Newsday – Digital Transformation, Big Tech Moves in Healthcare, Remote Work and Care
March 15, 2021

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March 15, 2021: It’s Newsday. Bill is joined by Dr. Eric Quiñones, Chief Healthcare Advisor at World Wide Technology. Amazon Care’s partner “Care Medical” has filed to operate in 17 more states. This is concierge level service. They’ll meet you in your office, your home, wherever you are. What can hospitals learn from Amazon and big tech? How can we be more consumer centric? Mercy and Humana partner to expand access to virtual. Home care is the next frontier. And working from home is not a slam dunk. It’s challenging. But what big questions does returning to the office raise for CIOs?

Key Points:

  • Apple know that the patient experience is critical [00:11:10] 
  • If we are going to be consumer centric in healthcare, what does that look like? [00:16:45] 
  • An ARP study saw that adults 50 years or older prefer to age in their homes and communities [00:18:15] 
  • CMS estimates that home care in Medicare saves $370 million a year [00:18:35] 
  • Best Buy is trying to reposition themselves as a healthcare company that delivers equipment into the home and sets it up [00:39:15] 
  • wwt.com/this-week-in-health-IT

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Newsday – Digital Transformation, Big Tech Moves in Healthcare, Remote Work and Care

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Newsday – Digital Transformation, Big Tech Moves in Healthcare, and Remote Work and Care

Episode 377: Transcript – March 15, 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.

Bill Russell: [00:00:00] [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.

[00:00:18]Special thanks to Sirius Healthcare, Health Lyrics and Worldwide Technology who are Newsday show sponsors for investing in our mission to develop the next generation of health IT leaders. 

[00:00:27] We set a goal for our show. And [00:00:30] one of those 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. We also launched Today in Health IT. A weekday daily show that is [00:01:00] on todayinhealth it.com. We look at one story each day and try to keep it to about 10 minutes or less. So it’s really digestible. This is a great way for you to stay current. It’s a great way for your team to stay current. In fact, if I were a CIO today, I would have all my staff listening to Today in Health IT so we could discuss it. You know, agree with the content, disagree with the content it is still a great way to get the conversation started. So check that out as well. 

[00:01:25]Hopefully you’ve heard our big announcement. We are introducing written content onto our site to [00:01:30] accompany our existing four podcasts. I’m personally excited about this and it really allows us to reach a different group of people than we’ve reached in the past. I hear stories about people who listen to our shows on their daily runs or their commute to work. If those things still exist. But I also know of professionals who’d rather skim an article than listened to an hour long podcast. So I’m excited to say starting next week. We’re going to be hosting news write-ups of our shows as well as feature stories on thisweekhealth.com. And we want to hear from you. So [00:02:00] please shoot us a note and tell us what you think. If you’re excited, if you have questions or even if you’re interested in becoming a contributor. One of the things I am really excited about with this move is we opened up all new avenues to allow contributors to come in to the platform. So we’re going to be able to share articles that you write. We’re going to also be able to potentially have you host podcasts and submit them to the show so that we can put them out there to our community. And we are really excited about that. [00:02:30] So thank you for listening and joining in our mission of raising up the next generation of health leaders by amplifying great thinking to propel healthcare forward.

[00:02:37]WWT is a sponsor of today’s show. So if you want to find out more about them you can do that at wwt.com/this-week-in-health-it. Now, let me explain that a little bit cause it’s wwt.com/this-weak-in-health-it so wwt.com/the name of the [00:03:00] show This Week in Health IT. 

[00:03:01]It’s news day. And today we have Dr. Eric Quinones, the Chief Healthcare Advisor for Worldwide Technology with us. Welcome to the show. Eric. It’s the first time on. 

[00:03:11] Eric Quinones, MD: [00:03:11] It is the first time on Bill and thank you for having me.

[00:03:14] I’m looking forward to diving in some diving into some really good discussions. 

[00:03:19] Bill Russell: [00:03:19] I, you sent over some great stories. I mean, clearly I you really want to go after where digital transformation and disruption is happening in healthcare. 

[00:03:30] [00:03:30] Eric Quinones, MD: [00:03:30] Yeah. It’s interesting. I have conversations with a lot of my colleagues.

[00:03:35] I’ve been at this for 21 plus years and in healthcare, it clinical information systems in one way or another. And you know, in all of this time, you know, clinicians have you know, we know what we want. You know, we want, you know, things to be less frictiony left, you know, more smooth. We want to be able to interact with our patients.

[00:03:58] We’ve known all these things for [00:04:00] years. And finally, I think we’re starting to see real traction with some technologies. I mean, the pandemic is, you know, it took a pandemic, right, unfortunately to help realize some of these things. But yeah, I think right now the time is right. And we’re seeing some really great and I don’t like to say disruption in technology, or I like to use more like evolution, right? So 

[00:04:27] Bill Russell: [00:04:27] The evolution happens so fast, right? It went [00:04:30] from telehealth is a great example. It went from, I don’t really want to do telehealth it’s not a part of my practice to okay. We’re going to do telehealth to fast forward, like a couple of months, and they’re saying, look, I need one click telehealth visits with my patients.

[00:04:44] I need to text them a link. They clicked on it and they show up. And by the way, that needs to be integrated with the, I mean, you see how far that went in such a short period of time. It’s really amazing. That’s why I say disruption from time to time. Cause that’s an [00:05:00] amazing amount of movement in healthcare.

[00:05:01] Eric Quinones, MD: [00:05:01] It really is. And you know, where would we be if we didn’t have the COVID virus? You know, if we didn’t have you know, SARS too maybe we’d still be having these discussions pre pandemic in terms of, in terms of virtual care. But I think we. You know, we go through these experiences. We have to, we have to pivot quickly and then, you know, it wasn’t good enough, even when we got it now we want [00:05:30] it better and quicker or faster. So that’s kind of human nature. So that’s good. 

[00:05:35] Bill Russell: [00:05:35] Yeah, absolutely. So 21 years, tell us, tell us how you got to, to this current role and as Chief Healthcare Advisor, how did you get into the technology space? 

[00:05:46] Eric Quinones, MD: [00:05:46] Oh, that started early on. So I was at Dartmouth-Hitchcock and we were working on a project there to actually build our own EHR. So we were building the [00:06:00] ambulatory side of the house. Now they’re an Epic shop, but we were doing that. So I was involved as a liaison, working with clinicians and working with the engineers and doing a lot of QA process with that rudimentary EHR at the time. And mostly it was it was a glorified, you know, documentation and lab system at that time.

[00:06:21] So, but it was interesting because I saw the writing on the wall for me. And that I knew the way we were practicing [00:06:30] medicine had to go in this direction some way somehow. But yeah. And then from there so I have an ED background, but from there I really got involved with Allscripts healthcare solutions.

[00:06:44] And I was their Clinical Director for several years. Had also taken some opportunities to work with some consultancies Deloitte, Slalom was also the Director of [00:07:00] Clinical Information Systems over at Healthcare Partners, which you probably know very well. So and that was prior to the DaVita acquisition.

[00:07:09] So we were that was very interesting because we had did the first D install of Epic. Cause we were, we have both Allscripts and Epic, so it was the first de-install and history of Epic. And that was that’s a whole nother story, but anyway, we, we made [00:07:30] that happen and it was a financial decision of course.

[00:07:33] And then I had an opportunity to work with a startup over in Houston. That really works in clinical decision support in the hospital space. Identifying patients that may be decompensating early. And so to let the right people at the right time know about these patients and within their particular workflows.

[00:07:55] So yeah, I’ve been on one side as you know, on the provider [00:08:00] side as the administrator side on the vendor side, I’ve had a little taste of everything. 

[00:08:06] Bill Russell: [00:08:06] Wow, which is phenomenal. I look forward to the conversation. We can go in a lot of a lot of different directions. We have six stories, as I told you earlier, it will be a miracle to get through them.

[00:08:18] There’s a handful that are knitted together because they’re Amazon stories. You have a story here from Healthcare IT News around a new group that is [00:08:30] talking about hospital at home initiatives. We have the Fierce Healthcare story. What healthcare can learn from from big tech, which is always interesting to me, the Humana teams with Mercy to expand access to virtual care.

[00:08:46] And that’s an interesting partnership and an interesting way that Mercy has gone to market. I think I have a stat news story, which is also an Amazon story. So we’ll knit those two together. That’s just the. You know, the 18 new [00:09:00] locations that that Care medical, which is Amazon cares partner has filed to operate in those States.

[00:09:08] We have gosh, what else do we have here? We have you know, money for nothing making sense of data collaboration, which is a really good story. I don’t know if we’ll get to that one. I hope we do. And then there’s a story about transitioning back to the office, which raises some questions for IT. So six.

[00:09:28] Really cool stories. [00:09:30] Do you want to, do you want to try to kick us off with one of these? 

[00:09:34] Eric Quinones, MD: [00:09:34] Sure. How about you know, basically what hospitals can learn from big tech? 

[00:09:43] Bill Russell: [00:09:43] Yeah. Let’s go there. Why don’t you tee it up and we’ll head into it. 

[00:09:48] Eric Quinones, MD: [00:09:48] Yeah. So you know, I think Amazon and others, Apple and Google, they’re all really, you know I would call these non-traditionals right, that are getting into the healthcare space, [00:10:00] as we know, and they are really pushing the envelope  and kind of you know, putting traditional healthcare providers on their heels.

[00:10:10] So one, they have the technologies and two, they have, I think if we’re speaking particularly about Amazon, they have the experience in terms of. You know, evolving I like to say evolving not disrupting but evolving different industries, retail, [00:10:30] grocery you know, think of anything you go on Amazon, especially during the pandemic we had those that weren’t using Amazon.

[00:10:36] They definitely have that experience I’m sure. And it’s a seamless experience for the most part. So that customer experience, they really have nailed down and being able to have the data. I think Riz really helped them. So they see that, you know, there’s a play, obviously in healthcare they’ve tried it with Haven Health.

[00:10:58] I think there are way ahead of the game [00:11:00] there. We can have that discussion as well, but but yeah they’re placed really well. And I think again like Apple well, I mean, they just know that the patient experience is so critical. I mean, the fine experience and consumer experience is so critical and they really focus on those things. So that really positions them differently. 

[00:11:20] Bill Russell: [00:11:20] Well let me me see if I can throw something out and see if it resonates with you, which is you know, Amazon, Apple and some of these other big tech players. They are [00:11:30] consumer centric. I mean, Amazon is notoriously. You know, consumer centric, they know everything they do is around the consumer and how to make their lives better and how to make it more efficient.

[00:11:42] Health systems are provider centric and have been for decades. And that’s, and I’m not the first to say this, obviously there there’s others. This is the you know, the famous quote from Geisinger’s former CEO who’s now [00:12:00] acting role. Who said, you know, the waiting room is indicative of everything. We think about the patient, which is you will go into this queue and wait for us.

[00:12:08] And when we’re ready to see you we will, we’ll we’ll call you cause we are maximizing the time of the provider. And so everything is about the provider. So that I think is the most stark contrast between a big tech’s approach. And they’re always thinking, how can we make this better for the [00:12:30] consumer and health systems approach, which is how do we make this better for the provider?

[00:12:35] And I’m not against making it better for the provider. I’m just saying, is there a gap there that health systems have to close in order to not be you know, evolved, I guess is what you’re saying? I would say disrupted but. 

[00:12:52] Eric Quinones, MD: [00:12:52] Yeah, I think there is a gap and you know, but I think that becoming painfully aware that the gap exists. [00:13:00] You know, we as patients, we, it, you know, I think of like, you know, when I used to go to the doctor when I was a kid or when I would go with my grandparents, to the doctor, it was like, you know, it was that old school relationship. Right. You just, like you said, you’d wait in the waiting room for, you know, you know, 45 minutes past your appointment time, if not longer. The ED is worse by the way, as you know, so you know, so it just, that’s what we got used [00:13:30] to, and I think what’s happened, especially as, you know, the consumeristic demographics have changed.

[00:13:37] That’s not what consumers are used to anymore. Again they’re seeing these experiences. They’re having such as, you know, with retail applications that they’re using you know, that financial applications they’re using, it’s very seamless. I mean, you can walk near, you know, a Starbucks, you don’t, you’re not going to get a coffee, but you go walk near it.

[00:13:59] And all of a [00:14:00] sudden, your phone shows you your favorite drink. And you’re like, Oh, that’s right. And maybe you do want a coffee. So it makes it, it’s predicting. What do 

[00:14:07] Bill Russell: [00:14:07] Thank you for reminding me that I’m thirsty and I wanted one of your coffees. 

[00:14:13] Eric Quinones, MD: [00:14:13] Well come on over, flying over to LA. We’ll have one. 

[00:14:17] Bill Russell: [00:14:17] That’s how they think. They’re like, you know, we don’t know who’s going to walk across our front door but we’re going to have the technology set up to remind you of our relationship, remind you that we’re here to [00:14:30] serve you. And we have something that you want and you need right. 

[00:14:33] Eric Quinones, MD: [00:14:33] Right. Right. And that I think is the secret sauce. Right. And I think, again, the expectation of patients that are con they’re consumers, they’re expecting that now. And I think, you know, healthcare organizations are realizing that. And you’re starting, obviously you’re seeing this and, you know, and revamping digital front doors and that kind of, you know, play and that’s very important.

[00:14:58] They need to do that. [00:15:00] Give you an example. So at St. Jude’s we did some really amazing work with them. So you think of a children’s hospital, right? A cancer, you know, specialty hospital people coming from all over the world where they had a problem and like, how do we make their experience? You know desirable, less friction based.

[00:15:21] And, you know, they brought us in to help them with that. And we created a, you know, an award winning app and won two Webby awards and what this, [00:15:30] what the application does. And even if they don’t have the families come in and they don’t have the technology, they’re provided the technology while they’re there.

[00:15:37] And, but Wave finds them from literally from the airport to their hotel, to the hospital, finding within the hospital, shows them where their appointments are. It connects the, you know, them with their care teams. It, you know in terms of the patients, the children, it allows them to connect to other children that may be going through the same [00:16:00] thing.

[00:16:00] And then again, they may be the patient themselves, the child may be separated from their family because their family went to go to have dinner and they could make reservations from this app. You know go and have dinner and the, the child can speak to, you know, their family while they’re having dinner and the child, you know, it just, it’s a whole different ball game now. And I think that’s that just as consumers we’re expecting that. 

[00:16:26] Bill Russell: [00:16:26] Yeah. You know, it’s interesting. [00:16:30] We’ve seen all those technologies and you just gave a great use case at St. Jude where you know, it’s taking wayfinding, it’s taking Open Table and reservations, and it’s just taking all those things, knitting them together and saying how, if we’re going to be consumer centric in healthcare, what does it look like?

[00:16:49] And that’s just one example of what is possible when we step back and say, what does it look like? Let me tee this up a little bit because you have, [00:17:00] and I’m going to steal one of your stories. So you have the story of the a group that launched the hospital at home initiative. Let me read a little bit.

[00:17:08] So founding members of this coalition include Amazon care, Ascension Dispatch health, Alara caring, Intermountain Healthcare, Home Instead Landmark Health and Signified Home. Among the groups, policy priorities, expand the services covered in a home-based setting. Retain important hospital without walls, site of care flexibilities, support [00:17:30] home-based hospital services ensure equal access for seniors through fair reimbursement for home-based evaluation and monitoring codes, advocated for bundled payment models where extended care in the home encouraged greater flexibility for home-based care services to meet commercial and Medicare advantage network adequacy standards.

[00:17:50] And so there’s, you know, so this group is advocating for that set of policy initiatives, which is, Hey, you know, the home is a [00:18:00] great place and there’s, there’s a lot of statistics to support it. In fact, I think they have some of the statistics in here. Let’s see, moving home, moving health, home members, point to an array of statistics that say bolster their case for more technology, they have a virtual care they point for instance to an ARP study that saw that three and four adults, 50 years or older, preferring to age in their homes and communities. And that’s absolutely true. Beyond that the quality and cost improvements are [00:18:30] apparent they said noting CMS estimates that show home health care in Medicare saves at least $370 million a year.

[00:18:40] That’s like real money. And there’s a couple of other statistics in here. So we know that the home is the next frontier. And so does Amazon. That’s why they’re a part of this initiative. You just shared the story of what we can learn from Amazon. And one of the things that Amazon did to the malls and the stores that were all thriving at the [00:19:00] time when they came up with their model is they just skipped the malls.

[00:19:04] They didn’t put a facility in each city. They, I know they’ve gone back and done that after the fact, but what they did is essentially as they went to the home, they said, do people really want to go to the mall? Do they really want to shop for something? Find out it’s not in this store, go to the next store and then go to the next store.

[00:19:22] And it turns out they placed a bet on it and they were right. So let me tie that with the last story on Amazon, [00:19:30] which is stat news story. And we alluded to this earlier. Care Medical, Amazon Cares partner for providing Amazon Cares or concierge level service for their employees that they were offering in the Washington market.

[00:19:46] They’ve now filed to operate in 17 more States. Okay. So they are, and they will essentially concierge level service. They’ll meet you in your office, they’ll meet you in your home. They will care for your family, [00:20:00] wherever they’re at. They will get you same day medications shipped to your home. And you know, if you have a serious problem, they signed deals with organizations like City of Hope.

[00:20:11] And that’s similar to what what Walmart did. And they signed deals with. With with Mayo and Geisinger and others for specialty care. And so you have these interesting things evolving around the home. And I think people have asked me to go, is Amazon going to build a [00:20:30] hospital? And the answer is no, they’re not going to build a hospital.

[00:20:33] They don’t want the high acuity care, but they absolutely are going to start delivering care in the home. And that care of the home is going to be essentially hospital rooms in the home, but that acuity of care is going to continue to rise that we can deliver in the home. And that is the, that’s the chink in the armor that they’ve identified and said, look, we’re going to have thousands if not hundreds of [00:21:00] thousands of hospital rooms across the country, we’re not going to pay for a single building. They’re all going to be in the home and we’re going to technology enable those, and we’re going to partner with people to deliver the care. That’s what I’m seeing. Am I mean, I mean, that’s my crystal ball is how often do you think that is?

[00:21:17] Do you think there’s another way of really interpreting these things? 

[00:21:21] Eric Quinones, MD: [00:21:21] It’s a great question Bill. You know, your crystal ball is pretty spot on. Matter of fact, I think we got it at the same store. [00:21:30] Yeah, I think you wrote something in December and I responded to what you had wrote, and it was basically talking about some of the things we are talking about here with Amazon in terms of where they’re positioned.

[00:21:41] And I think in my response, I was just saying that you know, can you imagine, like, again, this is the quintessential one-stop shop place to get everything done. Your primary care, your Amazon pharmacy pill pack. Right? You get your, you know, drone [00:22:00] delivers your medications. I may be going a little far out there, 

[00:22:03] Bill Russell: [00:22:03] but yeah, durable goods as well. You can get your, you know, your crutches, anything else you might need. 

[00:22:09] Eric Quinones, MD: [00:22:09] Right. And you know, Oh my groceries and et cetera, right? It’s all one stop shopping. And then you have Alexa in the house, you know, that can maybe with ambient, you know technologies and things like that, to be able to, if there’s falls in the [00:22:30] house and things like that, or you need help or, you know,  Alexa’s just reminding you to take your medication or reminding you know, to, you know, take your blood pressure, et cetera.

[00:22:40] Again, with the ioT play as well. So I think they are, they’re positioned really well to be the juggernaut and to come out, I would say with the Coliseum victor in this play for sure. 

[00:22:56] Bill Russell: [00:22:56] It’s going to be interesting. All right. So I’m going to, I’m going to push [00:23:00] on you a little bit here and I’ll think about it as well. So if I were at a health system today, I really have to sharpen my consumer centric skills. I have to have a team that’s good at interacting with patients and know, and consumers, right. And finding out what they’re looking for. One of my favorite stories on this was we spent six to nine months working on our portal.

[00:23:25] We were developing a custom portal and it had a, my gosh. [00:23:30] We spent all the time working on how the medical record was going to appear. And it finally dawned on somebody, you know we should talk to consumers and find out what’s important to them and sure enough how the, getting the medical record and how it appeared was like number eight on their list of 10 things that they prioritize.

[00:23:47] And number one was scheduling, as you would imagine. Number two was communicating with their doctor via text messaging. And I just remember when we got that information back, I was like, it was like that old VA commercial where you [00:24:00] hit your head and go, wow that makes perfect sense. I can see where we’re spending this much time, but I mean, that’s my advice to health systems. Start interacting with the patient, ask them what they want and develop that consumer centric capability, and then figure out who you need to partner with and build in order to start meeting some of those needs. 

[00:24:24] Eric Quinones, MD: [00:24:24] You hit it right on the spot, you know? Per usual. [00:24:30] The one thing I think, you know, your, your example that you use from this was that St Joe’s.

[00:24:36] Bill Russell: [00:24:36] Yeah, sure. 

[00:24:36] Eric Quinones, MD: [00:24:36] Okay. So at St. Joe’s, I mean, you know, we know what we know, and we don’t know what we don’t know sometimes. Right. So, you know and we tend to go towards what we know. And I think you know organizations are getting more sophisticated and they’re realizing, Hey, how are other organizations, how are other [00:25:00] outside of  healthcare, hhow are other industries doing this? How are they making their, you know, consumer experience you know platinum level? How are they doing that? And I would say, they’re really, like you just said, they’re going to the users, they’re going to the consumers, they’re going to the patients, they’re doing journey mapping.

[00:25:20] And they’re asking them these things. What are the frustrations you’re encountering in your experience in your care journey? You know, what are the things you would like to have? So when you think of [00:25:30] like and bringing that to, again, an experience to that say you know, a digital front door, you know, they would like to have, as you said, scheduling and not just scheduling, being able to pick the time, the date, right, with their doctor. And maybe I have the option to do, am I going to be physically there or can I, does it need to be physically there? Can I do a telehealth visit? You know, so I have that, you know, again one app to rule them all. And again I could do my telehealth visit right [00:26:00] there. They would like to be able to obviously prescriptions, they would like to do all those things that they need to do to get their healthcare stuff done.

[00:26:08] I think is really critical and stitch those things together, as you said with, and people use different hats, but really bring into one place, but you have to go to the patient and do that journey mapping with them and not just the patient. Obviously you should be talking to, you know, the nurses, the doctors, again, what is their experience?

[00:26:28] And what are they hearing? And I think bringing [00:26:30] that all together, I think is extremely important. 

[00:26:33] Bill Russell: [00:26:33] But actually I think. It’s interesting that you bring that up because I think that’s the thing that keeps us from moving forward. Is we absolutely want to be clinician centric in our technology and the bill of our technology.

[00:26:48] I mean some of the stuff we’ve put in front of clinicians has been incredibly wasteful of their time and their energy. And so we want to be cognizant. But when you’re talking about consumer [00:27:00] things it’s disruptive to their current practice. It would be as if, you know, you go to the purveyors in the malls way back when and say, Hey, we’re going to start competing with Amazon and we’re going to start doing shipping and this way and whatever.

[00:27:17] And they’re like, there’s the mall’s full there’s people here every day. They’re, they’re hitting our stuff. Why do we need to change? We don’t need to change. So you end up having these very long conversations, trying to convince people that they need to change. [00:27:30] Until, you know, until all of a sudden the malls are empty.

[00:27:34] Eric Quinones, MD: [00:27:34] Right. Yeah. I mean, so I think that the gap or do you want to see this, to reduce the gap and reduce the friction on both sides is very critical. So again, we may have new interfaces or new experiences for the patient, but it has to like that’s why I said, you know, we need to talk to the clinicians as well.

[00:27:59] The [00:28:00] administrators as well, family members as well to really understand the journey mapping so that we can really, whatever we’re using technology for, you know, technology, data, people process. Whenever we’re doing that. It’s going to help reduce the friction on both sides of the equation. Yeah.

[00:28:18]Bill Russell: [00:28:18]  I remember going into the Southern California market and you you you were there. I mean, you remember this Kaiser Kaiser came in a big way.

[00:28:26] And this is one of the Kaiser strongest markets now, Northern Cal and Southern Cal, but [00:28:30] Southern Cal is a strong market for them. And they came in their quality numbers were not that good. Quite frankly they didn’t hold a candle to us. At first and then they got better and they reduced clinical variability.

[00:28:43] They did a lot of really excellent things. And then their quality numbers exceeded ours. And we’re like, well, but nobody really wants to work there because they don’t have the creativity and all this other stuff. And then they started hiring some of our doctors away and people are like, Hey, what’s going on while you talk to some of those doctors and they’re [00:29:00] like hey our quality of life’s better over here.

[00:29:03] I’m like wow. That’s interesting how that just sorta snuck up on everybody’s. It was, you know, hey, low quality, not a great place to work to then all of a sudden extremely high quality, great place to work. Well they didn’t have a hospital. Well, now they have a significantly huge hospital in Southern California as well.

[00:29:23] And I’m afraid that we’re not, we’re not taking some of these things serious enough and [00:29:30] it could just sneak up on us. And And we just need to have honest conversations of what does it mean to be consumer centric in our approach. And quite frankly, if you walk around and see a fax machine, you’re not consumer centric. If you walk around and see clipboards, you’re not consumer centric.

[00:29:48] Eric Quinones, MD: [00:29:48] Right. Yeah. It’s interesting, you know, you bring that up because it reminds me when I was back at Healthcare Partners one of [00:30:00] the. One of the initiatives I was trying to push was okay. If we’re going to compete with X, Y, and Z you know it takes, it takes a lot, yeah resources to find, you know, good, you know, good positions and et cetera. So you go through that process, but we’re going to make that. Yeah, we’re making this investment. We’re looking for those top, you know, top flight docs and nurse practitioners, et cetera. Now, why would they come to, [00:30:30] if we’re going to pay them the same amount versus the competition, what differentiates us versus them? It’s like, why would they want to come to us? So in other words, what I was trying, because I was talking about at this particular, with this particular initiative was also retention as well. So how do we create an environment that is, you know conducive that we can reduce the friction for the physicians that they want to stay, if they’re going to get paid the same.

[00:30:59] Right. [00:31:00] So I think we missed that boat. I was working on some initiatives and I think the, and that’s when DaVita came in and. And they bought us up and things just got really interesting then. And then, you know, so if I were, again, you know, a primary care doctor and I’m working and I’m seeing 30 patients a day and I’m staying until seven o’clock at night, but, or I have, I get paid X and I have this other place that I can get paid X [00:31:30] say I see 30 patients a day, but I’m leaving like five o’clock. That’s a whole nother story 

[00:31:36]Bill Russell: [00:31:36] We’ll get back to our show in just a minute. The future of healthcare is powered by digital transformation organizations must leverage technology to solve complex clinical and business problems. WWT worldwide technology has real world healthcare experience to build and execute solutions that push healthcare organizations past the status quo and towards the [00:32:00] successful transformation of their business model together with Intel.

[00:32:04] WWT is driving innovations in tele-health healthcare, IOT and data analytics and AI making healthcare more connected, personalized, and intelligent. From strategy development to solution creation, WWT supports our healthcare clients every step of their journey. For more information, visit wwt.com/this-weak-in-health dash [00:32:30] IT. That’s the name of the show. wwt.com/this week in health it with dashes in it. And now back to our show.

[00:32:37]So you pulled up a story from Humana and Mercy, do it, tee that up. Cause I think Mercy’s you know, their, their virtual hospital thing is pretty interesting and it, it sort of lends itself to, to this conversation.

[00:32:54] Eric Quinones, MD: [00:32:54] Yeah. Well, so with [00:33:00] Mercy, Mercy hospital of Mercy, Virtual mercy health they did something pretty unique here. And B, have you ever been to the facility? Have you seen that? 

[00:33:09] Bill Russell: [00:33:09] I haven’t. So we’re talking Mercy in St. Louis and they have a virtual hospital, essentially. 

[00:33:15] Eric Quinones, MD: [00:33:15] Yes. And so it’s a hospital without beds. And it’s quite amazing. I have been there and the it’s one of the highest tech places I’ve ever been to in healthcare. So [00:33:30] there, they are able to monitor patients either at home or in the hospital and to be able to be proactive in their care. So they’re seeing those particular metrics that they’re following to, you know, to be you know, again, like I said, proactive and instead of reactive with these patients and they’ve had tremendous success I’ll be shameless here and I’ll plug in.

[00:33:56] I mean, Worldwide Technology and Cisco, we were the [00:34:00] ones that helped you know, Mercy Virtual do that. So but with Humana now, they’re basically working together now. So they struck this agreement virtually Mercy Virtual and it’s a value-based play and, and it’s, it’s pretty cool. I mean, they’re like, Humana’s like, yeah, take our patients, manage these patients, like your, do your own patients at risk. And, you know we’re going to have that [00:34:30] arrangement and mercy virtual has been able to show, you know, from the article there some really substantial, you know you know, I would say savings, especially on that virtual, I mean, on the value-based care model. You know, reduce readmissions, they reduce sepsis, they reduce stroke incidents and things like that.

[00:34:51] So they’ve been really proactive and been really successful. 

[00:34:55] Bill Russell: [00:34:55] Yeah. And so they have, it’s a virtual hospital, they have 300 plus [00:35:00] clinicians in that facility. They’re doing seven 24 monitoring. It can be to the home, it can be remote ICU and that kind of stuff as well. This deal is Arkansas, Kansas, Missouri, and Oklahoma. I would assume it can be expanded beyond that. Couldn’t it? 

[00:35:17] Eric Quinones, MD: [00:35:17] Absolutely. I mean, there’s you don’t think of, you know, surgeons at UCLA doing surgeries in Ghana. Right it doesn’t matter where, I mean, they’re just, they can be remote and be monitoring those patients. [00:35:30] And so no, it can be just about anywhere.

[00:35:33] And I think it’s interesting because I think we’re going to see more of that. I mean, again, in my crystal ball and why? We just, we don’t have the resources sources I think that we need to be able to care for a lot of these patients. And again, instead of having episodic care, especially for the patients that are home, you know, episodic care to have more, a longditudinal care and continuity of care for these patients, especially with the chronic disease with [00:36:00] chronic diseases.

[00:36:00] You know, it’s so important to be proactive. So I think to be able to scale right, to monitor the population, you’re going to have to have these kinds of technologies to be able to enable that. So I think we’re going to see more of that. 

[00:36:13] Bill Russell: [00:36:13] Right and be able to compete with Amazon or whoever else really tries to get a foothold in the home. You know, Mercy is set up for this as is Intermountain has something similar. And I think Mayo is also heading down this path. If I were an academic medical center, I’d absolutely be heading down [00:36:30] this path. I think the audience have an opportunity to win here. But they have to stand up these capabilities.

[00:36:36] And I think that’s why, what a Glock was doing up at Mayo is so interesting to just keep an eye on. 

[00:36:44] Eric Quinones, MD: [00:36:44] Right? No it’s it’s, pretty pretty exciting stuff. And I think, you know, so the last company I was with a company called Decisio Health. It’s a startup in Houston. We, this is something that we were working on in, in a [00:37:00] sense where we were able to create a a dashboard, right?

[00:37:04] This is more for the ICU or for the med surge environment and for the ED. So anywhere in the hospital space that we’re able to bring the data, disparate data. You know, in a way that the clinicians want to see it at the bedside in real time. And again, each population is different. So your, you know, your ED population may be very different than your shock trauma ICU.

[00:37:28] So they may want to see different [00:37:30] things and they can see those things come up in real time. But then taking that model from. That say using you know, a rapid response team to be able to monitor patients in the, on the, you know, on the floor, you know, cause a lot of problems happen on the floor, these patients decompensate and they, you know, you know, alerts in EHR don’t work by the way.

[00:37:49] I mean, I’ve seen situations that you have to, you know, log in to the patient’s record and Oh, the alert comes off and that patient actually had expired. So, [00:38:00] and that alert was two hours old. So I’ve seen situations like that. So that’s not an alert, you know, Hey, they’re already robbing my house, you know? And now you get an alert, you know, two days later.

[00:38:10] No, that doesn’t help me. So, you know, we were very proactive in unloading the right people at the right time about the right patient. According to their workflows. So I think you’re going to see these plays and we moved it outside of the hospital and we were doing work at OSU and with [00:38:30] GE healthcare.

[00:38:31] And they have kind of built this model, a similar model, not to just to monitor their hospital, but to bring that out to, you know, other hospitals outside the network as a service. 

[00:38:42] Bill Russell: [00:38:42] Yeah you know, I had someone say to me, it’s you know, we have the physicians, you know, why won’t big tech win? They’re like we have the positions. I’m like, well until they start taking the money, cause once they take the money, they can hire the physicians. And they just, they looked at me like, yeah, I guess that makes sense. [00:39:00] Yeah that is how it works. So I think this is one of the best plays I’ve seen for preparing for this new hospital at home type scenario. I think one is partnering with Best Buy who is trying to reposition themselves as a healthcare company that delivers you know, equipment into the home and sets them up in the home. I, is that something that worldwide technology does or do partner with others? 

[00:39:29] Eric Quinones, MD: [00:39:29] We [00:39:30] partner with others. We have you know, quite a few OEMs when we do a project and we built this, so we build something. We build, you know, the, the solution. So from idea to outcome and you know, we’re not holding onto that IP that belongs to the, our client. They, that’s theirs, but we’ll bring in others to help us do it.

[00:39:51] So. You know, an example is we have I’m involved with an opportunity right now that is it’s a remote patient [00:40:00] monitoring opportunity, but for a national fall, a federally qualified environment and what they needed to do is to bring in the technology component. And they have to, again, being mindful of the population, right?

[00:40:17] So not everybody has an iPhone 12 pro max, right. So they may have an older model. So you have to think of those technology gaps. And so the, and then they wanted [00:40:30] the technology partner to be able to have the remote patient monitoring partner to be able to integrate into Epic has to do that.

[00:40:36] So there are some basics that they had and, you know, we found one and and they do a really good job. They’ve worked in these these kinds of settings before. And they use cellular technology. So you don’t have to tether your, you know, your, this is my stigma, my nominator, my blood pressure cuff here.

[00:40:55] So you don’t have to tether it to your phone it’s cellular and it just goes right to [00:41:00] the right to the cloud. And so yeah, those, our partners we partner with to help you know, bring outcomes to our customers. 

[00:41:10] Bill Russell: [00:41:10] Yeah. You know, the home is not a slam dunk. I mean, it is, it’s challenging. It’s I mean, the logistics of putting technicians in the home, I guess, because we did this at St. Joe’s. We had a pilot program. We sent our people out to actually set up the technology and then we learned a whole bunch of stuff of what happens to technology. [00:41:30] Once you put it in somebody’s home we learned how simple the technology needs to be in order for the patients to use it.

[00:41:38] I mean there’s a whole bunch of stuff we learned. And the process and I, we didn’t make any money at it for at least while I was there. We didn’t make money at it because we were constantly in the learning phase. But that’s, I don’t think Amazon’s making money at this stuff until all of a sudden they are, you know, it’s that kind of thing where you’re learning, you’re learning, [00:42:00] you get the model, right.

[00:42:01] And then you move forward. So it’s challenging to go into the home and we’ll see who’s able to set it up. But I think these virtual, I guess they’re calling a virtual hospitals. I know that’s, Mercys something to that effect. Intermountain calls there’s a virtual hospital and there’s essentially no beds and there’s, there’s there’s really no rooms there shifts.

[00:42:22] There’s just a command center with an awful lot of technology. And they I I mean the remote ICU stuff is really [00:42:30] impressive. The technology, I mean, they can, they can read the arm band on a patient. I mean, it’s really impressive. 

[00:42:37] Eric Quinones, MD: [00:42:37] Right. No, that’s the whole nother you. Cause I consider like virtual care like a big bucket and then there’s or yeah, big bucket with small buckets. And that’s another example. So again, you know, really bringing in that virtual care into the hospital space is pretty awesome. And not just. You know, like I think InTouch health, for example, they were able to, you know, they have the [00:43:00] AB component done, they were able to document so they can zoom in really, really fine and see, like you said, the monitors and things like that. But the challenge was you know, we were working with them as a partner, back at Desicio and we said, well, you, what they want is the clinical information. They want it to be able to survey surveillance, you know populations of patients and be, and I don’t want the white noise. Give me the signal. 

[00:43:28] So if I’m tracking [00:43:30] patients, for example, that may be decompensating. And I use a certain algorithm that’s that’s, you know, accepted within our community. Then notify me about that patient when they reach a certain, you know  you know, score. And then I can look at that patient expanded, see all our current data, and then I can make a decision that I need to consult an AB con. So yeah it’s pretty amazing. It’s pretty cool stuff. 

[00:43:57] Bill Russell: [00:43:57] Well I’ll give you the [00:44:00] choice here. We can go into the data direction or we can do work. Let’s do work from home. Cause I’m curious  your perspective on this you’ve worked in consulting and worked in in a hospital setting. I try to explain this to my consulting friends.

[00:44:16] There’s something about healthcare where people being in the same room, people being in the same building has a, I don’t know, a significant amount of value and I’m not sure this [00:44:30] I know, I know a lot of health systems are talking to going hybrid. I’ve even talked to some health systems that are like, look we’re remote now and we’re never coming back. But I don’t think that would have flown at St. Joe’s. I think we would have brought people back at least you know, at least three quarters of the time, and maybe we would have gone to a, you know, a Friday virtual day kind of thing, but because there was so much value in the culture in [00:45:00] bringing people together.

[00:45:01] And those kinds of things. Where do you think this is? What are you hearing and where do you think this is going to go? 

[00:45:06] Eric Quinones, MD: [00:45:06] Great question. I like what you bring up that last part. When I read that article, I’m like, eh, yeah, a lot of questions there. And those, some to me were little. I don’t know, uncomfortable but she gets the last part, knew he was talking about culture in which you mentioned.

[00:45:25] And I think that’s an a very important component of the team [00:45:30] that you work with. Obviously when you’re in the hospital you know, you’re in the trenches, you’re in the ED, you know, you have a certain culture, you know, you’re always with these people and you’re, you know, you’re, you’re fighting the good fight and you get to know people, you know, very well.

[00:45:44] As opposed to, again, working from home, So my experience from working from home on my latest experiences. So when I started with worldwide technology, I was hired remotely. Okay. I have [00:46:00] my boss. I have never met except through like how we’re communicating on my team, one of our other chief healthcare advisors she’s a close friend of mine I’ve known for years.

[00:46:10] So that was, that’s my, okay. So I have a connection with her, but literally everyone else at worldwide technology, which is close to 8,000 folks, I don’t know, you know, so how do we build? And then our team our healthcare team has made up of four folks and for, you know, [00:46:30] clinicians. And yeah, with the exception of one, I don’t know the, you know, the three quarters of them except for how we’re interacting, but it, you’re not to say that, you know, we do connect on different levels.

[00:46:46] Cause we’re at that healthcare clinical relationship, you know, we have stories, right? We can, we can kibitz on those stories and we just, we connect that way. However [00:47:00] you know, looking at others that, and I think it depends on the person too. I know I’m rambling on a little bit because I’m thinking, yeah, I’m okay with it. I would love to be with my colleagues and, you know, see them more often for sure. But I’m pretty, I get a lot of work done like in this environment. Whereas when I’m, you know, sitting on the hospital more on the administrative side in the hospital you get a lot of interruptions, at least I did. And a lot of distractions and things like that.

[00:47:27] And the next thing, you know, it’s five, o’clock five [00:47:30] 30 and you’re still behind, you know, it’s like, Oh boy, You know, so it, it depends Bill, I think there’s that give and take, and now I would just add this and I read the, read the story. I think at the end of the day, when I finished that story, I’m like, it depends on the person’s job you know, in some ways the cultural thing is important and I’m with you a hundred percent of that. But it depends at the end of the day you get hired for a four position now, does that position require you to be [00:48:00] there? You know, obviously if you’re a clinician, you know, in the ED or, you know, in the, you know, anywhere in the hospital yeah. You probably need to be there. Right. You know, except if you’re doing remote surgeries, you know, you can be shooting.

[00:48:14] If you have the technology, you can do it at your house. So as opposed to. You know, maybe somebody maybe one of the IT folks, they don’t have to be there necessarily. They could be monitoring the infrastructure from somewhere else and be taken care of [00:48:30] problems somewhere else. So I think it depends.

[00:48:32] Bill Russell: [00:48:32] Yeah. And I have heard from some CIOs who are going through the different roles and saying, okay, this role never needs to come in. This role has to come in every day and they’re sort of breaking it down that way and breaking it down. 

[00:48:46] Eric Quinones, MD: [00:48:46] But I think HR gets involved with that too. Right? I would suspect.

[00:48:50] Bill Russell: [00:48:50] Yeah. It’s hard for consultants. And here’s why, because we’re used to this, right? We’re if we’re [00:49:00] not, if we’re not remote, we’re in an airplane. If we’re not in an airplane, we’re in a hotel. If we’re not in the hotel, we’re at our client’s site. I mean, that’s how we generally function.

[00:49:08] I’ve managed a VP of services for a national company. I had 2000 engineers. And building culture across that was almost impossible. They ended up aligning themselves more with local markets and those kinds of things. And you ended up with some goofy problems, to be honest with you. I mean, you ended up with stuff where people just didn’t get the culture and they just did, [00:49:30] I mean, you ended up with expense reports that you were looking at going, how could you possibly have thought that that was a good idea? And the culture’s not there now. Worldwide’s has a phenomenal culture. I remember Dave Stewart came out to meet with me when I was CIO at St. Joe’s. And I, when he left, I was riveted.

[00:49:52] I mean, just such a presence and his ethos is [00:50:00] throughout the entire organization. And there’s some, there’s some organizations that are like that. The sisters of St. Joseph. And at St. Joe’s is their ethos is but it takes, it takes stewardship. It takes a constant retelling of the stories that the sisters came to orange County with essentially 67 cents in their pocket.

[00:50:22] And they started a $7 billion health system that, that, you know, one third of all, people in orange County were coming through their front [00:50:30] doors. We all knew the stories because they got retold over and over again. That’s. Yeah, that’s an intentional thing. That’s not to be taken for granted. It just doesn’t happen. 

[00:50:42] Eric Quinones, MD: [00:50:42] You’re, you hit it totally on the head. I was, I was talking to my team and we all have different come from different experiences, different places, and which makes us awesome. Right. So we all have these different, you know life stories. And [00:51:00] this is the only place worldwide technologies that I have that I have worked at that literally walks the walk and talks the talk, others have mission statements or have visions, et cetera, and all that stuff. And you know, you hear it once a year you know, at the annual meeting or et cetera, no, this is a daily thing. We live it, we breathe it and we hold people accountable to it. So you know, Dave Steward and Jim Kavanaugh, you know, the [00:51:30] founders they really wanted to have that kind of a company.

[00:51:35] And I’m so glad to work here. I’m so happy to work here because you know, people not only do they hold themselves to that higher level, that higher standard, it’s an expectation. So, you know, and I like that, you know, I I’ve been in places where it’s like, boy, how did you get hired here? You know? And you know, you did not just I’m [00:52:00] shocked, you know?

[00:52:02] And but then here, now I have the the fortune to work with some extremely talented, smart folks way smarter than me, for sure. I mean, a lot of times the discussions are, ooh, you know, cause it’s a lot of technical discussions, but you know, these are brilliant folks and again, they’re all driving towards, you know, humility truth. You know [00:52:30] honesty, et cetera. I mean, it’s really, yeah. David Steward is something else. His story is an amazing story too, by the way. 

[00:52:36] Bill Russell: [00:52:36] Yeah, well it was the little things too, you know, he, he sent me a copy of his book, had a handwritten note in it and I thought, I guess this guy has time. No, he doesn’t have time. That’s the point? I mean, he, you know, he took the time to write a really nice note. It’s, I’ve moved so many times. I don’t know where all my books are, so I apologize. I wish I could just pull it out and show it to you, but I’m sure  it could potentially be in a box [00:53:00] with all my other books. Do we still have books? Do you still have books? Do you have a bookcase? 

[00:53:04] Eric Quinones, MD: [00:53:04] I, you know I do. All my medical books though. They’re in the garage and, but like all the stuff that I. And I do like to hold books, you know personally. Matter about digital transformation is one that are being right now by Paddy. And it’s a great book. I’m reading it like a second time now. There’s a lot of exceptional nuggets in there and but [00:53:30] yeah, I still have books. So to answer your question. 

[00:53:32] Bill Russell: [00:53:32] Well my wife  she goes well we need some bookshelves. I’m like, do we, do we really need bookshelves? And she’s like, well, we have a lot of books. I’m like, we do have a lot of books.

[00:53:41] I guess we need bookshelves. So I was, I was just trying to see if I’m the only one who’s fighting this battle of, you know, can’t we just put like two Kindles up on a shelf somewhere and say they’re a bookshelf and it’s just doesn’t have the same that I’m not trying to show off that I’ve read books. I’ve been in those moments. Have you been in those [00:54:00] homes where you walk and you’re like have you read all these books and read all those books after you had the conversation you realize it’s like, I don’t deserve to be in the same group. 

[00:54:13] Eric Quinones, MD: [00:54:13] I remember a story. I was visiting somebody back East and they were Dartmouth some family. And again, yeah, new England style home, you know,  they come from that [00:54:30] lineage and I walked into the library which was an office.

[00:54:35] And I couldn’t believe the books that they had there. And there was a like first additions and I’m like, I didn’t even ask the question. Did you read these books? I had just assumed they did. And I just felt really dumb. 

[00:54:49] Bill Russell: [00:54:49] First edition to Edgar Allen Poe. Oh yeah uncle Edgar. Yeah. He wrote that.

[00:54:56] Eric Quinones, MD: [00:54:56] One piece of advice. I’d say your wife told you to build [00:55:00] those shelves. Happy wife hapy life.

[00:55:02] Bill Russell: [00:55:02] Yes. And we will probably, build is giving me an awful lot of credit. I will be I will be purchasing some bookshelves. I assume they still sell them. So I, it should be okay. Well Eric has, this has been a pleasure. I’m looking forward to doing more of these. If people don’t know the, Worldwide Technology is a sponsor. And one of the cool things is they’re rotating the various advisors through to do this show with me. [00:55:30] And it’s great. The last conversation with, and I always get her name wrong. It’s Sanaz Cortez. Right. And now, and now you and I don’t know who they’re going to bring on next, but it should be fun.

[00:55:41] Eric Quinones, MD: [00:55:41] It’s going to be awesome and we appreciate it. And Bill, I kind of feel like you’re a celebrity I’ve known you for, you know, followed you for a while. And I think we met way back and in your Providence, I mean, they are St Joe’s days. And you know, we, we know a lot of the same people, so it’s just really nice to have a face-to-face and hopefully someday [00:56:00] I really get to meet you.

[00:56:01] Bill Russell: [00:56:01] Yeah, I’m looking forward to those days where we finally get into the you know, everybody flies into the city and we all see each other again, should be great. Well thanks. Thanks again for your time. Really appreciate it. 

[00:56:12] Eric Quinones, MD: [00:56:12] Thank you Bill. Take care.

[00:56:14]Bill Russell: [00:56:14] 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 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 [00:56:30] 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. Those are VMware, Hill-Rom, StarBridge Advisers, Aruba and McAfee. Thanks for listening. That’s all for now. [00:57:00]

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