July 6, 2021: Anne Weiler, health tech entrepreneur and advisor to This Week in Health IT joins Bill for the news. Is there enough help for seniors who aren’t tech savvy or should tech in healthcare just be simpler to use? An AARP survey found that more than half of older adults said they needed a better understanding. Huge investments have been made in digital health startups in 2021 so far. Beckers lists the top 13. This past year poured rocket fuel on the adoption of digital health across every demographic. And data shows that many patients are on board to continue the trend. What will the post-Covid-19 landscape look like? How can health systems address possible challenges? And what are the opportunities to revolutionize care?
Newsday – Designing Healthcare Around the Consumer at Any Age
Episode 421: Transcript – July 6, 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 Newsday. My name is Bill Russell, former healthcare CIO for 16 hospital system and creator of This Week in Health IT, a channel dedicated to keeping health IT staff current and engaged.
[00:00:17]Special thanks to Sirius Healthcare, Health Lyrics and World Wide Technology who are Newsday show sponsors for investing in our mission to develop the next generation of health IT leaders. We set a goal for our show. And one of those [00:00:30] goals for this year is to grow our YouTube followers. We have about 600 plus followers today on our YouTube channel. Why you might ask? Because not only do we produce this show in video format but we also produce four short video clips from each show that we do. If you subscribe, you’ll be notified when they go live. We produced those clips just for you the busy health IT professionals. So go ahead and check that out.
[00:00:55]A common question I get is how do we determine who comes on This Week in Health IT? To be honest, it started [00:01:00] organically. It was just me inviting my peer network. And after each show I’d ask them, is there anyone else I should talk to. The network group larger and larger and it helped us to expand our community of thought leaders and practitioners who could just share their wisdom and expertise with the community. But another way is that we receive emails from you saying hey, cover this topic, have this person on the show. And we really appreciate those submissions as well. You can go ahead and shoot an email to [email protected] We’ll take a look at it and see if there’s a good fit to bring [00:01:30] their knowledge and wisdom to the community as well.
[00:01:32]Today we are joined by Anne Weiler. She’s an advisor to This Week in Health IT and recovering health tech CEO. Good morning Anne. Welcome back to the show. Are you okay with recovering healthcare, health tech CEO?
[00:01:44]Anne Weiler: [00:01:44] No, I think that is the perfect way to frame it. I am currently doing actually, so I’m currently at AWS and I run a service for interactive messaging and many of my [00:02:00] customers are healthcare. And so that’s, I love it, but I also love that many of my customers are not healthcare. So recovering is exactly right.
[00:02:10]Bill Russell: [00:02:10] It’s a little different, right? When you’re a health tech startup, you have to get your first client. Otherwise you have no credibility. After you get your first client, now you’re going out and saying, Hey, we’re doing work with, fill in the blank, whatever the big name is that got on your thing. It is hard to get that momentum going and it feels like every time you get that one [00:02:30] client you’ve really gotten one client and you have to go out and do the whole thing over again, every time.
[00:02:35] Anne Weiler: [00:02:35] I just saw a tweet from some VC and there’s like many people on Twitter who make fun of VCs. But it was like one great story in your deck is from named customers so much better than a hundred data points. A hundred data points of anonymous customer shows that you have a hundred customers. One customer story might mean that you have one customer.
[00:03:00] [00:03:00] Bill Russell: [00:03:00] One of the things that always impressed me about you is you did go into the medical study route. And a lot of the health tech startups don’t do that. And that’s one of the roadblocks that you hit, as they say, okay, show me, prove it to me. Can you do this? So was that effective?
[00:03:17] Anne Weiler: [00:03:17] So effective. I wouldn’t say that was the smartest thing we did, but that was a very smart thing that we did very early. And I think it was because we came from Microsoft, which is very [00:03:30] data-driven and so the ability for somebody else to do a study, improve the efficacy of what we were doing.
[00:03:38] We jumped on that right away and on like the, one of the very first people we met when we started, this was Dr. Terry Ellis from Boston university who wanted to do a clinical trial. Oh, this sounds good. And so not only did we get that, she introduced us to Dr. Jonathan Bean at Harvard. [00:04:00] But they did the studies independently because they didn’t want their research to be biased.
[00:04:05] So they did the studies, the outcomes were there and we didn’t pay for the studies. Like now the thing that scary. VCs and startups about them is that from the time of conceiving the study through published in a peer reviewed journal, which is the point where everybody goes, okay, yes, this is correct. That can be five to seven years. And that is, [00:04:30] that’s not a startup timeframe.
[00:04:31] Bill Russell: [00:04:31] I was going to say, you can be out of business and starting your second or third startup by then.
[00:04:35] Anne Weiler: [00:04:35] Yeah, you totally could be. We were fortunate that we weren’t. But yeah, I mean there were times where it was like we’d have the early results, but the people who are going to publish them, they don’t want you to talk about them until they’re published.
[00:04:51] Bill Russell: [00:04:51] So are you, are you presented with the, the I’ve often wondered this, are you presented with the impossible sale, which is [00:05:00] essentially selling your soul to a large health system just to get that reference client? I mean, almost giving the product away, knowing that you’re going to lose money, knowing that whatever, or have we gotten more sophisticated?
[00:05:11] Anne Weiler: [00:05:11] Well, okay. I want to say yes and no. I mean, we, we went down the path of let’s pilot, let’s pilot, and then we got to a point where we’re like, no, yeah, you can pilot and you can pay us. And as soon as you figure out there are no free pilots, like, I think that’s a, a [00:05:30] challenge that, I mean, obviously if somebody pays you, you’re always better off, but I think in other industries, they’re more likely to go from a pilot to deployment.
[00:05:41] Whereas in healthcare, we had a lot of like kicking the tires and then also I would say kicking the tires and then face like going, oh, we’ll, we’ll build it ourselves. And then a year and a half later, of course they hadn’t built it themselves. So we very quickly got to the, yeah, you [00:06:00] can do a pilot and you can pay us for it because there’s value here. And you can continue to pay us when you go into deployment.
[00:06:06]Bill Russell: [00:06:06] We have five stories here, but you know, one more question on this. How important is the lawyer, the legal team that you have up front? Hey, it’s gotta be hard, right? It’s hard.
[00:06:18] Anne Weiler: [00:06:18] It’s so important. And we had a few before we, we settled not say settled before we found this fantastic person.
[00:06:27]Bill Russell: [00:06:27] Do they have to specialize in [00:06:30] healthcare or health tech
[00:06:32] Anne Weiler: [00:06:32] We had one who was specialized in health tech, IP and contracts. And I wish if the cameras weren’t rolling, I would tell you some stories, but he was fantastic. He, he understood. So the other thing that you have to make sure as a startup is that your lawyer understands the risks you’re willing to take.
[00:06:57] So if you’ve got somebody who’s really only done big corporates, [00:07:00] They’re so risk averse and we did actually have one like that. At one point we had the, we got, I want to say second, but there was this big law firm who was like, we’re going to start working with startups and we’ll pilot with you and all this.
[00:07:12] And we go in there and I was just like person could not understand that we were willing to take certain risks because we had to, because we were Florida and because we had to get these contracts done and things like that. And so when we found this next person, Yeah, I’ll [00:07:30] say, I’ll say his name in case anybody is looking for a lawyer, David Finney of Atkins Plant or Aquins black.
[00:07:37] He understood the risk we were willing to take, start up and he would lay it out. Like he would say okay, well here if we do this, this is the. Are you okay with it? And obviously the client has to agree, so that was amazing. He could also deescalate any situation. Now you were in a health system.
[00:07:57] I don’t know you were on the other side of the [00:08:00] table. I don’t know how you felt about your lawyers but the health system lawyers are very tough and they were often I don’t want to say, I don’t know, things would escalate and my lawyer would just be hey we understand what you’re saying and but Finn’s fantastic.
[00:08:18] Yeah, absolutely. If you’re selling to large enterprises and that’s, if you’re in healthcare, that’s PR unless you’re doing top to bottom yourself, but even if you are, and you’re still selling to [00:08:30] insurers you’re going to be a startup. You’re working with these massive corporations or organizations who have fantastic in-house counsel, you better have a good lawyer. That’s what I was saying.
[00:08:42] Bill Russell: [00:08:42] And good insurance too. It’s it’s kind of crazy. I had somebody look at our insurance and they’re just like, why do you have so much insurance? I’m like, well I do business with healthcare organizations? Do they require this? I’m like every contract I’ve had requires all these limits and things on the insurance.
[00:08:57] So you, you really do have to maintain that [00:09:00] level of insurance. And to be honest with you, I’m not working with Phi. I’m not working with data and those kinds of things. I’m providing advisory services. Now I might see strategy documents. I might see technology strategy, but at the end of the day, I still have to have the insurance that covers the loss of Phi through my entity.
[00:09:18] Anne Weiler: [00:09:18] Right. And why you might give them bad advice.
[00:09:21] Bill Russell: [00:09:21] Well that’s a different funnel. That’s a different policy, but yes errors and emissions is, is in there as well. All right. Let’s get to the five stories before we reveal all of our secrets here. Let’s [00:09:30] see. Where do you want to start? Do you wanna start with the Kaiser story? All right.
[00:09:34] Anne Weiler: [00:09:34] I was going to say if you’ve seen me on this show before and you have, because we’ve talked you’ll know that I’m very passionate about technology for seniors. So Kaiser health news article is talking about computer help for seniors and also how things of accelerated during the pandemic. And so the reason I chose this one is because this is [00:10:00] a topic that is close to my heart.
[00:10:03]Bill Russell: [00:10:03] I didn’t realize there was this many kinds of agencies that are helping seniors. There’s a lot listed here.
[00:10:09] Anne Weiler: [00:10:09] So this is the interesting thing. And what this article is listing is both not-for-profits and for-profits. And I think that the, the idea that helping seniors use technology should be altruism is kind of odd, right? Like, first of all, this is a very large [00:10:30] population. Second of all it’s obvious now if you didn’t realize it before, but the pandemic really showed, like, we need to keep everybody connected.
[00:10:41] We need to be able to do things remotely. We need to build, to do things digitally and seniors are a large population of the people that need to do these things. And then you look at like some services don’t even have in-person things anymore, or they require you to do multifactor [00:11:00] authentication. All of these things. And so on the one hand, great that there are all these organizations helping seniors. On the other hand, I’m also very passionate that we should just make things that are easy to use. I mean, I don’t know why I think about this all the time. Like maybe it was like when I was little, I spent a lot of time with my grandmother and her friends and stuff.
[00:11:22] So I think about aging a lot. And whenever I can’t open something, a package or whenever I am [00:11:30] like beyond frustrated trying to figure something out, how to figure it, figuring out something works, especially with technology and I’m thinking. I work in technology and I can’t figure this out. I don’t know if, I don’t know if I ever told you this part, but I need it, I have an apple TV and it’s like the second generation. So it’s very old and it stopped supporting HBO Plus. So I was like, okay, I’m going to get a new one. I get the new one. Okay the remote on it [00:12:00] was so unusable that within the first five minutes I had accidentally just subscribed to Disney Plus or something like, and I was just like, are you kidding me? Like, I could not make this thing work. And I was just, I sent it back. And as I learned later, you can use the old remote with it. But like, first of all, how did I learn that? And second of all, I’m thinking of like, I’m looking at this and I’m like, yeah, no one. When I’m on the phone with my parents, like I’m trying to troubleshoot things remotely and I just can’t do it.
[00:12:29] So [00:12:30] I think that this initiative is, is amazing. There’s a couple things. We need to stop thinking that seniors are incapable. We actually need to examine what we’re building, because I heard all these pandemic stories of seniors doing now doing all their community center stuff on zoom, doing classes on zoom. So I think zoom is pretty usable. There’s a whole lot of things that aren’t, so that’s, that’s the part of like, and I’m hoping [00:13:00] that these, even if they’re altruistic, that they’re giving feedback to the tech industry, rather than just saying the problem is the seniors. They can’t use technology. I mean, that was going back to my startup time and before we came on, No, we were talking about the, are we talking about the clinical study before or after we
[00:13:19] Bill Russell: [00:13:19] We had a long conversation before we came on here
[00:13:23] Anne Weiler: [00:13:23] We just talk. We talk a lot. So the clinical studies were specifically because when we started the startup, people said, well, [00:13:30] this digital technology is great, but it’s seniors who have the problem and they can’t use tech. And so that was what the studies were too. Well. I mean, the studies were to prove two things. One that the tech actually improved patient outcomes, which is obviously the most important. And second was that it was usable by people in an older age bracket and it absolutely was. And here’s the most important part.
[00:13:52] And I say this to teams all the time. If you design something that’s highly usable, a more [00:14:00] advanced, more technical user is not going to complain. We never had like a younger person’s like, oh gee, this App is too easy for me to track my patient outcomes.
[00:14:10]Bill Russell: [00:14:10] The age old story. The walled garden is beautiful from this perspective. None of us really liked the walled garden, except when apple hands a two-year-old or a one and a half year old an iPad. And you watch them just go flip, flip, hit the game, do the thing, close it up, open a video and you sit there. Oh, [00:14:30] my gosh, this is like not even a fully developed brain sitting there with the iPad.
[00:14:34] They intuitively know what to do, and they just start flipping through things. That’s the level of simplicity. That’s the goal. Apple’s always the goal from a simplicity standpoint. I love the fact that you shared Apple TV.
[00:14:45] Anne Weiler: [00:14:45] I was going to say except they seem to have lost the plot a little bit. I mean, this was unbelievable.
[00:14:53] Bill Russell: [00:14:53] It’s interesting. This is a good article from this perspective. You have a generations online, you have cyber seniors, you [00:15:00] have Digi age, you have aging connected. They list a whole bunch of the can do tech. They have a whole bunch of companies, they list that are helping seniors.
[00:15:09] So it’s really good from that perspective. Let me tell you my story for the week. I shared this on Today in Health it yesterday. My neighbor is seeing an academic medical center. I will leave the name off for purposes of this story. And and so he said, look, I have this meeting with a specialist at 1:30 tomorrow. Can you come over and make sure I get connected correctly? So I [00:15:30] go over there and sure enough the instructions are perfect. I mean, it’s beautiful. You go into the portal, you hit connect to the thing and it pops up. But the first thing is he’s on AOL, right? So I’m looking at this thing going AOL. Really? Okay. So but it works, it pops up, but there’s a little error message that pops up in the background. And first of all, I had to get past pop-up blockers. Right. Cause it’s popped up which is not a small deal for a senior. So I’m there. I know how to do this. I get through it. We opened it again. It’s sitting there.
[00:15:58] 1:30 comes and goes. [00:16:00] Nothing. 1:40 comes and goes. About one 1:42, 1:45ish he goes, I’m going to call him. So he calls the help desk number and says, Hey, I’m online. I’m supposed to be seeing Dr. Whatever. And and it’s just spinning. I don’t know if it’s working or not. At this point, I’m a former CIO. I’m looking at it going, I don’t know if it’s working or not.
[00:16:24] And it was just a Zoom call and I know what zoom calls look like, and it’s waiting for the person to can. But there’s [00:16:30] part of me in the back of my mind going, what was that error message and did that really cause it? So he’s, he’s sitting there waiting on hold and she goes, well, I can’t see that what the physician is doing.
[00:16:39] I’m actually at a call center. He’s over here. I’m going to transfer you to that department. So that whole thing takes about three minutes, transfers to the department and about 1:48 he’s finally on hold with the radiology departmen, or I’m sorry, with cardiology department at 1:49, all of a sudden, boom physician [00:17:00] pops up on the screen.
[00:17:00] I’m like, I knew that’s what should happen. But think about that 19 minutes late and the workflow is broken, the workflow’s broken. The patient didn’t know he could have very easily just close it up and said, I couldn’t get it to work. This, this system didn’t work for me. I’m not sure that would have been different for a senior or you and I. I mean 19 minutes, there should be some process where the physician is running late that I don’t know. You can send a text message or something to the user that says I’m running [00:17:30] behind, stay on the line. I will be there a little late.
[00:17:33] Anne Weiler: [00:17:33] Yes. Yes. The basic usability. Like you think of you think of zoom, any sort of meeting software, you can tell people that you’re running late.
[00:17:44] Bill Russell: [00:17:44] You, you, you would think. I was, I was kind of I dunno, I was kind of we have to be thinking through the user experience. We have to be thinking through how they use the technology. And I understand the complexity of that. We’ve now [00:18:00] expanded from not only from a health IT standpoint, not only supporting the computers within the four walls, we now have to think about all kinds of devices, all kinds of locations. Yeah. All right, let me hit the Harvard business review article.
[00:18:14] I think this is interesting. The Scottsdale Institute got their CIO forum results. What they do is they bring a bunch of CEOs from the Scottsdale Institute together. They have a conversation and they said, all right, let’s talk about the new normal post pandemic.
[00:18:29] What are [00:18:30] the three things that we have to deal with? And they said there’s three overarching things that they have to deal with. And, and what the Scottsdale Institute did is they actually publish us through the Harvard business review. A larger reading, I think, from there anyway. So the three things that they have to deal with. Virtual care, obviously coping with the financial impact of the pandemic, and I want to talk about that a little bit with you and embracing the lessons learned from managing the crisis. Let’s go, let’s go in reverse order. [00:19:00] So the lessons learned from managing the crisis, the number one lesson learned from managing the crisis is we can do a lot in healthcare if we are focused. That is the number one lesson. We were able to be agile. We’ve made decisions very rapidly. We reduced the administrative burden around things. We got things ordered quickly. We moved people quickly because we knew what it was about. It was about safety. It was about protecting our providers, that it was about protecting our people and our community.
[00:19:28] And we were going to do everything we could [00:19:30] around those two things. How do we keep that going? Why can’t we keep that going? I’m already hearing people go our culture slapping back. I could feel it snapping back. We have 150 projects again.
[00:19:41] Anne Weiler: [00:19:41] Yeah. It’s interesting because this is, it’s not just healthcare. We think that healthcare, I mean, healthcare was what’s failing but as I said, I now work in more general tech and we, what we’ve seen in digital investments [00:20:00] is they have moved ahead three to five years in very short periods of time and companies that you didn’t expect not to be text messaging set up text messaging.
[00:20:12] So I think that the key thing, and this was my concern with telehealth at the beginning is these investments were made. Somebody needs to be on top of like, okay, we’ve made the investment, we got over the hump. We did the thing that we didn’t think we could [00:20:30] do now. What are we going to use it for? What’s next?
[00:20:32] And for things like vaccine notifications and COVID tests, the volume and the urgency is never going to be as high. But why why are you not doing flu shot reminders? Why are you not doing wellness visits? When the infrastructure is set up, why, what are the other things you’re going to use it for?
[00:20:54] Bill Russell: [00:20:54] I’m going to go right there where you just went, because I get this question all the time. People are like, what can we do? And I’m like, you have [00:21:00] to start with what you believe. Right? We believe ED volumes will not return until 2023 or ever again. Okay. That’s a belief statement. Put your beliefs down. Start with what you believe, what is going to happen?
[00:21:12] What is the future? What do we believe is going to happen? Then pressure test those. Do some studies in the community. We believe telehealth is going to be a major component. Is it? I don’t know get the data let’s we believe that but there’s a lot of healthcare decisions that are made on the belief of a few [00:21:30] people that doesn’t get pressure tested out in the community.
[00:21:33] And that’s why you end up with a lot of failed startups and those kinds of things, or failed projects or projects that don’t get the right emphasis within the organization. The management might believe it. And then they say, go kick it off. And then the clinicians look at you and go, that’ll never fly.
[00:21:50] You just have to pressure test this thing, but I would start with the belief statements. That’s how you stay focused because you’re going to put together a five-year strategy and [00:22:00] really what you should look at has anything changed. Do we believe that healthcare is heading in this direction? Do we believe that competition will materialize in this way? Do we believe that technology will start to enable us to provide more care in the home? Once you have those belief statements in place, then go ahead and put the projects around it and that will help you prioritize them and hopefully get all these other things to fall off, to fall by the wayside. But because they’re all good projects, as we always say, they’re all good projects and they’re all [00:22:30] in pursuit of health and making the clinician’s life easier.
[00:22:34] And more acts, they’re all good projects, but you can only do so many of them. And when we do narrow that down, we are much more effective, I believe.
[00:22:46] Anne Weiler: [00:22:46] Yeah, totally. It’s funny you say that because I saw a large health system advertising. Hey, we we’re expanding our innovation group. And I was like, huh, okay. I’ll look at this. And I looked and I said, look at all these [00:23:00] projects we’ve done. And there were 20 or more projects on their website. And I was like, oh yeah, there’s innovation theater. You’re the one who talks about that. It’s like, yeah, prioritize like this is, I think this is one of the challenges in healthcare, right?
[00:23:15] Is that everything is has meaning. Everything could benefit patients and or providers or whoever. And so, yeah, it’s about the prioritization and that’s what the pandemic did was [00:23:30] hyper prioritization. Yep.
[00:23:32] Bill Russell: [00:23:32] I agree. So the second thing is financial health. We don’t talk about this a lot. I’m glad they didn’t bring it up from March 1st to June 30th, hospitals and health systems lost an estimated of 202 billion dollars as a result of forgone revenue. That’s important to note that a lot of health systems are running on, operating margins are running on 1 to 6% really successful ones. now. Mayo might be 12% and Cedar’s might be 12% or whatnot. UTMC might be high. [00:24:00] Intermountain might be. I’m naming all the really high ones because they’re, they’re rare cases. They’re, well run the specialty care kind of places, but a majority of them are, or one does and you take $202 billion out of that system. That means a lot of them are operating at a loss during the pandemic.
[00:24:19] For sure. And potentially if volumes haven’t come back, which they’re saying they’re, they’re not coming back just yet. 2021 could also be with them. They’re talking to the CIOs. And what the CIO’s are [00:24:30] essentially saying is, and this is one of the realities we have to grapple.
[00:24:33] So yes, we have to continue to prioritize and yes, we have to put virtual care everywhere. It makes sense. But one of the realities we have to grapple with is that there’s less revenue to play with. And which means typically what it means is revenue was this big and our costs were this big, well, when revenue shrinks costs have to shrink and they have the normal things that you have in here around consolidating instances of applications, [00:25:00] which is an epidemic and healthcare. I mean, and is there just proliferation of applications happened over decades and I’m not sure we pulled that back enough yet we should, we should be able to really continue to pull that back. Explore the use of cloud initiate, initiate efforts, optimize performance of existing applications and leverage vendor capabilities where possible.
[00:25:23]And then the other thing they talked about is capitation that their health systems, what they’ve noticed through the pandemic is that health systems did better [00:25:30] when they had managed lives when they had capitated agreements, because the payers did well during the pandemic, but the providers did not do well during the pandemic.
[00:25:42] But one of the things they point to is their analytics need to be better support systems. One of the things I will say. They think it’s easy to go out and get a patient population to put them under contract, but healthcare systems don’t know how to market and they don’t know how to sell. They really don’t know how to sell. They think marketing is sales [00:26:00] and marketing isn’t sales. I remember when I went in, I said, all right, you need to hire a sales organization. They’re like, well, no, the executives will take these meetings and stuff. That’s fine. Have any of them ever had a sales quota? Have any of them ever there’s actually a skill to selling that was so undervalued in this and sure enough I think over a two or three-year period, we closed one, one employer on our, our program. And I’m like, it’s because you don’t do sales and you don’t really do marketing.
[00:26:29][00:26:30] Anne Weiler: [00:26:29] Yeah Either. Either .The marketing. Yeah. It’s, I mean, it’s marketing, but it’s like that the thing that, what we’re seeing elsewhere is that customer experience and there’s that reluctance to consider patients to be customers, but they are actually customers, but I saw oh shoot, I’m gonna forget his name now, but he’s someone I know from healthcare journalists [00:27:00] a freelance writer posted on Twitter.
[00:27:02]He had just. Well, he hadn’t had the baby, his wife did have the baby. The first outreach from the hospital was an H cap survey. And it’s like, we understand you may have recently visited our hospital and he’s like like, do you understand that like the most amazing thing just happened to me and my family.
[00:27:20] And because you can imagine also like, what if it hadn’t gone well? Like welcome like, like he’s like the where’s the [00:27:30] like congratulations new parents, like it’s, it’s the nope. We’re worried about our our age cap survey and our, our patient impact.
[00:27:40] Bill Russell: [00:27:40] When I was trying to make the case for CRM and we did bring CRM into our system. It was kind of interesting. It’s like, well, we have all these databases of people and we know their birthdays. We know their address. Do we really need another system to track. It’s like, it’s not a system to track that it’s a system of engagement. Right. And to, to explain that to people, they’re just, [00:28:00] it’s like, it’s, it’s not just sending the email out, but it’s actually knowing whether they open the email.
[00:28:05]It’s interacting with them through texting, it’s interacting with them in a lot of different ways. It’s knowing that it was a child that was just born and we can customize the letter to say, Hey, congratulations, whatever. The challenge we had, of course, was you’re taking a PIPA data and you’re taking CRM data.
[00:28:25] And you’re, you have to be very careful when you’re doing that. But at the end of the day saying, Hey, [00:28:30] congratulations on your new child is not, it’s not really violating that, but you really have to understand that.
[00:28:35] Anne Weiler: [00:28:35] I mean, there’s definitely a lot more sensitivity when you’re dealing with health data, but think about like financial services. There’s a lot of sensitivity there and they managed to understand who their customers are.
[00:28:46] Bill Russell: [00:28:46] Yep. That’s true. And we do, we have to understand who our customers are. Have you been hearing the same things around financial health of health systems?
[00:28:55] Anne Weiler: [00:28:55] Yeah, well sort of, I mean, definitely, definitely at the beginning of the [00:29:00] pandemic it was obvious when everyone’s canceling all of their elective procedures. And then I think that was always an interesting conversation was people didn’t understand what elective. But having benign brain tumor removed is actually elective surgery. So like the seriousness of, of elective surgeries quite high. Anyway the, so it was obviously were losing money.
[00:29:28]That was the first time I saw the [00:29:30] full collective stat. And I’m curious about what does that mean? Like where, where are the, a re the budget cuts coming or are they coming and where are they coming from? And then also there’s, before this the rural hospitals were in trouble, right? Like the safety net, hospitals. So like what is going to be the longterm fallout of this?
[00:29:50] Bill Russell: [00:29:50] I think I’m going to do a week on today in health it on rural hospitals and their situation. I’ve been, I’ve been reading a lot of articles. I’ve been researching [00:30:00] it and the crazy thing. I don’t think there’s going to be a huge audience that’s going to say, well, Bill’s covering rural health, but the reality is it’s a major it’s a major challenge. And I think it presents a real significant opportunity for us in healthcare if we really think through it well, but I, I don’t want to go into that just yet, because I’m just still forming my, my thoughts on that in terms of where do cuts come from. Unfortunately they’re going to come from operations [00:30:30] and that could be anything from administrative cuts to nursing and some other areas that it’s hard, it’s hard to make those. I’ve been, I’ve been at a system where we had to make those cuts and it’s, it’s really hard to make those cuts and it’s hard to justify to cause you’re letting people go and they look at you and go don’t we have a billion dollars in investments and don’t we collect money in philanthropy and, but you have to ask yourself is the role of the health system to provide [00:31:00] employment? I think the answer to that is somewhat it is. They’re the largest employer in the community. But part of that is to remain fiscally healthy in order to provide employment for and care for the community as well.
[00:31:13] We, we always took heat every time we did cuts because we were a not-for-profit. We were making a profit not we’re making a profit, but we were, we had an, we had an operating profit every year that got reinvested back into the [00:31:30] organization. So people were like, why didn’t you do cuts in a year that you went.
[00:31:34] And this was an always an interesting conversation. Why did you do cuts in a year that you were profitable? And the answer to that was we were not meeting the mission of our organization, which was to provide it’s the triple aim and to provide access to everyone in the community and to lower the costs. And what we realized is we were making more money, but it’s because we were raising the cost of healthcare across the board. And the sisters essentially looked at us and said, no more. [00:32:00] Stop you’re, you’re making money on the backs of people that can’t afford it. And, and so even though we were driving profit, we were still doing cuts and it was hard to explain.
[00:32:11] Anne Weiler: [00:32:11] Yeah. It’s it’s well, as we know, it’s so complicated.
[00:32:17] Bill Russell: [00:32:17] It is complicated. The last thing that we talk about is virtual care and you’ll be glad to know that they say creating a great patient experience has been elevated as a result of COVID and delivering [00:32:30] care in the right setting is one of the things that we were looking at very closely with telehealth.
[00:32:34]I’m bullish on telehealth, but I’m not sure it’s going to be phenomenal for providers. My other story of my telehealth visit is my wife had a nagging problem and I said I think United healthcare offers tele-health through Teladoc. Sure enough, they do. It’s free to me. 7 by 24, 365.
[00:32:51] It’s free to us. I said, just you, she goes well is it hard to use? I’m like, well, let’s go see she logs in and says fill out [00:33:00] this medical information and click on this button and sure enough. You select telephone visit or video visits, you selected telephone. She got a text message and an email almost immediately.
[00:33:10] And the call was initiated within five minutes. I’m like, Hmm. Did any money go to the provider? In that case while I went to Teladoc as the provider and I’m sitting there gone, that’s really interesting to me. If the local health system doesn’t figure out a way to create a relationship with the consumer, [00:33:30] somebody else is going to be directing care.
[00:33:32] Anne Weiler: [00:33:32] I think this goes back to the, year ago I talked to somebody who was doing team-based medicine and they, of course it was out of a, it might’ve been out of Stanford, like the kind of thing where you could fund something like that. But the team, there was a primary care physician. There were a number of nurse practitioners.
[00:33:51] There were some PTs, there were OTs there might’ve been even behavioral health and they worked as a part. And I think that if the health [00:34:00] systems want to have tele-health that maintains their patient continuity and maintain to their patient, that’s the way to go because the, the frustration with, I mean, if you need something urgent, urgently, and you don’t want to leave home, it’s great.
[00:34:16] But if you want that continuity of care with your health team, like you can’t have a doctor who’s available. 24 7 for telemedicine visits and seeing people in person and like the whole scheduling of the strategic. [00:34:30] Right, but you also like I go to university of Washington medicine and for telemedicine, they’ll just put me on with any doctor and okay, sure.
[00:34:38] It’ll still go into the same record, but I have no relationship with this person, but my doctor is not going to be available. I mean, she does do some telehealth telemedicine visits, but it’s not that like you got to book that telemedicine visit far in advance. So I think they need to move to this.
[00:34:52] Like, we’re going to have a pod of clinicians. Who work with patients so that if I’m not [00:35:00] talking to my doctor, I’m talking to the nurse practitioner that works with my doctor and they might even talk later about me versus like this doctor I’ve never seen, who’s only going to put notes in and never go back and talk to my doctor about me.
[00:35:12] I think that’s the model. Like they have to move to this and they can have, they could have those people rotate in, in telemedics. To like maybe the nurse practitioner sometimes does telemedicine. Sometimes it doesn’t like . That’s how you have to do it.
[00:35:27] Bill Russell: [00:35:27] Dr. Kvedar , American telemedicine [00:35:30] association. He’s like chairman or something to that effect. And he essentially was saying one of the benefits we have in going as providers is you can actually talk to someone who knows you. Somebody you have a relationship with, whereas a Teladoc or something like that you’re going to get whoever’s on the phone. If you’re experience is the same as I mean that’s missing, missing the boat, but I agree with you. The scheduling was so hard. It was so hard to take somebody who sees patients physically all day and figure out how to do the telehealth visits as [00:36:00] well. You can’t do them. You can’t do them all on demand.
[00:36:02] Anne Weiler: [00:36:02] The in-person scheduling is so hard. Right,
[00:36:04] Bill Russell: [00:36:04] Right. Alrigh here’s what we’re going to try and do. We’ll try this out. I sometimes I like to try things out and see what happens and maybe incorporate it later. So three stories left. The new normal digital health and the post COVID world. This is a Carina Edward’s writing on LinkedIn.
[00:36:20] She has two points. I’m going to ask you about one of them. So engaging consumers and giving consumers control, engaging consumers, we’ve already talked about giving consumers control. [00:36:30] Do you think the pandemic has changed that that consumers want control of their health? It still feels to me like a very passive kind of thing.
[00:36:38] I mean, I, I am not in control of my health when I need help it just doesn’t feel right. I don’t know how to demand control of the process.
[00:36:48] Anne Weiler: [00:36:48] Yeah. I don’t think it’s, I think it’s the people who always wanted to have some control have it and the other, I mean, it’s not that people don’t want to.
[00:36:58] It’s just, they don’t know how, but [00:37:00] like I look at, I look at people when the resourcefulness of getting vaccines like I was astounded at people sharing information among my friends who are all type A technology. People like there are, people were very, I want to say creative, but resourceful about like, oh, I found a vaccine over here before it was like, they were widely available.
[00:37:26] So there are always people who are bing [00:37:30] proactive. And I don’t want to say that other people aren’t being proactive, I’m saying like, it’s, who’s willing to, to deal with the pain and make the effort to try and figure out how to manage your own health. Right?
[00:37:41] Bill Russell: [00:37:41] So from that perspective, I hope Carina is right. That health systems are figuring that out. Otherwise United healthcare is trying to figure it out. Optum’s trying to figure it out. Walmart and and others I’ll just say others with you on the line are trying to split it. Let me tell you the next story. 13 health [00:38:00] systems are investing in their innovation dollars where they’re investing their innovation dollars this year. This article was in Becker’s struck me as amazing from this perspective, Ascension ventures, a billion dollars, Northwell Health investing hundreds of millions of dollars. You have Mayo invest anyway. They’re all investing significant dollars. Here’s the one thing I thought was interesting.
[00:38:24] Mayo has partnered with Kaiser on the hospital and home initiatives. Whose [00:38:30] name I forget right now. And they also have partnered with Providence on Dex care. So you have, you have these, these funding arms coming together, and that creates kind of an interesting dynamic too. Doesn’t it? I mean, is this a way, are they using their venture arm as a way to partner with each other where they normally.
[00:38:54] Anne Weiler: [00:38:54] I don’t know. No I think there’s, I think there might be a little bit of FOMO, first of all. And then second of all [00:39:00] this, there always were these, I don’t want to say secret, but like that Scottsdale Institute you gave that example, they were already all sort of collaborating and various things. AVIA’s like that too. You’ve got a bunch of competitors that go in together to invest in things. So I think it was always there. And then there’s the FOMO. And then there’s also the it’s easier if someone else has validated it. So if you know that Providence or Mayo have these great venture groups who are doing all the validation, then [00:39:30] it’s easier to go in and go, yeah, I’ll come into, I’ll come in on this too. With Providence and Mayo, I would say are not really competitors, right? Like Providence is not a destination and they’re so far geographically. But that’s pretty safe too. And yeah, so that’s an, that’s my take.
[00:39:44]Bill Russell: [00:39:44] Providence and Kaiser are for sure in certain markets. Anne I want to thank you for your time. Really appreciate you coming on the show.
[00:39:50]Anne Weiler: [00:39:50] Always great to talk to you.
[00:39:52]Bill Russell: [00:39:52] What a great discussion. If you know someone that might benefit from our channel, from these kinds of discussions, please forward them a note, perhaps your [00:40:00] team, your staff. I know if I were a CIO today, I would have every one of my team members listening to this show. It’s conference level value every week. They can subscribe on our website thisweekhealth.com or they can go wherever you listen to podcasts, Apple, Google, Overcast, which is what I use, Spotify, Stitcher. You name it. We’re out there. They can find us. Go ahead. Subscribe today. Send a note to someone and have them subscribe as well. We want to thank our channel sponsors who are investing in our mission to develop the next generation of health IT leaders. [00:40:30] Those are VMware, Hill-Rom, StarBridge Advisers, Aruba and McAfee. Thanks for listening. That’s all for now.