May 17, 2021: Sue Schade from StarBridge Advisors joins Bill for the news. What does work look like in the post pandemic era? What mix of work from home and office time is right? A Finland cyber breach leads to the leaking of thousands of mental health records. An attack on a company is scary. An attack on individuals? That’s downright terrifying. Boost Mobile is helping with health equity by offering telehealth, the State of Ohio offers a chance to win a million dollars if you’re vaccinated and AHIMA releases their public policy statement on telehealth.
Newsday: Doing Hybrid Work Right, Commercial Telehealth Plays and Cyber Update
Episode 404: Transcript – May 17, 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 Worldwide 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.
[00:00:53]We’re going to a summer schedule starting on June 1st. Monday, we’re going to do Tuesday, Friday. We’re going to do influence [00:01:00] occasionally we’ll drop a solution. Showcase the big differences we make no commitment to have a Wednesday show. It’s a break for my team which has been producing eight shows a week and a chance for you to catch up on some of the shows you may have missed.
[00:01:12]If you really miss me you can still check out the Today in health IT show where I’m going to be doing that on a daily basis where we look at one story every weekday morning. All right, let’s get to it. Sue Schade in the house and we look at the future of work amongst other stories. Sue. Welcome back to the show.
[00:01:30] [00:01:29] Sue Schade: [00:01:29] Thank you Bill Good morning. And good to see you.
[00:01:33] Bill Russell: [00:01:33] Good to see you. You were the story the last time you were on the show cause you took the interim role at Boston Children’s. How’s that going?
[00:01:41] Sue Schade: [00:01:41] It’s going well, I just had a great call with my team on our major focus project while I’m there which is the EHR strategy. And yeah, I’m a couple months in and busy going well, great organization.
[00:01:56] Bill Russell: [00:01:56] How do you juggle it all? Because it’s not like you stepped down from [00:02:00] Starbridge, you’re still a principal of Starbridge and keeping all that stuff going as well.
[00:02:03] Sue Schade: [00:02:03] Right. So, I had told my Starbridge admin that she has to take my calls down to a minimum and they have to happen early morning end of day or noon time. So and they’re down to a minimum and that’s when they happen so that I can just focus on Boston Children’s. And it’s going okay. And some of the work has shifted to my colleagues, David and Russ during this time. So that’s okay as well.
[00:02:28] Bill Russell: [00:02:28] Are you committed and [00:02:30] keeping up with the blog post as well. You’re I mean, you’ve been doing that for so many years. I assume that’s just part of your routine now.
[00:02:36] Sue Schade: [00:02:36] You know, it is. And a friend of mine who’s retired, who I talk with every week, a couple of my Michigan days friends, they’re all retired are okay Sue maybe you could give up the blog. I mean, if you need more time, I’m like, no that’s, I got to keep it up. So no that’s a discipline. I’ll be writing it every week. And right now I have about 10 ideas for this week, but I haven’t read it yet. So the ideas are [00:03:00] there.
[00:03:00] It’s the time to write it. So as long as I get feedback that people are reading it and it’s got some value.
[00:03:07] Bill Russell: [00:03:07] Yeah. That’s how I feel. I tell people that the fuel to keep me going on, this is the the emails I get. I had a CEO for a startup actually fly down here to Florida and we’ve met for lunch.
[00:03:18] It’s actually one of the first business lunches I’ve had for a long time. And it was you know, it was a phenomenal conversation. It was great to hear them say, you know, I remember on this episode, you said [00:03:30] this and you were talking to this person and this CIO said this. And I’m like, yeah that’s why we do it.
[00:03:35] It’s, you it’s getting ideas flowing in the industry.
[00:03:37] Sue Schade: [00:03:37] Yeah. You know, it’s a that’s a great se wayg to congratulations on 400 episodes, I listened to your show last week, where you were the interviewee and you kind of went over the last couple years. And I remember you and I Bill talking about you thought me writing a weekly blog was so much work and I’m like [00:04:00] you’re doing a weekly show. Now you do three weekly shows and five daily shows. But you know how much work it is or not. We share that commitment in terms of developing next generation leaders. And you’re doing great stuff in the industry and it is much appreciated and kudos for what you’re doing.
[00:04:16] Bill Russell: [00:04:16] Well I appreciate that. And I have some people committed to the 1000th show when we put that one on. I can’t even imagine but we one of the things we have talked about is, and it’s got to do something a little more special for the 500th episode. More special than [00:04:30] just me being interviewed.
[00:04:31] We were so busy that it snuck up on us. We thought hey, should we do something? And we decided to do that. But for the 500, I think I’m going to have a, you know, just a bunch of guests from over the years, come on. And we’ll won’t talk about how things have moved forward. I dunno. Maybe we could just do it like an open channel and people just pop in over the course of an hour or so and just record some things. I don’t know. I don’t really have the idea of if people have an idea of what we should do for the 500th episode.
[00:05:00] [00:05:00] Sue Schade: [00:05:00] Well, I know you’ll get creative and you’ve got a staff that will help you, you know, with some new ideas and you know, put me on your list for participating somehow. I’d love to.
[00:05:10] Bill Russell: [00:05:10] Yeah. And I appreciate your participation over the years. So you are, I mean, you’re working this full-time job, but you’ve given me three really good stories. And I want to start with you know the hybrid work story, because I know as you do. I’m talking to a lot of CEOs in this. This is really top of mine.
[00:05:28] What does work look like in [00:05:30] the post pandemic era? And we’re getting closer and closer to that. And there’s just a lot of conversations of what it’s going to look like. So you pulled out an article. Do you want to set that up for us?
[00:05:40] Sue Schade: [00:05:40] Yeah, I will do that and I’ll make it concrete first as well in terms of what we’re doing at Boston children’s.
[00:05:46]And then get into the articles in the bigger picture. So as of July 1st at Boston children’s we will start the phase returned to the office. Saying return to work as a misnomer because people have been. [00:06:00] So return to the office whatever want to call that? And it’ll be faced through the year.
[00:06:04]The group that’s been working on it basically asked all the leaders to identify by job code. Is this a job code that can be fully remote, fully onsite required, or a hybrid. And we have in the IT department gone through that exercise. Now I saw the results of that yesterday and we have a mix for sure.
[00:06:27]And. the if you [00:06:30] think about exceptions for employees, it’s within job code. So if you just take that example that a job code can be fully remote. And will be fully remote. There might be some individuals that want the exception. My remote situation at home is not working. I’d like to come into the office.
[00:06:48] I’d like to come into the office certain days. So you know, all those things are being worked out at this point, I think. It’s it, you know, the articles that I shared with you, I’m gonna, if I can give you all three titles at one time, can [00:07:00] I do that? Sure. So one of them is from the globe and it’s the hybrid workplace probably won’t last.
[00:07:08] Okay. Some very interesting arguments in it. The other two are from Harvard business review. One of them is called what mix of work from home and office time is right for you. And that’s really more individually focused. It’s an article that says. You know, figure out your rhythms, your what kind of work you do, how many hours of this, that, and the other thing.
[00:07:28] And what’s going to be [00:07:30] the model for you. Take that to your boss if you’ve got the flexibility to talk through, what’s going to work for you. The other one from Harvard business review is called how to do hybrid right? That’s really interesting in terms of you know, there’s some work that’s been done over the years.
[00:07:46]And it’s not just during the pandemic. So one reference here is to a future of work consortium that this person has led for over 10 years. So there’s a lot of research around the whole idea of on-site versus remote. And it goes [00:08:00] into, this is the one I sent you this morning. Did you see it?
[00:08:02] Bill Russell: [00:08:02] Yep.
[00:08:02] Sue Schade: [00:08:02] Okay, you’re totally on top of it. It goes into the elements of hybrid and place in time. And you know, the classic quadrants in the top quadrant is anywhere anytime. And that’s now what we’re moving into. This one I think does some really good stuff in terms of talking about leadership, needing to figure out personality types, what’s going to work, how you set up that space. And quite honestly, I don’t know that we’ve gotten there yet in terms of at Boston children’s when we talk about [00:08:30] hybrid is you know so hybrid, you’re going to come in certain days up to you, is it for certain collaboration? Is it in collaboration space? Is that you come in these days by yourself, you work in a cubicle or an office space.
[00:08:45] So I think that’s a big challenge for people to work through. Before, let me get some reactions from you on that. And then I’ll talk about the conclusions in that article and the the one in the globe.
[00:08:56] Bill Russell: [00:08:56] Yeah. So how did you hybrid, right? I found fascinating because [00:09:00] Fujitsu is one of the main companies here that they’re talking about.
[00:09:03] And they talk about just the culture of a Japanese company, Japanese offices. Face-to-face interaction is highly valued. The long office hours they talked about the fact that, you know, prior to the pandemic, 74% of all employees considered the office to be the best place to work. You fast forward, middle of March, the majority of Fujitsu Japan’s based employees, some 80,000 were working from home.
[00:09:30] [00:09:30] And so they do another survey. And the followup survey says only 15% of the employees considered the office to be the best place to work. Now that’s right in the middle of a pandemic. It’ll be interesting to see how that moves forward. Some 30% said that the best place was their homes and the remaining 55% favored a mix of home and office which is the hybrid model.
[00:09:50] But we get into these interesting conversations around this. You noted you know, it’s going through each job specification and saying fully onsite [00:10:00] remote only or hybrid, but each one, here’s what I like about this. Each one of these cases is really individual. And this article goes on to talk about some of that, that, you know, there could be this person that whose job it is can be done remotely, but who might choose to come into work because they’re in an apartment.
[00:10:20] That they’re sharing with three roommates and there’s nowhere to work and it’s too loud. And those kinds of things they may choose to come into work for other reasons. But I think the [00:10:30] key word there is choice. I think that’s what people are looking for coming out of this. Am I going to have the choice?
[00:10:35] Sue Schade: [00:10:35] Yeah, I think you’re absolutely right. And it’s, you know, you put your leadership hat on. It’s like, what are we going to do for thousands of employees? What makes the most sense? How do we figure this out? How do we have some level of consistency yet? We’ve got some flexibility for people’s choice. And I think that you know, I think one of the things that’s coming out of the pandemic and I didn’t pull an article on this, but I’ve read [00:11:00] some other stuff.
[00:11:00]Because if people are rethinking their careers. So if you came through the pandemic healthy and alive and with a job, Right. Yep. First off, if you’re on that path, you know, you may be going, okay, I could have choices in the future. I could go work for a company that’s all virtual. I don’t even have to go down this path of thinking about, am I going to do a commute again or not?
[00:11:23]You might be looking for different kinds of work. You might be looking for more meaningful work. So, you know, I [00:11:30] think it can be I know I talked to someone last week who. One of the big consulting firms on the road, three cities a week. Right. And has been home basically able to see family wife, four kids in a way he hadn’t for decades, you know?
[00:11:51] And I said to him, I said, I think this can be really transformative in terms of people thinking about job changes. And what they want to do going [00:12:00] forward and what they’re willing to do, you know, he, he doesn’t intend to repeat what he had before. Though he’s staying with the same company going to be on the road to three cities every week.
[00:12:10] Bill Russell: [00:12:10] So I think where I want to go with this, I want to play devil’s advocate. So I’ll take the we need to all come back into the office. You can take the other side on this. Because I agree, by the way, I agree with you a hundred percent. There’s a shift. There’s a change. There’s a cultural change that’s going on in our country right now.
[00:12:26] And you only have to look at one factor to really [00:12:30] realize what’s going on and it’s that. There’s no homes for sale. Like all these homes have been bought up and it’s just outside the city. It’s even further away from the city. It’s I’ve talked to people that are like you know, their jobs in LA and they now live in Colorado.
[00:12:44] I’m like, did you clear that with your company? It’s like, well we’re remote. I didn’t clear with my company. I’m like, eeesh you should probably clear it with your company, but I mean, but that things happening all over the place, I mean there, and it’s a weird back there. I mean, they’re literally, [00:13:00] every time I talked to somebody in another city, I go, Hey, are there any homes for sale?
[00:13:03] They’re like, no, it’s crazy. I mean, the prices are going through the roof. And so and it’s everywhere. So there’s a fundamental shifts and I don’t know what that’s telling me yet, but it’s telling me something. All right. So let’s play the devil’s advocate. I think everybody should come back to the office, by the way, I’m just playing those out again.
[00:13:19] I don’t really think this. But I did hear Jamie Diamon talked about this in his shareholders call and he said, look we have an equity problem. That’s going to happen as a result of this. We have because you have. [00:13:30] I think he said like 40 to 60% of his employees have to come into the office.
[00:13:35] There’s no getting around it. They just have to come into the office. You expect the teller to be in the branch. When you go to that branch is just the case. And we have that significant in healthcare. It’s, there’s a physical aspect to our business. So at least 60%, if not more of our employees are going to have to be there full time.
[00:13:52] Yeah. So, so what, how do we handle, how are you going to handle the equity aspect of that of people feeling like, Hey why do they get a [00:14:00] choice? And I don’t get a choice and it’s just, Hey, I’m sorry. That’s the nature of your job.
[00:14:05]Sue Schade: [00:14:05] I think saying everybody has to come back is too rigid and strict and we already had arrangements in many organizations for people to work remote some days a week or all days. Right? You might’ve had like the technical wizard who maybe because of their spouse moved to another state a few years ago. And you said, wow, we don’t [00:14:30] want to lose you. You stay with us. You’re remote. That’s fine. Right. So you’ve already made all those exceptions you know, you’re absolutely right though, in terms of equity issues and fairness.
[00:14:40]There are going to be those kinds of arguments. So what’s that balance between what the organization needs and what is the employee need?
[00:14:47]Bill Russell: [00:14:47] There’s a handful of things around management and maybe we’ve gotten better at this, through the pandemic of managing people through teams and managing people through Zoom but there’s an awful lot of practices that happen better face to [00:15:00] face.
[00:15:00] And I guess we could do that in a hybrid model but what about teams that aren’t as effective without you know, a significant amount of face-to-face. And I think specifically, and again, Jamie Diamon talked about mentoring. He said, you know, it’s hard to mentor somebody over the phone. It’s not impossible, but it you lose something of not being at the elbow of not being with them as they’re interacting with their clients and those kinds of things, unless all of the business is going to be handled this way. There’s going to be people that are [00:15:30] progressing in their career faster because they are doing that versus people who aren’t.
[00:15:35] Sue Schade: [00:15:35] Yeah. Well, I think there’s a lot about the younger generation too. And how are they going to, how are they going to be mentored and how are they going to get the opportunities? If they come into an organization it’s all remote and, you know, period, that’s it. So, you know. The globe article, I said the headline, the hybrid workplace probably won’t last and it gave a couple of different reasons.
[00:15:58] And it concluded with [00:16:00] that it’ll probably swing back at some point to be much more onsite and remote will be, you know, far less than maybe exceptions. I, you interviewed Jamie Nelson recently hospital special surgery in Manhattan. Jamie said she’s been there. All the time through the pandemic, as long, she thinks leadership needs to be onsite.
[00:16:20] She thinks that as long as some of her, it people need to be there, then she should be there. And I think she, you know, I express the preference for everybody being back onsite. I [00:16:30] don’t think they’ve figured it out yet, but and I think she talked about the pendulum swinging back. So, you know, I, what we see for the remainder of this year may not be the long-term future.
[00:16:42] Bill Russell: [00:16:42] You know, I it’s interesting. I think when I get at, and I want to say this on the show, because I think some CIOs will come on and not be able to really say this at this point or articulate it but definitely what you just said is true.
[00:16:54] There’s going to be a pull back to everybody being in the office. You know, innovation teams [00:17:00] function better when people are you know, regardless of if there’s bean bag chairs or not but when they’re sitting around and they’re interacting and they’re in front of a whiteboard and doing all those things and the tools are going to get better and it’s also, I’ve gotten better and the tools aren’t going to get better and we’re going to be able to do things I think.
[00:17:18] Even if this pendulum swings back, the thing I will probably be a proponent for is choice. And it is the beautiful thing that’s happened here is my kid needs to stay home for [00:17:30] two weeks because they had to be quarantined because of whatever. And you just go great. You can keep working, be at home that’s phenomenal.
[00:17:37] Or yeah. Or it’s just, you know, some people need to be home for. A break from meetings. This is one of the things I hated about being in the office as the CIO is, I mean, every day I had six hours of meetings and it was hard to get that concentrated time of what is, you know, what should our focus be for the next six months?
[00:17:58]Or how should I be thinking about this [00:18:00] problem? Because you’re just going from meeting to meeting. And I guess maybe that, that still exists, but it’s it’s easier for me to turn off zoom. Than it is to turn down meetings when I’m in the office, I guess.
[00:18:12] Sue Schade: [00:18:12] Before we leave this can we just talk about the fact that healthcare and provider organizations are unique? We are not a company. That’s basically got everybody in a big office building. Right? We have people on premise every day, taking care of patients and we have a [00:18:30] support staff around them. Taking care of helping them to take care of patients. Right. So that’s one of the IT people who have to be on site come into play.
[00:18:38]I always tell my ITteams, we are the extended care team. We’re part of we’re part of the extended care team. We don’t touch the patients, but we provide the solutions and the systems for the people who do. And I think that truly something is lost when [00:19:00] your IT people are remote and not having that interaction with your clinical and support staff.
[00:19:10] Right? We do at Boston, children’s something called rounding to influence every other week. And there’s key questions that leaders are asked to go for half an hour and talk with a group of their staff in a rounding situation and surface issues and get input. Those have gone to [00:19:30] virtual, but for many they can be on site.
[00:19:35] And I asked this most recently to be included in one with clinicians. I asked the CNO, whatever you are organizing, I’d like to be with you. Because the questions this week are very pertinent. Things that I need to hear as the CIO and her first response was virtual or in-person, and I’m like, eh, you know, I’m virtual at this point.
[00:19:52] So yeah, we’ll do it virtual. And we did, and we had 10 clinicians on the zoom call with us in half an hour, very rich [00:20:00] conversation, giving salons input. But I just think, you know, my point is we have to be very careful within healthcare as to what’s gonna work best in most effectively supporting our our clinicians.
[00:20:10] Bill Russell: [00:20:10] Yeah, and I liked that you brought that up before we leave this. There’s a section in, and I highly recommend these articles. we put them in the show notes, the Harvard business review one on how to do hybrid, right has a bunch of really good research in it. Towards the end it goes companies are using this moment as an opportunity to re-imagine workflows.
[00:20:29] New [00:20:30] hybrid arrangements should never replicate existing bad practices. As was the case when companies began automating work processes decades ago, and they go on to say, Hey, companies are taking the opportunity. They give a handful of examples. And they said one of our retail banks, future of work consortium analyze, and re-imagined workflows by asking three crucial questions.
[00:20:51] The first is, are any teams or are any team tasks redundant? Right? That seems like an obvious can any team as [00:21:00] can any tasks be automated or reassigned to people outside the team? And the third one is can we, re-imagine a new purpose for our place of work. You know, those are the three questions. I’d probably add a couple into that, but generally speaking, this is an opportunity we’re seeing the tools really become more sophisticated and yeah, to a certain extent, we need to reimagine what our conference rooms look like, because you could imagine in the future that, you know, five people will be in that room and 10 people [00:21:30] will be remote.
[00:21:30] Now we did this with vendors a long time ago, but doing it with your team, how do you bring them into the room? How do you make that? How do you make that really work really? Re-imagining the work workflows and the work processes. I think it’s a great opportunity to do that. Yeah, absolutely. If only we had no other work going on, I guess, I wanted to get your thought on this, and I know you sent me over an article this morning.
[00:21:53]I didn’t even send you this article but I commented on it on the today show this morning Boost mobile [00:22:00] offers telehealth. The reason it’s fascinating is if you sign up for a new plan, you essentially get telehealth and their comments were really fascinating around this.
[00:22:11]So if you sign up for their free unlimited plus plan as a subscriber, you get the telehealth for free. If not, you can add it to your plan for $8 a month. And the CEO said a significant portion of Boost Mobiles customers are low income and may struggle to get access to affordable healthcare. The company’s [00:22:30] CEO sees this partnership as a way to provide healthcare to people who need it most. And just to be clear, they partnered with another company called K health. Who’s going to be providing the services.
[00:22:41] And I, you know, I was just reading this whole thing and Verizon has launched something it’s a little different, but they’ve launched something as well. And towards the end, their chief product officer said Boost Mobile, truly prioritizes its customers and is creating solutions to meet their needs. I read this article and at first I thought, Oh, I’m not going to comment on this.
[00:23:00] [00:22:59] It seems like one of those, you know, out there kind of articles that I thought about it, I’m like, that’s really fascinating to me from a health equity standpoint, everybody who’s on Boost Mobile. If you’re on that unlimited plan of which again is a significant portion now has access to to telehealth.
[00:23:15]That’s a pretty powerful offering. I mean, you know, what is, what do you think this, what do you think as a CIO for, let’s say an integrated delivery network, how would you be looking at this? And how would you. You know, how would [00:23:30] you digest this and look at it for offering services to your, or to your community or to your organization?
[00:23:37] Sue Schade: [00:23:37] Yeah, I, you know, my first response with whatever hat I’m wearing and saying, this is it’s positive. If it is. Reaching an underserved community that may not have other access. And it’s yet one more go to where people are in delivering health care. It’s a good thing. You know, if I put my hat on as a CIO and a, in a healthcare delivery system, [00:24:00] you know, I would still say that is there any play for us?
[00:24:04] Is there any connection to us? I don’t know, but you know, I have said for a while that What we’re seeing in the emergence of, you know, retail. I mean, you sent me the article, Walmart health acquires telehealth provider Me MD. Yeah. That connects to this. Right. But CVS and what, you know retailers are doing in the healthcare space to, in my mind while it could be perceived as a threat to healthcare traditional [00:24:30] healthcare delivery systems, it really needs to be looked at as, okay it’s one more offering. How do we get in on it and how do we partner? How do we support it? Cause ultimately you want to reach the people in your community and keep them healthy. And you know, that’s what I thought. When I read the Walmart article, you sent as well, it’s like go to where people are and another, I mean, a segway to go to where people are.
[00:24:50]I don’t know if you’ve heard the latest incentives to get the vaccine in a couple States. And, you know, in previous shows, we’ve talked a lot about the vaccine we’re now at that point, you [00:25:00] always predicted, which is people who don’t want to get it though. There’s also people who don’t have access to it. So did you see the thing about Ohio?
[00:25:08] Bill Russell: [00:25:08] Oh, yeah. You know, I saw that in my feed, but I didn’t read the story. What’s it about?
[00:25:15] Sue Schade: [00:25:15] Basically if you get a vaccine you are eligible for a million dollar lottery and there. Will be five $1 million lotteries over the next five weeks. So if I get it [00:25:30] tomorrow and then I’m in Ohio, I’d be eligible for the next $1 million lottery next week.
[00:25:34] Something like that. The other States are getting creative. The other one I heard I may not get this one fight. Right is Maine offering hunting licenses for free. So deer hunting, whatever for free, if you get, you know, if you get your vaccine. So it, you know, it’s an incentive to go to where people are, right?
[00:25:56] Bill Russell: [00:25:56] Yeah. I, you know, I do, I like those things. It [00:26:00] seems like very expensive way to go about it. $5 million. We’ll have to see how many people in Ohio get, get the vaccine as a result of it. But I would imagine your odds of winning that lottery are a lot better than buying a ticket. Yeah, no, man. That’s amazing.
[00:26:14]Yeah, I didn’t put the story on the vaccine credential initiative, but they are starting to really get out there and move that move that forward. So you have 300 health related institutions coming together to create the vaccine credential initiative. Because I think my cards on my desk, actually, I it’s [00:26:30] not on my desk.
[00:26:30] I don’t know where it is, but it kind of cracked me up when they gave it to me because it really looked like the card I remember having as a kid, it’s literally, the person gave me the shot and then like signed it and dated it. And I thought, wow, that’s amazing. But the backseat credential initiative is an attempt to really bring that forward and move it into the at least the 20th century. So we’ll have it. Yeah. It’ll be interesting. I’d be remiss if we didn’t talk about security a little bit, there’s [00:27:00] so much going on here and I don’t really want to talk about the blind outage and whatnot. Cause we don’t know enough about that yet, but we saw Scripps get an attack about a week ago or so a little over a week ago.
[00:27:12] And And the one I’m really more concerned about is the one that happened in Finland where they hacked into a a mental health psychologist practice and 30,000 patients. They actually took the transcripts of their meetings with their with [00:27:30] their mental health professionals. And they’re not going to, they’re not trying t go after the health system for ransom, they’re actually going after the individuals. And I don’t know, maybe I just hadn’t been paying attention, but that’s the first time I saw that kind of that kind of attack to really go after the individuals. And I’m trying to, I’m trying to think about how I feel about that because I’m a proponent of [00:28:00] something.
[00:28:00] That I think is as this is really extreme. And that is, I want the ability to make a request for my record to be deleted from certain health organizations, knowing what I know about cybersecurity and knowing what I know about certain health institutions that I have visited in the past. I know that my records at risk of being hacked.
[00:28:23] And I also recognize that I don’t own the record that it’s the creator of the record, which is the health system. But [00:28:30] there’s part of me when I read this kind of story. I’m like, I want to have that record deleted from their system not made available for research and those kinds of things. I’m more than happy to make it available to certain research institutions to use it.
[00:28:44] I just don’t want it to be sitting there just waiting for when the hacker finally realizes they can go into that spot. They didn’t get that record. I mean, I assume you’re horrified by that story as I am in terms of the hack
[00:28:59] Sue Schade: [00:28:59] I am, [00:29:00] I will tell you your, the acronym TLDR.
[00:29:05] Bill Russell: [00:29:05] Yes.
[00:29:06] Sue Schade: [00:29:06] So I had a little TLDR as I was scanning that article hoping that you would help me get to the so what of it, but it is alarming. Should I say what TLDR is? Does everybody know
[00:29:17] Bill Russell: [00:29:17] Yeah too long didn’t read.
[00:29:19] Sue Schade: [00:29:19] Yeah. Yeah. Just remember that everybody on social media too long, didn’t read when you put the stuff out there. But yeah, you know, it’s scary to think about that in terms of mental health records, that reinforces why [00:29:30] we are so tight on, you know, mental health records you know, another one.
[00:29:34]In terms of privacy within the health record Yeah, I was as alarmed as you are. And to your point about wanting to remove your record, if you could, from certain organizations, I mean, you’re one of, you know, how many million people you know, that’s going to give you a sense of control over it.
[00:29:52] I mean, what we need to be focusing obviously is, you know, our response to these cybersecurity threats all the time You [00:30:00] know, and the preparedness for, and the preparedness.
[00:30:02] Bill Russell: [00:30:02] I love it. I love having you on the show. Just listening to all those things, pop up it’s like your next meeting’s coming up. There’s something.
[00:30:09] Sue Schade: [00:30:09] I’m sorry, I didn’t turn everything off. Yeah it’s the 15 minutes to the next meeting. Sorry, the doorbell hasn’t rung my phone hasn’t rung.
[00:30:20] Bill Russell: [00:30:20] I know. We’re getting better at this. This is this like the the fourth time we’ve done a new state share or a third time we set a newsday show.
[00:30:27] Sue Schade: [00:30:27] And maybe you need to tell me to turn off my [00:30:30] sound next time.
[00:30:30]Bill Russell: [00:30:30] I just appreciate you doing it. You know, doing that today, show every day and just talking about stuff, I can easily create an echo chamber and this sorta holds me accountable to talking to you guys and you know, and sometimes, you know, I want to hear you say no Bill I think you’re a little and you have, you definitely have. It’s like, ah, I don’t agree with you because my staff was laughing. It’s like, did Sue just say she doesn’t agree with you that we need to get more guests and say that [00:31:00] I’m sure we can. It won’t be too hard. You know, it’s interesting. They I’m a huge fan of patient centered interoperability. And having a lot of conversations around that topic. And if I take that to the extreme patients that are in an interoperability just means I want the entire record on my phone and I want to determine how it gets used and who uses it. And if I share it with an organization, that’s going to provide me more health related as opposed to a sick care, I want to be able to do that.
[00:31:26] I want it, I want to be able to have sort of a joint [00:31:30] custody of the record will and I get a lot of yeah. That makes sense, whatever. And then I take it to its natural extreme. Which is okay. Once I have joint custody of the record, I don’t want you to have custody anymore. That’s when people go, Whoa, wait a minute.
[00:31:42] Are you saying you want me to delete that record from the health system? I’m like, well, you know, we haven’t had the most stellar history on cybersecurity today. Now. Hopefully that’ll get better with this renewed emphasis. I think CEOs are focused on it. But you know, I [00:32:00] also wonder. You know, given that there’s going to be genetic data and those kinds of things, what happens to people’s records once they die.
[00:32:08] And if it has to metric data in there that impacts the kids and the grandkids and everybody else. So, you know, should there be some, it’s almost like we need to sit down and write, okay what is the patient’s right to their data and how should the patient, because this is coming. With with information, blocking whatnot, it’s coming, [00:32:30] patients are going to have access to their data.
[00:32:31] Let’s educate them on how to use the data effectively, how to secure their own data, which is what we’re worried about. We’re going to give them the data and they’re going to lose it. Well, we’re already losing it. So let’s all get better at figuring out how to protect our data. This is something I’ve been thrown out there. I’m curious. How far off base am I on this? Do you think.
[00:32:51] Sue Schade: [00:32:51] I don’t think you’re off base. It’s got me. You know, I’m thinking about a lot of things here, just in terms of how educated our people to even worry about these things in terms of their own [00:33:00] record. Yeah. I don’t think you’re off base. I don’t have a good answer or projection on where that needs to go though.
[00:33:08] Bill Russell: [00:33:08] Yep. No, I’m going to have to give more thought to it. I’m getting a lot more conversations around it. Okay. What else haven’t we talked about, we got, we have about can we go to the, can we go to the AHIMA statement that you sent me?
[00:33:23] Sure. Yeah. Let’s go ahead and do that. AHIMA public policy statement on telehealth and they came out. They’ve essentially seven [00:33:30] things in here around telehealth promote patient and provider choice, ensure parody between telehealth services and in-person services.
[00:33:36] Invest in tele-health infrastructure, prioritize privacy and security facilitate the delivery of healthcare services across state lines, address disparities in the use and willingness to use telehealth and remote patient monitoring technologies and promote program integrity. And if you want to, if you want to see this it’s out in the journal of AHIMA.
[00:33:57] And they, I’m sure you can find it another [00:34:00] place. It’s the title of this is AHIMA public policy statement on telehealth. All right. So what aspect of that would you like to talk about?
[00:34:06] Sue Schade: [00:34:06] No. Yeah, so it wasn’t TLDR. Okay. Excellent. Summary of key points in, in, the world of telehealth.
[00:34:13] You know, the ones I would emphasize that I was really happy to see there is invest in the telehealth infrastructure. Absolutely. You know, we were organizations were pretty ready a year ago and then adoption took off. But there’s a need to continue to invest in the infrastructure at [00:34:30] scale. The point about state lines facilitate the delivery of healthcare services across state lines.
[00:34:35] I mean, that’s been one of the obstacles relative to telehealth and you know, my husband had an example of this. He had an incident in September, he was hospitalized. He had all sorts of procedures and specialists, then that he had to talk to, after that he did. Some of it in person for procedures. Some of it was telehealth.
[00:34:56] One of the sub-specialists that he had to talk to for telehealth. [00:35:00] Turns out state lines. Couldn’t we live in Rhode Island. We get our care through mass general Brigham still in the Boston area. And that sub-specialist was not approved for telehealth to talk to him in Rhode Island. He had to go in which you know, it, it made no sense to me.
[00:35:19] There’s many places in this country where state lines. They’re a blur, right? The big box stores for us to go to, if we have to go shopping are just over the state line. They’re [00:35:30] five minutes away. Right? So you got to address this state lines and then disparities absolutely addressing disparities in the use and willingness to use telehealth and remote patient monitoring technologies.
[00:35:40] I mean, if you know, we have many takeaways from the last year, one of them is. hHealth disparities, and I am happy to see organizations fully aware and trying to address that in many ways.
[00:35:50] Bill Russell: [00:35:50] You know, what’s interesting about that across state lines things shoot is I asked Dr. Kvedar who you’re familiar with and he I never know if I’m saying [00:36:00] his name, right.
[00:36:00] It’s sorta like Halamka. I think I’m saying it right, but I can be close. But salty service delivery across state lines, I asked them and he said he thinks that should stay in state control. And it’s interesting because he replicated things I hear. And most of the time I hear that argument.
[00:36:17] I hear from doctors and specifically doctors that they like the oversight that the States provide. Around the delivery of care in their communities. And I was, I’m just surprised. And I was surprised I had heard it from him, the [00:36:30] American tele-health association. I’m surprised from the other doctors that I hear from.
[00:36:33]But they also point out that there’s been a significant amount of progress around this in terms of PACS made between States. And I think like 36 of the States actually will honor the ability to go across state lines. But as long as we’re under the emergency. Situation they, I think they’re right now allowed to practice across state lines until that is rescinded. Unless I’m mistaken. I don’t know.
[00:36:56] Sue Schade: [00:36:56] Does Dr. Kvedar think the state control is [00:37:00] good in part because of competition.
[00:37:03] Bill Russell: [00:37:03] I, you know, that, that actually, if I were an integrated delivery network, I would be so for this because I may not be ready to compete with Amazon care, Walmart with. Boost mobile with, I may not have all my ducks in a row around this, and I need to, I need a little bit more time to get my ducks in a row.
[00:37:22] But but that was not one of the, one of his main arguments I’ll have to go back and really look back cause this is going to come up again, especially after [00:37:30] you know, the emergency situation
[00:37:32] Sue Schade: [00:37:32] That’s going to take off. Yeah. Yeah.
[00:37:35] Bill Russell: [00:37:35] So thanks for bringing that up, Sue. It is always great. To to talk to you. I really appreciate you coming on the show.
[00:37:43] Sue Schade: [00:37:43] My pleasure. I look forward to it next six weeks, next time, six weeks away. Right
[00:37:48] Bill Russell: [00:37:48] Next time, six weeks away. So I will be looking for articles that I want to talk to you about. So look forward to that.
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