the hospital. So we could do all sorts of things around the experience, all sorts of things around the technology. But at the end of the day, if we can’t figure out what Disney has [00:08:00] figured out and what others and Southwest has figured out and what others have figured out in terms of keeping our staff motivated, keeping them valued and and trained on doing the right things. And then measuring  those things. We’re still going to fall down in certain areas. I will say this frontline caregivers have a tough job. We saw families come in and they were incredibly demanding, and I understand that that [00:08:30] happens.

[00:08:30] Yeah, people are at the lowest point in their lives. It’s a very difficult job. Even though you’re sitting there going, Hey, why why aren’t they coming in? If you, if you get beat up all week with a bunch of families that you know, are very demanding, I can understand how that could wear on you after a while. On the flip side, there’s people he could tell this is their life calling. They are amazing. They can take that and they take it with a smile and they a kind word back and those kinds of things, [00:09:00] they diffuse those situations really well. They’re, they’re just heroes is thrown around a little too much in our industry.

[00:09:08] We used to say all frontline workers are heroes. I believe that they are have been in challenging times. All of them have been in challenging times for the last year. For granted, but not all of them really are heroes per se. I mean, yes, they have courage and yes, they work really hard.

[00:09:27] But you know a hero when you [00:09:30] see them it’s that, it’s that person that puts the dying person at ease. It’s the it’s the doctor who sat with my wife and told spent the time. Yeah, I think this was a cardiologist, actually. I’m sure it was a cardiologist spent the time talking to my wife about his family experience and just the empathy that came across and how he had to, he just recently had to bury his mother and he knew what she was going through and, and she was, she was moved.

[00:09:58] I mean, there’s, there’s just [00:10:00] so many of those stories in our industry. And, and I sorta, I, I get a little concerned that we throw hero around and we say all healthcare workers are heroes. When there are people that really are distinctive in terms of the amazing care, compassion, empathy skill that they, that they practice with.

[00:10:21] So anyway, that was, that was amazing. I think it, you know, it was. They sent a [00:10:30] financial person in one of the things you start to think after a while you hear all these surprise bills, stories and whatnot, you start to wonder, it’s like, how much is this going to cost? And they sat down with us and went through everything and and not only hey, here’s what this is going to cost.

[00:10:42] Here’s what this is costing you. Here’s what the insurance is going to cover. It was, it was really well done. Not only that we found out that his hospice care was going to be covered by Medicare. Something, we didn’t really know. 

[00:10:53] And for that matter while we’re talking about Medicare, Medicare really is good insurance. We can [00:11:00] argue if the country can afford it. We can argue if a single payer system for all really makes sense but I’m not sure we can argue too much that Medicare is pretty good insurance. They covered a significant amount of his care coming out of this experience.

[00:11:16] So that took a load off. I appreciate you letting me share this this tribute and a little bit, the personal experience I think we’re [00:11:30] all gonna have this kind of experience. And it helps us to think through from the from the patient perspective, from the family perspective how our work is really impacting people.

[00:11:45] So I just wanted to share that let’s let’s get to the news. I don’t have a lot of news. In fact, I’m just going to do one story because I think it’s it’s good to really look at how the leaders in healthcare are thinking going [00:12:00] into 2021 and a lot happened in 2020. And this is a good article.

[00:12:07] It’s a Becker’s article 22 hospitals c-level execs share 2021 IT predictions, trends, advice, and more. A bunch of these are former guests. Stephen Klasko BJ more. John Halamka, Kristin Myers. Zafar Chaudry has been on the show. Michael Pfeffer has been on the show. Jason Joseph last show of the year [00:12:30] was Jason Joseph.

[00:12:32] Let’s see anybody else. Who’s also been on the show. Some people I’m trying to get on the show, Darren Dworkin, Andrew Rosenberg. So a lot of, a lot of people who’ve been on the show. Well, they they published this article late in the year, last year. And this is, this is what some of these are predictions.

[00:12:51] Some of these are just observations. So let’s start with some of the predictions, Stephen Klasko. Everyone loves Stephen Klasko cause he he’s out there. He [00:13:00] speaks he speaks in the future. He lives in the future. He speaks in the future. This is what he has to say. This is healthcare’s Amazon moment. If you are a provider and you think you’re going to go back to your business model, solely being based on hospital revenue and not. and not relevant to people who want care at home. I think you will end up out of business. If you are an insurer and think you can just be the middleman between the hospital and the patient you’ll, you will become irrelevant.

[00:13:27] If a hospital believes that innovation can [00:13:30] be just a little cute thing that they do in the background but the real business is just getting heads in beds. They’re nuts. I think we’re always wondering what the big disruption would be that got us into. Got us to join the consumer revolution. And I think this is it. 

[00:13:50] Since I don’t have my glasses, I’m going to increase the font size here so I can read it a little better for you. I love that. I think that’s what we’re going to be talking about next. Oh, [00:14:00] he’s absolutely right. This is one of the things we’re going to be talking about going into next year, but in fairness, we’ve been talking about this. When’s the digital revolution really going to hit? When is the hospital model going to change? When is the payer model gonna change? Who is the most relevant in the model? Is it going to be the insurance? The payers is going to be the providers. Is it going to be the IT startups? Regardless of who is going to win out and that, he’s right. Some things have changed. [00:14:30] Expectations have changed. And if expectations have changed, yeah, we have to keep our eye on the ball and understand where expectations are going. 

[00:14:39] BJ Moore CIO, Providence. He’s talking a little bit about their Microsoft thing, Microsoft partnership. And he said from the beginning we defined this within our strategic framework of simplify modernize innovate. I love that in and of itself. Simplify. Simplify the environment, modernize the environment, innovate around that environment. In fact, [00:15:00] innovate is really hard to do if you haven’t simplified and modernized, it’s, it’s almost a continuum. In, in the innovative space, we are focused on the future of care delivery, a future that has the patient, not the site of care at the center with innovations on how care is delivered for example, around telehealth and home monitoring scenarios. And innovation on the way we enable care providers for greater experience and outcomes. And an example emerging from the collaboration with Microsoft is natural language processing in cancer treatment. 

[00:15:29] So much wisdom here [00:15:30] and I, it BJ Moore will be on the show again, probably February, March, February, March timeframe. I think it’s already scheduled. I love this and the innovative space, we focus on the future of care delivery, a future where the patient, not the site of care is at the center. And I think we’re going to see the locus of care change, and that will require us to rethink some things. We will see more stuff go to the home. We will see more things go outside of the hospital. We will see more care at a distance. I think those are, those are givens just [00:16:00] based on what we saw during the pandemic. And the pandemic is not going away. It’s not like. We’re going to start January 1st, pandemics gone away and we can go back to normal.

[00:16:07] This is going to be something that has, that will go on for a fair amount of time. And because it’s going on for a fair amount of time, it’s creating new habits, new habits form in about 30, 60 days type thing. Well, this has really hit us and changed the way we operate since March of last year. And it’s probably going to go most people I’m talking to are saying. At [00:16:30] least July before we get some semblance of normal normalcy, but more than likely through the end of the year is what I’m hearing. So a lot of new habits are going to be formed. A lot of how people, their expectations we already talked about.

[00:16:45] So we’re going to have to look at delivering care in different venues in different ways. John Halamka President Mayo clinic platform. We were talking a lot about healthcare in 2030, but, this is a great quote, but what [00:17:00] we are seeing now is that 2030 is going to arrive in 2021 because COVID-19 has reshaped the culture and the policy around the use of technology.

[00:17:08] And anything we thought would take a decade to do is going to be an exception expectation for next year. We’re going to have more demand for telemedicine, telehealth hospital level care in the home wearables and the ability to apply machine learning and artificial intelligence to new data sources for cure plans that’s going to be here very soon because we have [00:17:30] changed so much so fast with COVID-19 and that is going to be the legacy of COVID-19. COVID 19 didn’t kick off the digital transformation but it proved the imperative of digital transformation in healthcare.

[00:17:45] So Kristin Myers, executive vice president, CIO, and Dean of IT at Mount Sinai health system. Someone who we will also have back on the show we’ve already reached out delivering the patient experience so that patients and families [00:18:00] strengthen their relationship with their health system is our best opportunity.

[00:18:03] Technology can be an enabler when there is a holistic experience from scheduling all the way through the discharge and remote monitoring at home will be an important part of our strategy. The key to all of this is providing a seamless patient experience. One that is easy, clear, and from the tech perspective, not fragmented. Pulling all that together is a challenge, but patients will become more empowered in the future and they will expect the kind of consumer experience that [00:18:30] they get in retail and other sectors.

[00:18:33] Again, a lot, a lot of wisdom there, but I just want to drive home this whole idea of. Who’s going to be the locus or who’s going to be the center of this payer provider tech companies. Now tech companies understand the consumer better than anybody. The payers, the least trusted in the equation. And sometimes people are wondering why are they even there? And then the provider. The provider is in an [00:19:00] interesting space and they can claim that that mantle of trusted source of health information and trusted source of building a healthy community. They can be the foundation for a healthy community in which they live.

[00:19:14] They just have to grab that mantle, take it. And what that means is not only from a technology perspective, but also from a communications perspective. And this is the area where I think health systems have gotten better and they’ve exercised a new muscle over the last year. And that is [00:19:30] in utilizing communication platforms to get information out into the community.

[00:19:34] Right. So utilizing social media, utilizing the local news utilizing billboards, utilizing everything, they can to get a message out to the community. And we’re actually flexing this muscle right now, as we speak around the the vaccine distribution as well letting people know how they can get in line, what it looks like.

[00:19:55] And those kinds of things, I’m not sure we’re doing a great job of it yet. This is still a muscle that we have to be [00:20:00] convinced that this is an important thing to build. I don’t know where it sits. This is where this is that weird dynamic that exists within a lot of health systems of marketing. And it.

[00:20:10] And we never thought of marketing and it really coming to loggerheads on certain things, but they really have, because you’re hiring these new chief marketing officers who fashioned  themselves as tech savvy. And that’s great. They understand the tech aspect of it, and they can really move the needle forward.

[00:20:28] But on the flip side [00:20:30] there’s a lot of health systems that don’t have that tech savvy CMO. And the CIO needs to step forward and say, I know how to use these communication platforms and to make you more effective and they have to drive that relationship. Anyway, just something that’s been bouncing around.

[00:20:45] I’ve been thinking about that quite frankly, since about 2012, when I first came in to healthcare that we do not use social media well enough in healthcare. Anyway that is some great [00:21:00] insights from Kristen Myers. 

[00:21:02] Let’s see. Zafar Chaudry MD, vice-president CIO, Seattle children’s hospital. I can see Walmart’s capabilities scaling with developing markets because of their retail exposure in the remotest communities. I’m a true believer that giving consumers low costs better and expanded access to primary and urgent care will lead to better community access, reduce hospital admissions, and therefore lower healthcare costs. Again. This is going to be something we’re going to be talking about next year. It might be [00:21:30] more appropriate for some communities than others.

[00:21:33] I think if you’re one of the rural communities that this became very real to you, I mean, the vaccine distribution is going through CVS. Right. It’s going through some of these players. Because it was a more effective supply chain to get the vaccine out into the remotest parts of the country. And it’s when you’re talking about the logistics of this trying to get it to [00:22:00] 10,000 hospitals versus getting it to walmart who can get it into all those communities as part of a distribution mechanism they already have, or even an Amazon who can do that or a CVS that can do that. We don’t have that kind of logistic capability and it’s something that we will have to consider moving forward. Great insights, Zafar Chaudry.

[00:22:24] Let’s see Ryan Smith, CIO, Intermountain healthcare talks a lot. I’m not gonna read all these things. [00:22:30] He talks a lot about how the pandemic really changed things. And we talked a lot about this on the show, right? We have a lot of people working out of the home. We have a huge increase in telehealth visits and virtual visits new clinical workflows analytics, a lot of things, a lot of new lessons learned. And it really is going to shape our priorities going into 2021 and beyond. We will have to keep an eye on that. 

[00:22:56] Edward Lee MD associate executive director at [00:23:00] Kaiser Permanente and executive vice president of it and CIO at the Permanente Federation. Wow. He’s going to have to shorten this title a little bit, but Edward Lee important person in the healthcare community at Kaiser it’s important. This is from his quote, it’s important for the healthcare industry to recognize that AI algorithms trained on insufficiently diverse data can lead to AI bias. Again, a topic we’ve talked about on the show, and we will continue to focus in on at a time when [00:23:30] we are incorporating more and more AI. In medicine, this bias can inadvertently contribute to a widening of healthcare disparities.

[00:23:37] One of the first steps we need to take is to be intentional in looking for bias. If we don’t look, we’ll never find it. So understanding the AI bias can be a part of any algorithm. Can be a part of any algorithm is essential. Ultimately I consider AI to be augmented intelligence and not simply artificial intelligence.

[00:23:57] It is most impactful when used as a tool for [00:24:00] physicians to augment, assist and compliment their clinical decision-making rather than standalone technology. I, again, I think we’ve seen that these technologies that we’re on the edge. Are now mainstream or they are becoming mainstream.

[00:24:18] And let’s say that they’re becoming mainstream, you’re starting to see them baked into just about as many workflows as you can. AI has really taken off in the administrative space and it is going to continue to do so, but it’s [00:24:30] also going to see huge. Huge movement in most, mostly driven from the academic medical centers who are going to drive this forward.

[00:24:38] And we’re going to see AI start to get baked into a lot of a lot into the workflows. The analytics platforms are going to need to become more real time and and we’re really going to have to clean up our data because AI isn’t magic. It doesn’t clean up your data for you. You have to have a clean as clean a data [00:25:00] as you could possibly get.

[00:25:02] Michael Pfeffer MD CIO at UCLA Health. We know that social determinants of health play a critical role in health outcomes, but often are hard to capture fully within office visits. But now I have a lot of physicians coming to me, how they’re able to connect with patients on a different level with video visits, to better obtain this key information.

[00:25:23] That’s really true. I heard this as well. In fact, I may have even heard it from Michael when we interviewed him on the show. [00:25:30] There’s a, there’s a benefit of, of the video visit and it brings you right into their home. You can see things in the home, you can have conversations of what’s going on in the hallway. I don’t think that’s the end all be all a social determinants. We did a show with Intermountain and United way towards the end of last year. It’s it’s worth listening to. Intermountain has really taken to heart, the social determinants. It’s going to lead to healthier communities. They’ve partnered with the United way. The United way [00:26:00] has brought together a lot of other organizations. These are people were on the frontline of the social determinants. They are the frontline workers of social determinants healthcare workers. See it. But they see it on a cursory level. These are people who are actually in the house there in the community.

[00:26:16] There they’re working the soup kitchens. They’re working, they’re working in the communities with the kids and those kinds of things. You’re going to see it at a different level than the healthcare workers do. And without those partnerships, I don’t think we’re going to make [00:26:30] nearly enough progress. And so it is going to require again, a new muscle of creating those partnerships and in really leveraging Information flow, technology, communication, back and forth for the good of the community as a whole.

[00:26:46] Jason, Joseph, again, a CIO spectrum health. There’s still a lot of variation in care processes that get. It gets in the way of digital transformation. For example, while we have a high degree of automation and digitization within our health system, we [00:27:00] still use faxes in healthcare to communicate with other providers. The fax is essentially a giant red flag sticking up, saying a process somewhere around here is broken because I have now resorted to the least common denominator of communications that is true about the facts is absolutely true, but don’t miss out on his first statement, which is there’s still a lot of variation in care processes that gets in the way of digital transformation.

[00:27:23] Care process variation is not something that’s solved with technology. It is exposed with [00:27:30] technology is exposed with data but it isn’t solved. It is still going to require a significant operational partnership in order to and clinical leadership in order to really address the clinical variation.

[00:27:43] Across any health system and it’s interesting. I don’t think there’s, I don’t care how good your health system is. I don’t think there’s a single health system that doesn’t have that challenge and and really could use, [00:28:00] I wouldn’t say more emphasis, but could use emphasis on reducing care variation.

[00:28:05] Let’s see. How far, how far have we gone here? I said short episode and I’m already getting up around 30 minutes. So let’s see. I will pick one or two more Michael Restuccia. Restuccia. Good italian name, senior vice president and CIO for corporate information services. As our region, state, country, and world react to the spike and COVID-19 cases, we have [00:28:30] recognized that our corporate IS team’s top priority is less project focused, but more focused on mirroring the behavior of our frontline caregivers and leadership team.

[00:28:38] Although this second wave of coronavirus was somewhat predictable. The environment we are operating within is different than the initial COVID-19 spike in the spring of 2020. Our healthcare teams are still fearful, but there’s an extended level of fatigue and frustration among the community. In addition, new variables, such as resurgence, widespread testing, vaccine availability, distribution [00:29:00] require thoughtful decisions guided by data and technology.

[00:29:03] As a result together, we all need to be nimble available and flexible to adapt our systems, technologies, and processes and support of our community and front line caregivers. I love this whole concept of mirroring the behavior of our frontline caregivers. That’s an interesting concept. To me, one I’d have to really digest and think about but the reason I like this quote was to say, we were incredibly nimble last year and we might be resting on our laurels [00:29:30] saying, look how nimble we were last year. I don’t think that’s going to change. I don’t think it’s going to change ever again. I think the we have proven the ability to be nimble. And we have restructured our platforms while we’ve adopted platforms and we’ve restructured our technologies to be more nimble. And I think that’s going to be the expectation of the system.

[00:29:50] So we are going to have to be very careful not to overwork our people. We’re going to have to figure out this remote work environment. One of the quotes I was going to read was on how I think healthcare is going to remain [00:30:00] remote work. This was Jonathan Schumacher, CIO of Lena Health. I’m not sure that’s the case. I think. Clearly there’s some people that need to work in the hospital and that’s going to continue to happen. We still need frontline. It staff, if you will, in the hospital and around the, around the healthcare system, there are jobs that will continue to be remote.

[00:30:23] Again, I still think it’s a panacea. I don’t think it’s a panacea. I think it’s hard to maintain culture. [00:30:30] It’s easy. It’s hard to maintain culture over a longer period of time. You have to be intentional about it. I’m not sure how systems have really thought through building and maintaining a culture across a virtual environment.

[00:30:44] And so while it, I, again, I think it feels good this year. The Employee satisfaction. Numbers are up probably across the board and people are saying, look, that’s what we want. That’s a huge win. That’s where we’re going to stay. [00:31:00] We’ll see if we can do that. We’ll see if we can maintain it. I’m skeptical.

[00:31:05] I think we’re going to have to, I think what’s going to happen is  our staff is going to get split. And I think there is going to be a virtual staff that can remain virtual without really a lot changing. And their productivity probably will be higher. But I think there’s going to be a bunch that are going to have to be onsite.

[00:31:24] I think it’s going to build resentment. I think it’s really going to require a significant [00:31:30] thought in order to build the right culture around this and the right mix of onsite and remote. Let’s see any man, there’s so much wisdom here. Stephanie Reel talks about artificial intelligence again, and I think that’s important.

[00:31:45] Heather Nelson talks about how our focus has become so our focus is the most critical thing for our patients, physicians and care team members. And I think focus was the key word in [00:32:00] 2020. And I think in 2021, our focus will get even more fine tuned. And I think that’s a great sentiment.

[00:32:07] Darren Dworkin, our encounters with our patients are often at a time when they’re most vulnerable and looking for answers. One of the most helpful technologies we have found to engage patients in their journey is the use of real time information. And I think that is going to be one of the things I love that Darren brought that up.

[00:32:22] I think that’s going to be one of the things for 2021 and beyond. I think this a retrospective view of information [00:32:30] is not going to cut it. I think we’re going to need we’re going to need better. Ways of turning our data into information into knowledge we’re going to need better workflows in order to get that information to the right place.

[00:32:45] In fact, one of the things Taren talks about is getting into the portals and mobile apps and tablets and you name it. And I think that’s where we’re going to have to get more creative. We used to say, well, we got into the portal, we got into the EHR. We’re good to go. I think we need to be more creative and [00:33:00] that’s, what’s, that’s going to be one of the marks of the leaders going into 2021.

[00:33:06] One of the things I said about 2021 on a post is that I think in 2021, we’re going to see. And I think in 2020, yeah, we really saw the digital front runners start to distance themselves from the others. I think the the fast followers are spending a lot of money trying to keep up and they’re going to struggle to spend that money to keep up.

[00:33:27] They’re going to have to really put in the right platforms [00:33:30] in order to keep up. And then I think the laggers are just saying, well once my EHR provider has the technology. I’m going to … I will be good to go at that point. And I think they’re going to lag even further and further behind. I think the EHR providers are going to struggle mightily to keep up with the regulatory demands and the innovation demands of their clients. And so I, I really do believe that innovation needs to come outside the EHR. I’ve believed that since we started this [00:34:00] show, I believe this since 2014 that we have to free the data, get it into repositories that can be accessible via API APIs.

[00:34:09] And then we build technologies around that and that requires you to set up the platform. So you know that, that’s what some of the leaders are saying. This is a good article. If you get a chance 22 was called 22 hospitals, C level execs shared their it perspectives. And [00:34:30] and it was not only, not only the ones you heard, there’s plenty more where that came from.

[00:34:34] So that’s all for this week. If someone that might benefit from our channel, please forward them a note. They can subscribe on our website thisweekhealth.com or wherever you listen to podcasts, Apple, Google, Overcast. That’s my that’s where I listen, Spotify. Stitcher, you get it. We want to thank our channel sponsors who are investing in our vision and mission to develop the next generation of health IT leaders. VMware, Hill-Rom and StarBridge advisors. Thanks for [00:35:00] listening. That’s all for now.